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CORK Bibliography: Media

90 citations. June 2010 to present

Prepared: December 20011

Albedah AM; Khalil MK; Khalil AA; Elolemy AT. Use of the target group index survey to evaluate the cigarette smoking profile in Saudi Arabia. Saudi Medical Journal 32(10): 1055-1059, 2011

To draw a profile, and study the media habits for cigarette smokers in Saudi Arabia using the Target Group Index survey (TGI). A household survey using the TGI sample was conducted in March 2008 in 21 cities in Saudi Arabia. A sample of 7003 individuals aged 15 years or more, male and females, living in town and cities, were randomly selected using the multistage sampling technique. One individual per household was interviewed using a structured questionnaire covering socio-economic profile, media exposure, and cigarette consumer information. The study was conducted in Arabian Center for Tobacco Control, Riyadh, Kingdom of Saudi Arabia. Cigarette smoking was 35.9% in males, and 2.3% in females. This was significantly higher in the age group 30-49 years compared with younger ages (p=0.001). Among smokers, 22.3% were heavy smokers, 69.3% were using regular flavor cigarettes, and 22.4% tried to quit smoking but failed. The most common methods of quitting smoking were nicotine gum (18.5%), hypnosis (14%), nicotine patch (8%), and acupuncture (3%). Ninety-eight percent of the smokers watched TV daily, noticed mainly big outdoor ads, and 46% used the Internet daily. Favorite TV and radio channels, newspaper, magazine, and interesting topics for the smokers were recorded, and the main smoker profile was drawn. The TGI can be used to draw a smoker profile and identify different segments with the greatest opportunities to send anti-smoking messages.

Al-Bedah AM; Qureshi NA; Al-Guhaimani HI; Basahi JA. The Global Youth Tobacco Survey-2007: Comparison with the Global Youth Tobacco Survey 2001-2002 in Saudi Arabia. Saudi Medical Journal 31(9): 1036-1043, 2010. (22 refs.)

Objectives: To primarily describe both smoking pattern in the youth population and a comparison with the Global Youth Tobacco Survey (GYTS) in 2001-2002. Methods: The standard 2-stage methodology and a cross-sectional design were used to select randomly a representative sample of intermediate schools, classes, and students from all regions in the Kingdom of Saudi Arabia from January to June 2007. Result: Comparing results with the 2001 GYTS, the prevalence of ever and current smoking, use of other tobacco products, and initiation of smoking by never smokers in the next year increased among males, but with improvement in the students' knowledge and attitudes towards smokers. The second-hand tobacco smoke items were not distinguished, however, one or both parent smokers increased by 6% over 6 years. Media anti-smoking messages and awareness improved, however, the widespread display and proliferation of items with a cigarette brand logo on it, encourages participants to buy more cigarettes. Teaching hazards of smoking to students improved, however, the reasons why people of their age smoke were not discussed interactively. Females less than 18 years of age (minors) were not denied cigarette purchase compared to male participants of the same age. Conclusion: The National Tobacco Control Programs is apparently working effectively but differentially against smoking. The program needs to be evaluated systematically and accordingly and intensified further to reduce smoking among youths in the Kingdom of Saudi Arabia.

Alday J; Murukutla N; Cedillo C; Johns P; Monteiro A; Wakefield M. Smoke-free Sao Paulo: A campaign evaluation and the case for sustained mass media investment. Salud Publica de Mexico 52(Supplement 2): S216-S225, 2010. (10 refs.)

Although evidence from high-income countries suggests that mass media campaigns can increase knowledge of tobacco harms and encourage smoking cessation, there is little evidence of this from developing countries, particularly related to campaigns that seek to increase support for smoke-free places and laws.Two campaigns that ran in Sao Paulo, Brazil during implementation of a smoke-free law in Sao Paulo were evaluated to assess their effectiveness in changing attitudes and creating support for the law, The campaigns were evaluated through street-intercept surveys conducted in early July and late August in Sao Paulo (Ns=603; 615). Findings reveal that mass communications can generate support for smoke-free laws and underscore the importance of running campaigns that are both well-funded and that use harder-hitting, more graphic messages.

Anderson DM. Does information matter? The effect of the Meth Project on meth use among youths. Journal of Health Economics 29(5): 732-742, 2010. (39 refs.)

Are demand-side interventions effective at curbing drug use? To the extent demand-side programs are successful, their cost effectiveness can be appealing from a policy perspective. Established in 2005, the Montana Meth Project (MMP) employs a graphic advertising campaign to deter meth use among teens. Due to the MMP's apparent success, seven other states have adopted Meth Project campaigns. Using data from the Youth Risk Behavior Surveys (YRBS), this paper investigates whether the MMP reduced methamphetamine use among Montana's youth. When accounting for a preexisting downward trend in meth use, effects on meth use are statistically indistinguishable from zero. These results are robust to using related changes of meth use among individuals without exposure to the campaign as controls in a difference-in-difference framework. A complementary analysis of treatment admissions data from the Treatment Episode Data Set (TEDS) confirms the MMP has had no discernable impact on meth use.

Anderson SJ; Millett C; Polansky JR; Glantz SA. Exposure to smoking in movies among British adolescents 2001-2006. Tobacco Control 19(3): 197-U43, 2010. (27 refs.)

Objective: To estimate youth exposure to smoking in movies in the UK and compare the likely effect with the. Methods: We collected tobacco occurrences data for 572 top-grossing films in the UK screened from 2001 to 2006 and estimated the number of on-screen tobacco impressions delivered to British youths in this time period. Results 91% of films in our sample that contained smoking were youth-rated films (British Board of Film Classification rating '15' and lower), delivering at least 1.10 billion tobacco impressions to British youths during theatrical release. British youths were exposed to 28% more smoking impressions in UK youth-rated movies than American youth-rated movies, because 79% of movies rated for adults in the USA ('R') are classified as suitable for youths in the UK ('15' or '12A'). Conclusion: Because there is a dose-response relation between the amount of on-screen exposure to smoking and the likelihood that adolescents will begin smoking, the fact that there is substantially higher exposure to smoking in youth-rated films in the UK than in the USA suggests that the fraction of all youth smoking because of films in the UK is probably larger than in the USA. Other countries with ratings systems that are less conservative (in terms of language and sexuality) than the USA will also be likely to deliver more on-screen tobacco impressions to youths. Assigning an '18' classification to movies that contain smoking would substantially reduce youth exposure to on-screen smoking and, hence, smoking initiation among British youths.

Atkinson AM; Sumnall H; Measham F. Depictions of alcohol use in a UK Government partnered online social marketing campaign: Hollyoaks 'The Morning after the night before'. Drugs: Education, Prevention and Policy 18(6, special issue): 454-467, 2011. (107 refs.)

Aims: This study analysed the depiction of alcohol in an online government partnered social marketing campaign: Hollyoaks 'The Morning After the Night Before'. This was a new initiative, providing Internet-delivered episodes of a popular terrestrial drama targeted at young people. Methods: All the 12 episodes were coded for visual representations of alcohol, drinking acts and alcohol effect references. The drinking setting, point in time, type of alcoholic beverage consumed, drinker's demographics, effects/consequences of drinking, and official and unofficial responses to alcohol consumption and related harms were also coded. Audience comments were then categorized according to their content in order to gain an insight into viewers' thoughts regarding the campaign. Findings: A wide variety of data is reported. Most representations of alcohol were positively framed, and were depicted without immediate consequence. No explicit sensible drinking messages were included in the episodes. Analysis of viewer feedback indicated a lack of awareness of the intentions of the campaign and little discussion of alcohol-related issues was generated. In contrast, viewers seemed to reject the depictions of alcohol portrayed, and identified with, or admired, the central characters. Further analysis indicated little coherence between alcohol framing in the online campaign and representations in the terrestrial TV series. Conclusions: This article uses the example of KYL/Hollyoaks to draw attention to the emergent use of the internet and other new media in health promotion. New media provides creative new opportunities to engage young people with health-promoting messages. However, although new ways of delivery are important they should be part of a co-ordinated and internally consistent campaign, present realistic depictions of alcohol use, and be based upon clear evidence-based principles.

Banerjee SC; Greene K; Yanovitzky I. Sensation seeking and dosage effect: An exploration of the role of surprise in anti-cocaine messages. Journal of Substance Use 16(1): 1-13, 2011. (40 refs.)

This article examines emotional and cognitive responses to graphic illustrations of the effects of cocaine among a sample of low and high sensation seekers (LSS & HSS). Two-hundred-and-five (n = 205) undergraduate students at a large northern university in the United Kingdom participated in the study and were randomly assigned to one of two conditions: low-image or high-image print adverts about the consequences of cocaine use. Results indicated that although high sensation seekers report greater cocaine use as compared with low sensation seekers, report less surprise and have less dominant cognitions than LSS, they do not differ from LSS in terms of other affective responses when exposed to anti-cocaine visual messages. However, the high-image advert was more successful than the low-image adverts in eliciting surprise, which has important theoretical and empirical implications for the design of effective messages targeting HSS.

Baum F. From Norm to Eric: Avoiding lifestyle drift in Australian health policy. (editorial). Australian and New Zealand Journal of Public Health 35(5): 404-406, 2011. (22 refs.)

There is no doubt that the Australian Labor Party Government has made a strong commitment to preventing disease, as shown by the Council of Australian Governments' (COAG) National Partnership Agreement on Preventive Health (NPAPH), the commissioning of the National Preventative Health Taskforce (NPHT) and the Commonwealth Government's response to that Taskforce report. Each of these initiatives stresses the importance of preventing chronic disease by encouraging people to adopt appropriate lifestyles. These lifestyles involve not smoking, drinking in moderation, eating a healthy diet and taking enough exercise. Similar messages were evident in the lifestyle push of the 1980s when the 'Life be in it' campaign promoted Norm as a model of a coach potato who did not heed the lifestyle advice. The face of the lifestyle campaign this time around is Eric, an obese-looking balloon man, and his family who urge people to swap an unhealthy lifestyle habit for a more healthy one. The large lifestyle campaigns of the 1970s and 1980s have been shown to have had little, if any, impact on population health, and if anything act to increase inequities. The programs that did work were those that were implemented alongside a program of policy and structural change (such as changing the food supply), the Finnish North Karelia experiment being an example. In the past decade the power of the social determinants of health in shaping overall population health and the distribution of health within populations has received considerable attention, most prominently in the work of the Commission on the Social Determinants of Health. Why haven't we learned from this evidence? A crucial reason for the failure to learn from the evidence is that, politically, action on the social determinants of health is generally less palatable than instituting a lifestyle advice program.

Belackova V; Stastna L; Miovsky M. 'Selling by drugs': Content analysis of the coverage of illicit drugs in different news media types and formats. Drugs: Education, Prevention and Policy 18(6, special issue): 477-489, 2011. (73 refs.)

Aims: News media coverage of drugs represents an important source for public perceptions of illicit drugs, which shape national drug policies. The aim of this article is to acknowledge differences between media types and formats, which are often neglected in the literature, so that drug field professionals can target them efficiently in order to achieve balanced media coverage of drug issues. Methods: We coded a total of 8380 Czech news media articles from 2007 related to drugs and drug use and analysed them with respect to their characteristics and drug-related coverage. With the use of multinomial logit models, two hypotheses were tested: (1) media types and formats differ with respect to their drug-related contents, and (2) media sources differ across media types and formats. Findings: Significant differences in drug-related coverage between media types and formats were found, except for public and private TV and the partisan and serious press; the media sources differed significantly across all media types and formats, public and serious media allow a broader range of sources. An exploratory analysis showed that there was a greater likelihood of TV and radio broadcasting supply reduction news, while tabloid journals, the partisan press, and local newspapers featured crime-related drug coverage. Conclusion: Drug field professionals can shape their media outputs to the needs of differing media types and formats, such as local media, which allow for direct contact with individual reporters, or audiovisual media, which require competent direct speakers.

Brennan E; Durkin SJ; Cotter T; Harper T; Wakefield MA. Mass media campaigns designed to support new pictorial health warnings on cigarette packets: evidence of a complementary relationship. Tobacco Control 20(6): 412-418, 2011

Background: In Australia, introduction of pictorial health warnings on cigarette packets was supported by a televised media campaign highlighting illnesses featured in two of the warning labels-gangrene and mouth cancer. Methods: Two studies examined whether the warnings and the television advertisements complemented one another. Population telephone surveys of two cross-sections of adult smokers measured changes in top-of-mind awareness of smoking-related health effects from before (2005; n=587) to after the pack warnings were introduced (2006; n=583). A second study assessed cognitive and emotional responses and intentions to quit after smokers watched one of the campaign advertisements, comparing outcomes of those with and without prior pack warning exposure. Results Between 2005 and 2006, the proportion of smokers aware that gangrene is caused by smoking increased by 11.2 percentage points (OR=23.47, p=0.000), and awareness of the link between smoking and mouth cancer increased by 6.6 percentage points (OR=2.00, p=0.006). In contrast, awareness of throat cancer decreased by 4.3 percentage points, and this illness was mentioned in the pack warnings but not the advertisements. In multivariate analyses, smokers who had prior exposure to the warnings were significantly more likely to report positive responses to the advertisements and stronger post-exposure quitting intentions. Conclusions: Television advertisements and pictorial health warnings on cigarette packets may operate in a complementary manner to positively influence awareness of the health consequences of smoking and motivation to quit. Jurisdictions implementing pictorial warnings should consider the benefits of supportive mass media campaigns to increase the depth, meaning and personal relevance of the warnings.

