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Southeast > News > Prevention News > July 05 News this Month |
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New this Month - July 2005 Below are citations/abstracts of recently published articles and publications that have been authored and/or co-authored by Pacific Institute staff. Berkeley - Bridget Freisthler Freisthler, B.; LaScala, E.A.; Gruenewald, P.J.; Treno, A.J., An examination of drug activity: Effects of neighborhood social organization on the development of drug distribution systems. Substance Use & Misuse, 40(5):671-686, 2005. [with P.J. Gruenewald and A.J. Treno of PRC]. Abstract: Objective: The ability to determine the geographic locations of illicit drug markets is central to the development of preventive interventions that address access to drugs and associated problems, such as violence and crime. Method: The current study examined individual self-reports of drug activities and demographic information obtained from two waves of a telephone survey of 1,704 individuals aged 15 to 29 conducted in 1999 and 2001 across 95 census tracts in a Northern California city and measures of neighborhood characteristics derived from Census 2000 measures. Results: The results of the study showed that, at the individual level, younger people and male respondents reported most drug activities. At the aggregate level, neighborhood poverty was directly related to higher rates of drug activity. Residential stability was found to moderate reports of drug activity observed by African-Americans and young people. Conclusion: Social processes reflected in neighborhood characteristics of census tracts influence rates of self-reports of individuals' exposures to drug activities. Paul Gruenewald Lipton, R.; Gorman, D.M.; Wieczorek, W.F.; Gruenewald, P., Spatial analysis in a public health setting. In M. Khosrow-Pour (ed.) Encyclopedia of Information Science & Technology, pp. 2576-2583. Hershey, PA: Idea Group Reference, 2005. Abstract: Spatial methods are becoming an increasingly important tool in understanding public health issues. Spatial analysis addresses an often forgotten or misunderstood aspect of public health, namely, studying the dynamics of people in places. As advances in computer technology and speed have continued apace, spatial methods have become an increasingly appealing way to more capably understand the manner in which the individual exists within a larger framework that is composed of both the human community and the physical reality of the environment (streets with intersections, dense vs. sparse neighborhoods, high or low densities of liquor stores or restaurants, etc.). Spatial methods are extremely data intensive, often pulling together information from disparate sources that have been collected for a variety of reasons such as research, business, governmental policy and law enforcement. This ability to handle such a spectrum of data allows for an unusually flexible research program compared to typical survey or census research. We will discuss general methods of spatial analysis and mapping and discuss a practical research example focusing on the relationship between alcohol and violence.
Miller, B.A.; Furr-Holden, D.C..; Voas, R.B.; Bright, K., Emerging adults' substnace use and risky behaviors in club settings. Journal of Drug Issues, 35(2): 357-378, 2005. [with D.C. Furr-Holden of PIRE/Calverton , R.B.Voas of PIRE/Calverton and K. Bright of PRC/Berkeley]. Abstract: This article explores the prevalence of drug and alcohol use and related risks by attendees at electronic music dance events (EMDEs) in club settings. From six events located on the East and West Coasts, anonymous data were collected via self-report questionnaires, drug bioassays, and alcohol breath tests prior to entry (N = 240) and upon exit from the venues (N = 219). EMDEs were locations for identifying young adults who were aged 18 to 25 (70%), not college students (54%), and at risk for substance use. Nearly half of the sample (45%) were positive for drug use, and 60% were positive for alcohol use at entrance. Slightly more than one third (38%) were positive for drug use, and 59% were positive for alcohol use at exit. Only a small percentage of the sample converted from no use to drug use on premises (5.4%). Future investigations need to explore targeted substance use prevention strategies within this context.
