Serving Substance Abuse Professionals Since 1993

Last Update: 20.1.09

C O R K O N L I N E

powerpoint presentations
CORK database search
resource materials
bibliographies
clinical tools
user services
newsletters
about cork
home

CORK Bibliography: Laws

87 citations. January 2005 to present

Prepared: December 2008

Agrawal A; Sartor C; Pergadia ML; Huizink AC; Lynskey MT. Correlates of smoking cessation in a nationally representative sample of US adults. Addictive Behaviors 33(9): 1223-1226, 2008. (21 refs.)

>Persistent cigarette smoking is associated with significant morbidity and mortality. Correlates of difficulty quitting smoking include psychopathology, such as major depressive disorder, and problems with other substances, such as alcoholism. In addition, socio-demographic risk (e.g. poverty) and protective (e.g. living in a region with stringent tobacco laws) influences can modify risk for persistent cigarette smoking. Using data on 17,919 individuals with a lifetime history of smoking 100 or more cigarettes, from a nationally representative U.S. sample, we examine the constellation of risk and protective factors that correlate with smoking cessation (defined as remaining smoke-free in the past 12 months) across four cohorts: young (18-31 years), intermediate-aged (32-43 years), middle-aged (44-60 years) and older (61-99 years) adults. Using survival analyses, we demonstrate that in addition to a history of DSM-IV nicotine dependence, which is negatively associated with smoking cessation, living below the poverty line is also associated with persistent smoking across all age cohorts. Residents over the age of 31 years living on the U.S. West Coast are less likely to be persistent smokers as well. Major depressive disorder is associated with persistent smoking, but interestingly, only in middle-aged and older adults. Alcoholism and a family history of substance use problems are both correlated with persistent smoking but only in older adults. Here, we find evidence for psychopathology that may hinder successful quit attempts during the developmental period when a majority of quit attempts are made (early to mid-40's). However, our analyses also highlight the important benefits of effective tobacco legislation on the U.S. West Coast and urge policy makers to actively consider addressing issues surrounding tobacco taxation and the impact of poverty on tobacco use, in addition to the risks posed by co-occurring psychiatric problems and other substance use disorders.

Aldridge J; Charles V. Researching the intoxicated: Informed consent implications for alcohol and drug research. Drug and Alcohol Dependence 93(3): 191-196, 2008. (40 refs.)

This article considers the informed consent process in relation to carrying out research with intoxicated participants in 'field' research settings. There is little discussion in the literature of the potential problems that the intoxication of research participants may pose to research. Intoxication is a potential problem for all researchers but is heightened in field research that takes place in settings where participants are likely to be intoxicated, such as licensed venues, in drug consumption rooms, or police custody suites. The risks to research participants that intoxication poses should not be resolved by electing not to do research with intoxicated participants; it is argued that these risks can be managed to some extent, and are offset by the benefits of such research. Moreover, intoxication (and the impairment of cognitive functions relevant to valid informed consent) may not always be identifiable through behavioural or biochemical methods of detection. The search for accurate and field-practical methods for identifying intoxication amongst participants is useful, but not the only strategy for researchers who want to ensure the validity of the consent process. Suggestions are provided for devising research protocols that acknowledge and accept intoxication of research participants and attempt to protect them. One solution is to side-step identification of intoxication per se as a strategic objective in the consent process, and turn instead to established methods for ensuring that information has been understood by potential research participants.

Amir M. Motivation for recreational marijuana. (commentary). Substance Use & Misuse 43(3/4): 575-576, 2008. (0 refs.)

The author notes that the language of Osborne and Fogel tends to discount any legitimate concerns about drug use, by chalking it up to "moral panic." The author also raises question about the methodology, and qualitative approach, which may well limit generalizability, as well as the failure to define the context of marijuana use in Canada, and the failure to inquire about negative effects. In conclusion it is suggested one can well be for harm reduction strictly on the basis of the failure of the strict prohibitionist approach, and not be moved by the data presented.

Anker P; Imwinkelried EJ. Controlled substance analogue enforcement act criminal defense. Southwestern University Law Review 37: 267-311, 2008. (252 legal refs.)

Summary: ... The District Court judge detailed the state of the evidentiary record at trial: Each of the three experts agreed that the two substances in question contain a different "functional group": 1,4-butanediol has an alcohol major functional group while GHB has a carboxlyic acid major functional group. ... In some cases, defense experts have relied on Tanimoto Coefficient computations as a basis for arguing that the alleged analogue is dissimilar to the controlled substance in chemical structure. ... And, again, as emphasized during the discussion of the general acceptance test for admissibility, these diagrams convey very little information about the chemical structure of the molecules depicted. ii. ... Stick and letter diagrams are such incomplete depictions of substances and the comparison of such diagrams is so subjective that there is a strong case that those opinions do not pass muster under Daubert. iii. ... Suppose, for example, the prosecution relies heavily on the superficial similarity between stick and letter diagrams of features of a Controlled Substance and an alleged CSAEA analogue.

Batin MP; Lunia E; Lipman AG; Gahlinger PM; Rollins DE; Roberts JC et al. Drugs and Justice: Seeking a Consistent, Coherent, Comprehensive View. New York: Oxford University Press, 2008. (198 book refs.)

This multi-authored, collaborative interdisciplinary volume involves physicians, lawyers, pharmacologists, pharmacists, and philosophers. This volume, organized into seven chapters has several objectives. It endeavors to identify the false dichotomies in both professional and lay thinking in respect to drug use. These are apparent in how drugs are identified in terms of the law, i.e. the illicit/licit categories which may have little reference to their pharmacological effects. It also notes discrepancies within a single class of drugs, such as cocaine, depending on its route of administration. Within this discussion the book describes the origins and evolution of drug regulation, it highlights core conceptual problems, and the dilemmas in management and control. A number of case studies are provided which illustration the issues being discussed.

Baumberg B; Anderson P. Reassurance -- but not complacency -- on trade law and alcohol. A response to Osterberg. (commentary). Addiction 103(12): 1959-1960, 2008. (6 refs.)

Baumberg B; Anderson P. Trade and health: How World Trade Organization (WTO) law affects alcohol and public health. Addiction 103(12): 1952-1958, 2008. (55 refs.)

The alcohol field is becoming more aware of the consequences of world trade law for alcohol policies. However, there is a need for greater clarity about the different effects of trade on alcohol-related harm. A comprehensive review of all literature on alcohol and world trade [including World Trade Organization (WTO) disputes on alcohol], supported by a more selective review of other relevant cases, academic reports and the grey literature on trade and health. The burden of WTO law on alcohol policies depends upon the type of policy in question. Purely protectionist policies are likely to be struck down, which may lead to increases in alcohol-related harm. Partly protectionist and partly health-motivated policies are also at risk of being struck down. However, purely health-motivated policies are likely to be defended by the WTO-and to the extent that policy makers misunderstand this, they are needlessly avoiding effective ways of reducing alcohol-related harm. WTO agreements contain genuine and substantial risks to alcohol policies, and various ways of minimizing future risks are suggested. However, the 'chilling effect' of mistakenly overestimating these constraints should be avoided. Health policy makers should decide on which policies to pursue based primarily on considerations of effectiveness, ethics and politics rather than legality. As long as any effect of these policies on trade is minimized, they are overwhelmingly likely to win any challenges at the WTO.

Ben Lakhdar C. Quantitative and qualitative estimates of cross-border tobacco shopping and tobacco smuggling in France. Tobacco Control 17(1): 12-16, 2008. (15 refs.)

Objective: In France, cigarette sales have fallen sharply, especially in border areas, since the price increases of 2003 and 2004. It was proposed that these falls were not due to people quitting smoking but rather to increased cross-border sales of tobacco and/or smuggling. This paper aims to test this proposition. Methods: Three approaches have been used. First, cigarette sales data from French sources for the period 1999-2006 were collected, and a simulation of the changes seen within these sales was carried out in order to estimate what the sales situation would have looked like without the presence of foreign tobacco. Second, the statements regarding tobacco consumed reported by the French population with registered tobacco sales were compared. Finally, in order to identify the countries of origin of foreign tobacco entering France, we collected a random sample of cigarette packs from a waste collection centre. Results: According to the first method, cross-border shopping and smuggling of tobacco accounted for 8635 tonnes of tobacco in 2004, 9934 in 2005, and 9930 in 2006, ie, between 14% and 17% of total sales. The second method gave larger results: the difference between registered cigarette sales and cigarettes declared as being smoked was around 12 000 to 13 000 tonnes in 2005, equivalent to 20% of legal sales. The collection of cigarette packs at a waste collection centre showed that foreign cigarettes accounted for 18.6% of our sample in 2005 and 15.5% in 2006. France seems mainly to be a victim of cross-border purchasing of tobacco products, with the contraband market for tobacco remaining modest. Conclusion: in order to avoid cross-border purchases, an increased harmonisation of national policies on the taxation of tobacco products needs to be envisaged by the European Union.

Berman ML. Current issues in tobacco regulation, litigation, and policy. Symposium: Tobacco Litigation without the smoke? Cigarette companies in the smokeless tobacco industry. Journal of Health Care Law & Policy 11: 7-56, 2008. (27 refs.)

SUMMARY: ... The MSA broadly prohibits directly or indirectly targeting underage youth in the "advertising, promotion or marketing of Tobacco Products" (and, as discussed above, the definition of "Tobacco Products" includes smokeless tobacco). ... In the case of smokeless tobacco, narrowly-focused litigation may serve to educate the public about the harms of smokeless tobacco and the fact that the tobacco industry has made - and continues to make - deliberate choices that increase the toxicity of smokeless tobacco products. ... Reynolds and Philip Morris have not made any explicit harm reduction claims on behalf of their smokeless tobacco products, USST has argued to the U.S. ... Department of Health and Human Services that "any comprehensive evidence-based tobacco control program should include a tobacco harm reduction strategy providing that cigarette smokers who do not quit and do not use medical nicotine products should be encouraged to switch completely to smokeless tobacco ... ." Of course, tobacco companies will continue to argue in court, as they have in the past, that smoking is an "adult choice" (despite the fact that most smokers became addicted to cigarettes as minors) and that the public is well-informed of the health risks of smoking (despite the companies' decades-long conspiracy to mislead the public about the dangers of smoking).

Berman M; Crane R. Tobacco Law Symposium. Mandating a tobacco-free workforce: A convergence of business and public health interests. William Mitchell Law Review 34: 1651- 1673, 2008. (105 legal refs.)

Summary: ... plus dozens of articles in local newspapers that detail the conflict between company executives determined to cut healthcare costs and "privacy advocates" (or, in some articles, "civil rights activists"). 60 Minutes has run more than one episode about the employees who left Weyco, Inc., in Okemos, Michigan, rather than submit to a nicotine test. ... However, some states' "smokers' rights" laws may have an impact on the ability of employers to implement tobacco-free workforce policies. ... The vast majority of smokers begin smoking before the age of eighteen, when they develop a nicotine addiction that keeps them smoking into adulthood. ... No one seriously disputes that obesity and other conditions that impact health, like smoking, impose significant health and productivity costs on employers.

Bjerre B; Thorsson U. Is an alcohol ignition interlock programme a useful tool for changing the alcohol and driving habits of drink-drivers? Accident Analysis and Prevention 40(1): 267-273, 2008. (15 refs.)

This study evaluates whether the completion of an alcohol ignition interlock programme (AIIP) results in lasting changes of the behaviour of drink drivers and whether such a programme is more effective than a conventional licence revocation followed by an approved doctor's assessment. In Sweden, DWI offenders can voluntarily select a 2-year AIIP in lieu of a 12-month licence revocation. The AIIP includes regular medical checkups designed to alter alcohol use habits. The study has a quasi-experimental design. Two groups of controls were used for comparisons. One with revoked licences, but with no comparable opportunity to participate in an AIIP and another with DWI offenders who had abstained from participating in the AIIP. Significantly more persons were relicensed in the AIIP group 2 and 3 years after the DWI offence. According to the AUDIT scores participants in the AIIP had lower rates of harmful alcohol consumption than compared controls I and 3 years after the DWI offence. In the post-treatment period the rate of DWI recidivism was about 60% and the rate of police-reported traffic accidents about 80% lower than during the 5-year period prior to the offence. Among controls being relicensed a similar reduction in traffic accidents, but not in DWI recidivism, was observed. In the post-treatment period sick leave, but not hospital-care utilisation, differed significantly between the groups. Conclusions: The completion of an AIIP has favourable effects compared to conventional licence revocation and would appear to be a useful tool for attaining lasting changes in the alcohol and driving habits of DWI offenders.

Blanke DD; Cork K. Tobacco Law Symposium. Exploring the limits of smoking regulation. William Mitchell Law Review 34: 1587-1593, 2008. (8 legal refs.)