Chapman S; Farrelly MC. Four arguments against the adult-rating of movies with smoking scenes. (editorial). PLoS Mediciine 8(8): e1001078, 2011. (24 refs.)

Choi K; Forster JL; Erickson DJ; Lazovich D; Southwell BG. Prevalence of smoking in movies as perceived by teenagers longitudinal trends and predictors. American Journal of Preventive Medicine 41(2): 167-173, 2011. (32 refs.)

Background: Smoking in movies is prevalent. However, use of content analysis to describe trends in smoking in movies has provided mixed results and has not tapped what adolescents actually perceive. Purpose: To assess the prospective trends in the prevalence of smoking in movies as perceived by teenagers and identify predictors associated with these trends. Methods: Using data from the Minnesota Adolescent Community Cohort Study collected during 2000-2006 when participants were aged between 12 and 18 years (N=4735), latent variable growth models were employed to describe the longitudinal trends in the perceived prevalence of smoking in movies using a four-level scale (never to most of the time) measured every 6 months, and examined associations between these trends and demographic, smoking-related attitudinal and socio-environmental predictors. Analysis was conducted in 2009. Results: At baseline, about 50% of participants reported seeing smoking in movies some of the time, and another 36% reported most of the time. The prevalence of smoking in movies as perceived by teenagers declined over time, and the decline was steeper in those who were aged 14-16 years than those who were younger at baseline (p <= 0.05). Despite the decline, teenagers still reported seeing smoking in movies some of the time. Teenagers who reported more close friends who smoked also reported a higher prevalence of smoking in movies at baseline (regression coefficients=0.04-0.18, p<0.01). Conclusions: Teenagers' perception of the prevalence of smoking in movies declined over time, which may be attributable to changes made by the movie industry. Despite the decline, teenagers were still exposed to a moderate amount of smoking imagery. Interventions that further reduce teenage exposure to smoking in movies may be needed to have an effect on adolescent smoking.

Cotter T; Hung WT; Perez D; Dunlop S; Bishop J. Squeezing new life out of an old Sponge: how to modernise an anti-smoking media campaign to capture a new market. Australian and New Zealand Journal of Public Health 35(1): 75-80, 2011. (20 refs.)

Objectives: The iconic Sponge anti-smoking television advertisement was first made in Sydney, Australia, in 1979. In 2007, it was re-made for a new generation of smokers. This paper examines the impact of the re-made Sponge advertisement. Methods: Qualitative evaluation of the original Sponge ad by younger and older smokers (n=51) was followed by an online pre-test survey of the modernised version (n=301). A continuous tracking telephone survey of smokers and recent quitters (quit in past 12 months) over 18 years monitored performance of the modernised version while on air in late 2007 (total n=453; seen ad n=380). Results: Qualitative research found that the concept of the original Sponge ad may motivate younger smokers - who had not previously seen the ad - to quit. Online pre-testing demonstrated that the modernised version provided new information to 54% of 18-24 year olds (compared to 31% of older smokers). Tracking survey results indicated that believability of the modernised version was highest among 18-24 year olds (92%), that the ad was 'attention-grabbing' (86%), and that it was effective at influencing quitting intentions. Effects were amplified by the generation of pressure from family and friends. Implications: The re-made Sponge advertisement had a positive impact on smokers, and was particularly effective among the new market of smokers aged less than 40 years. Adapting successful mass media campaign material can be an effective and economical strategy to influence smokers.

Cotter T; Perez D; Dunlop S; Hung WT; Dessaix A; Bishop JF. The case for recycling and adapting anti-tobacco mass media campaigns. Tobacco Control 19(6): 514-517, 2010. (12 refs.)

Effective mass media campaigns are hard to come by. A delicate blend of art and science is required to ensure content is technically accurate as well as being creatively engaging for the target audience. However, the most expensive component of a media campaign is not its development but its placement at levels that allow smokers to see, engage and respond to its content. This paper uses two examples to illustrate the process of adapting existing effective material to maximise the expenditure of precious resources on the placement of material.

Cullen J; Sokol NA; Slawek D; Allen JA; Vallone D; Healton C. Depictions of tobacco use in 2007 broadcast television programming popular among US youth. Archives of Pediatrics & Adolescent Medicine 165(2): 147-151, 2011. (37 refs.)

Objectives: To determine the quantity of tobacco use in network television programming popular among US youth and to examine variation in tobacco depictions by TV Parental Guidelines system rating and television network. Design: A content analysis was conducted of broadcast network television programming popular among youth. Nielsen viewership rating data were used to identify a sample of top-rated television series for youth aged 12 to 17 years during the fall 2007 television season. Depictions of tobacco use per television episode were examined by TV Parental Guidelines rating and television network. chi(2) testing was used to examine differences in proportions of tobacco depictions across television episode ratings and networks. Setting: Data collection and analysis were conducted at the American Legacy Foundation (now known as Legacy). Subjects: Broadcast television viewers in 2007. Main Outcome Measure: Tobacco use depictions on broadcast television were examined. Results: Forty percent of television episodes examined had at least 1 depiction of tobacco use. Of these depictions, 89% were of cigarettes. Among episodes rated TV-PG (ie, parental guidance suggested) (N=73), 50% showed 1 or more incidents of cigarette use, in contrast to 26% of TV-14 (ie, parents strongly cautioned) episodes. The percentage of episodes with any tobacco use depictions was highest on the FOX network (44%; n=32), followed closely by The CW (CBS-Warner Brothers) (41%; n=30). Conclusions: Substantial tobacco use was observed in television shows popular among youth. It is projected that almost 1 million youth were exposed to tobacco depictions through the programming examined. Tobacco use on television should be a cause for concern, particularly because of the high volume of television viewing among younger audiences.

Curry LE; Pederson LL; Stryker JE. The changing marketing of smokeless tobacco in magazine advertisements. Nicotine & Tobacco Research 13(7): 540-547, 2011. (34 refs.)

Concerns about secondhand smoke, increasing indoor smoking bans, and health concerns regarding cigarettes are contributing to the development of new smokeless tobacco (ST) products by the tobacco industry and the repositioning of traditional ST products. The objective of this research was to systematically document the changing advertising strategies and themes of the ST industry. Using descriptive content analysis, this study analyzed 17 nationally circulated magazines for ST advertisements (ads) from 1998-1999 and 2005-2006, recording both magazine and advertisement characteristics (e.g., themes, selling proposition, people portrayed, and setting/surroundings.) Ninety-five unique ads were found during the two time periods-occurring with total frequency of 290 ad placements in 816 issues. One hundred ninety-one ads were found in the 2005-2006 sample, while 99 were found in the 1998-1999 magazines. Significant differences in ST ads were identified between time periods and magazine types. A greater percentage of ads were found in the latter time period, and the average number of ads per issue increased (0.24 in 1998-1999 and 0.49 in 2005-2006, p < .001). More recent magazines and general adult magazines contained a greater proportion of flavored products, "alternative to cigarette" messages, and indoor settings when compared with earlier magazines and men's magazines, respectively. While continuing to advertise in men's magazines with themes appealing to men and "traditional" ST users, the ST industry appears to be simultaneously changing its message placement and content in order to include readers of general adult magazines who may not currently use ST.

Davis KC; Crankshaw E; Farrelly MC; Niederdeppe J; Watson K. The impact of state tobacco control program funding cuts on teens' exposure to tobacco control interventions: Evidence from Florida. American Journal of Health Promotion 25(3): 176-185, 2011. (24 refs.)

Purpose. Explore the impact of dramatic budget cuts to the Florida Tobacco Control Program (FTCP) on Florida teens' exposure to tobacco control interventions. Design. Survey data on teens in Florida and a comparison sample of the remainder of the United States. Data were collected in six waves between 2002 and 2006, with three waves collected before and three waves collected after the PTCP midget cut in fiscal year (FY) 2004. Setting. Florida. Subjects. Twelve- to 17-year-old teem in Florida and the remainder of the United States. Between spring 2002 and summer 2006, 7841 interviews of Florida teens and 10,875 interviews of teens in the remainder of the United States were conducted. Measures. Exposure to FTCP interventions, including tobacco countermarketing, school and community organizations, and in-school tobacco prevention curricula. Analysis. Multivariable logistic regression models were used to test whether declines in Florida youth's exposure to FTCP interventions were associated with the FTCP budget cut. Results. Following the FY2004 FTCP budget cut, there were greater declines in teens' exposure to tobacco countermarketing campaigns in Florida compared with the remainder of the United States (odds ratio [OR] = .42; p < .001). The FY2004 budget cut also may have had an impact on. exposure to in-school tobacco prevention curricula and school youth organizations (OR = .67; p < .001). Conclusion. Program budget cuts in Florida resulted in significant declines in exposure to some FTCP interventions (particularly tobacco countermarketing). Research on the correlates of smoking suggests that these budget cuts could have a significant impact on tobacco-related outcomes among teens.

Davis KC; Nonnemaker JM; Farrelly MC; Niederdeppe J. Exploring differences in smokers' perceptions of the effectiveness of cessation media messages. Tobacco Control 20(1): 26-33, 2011. (32 refs.)

Objective To examine which types of cessation-focused advertisements are associated with perceived advertisement effectiveness among smokers and to assess whether key smoker characteristics (ie, cigarette consumption, desire to quit and past quit attempts) influence perceived effectiveness of different types of cessation ads. Methods We used data from the New York Media Tracking Survey Online, a web survey of 7060 adult smokers in New York. Participants were exposed to four categories of cessation ads: (1) why to quit-graphic images, (2) why to quit-testimonial, (3) how to quit and (4) anti-industry. Perceived ad effectiveness was measured with a four-item scale assessing the degree to which participants thought the ads made them stop and think, grabbed their attention, were believable and made them want to quit smoking. We categorised smokers based on cigarette consumption, desire to quit and past quit attempts. We used multivariable analyses to examine how smoker characteristics and category of cessation ads predict perceived ad effectiveness. Results Ads using the 'why to quit' strategy with either graphic images or personal testimonials were perceived as more effective than the other ad categories. Smokers who had less desire to quit or had not tried quitting in the past 12 months responded significantly less favourably to all types of cessation ads tested. Greater cigarette consumption was also associated with lower perceived effectiveness, but this association was smaller in magnitude. Conclusions Tobacco control programmes that utilise cessation-focus advertising should focus relatively more on ads that adopt the 'why to quit' strategy with either graphic images or personal testimonials.

de Leeuw RNH; Sargent JD; Stoolmiller M; Scholte RHJ; Engels RCME; Tanski SE. Association of smoking onset with R-rated movie restrictions and adolescent sensation seeking. Pediatrics 127(1): E96-E105, 2011. (47 refs.)

OBJECTIVES: In this study, we examined how often US youths reported having complete parental restrictions on watching R-rated movies. In addition, we assessed the relationship between parental R-rated movie restrictions and adolescents' sensation seeking and how this interplay is related to smoking onset. METHODS: Data from a 4-wave longitudinal study of 6522 adolescents (10-14 years of age) who were recruited through a random-digit-dial telephone survey were used. At baseline, subjects were nationally representative of the US population. Subjects were monitored for 2 years and queried about their smoking status, their sensation-seeking propensity, and how often they were allowed to watch R-rated movies. A cross-lagged model combined with survival analysis was used to assess the relationships between parental R-rated movie restrictions, sensation-seeking propensity, and risk for smoking onset. RESULTS: Findings demonstrated that 32% of the US adolescents reported being completely restricted from watching R-rated movies by their parents. Model findings revealed that adolescents' sensation seeking was related to greater risk for smoking onset not only directly but also indirectly through their parents becoming more permissive of R-rated movie viewing. Parental R-rated movie restrictions were found to decrease the risk of smoking onset directly and indirectly by changing children's sensation seeking. CONCLUSIONS: These findings imply that, beyond direct influences, the relationship between adolescents' sensation seeking and parental R-rated movie restrictions in explaining smoking onset is bidirectional in nature. Finally, these findings highlight the relevance of motivating and supporting parents in limiting access to R-rated movies.

Falk EB; Berkman ET; Whalen D; Lieberman MD. Neural activity during health messaging predicts reductions in smoking above and beyond self-report. Health Psychology 30(2): 177-185, 2011. (62 refs.)

Objective: The current study tested whether neural activity in response to messages designed to help smokers quit could predict smoking reduction, above and beyond self-report. Design: Using neural activity in an a priori region of interest (a subregion of medial prefrontal cortex [MPFC]), in response to ads designed to help smokers quit smoking, we prospectively predicted reductions in smoking in a community sample of smokers (N = 28) who were attempting to quit smoking. Smoking was assessed via expired carbon monoxide (CO; a biological measure of recent smoking) at baseline and 1 month following exposure to professionally developed quitting ads. Results: A positive relationship was observed between activity in the MPFC region of interest and successful quitting (increased activity in MPFC was associated with a greater decrease in expired CO). The addition of neural activity to a model predicting changes in CO from self-reported intentions, self-efficacy, and ability to relate to the messages significantly improved model fit, doubling the variance explained (R-self-report(2) = .15, R-self-report(2) (+ neural activity) = .35, R-change(2) = .20). Conclusion: Neural activity is a useful complement to existing self-report measures. In this investigation, we extend prior work predicting behavior change based on neural activity in response to persuasive media to an important health domain and discuss potential psychological interpretations of the brain behavior link. Our results support a novel use of neuroimaging technology for understanding the psychology of behavior change and facilitating health promotion.

