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CORK Bibliography: Drug Control Policy

36 citations. 2007 to present

Prepared: March 2008

Acevedo B; Common R. Governance and the management of networks in the public sector: Drugs policy in the United Kingdom and the case of cannabis reclassification. Public Management Review 8(3): 395-414, 2006. (43 refs.)

This essay utilizes policy network analysis to examine UK drugs policy within the wider context of the government's approach to joined-up governance. While confronting the definitional problems and limitations associated with the policy network concept, it is assumed that multiple agencies work towards pre-determined policy objectives. In particular, Atkinson and Coleman ( 1992) challenge three aspects of policy network analysis; the macro-political context, the international dimension of many policy domains, and the dynamics of political change. These aspects are addressed through the case of drug policy in the United Kingdom in general, and the decision to reclassify cannabis in particular. In addition, it is suggested that the analysis of networks requires a systemic approach to understanding how the duality of power and knowledge determines the dynamics of networks and their impact on institutional change. This includes an assessment of the consequences of the managerialist discourse surrounding changes to drug policy.

Al-Delaimy WK; Pierce JP; Messer K; White MM; Trinidad DR; Gilpin EA. The California Tobacco Control Program's effect on adult smokers: (2) daily cigarette consumption levels. Tobacco Control 16(2): 91-95, 2007. (35 refs.)

Objective: To investigate the association of the California Comprehensive Tobacco Control Program with self-reported population trends of cigarette consumption during 1992-2002. Setting and Participants: Participants were non-Hispanic white daily smokers (aged 20-64 years, n = 24 317) from the Tobacco Use Supplements to the Current Population Survey (1992-2002). We compared age-specific trends in consumption among daily smokers in three groups of states with differing ;tobacco control initiatives: California (CA; high cigarette price/comprehensive programme), New York and New Jersey (high cigarette price/no comprehensive programme), and tobacco-growing states (TGS; low cigarette price/no comprehensive programme). Results: There was a general decline in cigarette consumption across all age groups in each category of states between 1992 and 2002, except the oldest age group in the TGS. The largest annual decline in the average number of cigarettes per day was observed among daily smokers in CA who were aged >= 35 years (-0.41 cigarettes/day/year (95% CI -0.52 to -0.3)). This rate was significantly higher than the -0.22 cigarettes/day/year (95% CI -0.3 to -0.16; p < 0.02) observed in same-age daily smokers from New York and New Jersey, and significantly higher than the rate in same-age daily smokers from the TGS (-0.15 cigarettes/day/year (95% CI -0.22 to -0.08; p < 0.002)). There were no significant differences across state groups in the decline observed in daily smokers aged 20-34 years. In 2002, only 12% of daily smokers in CA smoked more than a pack per day, which was significantly lower than the 17% in New York and New Jersey, which again was significantly lower than the 25% in the TGS. Conclusions: The California Tobacco Control Program was associated with significant declines in cigarette consumption among daily smokers aged >= 35 years of age, which in turn should lead to declines in tobacco-related health effects. The decline in consumption among young adult smokers was a national trend.

Boerm M; Gingiss P; Roberts-Gray C. Association of the presence of state and district health education policies with school tobacco prevention program practices. Journal of School Health 77(4): 207-214, 2007. (25 refs.)

Texas does not require health education or tobacco use prevention education (TUPE) in its middle schools. During planning for the Texas Tobacco Prevention Initiative, this baseline research was conducted to (1) describe tobacco prevention and control practices in middle schools prior to the pilot, (2) analyze implementation of a state law prohibiting tobacco use on campuses and at school events, and (3) identify how schools are influenced by district policies requiring health education. Written surveys derived from the 2000 School Health Education Profile Tobacco Module developed by the Centers for Disease Control and Prevention were completed by principals and health coordinators at schools in districts requiring health education (n = 31) and schools without district requirements (n = 32). School tobacco policy familiarity and enforcement were consistently reported in response to a state law with rigorous recommendations prohibiting tobacco use. Significantly more activity in numerous components of TUPE was reported in schools in districts with a health education requirement. Results have implications for intervention programs planned in schools located in states seeking to develop or strengthen state laws, or in states without health education or specific health content requirements.

Chapman S. Global perspective on tobacco control. Part II. The future of tobacco control: making smoking history? International Journal of Tuberculosis and Lung Disease 12(1): 8-12, 2008. (30 refs.)