Paschall, M.; Lipton, R.I., Wine preference and related health determinants in a U.S. national sample of young adults. Drug and Alcohol Dependence, 78: 339-344, 2005. [with R.I. Lipton of PRC/Berkeley]. Abstract: This study examined relationships between wine preference and selected health determinants in a U.S. national sample of young adults to improve understanding of the association between light-moderate wine consumption and long-term morbidity and mortality risk. Interview data collected from 12,958 young adults who participated in the National Longitudinal Study of Adolescent Health were analyzed to determine whether wine preference was related to educational, health and lifestyle characteristics that are predictive of long-term morbidity and mortality. Wine drinkers generally had more formal education, better dietary and exercise habits, and more favorable health status indicators (e.g., normal body mass) than other drinkers and non-drinkers. A larger proportion of wine drinkers were light-moderate drinkers compared to beer or liquor drinkers, and wine drinkers were less likely to report smoking or problem drinking than beer or liquor drinkers. These findings indicate that wine preference in young adulthood is related to educational, health and lifestyle characteristics that may help to explain the association between light-moderate wine consumption and morbidity, and mortality risk in later adulthood. Calverton- David Levy Levy, D.; Romano, E.; Mumford, E., The relationship of smoking cessation to sociodemographic characteristics, smoking intensity and tobacco control practices. Nicotine and Tobacco Research, 7(3): 387-396, 2005. [with E. Romano and E. Mumford of PIRE/Calverton]. Abstract: The present study examined the relationship between recent smoking cessation activities and sociodemographic characteristics, smoking intensity, and tobacco control policies among daily smokers in the United States. The study used the U.S. Current Population Survey 1998–1999 Tobacco Use Supplement, supplemented with information on state-level tobacco control policies. The sample was limited to individuals aged 25 years or older who were smoking daily 1 year ago. We estimated frequencies and multivariate logistic equations for making a quit attempt and remaining abstinent at least 3 months. These measures were related to demographic characteristics, smoking intensity, and tobacco control policies. Younger, higher socioeconomic status (SES), and less intense (fewer cigarettes per day) daily smokers were more likely to make quit attempts, but the likelihood of remaining abstinent for those making a quit attempt was greater for older, higher SES, and heavy daily smokers. We found evidence that cessation behaviors were related to higher cigarette prices and the presence of state-level media/ comprehensive campaigns, but less clear evidence exists for an association with bans restricting workplace smoking. The results indicate that certain types of smokers are more likely to attempt to quit and to have success and that the characteristics of these smokers differ. Price policies can have an important role in helping daily smokers to quit. Further research is needed regarding the role of quantity smoked. Levy, D.T.; Mumford, E.; Nikolayev, L, The Healthy People 2010 smoking prevalence and tobacco control objectives: results from the Simsmoke simulation model. Cancer Causes and Control, 16(4): 359-371, 2005. [with E. Mumford of PIRE/Calverton]. Abstract: Objectives: Healthy People 2010 (HP2010) set a goal of reducing
the adult smoking prevalence to 12% by 2010. Smoking prevalence rates
do not appear to be declining at or near the rate targeted in the HP2010
goals. The purpose of this paper is to examine the attainability of HP2010
smoking prevalence objectives through the stricter tobacco control policies
suggested in HP2010. Methods:Atested dynamic simulation model of smoking
trends, known as SimSmoke, is applied. Smoking prevalence evolves over
time through initiation and cessation, behaviors which are in turned infuenced
by tobacco control policies. We consider the effect of changes in taxes/prices,
clean air laws, media campaigns, cessation programs and Wen, C.P.; Tsai, S.P.; Cheng, T.Y.; Chen, C.-J.; Levy, D.T.; Yang, H.-J.; Eriksen, M.P., Uncovering the relation between betel quid chewing and cigarette smoking in Taiwan. Tobacco Control, 14(Suppl. 1): i16-i22, 2005. Abstract: Objective: To describe the characteristics of betel quid chewers and to investigate the behavioural and mortality relations between betel quid chewing and cigarette smoking. Method: Prevalence and mortality risks of betel quid chewers by smoking status were calculated, based on the National Health Interview Survey in 2001 and a community based cohort, respectively. Cox’s proportional hazards model was used to adjust mortality risks for age, alcohol use, and education. Results: Almost all betel quid chewers were smokers, and most started chewing after smoking. Chewers were predominantly male, mostly in their 30s and 40s, more likely being among the lowest educational or income group, and residing in the eastern regions of Taiwan. On average, betel quid chewers who smoked consumed 18 pieces of betel quid a day, and smoked more cigarettes per day. Far more smokers use betel quid than non-smokers (27.5% v 2.5%), but ex-smokers quit betel quid more than smokers (15.1% v 6.8%). The significantly increased mortality of betel quid users who also smoked, for all causes, all cancer, oral cancer, and cancer of the nasopharynx, lung, and liver, was the result of the combined effects of chewing and smoking. Smokers who chewed betel quid nearly tripled their oral cancer risks from a relative risk of 2.1 to 5.9. Increasing the number of cigarettes smoked among betel quid chewers was associated with a synergistic effect, reflective of the significant interaction between the two. Conclusion: To a large extent, the serious health consequences suffered by betel quid chewers were the result of the combined effects of smoking and chewing. Betel quid chewing should not be considered as an isolated issue, but should be viewed conjointly with cigarette smoking. Reducing cigarette smoking serves as an important first step in reducing betel quid chewing, and incorporating betel quid control into tobacco control may provide a new paradigm to attenuate the explosive increase in betel quid use in Taiwan.