Farrelly MC; Davis KC; Nonnemaker JM; Kamyab K; Jackson C. Promoting calls to a quitline: Quantifying the influence of message theme, strong negative emotions and graphic images in television advertisements. Tobacco Control 20(4): 279-284, 2011. (28 refs.)

Objective. To understand the relative effectiveness of television advertisements that differ in their thematic focus and portrayals of negative emotions and/or graphic images in promoting calls to a smokers' quitline. Methods. Regression analysis is used to explain variation in quarterly media market-level per smoker calls to the New York State Smokers' Quitline from 2001 to 2009. The primary independent variable is quarterly market-level delivery of television advertisements measured by target audience rating points (TARPs). Advertisements were characterised by their overall objective-promoting cessation, highlighting the dangers of secondhand smoke (SHS) or other-and by their portrayals of strong negative emotions and graphic images. Results. Per smoker call volume is positively correlated with total TARPs (p<0.001), and cessation advertisements are more effective than SHS advertisements in promoting quitline call volume. Advertisements with graphic images only or neither strong negative emotions nor graphic images are associated with higher call volume with similar effect sizes. Call volume was not significantly associated with the number of TARPs for advertisements with strong negative emotions only (p=0.71) or with both graphic images and strong emotions (p=0.09). Conclusions. Exposure to television advertisements is strongly associated with quitline call volume, and both cessation and SHS advertisements can be effective. The use of strong negative emotions in advertisements may be effective in promoting smoking cessation in the population but does not appear to influence quitline call volume. Further research is needed to understand the role of negative emotions in promoting calls to quitlines and cessation more broadly among the majority of smokers who do not call quitlines.

Flynn BS; Worden JK; Bunn JY; Solomon LJ; Ashikaga T; Connolly SW et al. Mass media interventions to reduce youth smoking prevalence. American Journal of Preventive Medicine 39(1): 53-62, 2010. (33 refs.)

Background: Mass media interventions for reduction of youth cigarette smoking have been recommended based on a broad array of evidence, although few randomized community trials have been reported. Design: Four matched pairs of independent media markets were identified; one member of each pair was randomized to receive the intervention. School surveys were conducted in all markets, in 2001 before (n = 19,966) and in 2005 after (n = 23,246) the interventions were completed. Setting/participants: Grade 7-12 students from public schools in these eight medium-sized metropolitan areas participated in the summative evaluations; Grades 4-12 students were targeted to receive mass media interventions in four of these markets. Intervention: Four simultaneous campaigns consisting of specially developed messages based on behavioral theory and targeted to defined age groups of racially and ethnically diverse young people were placed in popular TV, cable, and radio programming using purchased time for 4 years. Main outcome measures: Prevalence of youth smoking and psychosocial mediators of smoking. Results: No significant impacts of these interventions on smoking behaviors or mediators were found for the overall samples. A positive effect was found for one mediator in subgroups. Among Hispanic participants a marginally favorable effect on smoking prevalence and significant effects on mediators were found. General awareness of smoking prevention TV messages was slightly higher over time in the intervention areas. Conclusions: Mass media interventions alone were unable to induce an incremental difference in youth smoking prevalence, probably because of a relatively strong tobacco control environment that included a substantial national smoking prevention media campaign.

Forsyth SR; Malone RE. "I'll be your cigarette-Light me up and get on with it": Examining smoking imagery on YouTube. Nicotine & Tobacco Research 12(8): 810-816, 2010. (46 refs.)

Smoking imagery on the online video sharing site YouTube is prolific and easily accessed. However, no studies have examined how this content changes across time. We studied the primary message and genre of YouTube videos about smoking across two time periods. In May and July 2009, we used "cigarettes" and "smoking cigarettes" to retrieve the top 20 videos on YouTube by relevance and view count. Eliminating duplicates, 124 videos were coded for time period, overall message, genre, and brand mentions. Data were analyzed using descriptive statistics. Videos portraying smoking positively far outnumbered smoking-negative videos in both samples, increasing as a percentage of total views across the time period. Fifty-eight percent of videos in the second sample were new. Among smoking-positive videos, music and magic tricks were most numerous, increasing from 66% to nearly 80% in July, with music accounting for most of the increase. Marlboro was the most frequently mentioned brand. Videos portraying smoking positively predominate on YouTube, and this pattern persists across time. Tobacco control advocates could use YouTube more effectively to counterbalance prosmoking messages.

Glantz SA. Commentary on Hanewinkel et al. (2010): Anti-smoking advertisments vaccinate movie viewers against effects of on-screen smoking. (commentary). Addiction 105(7): 1278-1279, 2010. (19 refs.)

Glantz SA; Mitchell S; Titus K; Polansky J; Kaufmann RB; Bauer UE. Smoking in top-grossing movies --- United States, 2010. MMWR. Morbidity and Mortality Weekly Review 60(27): 909-913, 2011. (10 refs.)

The National Cancer Institute has concluded that studies indicate a causal relationship between exposure to depictions of smoking in movies and youth smoking initiation. Adolescents in the top quartile of exposures to onscreen tobacco incidents have been found to be approximately twice as likely to begin smoking as those in the bottom quartile. o monitor tobacco use in movies, Thumbs Up! Thumbs Down! (TUTD), a project of Breathe California of Sacramento-Emigrant Trails, counts occurrences of tobacco incidents in U.S. top-grossing movies each year. In 2010, the number of onscreen tobacco incidents in youth-rated (G, PG, or PG-13) movies continued a downward trend, decreasing 71.6% from 2,093 incidents in 2005 to 595 in 2010. Similarly, the average number of incidents per youth-rated movie decreased 66.2%, from 20.1 in 2005 to 6.8 in 2010. The degree of decline, however, varied substantially by motion picture company. The three companies with published policies designed to reduce tobacco use in their movies had an average decrease in tobacco incidents of 95.8%, compared with an average decrease of 41.7% among the three major motion picture companies and independents without policies. This finding indicates that an enforceable policy aimed at reducing tobacco use in youth-rated movies can lead to substantially fewer tobacco incidents in movies and help prevent adolescent initiation of smoking. The findings in this report indicate continuing progress toward the U.S. Department of Health and Human Services goal of reducing youth exposure to onscreen smoking (3). Across all MPAA rating categories, the percentages of 2010 top-grossing movies with no tobacco incidents were the highest observed in 2 decades.

Public Domain

Glantz SA; Titus K; Mitchell S; Polansky J. Smoking in top-grossing movies --- United States, 1991--2009. MMWR. Morbidity and Mortality Weekly Review 59(32): 1014-1017, 2010. (10 refs.)

Exposure to onscreen smoking in movies increases the probability that youths will start smoking. Youths who are heavily exposed to onscreen smoking are approximately two to three times more likely to begin smoking than youths who are lightly exposed (1); a similar, but smaller effect exists for young adults (2). To monitor the extent to which tobacco use is shown in popular movies, Thumbs Up! Thumbs Down! (TUTD), a project of Breathe California of Sacramento-Emigrant Trails, counted the occurrences of tobacco use (termed "incidents") shown in U.S. top-grossing movies during 1991--2009. This report summarizes the results of that study, which found that the number of tobacco incidents depicted in the movies during this period peaked in 2005 and then progressively declined. Top-grossing movies released in 2009 contained 49% of the number of onscreen smoking incidents as observed in 2005 (1,935 incidents in 2009 versus 3,967 incidents in 2005). It is noted that nearly half of popular movies still contained tobacco imagery in 2009, including 54% of those rated PG-13, and the number of incidents remained higher in 2009 than in 1998. This analysis shows that the number of tobacco incidents increased steadily after the 1998 Master Settlement Agreement (MSA)� between the state attorneys general and the major cigarette companies, in which the companies agreed to end brand placement.

Public Domain

Goel RK. Advertising media and cigarette demand. Bulletin of Economic Research 63(4): 404-416, 2011. (19 refs.)

Using state-level panel data for the USA spanning three decades, this research estimates the demand for cigarettes. The main contribution lies in studying the effects of cigarette advertising disaggregated across five qualitatively different groups. Results show cigarette demand to be near unit elastic, the income effects to be generally insignificant and border price effects and habit effects to be significant. Regarding advertising effects, aggregate cigarette advertising has a negative effect on smoking. Important differences across advertising media emerge when cigarette advertising is disaggregated. The effects of public entertainment and Internet cigarette advertising are stronger than those of other media. Anti-smoking messages accompanying print cigarette advertising seem relatively more effective. Implications for smoking control policy are discussed.

Gosselt JF; Van Hoof JJ; Baas N; De Jong MDT. Effects of a national information campaign on compliance with age restrictions for alcohol sales. Journal of Adolescent Health 49(1): 97-98, 2011. (5 refs.)

Purpose: To investigate the effect of a national information campaign, introduced by the Dutch Food Retail Organization, named "Under 20? Show Your ID!," on compliance with age restrictions on alcohol sales. The compliance level after the campaign was compared with a baseline compliance, that we calculated based on 458 preintervention compliance measurements. Methods: Data were collected using the method of mystery shopping. Three teams, each consisting of two 15-year-old mystery shoppers, conducted 105 alcohol purchase attempts in supermarkets in three regions in the Netherlands. Results: A compliance rate of 24.8% was found, which is a significant improvement compared with Dutch basement compliance rate from the past (14.9%), but is nominally still very low. Conclusions: This mass media intervention campaign failed to increase compliance to an acceptable level. Also the specific goal of the campaign (ask everybody under <20 years old for identification [ ID]) failed because fewer than half of the 15-year-old mystery shoppers in the study were asked to show their ID when purchasing alcoholic beverages.

Hanewinkel R; Isensee B; Sargent JD; Morgenstern M. Effect of an antismoking advertisement on cinema patrons' perception of smoking and intention to smoke: A quasi-experimental study. Addiction 105(7): 1269-1277, 2010. (36 refs.)

Aims: To assess the effect of an antismoking advertisement under real-world conditions. Design: Quasi-experimental study. Setting/participants: Multiplex cinema in Kiel, Germany; 4073 patrons were surveyed after having viewed a movie. Some 4005 patrons were >= 10 years old (28.7% between 10 and 17 years). A total of 654 subjects (16.3%) were smokers. Intervention: In the intervention condition (weeks 1 and 3), a 30-second antismoking advertisement-accentuating long-term health consequences of smoking and promoting cessation-was shown prior to all movies; in the control condition (weeks 2 and 4) no such spot was shown. Main outcome measures: (i) Awareness of smoking in the movie, (ii) approval of smoking in the movie, (iii) attitude towards smoking, (iv) intention to smoke in the future and (v) desire to smoke among smokers. Findings: Patrons who were exposed to the antismoking advertisement were more likely to be female, but did not differ with respect to smoking status. After controlling for gender differences, patrons exposed to the antismoking advertisement had (i) higher awareness of smoking in the movies, (ii) lower levels of approval of smoking in the movies, and (iii) a more negative attitude towards smoking in general compared with those not exposed. Among smokers, smoking in the movies increased urge to smoke, but there was no interaction between smoking in the movies and experimental condition. Conclusions: Study results suggest that placing an antismoking advertisement before movies can affect attitudes towards smoking, bolstering evidence in support of such policies.

Harakeh Z; Engels RCME; Vohs K; van Baaren RB; Sargent J. Exposure to movie smoking, antismoking ads and smoking intensity: An experimental study with a factorial design. Tobacco Control 19(3): 185-190, 2010. (24 refs.)

Background: This study examines whether smoking portrayal in movies or antismoking advertisements affect smoking intensity among young adults. Methods: We conducted an experimental study in which 84 smokers were randomly assigned using a two (no-smoking versus smoking portrayal in the movie) by three (two prosocial ads, two antismoking ads or one of each) factorial design. Participants viewed a 60-minute movie with two commercial breaks and afterwards completed a questionnaire. Smoking during the session was allowed and observed. Results: Exposure to the movie with smoking had no effect on smoking intensity. Those who viewed two antismoking ads had significantly lower smoking intensity compared with those who viewed two prosocial ads. There was no interaction between movie smoking and antismoking ads. Baseline CO (carbon monoxide) level had the largest effect on smoking intensity. Conclusion: These findings provide further evidence to support antismoking ads placed with movies because of their possible effect on young adult smoking behaviour. However, caution is warranted, because nicotine dependence appears to be the primary predictor of smoking intensity among young adult smokers in this study.

Heikkinen H; Patja K; Jallinoja P. Smokers' accounts on the health risks of smoking: Why is smoking not dangerous for me? Social Science & Medicine 71(5): 877-883, 2010. (57 refs.)

Drawing on qualitative interviews with forty smokers, aged 24-58 years, in Finland, this study aimed to identify key accounts that smokers used to respond to the hegemonic claim that smoking is harmful to health. While the smokers defended themselves in the face of the presumed health risk argument, they both agreed with and challenged the predominant medical and epidemiological discourses. The five most frequently observed account types that the smokers used were: health risk perspective, moderate use is not harmful, counter-evidence, compensatory behaviour, and smoking as the lesser evil. The accounts seemed to have two purposes. First, they served to protect the smokers from self-blame as well as blame from others. The smokers presented themselves as risk-aware and calculating actors, who have nevertheless made their choice to smoke. Second, the smokers tried to convince the interviewers and themselves of the harmlessness and acceptability of their own smoking. The results of the study with respect to smoking further the understanding about the way laypeople make sense of information about health risks that relates directly to their own 'unhealthy' behaviours and how they use this knowledge to justify their behaviour. Based on the findings of our study, we recommend that future anti-smoking campaigns and interventions should take into account and target lay epidemiological health accounts that are applied by smokers themselves. Rather than trying to motivate and persuade smokers to quit with information translated from epidemiological and medical research, the anti-smoking advocates and health promotion specialists should provide answers to the questions that smokers themselves are pondering and answering, too. Consequently, the results can be used in relation to other pleasurable but 'unhealthy' activities, such as unhealthy eating or drinking, by offering insights into how individuals manage to rationalise and maintain activities which the hegemonic public health perspective terms unhealthy.