Serious efforts to reduce the harm caused by tobacco use throughout populations require implementation policies and interventions capable of reaching all smokers and potential smokers. While the Framework Convention on Tobacco Control promises to accelerate the adoption of comprehensive tobacco control policies throughout the world, its extensive 'optional' language provides considerable latitude for governments unwilling to implement rigorous controls. This paper examines four broad areas in which important debates and policy advances will be necessary to ensure population-wide impact of tobacco control: harm reduction; demand reduction strategies involving particularly the use of news generation in increasing the coverage of tobacco and health issues; denormalisation of tobacco use, especially among health workers in nations where use remains high; and further efforts to regulate the tobacco industry, particularly in regard to plain packaging, under-the-counter retail sales and the regulation of tobacco products.

Chen ZL; Huang KC. Drug problems in China - Recent trends, countermeasures and challenges. International Journal of Offender Therapy and Comparative Criminology 51(1): 98-109, 2007. (26 refs.)

Drug crime in China is on an overall rising trend. Major drug crime cases are becoming more common, the types of drugs being trafficked are more diverse, and the smuggling and trafficking of drugs into the country and the smuggling of precursor chemicals out of the country have formed a bidirectional cycle. Drug crimes in China have also begun to show a conspicuous trend of internationalization. China's main countermeasures against drug crimes have been to pass new laws and regulations against drugs, to increase the efforts to eradicate cultivation, to establish and expand "drug-free communities" programs, and to strengthen international cooperation in antidrug campaigns. The existing problems demand prompt solutions, which include a shortage of funding and lack of accurate knowledge about prevalence of drug abuse and related data for scientifically studying the drug problems.

Chiang CY; Slama K; Enarson DA. Tobacco use and tobacco control. International Journal of Tuberculosis and Lung Disease 11(4): 381-385, 2007. (26 refs.)

Smoking begins when tobacco is readily available and others smoke. It easily becomes something more than experimentation, as the symptoms of nicotine dependence can develop rapidly. The social and environmental cues to smoke, the personal perceptions of smoking and the physiological effects of nicotine create strong links that are difficult to break. Programmes should be put in place to help people to stop smoking, but these programmes cannot reach their potential for success if the wider social and environmental factors are not also changed through strengthened anti-tobacco social values and tobacco control legislation, as exemplified in the WHO Framework Convention on Tobacco Control.

Cook DM; Bero LA. Identifying carcinogens: The tobacco industry and regulatory politics in the United States. International Journal of Health Services 36(4): 747-766, 2006. (94 refs.)

The process of identifying carcinogens for purposes of health and safety regulation has been contested internationally. The U.S. government produces a "Report on Carcinogens" every two years, which lists known and likely human carcinogenic substances. In the late 1990s the tobacco industry responded to the proposed listing of secondhand smoke with a multi-part strategy. Despite industry efforts to challenge both the substance of the report and the agency procedures, environmental tobacco smoke was declared by the agency in 2000 to be a known human carcinogen. A subsequent lawsuit, launched by chemical interests but linked to the tobacco industry, failed, but it produced a particular legal precedent of judicial review that is favorable to all regulated industries. The authors argue that, in this case, tobacco industry regulation contradicts academic expectations of business regulatory victories. However, the tobacco industry's participation in the regulatory process influenced the process in favor of all regulated industry.

Cook PJ; Reuter P. When is alcohol just another drug? Some thoughts on research and policy - Response to comments. Addiction 102(8): 1192-1193, 2007. (7 refs.)

Cook PJ; Reuter P. When is alcohol just another drug? Some thoughts on research and policy. Addiction 102(8): 1183-1188, 2007. (29 refs.)

Aim: To reflect on the divergence and overlap between alcohol and illicit drugs with respect to both current policies and policy research. Results: For demand reduction, there is considerable overlap in programs and services for prevention and even more clearly for treatment. For supply controls there is mostly divergence, reflecting the difference in legal status. Research generally follows the same pattern. However, a cross-cutting research agenda on the supply side has merit. Conclusion: Even in a prohibition regime, law-enforcement agencies have considerable discretion. A systematic, pragmatic, 'evidence-based' use of that discretion to reduce harm is possible. It can be accomplished only by a continuing program of policy research that measures the harms of drug use and drug enforcement, assesses the effects of current policies on both these sources of social cost and explores alternative strategies. There is a similarly important project for alcohol and tobacco control policy. The goal for research on alcohol and tobacco is to document the extent to which supply controls can be effective in reducing harm; the additional goal for illicit drugs is to document just how much the current ideologically driven approach is costing the public.

editor. Adding harm reduction to tobacco control. (editorial). Lancet 370(9594): 1189-1189, 2007. (0 refs.)

Florin P; Celebucki C; Stevenson J; Mena J; Salago D; White A et al. Cultivating systemic capacity: The Rhode Island Tobacco Control Enhancement Project. American Journal of Community Psychology 38(3-4): 213-220, 2006. (12 refs.)