Abstract: Objective: To assess the impact of promotions on cigarette sales in Taiwan after the cigarette market opened to foreign companies, and to assess whether young smokers were targeted by these companies. Methods: Trends in cigarette sales, advertising expenditure, brand preference, and cigarette consumption were examined for the period following the 1987 opening of the cigarette market. Tobacco industry internal documents from Legacy Tobacco Documents Library of the University of California, San Francisco, were searched for corporate strategies on promoting youth consumption in Taiwan. Results: Between 1995 and 2000, the inflation adjusted advertising expenditures by all foreign firms increased fourfold. Much of the expenditure was spent on brand stretching the Mild Seven (Japan) and Davidoff (Germany) brands in television advertising. By 2000, the market share of foreign cigarettes exceeded domestics by three to one among young smokers and the leading brand preferred by this segment shifted from the most popular domestic brand (Long Life) to a foreign brand (Mild Seven). Furthermore, there was a sudden increase of 16.4% in smoking rates among young adults (from 36.1% to 42.0%) during the first five years after the market opened. This was also accompanied by increased per capita cigarette consumption and decreased age of smoking initiation. Industry documents confirmed the use of strategies targeted at the young. In particular, establishing new point of sale (POS) retail stores or promotional activities at POS were found to be more effective than advertising in magazines. Conclusions: This study provides evidence that advertising increased with increased competition following the market opening, which, in turn, spurred cigarette sales and consumption. Foreign tobacco companies have deliberately targeted youth in Taiwan and succeeded in gaining three quarters of their cigarette purchases within a decade. Expanding youth consumption will incur excessive future health care costs borne by society. Foreign tobacco companies should be obligated to reimburse these expenses through higher tariffs on cigarettes.
Abstract: Objective: To develop a simulation model to predict the effects of tax policies on smoking prevalence rates and smoking attributable deaths. Methods: Using data from Taiwan, a simulation model is developed that projects population using birth and death rate data, future smoking rates using initiation, cessation and relapse data, and smoking attributable deaths using smoking prevalence and relative risk estimates. The model projects the number of smokers and smoking related deaths from a baseline year forward. The effects of taxes of different sizes, indexed and unindexed, and temporary versus sustained are modelled using elasticities based on published studies of demand. Results: The model predicts that sustained tax increases have the potential to substantially reduce the number of smokers and the number of premature deaths, with the effects growing over time. Indexing taxes to inflation stems erosion of the tax effect. In our model, when the tax increases by 10 times (NT$50) over the recent tax increase (NT$5) and taxes are indexed to inflation, the smoking prevalence rate falls by over 15% soon after the tax increase, and by about 30% in relative terms by the year 2040, resulting in 4500 lives saved per year. Conclusions: Tax rises have the ability to substantially affect smoking rates in Taiwan. These effects grow over time and lead to substantial savings in lives and health care costs.
