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CORK Bibliography: Laws

85 citations. January 2010 to present

Prepared: December 2010

Akhtar PC; Haw SJ; Levin KA; Currie DB; Zachary R; Currie CE. Socioeconomic differences in second-hand smoke exposure among children in Scotland after introduction of the smoke-free legislation. Journal of Epidemiology and Community Health 64(4): 341-346, 2010. (33 refs.)

Background: To examine the impact of the Scottish smoke-free legislation on social inequalities in secondhand smoke (SHS) exposure among primary school children. Methods: Comparison of nationally representative, cross-sectional, class-based surveys carried out in the same schools before and after legislation. Participants were 2532 primary school children ( primary 7; aged around 11 y) surveyed in January 2006 ( before legislation) and 2389 in January 2007 ( after legislation). Outcome measures were salivary cotinine concentrations, self-reported family socioeconomic classification ( family SEC) and family affluence scale (FAS). Results: After adjusting for number of smoking parents, mean cotinine concentration varied significantly across both family SEC and FAS groups, and increased significantly stepwise from high to low family SEC/FAS. Mean cotinine fell in all family SEC/FAS groups after legislation. The relative drop in mean cotinine was equal across all family SEC/FAS groups. Adding an interaction term between survey-year and family SEC/FAS to the model showed an increase in inequalities over time, but was only significant at the 93% level using FAS and 73% using family SEC. Conclusion: Inequalities in SHS exposure exist among 11-year-old children in Scotland. Smoke-free legislation has reduced exposure to SHS among all children. Although the greatest absolute reduction in cotinine is observed in the lowest SEC/FAS group, cotinine levels remain highest for this group and there is a suggestion of possible increases in inequalities, which may warrant longer-term monitoring.

Copyright 2010, BMJ Publishing Group

Antin TMJ; Moore RS; Lee JP; Satterlund TD. Law in practice: Obstacles to a smokefree workplace policy in bars serving Asian patrons. Journal of Immigrant and Minority Health 12(2): 221-227, 2010. (32 refs.)

The California smokefree workplace ordinance (AB13) has been well-received, even in bars where deeply established traditions of smoking may exist. However, a closer investigation of bars where indoor smoking persists revealed that bar workers in some ethnic minority communities continue to be exposed to secondhand smoke in their workplaces. To identify sociocultural factors that may impede the adoption of AB13, the researchers conducted 150 observations and 29 patron and staff interviews in 50 California bars serving Asian patrons in Los Angeles and San Francisco counties. Observers witnessed indoor smoking in 82% of the bars. Interviews revealed that social relationships, social interactions, and a tendency to avoid confrontation complicated the positive reception of AB13 within these bars. Accounting for sociocultural factors provides a nuanced understanding of the challenges involved in implementing tobacco control policy in such diverse settings and may allow for culturally appropriate tobacco policy development and implementation in other jurisdictions.

Copyright 2010, Springer

Assum T. Reduction of the blood alcohol concentration limit in Norway: Effects on knowledge, behavior and accidents. Accident Analysis and Prevention 42(6): 1523-1530, 2010. (21 refs.)

From January 1, 2001, the legal blood alcohol concentration (BAC) limit in Norway was reduced from 0.5 to 0.2 g/l. A before-and-after telephone survey concerning the effects of the reduced BAC limit was carried out. 3001 driver's license holders were interviewed before and after the amendment. The percentage of drivers claiming that they will drink no alcohol before driving has increased from 82 to 91 percent, thus the distinction between driving a motor vehicle and drinking alcohol has become clearer. Drivers influenced by alcohol and involved in accidents have on the average much higher BACs than 0.5 g/l. Statistics on alcohol-related accidents are not available for the years before and after the legal amendment, but single-vehicle night-time and weekend personal-injury and fatal crashes are used as surrogate measures. There are no significant decreases in these proxies from the six years before to the six years after the reductions of the legal limit.

Copyright 2010, Elsevier Science

Babor TF. Drug Policy And The Public Good: A summary of the book. Addiction 105(7): 1137-1145, 2010. (30 refs.)

Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence.

Copyright 2010, Wiley-Blackwell

Baehr RJ. A new wave of paternalistic tobacco regulation. Iowa Law Review 95(5): 1663-1696, 2010. (21 refs.)

This Note proposes that the engine of tobacco policy in the United States the nonsmokers' rights movement has largely and successfully run its course, leaving the United States primed for greater paternalistic tobacco regulation. Sure enough, we may be witnessing a sea change in tobacco policy with the introduction of the Family Smoking Prevention and Tobacco Control Act. Many commentators from both sides of the debate, however, have decried the Act: It either bloodies the hands of the Food and Drug Administration by making it complicit in the distribution of the world's deadliest consumer good, or it marks the anti-tobacco movement's furthest intrusion into free markets and free speech. This Note charts a middle course, alternatively praising and critiquing the Act. It also draws parallels to some recent instances of paternalistic regulation on the municipal level, specifically laws banning tobacco sales in pharmacies. Finally, it attempts to derive from these discussions some normative conclusions for future paternalistic tobacco regulation.

Copyright 2010, University of Iowa

Baldwin ML; Marcus SC; De Simone J. Job loss discrimination and former substance use disorders. Drug and Alcohol Dependence 110(1-2): 1-7, 2010. (26 refs.)