This paper describes the Rhode Island Tobacco Control Enhancement Project (TCEP), a state-university-community technical assistance system. TCEP was developed under the auspices of the Rhode Island Department of Health's Tobacco Control program and was designed to build capacity among nine community-based organizations to mount comprehensive tobacco control interventions in five diverse communities within the state. This paper: (1) provides a description of community mobilization; (2) presents a logic model for planning and decision making used by state-university-community partners; (3) describes training, technical assistance services and implementation; and, (4) describes the evaluation and program improvement activities used to support on-going project development.

Hammond D; Costello MJ; Fong GT; Topham J. Exposure to tobacco marketing and support for tobacco control policies. American Journal of Health Behavior 30(6): 700-709, 2006. (22 refs.)

Objectives: To examine the salience of tobacco marketing on postsecondary campuses and student support for tobacco control policies. Methods: Face-to-face surveys were conducted with 1690 students at 3 universities in southwestern Ontario. Results: Virtually all (97%) students reported noticing tobacco marketing in the past year, and 35% reported noticing marketing on campus. There was strong support for smoke-free restrictions on campus, including restaurants and bars (82%), and for prohibitions on campus marketing. The presence of campus policies was associated with reduced exposure to marketing and increased policy support. Conclusions: There is strong support among students to remove tobacco marketing from campus and to introduce comprehensive smoke-free restrictions.

Jha P; Chaloupka FJ; Corrao M; Jacob B. Reducing the burden of smoking world-wide: Effectiveness of interventions and their coverage. Drug and Alcohol Review 25(6): 597-609, 2006. (62 refs.)

Cigarette smoking and other tobacco use imposes a huge and growing public health burden globally. Currently, approximately 5 million people are killed annually by tobacco use; by 2030, estimates based on current trends indicate that this number will increase to 10 million, with 70% of deaths occurring in low- and middle-income countries. Numerous studies from high-income countries, and a growing number from low- and middle- income countries, provide strong evidence that tobacco tax increases, dissemination of information about health risks from smoking, restrictions on smoking in public places and in work-places, comprehensive bans on advertising and promotion and increased access to cessation therapies are all effective in reducing tobacco use and its consequences. Despite this evidence, tobacco control policies have been unevenly applied-due partly to political constraints. This paper provides a summary of these issues, beginning with an overview of trends in global tobacco use and its consequences and followed by a review of the evidence on the effectiveness of tobacco control policies in reducing tobacco use. A description of the types and comprehensiveness of policies currently in place and a discussion of some of the factors correlated with the strength and comprehensive of these policies follows.

Kees J; Burton S; Andrews JC; Kozup J. Tests of graphic visuals and cigarette package warning combinations: Implications for the Framework Convention on Tobacco Control. Journal of Public Policy and Marketing 25(2): 212-223, 2006. (42 refs.)

The World Health Organization recently adopted the Framework Convention on Tobacco Control, a groundbreaking public health treaty that will require that warning information in the form of text, pictures, or a combination of these two forms cover at least 30% of the front and back of cigarette packages. In three studies using smokers from the United States and Canada, the authors examine the effects of specific graphic visuals in the context of current U.S. verbal warnings. The findings indicate that including both graphic visual warnings, such as those used in Canada, and warning statements currently used in the United States can decrease the perceived attractiveness of the package and create higher levels of negative affect, such as fear or anxiety. The results also show that the addition of the specific visual warnings examined to the U.S. statements increases smokers' perceived intentions of quitting smoking compared with warning statements alone. The authors offer implications for public policy and public health and provide suggestions for further research.

Kunkel D. Inching forward on tobacco advertising restrictions to prevent youth smoking. Archives of Pediatrics & Adolescent Medicine 161(5): 515-516, 2007. (10 refs.)

Lambert TA. The case against smoking bans. Missouri Environmental Law & Policy Review 13: 94-113, 2005. (61 legal refs.)

In recent months, dozens of localities and a number of states have enacted laws banning smoking in public places. ... In other words, smoking bans are justified on risk-based grounds even if there's no need to remedy a market failure or to correct a preference-shaping bias in the law. ... But a purely risk-based argument likely cannot justify a sweeping smoking ban. ... Controversies over smoking in public places are ultimately controversies over property rights: does a smoker have the right to fill the air with his or her smoke, or do non-smoking patrons have the right to insist upon clean air? In other words, who "owns" the air? A smoking ban effectively gives non-smoking patrons the right to the air. ... Under the laissez-faire approach, a business owner, seeking to maximize his or her profits, will set the establishment's smoking policy to accommodate the patrons who most value their preferred policy (and thus are most willing to pay a premium to be in the proprietor's space). ... A smoking ban, then, is less likely to maximize social welfare than a laissez-faire approach, which ensures that the right to any particular public place's air is allocated to the group who values it most. This essay consists of two parts. Part I rebuts the most commonly asserted arguments in favor of government-imposed smoking bans. Part II sets forth an affirmative argument for a laissez-faire approach to the issue of public smoking.