Ho SY; Wang MP; Lai HK; Hedley AJ; Lam TH. 'Carcinogens in a puff': Smoking in Hong Kong movies. Tobacco Control 19(6): 518-519, 2010. (7 refs.)

Smoking scenes in movies, exploited by the tobacco industry to circumvent advertisement bans, are linked to adolescent smoking. Recently, a Hong Kong romantic comedy Love in a puff put smoking at centre stage, with numerous smoking scenes and words that glamourise smoking. Although WHO has issued guidelines on reducing the exposure of children to smoking in movies, none is adopted in Hong Kong. Comprehensive tobacco control strategies are urgently needed to protect young people in Hong Kong from cigarette promotion in movies.

Hughes CE; Lancaster K; Spicer B. How do Australian news media depict illicit drug issues? An analysis of print media reporting across and between illicit drugs, 2003-2008. International Journal of Drug Policy 22(4): 285-291, 2011. (35 refs.)

Background: Media reporting on illicit issues has been frequently criticised for being sensationalised, biased and narrow. Yet, there have been few broad and systematic analyses of the nature of reporting. Using a large sample and methods commonly adopted in media communications analysis this paper sought to identify the dominant media portrayals used to denote illicit drugs in Australian newspapers and to compare and contrast portrayals across drug types. Methods: A retrospective content analysis of Australian print media was carried out over the period 2003-2008 from a sample comprised of 11 newspapers. Articles that contained one or more mention of five different drugs (or derivatives) were identified: cannabis, amphetamines, ecstasy, cocaine and heroin. A sub-sample of 4397 articles was selected for media content analysis (with 2045 selected for full content analysis) and a large number of text elements coded for each. Key elements included topic, explicit or implicit messages about the consequences of drugs/use and three value dimensions: overall tone, whether drugs were portrayed as a crisis issue and moral evaluations of drugs/use. Results: The dominant media portrayals depicted law enforcement or criminal justice action (55%), but most articles were reported in a neutral manner, in the absence of crisis framings. Portrayals differed between drugs, with some containing more narrow frames and more explicit moral evaluations than others. For example, heroin was disproportionately framed as a drug that will lead to legal problems. In contrast, ecstasy and cocaine were much more likely to emphasise health and social problems. Conclusion: Media reporting on illicit drugs is heavily distorted towards crime and deviance framings, but may be less overtly sensationalised, biased and narrowly framed than previously suggested. This is not to suggest there is no sensationalism or imbalance, but this appears more associated with particular drug types and episodes of heightened public concern.

Hunt K; Henderson M; Wight D; Sargent JD. Exposure to smoking in films and own smoking among Scottish adolescents: A cross-sectional study. Thorax 66(10): 866-874, 2011. (37 refs.)

Background: Evidence of high exposure of UK youth to images of smoking in films has led to calls for an 18 rating for films with smoking to reduce smoking in youth. However, the only study to date in the UK to test for an association showed no relation between film-smoking exposure and smoking among young adults. Objective To assess whether there is an association between exposure to film images of smoking and own smoking among UK adolescents and whether repeated viewings of films has an impact. Design: Cross-sectional study. Participants 1999 pupils aged 15-16 years from 13 Scottish schools. Outcome Smoked tobacco in the past year. Exposure measure: Film-smoking exposure was assessed using the Beach method; account for repeated viewings of films was then used to modify estimated exposure. Covariates included: media usage, parental restriction on and context of TV/film viewing, family connectedness, parental monitoring and friends' smoking. Results Most (71%) students had not smoked in the past year. About half reported no parental restrictions on TV/film viewing. Many reported repeated viewings of films; accounting for this more than doubled exposure estimates and strengthened the association with smoking. Adolescents with high exposure to film smoking were more likely to have smoked than those with low exposure (adjusted odds ratio (AOR) 2.08, 95% CI 1.22 to 3.55). Additionally, adolescents who reported parental rules about TV/film watching were less likely to smoke (AOR 0.37 (0.27 to 0.52)) than those who did not. Adolescents who mainly watched films with friends had higher exposure to film smoking and were more likely to smoke (AOR 2.19 (1.10 to 4.38)). Conclusions: Exposure to film smoking is associated with smoking among Scottish adolescents. These data lend support to calls for an 18 rating for films with images of smoking.

Hunt K; Sweeting H; Sargent J; Lewars H; Young R; West P. Is there an association between seeing incidents of alcohol or drug use in films and young Scottish adults' own alcohol or drug use? A cross sectional study. BMC Public Health 11(e-article 259), 2011. (48 refs.)

Background: As the promotion of alcohol and tobacco to young people through direct advertising has become increasingly restricted, there has been greater interest in whether images of certain behaviours in films are associated with uptake of those behaviours in young people. Associations have been reported between exposure to smoking images in films and smoking initiation, and between exposure to film alcohol images and initiation of alcohol consumption, in younger adolescents in the USA and Germany. To date no studies have reported on film images of recreational drug use and young people's own drug use. Methods: Cross sectional multivariable logistic regression analysis of data collected at age 19 (2002-4) from a cohort of young people (502 boys, 500 girls) previously surveyed at ages 11 (in 1994-5), 13 and 15 in schools in the West of Scotland. Outcome measures at age 19 were: exceeding the 'sensible drinking' guidelines ('heavy drinkers') and binge drinking (based on alcohol consumption reported in last week), and ever use of cannabis and of 'hard' drugs. The principle predictor variables were an estimate of exposure to images of alcohol, and of drug use, in films, controlling for factors related to the uptake of substance use in young people. Results: A third of these young adults (33%) were classed as 'heavy drinkers' and half (47%) as 'binge drinkers' on the basis of their previous week's consumption. Over half (56%) reported ever use of cannabis and 13% ever use of one or more of the 'hard' drugs listed. There were linear trends in the percentage of heavy drinkers (p =.018) and binge drinkers (p = 0.012) by film alcohol exposure quartiles, and for ever use of cannabis by film drug exposure (p =.000), and for ever use of 'hard' drugs (p =.033). The odds ratios for heavy drinking (1.56, 95% Cl 1.06-2.29 comparing highest with lowest quartile of film alcohol exposure) and binge drinking (1.59, 95% Cl 1.10-2.30) were attenuated by adjustment for gender, social class, family background (parental structure, parental care and parental control), attitudes to risk-taking and rule-breaking, and qualifications (OR heavy drinking 1.42, 95% Cl 0.95-2.13 and binge drinking 1.49, 95% Cl 1.01-2.19), and further so when adjusting for friends' drinking status (when the odds ratios were no longer significant). A similar pattern was seen for ever use of cannabis and 'hard' drugs (unadjusted OR 1.80, 95% Cl 1.24-2.62 and 1.57, 95% Cl 0.91-2.69 respectively, 'fully' adjusted OR 1.41 (0.90-2.22 and 1.28 (0.662.47) respectively). Conclusions: Despite some limitations, which are discussed, these cross-sectional results add to a body of work which suggests that it is important to design good longitudinal studies which can determine whether exposure to images of potentially health-damaging behaviours lead to uptake of these behaviours during adolescence and early adulthood, and to examine factors that might mediate this relationship.

Jamieson PE; Romer D. Trends in US movie tobacco portrayal since 1950: A historical analysis. Tobacco Control 19(3): 179-184, 2010. (46 refs.)

Objective: Portrayal of tobacco use in films has been causally linked to youth smoking initiation. However, findings regarding trends in portrayal in US films since 1950 are inconsistent, potentially due to differences in sampling densities, intercoder reliabilities and time periods covered. The present study was designed to overcome these inconsistencies with a common sampling frame and methodology. Methods: A half sample of the 30 top-grossing US films per year from 1950 to 2006 (N=855) was coded in 5-min segments for total tobacco-related content and main character tobacco use. Film tobacco trends were identified using linear regression and compared to national per capita cigarette consumption and historically significant tobacco control events. Results Tobacco content declined considerably since 1950. Total tobacco-related content peaked around 1961, while the decline in portrayal of main character use was already underway in 1950. Cigarette consumption peaked around 1966 with a trend that closely paralleled total tobacco content and that coincided with major tobacco control events. Conclusions: This study, which had high reliability, dense sampling and covered a long time period, indicates that tobacco content has declined in top-ranked US movies since 1950 with a trend in total tobacco content that closely paralleled the drop in per capita cigarette consumption and the increase in significant tobacco control efforts. Despite the inability to draw causal conclusions, tobacco portrayal in films may serve as barometer of societal support for the habit and thus efforts should continue to limit exposure to such content.

Jiang N; Ling PM. Reinforcement of smoking and drinking: Tobacco marketing strategies linked with alcohol in the United States. American Journal of Public Health 101(10): 1942-1954, 2011. (177 refs.)

Objectives. We investigated tobacco companies' knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities. Methods. We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results. Results. Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use. Conclusions. Tobacco companies' numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use.

Koordeman R; Kuntsche E; Anschutz DJ; van Baaren RB; Engels RCME. Do we act upon what we see? Direct effects of alcohol cues in movies on young adults' alcohol drinking. Alcohol and Alcoholism 46(4): 393-398, 2011. (60 refs.)

Aims: Ample survey research has shown that alcohol portrayals in movies affect the development of alcohol consumption in youth. Hence, there is preliminary evidence that alcohol portrayals in movies also directly influence viewers' drinking of alcohol while watching movies. One process that might account for these direct effects is imitation. The present study therefore examined whether young people imitate actors sipping alcohol on screen. Methods: We observed sipping behaviours of 79 young adults (ages 18-25) watching a 60-min movie clip, 'What Happens in Vegas', in a semi-naturalistic home setting. Each of the 79 participants was exposed to 25 alcohol cues. Two-level logistic regression analyses were used to analyse whether participants in general imitated actors' sipping during this clip. In addition, we applied proportional hazard models in a survival analysis framework (Cox regression) to test whether there was a difference in imitation of the cues between male and female participants, and to test whether the timing of the actors' sipping throughout the movie played a role. Results: The findings showed that participants were more likely to sip in accordance with the actors' sipping than without such a cue. Further, we found that men were more likely to imitate actors' sipping than females and that participants tended to respond to actors' sipping at the beginning of the movie rather than at the end. Conclusion: Exposure to actors sipping alcohol in a movie seems to have an immediate impact on the drinking behaviour of viewers, via the mechanism of imitation.

Kosovski JR; Smith DC. Everybody hurts: Addiction, drama, and the family in the reality television show "Intervention". Substance Use & Misuse 46(7): 852-858, 2011. (25 refs.)

This article employs the literature on reality television as well as empirical studies on addiction to analyze Intervention's narrative. We look at the narrative structure of the Intervention's first six seasons (2005-2009), its repeated emphases on the causes of addiction, and the show's purported success rate. Highlighting disturbing discrepancies between the show's representations and assertions versus empirical research, Intervention's notions of what constitutes effective remedies are those treatments generally available only to the financially affluent, and the program's depictions of addiction and intervention practices reinforce a popular culture, rather than a science-based understanding, of the family and of addiction itself.

Kupersmidt JB; Scull TM; Austin EW. Media literacy education for elementary school substance use prevention: Study of Media Detective. Pediatrics 126(3): 525-531, 2010. (32 refs.)

OBJECTIVES: Media Detective is a 10-lesson elementary school substance use prevention program developed on the basis of the message interpretation processing model designed to increase children's critical thinking skills about media messages and reduce intent to use tobacco and alcohol products. The purpose of this study was to conduct a short-term, randomized, controlled trial to evaluate the effectiveness of Media Detective for achieving these goals. METHODS: Elementary schools were randomly assigned to conditions to either receive the Media Detective program (n = 344) or serve in a waiting list control group (n = 335). RESULTS: Boys in the Media Detective group reported significantly less interest in alcohol-branded merchandise than boys in the control group. Also, students who were in the Media Detective group and had used alcohol or tobacco in the past reported significantly less intention to use and more self-efficacy to refuse substances than students who were in the control group and had previously used alcohol or tobacco. CONCLUSIONS: This evaluation provides evidence that Media Detective can be effective for substance use prevention in elementary school-aged children. Notably, media-related cognitions about alcohol and tobacco products are malleable and relevant to the development and maintenance of substance use behaviors during late childhood. The findings from this study suggest that media literacy-based interventions may serve as both a universal and a targeted prevention program that has potential for assisting elementary school children in making healthier, more informed decisions about use of alcohol and tobacco products.

Lancaster K; Hughes CE; Spicer B; Matthew-Simmons F; Dillon P. Illicit drugs and the media: Models of media effects for use in drug policy research. Drug and Alcohol Review 30(4): 397-402, 2011. (64 refs.)

Issues. Illicit drugs are never far from the media gaze and although identified almost a decade ago as 'a new battleground' for the alcohol and other drug (AOD) field there has been limited research examining the role of the news media and its effects on audiences and policy. Approach. This paper draws together media theories from communication literature to examine media functions. We illustrate how each function is relevant for media and drugs research by drawing upon the existing literature examining Australian media coverage during the late 1990s of escalating heroin-related problems and proposed solutions. Key Findings. Media can influence audiences in four key ways: by setting the agenda and defining public interest; framing issues through selection and salience; indirectly shaping individual and community attitudes towards risk; and feeding into political debate and decision making. Each has relevance for the AOD field. For example, media coverage of the escalating heroin-related problems in Australia played a strong role in generating interest in heroin overdoses, framing public discourse in terms of a health and/or criminal issue and affecting political decisions. Implications and Conclusion. Media coverage in relation to illicit drugs can have multifarious effects. Incorporating media communication theories into future research and actions is critical to facilitate understanding of the short-and long-term impacts of media coverage on illicit drugs and the avenues by which the AOD field can mitigate or inform future media debates on illicit drugs.