Summary: ... Whether some recent proposals for smoke-free regulation have crossed this line was the subject of a thought-provoking symposium convened by the Tobacco Control Legal Consortium at William Mitchell College of Law on October 23, 2007. ... In 2007, recognizing that these new initiatives were beginning to spark debate around the world, the Tobacco Control Legal Consortium, headquartered at William Mitchell College of Law, organized a forum for leaders in tobacco control policy to exchange views on this issue in a structured format to identify the key points of consensus and disagreement. ... Symposium participants included approximately fifty nationally-recognized experts in tobacco control policy, public health lawyers, academics, and leading professionals from national public health organizations. ... "If we want to prohibit smoking in all indoor public areas, workplaces, and multi-unit housing complexes, we actually hurt our cause by passing laws that prohibit smoking in cars and outdoor areas because we look fanatical." . ... Sweanor's concern about the risk of excessive or unwise regulation is shared by Simon Chapman, a leading figure in tobacco control and Professor of Public Health at the University of Sydney, Australia, who takes up the issue of outdoor smoking policies. ... They discuss the increased healthcare and productivity costs of smoking employees; legal measures, such as insurance surcharges, that employers can take to regulate smoking; and the overall need for tobacco control advocates to work with business to support private-sector initiatives such as tobacco-free workforce policies.

Blankenship M. The Unlawful Internet Gambling Enforcement Act: A bad gambling act? You betcha! Rutgers Law Review 60(2): 485-518, 2008. (253 refs.)

Congress determined that there was a need for "new mechanisms for enforcing gambling laws on the Internet" because the old laws were inadequate to enforce gambling prohibitions or Internet regulations. Thus, Congress enacted the Unlawful Internet Gambling Enforcement Act (UIGEA). The main goal was to ultimately cut-off the money flow from the banking institutions of gamblers domiciled in the United States, which was used to pay wagers over Internet gambling Web sites. Thus, the federal government seems to be preaching the ultimate cognitive dissonance: allowing so-called "pathological gambling" within traditional state casinos, state lotteries, and horse and off-track betting parlors, while simultaneously seeking to ban Internet gambling. While the United States is trying to ban Internet gambling for a number of reasons, several European countries have taken different approaches to Internet gambling. Taxing the Internet gambling industry is a great opportunity for a significant growth in tax revenues. The tax could work by forcing Internet gambling operators to report all winnings to the U.S. government. Further, if the United States wishes to completely end online gambling, it should enter into an international pact with other governments because "unless there is some uniform policy against gambling among the different countries, there will always be gambling sites on the Internet." By focusing on the UIGEA's recent enactment and its constitutional reach across state boundaries, this Note argues that the Act itself can be viewed as impermissible because there are better solutions for combating "morally wrong" problems associated with online gambling. Part II discusses the history of gambling laws in the United States and the prohibition of financial payment of Internet wagers. Further, this Note discusses the history of the UIGEA and the federal government's argument for banning Internet gambling in Part III. Part IV discusses other countries and their regulation or nonregulation of domestic online gambling, and the recent World Trade Organization ruling against the United States, a ruling that may have broad consequences. Next, Part V examines federal and state taxation and its relationship to Internet gambling. Finally, Part VI lays out three distinct options the United States could adopt to improve current laws that purport to monitor Internet gambling. Each option could effectively combat underage Internet gambling while taking "a piece of the action."

Borders TF; Booth BM; Han X; Wright P; Leukefeld C; Falck RS et al. Longitudinal changes in methamphetamine and cocaine use in untreated rural stimulant users: Racial differences and the impact of methamphetamine legislation. Addiction 103(5): 800-808, 2008. (53 refs.)

Aims: To examine how race and methamphetamine legislation are associated with changes in cocaine and methamphetamine use among untreated rural stimulant users. Design A longitudinal study of stimulant users identified through respondent-driven sampling. Design: Rural areas of three US states. Participants Participants at baseline were current users of methamphetamine and/or cocaine. Measures Self-reports of methamphetamine, crack cocaine and powder cocaine use were assessed at 6-month intervals over a 2-year period. Generalized estimating equations were performed to account for correlations between the repeated measurements. Findings Compared to whites, African Americans were much more likely to use crack cocaine, equally likely to use powder cocaine and much less likely to use methamphetamine. Both whites and African Americans reduced their consumption of methamphetamine and both forms of cocaine over 2 years. Exposure to laws restricting the purchase of over-the-counter cold medications containing methamphetamine precursors was not associated with methamphetamine use, but associated with a slight rise in powder and crack cocaine use. Conclusions: The study yielded disconcerting as well as promising findings regarding the natural history of stimulant use in rural areas. Of some concern is that methamphetamine precursor laws were correlated with increased cocaine consumption, diminishing their net public health benefits. However, despite its insurgence in rural areas of the United States, very few African Americans have initiated methamphetamine use. Regardless of race, many stimulant users stopped using cocaine and methamphetamine without formal substance abuse treatment over 24 months.

Bosky A. Loyola University Chicago Law Journal 39(Summer): 847-907, 2008. (445 legal refs.)

Summary: ... To anti-smoking advocates, the fairest solution seems to be to require smokers to step outside when they smoke instead of forcing nonsmokers to avoid these establishments completely. ... The SFIA Provides Greater Protections for Nonsmokers than do Bans in Other States Though all the statutes prohibit smoking in bars and restaurants, the SFIA is more comprehensive than the smoking bans in other states. ... Specifically, the Illinois statute only allows four exemptions, and they are all places that the nonsmoking public generally does not enter - private residences, retail tobacco stores, private rooms in nursing homes, and 25% of hotel/motel rooms. ... Secondhand smoke has particularly harmful effects on children, who are among the most vulnerable to ETS because they have no choice as to their exposure. ... The prevailing social paradigm is that secondhand smoke is harmful and that public health interests demand smoking regulations in public places.

Bourgois P. The mystery of marijuana: Science and the US War on drugs. (commentary). Substance Use & Misuse 43(3/4): 581-583, 2008. (10 refs.)

The author notes at the outset that the legal stance toward marijuana use cannot be justified by scientific evidence. To the contrary it is necessary to to consider how central institutional power, the media, and cultural values are in defining drug policy. It is suggested that it is critical for public health researchers to develop theoretical and practical strateifes to explore this phenomenon. While marijuana is not harmless to everyone, the pharmacological properties are not the sole determinants of harm. In many instances the greatest dangers results from the legal status. Among the collateraal damage noted is the profitability of marijuana, and associated violence, the prisons terms for selling trivial amounts , and the revolving doors of the correctional system. The author suggests that the possibility that marijuana use has reduced alcohol and narcotic drug consumption needs to be considered. In closing, the author suggests that the stance on marijuana is only one example of the neagative health effects of the war on drugs -- others are noted, particularly the aversion to harm reduction efforts

Boyer EW; Wines JD. Impact of Internet pharmacy regulation on opioid analgesic availability. Journal of Studies on Alcohol and Drugs 69(5): 703-708, 2008. (19 refs.)

Objective: Access to prescription opioid analgesics has made Internet pharmacies the object of increased regulatory scrutiny, but the effectiveness of regulatory changes in curtailing availability of opioid analgesics from online sources has been not assessed. As part of an ongoing investigation into the relationship between the Internet and substance abuse, we examined the availability of prescription opioid analgesics from online pharmacies. Method: From a pharmacy watch Web site, we constructed a data set of postings entered every 3 months beginning November 1, 2005, that were related to the purchase of prescription opioid analgesics. Trained examiners assessed whether the final post described accessibility of pain medications that was increasing or decreasing. Results: We identified 45 threads related to the availability of opioid analgesics from Internet pharmacies. Of the 41 (91%) threads describing the declining availability of opioid analgesic agents from Internet pharmacies, 34 (82%) received posts on November 1, 2007. Despite the subjective nature of the research question, there was high interobserver agreement between coders (K = .845) that availability of opioid analgesics from online pharmacies had decreased. This finding was supported by a dramatic rise in the number of pageviews (an accepted measure of Web site visitor interest in a page's content) of Web pages describing decreased availability of opioid analgesics. Conclusions: These data suggest striking decreases in the availability of prescription opioid analgesic pharmaceuticals. This self-reported change in drug availability may be related to increased regulation of and law enforcement operations directed against Internet pharmacies.

Bush DM. The US Mandatory Guidelines for Federal Workplace Drug Testing Programs: Current status and future considerations. Forensic Science International 174(2-3): 111-119, 2008. (10 refs.)

The U.S. Department of Health and Human Services (HHS) drug testing standards were published in 1988 and revised in 1994, 1998, and 2004. In 2004, significant revisions defining, standardizing, and requiring specimen validity testing on Federal employee donor urine specimens were included. In a separate notice, HHS proposed to establish scientific and technical guidelines for the Federal Workplace Drug Testing Program to: (1) permit laboratory testing of hair, oral fluid, and sweat patch specimens in addition to urine specimens for marijuana, cocaine, phencyclidine, opiates (with focus on heroin), and amphetamines [including methylenedioxymethamphetamine (MDMA), methylenedioxyethamphetamine (MDEA), methylenedioxyamphetamine (MDA)]; (2) permit use of on-site point of collection test (POCT) devices to test urine and oral fluid at collection sites; (3) permit use of instrumented initial test (screening only) facilities [IITF] to quickly identify negative specimens; and (4) add training requirement for collectors, on-site testers, and MROs. This proposal was published in the Federal Register on 13 April 2004, with a 90-day public comment period. The Substance Abuse and Mental Health Services Administration, HHS, reviewed those comments and is preparing the Final Notice that will define the requirements for such testing, including: specimen collection procedures, custody and control procedures that ensure donor specimen identity and integrity, testing facility, initial and confirmatory test cutoff concentrations, analytical testing methods, result review and reporting, evaluation of alternative medical explanations for presence of drug or metabolite in the donor's specimen, and laboratory certification issues. Voluntary pilot performance testing programs for each specimen type are on-going since April 2000 to determine how to prepare PT materials for specimens other than urine to evaluate laboratories' ability to routinely achieve accuracy and precision required. Certification programs will be developed using the current urine drug testing National Laboratory Certification Program model. The addition of accurate and reliable workplace drug testing using hair, oral fluid, and sweat patch specimens will complement urine drug testing, and aid in combating industries devoted to suborning drug testing through adulteration, substitution, and dilution. For example, hair testing may detect chronic drug use for up to 90 days and be useful in pre-employment situations; oral fluid testing may detect drug use in past hours and be useful in post-accident situations; sweat patch testing may be useful in follow-up drug testing and treatment programs; onsite collection tests and instrumented initial test (screening only) facilities may be most useful for quickly identifying specimens that are negative for drugs and indicate that the specimen is valid.

Capella ML; Taylor CR; Webster C. The effect of cigarette advertising bans on consumption: A meta-analysis. Journal of Advertising 37(2): 7-18, 2008. (75 refs.)

Because previous research and reviews on the effect of cigarette advertising bans on cigarette consumption have reported mixed results, the effectiveness of cigarette advertising bans has been a point of controversy. To ascertain the efficacy of cigarette advertising bans, the current research is a quantitative integration (meta-analysis) of the entire available published cigarette advertising ban research conducted to determine what impact, if any, advertising bans have on cigarette smoking behavior. Results of the meta-analysis show that cigarette advertising bans do not have a significant effect on cigarette consumption.

Carroll A; McSherry B; Wood D; Yannoulidis S. Drug-associated psychoses and criminal responsibility. Behavioral Sciences and the Law 26(5): 633-653, 2008. (80 refs.)

At present, the law draws a distinction when assigning criminal responsibility to those who commit offences while experiencing psychotic symptoms: if the symptoms are believed to arise because of ingesting drugs (an external cause), the offender is generally convicted of the offence; if the symptoms arise from a mental illness (an internal cause), the offender may be afforded a defence of insanity. In practice, drawing such a distinction can be problematic. There are difficulties for example in determining criminal responsibility when the use of drugs is followed by the emergence of a psychotic illness process that then continues to have an independent existence even in the absence of the ongoing substance use. This article analyses legal, policy, and expert witness perspectives relating to liberal, conservative, and intermediate approaches to this problematic area of jurisprudence.

Chamberlain E; Solomon R. Zero blood alcohol concentration limits for drivers under 21: Lessons from Canada. Injury Prevention 14(2): 123-128, 2008. (63 refs.)

Graduated licensing programs (GLPs) that include zero or low blood alcohol concentration (BAC) restrictions have proven to be a popular and effective measure for improving traffic safety among young people. However, a major drawback of such programs, at least in Canada, is that the BAC restriction is lifted on completion of the GLP, which typically occurs around the age of 18 or 19. This corresponds to the legal drinking age in Canada, a time when alcohol consumption and rates of binge drinking increase. It is not surprising, then, that 18 - 20 year-old drivers are dramatically overrepresented in alcohol-related deaths and injuries. One way to address this problem is to raise the legal drinking age, as has occurred in the United States. In jurisdictions, like Canada, that are unlikely to raise the legal drinking age, other measures are necessary to separate drinking from driving among 18 - 20 year-olds. This article recommends that the zero BAC restrictions be extended beyond the completion of the GLP, until drivers reach the age of 21. The scientific evidence for such a measure is reviewed, and the growing government support for enacting such BAC limits in Canada is described.

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.

Cogswell T. 'In the power of the State': Mr Anys's project and the tobacco colonies, 1626-1628. English Historical Review 123(500): 35-64, 2008. (50 refs.)