Levy DT; Mumford EA; Gerlowski DA. Examining trends in quantity smoked. Nicotine & Tobacco Research 9(12): 1287-1296, 2007. (54 refs.)

Although the quantity smoked is known to affect smokers' health risks and likelihood of cessation, little is known about trends in quantity smoked and the role of policies in affecting those trends. We examined trends in quantity smoked using a new measure derived from U. S. Department of Agriculture per-capita cigarette consumption (PCC) and smoking prevalence data. We compared this measure to a survey measure of mean cigarettes smoked per day from the National Health Interview Survey (NHIS). Using our measure, we examined trends in quantity smoked at the national level from 1974 to 2004 and for two states, California and Massachusetts. We used regression analysis to distinguish price and other policy-related trends from long-term trends. The derived measure of quantity tracked well with the NHIS measure. Through 1990, changes in quantity were well explained by price changes, with no residual trend in quantity smoked. Since 1990, price showed similar effects, but a downward trend was observed. In California and Massachusetts the initiation of a comprehensive tobacco program as well as price and tax changes were found to explain trends in quantity smoked. Continued progress in reducing the quantity smoked is likely to require the consistent implementation of current policies and the introduction of new policies. Although sustained reductions in quantity smoked may take a long time to affect smokers' health outcomes, sustained reductions appear to be related to cessation. The measure developed in the present study provides a useful tool for tracking trends in quantity smoked.

Libby RT. Treating doctors as drug dealers: The Drug Enforcement Administration's war on prescription painkillers. Independent Review 10(4): 511-547, 2006. (101 refs.)

The article discusses the causes of medical undertreatment in the United States. One cause mentioned is that few doctors specialize in pain management, therefore, only few patients receive the appropriate treatment for chronic pain. Another is that a lot of physicians are being sued either for overprescribing or underprescribing painkiller drugs, as a result only few of these doctors are left to take the risks. There are many doctors prosecuted for prescribing painkillers as part of the government's effort to control narcotic drugs. The much publicized lawsuits against these doctors also contributed to the problem.

Lloyd C. UK cannabis classification: a flawed debate. (letter). Lancet 371(9609): 300-301, 2008. (4 refs.)

Loomis BR; Farrelly MC; Mann NH. The association of retail promotions for cigarettes with the Master Settlement Agreement, tobacco control programmes and cigarette excise taxes. Tobacco Control 15(6): 458-463, 2006. (30 refs.)

Background: Retail stores are the primary medium for marketing cigarettes to smokers in the US. The prevalence and characteristics of cigarette retail advertising and promotions have been described by several investigators. Less is known about the proportion of cigarette sales occurring as part of a retail promotion and about the effects of tobacco control policies on cigarette promotions. Objective: To estimate the effect of the Master Settlement Agreement (MSA), state tobacco control programme funding and cigarette taxes on retail promotions for cigarettes in supermarkets in the US. Outcome measures: Proportion of cigarette sales occurring under a retail promotion and the value of multipack promotions (eg, buy one pack, get one pack free) and cents- off promotions, measured using scanner data in supermarkets from 50 retail market areas from 1994 to 2004. Results: Promoted cigarette sales have increased significantly since the MSA (p < 0.01), and are higher in market areas with high tobacco control programme funding (p < 0.01) and high cigarette tax (p < 0.01). The value of a multipack promotion is higher since the MSA (p < 0.01) and in market areas with high cigarette tax (p < 0.01). The value of a cents-off promotion is negatively related to the MSA (p < 0.01), with mixed results for tobacco control programme funding (p < 0.05), and is unassociated with tax. Conclusions: Higher promoted cigarette sales and increased promotional values in market areas with strong tobacco control policies, compared with market areas with weaker tobacco control policies, may partially offset the decline in smoking achieved in those areas.

Mold A. Illicit drugs and the rise of epidemiology during the 1960s. Journal of Epidemiology and Community Health 61(4): 278-281, 2007. (34 refs.)

Epidemiology has been crucial to the understanding of both tobacco smoking and illicit drug taking as public health issues in Britain since the 1960s. There were, however, siginificant differences in the way in which epidemiology was used between the two psychoactive substances.

Morgan GD; Backinger CL; Leischow SJ. The future of tobacco-control research. Cancer Epidemiology, Biomarkers & Prevention 16(6): 1077-1080, 2007. (27 refs.)

