African Americans' attitudes toward cigarette excise taxes

Perceptions of Tobacco Price Policy among Students from Sapienza University of Rome: Can This Policy Mitigate Smoking Addiction and Its Health Impacts?

Tobacco use is one of the main risk factors for non-communicable diseases. Avoiding youth initiation and treating addiction are fundamental public health issues to ensure better health. Among tobacco control policies, increasing tobacco price is the single most effective intervention. It reduces tobacco consumption, especially among youths, while representing a government financing source. This study aimed to assess the agreement with the proposal of a one-euro increase in tobacco price earmarked to health issues among students at Sapienza University. Two convenience samples were surveyed, five years apart, on World No Tobacco Days. Smoking habits, agreement with the proposal and reasons for it were collected. Results from the 208 questionnaires (107 in 2014, 101 in 2019) showed 46.6% of agreement with the proposal (53.3% in 2014, 39.2% in 2019, p = 0.044). Main predictive factor for agreement was being a non-smoker (OR = 6.33 p < 0.001), main reason (64.8%) was it could trigger smokers to quit or reduce consumption. Several factors might have influenced this finding, including the introduction of novel tobacco products and their increased advertisement on social media. In 2024, European Union is planning to update the Tobacco Taxation Directive which could greatly contribute to the reduction of non-communicable diseases and premature deaths.

Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study

OBJECTIVES

We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act.

METHODS

We surveyed a US nationally representative sample of 17, 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers.

RESULTS

Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors' access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%).

CONCLUSIONS

Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment.

Unhealthy partnerships: the tobacco industry and African American and Latino labor organizations

The tobacco industry in the 1980s began to form relationships with outside groups for assistance on key policy issues due to its own poor credibility in the policy arena. This strategy allowed the industry to advance its own interests while seeming to match the agendas of very different organizations. Between 1988 and 1998, the tobacco industry developed coalitions with the A. Philip Randolph Institute (APRI), representing African American trade unionists, and the Labor Coalition on Latin American Advancement (LCLAA), representing Latino trade unionists. APRI and LCLAA each adopted resolutions supporting industry positions on smokefree worksites and excise taxes, issues on which they had not previously taken positions, and promoted these positions to their members, political leaders and the public. They also supported the industry's youth programs. This research relied upon a review of background literature and document searches through the Legacy Tobacco Documents Library and Tobacco Documents Online to examine the development of the excise tax coalition. The tobacco industry built support with APRI and LCLAA by framing policy positions in line with the organizations' interests, creating institutional arrangements that circumvented direct funding from the industry, and enhancing the industry's ability to influence excise tax debates indirectly. Although tobacco control advocates do not have the financial resources of the tobacco industry at their disposal, they can learn from tobacco industry techniques as they seek to build coalitions with people of color in the labor movement. Tobacco control advocates can both counter tobacco industry issue frames and also align their interests with those of working people of color by working on other issues of interest to this population, including health care and worker health and safety.

Link between facultative melanin and tobacco use among African Americans

Nicotine's affinity for melanin-containing tissues may result from its precursor function in melanin synthesis or the irreversible binding of melanin and nicotine. The objective of this study was to investigate a hypothesized association of tobacco use, dependence, and nicotine exposure with melanin pigmentation among African American smokers. A criterion-based sample was employed to collect data from a study of 147 adult African American current smokers. Carbon monoxide, saliva cotinine samples, and skin reflectance measures were obtained from each participant. Questionnaire data on demographic, sociological and behavioral questions related to smoking and skin color were gathered. The three dependent measures were the average number of cigarettes per day (CPD), Fagerström Test of Nicotine Dependence (FTND) score, and cotinine concentration. Analysis of variance, Pearson Correlations, and Multiple Linear Regression were conducted to analyze findings. The mean constitutive melanin reading was 56.3 and 66.5 for facultative melanin. Respondents on average smoked 19 CPD, had a mean FTND of 5.6, and a cotinine concentration of 435 ng/ml. Facultative melanin level was correlated with CPD and cotinine concentration in the bivariate analysis. The multiple linear regression results revealed that facultative melanin was significantly and positively related to CPD, the FTND, and cotinine. The results of this analysis support the hypothesis of a positive association between melanin levels and tobacco use, dependence, and exposure among African American smokers. This analysis may have important implications for research and interventions on tobacco dependence and disease outcomes. Further research on melanin and nicotine among African Americans as well as other population groups is warranted.