Scholars have generally assumed that the dissolution of the Virginia Company in 1624 initiated an extended period of benign royal neglect in which Virginia were able to develop as they wished. Yet the recent discovery of detailed minutes for a Whitehall committee makes abundantly clear that Charles I and his councilors had not forgotten about the colony -- and the wealth it might bring into the Exchequer. As this article will make clear, a remarkable projector, William Anys, prompted the royal government to establish a tight monopoly in 1626-1628 both on the colonial production of tobacco and on its retail sale within England. Mounting colonial opposition and the prospect of parliamentary criticism in 1628 eventually prompted Charles to abandon the scheme, but the prospect of a windfall profit from tobacco continued to haunt him and his ministers. A full understanding of the Anys episode in turn finally renders much more comprehensible the hitherto mysterious events in 1634-5 when Charles I again established a transatlantic tobacco monopoly and when the colonists in their rage physically ejected his governor from Virginia. Consequently, the first blow against the meddling Caroline regime arguably came, not in Edinburgh in 1637, but rather in James City in 1635.

Colman GJ; Remler DK. Vertical equity consequences of very high cigarette tax increases: If the poor are the ones smoking, how could cigarette tax increases be progressive? Journal of Policy Analysis and Management 27(2): 376-400, 2008. (43 refs.)

Cigarette smoking is concentrated among low-income groups. Consequently, cigarette taxes are considered regressive. However, if poorer individuals are much more price sensitive than richer individuals, then tax increases would reduce smoking much more among the poor and their cigarette tax expenditures as a share of income would rise by much less than for the rich. Warner (2000) said this phenomenon would make cigarette tax increases progressive. We test this empirically. Among low-, middle-, and high-income groups, we estimate total price elasticities of -0.37, -0.35, and -0.20, respectively. We find that cigarette tax increases are not close to progressive, using both tax expenditure-based and traditional welfare measures. This finding is robust to cross-border purchasing, generic cigarettes, and substantial external effects. However, we find that taxes can be progressive under some behavioral economic models (Gruber & Koszegi, 2004) but that these may only apply to a small share of smokers.

Dave D. Illicit drug use among arrestees, prices and policy. Journal of Urban Economics 63(2): 694-714, 2008. (29 refs.)

Prior studies, by relying on nationally representative surveys, have overlooked the important fact that use of addictive substances is not uniformly distributed; subgroups of hardcore users account for most of the drug consumption. This study employs the Arrestee Drug Abuse Monitoring system to analyze the demand for cocaine and heroin by urban arrestees, employing objective indicators of use based on urinalysis. The data are repeated city cross sections, and panel data methodology is employed to account for endogeneity. Cocaine and heroin prices have a negative effect on the probability of use even among this group of heavy users. Results indicate that subjective, self-reported measures of participation are likely to be under-reported, which may impart bias to estimates of the price elasticity. The own-price cocaine participation elasticity is about -0.15, and the own-price heroin participation elasticity is about -0.10 for arrestees. This contemporaneous elasticity understates the full effect, and the long-run price elasticity is about twice the magnitude. The magnitude of the price response is substantially smaller relative to the estimates in the prior literature, and calculations suggest that further enforcement and interdiction-driven increases in drug prices may not be cost-effective.

de Bruijn A. No reason for optimism: The expected impact of commitments in the European Commission's Alcohol and Health Forum. (editorial). Addiction 103(10): 1588-1592, 2008. (17 refs.)

Background: Europe is the heaviest-drinking region in the world, more than 2.5 times the rest of the world's average. The Commission's conclusion: The cornerstone for the European Commission's action to decrease the alcohol-related harm of this consumption and the main emphasis for its work is the Alcohol and Health Forum, with its Task Forces on Marketing Communication and Youth-Specific Aspects of Alcohol. The Forum, which was launched in June 2007, aims to provide a common platform for all interested stakeholders. Forum members are invited to make commitments to reduce alcohol-related harm, in the form of a monitored and evaluated action plan. By 29 February 2008, 79 commitments have been provided by the members of the Forum. Appraisal of the initiative Taking into account the limited information available, the proposed commitments indicate few evidence-based approaches. A large majority of the summaries do not, or only slightly, address the relevance of their commitment and give no evidence of why their proposed action is important in reducing alcohol-related harm. Even fewer commitments mention indicators of effectiveness of the proposed actions or propose to evaluate the effectiveness of the proposed actions. Conclusion: While most economic operators in the Forum have resources to undertake actions which could be highly effective, they commit principally to educational programmes which have been found to be mainly ineffective. This, and the neglect of existing legislation, do not give reason for optimism on the impact of the proposed commitments.

Eadie D; Heim D; MacAskill S; Ross A; Hastings G; Davies J. A qualitative analysis of compliance with smoke-free legislation in community bars in Scotland: implications for public health. Addiction 103(6): 1019-1026, 2008. (25 refs.)

Aim To explore compliance with the smoke-free legislation within a cross-section of community bars in Scotland. Design Ethnographic case study combining unobtrusive observation and in-depth interviews conducted pre- and post-introduction. Setting: Eight Scottish community bars in three contrasting study communities. Participants: Ten bar proprietors, 16 bar workers and 44 customers. Measurements: Observations and participant reports of compliance over the first 12 months of the smoking ban. Findings All eight study bars endeavoured to enforce the ban, but with varying enthusiasm. Compliance varied, with violations more prevalent in those bars serving deprived communities. Most violations occurred in peripheral areas and generally went unchallenged. Six bars reported some form of complicit behaviour with staff and customers smoking together, either in the entrance area or during 'lock-ins' when access to the bar was restricted to regular customers. Three factors were particularly important to explaining variance between bars: smoking norms, management competency and management attitudes towards the ban. The first and last were related to social disadvantage. Conclusions: Official data provide only a crude assessment of compliance in licensed premises. Data from this study offer a detailed picture of the nature and levels of compliance, and suggest a need for more sophisticated surveillance methods, greater enforcement and use of prosecutions where merited, and targeted support for bars serving deprived communities to help ensure that the major gains already achieved are retained and built upon. It is also suggested that acceptance of the smoke-free legislation could be enhanced by complementary initiatives targeting support to smokers in deprived communities. Those planning to introduce smoke-free legislation need to set in place these measures in advance in order to realize the benefits of full compliance.

Echeburua E; Fernandez-Montalvo JHyland A; Higbee C; Hassan L; Fong GT; Borland R; Cummings KM et al. Does smoke-free Ireland have more smoking inside the home and less in pubs than the United Kingdom? Findings from the international tobacco control policy evaluation project. European Journal of Public Health 18(1): 63-65, 2008. (11 refs.)

Background: In March 2004, Ireland implemented comprehensive smoke-free regulations. Some were concerned this would cause pub patrons to move their smoking and drinking from inside pubs to inside homes. This article aims to assess whether nationwide smoke-free policies are associated with more smoking or drinking inside the home. Methods: Participants were 1917 adult smokers (> 18-years old) from Ireland (n = 582), Scotland (n = 507) and the rest of the United Kingdom (n = 828), which did not have smoke-free laws at the time of the interview, who completed a random digit-dialed telephone survey in February to March 2006. The percentage of alcoholic drinks consumed in the home versus pubs was compared by country as well as the percentage of daily cigarette consumption occurring in the home after work. Results: Irish respondents reported a significantly lower percentage of alcoholic drinks consumed in the home compared to Scotland and the rest of the United Kingdom, and cigarette consumption in the home was comparable in all three regions. Conclusions: Smoking and drinking in the home was not greater in smoke-free Ireland than in the United Kingdom, where there was not a smoke-free law at the time of the survey. These findings add further support to the enactment of comprehensive smoke-free laws, as called for in the Framework Convention on Tobacco Control.

Edwards R; Thomson G; Wilson N; Waa A; Bullen C; O'Dea D; Gifford H; Glover M; Laugesen M; Woodward A. After the smoke has cleared: Evaluation of the impact of a new national smoke-free law in New Zealand. Tobacco Control 17(1): e-article 2, 2008. (37 refs.)

Background: The New Zealand 2003 Smoke-free Environments Amendment Act (SEAA) extended existing restrictions on smoking in office and retail workplaces by introducing smoking bans in bars, casinos, members' clubs, restaurants and nearly all other workplaces from 10 December 2004. Objective: To evaluate the implementation and outcomes of aspects of the SEAA relating to smoke-free indoor workplaces and public places, excluding schools and early learning centres. Methods: Data were gathered on public and stakeholder attitudes and support for smoke-free policies; dissemination of information, enforcement activities and compliance; exposure to secondhand smoke (SHS) in the workplace; changes in health outcomes linked to SHS exposure; exposure to SHS in homes; smoking prevalence and smoking related behaviours; and economic impacts. Results: Surveys suggested growing majority support for the SEAA and its underlying principles among the public and bar managers. There was evidence of high compliance in bars and pubs, where most enforcement problems were expected. Self reported data suggested that SHS exposure in the workplace, the primary objective of the SEAA, decreased significantly from around 20% in 2003, to 8% in 2006. Air quality improved greatly in hospitality venues. Reported SHS exposure in homes also reduced significantly. There was no clear evidence of a short term effect on health or on adult smoking prevalence, although calls to the smoking cessation quitline increased despite reduced expenditure on smoking cessation advertising. Available data suggested a broadly neutral economic impact, including in the tourist and hospitality sectors. Conclusion: The effects of the legislation change were favourable from a public health perspective. Areas for further investigation and possible regulation were identified such as SHS related pollution in semi-enclosed outdoor areas. The study adds to a growing body of literature documenting the positive impact of comprehensive smoke-free legislation. The scientific and public health case for introducing comprehensive smoke-free legislation that covers all indoor public places and workplaces is now overwhelming, and should be a public health priority for legislators across the world as part of the globalisation of effective public health policy to control the tobacco epidemic.

Ehrlich JB. Breaking the law by giving birth: The war on drugs, the war on reproductive rights, and the war on women. New York University Review of Law & Social Change 32: 381-420, 2008. (310 legal refs.)

Summary... Prosecuting women who become mothers while simultaneously experiencing a drug addiction or engaging in drug use is not necessary to further the government's interest in promoting healthy fetuses and children. ... But, as this article will show, prosecuting as child abusers or even murderers the thousands of American women who carry pregnancies to term despite their drug addictions not only fails to further the states' goal of protecting fetal health, but also violates the constitutional rights of pregnant women. ... This article also argues that either intermediate or strict scrutiny - not the rational basis scrutiny the Supreme Court has often applied to distinctions based on pregnancy outside the employment context - is the proper lens through which to measure the equal protection violations at issue in the prosecutions of pregnant women for drug use. ... Finally, the claim that these prosecutions protect fetal health and encourage healthy births is betrayed by the fact that such prosecutions incentivize abortion by pressuring women to face a sort of Sophie's choice that weighs an unwanted abortion against a severe prison sentence and the relegation of a child to foster care. ... Geduldig, the Court indicated in Satty, should only apply when a state's conferral of benefits is at issue; when alleged pregnancy discrimination is based on a burden borne by only one sex, Geduldig does not apply and pregnancy discrimination may be sex discrimination. ... Applying Intermediate Scrutiny Since it is established that these prosecutions are gender discriminatory, intermediate scrutiny as interpreted under VMI - the standard applied to sex-discrimination claims - should apply. ... Women have been prosecuted due to their use of a range of drugs, but most used crack cocaine, which is often "associated with inner-city Blacks."

Elliott R. Adrift from the moorings of good public policy: Ignoring evidence and human rights. International Journal of Drug Policy 19(3): 229-230, 2008. (11 refs.)

Elovich R; Drucker E. On drug treatment and social control: Russion narcology 's great leap backward. (editorial). Harm Reduction Journal 5(1): e-article 23, 2008. (9 refs.)

The medical discipline of narcology in Russia is a subspecialty of psychiatry from the Soviet era and it is given warrant to define the scope of health activities with regard to alcohol and other drug use, drug users, and related problems. Narcological practice is in turn constrained by the State. The emergence of widespread injection opiate use and associated HIV morbidities and mortalities during the first decade following the collapse of the Soviet Union has brought the contradictions in Russian narcological discourse into high relief. Narcology officials in the Russian Federation have consistently opposed substitution treatment for opiate dependence � the replacement of a short-acting illegal substance with a longer acting prescribed drug with similar pharmacological action but lower degree of risk. Thus, despite the addition of methadone and buprenorphine to WHO's list of essential medicines in 2005 and multiple position papers by international experts calling for substitution treatment as a critical element in the response to HIV (IOM, 2006; UNODC, UNAIDS, and WHO, 2005), methadone or buprenorphine remain prohibited by law in Russia. The authors detail Russian opposition to the prescription of methadone and buprenorphine, describing four phenomena: (1) the dominance of law enforcement and drug control policy over public health and medical ethics; (2) the conflation of Soviet era alcoholism treatment with treatment for opiate dependence; (3) the near universal representation of detoxification from drugs as treatment for dependence; and (4) a framework for judging treatment efficacy that is restricted to "cure" versus "failure to cure," and does not admit its poor outcomes or recognize alternative frameworks for gauging treatment of opiate dependence. In keeping with this position, Russian narcology officials have taken an implacable ideological stance toward illicit drug use, the people who use drugs, and their treatment. By adopting policies and practices totally unsupported by scientific evidence and inquiry, officials in Russia have rendered narcology ( and medical practice) insensitive to the alarming rates and continued spread of HIV, with its dire morbidity and mortality rates in the Russian Federation, turning their backs on all the other health problems posed by opiate use and dependence itself

Evans E; Li LB; Hser YI. Treatment entry barriers among California's Proposition 36 offenders. Journal of Substance Abuse Treatment 35(4): 410-418, 2008. (35 refs.)