Recent epidemiologic data on the stabilization of adult and youth smoking rates underscore the need for vigorous research across the cancer control spectrum on tobacco use interventions. The steady decline in adult rates of smoking has stalled for the first time in 8 years, and certain race, ethnic, and population groups are disproportionately at risk to tobacco-related cancers because of disparities in tobacco use or access to effective interventions. Although substantial progress has been made across levels of basic through applied research, tobacco-control research across the discovery and delivery continuum must be accelerated to further reduce the cancer burden. Following a brief review of the prevalence and trends affecting tobacco use initiation and cessation, we identify and describe four domains of extraordinary research opportunities: genetics and gene-environment interactions, bioinformatics and health informatics, disparities and disproportionate risk, and prevention and treatment. Evolutionary scientific changes, like rapidly advancing technology and emphasis on the paradigm of team science research approaches, provide both a challenge as well as unparalleled opportunities for scientific advancement and public health progress.

Ponder P; Jefferson AM; Backinger C; Grana R. Tobacco-related research funding at the National Cancer Institute: Portfolio analysis, fiscal year 2003. Nicotine & Tobacco Research 9(10): 1053-1057, 2007. (4 refs.)

A variety of methods is used to classify research conducted or funded by the National Institutes of Health (NIH). We undertook this analysis to delineate research funded by the National Cancer Institute (NCI) that specifically addresses a tobacco-related research question. Intramural projects, extramural grants, and contracts were coded according to eight categories based on information in the abstracts. One category, "research area,'' classified projects by the primary study outcome. A total of 318 projects met our inclusion criterion of addressing a tobacco-related research question. As a result, our estimate of about US$107 million in tobacco research during the 2003 fiscal year is different from what is officially reported by NCI. The greatest proportion of tobacco research dollars was devoted to policy research (20%, n=47) and research on the determinants of tobacco use (19%, n=36). The greatest number of studies focused on investigating the consequences of tobacco use (32%, n=105). A substantial number of projects addressed a tobacco-related question specifically about women (n=45) or a racial/ethnic group (n=99) and used cigarettes as the primary tobacco product (n=277). These findings elucidate key areas for future tobacco control research and may help to determine future funding priorities at NCI and in the research community at large. Although tobacco causes nearly 30% of all cancer deaths, NCI spent 2.3% of its total fiscal year 2003 budget on tobacco-related research funding.

Poulin CC. School smoking bans: Do they help/do they harm? Drug and Alcohol Review 26(6): 615-624, 2007. (34 refs.)

Introduction and Aims. The international evidence about the effectiveness of school smoking bans on youth smoking initiation is equivocal. The purpose of the present study was to examine the association between school smoking bans and smoking initiation as a health outcome as well as academic achievement as an educational outcome, taking into account socioeconomic status. Design and Methods. This multi-level study was based on a cross-sectional self-reported anonymous data from 12 990 students who participated in the 2002 Student Drug Use Survey in the Atlantic Provinces. The main outcomes were having smoked a first whole cigarette in the year prior to the survey, and academic performance. The main independent variable at the individual- and school-levels was a school rule against smoking on school property or at school events, as reported by students. Results. Smoking initiation was predicted by individual-level demographic factors and by the contextual factor of attending a school with a high prevalence of established smoking, but failed to be predicted by a school smoking ban. The academic performance of students who indicated there was no school smoking ban was found to worsen as an increasing proportion of the student body indicated that such a rule existed. Lower socio-economic status was found to be an independent predictor of smoking initiation and poorer academic performance. Discussion and Conclusions. A school ban against smoking, in addition to not being clearly effective, might also not be entirely benign. School smoking policy should be monitored as to educational outcomes and the impact of policy on groups vulnerable to smoking.

Pyles MK; Mullineaux DJ; Okoli CTC; Hahn EJ. Economic effect of a smoke-free law in a tobacco-growing community. Tobacco Control 16(1): 66-68, 2007. (17 refs.)

Objective: To determine whether Lexington, Kentucky's smokefree law affected employment and business closures in restaurants and bars. On 27 April 2004, Lexington-Fayette County implemented a comprehensive ordinance prohibiting smoking in all public buildings, including bars and restaurants. Lexington is located in a major tobaccogrowing state that has the highest smoking rate in the US and was the first Kentucky community to become smoke-free. Design: A fixed-effects time series design to estimate the effect of the smoke-free law on employment and ordinary least squares to estimate the effect on business openings and closings. Subjects and settings: All restaurants and bars in LexingtonFayette County, Kentucky and the six contiguous counties. Main outcome measures: ES-202 employment data from the Kentucky Workforce Cabinet; Business opening/ closings data from the Lexington-Fayette County Health Department, Environmental Division. Results: A positive and significant relationship was observed between the smoke-free legislation and restaurant employment, but no significant relationship was observed with bar employment. No relationship was observed between the law's implementation and employment in contiguous counties nor between the smoke-free law and business openings or closures in alcohol-serving and or non-alcohol-serving businesses. Conclusions: No important economic harm stemmed from the smoke-free legislation over the period studied, despite the fact that Lexington is located in a tobacco-producing state with higher-than-average smoking rates.