Lavoie D. Smoking the other: Marijuana and counterhegemony in weeds. Substance Use & Misuse 46(7): 910-921, 2011. (32 refs.)

Subverting suburban modernity, the SHOWTIME television series Weeds invites its audiences to situate their opinions about marijuana amid spheres of bourgeois soccer-moms, class politics, turf wars, raw economics, violent milieux, and multiculti heterogeneity. I argue that Weeds encourages us to "smoke the Other"; that is, to hesitantly accept difference, in line with many drug circles' etiquette. The phrase "smoking the Other" is a critical alteration of bell hooks' (1992, Black looks: Race and representation. Boston: South End Press) conception of whites' ethnic "devouring" as "eating the Other," a rather rigid schematic itself problematized by Weeds' transgressive self-conscious playfulness with stereotyped ethnicities, loopy plotlines, and counterhegemonic dialogue. Cultural/political implications follow.

Lee MJ. The effects of self-efficacy statements in humorous anti-alcohol abuse messages targeting college students: Who is in charge? Health Communication 25(8): 638-646, 2010. (31 refs.)

This study examined the effect of self-efficacy statements in humorous anti-alcohol abuse television advertisements on college students. A posttest only group design experiment was conducted with 124 college students. It was found that highly rebellious individuals who watched ads with a self-efficacy statement (i.e., 'You Are in Control of the Situation') indicated lower alcohol expectancies, higher risk perceptions, and higher intentions to change their drinking behaviors than those in the non-self-efficacy condition. The findings suggest that health promotional messages should be tailored to rebellious college students, particularly those who are at risk, in a manner that not only gains their attention but also minimizes possible defensive reactions to the given messages. Humorous messages with self-efficacy statements could offer ways to communicate with rebellious college students regarding their drinking problems.

Leskauskas D; Gudaityte R; Kiudulaite I; Adomaitiene V. Attitudes of Lithuanian secondary school children toward addictive behaviors, their promoting and preventive factors with regard to the age. Medicina-Lithuania 47(2): 113-119, 2011. (26 refs.)

The aim of this study was to evaluate the attitudes of Lithuanian secondary school children toward addictive behaviors, their promoting and preventive factors with regard to the age. Material and Methods. The study sample consisted of all 5th-, 9th-, and 12th-grade schoolchildren of 6 secondary schools in Kaunas and Sakiai (N=856). Schoolchildren were surveyed with a questionnaire consisting of the questions about their attitudes and experience regarding addictive behaviors and factors promoting and preventing such behaviors. Results. Smoking (82.8%), use of illegal drugs (81.0%), and consumption of strong alcoholic beverages (80.6%) were most often indicated as addictive behaviors. Consumption of light alcoholic beverages and computer gaming were least often indicated as addictive behaviors: by 67.2% and 57.1% of respondents, respectively. Less than one-third (32.7%) of respondents answered that they had one or more of potentially addictive behaviors: computer gaming (27.8%), consumption of light alcoholic beverages (24.6%), smoking (16.3%), and consumption of strong alcoholic beverages (12.1%). The most significant difference was observed between the answers of schoolchildren of 5th and 9th grades. Friends (38.4%), TV (37.9%), and Internet (24.6%) were most often mentioned as influencing a wish to try and abstain from addictive behaviors. Fear for one's health (74.4%) and possible impediment for the life (71.4%) were the most frequently mentioned reasons for abstaining from addictive behaviors. Conclusions. Involvement in potentially addictive behaviors and acknowledgement of their risks were found to increase with the age of schoolchildren, most significantly from 5th to 9th grades. Consumption of light alcoholic beverages was the second most prevalent behavior among respondents, highly noticed in advertising, but least often acknowledged as addictive behavior. TV and Internet were most often mentioned by respondents as mass media influencing their wish to try or abstain from trying addictive behaviors. Reasons for abstaining from addictive behaviors differed with regard to the age but fears for health and life impediment were most prevalent in all grades.

Levy DT; Cho SI; Kim YM; Park S; Suh MK; Kam S. SimSmoke model evaluation of the effect of tobacco control policies in Korea: The unknown success story. American Journal of Public Health 100(7): 1267-1273, 2010. (46 refs.)

Objectives. We evaluated the effect of strict tobacco control policies, implemented beginning in 1995 in the Republic of Korea, on smoking prevalence and deaths. Methods. SimSmoke is a simulation model of the effect of tobacco control policies over time on smoking initiation and cessation. It uses standard attribution methods to estimate lives saved as a result of new policies. After validating the model against smoking prevalence, we used it to determine the Korean policies' effect on smoking prevalence. Results. The model predicted smoking prevalence accurately between 1995 and 2006. We estimated that 70% of the 24% relative reduction in smoking rates over that period was attributable to tobacco control policies, mainly tax increases and a strong media campaign, and that the policies will prolong 104812 male lives by the year 2027. Conclusions. Our results document Korea's success in reducing smoking prevalence and prolonging lives, which may serve as an example for other Asian nations. Further improvements may be possible with higher taxes and more comprehensive smoke-free laws, cessation policies, advertising restrictions, and health warnings.

Lochbuehler K; Voogd H; Scholte RHJ; Engels RCME. Attentional bias in smokers: Exposure to dynamic smoking cues in contemporary movies. Journal of Psychopharmacology 25(4): 514-519, 2011. (28 refs.)

Research has shown that smokers have an attentional bias for pictorial smoking cues. The objective of the present study was to examine whether smokers also have an attentional bias for dynamic smoking cues in contemporary movies and therefore fixate more quickly, more often and for longer periods of time on dynamic smoking cues than non-smokers. By drawing upon established methods for assessing attentional biases for pictorial cues, we aimed to develop a new method for assessing attentional biases for dynamic smoking cues. We examined smokers' and non-smokers' eye movements while watching a movie clip by using eye-tracking technology. The sample consisted of 16 smoking and 17 non-smoking university students. Our results confirm the results of traditional pictorial attentional bias research. Smokers initially directed their gaze more quickly towards smoking-related cues (p = 0.01), focusing on them more often (p = 0.05) and for a longer duration (p = 0.01) compared with non-smokers. Thus, smoking cues in movies directly affect the attention of smokers. These findings indicate that the effects of dynamic smoking cues, in addition to other environmental smoking cues, need to be taken into account in smoking cessation therapies in order to increase successful smoking cessation and to prevent relapses.

Lowe JB; Baxter L; Hirokawa R; Pearce E; Peterson JJ. Description of a media campaign about alcohol use during pregnancy. Journal of Studies on Alcohol and Drugs 71(5): 739-741, 2010. (6 refs.)

Objective: This study describes the development and testing of a multicomponent media campaign aimed at increasing discussions of alcohol use during pregnancy. Method: Women, Infants, and Children (WIC) programs in Iowa were paired and, within each pair, were randomly assigned to a usual-care group (advice not to consume alcohol while pregnant and the opportunity to watch a 30-second television commercial about the effects of drinking during pregnancy) or intervention group (usual care plus a 10-minute videotape/DVD and a printed pamphlet. Among the 700 research participants in those out-reach programs, interpersonal communication about alcohol use during pregnancy was assessed both before and after intervention, and participants were surveyed for knowledge of the effects of alcohol use during pregnancy. Results: More women in the intervention group than in the usual-care group talked to friends about alcohol use during pregnancy. Also, only women in the intervention group demonstrated an increase in relative knowledge about the effects of drinking during pregnancy. Conclusions: A multimedia campaign may be an effective way to increase interpersonal discussions and awareness of the dangers of alcohol use during pregnancy.

Lowe P; Lee E; Yardley L. Under the influence? The construction of foetal alcohol syndrome in UK Newspapers. Sociological Research Online 15: e-article 4, 2010. (30 refs.)

Today, alongside many other proscriptions, women are expected to abstain or at least limit their alcohol consumption during pregnancy. This advice is reinforced through warning labels on bottles and cans of alcoholic drinks. In most (but not all) official policies, this is linked to a risk of Foetal Alcohol Syndrome (FAS) or one of its associated conditions. However, given that there is little medical evidence that low levels of alcohol consumption have an adverse impact on the foetus, we need to examine broader societal ideas to explain why this has now become a policy concern. This paper presents a quantitative and qualitative assessment of analysis of the media in this context. By analysing the frames over time, this paper will trace the emergence of concerns about alcohol consumption during pregnancy. It will argue that contemporary concerns about FAS are framed around a number of pre-existing discourses including alcohol consumption as a social problem, heightened concerns about children at risk and shifts in ideas about the responsibility of motherhood including during the pre-conception and pregnancy periods. Whilst the newspapers regularly carried critiques of the abstinence position now advocated, these challenges focused did little to refute current parenting cultures.

Lyons A; Britton J. Protecting young people from smoking imagery in films: Whose responsibility? (editorial). Thorax 66(10): 844-846, 2011. (20 refs.)

MacKenzie R; Chapman S; Holding S. Framing responsibility. Coverage of lung cancer among smokers and non-smokers in Australian television news. Australian and New Zealand Journal of Public Health 35(1): 66-70, 2011. (65 refs.)

Objective: To analyse news portrayals of lung cancer and associated inferences about responsibility in Australian television news. Methods: Analysis of television news reports, broadcast on Sydney's five free-to-air television channels between 2 May 2005 and 31 August 2009, for all statements pertaining to lung cancer. Results: Of 2,042 reports mentioning any cancer, 45 made reference to lung cancer, and 28 (62%) referred to diagnoses of lung cancer in non-smokers. Of 157 statements in these reports, 107 (68%) noted that the person featured was a non-smoker. Nonsmokers were portrayed sympathetically and as tragic victims, implying they were not responsible for their condition, the sub-text being that smokers are responsible for theirs. Conclusions: Television news portrays non-smokers with lung cancer with considerable sympathy. Conversely, smokers are implicitly and occasionally explicitly depicted as responsible for their disease. Implications: The marginalisation of tobacco caused lung cancer in news, together with sympathetic reporting of lung cancer in non-smokers may contribute to stigma surrounding smoking caused disease that may promote delay in seeking treatment, and de-emphasise the role of the tobacco industry's decades-long smoker reassurance program in promoting smoking.

MacKenzie R; Chapman S. Pig's blood in cigarette filters: How a single news release highlighted tobacco industry concealment of cigarette ingredients. Tobacco Control 20(2): 169-172, 2011. (37 refs.)

The tobacco industry is not obligated to disclose ingredients and additives used in manufactured tobacco production. This paper describes global reaction to a press release highlighting evidence that porcine haemoglobin ("pig's blood") was sometimes used in cigarette manufacturing while never being disclosed to smokers. The case study illustrates the power of press releases to ignite major interest in tobacco control issues.

Matthew-Simmons F; Shanahan M; Ritter A. Reported value of cannabis seizures in Australian newspapers: Are they accurate? Drug and Alcohol Review 30(1): 21-25, 2011. (18 refs.)

Introduction and Aims. The news media is often touted as an important, yet inaccurate source of information about drug issues for the general public. This paper investigates the accuracy of reporting in the Australian media regarding the value of cannabis seizures made by the police. Design and Methods. A sample of Australian newspaper articles, which featured both a direct estimate of the value of a cannabis seizure and the number of plants seized, were examined. The reported values from these articles were then compared with a range of estimates made using data on cannabis plant yield and price, taken from research literature. Results. Fifteen articles were examined, referring to fourteen different seizures. The reported value of cannabis seizures in this sample of articles was highly inflated when compared with the authors' estimated value. The reported newspaper values of seizures were between 1.8 and 11.9 times higher than our middle estimate. Discussion and Conclusions. The most likely reason for the wide difference between the reported and estimated value of these seizures is the possible variability in cannabis plant yield. Whatever the reason for the discrepancy between the reported values and our estimates, greater transparency surrounding the valuations of cannabis seizures would help to better determine the true impacts of law enforcement interventions on this illicit drug supply chain.

McCool J; Cameron LD; Robinson E. Do parents have any influence over how young people appraise tobacco images in the media? Journal of Adolescent Health 48(2): 170-175, 2011. (23 refs.)

Background: Socio-cultural factors, including media and family, play an important role in introducing and reinforcing pro-smoking intentions. Tendencies to appraise smokers in media in positive, negative, and empathic ways may play a role in the social and familial dynamics influencing smoking intentions. Objective: This study assessed: (1) social group differences in appraisals of pro-and antismoking imagery in media; (2) whether parental antismoking expectations are associated with less positive appraisals; and (3) whether these appraisal tendencies mediate the relationship between parental antismoking expectations and smoking intentions. Methods and Materials: Adolescents (N = 515, ages 11-13, M = 11.5 years) from Auckland, New Zealand completed a multimedia, computer-based questionnaire assessing media exposure of smoking imagery in four media clips as well as media exposure, parental attitudes toward smoking, and smoking intentions. Results: Appraisals of smoking imagery in the media clips and media consumption were patterned on the basis of gender, ethnic group, school economic status, and peer and parent smoking behaviors. Positive appraisals of the smoking images were found to mediate the relationship between weaker parental antismoking expectations and greater smoking intentions. Conclusion: Parents may have significant influence over how adolescents perceive smoking imagery in media by presenting clear and unambiguous expectations about tobacco use at home. These expectations may shape how adolescents respond to smoking images by effectively "tainting" the image.