To explore why some Proposition 36 offenders do not enter drug treatment, we analyzed self-reported and administrative data to compare the characteristics, perceptions, and rearrest rates of 124 untreated and 1,335 treated offenders assessed by 30 sites in five California counties. Offenders were comparable in many domains at assessment; however, untreated offenders were younger, not employed, more criminally severe, and less motivated for treatment. To avoid incarceration was the primary reason for choosing Proposition 36, but there were fewer untreated offenders who felt ready for treatment (12.9% vs. 35.7%) and there were more who accepted the Proposition 36 program only upon recommendation by others (37.9% vs. 11.7%). Reasons for not entering treatment included rearrest (31.6%), no desire for treatment (23.9%), and assignment to a program that was too far away (11.1%). Both groups had fewer total arrests after assessment, but recidivism was higher among untreated offenders. Understanding untreated Proposition 36 offenders can aid efforts to improve treatment entry rates and related outcomes.

Feige C; Miron JA. The opium wars, opium legalization and opium consumption in China. Applied Economics Letters 15(12): 911-913, 2008. (7 refs.)

The effect of drug prohibition on drug consumption is a critical issue in debates over drug policy. One episode that provides information on the consumption-reducing efffect of drug prohibition is the Chinese legalization of opium in 1858. In this paper we examine the impact of China's opium legalization on the quantity and price of British opium exports from India to China during the nineteenth century. We find little evidence that legalization increased exports or decreased price. Thus, the evidence suggests China's opium prohibition had a minimal impact on opium consumption.

Fleck RK; Hanssen FA. Why understanding smoking bans is important for estimating their effects: California's restaurant smoking bans and restaurant sales. Economic Inquiry 46(1): 60-76, 2008. (25 refs.)

A large literature has sought to determine whether smoking bans help or hinder restaurants. Much of the literature improperly specifies its econometric equations and thus mistakenly infers causality. Examining the relationship between restaurant smoking bans and restaurant revenues in 267 California communities, we reach two main conclusions. First, California's municipal restaurant smoking bans are endogenous in a critical way-restaurant sales growth (or something correlated with restaurant sales growth) appears to cause restaurant bans, not vice versa. Consequently, failure to control properly for trends can produce spurious "evidence" of causation. Second, ban heterogeneity (e.g., state versus local) can be exploited to sort out-or rule out-causal effects. In other words, pooling data and treating smoking bans implemented at different levels as homogenous (as many studies do) ignores an important source of information and is likely to lead to erroneous conclusions. Our analysis holds lessons for the many studies that have examined the arguably more important question of how smoking bans affect smoking rates.

Fowkes FJI; Stewart MCW; Fowkes FGR; Amos A; Price JF. Scottish smoke-free legislation and trends in smoking cessation. Addiction 103(11): 1888-1895, 2008. (27 refs.)

Aim: To investigate trends in smoking cessation before and after the introduction of Scottish smoke-free legislation and to assess the perceived influence of the legislation on giving up smoking and perceptions of the legislation in smokers. Design, setting and participants Longitudinal data on smoking cessation were obtained from 1998 to 2007 on a cohort of 3350 Scottish adults aged between 50 and 75 years at baseline. All members of the cohort were participating in a clinical trial of aspirin in people at moderately increased risk of cardiovascular events. A subgroup of 474 participants who had smoked in the year prior to the introduction of legislation in March 2006 also completed a questionnaire on the influence and perceptions of the smoke-free legislation following its introduction. Measurements Smoking status was recorded yearly, including dates of quitting and restarting. Participants who gave up smoking for at least 3 months were recorded as having quit smoking. The questionnaire included scales on whether the smoke-free legislation had helped/influenced cessation, made the individual think about/prompt them to quit and perceptions of the legislation. Findings The odds of smokers quitting annually increased throughout the 7-year period prior to introduction of the smoke-free legislation to 2 years afterwards (odds ratio 1.09, 95% confidence interval 1.05-1.12, P < 0.001). During 2006, the pattern of quarterly quitting rates changed, with an increase in quit rates (to 5.1%) in the 3-month period prior to introduction of the legislation (January-March 2006). Socio-economic status was not related to smoking cessation. In the subgroup completing the questionnaire (n = 474), 57 quit smoking between June 2005 and May 2007 and 43.9% of these said that the smoke-free legislation had helped them to quit. Most (>70%) smokers were positive about the legislation, especially those from more affluent compared with more deprived communities (P = 0.01). Conclusions: The Scottish smoke-free legislation was associated with an increase in the rate of smoking cessation in the 3-month period immediately prior to its introduction. Overall quit rates in the year the legislation was introduced and the subsequent year were consistent with a gradual increase in quit rates prior to introduction of the legislation. Socio-economic status was not related to smoking cessation, but individuals from more affluent communities were more positive about the legislation.

Frances A; Sreenivasan S; Weinberger LE. Defining mental disorder when it really counts: DSM-IV-TR and SVP/SDP Statutes. (review). Journal of the American Academy of Psychiatry and the Law 36(3): 375-384, 2008. (12 refs.)

Civil commitment under the sexually violent predator (SVP) statutes requires the presence of a statutorily defined diagnosed mental disorder linked to sexual offending. As a consequence of broad statutory definitions and ambiguously written court decisions, a bright line separating an SVP mental disorder from ordinary criminal behavior is difficult to draw. Some forensic evaluators reject whole categories of DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders: Text Revision) diagnoses as qualifying disorders (e.g., personality and substance abuse disorders), while others debate whether recurrent rape constitutes a paraphilic disorder. We argue that the ramifications of the SVP process, in representing both the balancing of public safety and the protection of an individual's right to liberty, demand that decisions about what is a legally defined mental disorder not be made in an arbitrary and idiosyncratic manner. Greater clarity and standardization must come from both sides: the legalists who interpret the law and the clinicians who apply and work under it.

Gorini G; Moshammer H; Sbrogio L; Gasparrini A; Nebot M; Neuberger M et al. Italy and Austria before and after study: Second-hand smoke exposure in hospitality premises before and after 2 years from the introduction of the Italian smoking ban. Indoor Air 18(4): 328-334, 2008. (35 refs.)

The aim of this paper was to compare nicotine concentration in 28 hospitality premises (HPs) in Florence and Belluno, Italy, where a smoking ban was introduced in 2005, and in 19 HPs in Vienna, Austria, where no anti-smoking law entered into force up to now. Airborne nicotine concentrations were measured in the same HPs in winter 2002 or 2004 (pre-ban measurements) and winter 2007 (post-ban measurements). In Florence and Belluno, medians decreased significantly (P < 0.001) from 8.86 [interquartile range (IQR): 2.41-45.07)] before the ban to 0.01 mu g/m(3) (IQR: 0.01-0.41) afterwards. In Austria (no smoking ban) the medians collected in winters 2004 and 2007 were, respectively, 11.00 (IQR: 2.53-30.38) and 15.76 mu g/m(3) (IQR: 2.22-31.93), with no significant differences. Measurements collected in winter 2007 in 28 HPs located in Naples, Turin, Milan (0.01 mu g/m(3); IQR: 0.01-0.16) confirmed post-ban results in Florence and Belluno. The medians of nicotine concentrations in Italy and Austria before the Italian ban translates, using the risk model of Repace and Lowery, into a lifetime excess lung cancer mortality risk for hospitality workers of 11.81 and 14.67 per 10,000, respectively. Lifetime excess lung cancer mortality risks for bar and disco-pub workers were 10-20 times higher than that calculated for restaurant workers, both in Italy and Austria. In winter 2007, it dropped to 0.01 per 10,000 in Italy, whereas in Austria it remained at the same levels. The drop of second-hand smoke exposure indicates a substantial improvement in air quality in Italian HPs even after 2 years from the ban.

Griffin OH; Miller BL; Khey DN. Legally high? Legal considerations of Salvia divinorum. Journal of Psychoactive Drugs 40(2): 183-191, 2008. (43 refs.)

The legal status of the hallucinogenic plant Salvia divinorum has been rapidly changing. Legal prohibitions on this plant native to Oaxaca, Mexico have emerged at the state level, a phenomenon that has not occurred since the passage of the Controlled Substances Act (CSA). Included will be a brief description of the plant that has only recently crept into the popular American consciousness, and a review of the different legal mechanisms through which states have controlled the plant and the pending legislation proposing controls. Lastly, the implications of various state laws are discussed.

Haden M. Controlling illegal stimulants: A regulated market model. (commentary). Harm Reduction Journal 5(1): doi:10.1186/1477-7517-5-1, 2008. (91 refs.)

Prohibition of illegal drugs is a failed social policy and new models of regulation of these substances are needed. This paper explores a proposal for a post-prohibition, public health based model for the regulation of the most problematic drugs, the smokable and injectable stimulants. The literature on stimulant maintenance is explored. Seven foundational principles are suggested that could support this regulatory model of drug control that would reduce both health and social problems related to illegal stimulants. These are as follows: Principle 1, the goal is to reduce harm. Principle 2, social capital needs to be increased. Principle 3, the culture of drug use needs to be understtod and influenced. Principle 4, the goal is to use the least restrictive intervention. Principle 5, prevention and treatment are vital. Principle 6, learn the lessons from alcohol and tobacco control. Prinicple 7, changes need to occur incrementally. Some details of this model are examined and the paper concludes that drug policies need to be subject to research and based on evidence.

Hall W; West R. Thinking about the unthinkable: A de facto prohibition on smoked tobacco products. (editorial). Addiction 103(6): 873-874, 2008. (7 refs.)

Heim J; de Andrade AG. Effects of alcohol and illegal drugs on at-risk adolescents' behavior: A review of the scientific publications between 1997 and 2007. (review) [Portuguese]. Revista de Psiquiatria Clinica 35(Supplement 1): 61-64, 2008. (22 refs.)

Background: International research indicates that there is a strong association between substance abuse and juvenile delinquency and the risk factors related to law infraction. In Brazil however, few studies have been carried out to investigate such relationships. Objectives: The aim of this study was to conduct a review of the research that focuses on the topics of alcohol, drugs, and delinquency; verifying the relationship between psychoactive drug abuse and juvenile delinquency. Methods: A review of scientific papers published from 1997 to 2007 selected on the basis of the keywords: adolescence, alcohol, illegal drugs, and delinquency. Conclusions: Studies indicate that the use of alcohol and illegal drugs among at-risk adolescents is high, and starts early when compared with non-risk adolescents; suggesting that the substance abuse is an important part of the at-risk delinquency problems.

Herring R; Thom B; Foster J; Franey C; Salazar C. Local responses to the alcohol licensing act 2003: The case of Greater London. Drugs: Education, Prevention and Policy 15(3): 251-265, 2008. (25 refs.)

This paper describes a preliminary study of local implementation of the Licensing Act 2003 in Greater London. The study investigated variability in local polices, perceptions of the opportunities afforded by the changes in the licensing system and perceptions of barriers and problems arising in the initial implementation process during 2005. The research was conducted in two stages: an analysis of the licensing policies of the 33 London boroughs and open discussion, in-depth interviews conducted in five London boroughs with licensing officers and chairs of licensing committees (elected councillors). From the policy analysis and interviews it was evident that licensing authorities varied in their level of engagement in licensing matters. Although there were reservations, the majority of respondents welcomed the changes in the administration and procedures, in particular the opportunity to have more control of licensing in their locality. Overall respondents did not report major problems or difficulties arising from the new arrangements and the extension of hours. However, it was recognized that it was still too early in the process to draw firm conclusions.

Hetland J; Hetland H; Mykletun RJ; Aaro LE; Matthiesen SB. Employees' job satisfaction after the introduction of a total smoke-ban in bars and restaurants in Norway. Health Promotion International 23(4): 302-310, 2008. (19 refs.)

The aim of the study was to investigate possible effects of a total smoke-ban in Norwegian bars and restaurants (introduced on June 1st 2004) on employees' job satisfaction. A national representative sample was randomly selected from the public registry of all companies in the hospitality business. A baseline survey was conducted in May 2004, follow-up measurements were performed in September/October 2004 and May 2005. Altogether, 1525 employees agreed to participate in the baseline survey. Among respondents at baseline, 894 (59.4%) remained in the sample at the first follow-up and 758 (49.7%) at the second follow-up. Analysis of variance for repeated measures revealed a significant three-way interaction between personal smoking behaviour, attitudes towards the ban before it was enacted and time from baseline to the second follow-up. A small decline in job satisfaction was found between baseline and the first follow-up among employees who were daily smokers and had a negative attitude towards the ban. There was, however, an increase in job satisfaction between the first and second follow-up among the others (non-smokers and smokers with a positive attitude towards the ban). While job satisfaction was higher among smokers with negative attitudes towards the ban than among other employees before the ban entered into force, the opposite was the case one year later. The work environments in bars and restaurants seem to have changed towards being more satisfactory for non-smokers and smokers with positive attitudes towards the ban before it was enacted. In contrast, a small but persisting worsening of job satisfaction was found among employees that were daily smokers and had a negative attitude towards the ban.