Ross H; Al-Sadat NAM. Demand analysis of tobacco consumption in Malaysia. Nicotine & Tobacco Research 9(11): 1163-1169, 2007. (15 refs.)

We estimated the price and income elasticity of cigarette demand and the impact of cigarette taxes on cigarette demand and cigarette tax revenue in Malaysia. The data on cigarette consumption, cigarette prices, and public policies between 1990 and 2004 were subjected to a time-series regression analysis applying the error-correction model. The preferred cigarette demand model specification resulted in long-run and short-run price elasticities estimates of -0.57 and -0.08, respectively. Income was positively related to cigarette consumption: A 1% increase in real income increased cigarette consumption by 1.46%. The model predicted that an increase in cigarette excise tax from Malaysian ringgit (RM) 1.60 to RM2.00 per pack would reduce cigarette consumption in Malaysia by 3.37%, or by 806,468,873 cigarettes. This reduction would translate to almost 165 fewer tobacco-related lung cancer deaths per year and a 20.8% increase in the government excise tax revenue. We conclude that taxation is an effective method of reducing cigarette consumption and tobacco-related deaths while increasing revenue for the government of Malaysia.

Severson HH. Tobacco control research: A journey of discovery in prevention and cessation. (editorial). American Journal of Health Behavior 30(6): 567-579, 2006. (49 refs.)

Slater SJ; Chaloupka FJ; Wakefield M; Johnston LD; O'Malley PM. The impact of retail cigarette marketing practices on youth smoking uptake. Archives of Pediatrics & Adolescent Medicine 161(5): 440-445, 2007. (31 refs.)

Objective: To examine the differential associations of cigarette retail marketing practices on youth smoking uptake. Design: Analyses from annual, nationally representative, cross-sectional surveys of 8th, 10th, and 12th graders in the United States. Setting: The February 1999 through June 2003 Monitoring the Future surveys involved 109 308 students and data on retail cigarette marketing collected from 966 communities in which the students reside, as part of the Bridging the Gap Initiative: Research Informing Practice and Policy for Healthy Youth Behavior. Participants: A total of 26 301 students were selected for this study. Main Exposures: Point-of-sale advertising, promotions, prices, and placement. Outcome Measure: Using a smoking uptake measure to account for stages that identify the process by which adolescents begin smoking, we calculated odds ratios and confidence intervals through generalized ordered logit analyses, with weighted data that controlled for demographic and socioeconomic characteristics and accounted for clustering at the community level. Results: Higher levels of advertising, lower cigarette prices, and greater availability of cigarette promotions were associated with smoking uptake. Advertising increased the likelihood of youth initiating smoking, price increased the likelihood of smoking at most levels of uptake, and availability of promotions increased the likelihood that youth will move from experimentation to regular smoking. Conclusions: Cigarette retail marketing practices increase the likelihood of smoking uptake. These findings suggest that specific restrictions on retail cigarette marketing may reduce youth smoking.

Stehr M. The effect of cigarette taxes on smoking among men and women. Health Economics 16(12): 1333-1343, 2007. (20 refs.)

The literature contains numerous studies that estimate the effect of cigarette taxes on smoking across various population groups. Although the conclusions are split, most US studies find that men are more responsive to cigarette taxes than women. This paper shows that these results are due to the failure to control for state-specific gender gaps in smoking rates that are correlated with cigarette taxes. When gender-specific state fixed effects are included to control for these gaps, the results indicate that women are nearly twice as responsive to cigarette taxes as are men. Since the econometric specification controls for variation in the tax response by household income, it is unlikely to be responsible for the difference.

Stockwell T. A cross-cutting research agenda on alcohol, tobacco and other drugs: Where to start? (editorial). Addiction 102(8): 1191-1192, 2007. (16 refs.)

This is a commentary on the article by Cook and Reuter (this issue) which reflects on the similarities and disparities in the response to licit and illicit drugs. For demand reduction, there is considerable overlap in programs and services for prevention and even more clearly for treatment. For supply controls there is mostly divergence, reflecting the difference in legal status. Policy research is required to explore the impact of these differences. Among the questions that need to be addressed are the costs to the public from a prohibitionist policy toward illlict drugs.

Sundh M; Hagquist C. Does a minimum-age law for purchasing tobacco make any difference? Swedish experiences over eight years. European Journal of Public Health 17(2): 171-177, 2007. (18 refs.)