McCoy SL; Nieland MNS. Are drinking habits really changing? A cross-generational test of the 'new' phenomenon of 'binge-drinking'. Drugs: Education, Prevention and Policy 18(5): 333-339, 2011. (40 refs.)

Aims: To investigate whether 'binge-drinking' is new by comparing the behaviour and attitudes of two generations at the same age and of one generation at different ages. Methods: Fifty-six student/parent pairs completed questionnaires partially based on the Adolescent version of the Alcohol Expectancy Questionnaire (Brown, S. A., Christiansen, B. A., & Goldman, M. S. (1987). The alcohol expectancy questionnaire: An instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol, 48, 483-491). Students' reports of their behaviour and attitudes were compared to their parents' memories of their behaviour and attitudes at 18. Parents' memories were compared to their current behaviour and attitudes to explore possible lifespan effects. Data regarding the groups' attachment to aspects of society were drawn on as a possible explanation of differences between generations. Findings: Parents recalled consuming more alcohol more frequently, having more favourable attitudes towards alcohol and having fewer ties with their communities when they were 18 than their children. They drank less and had a less favourable attitude towards alcohol at the time of the research than in their youth. Conclusions: Despite contrary 'evidence', it may be that today's young people are less prone to 'binge-drinking' than previous generations. Whilst it is recognized that data may be contaminated by parents' 'forgetting', the study highlights the possibility that the 'binge-drinking' crisis is merely media hype, spurious, or both.

Millett C; Polansky JR; Glantz SA. Government inaction on ratings and government subsidies to the US film industry help promote youth smoking. (editorial). PLoS Mediciine 8(8): e1001077, 2011. (38 refs.)

Montagne M. Drugs and the media: An introduction (editorial). Substance Use & Misuse 46(7): 849-851, 2011. (11 refs.)

Mass media accounts of drugs and drug use are a daily occurrence and the focus of much inquiry and debate. In this special issue, nine articles consider the role and impact of a specific type of mass medium in the depiction of drugs, drug use, and drug users. Media include television programs, newspapers, films, public service advertising and product-specific marketing campaigns, and the world of the Internet, including YouTube and message boards. Media accounts of alcohol, tobacco, marijuana, and prescription drugs such as antidepressants, and more broadly, drug abuse and addictions are examined through a variety of methods from the humanities and social sciences.

Mulder J; Ter Bogt TFM; Raaijmakers QAW; Gabhainn SN; Monshouwer K; Vollebergh WAM. Is it the music? Peer substance use as a mediator of the link between music preferences and adolescent substance use. Journal of Adolescence 33(3): 387-394, 2010. (60 refs.)

Both music preferences and the substance use behavior of peers are important elements in explaining adolescent substance use. The extent to which music preference and peer use overlap in explaining adolescent substance use remains to be determined. A nationally representative sample 017324 Dutch school-going adolescents (aged 12-16) provided data on music preferences, substance use behaviors and perceived number of peers using substances. Factor analyses showed that preferences for eight music genres factored into four styles: Pop (chart music, Dutch pop), Adult (classical music, jazz), Urban (rap/hiphop, soul/R&B) and Hard (punk/hardcore, techno/hardhouse); substance use was indicated by smoking, drinking, and cannabis use. Structural equation modeling revealed that the relationship between music preference and substance use was either wholly or partially mediated by perceived peer use. Music can model substance use and fans of different types of music may select friends with use patterns that reinforce their own substance use inclinations.

Nan XL; Zhao XQ. The influence of liking for antismoking PSAs on adolescents' smoking-related behavioral intentions. Health Communication 25(5): 459-469, 2010. (66 refs.)

In this research, we examine the influence of liking for antismoking public service announcements (PSAs), relative to that of PSAs' perceived argument strength, on adolescents' smoking-related behavioral intentions. Data from the first Legacy Media Tracking Survey (LMTS-I) suggest that the relative persuasive impact of PSA liking and perceived argument strength varies as a function of message recipients' smoking status. PSA liking appears to be an important predictor of smoking intentions for never smokers, whereas perceived argument strength strongly predicts quitting intentions for current smokers. For former smokers, both perceived argument strength and PSA liking have significant effects on smoking intentions, with perceived argument strength exerting a stronger impact. Theoretical and practical implications of the findings are discussed.

Nemeth Z; Kun B; Demetrovics Z. The involvement of gamma-hydroxybutyrate in reported sexual assaults: A systematic review. (review). Journal of Psychopharmacology 24(9): 1281-1287, 2010. (48 refs.)

Over the past few years gamma-hydroxybutyrate (GHB) has generated widespread media interest as a possible 'date rape drug'. Our goal was to examine the extent to which GHB is associated with drug-facilitated sexual assaults. Literature was searched systematically and 11 studies, published between 1961 and June 30, 2009, were identified dealing specifically with the role of GHB in sexual assaults. GHB was detected in 0.2-4.4% of reported sexual assaults. The results demonstrate that a wide range of drugs may be present in cases of sexual assault, and many of them are much more frequent than GHB. Our results do not support the widespread labelling of GHB as a date rape drug as the prevalence of GHB is much lower than of other substances used in sexual assaults. On the other hand, however, the possible risk of GHB in this regard should not be neglected. Nevertheless, over-sensitive and sensation seeking media reports focusing on the association of sex crime and GHB might be counterproductive and misleading as they turn the attention away from other substances that are often used in sexual assaults.

Nicholls J. UK news reporting of alcohol: An analysis of television and newspaper coverage. Drugs: Education, Prevention and Policy 18(3): 200-206, 2011. (26 refs.)

Aims: To identify patterns in the representation of alcohol-related stories in the UK news media. To consider what kind of stories are reported and how reports are framed through thematic focus, imagery and the selection of sources by journalists. Methods: Quantitative content analysis of seven daily newspapers and four television news programmes over two sample periods: 20 December 2008-2 January 2009 and 15-22 March 2009. Findings: News reporting strongly emphasizes negative outcomes, especially violence, drink-driving and long-term health impacts - specifically liver disease. Reports of celebrity drinking are commonplace. Public health perspectives play a central role in the framing of alcohol-related stories. There is a clear gender divide: male drinking is associated with violence, while female drinking is associated with simply appearing drunk. Supermarkets are identified as a central cause of problem drinking, and cheap alcohol is seen as a greater threat than relaxed licensing laws. Conclusions: Compared to previous studies, the ''normalization'' of drinking in news reporting has declined. Public health advocates have successfully established themselves as key sources for alcohol stories. However, there remains no consensus on public health policy initiatives.

Nunez-Smith M; Wolf E; Huang HM; Chen PG; Lee L; Emanuel EJ et al. Media exposure and tobacco, illicit drugs, and alcohol use among children and adolescents: A systematic review. (review). Substance Abuse 31(3): 174-192, 2010. (58 refs.)

The authors systematically reviewed 42 quantitative studies on the relationship between media exposure and tobacco, illicit drug, and alcohol use among children and adolescents. Overall, 83% of studies reported that media was associated with increased risk of smoking initiation, use of illicit drugs, and alcohol consumption. Of 30 studies examining media content, 95% found a statistically significant association between increased media exposure and negative outcomes. Similarly, of the 12 studies evaluating the quantity of media exposure, 67% reported an association with a negative outcome. Overall, all 17 of the identified longitudinal studies supported a causal association between media exposure and negative outcomes over time. The evidence was strongest for links between media exposure and tobacco use; it was moderate for illicit drug use and alcohol use. Substanceantial variability in methodological rigor across studies and expanding definitions of media exposure contribute to persistent gaps in the knowledge base.

Page RM; Huong NT; Chi HK; Tien TQ. Smoking media literacy in Vietnamese adolescents. Journal of School Health 81(1): 34-41, 2011. (26 refs.)

METHODS: A cross-sectional survey of 2000 high school students completed the SML scale, which is based on an integrated theoretical framework of media literacy, and items assessing cigarette use. Ordinal logistic regression was used to determine the association of SML with smoking and susceptibility to future smoking. Ordinal logistic regression was also to determine whether smoking in the past 30 days was associated with the 8 domains/core concepts of media literacy which comprise the SML. RESULTS: Smoking media literacy was lower among the Vietnamese adolescents than what has been previously reported in American adolescents. Ordinal logistic regression analysis results showed that in the total sample SML was associated with reduced smoking, but there was no association with susceptibility to future smoking. Further analysis showed that results differed according to school and grade level. There did not appear to be association of smoking with the specific domains/concepts that comprise the SML. CONCLUSIONS: The association of SML with reduced smoking suggests the need for further research involving SML, including the testing of media literacy training interventions, in Vietnamese adolescents and also other populations of adolescents.

Perkins HW; Linkenbach JW; Lewis MA; Neighbors C. Effectiveness of social norms media marketing in reducing drinking and driving: A statewide campaign. Addictive Behaviors 35(10): 866-874, 2010. (31 refs.)

This research evaluated the efficacy of a high-intensity social norms media marketing campaign aimed at correcting normative misperceptions and reducing the prevalence of drinking and driving among 2i-to-34year-olds in Montana. A quasi-experimental design was used, such that regions of Montana were assigned to one of three experimental groups: social norms media marketing campaign, buffer, and control. Four random samples of Montanans between the ages of 21 and 34 were assessed at four time points over 18 months via phone surveys. Findings suggest that the social norms media campaign was successful at exposing the targeted population to social norms messages in the counties within the intervention region. Moreover, results demonstrate the campaign reduced normative misperceptions, increased use of designated drivers, and decreased drinking and driving among those young adults in counties within the intervention region. Social norms media marketing can be effective at changing drinking-related behaviors at the population level. This research provides a model for utilizing social norms media marketing to address other behaviors related to public health.

Samet JM. Smoking in movies: When will the saga end? (editorial). Tobacco Control 19(3): 173-174, 2010. (14 refs.)

Sanders-Jackson AN; Cappella JN; Linebarger DL; Piotrowski JT; O'Keeffe M; Strasser AA. Visual attention to antismoking PSAs: Smoking cues versus other attention-grabbing features. Human Communication Research 37(2): 275-+, 2011. (59 refs.)

This study examines how addicted smokers attend visually to smoking-related public service announcements (PSAs) in adults smokers. Smokers' onscreen visual fixation is an indicator of cognitive resources allocated to visual attention. Characteristic of individuals with addictive tendencies, smokers are expected to be appetitively activated by images of their addiction-specifically smoking cues. At the same time, these cues are embedded in messages that associate avoidance responses with these appetitive cues, potentially inducing avoidance of PSA processing. Findings suggest that segments of PSAs that contain smoking cues are processed similarly to segments that contain complex stimuli (operationalized in this case as high in information introduced) and that visual attention is aligned with smoking cues on the screen.

Sare J. Medicine and the media: How the media helped ban mephedrone. (editorial). British Medical Journal 342: e-article d1138, 2011. (0 refs.)

Sargent J. Conflicts of interest: When media conglomerates rate their productions. (editorial). Archives of Pediatrics & Adolescent Medicine 165(2): 181-182, 2011. (13 refs.)

This is a commentary on an article in this issue by Cullen et al. It speaks to the influence of the media conglomerates on its "ratings" of programs. Venues for image-based advertising declined, beginning in 1969, when the industry voluntarily ended all television advertising in response to a fairness doctrine ruling by the Federal Communications Commission and again in 1998, when the State Attorneys General negotiated the Master Settlement Agreement. In the Master Settlement Agreement, the tobacco industry agreed to give up many of their venues for image-based advertising including billboards, product placement in entertainment media, sponsorships, and branded merchandise distribution in return for ending state-sponsored lawsuits to recoup smoking-related Medicaid expenditures. Many companies went further and gave up magazine advertising. As a result, the single most important source of glamorized smoking images kids see today is entertainment media. Movies serve up billions of images of stars smoking annually to teenagers in the United States and in other countries, and movie smoking is the attributable cause of more than one-third of adolescent smoking onset. The Cullen and colleague study counted smoking depictions in contemporary television shows popular with adolescents. Smoking was present in 40% of the episodes.

Scull TM; Kupersmidt JB; Parker AE; Elmore KC; Benson JW. Adolescents' media-related cognitions and substance use in the context of parental and peer influences. Journal Of Youth and Adolescence 39(9): 981-998, 2010. (64 refs.)

Two cross-sectional studies investigated media influences on adolescents' substance use and intentions to use substances in the context of exposure to parental and peer risk and protective factors. A total of 729 middle school students (n = 351, 59% female in Study 1; n = 378, 43% female in Study 2) completed self-report questionnaires. The sample in Study 1 was primarily African-American (52%) and the sample in Study 2 was primarily Caucasian (63%). Across the two studies, blocks of media-related cognitions made unique contributions to the prediction of adolescents' current substance use and intentions to use substances in the future above and beyond self-reported peer and parental influences. Specifically, identification with and perceived similarity to media messages were positively associated with adolescents' current substance use and intentions to use substances in the future, and critical thinking about media messages and media message deconstruction skills were negatively associated with adolescents' intention to use substances in the future. Further, peer influence variables (e.g., peer pressure, social norms, peer substance use) acted as risk factors, and for the most part, parental influence variables (e.g., parental pressure to not use, perceived parental reaction) acted as protective factors. These findings highlight the importance of developing an increased understanding of the role of media messages and media literacy education in the prevention of substance use behaviors in adolescence.