Johnson BD; Golub A; Dunlap E; Sifaneck SJ. An analysis of alternatives to New York City's current marijuana arrest and detention policy. Policing 31(2): 226-250, 2008. (67 refs.)

Purpose - During the 1990s, the New York City Police Department (NYPD) instituted a policy of arresting and detaining people for minor offenses that occur in public as part of their quality-of-life (QOL) policing initiative. The purpose of this paper is to examine the pros and cons of the current policy and compare it with possible alternatives including: arrest and issuing of a desk appearance ticket (DAT); issuing of a non-criminal citation (violation); street warnings; and toleration of public marijuana smoking. Design/methodology/approach - The paper reviews several studies of QOL policing and examines the pros and cons of the current NYPD policy, compared to possible alternatives. Findings - The number of NYPD arrests for marijuana in public view (MPV) (with most detained for one or two days) increased from 3,000 in 1994 to over 50,000 in 2000, and have been about 30,000 in the mid-2000s. Most of these arrestees (84 percent) were minority; Blacks were 2.7 more likely and Hispanics 1.8 times more likely to be detained than Whites for an MPV arrest. Minorities received more severe dispositions, even controlling for demographics and prior arrest histories. Originality/value - The paper recommends that the NYPD change to routinely issuing DATs to reduce detention for marijuana violators. Drug policy reformers might wish to further pursue changing statutes regarding smoking MPV into a violation (non-criminal) or encourage the wider use of street warnings, as in Britain. Any of these policy changes would help reduce the number detained and the disproportionate burden on minorities associated with the current arrest and detention policy. These policies could help maintain civic norms against smoking marijuana in public.

Jones AW; Holmgren A; Kugelberg FC. Driving under the influence of cannabis: a 10-year study of age and gender differences in the concentrations of tetrahydrocannabinol in blood. Addiction 103(3): 452-461, 2008. (57 refs.)

Background: Delta(9)-Tetrahydrocannabinol (THC) is the major psychoactive constituent of cannabis and its various preparations. Increasing use of cannabis for recreational purposes has created a problem for road-traffic safety. This paper compares age, gender and the concentrations of THC in blood of individuals apprehended for driving under the influence of drugs (DUID) in Sweden, where a zero-tolerance law operates. Measurements Specimens of blood or urine were subjected to a broad screening analysis by enzyme immunoassay methods. THC positives were verified by analysis of blood by gas chromatography-mass spectrometry (GC-MS) with a deuterium-labelled internal standard (d(3)-THC). All toxicology results were entered into a database (TOXBASE) along with the age and gender of apprehended drivers. Findings: Over a 10-year period (1995-2004), between 18% and 30% of all DUID suspects had measurable amounts of THC in their blood (> 0.3 ng/ml) either alone or together with other drugs. The mean age [+/- standard deviation (SD)] of cannabis users was 33 +/- 9.4 years (range 15-66 years), with a strong predominance of men (94%, P < 0.001). The frequency distribution of THC concentrations (n = 8794) was skewed markedly to the right with mean, median and highest values of 2.1 ng/ml, 1.0 ng/ml and 67 ng/ml, respectively. The THC concentration was less than 1.0 ng/ml in 43% of cases and below 2.0 ng/ml in 61% of cases. The age of offenders was not correlated with the concentration of THC in blood (r = -0.027, P > 0.05). THC concentrations in blood were higher when this was the only psychoactive substance present (n = 1276); mean 3.6 ng/ml, median 2.0 ng/ml compared with multi-drug users; mean 1.8 ng/ml, median 1.0 ng/ml (P < 0.001). In cases with THC as the only drug present the concentration was less than 1.0 ng/ml in 26% and below 2.0 ng/ml in 41% of cases. The high prevalence of men, the average age and the concentrations of THC in blood were similar in users of illicit drugs (non-traffic cases). Conclusions: The concentration of THC in blood at the time of driving is probably a great deal higher than at the time of sampling (30-90 minutes later). The notion of enacting science-based concentration limits of THC in blood (e.g. 3-5 ng/ml), as discussed in some quarters, would result in many individuals evading prosecution. Zero-tolerance or limit of quantitation laws are a much more pragmatic way to enforce DUID legislation.

Jones AW; Holmgren A; Kugelberg FC. Driving under the influence of central stimulant amines: Age and gender differences in concentrations of amphetamine, methamphetamine, and ecstasy in blood. Journal of Studies on Alcohol and Drugs 69(2): 202-208, 2008. (34 refs.)

Objective: A zero-tolerance law for driving under the influence of drugs (DUID) was introduced in Sweden in 1999. This change in legislation has led to a 12-fold increase in the number of blood samples sent by the police for toxicological analysis. Here we report the age and gender of offenders, along with the concentrations of amphetamine, methamphetamine, and ecstasy (3,4-methylenedioxymethamphetamine) in blood samples analyzed since the institution of the new legislation. Method: A forensic toxicology database (TOXBASE) was used to identify cases of DUID in which central stimulant amines were verified in blood during a 5-year period (2000-2004). Results: Amphetamine was present in 15,898 of 26,556 cases of DUID (60%) either alone or together with other licit or illicit drugs. In 6,094 cases, amphetamine was the only psychoactive substance in blood at mean (median) and highest concentrations of 1.01 mg/L (0.80 mg/L) and 11.9 mg/L, respectively. The users of amphetamine were mainly men (85% vs 15% women; p < .001), and men tended to be a few years older than the women; the mean (SD) age for men was 37 (9.2) years and for women it was 35 (8.1) years (p < .001). In 644 cases, amphetamine and methamphetamine were present in blood samples at mean (median) concentrations of 0.85 mg/L (0.60 mg/L) and 0.34 mg/L (0.20 mg/L), respectively (p < .001). The mean (median) and highest concentrations of ecstasy in 493 DUID offenders were 0.23 mg/L (0.10 mg/L) and 3.5 mg/L, respectively The mean age of ecstasy users was 26 (7.2) years, which was about 10 years younger than those using amphetamine (p <001). Conclusions: The high prevalence of amphetamines in blood of apprehended drivers in Sweden verifies widespread use of these stimulants as recreational drugs. The findings from this study suggest that a zero-tolerance DUID law has not deterred offenders, which suggests that more attention should be given to the underlying substance-abuse problem instead of conventional penalties such as monetary fines and/or imprisonment.

Kalant H. Smoked marijuana as medicine: Not much future. (editorial). Clinical Pharmacology and Therapeutics 83(4): 517-519, 2008. (19 refs.)

LaCroix T. Student drug testing: The blinding appeal of in loco parentis and the importance of state protection of student privacy. (notes and comment). Brigham Young University Education and Law Journal 8: 251+, 2008. (155 refs.)

SUMMARY: ... This means the adults in their lives have two choices: (1) return fire by never letting their children out of sight, constantly searching personal belongings for drugs, and even forcing their own children to submit to random drug tests, or (2) dismantle these intrusive weapons in enlightened recognition that a futile drug war with their own children merely destroys any possibility of developing a relationship of trust and respect. ... Acton (1995) In the late 1980s, students in the small logging town of Vernonia, Oregon, like many teenagers across the country, became noticeably attracted to the "drug culture" and student drug use was on the rise. ... The Court went on to find that the other part of the intrusion - the government's scientific examination of a citizen's bodily fluids - is not significant because the urine is tested only for drugs and the results given only to a few people. ... The unique needs of schools in dispensing discipline, and the unique role of school personnel as quasi-parents, do not in any way erase the fact that school personnel are state actors, or that students are American citizens. ... The foundation of the majority's holding is that extracurricular activities are voluntary, and thus participation in them is detached from compulsory attendance laws, and therefore the students themselves, and not the government, subject those who participate in extracurricular activities to drug testing. ... In many schools, teachers only get together to discuss student achievement data." ... Rejecting the notion in Earls that students' privacy rights implicated by the tests are trivial, the Pennsylvania court found it critical that the school district had offered no reason to believe a drug problem actually existed in its schools.

Lamberg ME; Kangasperko R; Partinen R; Lillsunde P; Mukala K; Haavanlammi K. The Finnish legislation on workplace drug testing. Forensic Science International 174(2-3): 95-98, 2008. (2 refs.)

In Finland, the Act on the Protection of Privacy in Working Life (759/2004) that entered into force in 2004 incorporates provisions related to drug use testing, e.g. on the employers' right to process in certain situations information on job applicants' and employees' drug use. In the same context, provisions were added to the Occupational Health Care Act (1383/2001) on the employer's obligation to draw up, together with the staff, a written programme dealing with alcohol and drugs for the workplace. The programme defines the overall objectives for and the practices to be observed at the workplace in order to prevent substance abuse and to refer the problem users to treatment. The Occupational Health Care Act also includes provisions on drug tests and the drug test certificate as well as on reimbursement of the expenses of drug tests. Furthermore, the Act lays down a definition of drug tests. Every workplace shall have a plan/programme on drug-free workplace, where the jobs in which the workers have to present a drug test certificate to the employer must be defined. This plan/programme shall be discussed in cooperation on tripartite basis at the workplace. A Government decree on drug use testing (218/2005) has been issued in virtue of the Occupational Health Care Act. It lays down provisions on the practical performance of drug tests, i.e. taking and analysis of samples, and interpretation of the test results. The purpose of the Government decree is to ensure that workplace drug testing is carried out in a way presupposed by a good occupational health care practice and the laboratory quality standards, taking into account the integrity and protection of privacy of the persons tested as well as their other fundamental rights.

Lawn S. Tobacco control policies, social inequality and mental health populations: Time for a comprehensive treatment response. (editorial). Australian and New Zealand Journal of Psychiatry 42(5): 353-356, 2008. (32 refs.)

Lee DJ; Dietz NA; Arheart KL; Wilkinson JD; Clark JD; Caban-Martinez AJ. Respiratory effects of secondhand smoke exposure among young adults residing in a "Clean" indoor air state. Journal of Community Health 33(3): 117-125, 2008. (56 refs.)

The objective of this study is to estimate the prevalence of self-reported secondhand smoke (SHS) exposures and its association with respiratory symptoms in a sample of young adults residing in a state with a partial clean indoor air law. A cross-sectional telephone survey of Florida households and a single state University was conducted in 2005. Enrolled participants between 18 and 24 years of age completed a 15-20 min interview assessing past and current SHS exposure and current respiratory symptoms (n = 1858). Approximately 60% of the sample were female; nearly 70% were non-Hispanic white, 10% were non-Hispanic Black, and 11% were Hispanic. Over two-thirds reported completing at least some college; 23% reported smoking in the past month. Nearly two-thirds (64%) reported visiting a bar or nightclub which exposed them to SHS in the previous month; nearly half (46%) reported SHS exposure while riding in automobiles; 15% reported occupational SHS exposure; and nearly 9% reported living with at least one smoker. In multivariable models, personal smoking behavior, parental smoking history, and exposure to SHS in automobiles and in bars or nightclubs were significantly associated with increased reports of respiratory symptoms. Despite residing in a "clean" indoor air state, the majority of surveyed young adults continue to report exposure to SHS, especially in automobiles and in bars, and these exposures adversely impact respiratory health. All municipalities should pursue clean indoor air legislation which does not exempt bars and restaurants. Educational campaigns directed at reducing SHS exposure in motor vehicles also are needed.

Lee JM. Effect of a large increase in cigarette tax on cigarette consumption: An empirical analysis of cross-sectional survey data. Public Health 122(10): 1061-1067, 2008. (29 refs.)

Objectives: This study used cigarette price elasticity estimates to assess the possible effects on cigarette consumption of a large increase in cigarette tax. It also investigated different responses to the cigarette tax increase among smokers from different socio-economic backgrounds and with different smoking characteristics. Study design: Cross-sectional study on 483 valid questionnaires completed during a telephone survey of current smokers aged 15 years and above from all 23 major cities and counties in Taiwan. Methods: This study analysed the willingness of current smokers to quit smoking or reduce cigarette consumption when faced with a tax increase of NT$22 per pack, which would raise the price of cigarettes by 44%. The Tobit regression model and the maximum likelihood method were used to estimate cigarette demand elasticity. Results: Estimation results yielded a cigarette price elasticity of -0.29 in connection with a 44% increase in the price of cigarettes. This suggests that smokers will have relatively little response to such an event. The most significant response to the price increase was found among women, low-income smokers, moderately addicted smokers, and smokers who regularly purchase low-price cigarettes. A 44% increase in the price of cigarettes would reduce the average annual per capita cigarette consumption in Taiwan by 14.86 packs; a reduction of 12.87%. The tax increase would also boost the Government's cigarette tax revenue by approximately NT$41.4 billion, and increase cigarette merchants' income by approximately NT$27.4 billion. Conclusions: Since current cigarette prices are low in Taiwan and smokers are relatively insensitive to cigarette price hikes, a large increase in cigarette tax would reduce cigarette consumption effectively, and would also increase the Government's cigarette tax revenue and cigarette merchants' income. Clearly, such a tax would create a win-win outcome for the Government, cigarette merchants and smokers, and it is therefore recommended.