Background: The purpose was to study possible changes in adolescents' opportunities for purchasing tobacco during the period 1996-2005. The study also investigated regional differences in adolescents' opportunities for purchasing tobacco, and elucidated the efforts by the authorities to affect the compliance with the minimum-age law of 18. Methods: In 1996, 1999, 2002, and 2005, 3150 test purchases of tobacco were conducted in controlled forms by 48 adolescents in three regions of Sweden. In addition, in 2005, 28 structured telephone interviews were conducted with key people in tobacco prevention work. Results: In 1996, 84% of all test purchases in shops with a voluntary age-limit ended with the test purchasers succeeding in purchasing tobacco. This may be compared with 48% in 2005, 8 years after the age-limit law was introduced. The result of the test purchases and of the interviews showed differences between the three regions in compliance and in activities connected with the minimum-age tobacco law. Conclusions: The study shows that the minimum-age law for the purchase of tobacco has had an effect on adolescents' opportunities for purchasing tobacco and that compliance has improved since its introduction in 1997. The result also indicates avenues for further improving compliance with the age-limit law.

Thomson CC; Hamilton WL; Siegel MB; Biener L; Rigotti NA. Effect of local youth-access regulations on progression to established smoking among youths in Massachusetts. Tobacco Control 16(2): 119-126, 2007. (40 refs.)

Objective: To test whether community-level restrictions on youth access to tobacco (including both ordinances and enforcement) are associated with less smoking initiation or less progression to established smoking among adolescents. Design: Prospective cohort study of a random sample of adolescents in Massachusetts whose smoking status was assessed by telephone interviews at baseline and 2-year follow-up, and linked to a state-wide database of town-level youth-access ordinances and enforcement practices. Participants: A random sample of 2623 adolescents aged 12-17 years who lived in 295 towns in Massachusetts in 2001-2 and were followed in 2003-4. Main outcome measures: The relationship between the strength of local youth access restrictions (including both ordinances and level of enforcement) and (1) never-smokers' smoking initiation rates and (2) experimenters' rate of progression to established smoking was tested in a multilevel analysis that accounted for town-level clustering and adjusted for potential individual, household and town-level confounders. Results: Over 2 years, 21% of 1986 never-smokers initiated smoking and 25% of 518 experimenters became established smokers. The adjusted odds ratio (OR) for smoking initiation was 0.89 (95% CI 0.61 to 1.31) for strong versus weak youth-access policies and 0.93 (95% CI 0.67 to 1.29) for medium versus weak policies. The adjusted OR for progression to established smoking among adolescents who had experimented with smoking was 0.79 (95% CI 0.45 to 1.39) for strong versus weak local smoking restrictions and 0.85 (95% CI 0.50 to 1.45) for medium versus weak restrictions. Conclusions: This prospective cohort study found no association between community-level youth-access restrictions and adolescents' rate of smoking initiation or progression to established smoking over 2 years.

West R. Tobacco control: Present and future. British Medical Bulletin 77-78: 123-136, 2006. (47 refs.)

The history of tobacco control in the twentieth century can be summed up by the phrase 'too little, too late'. The century saw the proliferation of the most deadly form of tobacco use: cigarette smoking. Until the 1970s, no government took serious action to protect its citizens. In fact, probably the most effective global tobacco control 'strategies' to date have not been motivated by health concerns: they have been inaccessible or uneconomic markets for tobacco companies and a cultural taboo on women smoking. Economic development has led to massive increases in male cigarette smoking in developing countries but even now < 10% of women in non-Western countries such as China, Russia and India smoke. With 'westernization', this picture is changing. Without drastic action to get current smokers to stop, the annual rate of tobacco-related deaths will grow from 5 million in 2006 to 10 million in 2025. Without further action to prevent take up of smoking, the subsequent death toll will be even higher. The recently enacted World Health Organization (WHO)-initiated Framework Convention on Tobacco Control (FCTC) can mitigate this impending disaster but only if it is implemented according to the spirit and not just the letter of the articles contained therein. Specific tobacco levies in every country should be the primary means of kick-starting the process, with the proceeds being used exclusively to fund other tobacco control initiatives, including product regulation.

West R. What lessons can be learned from tobacco control for combating the growing prevalence of obesity? (review). Obesity Reviews 8(Supplement 1): 145-150, 2007. (31 refs.)