Seear K; Fraser S. The 'sorry addict': Ben Cousins and the construction of drug use and addiction in elite sport. Health Sociology Review 19(2): 176-191, 2010. (53 refs.)

Australian Football League (AFL) player Ben Cousins is one of the most highly acclaimed and recognised athletes in Australia. Followed closely in the media, his off-field activities are subject to as much attention and speculation as those on the field. In 2007, Cousins and his family confirmed long-standing rumours that he was an illicit (non-performance enhancing) drug user. Following a series of incidents, his football contract was terminated and Cousin's publicly entered drug rehabilitation. In this article we explore the multiple extant accounts of Cousins' drug use. We examine media representations of his drug use, including accounts from a range of key stakeholders, and we also look at Cousins' public accounts of his own drug use. What emerges is paradoxical picture both of Cousins himself and of drug users more broadly. Cousins is simultaneously positioned as in control and out of control, as manipulative and as subject to the manipulations of his 'addiction', as criminal and victim, as culpable and innocent. In the process, he acts as a figure through which contemporary understandings of the nature and implications of addiction are produced and reproduced. What is addiction? If as many now take for granted, it is a disease requiring a medical response, what can be said about the agency and responsibility of the 'addict' in the context of elite sport? How do mainstream understandings of elite sportsmen as intrinsically masterful, commanding and physically exemplary mesh with assumptions about drug addicts as passive and physically compromised? In considering this intersection of discourses of elite sports and of addiction, we also explore some of the unique dimensions of the Cousins case including the challenge his embodied athleticism poses to understandings of his drug use, and the significance attributed to his rehabilitation and 'comeback' in 2009. We conclude with some reflections on the ways in which Cousins' case troubles certainties about drug use, and on the strategic efficacy of disease models of addiction in Australia.

Shadel WG; Martino SC; Haviland A; Setodji C; Primack BA. Smoking motives in movies are important for understanding adolescent smoking: A preliminary investigation. Nicotine & Tobacco Research 12(8), 2010. (22 refs.)

Introduction: Exposure to smoking in movies is strongly associated with smoking uptake and maintenance among adolescents. However, little is known about what features of movies (e. g., the context for smoking or motives for a character smoking) moderate the association between exposure to movie smoking and adolescent smoking. This laboratory study examined whether exposure to movie smoking that is portrayed as having a clear motive is associated with the desire to smoke differently than smoking that is portrayed as having no clear motive. Methods: A sample of 77 middle school students (mean age of 12.8 years, 62% male, 60% Caucasian) viewed movie clips that portrayed smoking as helping to facilitate social interaction, to relax, to appear rebellious, or as having no clear motive. After exposure to each clip, participants rated their desire to smoke. Results: Exposure to clips where smoking was portrayed as helping characters to relax was associated with a significantly stronger desire to smoke compared with clips where the motive for smoking was unclear. Desire to smoke was similar for clips where no motive was clear, social smoking clips, and rebellious smoking clips. Discussion: These results suggest that the way that smoking is portrayed in movies is important in determining its effect on adolescent smoking.

Slater MD; Hayes AF. The influence of youth music television viewership on changes in cigarette use and association with smoking peers: A social identity, reinforcing spirals perspective. Communication Research 37(6): 751-773, 2010. (38 refs.)

Prior research has found strong evidence of a prospective association between R-rated movie exposure and teen smoking. Using parallel process latent-growth modeling, the present study examines prospective associations between viewing of music video channels on television (e.g., MTV and VH-1) and changes over time in smoking and association with smoking peers. Results showed that baseline viewing of music-oriented channels such as MTV and VH-1 robustly predicted increasing trajectories of smoking and of associating with smoking peers, even after application of a variety of controls including parent reports of monitoring behavior. These results are consistent with the arguments from the reinforcing spirals model that such media use serves as a means of developing emergent adolescent social identities consistent with associating with smoking peers and acquiring smoking and other risk behaviors; evidence also suggests that media choice in reinforcing spiral processes are dynamic and evolve as social identity evolves.

Slater MD; Jain P. Teens' attention to crime and emergency programs on television as a predictor and mediator of increased risk perceptions regarding alcohol-related injuries. Health Communication 26(1): 94-103, 2011. (65 refs.)

This study examined the hypotheses that media exposure and attention would predict, and partially mediate, the effects of various individual-difference variables on alcohol-related risk perceptions among teen viewers of crime and emergency (e.g., medical drama) shows on television. Risk perceptions including perceived severity, perceived alcohol-attributable fraction of incidents involving alcohol, controllability, and concern regarding alcohol-related crime, assaults, and other injuries were the outcome measures. Attention to crime and emergency shows was predictive of increased concern and other risk perceptions regarding alcohol-related incidents. Attention also partially mediated the effects of demographic and other individual difference variables on adolescents' risk perceptions regarding alcohol-related injuries. The findings (a) suggest emergency and medical drama television narratives can at times have incidental positive impacts on health-related attitudes and (b) provide further evidence regarding the endogenous nature of media use variables in influencing such attitudes.

Smith EA; McDaniel PA. Covering their butts: Responses to the cigarette litter problem. Tobacco Control 20(2): 100-106, 2011. (103 refs.)

Background: Cigarette butt litter is a potential target of tobacco control. In addition to its toxicity and non-biodegradability, it can justify environmental regulation and policies that raise the price of tobacco and further denormalise its use. This paper examines how the tobacco industry has managed the cigarette butt litter issue and how the issue has been covered in the media. Methods: We searched the Legacy Tobacco Documents Library (http: legacy.library.ucsf.edu/) using a snowball strategy. We analysed data from approximately 700 documents, dated 1959-2006, using an interpretive approach. We also searched two newspaper databases, Lexis/Nexis and Newsbank, and found 406 relevant articles, dated 1982-2009 which we analysed quantitatively and qualitatively. Results: The tobacco industry monitored and developed strategies for dealing with the cigarette litter issue because it affected the social acceptability of smoking, created the potential for alliances between tobacco control and environmental advocates, and created a target for regulation. The industry developed anti-litter programs with Keep America Beautiful (KAB) and similar organisations. Media coverage focused on industry-acceptable solutions, such as volunteer clean-ups and installation of ashtrays; stories that mentioned KAB were also more frequently positive towards the tobacco industry. Among alternative approaches, clean outdoor air (COA) laws received the most media attention. Conclusions: Cigarette litter, like secondhand smoke, is the result of smoker behaviour and affects nonsmokers. The tobacco industry has tried and failed to mitigate the impact of cigarette litter. Tobacco control advocates should explore alliances with environmental groups and propose policy options that hold the industry accountable for cigarette waste.

Stephens RP. Addiction to melodrama. Substance Use & Misuse 46(7): 859-871, 2011. (54 refs.)

Addiction films have been shaped by the internal demands of a commercial medium. Specifically, melodrama, as a genre, has defined the limits of the visual representation of addiction. Similarly, the process of intermedialization has tended to induce a metamorphosis that shapes disparate narratives with diverse goals into a generic filmic form and substantially alters the meanings of the texts. Ultimately, visual representations shape public perceptions of addiction in meaningful ways, privileging a moralistic understanding of drug addiction that makes a complex issue visually uncomplicated by reinforcing "common sense" ideas of moral failure and redemption.

Vallone DM; Duke JC; Cullen J; McCausland KL; Allen JA. Evaluation of EX: A national mass media smoking cessation campaign. American Journal of Public Health 101(2): 302-309, 2011. (28 refs.)

Objectives. We used longitudinal data to examine the relationship between confirmed awareness of a national, branded, mass media smoking cessation campaign and cessation outcomes. Methods. We surveyed adult smokers (n=4067) in 8 designated market areas ("media markets") at baseline and again approximately 6 months later. We used multivariable models to examine campaign effects on cognitions about quitting, quit attempts, and 30-day abstinence. Results. Respondents who demonstrated confirmed awareness of the EX campaign were significantly more likely to increase their level of agreement. on a cessation-related cognitions index from baseline to follow-up (odds ratio [OR]=1.6; P=.046). Individuals with confirmed campaign awareness had a 24% greater chance than did those who were not aware of the campaign of making a quit attempt between baseline and follow-up (OR=1.24; P=.048). Conclusions. A national, branded, mass media smoking cessation campaign can change smokers' cognitions about quitting and increase quit attempts. We strongly recommend that federal and state governments provide funding for media campaigns to increase smoking cessation, particularly for campaigns that have been shown to impact quit attempts and abstinence.

Vallone DM; Niederdeppe J; Richardson AK; Patwardhan P; Niaura R; Cullen J. A national mass media smoking cessation campaign: Effects by race/ethnicity and education. American Journal of Health Promotion 25(5, Supplement S): S38-S50, 2011. (44 refs.)

Purpose. To assess the effectiveness of a large-scale, national smoking cessation media campaign., the EX campaign, across racial/ethnic and educational subgroups. Design. A longitudinal random-digit-dial panel study conducted prior to and 6 months following the national launch of the campaign. Setting. The sample was drawn from eight designated media markets in the United States. Subjects. The baseline survey was conducted on 5616 current smokers, aged 18 to 49 years, and 4067 (73% follow-up response rate) were resurveyed at the 6-month follow-up. Measures. The primary independent variable is confirmed awareness of the campaign advertising, and the outcome variables are follow-up cessation-related cognitions index score and quit attempts. Analysis. Multivariable logistic and linear regression analyses were conducted within racial/ethnic and educational strata to assess the strength of association between confirmed awareness of campaign advertising and cessation-related outcomes. Results. Confirmed awareness of campaign advertising increased favorable cessation-related cognitions among Hispanics and quit attempts among non-Hispanic blacks, and increased favorable cessation-related cognitions and quit attempts among smokers with less than a high school education. Conclusions. These results suggest that the EX campaign may be effective in promoting cessation-related cognitions and behaviors among minority and disadvantaged smokers who experience a disproportionate burden of tobacco-related illness and mortality.

van Gemert C; Dietze P; Gold J; Sacks-Davis R; Stoove M; Vally H et al. The Australian national binge drinking campaign: Campaign recognition among young people at a music festival who report risky drinking. BMC Public Health 11: e-article 482, 2011. (31 refs.)

Background: The Australian Government launched a mass media campaign in 2009 to raise awareness of the harms and costs associated risky drinking among young Australians. The aim of this study was to assess if young people attending a music festival who report frequent risky single occasions of drinking (RSOD) recognise the key message of the campaign, "Binge drinking can lead to injuries and regrets", compared to young people who report less frequent RSOD. Methods: A cross-sectional behavioural survey of young people (aged 16-29 years) attending a music festival in Melbourne, Australia, was conducted in January 2009. We collected basic demographics, information on alcohol and other drug use and sexual health and behaviour during the previous 12 months, and measured recognition of the Australian National Binge Drinking Campaign key message. We calculated the odds of recognition of the key slogan of the Australian National Binge Drinking Campaign among participants who reported frequent RSOD (defined as reported weekly or more frequent RSOD during the previous 12 months) compared to participants who reported less frequent RSOD. Results: Overall, three-quarters (74.7%) of 1072 participants included in this analysis recognised the campaign message. In the adjusted analysis, those reporting frequent RSOD had significantly lower odds of recognising the campaign message compared to those not reporting frequent RSOD (OR 0.7, 95% CI 0.5-0.9), whilst females had significantly greater odds of recognising the campaign message compared to males (OR 1.8, 95% CI 1.4-2.1). Conclusions: Whilst a high proportion of the target group recognised the campaign, our analysis suggests that participants that reported frequent RSOD - and thus the most important group to target - had statistically significantly lower odds of recognising the campaign message.

Verlhiac JF; Chappe J; Meyer T. Do threatening messages change intentions to give up tobacco smoking? The role of argument framing and pictures of a healthy mouth versus an unhealthy mouth. Journal of Applied Social Psychology 41(9): 2104-2122, 2011. (41 refs.)

Do preventive-behavior framing and outcomes of action framing moderate behavioral intention to stop smoking when health messages are illustrated by pictures? We manipulated arguments about preventive action (presence or absence), as well as arguments about the outcome of action (gain or loss), and the pictures that illustrated outcome action (healthy or unhealthy mouths). Behavioral intention was higher when pictures of unhealthy mouths were presented, regardless of framing, and when pictures of healthy mouths illustrated the presence of preventive action. Applications of this study on tobacco risk health campaigns based on text and pictures are discussed.

Viswanath K; Ackerson LK; Sorensen G; Gupta PC. Movies and TV influence tobacco use in India: Findings from a national survey. PLoS one 5(6): e11365, 2010. (28 refs.)

Background: Exposure to mass media may impact the use of tobacco, a major source of illness and death in India. The objective is to test the association of self-reported tobacco smoking and chewing with frequency of use of four types of mass media: newspapers, radio, television, and movies. Methodology/Principal Findings: We analyzed data from a sex-stratified nationally-representative cross-sectional survey of 123,768 women and 74,068 men in India. All models controlled for wealth, education, caste, occupation, urbanicity, religion, marital status, and age. In fully-adjusted models, monthly cinema attendance is associated with increased smoking among women (relative risk [RR]: 1.55; 95% confidence interval [CI]: 1.04-2.31) and men (RR: 1.17; 95% CI: 1.12-1.23) and increased tobacco chewing among men (RR: 1.15; 95% CI: 1.11-1.20). Daily television and radio use is associated with higher likelihood of tobacco chewing among men and women, while daily newspaper use is related to lower likelihood of tobacco chewing among women. Conclusion/Significance: In India, exposure to visual mass media may contribute to increased tobacco consumption in men and women, while newspaper use may suppress the use of tobacco chewing in women. Future studies should investigate the role that different types of media content and media play in influencing other health behaviors.