Lee K; Hahn EJ; Pieper N; Okoli CTC; Repace J; Troutman A. Differential impacts of smoke-free laws on indoor air quality. Journal of Environmental Health 70(8): 24-30, 2008. (25 refs.)

The authors assessed the impacts of two different smoke-free laws on indoor air quality. They compared the indoor air quality of 10 hospitality venues in Lexington and Louisville, Kentucky, before and after the smoke-free laws went into effect. Real-time measurements of particulate matter with aerodynamic diameter of 2.5 mu m or smaller (PM2.5) were made. One Lexington establishment was excluded from the analysis of results because of apparent smoking violation after the law went into effect. The average indoor PM2.5 concentrations in the nine Lexington venues decreased 91 percent, from 199 to 18 mu g/m(3). The average indoor PM2.5 concentrations in the 10 Louisville venues, however, increased slightly, from 304 to 338 mu g/m(3). PM2.5 levels in the establishments decreased as numbers of burning cigarettes decreased. While the Louisville partial smoke-free law with exemptions did not reduce indoor air pollution in the selected venues, comprehensive and properly enforced smoke-free laws can be an effective means of reducing indoor air pollution.

Levinson L. Half a gram: A thousand lives. Harm Reduction Journal 5(1): e-article 22, 2008. (1 refs.)

The article presents information on the latest drug policy change in the Russian Criminal Code: a decrease of the drug threshold amounts for which possession can lead to a criminal liability. Also, the article presents an assessment of the 2003�2004 liberal revisions in the Criminal Code, and an analysis of the background/premise for the 2006 counter-reform. The author examines the new criteria for establishing criminal liability and possible consequences of these changes for people who use illicit psycho-active substances for non-medical purposes.

Levy DT; Benjakul S; Ross H; Ritthiphakdee B. The role of tobacco control policies in reducing smoking and deaths in a middle income nation: Results from the Thailand SimSmoke simulation model. Tobacco Control 17(1): 53-59, 2008. (60 refs.)

Objectives: With the male smoking prevalence near 60% in 1991, Thailand was one of the first Asian nations to implement strict tobacco control policies. However, the success of their efforts has not been well documented. Methods: The role of tobacco control policies are examined using the "SimSmoke'' tobacco control model. We first validated the model against survey data on smoking prevalence. We then distinguished the effect of policies implemented between 1991 and 2006 from long-term trends in smoking rates. We also estimated smoking attributable deaths and lives saved as a result of the policies. Results: The model validates well against survey data. The model shows that by the year 2006, policies implemented between 1991 and 2006 had already decreased smoking prevalence by 25% compared to what it would have been in the absence of the policies. Tax increases on cigarettes and advertising bans had the largest impact, followed by media anti-smoking campaigns, clean air laws and health warnings. The model estimates that the policies saved 31 867 lives by 2006 and will have saved 319 456 lives by 2026. Conclusions: The results document the success of Thailand in reducing smoking prevalence and reducing the number of lives lost to smoking, thereby showing the potential of tobacco control policies specifically in a middle-income country. Additional improvements can be realised through higher taxes, stronger clean air policies, comprehensive cessation treatment policies, and targeted media campaigns.

Lewis M. Access to saloons, wet voter turnout, and statewide Prohibition referenda, 1907-1919. Social Science History 32(3): 373-404, 2008. (63 refs.)

When explaining the success of the Prohibition movement in the United States between 1900 and 1920, scholars argue that prohibitionists were able both to tap into the distrust of many rural, native-born, evangelical Protestants toward modern urban life and to bring together disparate groups of reformers around one goal: the elimination of the saloon. Furthermore, localized campaigns resulting in the elimination of saloons from many rural areas kept this base of voters energized, ultimately leading to impressive dry turnouts in statewide Prohibition referenda. This study extends and amplifies these findings through art analysis of three sets of factors on voting outcomes: the percentage of various demographic groups (urban, immigratn, and ritualistic religious populations) residing in a county; the distance of each county to saloons; the presence or absence of producers of alcohol in a county. Results of ordinary least-squares regression demonstrate that access to saloons and the percentage of immigrant and ritualistic church members in a. county are the variables that most influence tire results of Prohibition referenda. Furthermore, unlike what previous research has demonstrated, these variables have their greatest influence by affecting met turnout rates.

Littler A. Regulatory perspectives on the future of interactive gambling in the internal market. European Law Review 33(2): 211-229, 2008. (3 refs.)

This article seeks to provide some regulatory perspectives on the future of interactive gambling in the European Union's internal market. Long established state monopolies are pitted against private operators who seek to rely upon the free movement of services and the freedom of establishment to expand their markets. Consequently there is an increasing body of case-law from the European Court of Justice. With Member States differing in their views as to how gambling should be regulated and the ability of the internet to facilitate cross-border gambling, the question of how interactive gambling should be regulated within the context of the internal market is ever present. Following an overview of existing European case-law, specific secondary Community legislation is discussed as well as the so-called "race to the bottom" and the abuse of rights with the aim of giving some insights into the future regulation of this sector.

Lovenheim MF. How far to the border?: The extent and impact of cross-border casual cigarette smuggling. National Tax Journal 61(1): 7-33, 2008. (29 refs.)

This paper uses data on cigarette consumption in the Current Population Survey Tobacco Supplements to estimate cigarette demand models that incorporate the decision of whether to smuggle cigarettes across a lower-price border. I find demand elasticities with respect to the home state price are indistinguishable from zero on average and vary significantly with the distance individuals live to a lower-price border. However, when smuggling incentives are eradicated, the price elasticity is negative but still inelastic. I also estimate between 13 and 25 percent of consumers purchase cigarettes in border localities. The central implication of this study is cross-border smuggling confounds many of the potential health and revenue gains from cigarette taxation.

Maziak W; Al Ali R; Fouad MF; Rastam S; Wipfli H; Travers MJ et al. Exposure to secondhand smoke at home and in public places in Syria: A developing country's perspective. Inhalation Toxicology 20(1): 17-24, 2008. (26 refs.)

This study employs sensitive methods to address the issue of exposure to secondhand smoke among children and women in an understudied developing country setting ( Syria). The study combines data collected by the Syrian Center for Tobacco Studies as part of two international studies conducted in 2006: the Secondhand Smoke Exposure among Women and Children study ( Johns Hopkins) and the Global Air Monitoring Study ( Roswell Park Cancer Institute). We employed objective measures ( hair nicotine, and ambient household nicotine assessed by passive monitors) to assess children's and mothers' exposure to secondhand smoke at home, and used the TSI SidePak personal aerosol monitor to sample respirable suspended particles less than 2.5 mu m diameter ( PM2.5) in the air in public places ( 40 restaurants/ cafes in Aleppo). In homes, the mean ambient nicotine level ( +/- standard deviation, SD) was 2.24 +/- 2.77 mu g/m(3). Mean level of hair nicotine was 11.8 ng/ mg among children ( n = 54), and was higher if the mother was a smoker ( 19.4 +/- 23.6 ng/ mg) than nonsmoker ( 5.2 +/- 6.9 ng/ mg) ( p <.05). Mean hair nicotine among nonsmoking mothers ( n = 23) was 1.17 +/- 1.56 ng/ mg. Children's hair nicotine level was strongly correlated with ambient household nicotine and number of cigarettes smoked daily in the house ( r =. 54 and r =. 50, respectively, p <. 001), and also was related to having a father who smoked in the children's presence. In public places, average PM2.5 in the monitored 40 hospitality venues was 464 mu g/ m(3) and correlated with smoker density measured as cigarettes - waterpipes/ 100 m(3) ( r =.31, p = 0.049). Thus, children in Syria are exposed to high levels of secondhand smoke at home, in which mothers' smoking plays a major role. Also, levels of respirable hazardous particles are high in public hospitality venues, putting customers and workers at serious health risks. Efforts to limit exposure of children and women at home and to adopt clean air policies should become a public health priority in Syria and the Arab region.

Mcketin R. Methamphetamine precursor regulation: Are we controlling or diverting the drug problem? (editorial). Addiction 103(4): 521-523, 2008. (19 refs.)

Nykiforuk CIJ; Eyles J; Campbell HS. Smoke-free spaces over time: A policy diffusion study of bylaw development in Alberta and Ontario, Canada. Health & Social Care In the Community 16(1): 64-74, 2008. (68 refs.)

Policy diffusion is a process whereby political bodies 'learn' policy solutions to public health problems by imitating policy from similar jurisdictions. This suggests that diffusion is a critical element in the policy development process, and that its role must be recognised in any examination of policy development. Yet, to date, no systematic work on the diffusion of smoke-free spaces bylaws has been reported. We examined the diffusion of municipal smoke-free bylaws over a 30-year period in the provinces of Alberta and Ontario, Canada, to begin to address this gap and to determine whether spatial patterns could be identified to help explain the nature of policy development. Bylaw adoption and change were analysed within local, regional, and provincial contexts. Geographical models of hierarchical and expansion diffusion in conjunction with the diffusion of innovations framework conceptually guided the analyses. Study findings contribute to a broader understanding of how and why health policies diffuse across time and place. Policy development can be a powerful mechanism for creating environments that support healthy decisions; hence, an understanding of policy diffusion is critical for those interested in policy interventions aimed at improving population health in any jurisdiction.

Office of National Drug Control Policy. Who's Really in Prison for Marijuana?. Washington DC: Office of National Drug Control Policy, undated. (66 refs.)

This government document, directed to the general public, is intended to counter claims of "marijuana legalizers [who] claim that thousands of people are imprisoned for marijuana 'possession' ... whose crime was simply having in their possession a little bit of dope." Rather the document states that in reality those "technically serving time for marijuana possession were actually sent to prison on much more serious charges." In reality it is said, "The [those imprisoned] are criminals who have been found guilty of trafficking, manufacturing, selling or distributing the drug, or who were convicted of multiple offenses that happened to include a marijuana charge." The document discusses both state and federal laws and endeavors to clarify sources of misunderstandings, e.g. by clarifying distinctions between jails and prisons, or possession versus trafficking, the roll of plea bargains in distorting data. Tables are included with data on prison populations and marijuana offenders sentenced in federal courts. Several illustrative cases are included.

Osterberg E. Who's to blame? (commentary). Addiction 103(12): 1959, 2008. (6 refs.)

This commentary is in response to the article by Baumberg and Anderson, "Trade and health: How World Trade Organization (WTO) law affects alcohol and public health" who notes that while the WTO treats alcohol as if it were an ordinary commodity, this is not in fact the case.

Pickerill JM; Chent P. Medical marijuana policy and the virtues of federalism. Publius 38(1): 22-55, 2008. (38 refs.)

We analyze the policy issue of medical marijuana to illustrate how key virtues of federalism can be used to make a threshold determination as to whether a particular public policy should be subject to federal regulation or reserved for states-When the substantive merits of the policy issue are currently debated and unresolved, and that issue area has traditionally been regulated by states, we employ a three-prong test for determining as a threshold matter whether the federal government should assert preemptive jurisdiction over the policy. That test has is roots in well-established theories of federalism that comprise what we refer to as the "classic virtues of federalism." Based on our analysis, medical marijuana is a policy that should be left to the states.

Proescholdbell SK; Foley KL; Johnson J; Malek SH. Indoor air quality in prisons before and after implementation of a smoking ban law. Tobacco Control 17(2): 123-127, 2008. (24 refs.)

Objective: To ascertain whether a new indoor smoking ban law in North Carolina correctional facilities was successfully implemented and whether the indoor air quality has improved as a result. Method: Before the law came into effect, we tested the air quality of 22 dormitory and common areas within six North Carolina prisons using standard protocols for testing particulate matter. We measured particulate matter 2.5 mu m in diameter ( PM2.5) using state of the art TSI SidePak monitors. After the law went into effect, the same locations within each prison were tested again. Written inmate surveys were also conducted at two prisons, one with partial smoking ban ( indoors only) and one with a total smoking ban ( indoors and outdoors). Results: The findings indicate that, on average, levels of respirable suspended particulates ( RSPs), an accepted marker for secondhand smoke ( SHS) levels, decreased 77% in these prisons after the law took effect compared to levels obtained before ban implementation. Several areas were tobacco-free before the implementation of this ban. In those areas no significant decreases in RSPs were noted. Conclusion: Laws banning tobacco use in correctional facilities can significantly reduce indoor SHS exposure among inmates, visitors and staff and potentially lead to reduced use. To date, 24 US states have enacted 100% smoke-free correctional facility polices for all indoor areas even though inmates and staff have much higher tobacco use prevalence rates than the general population. With an estimated nine million people incarcerated worldwide, prison smoking bans could have a substantial impact in terms of health outcomes and long-term costs if they can effectively reduce exposure to secondhand smoke.

Ratschen E; McNeill A; Doody GA; Britton J. Smoking, mental health, and human rights: A UK judgment. (editorial). Lancet 371(9630): 2067-2068, 2008. (8 refs.)

Rayens MK; Hahn EJ; Langley RE; Zhang M. Public support for smoke-free laws in rural communities. American Journal of Preventive Medicine 34(6): 519-522, 2008. (18 refs.)