Abstract: Purpose: To examine smoking behaviours in Taiwan and compare those behaviours to those in the USA. Methods: Using the National Health Interview Survey (NHIS) of Taiwan (2001), a survey of over 20 000 participants, frequencies were calculated for smoking, ex-smoking, quantity smoked, and exposure to environmental tobacco smoke (ETS). Breakdowns by age, sex, and socioeconomic status were also calculated. Results: The ratio of male to female smoking rates was 10.9 to 1 among adults (46.8%/4.3%), but 3.6 to 1 among underage teenagers (14.3%/4.0%). The proportion of underage to adult smokers was three times higher for girls than for boys. Smoking prevalence substantially increased during and after high school years, and peaked in those aged 30–39 years. Smoking rates of high school age adolescents increased more than threefold if they did not attend school or if they finished their education after high school. Low income and less educated smokers smoked at nearly twice the rate of high income and better educated smokers. The smoker/ex-smoker ratio was close to 7. Male daily smokers smoked on average 17 cigarettes/day, and females, 11. Half of the total population, especially infants and women of childbearing age, were exposed to ETS at home. Conclusions: Taiwan has particularly high male smoking prevalence and much lower female prevalence. The low female prevalence is likely to increase if the current sex ratio of smoking by underage youth continues. The low quit rate among males, the high ETS exposure of females and young children at home, and the sharp increase in smoking rates when students leave school, are of particular concern. These observations on smoking behaviour can provide valuable insights to assist policymakers and health educators in formulating strategies and allocating resources in tobacco control.
Abstract: Objective: To assess the benefits of smoking cessation regarding mortality reduction after smokers quit, and regarding the health of newborns after smoking mothers quit. Methods: Relative mortality risks (RR) for smokers aged 35 or older who quit years ago were calculated from the follow up of 71 361 civil servants and teachers recruited since 1989. Data from the Pregnancy Risk Assessment Monitoring System in Taipei City were used to calculate the odds ratios of body weights of newborns born to mothers of different smoking status. Results: Mortality risk for ex-smokers was significantly lower than that of current smokers for all causes (18%), all cancer (22%), lung cancer (39%), and ischaemic heart disease (54%). These benefits were not distinguishable initially, up to five years, but by year 17 and thereafter, substantial benefits of cessation accrued. Two thirds of smoking women quit during the first trimester of pregnancy, and only 2.2% of mothers smoked throughout pregnancy. The newborns from smoking mothers were smaller than those from never smoking mothers, but, if these mothers quit early in the first trimester, birth weights were normal. Conclusions: The health benefits of smoking cessation, rarely reported for Asian populations, have been largely ignored by smokers in Taiwan, where cessation activities have been extremely limited. Findings of this study that risks from smoking can be attenuated or reversed should be widely communicated to motivate smokers to quit. Smokers should quit early, including smoking mothers, and not wait till medical conditions surfaced, to have the maximal benefits of cessation.
Abstract: Objectives: To estimate smoking attributable mortality (SAM) in Taiwan for the years 2001 through 2020 under scenarios of reductions in smoking rates by 0%, 2%, 4%, and 10% per year. Method: The smoking attributable fraction (SAF) was used to calculate SAM from the risk experience in following up a large cohort (86 580 people) in Taiwan. Smoking rates were based on the 2001 National Health Interview Survey and other national surveys. An average 10 year lag was assumed between smoking rates and subsequent mortality. Results: In 2001, 18 803 deaths, or 1 out of 4 deaths (27%), in middle aged men (35–69 years old) were attributable to smoking. SAM has been increasing and will continue to increase if smoking rates remain constant or even if reduced annually by 2%. SAM would begin to decrease only if rates were to be reduced by at least 4% a year. Conclusions: The projected SAM in this study illustrates the seriousness of smoking caused mortality. Current efforts in tobacco control would lead to a progressive increase in SAM, unless efforts were doubled and smoking rates reduced by more than 4% a year. The urgency in requiring stronger tobacco control programmes to attenuate the staggering death tolls is compelling.