Wackowski OA; Lewis MJ; Hrywna M. Banning smoking in New Jersey casinos: A content analysis of the debate in print media. Substance Use & Misuse 46(7): 882-888, 2011. (24 refs.)

New Jersey's (NJ's) 2006 statewide smoking ban controversially exempted Atlantic City casinos. This study presents a content analysis of 210 NJ newspaper articles printed between November 2005 and February 2007, and describes the different frames and supporting information used to argue for or against exempting casinos from the smoking ban. Those in favor of exempting casinos framed the issue in terms of economics and compromise, while those opposing it framed the issue in terms of equity and health. Implications for policy initiatives and media advocacy are discussed. This work was supported in part by funding from the NJ Department of Health & Senior Services.

Wade B; Merrill RM; Lindsay GB. Cigarette pack warning labels in Russia: How graphic should they be? European Journal of Public Health 21(3): 366-372, 2011. (37 refs.)

Methods: Nationally representative data were collected from 1778 participants in the Russian Federation in October 2009. A cross-sectional survey was conducted through person-to-person household interviews with respondents aged epsilon 14 years. Survey questions included standard demographic queries and three study-specific questions. Participants rated the strength of 13 cigarette warning labels according to their effectiveness to deter from smoking. Smoking status and the population's acceptance of similar warning labels was also measured. Results: A dose-response pattern is apparent between the degree of graphic content of cigarette warning labels and the public's perception regarding the warning label's ability to discourage smoking. Approximately 87% of all respondents thought Russian authorities should require tobacco manufacturers to place graphic warning labels on cigarette packs, while 80% of current smokers wanted their government to enact such enforcement. Conclusion: The Russian population would strongly support government policy that would require graphic warning labels to be placed on cigarette packs in their country. In order to best deter from smoking, future cigarette warning labels in Russia should be as graphic as possible.

Wakefield MA; Loken B; Hornik RC. Use of mass media campaigns to change health behaviour. (review). Lancet 376(9748): 1261-1271, 2010. (104 refs.)

Mass media campaigns are widely used to expose high proportions of large populations to messages through routine uses of existing media, such as television, radio, and newspapers. Exposure to such messages is, therefore, generally passive. Such campaigns are frequently competing with factors, such as pervasive product marketing, powerful social norms, and behaviours driven by addiction or habit. In this Review we discuss the outcomes of mass media campaigns in the context of various health-risk behaviours (eg, use of tobacco, alcohol, and other drugs, heart disease risk factors, sex-related behaviours, road safety, cancer screening and prevention, child survival, and organ or blood donation). We conclude that mass media campaigns can produce positive changes or prevent negative changes in health-related behaviours across large populations. We assess what contributes to these outcomes, such as concurrent availability of required services and products, availability of community-based programmes, and policies that support behaviour change. Finally, we propose areas for improvement, such as investment in longer better-funded campaigns to achieve adequate population exposure to media messages.

Walsh G; Hassan LM; Shiu E; Andrews JC; Hastings G. Segmentation in social marketing: Insights from the European Union's multi-country, antismoking campaign. European Journal of Marketing 44(7-8): 1140-1164, 2010. (73 refs.)

Purpose - In 2005, the European Union launched a four-year antismoking television advertising campaign across its 25 Member States. This study aims to evaluate the second and third years (2006 and 2007) of the campaign based on telephone interviews with over 24,000 consumers (smokers, non-smokers, and ex-smokers). Design/methodology/approach - The study focuses on smokers and examines the potential for using segmentation and targeting in informing the campaign. Three important factors are used to identify clusters: attitude toward the campaign; comprehension of the campaign; and inclination to think responsibly about their smoking behaviour. Findings - Cluster analyses identify three distinct and significant target groups (message-involved, message-indifferent, and message-distanced) who respond differentially to the advertising. Furthermore, the percentage of respondents within each cluster varies across the EU Member States. Using Schwartz's cultural framework, the cultural dimension of "openness to change versus conservatism" is found to explain substantial cross-national variation in message-involved and messaged-distanced respondents. Research limitations/implications - Cluster solutions are shown to be stable across the two data waves. Implications of these results are discussed. Originality/value - This is the first study that seeks to better understand consumer reactions to social-marketing advertising across different segments of the overall target group.

Waylen AE; Leary SD; Ness AR; Tanski SE; Sargent JD. Cross-sectional association between smoking depictions in films and adolescent tobacco use nested in a British cohort study. Thorax 66(10): 856-861, 2011. (36 refs.)

Objective: To assess associations between exposure to smoking depictions in films and adolescent tobacco use in a British population cohort. Methods: Data on exposure to smoking in films and smoking behaviour were collected from 5166 15-year-old adolescents in the UK. Main outcome measures were smoking initiation (ever tried a cigarette) and current smoking status. Social, family and behavioural factors were adjusted for, together with alcohol use and peer smoking as potential mediators. Data from all existing cross-sectional studies examining the effects of exposure to smoking in films were summarised in a meta-analysis. Results: Higher exposure to smoking in films was associated with a dose-response increase in the risk of smoking initiation even after adjusting for confounders. Adolescents in the highest exposure quartile were 1.73 (95% CI 1.55 to 1.93) times (RR) more likely to initiate smoking than those in the lowest quartile. They were more likely to report current smoking after adjusting for social and familial factors (RR 1.47 (95% CI 1.07 to 2.02)), but the association attenuated after including behavioural factors (RR 1.34 (95% CI 0.95 to 1.87)). The meta-analysis shows that, after aggregation of all relevant data, viewing smoking in films increases the risk of smoking onset by over 100% (combined RR 2.13 (95% CI 1.76 to 2.57)) and the risk of current or established smoking behaviour by 68% (combined RR 1.68 (95% CI 0.40 to 2.01)). Conclusions: This study provides evidence that adolescents in the UK and elsewhere who are exposed to smoking depictions in films are more likely to initiate smoking. Given the association between smoking and poor health outcomes, these data justify a review of film ratings.

Weeks MO. Tobacco and media exposure in poor neighbourhoods: Implications for the incidence of smoking among community residents. International Journal of Nursing Practice 17(5): 534-538, 2011. (12 refs.)

It is an accepted truth that tobacco, as well as second-hand smoke, causes lung and other cancers. This health policy fact sheet examines the need and implications for tobacco control legislation in the United States. Major stakeholders and special interest groups influence whether or not further tobacco control legislation can be passed and who it affects. This paper will review not only the ethical implications, such as the ethical theory, ethical principles and ethical rules of conduct that support tobacco control legislation, but also its legal and economic implications as well as media influences. This paper concludes with the authors' assessment that the United States is in fact in need of more tobacco control legislation.

Werse B. (Herbal) incenses, fertilizer pills and bath salts: Current developments in the legal grey area surrounding psychoactive substances Kriminologisches Journal. Kriminologisches Journal 54(2): 99-111, 2011. (16 refs.)

In Mid-2008, psychoactive so-called herbal blends named "Spice" were a big issue in the German media. The article presents results from a pilot study on types of users and (inter alia, law-induced) motivations of use: Herbal blends are mainly used as a substitute for cannabis. To a great extent, the demand for these products depends on media coverage. In addition to herbal blends, some other products have appeared on the legal market. These pills and powders, provided with deliberately wrong declarations as well, are used as party drugs.

Juventa Verlag GHBH

Whelan E; Asbridge M; Haydt S. Representations of OxyContin in North American newspapers and medical journals. Pain Research & Management 16(4): 252-258, 2011. (30 refs.)

BACKGROUND: There are public concerns regarding OxyContin (Purdue Pharma, Canada) and charges within the pain medicine community that media coverage of the drug has been biased. OBJECTIVE: To analyze and compare representations of OxyContin in medical journals and North American newspapers in an attempt to shed light on how each contributes to the 'social problem' associated with OxyContin. METHODS: Using searches of newspaper and medical literature databases, two samples were drawn: 924 stories published between 1995 and 2005 in 27 North American newspapers, and 197 articles published between 1995 and 2007 in 33 medical journals in the fields of addiction/substance abuse, pain/anesthesiology and general/internal medicine. The foci, themes, perspectives represented and evaluations of OxyContin presented in these texts were analyzed statistically. RESULTS: Newspaper coverage of OxyContin emphasized negative evaluations of the drug, focusing on abuse, addiction, crime and death rather than the use of OxyContin for the legitimate treatment of pain. Newspaper stories most often conveyed the perspectives of law enforcement and courts, and much less often represented the perspectives of physicians. However, analysis of physician perspectives represented in newspaper stories and in medical journals revealed a high degree of inconsistency, especially across the fields of pain medicine and addiction medicine. CONCLUSION: The prevalence of negative representations of OxyContin is often blamed on biased media coverage and an ignorant public. However, the proliferation of inconsistent messages regarding the drug from physicians plays a role in the drug's persistent status as a social problem.

Wills TA; Gibbons FX; Sargent JD; Gerrard M; Lee HR; Dal Cin S. Good self-control moderates the effect of mass media on adolescent tobacco and alcohol use: Tests with studies of children and adolescents. Health Psychology 29(5): 539-549, 2010. (72 refs.)

Objective: To investigate whether self-control moderates the effect of media influences on tobacco and alcohol use among youth and if so how this effect occurs. Design: In Study 1, a regional sample of 10-year olds (N = 290) was interviewed in households; attention to tobacco/alcohol advertising was assessed. In Study 2, a national sample of youth ages 10-14 years (N = 6,522) was surveyed by telephone; exposure to tobacco/alcohol use in movies was assessed. Good self-control was measured in both studies. Main Outcome Measures: Willingness to use substances and affiliation with peer substance users (Study 1); involvement in smoking or drinking (Study 2). Results: In Study 1, the effect of tobacco/alcohol advertising on predisposition for substance use was lower among persons scoring higher on good self-control. In Study 2, the effect of movie smoking/alcohol exposure on adolescent tobacco/alcohol use was lower, concurrently and prospectively, among persons scoring higher on good self-control. Moderation occurred primarily through reducing the effect of movie exposure on positive smoking/alcohol expectancies and the effect of expectancies on adolescent use; some evidence for moderation of social processes was also noted. Covariates in the analyses included demographics, sensation seeking, and IQ. Conclusion: Good self-control reduces the effect of adverse media influences on adolescent tobacco and alcohol use. Findings on the processes underlying this effect may be useful for media literacy and primary prevention programs.

Wilson N; Weerasekera D; Hoek J; Li J; Edwards R. Increased smoker recognition of a national quitline number following introduction of improved pack warnings: ITC Project New Zealand. Nicotine & Tobacco Research 12(Supplement 1): s72-s77, 2010. (18 refs.)

Introduction: We examined how recognition of a national quitline number changed after new health warnings were required on tobacco packaging in New Zealand (NZ). Methods: The NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) is a cohort study that surveyed smokers in two waves (N = 1,376 and N = 923). Wave 1 respondents were exposed to text-based warnings with a quitline number but no wording to indicate that it was the "Quitline" number. Wave 2 respondents were exposed to pictorial health warnings (PHWs) that included the word "Quitline" beside the number as well as a cessation message featuring the Quitline number and repeating the word "Quitline." Results: The introduction of the new PHWs was associated with a 24 absolute percentage point between-wave increase in Quitline number recognition (from 37% to 61%, p < .001). Recognition increased from a minority of respondents to a majority for all age groups, genders, deprivation levels (using small area and individual measures), financial stress (two measures), and ethnic groups (e. g., the level for Maori in Wave 2: 62%, Pacific peoples: 61%, and European/other: 62%). There was also an equalizing effect on previous differences in Quitline recognition by gender, ethnic group, and for both deprivation measures. Discussion: This study provides some evidence for the value of clearly identifying quitline numbers on tobacco packaging as part of PHWs. While this finding is consistent with previously published studies, the finding that this intervention appeared to benefit all sociodemographic groups is novel.

Zhu SH; Gardiner P; Cummins S; Anderson C; Wong S; Cowling D et al. Quitline utilization rates of African-American and white smokers: The California experience. American Journal of Health Promotion 25(5, Supplement S): S51-S58, 2011. (42 refs.)

Purpose. To compare the utilization rate of a statewide tobacco quitline by African-American smokers to that of white smokers. Design, Setting, and Subjects. Observational study of 18 years of state quitline operation in California. Subjects were 61,096 African-American and 279,042 white smokers who called the quitline from August 1992 to December 2009. Data from six California Tobacco Surveys, 1993, 1996, 1999, 2002, 2005, and 2008 were also used. Measure. Callers' answers' to the question how they heard about the quitline were grouped into four categories: media, health care providers, friends/family, and others. Analysis. The averaged annual quitline call volume fir each ethnic group was divided by the total number of smokers in that group, based on California Tobacco Surveys, to produce the annual quitline utilization rate. Results. In five out of six periods of comparison, African-American smokers had a higher annual utilization rate than white smokers. The odds ratios [ORs] ranged from 1.44 to 2.40 (all p < .05). In the 1996 comparison, the OR was .90 (p < .05). The difference in utilization rates that is attributed to media, accounts for most of the difference in total utilization rates between the two ethnic groups. Conclusions. Within the context of California's comprehensive tobacco control program, which includes a strong media campaign, African-American smokers were significantly more likely to call the state quitline than white smokers were. Promoting the quitline as part of antismoking media campaigns can help reduce disparity in cessation service utilization.