Background: There has been an upward trend in smoke-free laws in countries, states, and municipalities in recent years. However, these laws are more likely to be enacted in urban areas. The purpose of this study was to examine public opinion of smoke-free laws and to determine if there was a difference in support for these laws between urban and rural dwellers. Methods: A series of random-digit-dialed phone surveys was conducted in 2005-2006 with 3672 adult Kentucky residents living in rural and urban communities without smoke-free laws. In addition to demographics, respondents were asked whether they would support a local law prohibiting smoking in public places. Responses were weighted to adjust for an over-representation of women in the sample relative to the population. Logistic regression was used to test for a rural/urban difference in support; data analysis was conducted in 2007. Results: Respondents were primarily women, Caucasian, with at most a high school education, and nonsmokers; the average age was 49.3 years. About half lived in rural communities. More than half (59.6%) supported a local smoke-free law. Controlling for age, gender, ethnicity, education, and smoking status, there was a significant difference in the level of support for a smoke-free law between rural and urban respondents. Compared to urban dwellers, rural residents were more likely to support these laws (OR=1.21; 95% CI=1.03, 1.42). Conclusions: When controlling for demographic differences between groups, rural residents were more likely than those in urban settings to support a law for local smoke-free public places.

Reise ST. Comment. "Just Say NO" to pro-drug and alcohol student speech: The constitutionality of school prohibitions of student speech promoting drug and alcohol use. Emory Law Journal 57: 1259-1299, 2008. (361 refs.)

SUMMARY: ... In applying Tinker, the court held that the school violated Frederick's constitutional rights because his speech did not cause a substantial disruption. ... Therefore, allowing schools to prohibit vulgar, lewd, obscene, or offensive speech only when it causes a substantial disruption or occurs during school-sponsored activities frustrates the larger goal of protecting children from inappropriate speech. . ... The court attempted to limit its holding to speech that disapproves of substance abuse, finding that Guiles' shirt conveyed drug and alcohol use in a negative light. ... The Hazelwood dissent, discussing this broad reading of Fraser, argued, "If mere incompatibility with the school's pedagogical message were a constitutionally sufficient justification for the suppression of student speech, school officials could censor any student speech ... , converting our public schools into "enclaves of totalitarianism.'" ... Similarly, prohibiting pro-drug and alcohol student speech will assist schools in protecting students from the effects of drugs and alcohol. ... Pro-drug and alcohol speech is a clearly defined category of student speech that does not give a school broad authority to censor additional student expression. Part I of this Comment introduces the concept of the "school power continuum" as a way of understanding the Supreme Court's approach to defining the nature of school power and ability to limit or restrict free speech. Part II analyzes the case law relating to student expression, beginning with the trilogy of Supreme Court student-speech cases. This Part contends that, under most interpretations of these cases, schools lack the authority to restrict pro-drug and alcohol student speech. Part III demonstrates the importance of this issue and why schools should have the authority to restrict pro-substance use speech. That Part also describes the current state of drug and alcohol use in schools and illustrates the influence pro-substance use messages have on an adolescent's decision to use drugs or alcohol. Finally, Part IV asserts that the best solution is to create a new category of student speech. This contention is supported by evidence that the Court has increased school power in relation to students' constitutional rights when the issues involved drug and alcohol use. That Part also addresses arguments that schools already wield too much power over student speech.

Repace JL. Tobacco Law Symposium. Benefits of smoke-free regulations in outdoor settings: Beaches, golf courses, parks, patios, and motor vehicles. William Mitchell Law Review 34: 1621+, 2008. (87 legal refs.)

Summary: ... The law of conservation of mass dictates that this must be true whether tobacco smoke is inhaled in the act of smoking, or inhaled by nonsmokers out of the air indoors or outdoors, known as secondhand smoke (SHS). ... They concluded that these extremely high particle concentrations constitute a serious health risk for adults and children who are passengers in a car with a smoker. ... As Figure 2 shows, these levels are exceeded even at distances 3 or 4 meters (10 to 13 feet) downwind of a smoker in a sidewalk cafe, posing an irritation and annoyance problem even for healthy nonsmokers. ... Speer divided the nonsmokers into 2 groups: 191 nonsmokers with allergic diseases such as nasal allergy, asthma, and allergic headache, and a control group of 250 non-allergic nonsmokers without such diseases. ... Savel concluded that an allergy to cigarette smoke might produce clinically distressing upper respiratory tract symptoms in nonsmokers with allergic backgrounds, exert a depressant effect on the antibacterial defense mechanisms of the lung, exert a toxic effect on lymphocytes, and play a role in the pathogenesis of pulmonary distress. ... The proximity effect was studied in a controlled experiment involving 10 college student smokers placed in rings of increasing diameter around 2 air quality monitors so that no matter which way the wind blew, the monitors were always downwind of 1 smoker. ... Health Risks from Exposure to SHS and OTS Repeated exposure to a carcinogen, such as air pollution from SHS and OTS, over a lifetime increases the risk of cancer.

Richmond DR. Drunk in the Serbonian bog: Intoxicated drivers' deaths as insurance accidents. Seattle University Law Review 32(Fall): 83-122, 2008. (316 legal refs.)

Summary: ... Drunk driving is dangerous and irresponsible, and a person's decision to drive drunk is a serious misjudgment. But the fact that drunk driving is risky does not render drunk drivers' deaths non-accidental. Courts that hold otherwise based on supposed common sense, common knowledge, or the simplistic notion that the dangers of drunk driving are widely known, are wrong as a matter of fact and as a matter of law. They have, in short, wandered into a Serbonian Bog. Treating drunk drivers' deaths as accidents for insurance purposes is much firmer ground. However, the majority approach holds that drunk drivers' deaths are not accidents for purposes of conferring accidental death benefits. ... Judge Boggs faulted the district court for concluding that the cases applying a reasonable foreseeability standard on which the administrator relied in denying benefits misinterpreted Wickman and were thus wrongly decided, and opined that a court reviewing a plan administrator's decision under a deferential standard cannot substitute its judgment for the administrator's. ... As for Aetna's rationale that the serious risks associated with drunk driving are widely publicized, the court was unwilling to make the leap from "'serious risks,' i.e. , the possibility of injury or death, that are 'widely publicized' to the conclusion that a drunk driver knew or should have known that the consequences of driving while intoxicated are that he or she is 'highly likely' to suffer injury or death, i.e. , the probability of injury or death." ... For that matter, what "common sense" and "common knowledge" truly tell us is that intoxicated drivers are "far more likely to be arrested . . . than to be injured or die in an alcohol-related automobile crash, and far more likely to arrive home than to be either arrested, injured, or killed."

Riddle D; Bales R. Disability claims for alcohol-related misconduct. St. John's Law Review 82(spring): 699+, 2008

SUMMARY: ... The first employee tells the supervisor that an alcoholic binge the preceding night caused her to oversleep. ... Applied to the alcohol-related misconduct context, this "Inference of" approach allows employees fired for alcohol-related misconduct to prove a prima facie case with circumstantial evidence of disability discrimination. ... Therefore, under the Federal Circuit's approach, employees who notify their employer of their alcoholism only after it has resulted in misconduct are not entitled to reasonable accommodation for their disability because the employer was not notified of the disability before the misconduct occurred. ... Allowing an alcoholic employee to establish a prima facie case by establishing a causal connection between his absenteeism and his disability would shift the burden to the defendant to articulate a legitimate, nondiscriminatory reason for the adverse employment action. ... The proper approach lies somewhere in the middle, only allowing disability-related misconduct claimants to establish a prima facie case if employees can show that they were fired under circumstances giving an "Inference of" disability discrimination. ... This Article argues that this "Inference of" approach is the better approach because it allows employers to offer the employee misconduct as a legitimate, nondiscriminatory reason for the adverse employment action, and it prevents employers from using alcohol-related misconduct as a pretext for disability-based discrimination.

Rossow I; Karlsson T; Raitasalo K. Old enough for a beer? Compliance with minimum legal age for alcohol purchases in monopoly and other off-premise outlets in Finland and Norway. Addiction 103(9): 1468-1473, 2008. (29 refs.)

Aim: To assess whether government monopoly outlets comply better with minimum legal age for purchase of alcohol compared to other off-premise outlets for alcohol sales. Methods: Under-age-appearing 18-year-olds attempted to purchase alcohol in off-premise outlets applying identical procedures in Finland (n = 290) and Norway (n = 170). Outcomes were measured as whether or not the buyers were asked to present an identity (ID) card and whether or not they succeeded in purchasing alcohol. Results: The buyers were asked to present an ID card in slightly more than half the attempts, and they succeeded in purchasing alcohol in 48% of the cases. The buyers were more likely to be requested to present an ID card and less likely to succeed in purchasing alcohol in monopoly outlets compared to other types of outlets, and also when other outcome predictors, such as age and gender of salesperson and crowdedness in the outlet, were taken into account. Conclusion: Monopoly outlets may facilitate compliance with minimum legal age for purchase of alcohol.

Schoedel KA; Sellers EM. Assessing abuse liability during drug development: Changing standards and expectations. Clinical Pharmacology and Therapeutics 83(4): 622-626, 2008. (24 refs.)

As public health concerns have changed, regulatory expectations for assessing abuse liability of new central nervous system (CNS) drugs have increased. All CNS-active drugs with any properties indicating stimulant, depressant, hallucinogenic, or mood-elevating effects will require an evaluation of abuse liability. Abuse liability assessment involves the collection, analysis, and interpretation of data on chemistry and tampering, animal behavioral pharmacology, clinical trial adverse events (AEs), diversion and overdose, and potentially reinforcing (subjective) effects in recreational drug users.

Smith KC; Siebel C; Pham L; Cho JH; Singer RF; Chaloupka FJ et al. News on tobacco and public attitudes toward smokefree air policies in the United States. Health Policy 86(1): 42-52, 2008. (44 refs.)

Objectives: Smoking bans are a central component of comprehensive tobacco control programs, and an increasing number of states and localities have adopted them. Public support is critical as efforts continue to extend protection from secondhand smoke to all. We examine the relationship between state print news coverage of tobacco and public sentiment towards smoking bans. Methods: We utilize two data sources: the February 2002-Current Population Survey Tobacco Use Supplement, and articles from 2 months in a database comprised of content-analyzed newspaper articles on tobacco from all daily U.S. newspapers. We control for demographic and state-level tobacco covariates, and use logistic regression to identify associations between news coverage and attitudes towards policy initiatives by smoking status. Results: We find no association between tone of news coverage and any outcome measure and little evidence of a relationship between the volume of overall tobacco news and attitudes towards smoking bans. Our data suggest that people exposed to more news on secondhand smoke issues are less likely to support restaurant smoking bans. Higher volume of secondhand smoke news is also predictive of lower support for bar bans among recent quitters. Support for hospital bans is, however, largely independent of news coverage. Conclusions: We suggest two alternate explanations for our findings. First, for certain people, greater news volume on secondhand smoke may lead to lower support for bans. Alternatively, secondhand smoke may be more newsworthy in states where bans are more controversial.

Smith MP. America's methamphetamine crisis: Solving one of America's leading drug problems through child abuse and nuisance laws. Catholic University Law Review 57(2): 605-636, 2008. (39 refs.)

Super labs engage in large scale production of the methamphetamine and produce a majority of the methamphetamine consumed in the United States. This legislation has addressed availability of precursor chemicals, heightened penalties for individuals convicted of methamphetamine related crimes, created penalties for environmental harms caused by production of the drug, and supported other policy-related efforts to address the drug's impact in communities. Addressing the Effects on Individuals Exposed to the Production of Methamphetamine Much of the state legislation passed to address methamphetamine has focused on the particular effects of the drug on children. As this Comment will argue, although child abuse laws are effective tools to combat methamphetamine, states should more aggressively employ nuisance laws in the war against methamphetamine production. Nuisance statutes can also support charges against methamphetamine producers when prosecutors have insufficient evidence to support a charge under the drug laws. This Comment explores the various methods employed to combat methamphetamine. First, it considers the federal and state efforts to combat methamphetamine production. Then, this Comment explores the growing trend of targeting methamphetamine production using child abuse laws. Next, this Comment considers the use of nuisance law in efforts to combat illicit drug use. Finally, this Comment analyzes the effectiveness of using child abuse law and considers the value of employing nuisance theory. This Comment argues that child abuse laws, although helpful, are insufficient to address the external harms associated with methamphetamine production. Nuisance law, on the other hand, presents an opportunity for local communities to address the harms associated with small methamphetamine labs and provides superior remedies as compared to those available under child abuse laws.

Stout RG; Farooque RS. Claims of amnesia for criminal offenses: Psychopathology, substance abuse, and malingering. Journal of Forensic Sciences 53(5): 1218-1222, 2008. (47 refs.)

The forensic psychiatric examiner often encounters defendants who deny memory for their offense. Past research proposes a variety of factors to account for offense amnesia. To date there have been few systematic studies of offense amnesia in relation to psychiatric diagnosis, either alone or in combination with other known factors such as substance use and malingering. We studied 53 pretrial felony defendants who had been referred for psychiatric examination: 40% claimed amnesia for their offense. Examinees with psychotic disorders in general, and schizophrenia in particular, were relatively less likely to claim amnesia than were examinees with other diagnoses. Substance use at the time of the offense and associated substance use disorder diagnoses were positively associated with offense amnesia. Malingering diagnosed by general clinical criteria was a poor predictor of amnesia claims. These data suggests that two prominent reasons for referral for forensic psychiatric evaluation include the presence of psychotic symptoms and claims of amnesia for the offense.