Minority youth access to tobacco: a neighborhood analysis of underage tobacco sales

The geographic and racial-ethnic inequities in health in the US are concerning, and their reduction is a priority for the national health initiative: Health People 2010. Though voluntary, life-style factors, such as smoking, are partially a cause of unevenness in health outcomes, targeting tobacco to minority youth raises questions about the extent to which behaviors are exacerbated by the local retail environment. In this case study, a GIS analysis of neighborhoods where businesses sold tobacco to minors was conducted with 2005 Florida Department of Health, and US census data, finding that in Miami, underage tobacco sales were significantly more concentrated in Hispanic majority neighborhoods.

Opinion on tobacco tax increase: factors associated with individuals' support in Germany

OBJECTIVES

To assess the opinion on tobacco tax increases in Germany.

DESIGN

Ten wave cross-sectional study with assessments before and after the tax increases.

SETTING

General population of Germany.

PARTICIPANTS

Ten representative samples from general population with a total number of 27,608 persons aged 14 and above were interviewed.

MAIN OUTCOME MEASURES

Opinion ("support", "disapprove", and "undetermined") before and after tobacco tax increases.

RESULTS

Thirty-nine percent of the sample supported the tobacco tax increases. Support was higher among non-smokers and subjects with higher levels of education. Data indicated an increase of support over time from 35% in 2002 to 42% in 2005 which was not affected by the amount of price increase.

CONCLUSIONS

The preliminary findings, that the amount of price increase did not affect the support of the general population in a negative way, and that support grew during a succession of tax increases, might be useful for legislators.

Opinions of African Americans about tobacco industry philanthropy

OBJECTIVES

To investigate African Americans' opinions about the philanthropic contributions of the tobacco industry to Black organizations.

METHODS

One thousand African Americans were randomly selected using a stratified cluster sample design of 10 U.S. congressional districts represented by African Americans.

RESULTS

Almost two-thirds of African Americans favored accepting tobacco industry philanthropy as long as the recipients do not support smoking. A majority agreed that the tobacco industry gives money to African American communities to improve its image (71.2%), make money (83.2%), and to encourage people to smoke (60.5%). About one-third stated they believed it gave money to help the community (34.4%). Multiple logistic regression showed that women, the college educated, and current smokers were significantly (p<0.05) more likely to favor accepting tobacco industry philanthropy. Multiple logistic regression revealed significant differences by education, smoking status, and selective attitudinal and behavioral variables with regard to tobacco industry philanthropy. The 18-34 age group was significantly less likely to agree that the tobacco industry gives money to help the community, with or without covariate adjustment.

CONCLUSION

Results of this study are important because despite the perceived benefits to these communities, tobacco industry contributions could mitigate community concerns about tobacco-related diseases, mask their significance, and undermine tobacco control strategies and policies.

The $5 man: the underground economic response to a large cigarette tax increase in New York City

OBJECTIVES

We examined the mechanisms by which living in a disadvantaged minority community influences smoking and illegal cigarette sale and purchasing behaviors after a large cigarette tax increase.

METHODS

Data were collected from 14 focus groups (n=104) that were conducted during the spring of 2003 among Blacks aged 18 years and older living in New York City.

RESULTS

A large tax increase led to what focus group participants described as a pervasive illegal cigarette market in a low-income minority community. Perceived pro-smoking community norms, a stressful social and economic environment, and the availability of illegal cigarettes worked together to reinforce smoking and undermine cessation.

CONCLUSIONS

Although interest in quitting was high, bootleggers created an environment in which reduced-price cigarettes were easier to access than cessation services. This activity continues to undermine the public health goals of the tax increase.

Concordance rates for smoking among African-American twins

OBJECTIVES

Despite greater negative environmental influences such as lower socioeconomic status, less parental education, more single-parent households and urban dwelling, African Americans are less likely to begin smoking than European Americans. The goal of the current investigation was to examine the proportion of genetic and environmental influences on smoking in a sample of adult African-American twins.

DESIGN

Birth records from North Carolina Register of Deeds Offices were used to identify participants for the Carolina African-American Twin Study of Aging (CAATSA). Participants completed an in-person interview that included measures of health status, cognition and psychosocial measures.

PARTICIPANTS

Data for the analysis come from 200 pairs of same-sex twins (97 identical pairs and 113 fraternal), with a mean age = 46.9 years (SD = 13.9) and 38% of the sample being men.

RESULTS

Compared to previous research on smoking, our estimates are very similar with genetics, accounting for about 60% of the individual variance in current smoking. We did find that there was a significant amount of genetic variance in pack years but no shared environmental influences.

CONCLUSION

Similarity in proportions of genetic influences lead to larger questions about the genes involved in smoking among African Americans working in the same manner as in Caucasians or other groups. Additionally, this same question holds for the environmental variance. It is perhaps most likely that while the proportions of environmental variance are similar between groups that the actual source of variance (e.g., poverty, urban rural context, socioeconomic status, attitudes of family and friends) may differ when comparing ethnic groups.