This article is part of a regular feature on "Lessons Learned". It addresses what lessons can be gained from tobacco control efforts in confronting the problem of obesity. This review focuses on finding ways of decreasing energy consumption, but similar discussions could be undertaken on interventions to increase energy expenditure (typically by being more physically active). It considers similarity and difference between smoking and over-eating. It also considers how far the public, the media and therefore Government will tolerate what may be regarded as manipulative or coercive measures to control a behaviour. An approach is outlined as well as measures designed to combat or limit the activities of those who are actively promoting the unhealthy behaviour, usually for commercial gain: the 'supply side' of the supply-demand equation. This could involve creating incentives and disincentives to suppliers, or, more commonly, restricting their advertising and marketing activities. Specific areas addressed include: 1) Providing information about how to avoid over-eating; 2) Increasing concern about the adverse effects of over-eating; 3) Providing treatment for over-eating; 4) Increasing the price of particular kinds of foods; 5) Restricting the availability of certain types of food or opportunities to eat; 6) Restricting the supply of particular kinds of foods to children; 7) Regulating the marketing of foods; 8) Reducing the social acceptability of over-eating or eating too much of particular kinds of food.

Yang TZ; Wu YW; Abdullah ASM; Dai D; Li FZ; Wu JQ et al. Attitudes and behavioral response toward key tobacco control measures from the FCTC among Chinese urban residents. BMC Public Health 7: e-article 248, 2007. (23 refs.)

Background: The Chinese National People's Congress ratified the WHO Framework Convention on Tobacco Control (FCTC) on 27 August 2005, signaling China's commitment to implement tobacco control policies and legislation consistent with the treaty. This study was designed to examine attitudes towards four WHO FCTC measures among Chinese urban residents. Methods: In a cross-sectional design study, survey data were collected from two Chinese urban cities involving a sample of 3,003 residents aged 15 years or older. Through a face-to-face interview, respondents were asked about attitudes toward four tobacco control measures developed by the WHO FCTC. Data on the four dependent measures were analyzed using multivariate logistic regression analyses. Using descriptive statistics, potential change in smoking behavior that smokers might make in response to increasing cigarette prices is also reported. Results: 81.8% of the respondents in the study sample supported banning smoking in public places, 68.8% favored increasing the cigarette tax, 85.1% supported health warnings on cigarette packages, and 85.7% favored banning tobacco advertising. The likelihood to support these measures was associated with gender, educational level, and personal income. Smokers were less likely to support these measures than non-smokers, with decreased support expressed by daily smokers compared to occasional smokers, and heavy smokers compared to light smokers. The proportion of switching to cheaper cigarette brands, decreasing smoking, and quitting smoking altogether with increased cigarette prices were 29.1%, 30.90% and 40.0% for occasional smokers, respectively; and 30.8%, 32.7% and 36.5% for daily smokers, respectively. Conclusion: Results from this study indicate strong public support in key WHO FCTC measures and that increases in cigarette price may reduce tobacco consumption among Chinese urban residents. Findings from this study have implications with respect to policymaking and legislation for tobacco control in China.

Zhong F; Yano E. British American Tobacco's tactics during China's accession to the World Trade Organization. Tobacco Control 16(2): 133-137, 2007. (68 refs.)

Background: China entered the World Trade Organization (WTO) in 2001 after years of negotiations. As a WTO member, China had to reduce tariffs on imported cigarettes and remove non-tariff barriers to allow foreign cigarettes to be more competitive in the Chinese market. Among foreign tobacco companies, British American Tobacco (BAT) was the most active lobbyist during China's WTO negotiations. Objective: To review and analyse BAT's tactics and activities relating to China's entry into the WTO. Methods: Internal tobacco industry documents were reviewed and are featured here. Industry documents were searched mainly on the website of BAT's Guildford Depository and other documents' websites. 528 documents were evaluated and 142 were determined to be relevant to China's entry into the WTO. Results: BAT was extremely active during the progress of China's entry into the WTO. The company focused its lobbying efforts on two main players in the negotiations: the European Union (EU) and the US. Because of the negative moral and health issues related to tobacco, BAT did not seek public support from officials associated with the WTO negotiations. Instead, BAT lobbyists suggested that officials protect the interests of BAT by presenting the company's needs as similar to those of all European companies. During the negotiation process, BAT officials repeatedly spoke favourably of China's accession into the WTO, with the aim of presenting BAT as a facilitator in this process and of gaining preferential treatment from their Chinese competitor. Conclusions: BAT's activities clearly suggest that tobacco companies place their own interests above public health interests. Today, China struggles with issues of tobacco control that are aggravated by the aggressive practices of transnational tobacco companies, tobacco-tariff reductions and the huge number of smokers. For the tobacco-control movement to progress in China, health advocates must understand how foreign tobacco companies have undermined anti-tobacco activities by taking advantage of trade liberalisation policies. China should attach importance to public health and comprehensive tobacco-control policies and guarantee strong protection measures from national and international tobacco interests supported by international trade agreements.