Strasser AA; Tang KZ; Tuller MD; Cappella JN. PREP advertisement features affect smokers' beliefs regarding potential harm. Tobacco Control 17(Supplement 1): i32-i38, 2008. (27 refs.)

Background: The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. Objective: To determine the effect of altering advertisement features on smokers' beliefs of the harm exposure from a PREP. Methods: A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a "red'' condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a "no text'' condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using "incorrect,'' "unsure'' and "correct'' as outcomes, and advertisement type and covariates as predictors, was used for analyses. Results: Participants randomised to the "no text'' advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer. Conclusions: Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

Strouse BM. Inconsistent legislation, interpretation, and application: Iowa's Dramshop Act and its failed purposes. (note). Drake Law Review 56: 1117+, 2008

SUMMARY: ... Justice Schultz noted in his Connolly dissent that "preemption of all common law liability would relieve the licensee from civil responsibility for the sale of kegs and cases of beer or other intoxicants to sober minors, who do the predictable thing - drink to the point of intoxication and then drive vehicles on the streets and highways." ... Thirty other states have legislation that "enables victims to collect damages from the liquor licensee or permittee that either sold alcohol to an intoxicated person, served alcohol to an intoxicated person, or both." ... As previously discussed, the initial purpose of the Iowa Dramshop Act was to provide a remedy in situations when the common law had not previously done so. ... Fifteen months after Haafke, a narrow majority in Connolly cited the dissent in Haafke, holding that "the dramshop act preempts the tort field as to licensees and permittees ." ... According to the Fuhrman court, Connolly was rightly decided because the narrow issue before the Connolly court was whether the legislature set the parameters of the Dramshop Act; essentially, whether the legislature intended to preempt the field of dramshop torts.

Sweanor D. Tobacco Law Symposium. A Canadian's perspective: The limits of tobacco regulation. William Mitchell Law Review 34: 1595-1604, 2008. (54 legal refs.)

Summary: ... In examining the way policy changes have so dramatically reduced cigarette consumption in Canada, there can be a tendency to think that Canada is somehow different from other countries and that tobacco control policies were somehow easier to achieve. ... This raises some interesting questions, not the least of which is why a lawyer who was a key player in so many of these regulatory battles, who built a career around fighting for such measures and convincing others that policy interventions were the most important measures available to counter the health toll of smoking, would now be asked to talk about "the limits to regulation." ... To be honest to our long term health objectives, however, it is extremely important to critically examine what has been accomplished through policy interventions, to be open to the thought that some of our interventions have not achieved all of our goals, and to think about where tobacco control policy needs to head in the future. ... "Checked all the Boxes" Canadian tobacco control advocates are perhaps in an ideal position to consider the limits of regulation because Canada is one of a growing number of countries that have implemented virtually all of the components of traditional comprehensive strategies to reduce smoking. ... A tremendous number of smokers are impacted when workplaces and public areas go smoke-free, but once we move into the realm of "tidying up the leftovers" - such as trying to extend smoke-free policies into areas like shared residential buildings - we can expect less overall impact, simply because we are dealing with far smaller numbers of affected people. ... For instance, a regulatory strategy could include advertising less toxic tobacco products to current smokers as an alternative to cigarettes, mandating smoker-friendly package messaging aimed directly at facilitating cessation, or differentiating between the culpability of different tobacco companies as a way of changing the behavior of the tobacco companies that are benefiting most from a status quo centered on cigarettes. ... This orientation is also strongly at odds with past successful efforts to regulate goods and services which have been principally based on the recognition of differential risks and the resulting ability of regulation to reduce death, injury, and disease.

Taylor S. Medicalizing cannabis-science, medicine and policy, 1950-2004: An overview of a work in progress. Drugs: Education, Prevention and Policy 15(5): 462-474, 2008. (75 refs.)

Cannabis has been the subject of much policy and media attention in the last few years and the 2004 legal changes under the Misuse of Drugs Act in the UK, were widely, although incorrectly, presented as liberalization or legalization of the drug. Current debates over the classification of cannabis as Class C or B serve to emphasize the controversies that surround the drug. This paper provides an overview of a Wellcome Trust three-year project that is currently in progress. Framed as a history of science and policy making, the project aims to study the process whereby boundaries shift between illicit 'drug' and licit 'medicine' and the issues and interests that are involved in that transaction. Specifically, the project aims to analyse the trajectory of research since the 1950s, the interests involved, in particular the role of scientific research and allied professions; industry; drug technology; and lay knowledge and user activism. It aims to analyse the interaction of science and medicine with policy through the examination of the policy role of expert committees and their membership. The impact of international agencies will also be considered. Lastly, it will assess the overall impact of medicalization on the policy environment. Standard historical methodology will be applied and a wide variety of published and archival source material, as well as semi-structured oral history interviews, will be utilized.

Valery L; Anke O; Inge KK; Johannes B. Effectiveness of smoking cessation interventions among adults: A systematic review of reviews. (review). European Journal of Cancer Prevention 17(6): 535-544, 2008. (34 refs.)

The objective of this study was to identify the most effective intervention strategies and policies for smoking cessation among adults. The Medline and Cochrane Library databases were searched, limited to publications since January 2000. A 'review of reviews' approach was followed. Systematic reviews and meta-analyses were included. Reviews aimed at adolescents or specific subgroups were excluded. Two reviewers independently assessed titles and abstracts. For every intervention strategy, only the most recent publication was included. Twenty-three studies met the inclusion criteria. The included intervention strategies and policies were ranked according to their effect size, taking into account the number of original studies, the proportion of studies with a positive effect and the presence of a long-term effect. Evidence of effectiveness for the following strategies was found: group behavioural therapy [odds ratio (OR) 2.17, confidence interval (CI) 1.37-3.45], bupropion (OR 2.06, CI: 1.77-2.40), intensive physician advice (OR 2.04, CI; 1.71-2.43), nicotine replacement therapy (OR 1.77, CI: 1.66-1.88), individual counselling (OR 1.56, CI: 1.32-1.84), telephone counselling (OR 1.56, CI: 1.38-1.77), nursing interventions (OR 1.47, CI: 1.29-1.67) and tailored self-help interventions (OR 1.42, CI: 1.26-1.61). A 10% increase in price increased cessation rates by 3-5%. Comprehensive clean indoor laws increased quit rates by 12-38%. These results show and confirm that a wide array of effective smoking cessation intervention approaches and policies can have a large impact on smoking cessation rates.

Vandewalker I. Taking the baby before it's born: Termination of the parental rights of women who ue illegal drugs while pregnant. New York University Review of Law & Social Change 32: 423+, 2008. (211 refs.)

Summary ... While the termination of parental rights for drug use during pregnancy by itself fails to be narrowly tailored (because the alternative of offering treatment and services would not restrict a fundamental right), offering treatment and taking the child away only if the mother refuses treatment or fails to defeat her addiction theoretically restricts the right to care and custody of children only in cases where the state must separate the family to serve its interests in fetal health or child welfare. ... It provides that mothers who give birth to babies with a controlled substance or metabolite thereof in their blood, urine, or meconium are thereby unfit parents. ... A presumption that a woman who used drugs while pregnant is an unfit parent will effect the unnecessary separation of families - that is, the separation of families in which the mother was not unfit despite a drug addiction - counter to the state's interest in maintaining fit families. ... First, since prenatal drug use does not invariably harm the fetus, laws that provide for the termination of parental rights because of the presence of drugs alone infringe upon the interests of more women than is necessary to effect the state's purpose of protecting fetal health.

Warren MD; Bryant T; Agan M; Aligne CA. Pediatrics in the community: A smoking ban in the heart of tobacco country. (review). Pediatrics In Review 29(4): 137-138, 2008. (1 refs.)

This is a case study of an effort sparked by residents at Vanderbilt Children's Hospital to ban smoking in public places in Tennessee, which was begun in January 2007, under the auspices of the Resident Advocacy Group. The residents worked with numerous faculty members to review the scientific literature on public smoking bans and to develop a sample letter and a list of talking points based on their findings. Their points emphasized the negative consequences of secondhand smoke in terms of illness and medical costs, the positive impact of smoking bans in other localities, and the overall lack of negative economic consequences from smoking bans. In late February 2007, the residents incorporated the issue into their program's inaugural Advocacy Week, in which several state government officials participated. During this week, members of the resident group presented a lecture on the impact of secondhand smoke on children and began circulating their advocacy toolkit. The University's legislative liaison, as well as members from the local American Academy of Pediatrics (AAP) chapter and the Children's Hospital Alliance of Tennessee (CHAT), were very helpful in providing guidance in legislative advocacy for children. (2) In early March, residents and their advocacy partners began contacting state legislators by fax, e-mail, phone, letter, and office visits. One of the largest challenges with this initiative was overcoming resistance (among the public and legislators) to smoking regulation in a state where tobacco farming traditionally has been a linchpin of the rural economy. A secondhand smoke ban in Tennessee was not a sure thing. Numerous child advocacy groups in Tennessee (including Campaign for a Healthy & Responsible Tennessee, American Cancer Society, American Lung Association, American Heart Association) also worked on campaigns to promote passage of the bill. The culmination of these efforts was passage of a statewide smoking ban on May 31 that went into effect on October 1, 2007.

White WL. Alcohol, tobacco and other drug use by addictions professionals: Historical reflections and suggested guidelines. Alcoholism Treatment Quarterly 26(4): 500-535, 2008

Alcohol, tobacco, and other drug (ATOD) use by individuals working in the addictions field has existed as a complex, controversial personal and professional practice issue for more than 150 years. The central debate within this history involves the concept of nexus�the boundary that distinguishes rights to personal privacy from professional duties and obligations. Ambiguities related to this point of demarcation have contributed to misjudgments related to ATOD use by addictions professionals that have injured multiple parties. This essay reviews the history of ATOD use as a professional practice issue in the addictions field; discusses clinical, ethical, and legal issues related to ATOD use by addiction service professionals; and offers guidance on ATOD use decision making.

Wood DM; Warren-Gash C; Ashraf T; Greene SL; Shather Z; Trivedy C et al. Medical and legal confusion surrounding gamma-hydroxybutyrate (GHB) and its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD). QJM. An International Journal of Medicine 101(1): 23-29, 2008. (33 refs.)

Background: Gamma-hydroxybutyrate (GHB) is used as a recreational drug, with significant associated morbidity and mortality; it is therefore a class C drug under the Misuse of Drugs Act (1971). However, its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD) remain legally available despite having similar clinical effects. Aim: The aim of this study was to determine whether the relative proportions of self-reported ingestions of GHB or its precursors GBL and 1,4BD were similar to those seen in analysis of seized drugs. Design and methods: Retrospective review of our clinical toxicology database to identify all cases of self-reported recreational GHB, GBL and 1,4BD use associated with ED presentation in 2006. Additionally all seized substances on people attending local club venues were analysed by a Home Office approved laboratory to identify any illicit substances present. Results: In 2006, there were a total of 158 ED presentations, of which 150 (94.9) and 8 (5.1) were GHB and GBL self-reported ingestions respectively; 96.8 (153) were recreational use. Of the 418 samples seized, 225 (53.8) were in liquid form; 85 (37.8) contained GHB and 140 (62.2) contained GBL. None of the seized samples contained 1,4BD and there were no self-reported 1,4BD ingestions. Conclusions: Self-reported GHB ingestion was much more common than GBL ingestion, whereas GBL was more commonly found in the seized samples. These differences suggest that GBL use may be more common than previously thought and we suggest that there should be further debate about the legal status of the precursors of GHB.

Wright C; Schnoll S; Bernstein D. Risk evaluation and mitigation strategies for drugs with abuse liability public interest, special interest, conflicts of interest, and the industry perspective. Annals of the New York Academy of Sciences 1141(Addiction Reviews 2008): 284-303, 2008. (48 refs.)

Risk evaluation and mitigation strategies (REMS) formerly known as Risk Minimization Action Plans (RiskMAPs) are a regulatory technique for dealing with anticipated risks of new medications and are especially important for new drugs with abuse potential. This paper describes the origin and history of risk-management plans for drugs that might be abused, the proper use of these plans in minimizing the risk to the public, and the special difficulties inherent in managing risks for drugs with abuse potential. Drugs with abuse liability are distinctive since the risks inherent in manufacture and distribution include not only risks to patients prescribed the medications, but also risks to the general public including subgroups in the population not intended to get the drug and who receive no medical benefit from the medication. The crafting of risk-management plans intended to protect nonpatient populations is unique for these products. The content, extent, and level of intensity of these plans affect areas of medical ethics, civil liability, and criminal prosecution. The need for risk-management plans for drugs with abuse liability can potentially act as a deterrent to investment and is a factor in decisions concerning the development of new medications for the treatments of pain, ADHD, anxiety disorders, and addictions. This paper provides a framework for moving the process of REMS development forward and criteria for evaluating the probity and adequacy of such programs.