Tobacco taxation and public health: ethical problems, policy responses

This article aims to describe the major ethical issues surrounding tobacco taxation, and to identify policy responses to minimise any ethical dilemmas. It uses the standard ethical framework for biomedicine (covering beneficence, non-maleficence, respect for autonomy and justice), in conjunction with relevant data on tobacco taxation from various developed countries. Tobacco taxation contributes substantial benefits at the population level by protecting health (i.e., by deterring the uptake of smoking by youth, by promoting quitting, and by reducing harm from exposure to second-hand smoke (SHS)). However, tobacco taxes can contribute to financial hardship among low-socioeconomic status populations where smoking persists. Such taxes can contribute to autonomy, by reducing SHS exposure to non-smokers, and by allowing freedom from nicotine-dependency for those who quit smoking or do not start regular smoking as a result of high tobacco prices. Furthermore, increases in tobacco taxation may reduce health inequalities and so contribute to justice. Nevertheless, the additional tax burden imposed on smokers who wish to continue to smoke, or are unable to quit, can be considered unjust. The autonomy of such smokers may be partly impaired. Although tobacco tax can be regarded as ethically justifiable because of its substantial overall benefit to society, there is substantial scope for policy changes to further reduce any harms and injustices for those populations who continue to smoke.

Personal space smoking restrictions among African Americans

OBJECTIVES

This paper investigates the association between implementing a personal space smoking restriction for the home or automobile, and various sociodemographic, social, behavioral, and attitudinal variables.

METHODS

Approximately 1000 African-American adults (aged >18 years) residing in non-institutionalized settings were randomly selected using a cross-sectional stratified cluster sample of ten U.S. congressional districts represented by African Americans.

RESULTS

A 62.0% and 70.4% ban was found, respectively, on smoking in homes and cars. Multivariate analysis revealed that region, marital status, number of friends who smoked, beliefs about environmental tobacco smoke (ETS), and smoking status predicted home smoking bans, while age, number of children in household, number of friends who smoked, and beliefs about ETS and smoking status predicted car smoking bans.

CONCLUSIONS

Results suggest that a substantial segment of African Americans have accepted and translated public policy concerns about ETS into practice and reveal other variables that could be targeted in future interventions to increase implementation of personal space smoking restrictions.

The Master Settlement Agreement and African Americans: Opinions About the Allocation of Resources

This article analyzes demographic, attitudinal, and behavioral variables that predict African Americans’ opinions about state distribution of funds received from the Master Settlement Agreement (MSA). The sample consisted of 1,000 randomly selected African Americans from 10 U.S. congressional districts represented by African Americans. Descriptive analysis revealed that 38.7% of respondents favored dispersing funds evenly between tobacco control and other state functions, and 63% of respondents favored specifically directing MSA funds to African American communities. Cumulative logit regression analysis showed that age, education, geographic region, and smoking status were significant predictors of opinions about spending MSA funding on antismoking initiatives. Multiple logistic regression analysis revealed that opinions about targeted MSA funds to African Americans varied by homeownership, views on tobacco excise taxes, the fairness of tobacco taxes to African Americans, and the association between smoking and racism in U.S. society.

Eliminating tobacco-related health disparities: directions for future research

Certain groups in the United States remain at high risk and suffer disproportionately from tobacco-related illness and death despite progress made in reducing tobacco use. To address gaps in research on tobacco-related disparities and develop a comprehensive agenda aimed at reducing such disparities, representatives from funding agencies, community-based organizations, and academic institutions convened at the National Conference on Tobacco and Health Disparities in 2002. Conference participants reviewed the current research, identified existing gaps, and prioritized scientific recommendations. Panel discussions were organized to address research areas affecting underserved and understudied populations. We report major research recommendations made by the conference participants in several scientific domains. These recommendations will ultimately help guide the field in reducing and eliminating tobacco-related disparities in the United States.

Preventing 3 million premature deaths and helping 5 million smokers quit: a national action plan for tobacco cessation

In August 2002, the Subcommittee on Cessation of the Interagency Committee on Smoking and Health (ICSH) was charged with developing recommendations to substantially increase rates of tobacco cessation in the United States. The subcommittee's report, A National Action Plan for Tobacco Cessation, outlines 10 recommendations for reducing premature morbidity and mortality by helping millions of Americans stop using tobacco. The plan includes both evidence-based, population-wide strategies designed to promote cessation (e.g., a national quitline network) and a Smokers' Health Fund to finance the programs (through a 2 US dollar per pack excise tax increase). The subcommittee report was presented to the ICSH (February 11, 2003), which unanimously endorsed sending it to Secretary Thompson for his consideration. In this article, we summarize the national action plan.