Voas, R.B.; Marques, P.R., Coming up: a critical period for Interlock programs. In: D.J. Beirness and R.D. Robertson (eds.), Alcohol interlock programs: enhancing acceptance, participation and compliance: proceedings of the Fourth International Symposium on Alcohol Ignition Interlock Programs, October 27-28, 2003 (pp. 3-7), Hilton Head, South Carolina. Ottawa: Traffic Injury Research Foundation. 2005. [with P.R. Marques of PIRE/Calverton].
Waehrer, G.; Leigh, J.P.; Miller, T.R., Costs of occupational injury and illness within the health services sector. International Journal of Health Services, 35(2): 343-359, 2005. [with T.R. Miller of PIRE/Calverton]. Abstract: Knowledge of costs is essential to allocate medical resources efficiently. The authors' goal was to estimate and compare costs across occupations, industries, gender, race, and types of nonfatal injuries and illnesses. This is an incidence study of nationwide data, 1993. Nonfatal incidence data were drawn from the Bureau of Labor Statistics Annual Survey. Medical costs were from the Detailed Claims Information data set. Productivity (wage) costs were calculated using the Current Population Survey. Pain and suffering costs were estimated from data on jury verdicts. Injuries and illnesses to nursing aides and orderlies cost $2,200 million; costs were $900 million for registered nurses and $40 million for licensed practical nurses. The ranking of health services industries in terms of costs was: hospitals (52 percent of all costs), nursing care facilities (38 percent), home care services (6 percent), physicians' offices (4 percent), and laboratories (<1 percent). Types of injuries (sprains, strains, fractures) were similar across occupations and industries, but types of illness (carpal tunnel syndrome, respiratory diseases) varied. The most costly injured body parts were: back, shoulder, knee, wrist, and neck. Injuries and illnesses comprised roughly 90 percent and 10 percent, respectively, of total costs. The hospital industry was the third most expensive of 313 U.S. industries. Costs of occupational injury and illness in the health services industry were high and varied across occupation, industry, disease, race, and gender. Donna Xander Xander, D., Counselors and clergy: partners in healing. Counselor, 6(3): 32-37, 2005. Abstract: Addiction counselors and clergy operate on parallel tracks as they work to help their clients or congregants achieve a fuller life by helping them overcome addiction and stay in recovery. yet many addiction counselors and clergy may not understand how a collaboration or both professions could prove valuable as they work together toward the same goal. This article describes the Clergy Training Project, a joint venture between the National Association for CHildren of Alcoholics (NACoA) and the Johnson Institute (JI), and the development of core competencies for clergy and other pastoral ministers. It also illustrates collaborative efforts between addiction treatment centers and faith institutions and outlines specific strategies counselors can take to engage with their local faith community.
Karen Friend Friend, K.B.; Levy, D.T.; Mernoff, S., The adoption of tobacco treatment by rehabilitation clinicians. Disability and Rehabilitation, 27(4): 147-155, 2005. [with D.T. Levy of PIRE/Calverton]. Abstract: Purpose: Individuals with disabilities tend to smoke at rates
that surpass those of the general population. The Public Health Service
Guideline on the treatment of tobacco dependence suggests that all smokers
be screened at every health care visit and counselled regarding how best
to quit smoking. We review the literature on the adoption of tobacco dependence
treatment by rehabilitation clinicians working with disabled individuals.
Despite the deleterious health effects of smoking on individuals with
disabilities, the limited data suggests that rehabilitation clinicians
rarely encourage their clients who smoke to quit. Method: Studies were
collected using various computerized databases from 1980 to the present.
Because of the paucity of literature on tobacco dependence treatment utilization
among rehabilitation clinicians, we also examine research on the use of
tobacco dependence treatment by health care providers in the general population
and in substance abuse treatment settings. Results: Despite the efficacy
of tobacco dependence treatment in smokers with disabilities, tobacco
dependence treatment appears to be underutilized by rehabilitation clinicians.
Conclusions: Interventions that have successfully increased adoption by
the two other clinician groups should be utilized to increase tobacco
dependence treatment provision by rehabilitation clinicians. Additional
research is warranted to determine how to overcome obstacles to adoption.
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