Persons with former alcohol or drug use disorders are protected from labor market discrimination by the Americans with Disabilities Act of 1990. They have been neglected, however, in empirical studies of labor market discrimination following implementation of the Act. We apply econometric techniques used to study other disabled groups to determine if there are significant differences in employment outcomes for persons with and without former substance use disorders and, if so, what part of these differences potentially can be attributed to employer discrimination. There are no significant differences in employment rates between persons with and without former substance use disorders, and among those who are employed no significant differences in rates of full-time employment. But persons with former substance use disorders report significantly higher rates of involuntary job loss within the previous year. Part of the differential remains unexplained after controlling for other factors that affect employment outcomes, suggesting employer discrimination may be one cause of poor job stability among this group. Certain identifiable subgroups with low levels of human capital are particularly susceptible to substance-related discrimination.

Copyright 2010, Elsevier Science

Bell K; McCullough L; Salmon A; Bell J. 'Every space is claimed': Smokers' experiences of tobacco denormalisation. Sociology of Health & Illness 32(6): 914-929, 2010. (44 refs.)

Over the past decade, the strategy of 'denormalising' tobacco use has become one of the cornerstones of the global tobacco control movement. Although tobacco denormalisation policies primarily affect people on the lowest rungs of the social ladder, few qualitative studies have explicitly set out to explore how smokers have experienced and responded to these legislative and social changes in attitudes towards tobacco use. Drawing on a qualitative study of interviews with 25 current and ex-smokers living in Vancouver, Canada, this paper examines the ways they interpret and respond to the new socio-political environment in which they must manage the increasingly problematised practice of tobacco smoking. Overall, while not opposed to smoking restrictions per se, study participants felt that recent legislation, particularly efforts to prohibit smoking in a variety of outdoor settings, was overly restrictive and that all public space had increasingly been 'claimed' by non-smokers. Also apparent from participants' accounts was the high degree of stigma attached to smoking. However, although the 'denormalisation' environment had encouraged several participants to quit smoking, the majority continued to smoke, raising ethical and practical questions about the value of denormalisation strategies as a way of reducing smoking-related mortality and morbidity.

Copyright 2010, Wiley-Blackwell

Blanco-Marquizo A; Goja B; Peruga A; Jones MR; Yuan J; Samet JM et al. Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay. Tobacco Control 19(3): 231-234, 2010. (32 refs.)

Background: Smoke-free legislation eliminating tobacco smoke in all indoor public places and workplaces is the international standard to protect all people from exposure to secondhand smoke. Uruguay was the first country in the Americas and the first middle-income country in the world to enact a comprehensive smoke-free national legislation in March 2006. Objective To compare air nicotine concentrations measured in indoor public places and workplaces in Montevideo, Uruguay before (November 2002) and after (July 2007) the implementation of the national legislation. Methods: Air nicotine concentrations were measured for 7-14 days using the same protocol in schools, a hospital, a local government building, an airport and restaurants and bars. A total of 100 and 103 nicotine samples were available in 2002 and 2007, respectively. Results: Median (IQR) air nicotine concentrations in the study samples were 0.75 (0.2-1.54) mu g/m(3) in 2002 compared to 0.07 (0.0-0.20) mu g/m(3) in 2007. The overall nicotine reduction comparing locations sampled in 2007 to those sampled in 2002 was 91% (95% CI 85% to 94%) after adjustment for differences in room volume and ventilation. The greatest nicotine reduction was observed in schools (97% reduction), followed by the airport (94% reduction), the hospital (89% reduction), the local government building (86% reduction) and restaurants/bars (81% reduction). Conclusion Exposure to secondhand smoke has decreased greatly in indoor public places and workplaces in Montevideo, Uruguay, after the implementation of a comprehensive national smoke-free legislation. These findings suggest that it is possible to successfully implement smoke-free legislations in low and middle-income countries.

Copyright 2010, BMJ Publishing

Blumenson E; Nilsen E. Liberty lost: The moral case for marijuana law reform. Indiana Law Journal 85(1): 279-299, 2010. (115 refs.)

Marijuana policy analyses typically focus on the relative costs and benefits of present policy and its feasible alternatives. This Essay addresses a prior, threshold issue: whether marijuana criminal laws abridge fundamental individual rights, and if so, whether there are grounds that justify doing so. Over 700, 000 people are arrested annually for simple marijuana possession, a small but significant proportion of the 100 million Americans who have committed the same crime. In this Essay, we present a civil libertarian case for repealing marijuana possession laws. We put forward two arguments corresponding to the two distinct liberty concerns implicated by laws that both ban marijuana use and punish its users. The first argument opposes criminalization and demonstrates that marijuana use does not constitute the kind of wrongful conduct that is a prerequisite for just punishment. The second argument demonstrates that even in the absence of criminal penalties, prohibition of marijuana use violates a moral right to exercise autonomy in personal matters-a corollary to John Stuart Mill's harm principle in the utilitarian tradition, or, in the nonconsequentialist tradition, to the respect for personhood that was well described by the Supreme Court in its Lawrence v. Texas opinion. Both arguments are based on principles of justice that are uncontroversial in other contexts.

Copyright 2010, Indiana University School of Law

Brandt SD; Sumnall HR; Measham F; Cole J. Analyses of second-generation 'legal highs' in the UK: Initial findings. Drug Testing and Analysis 2(7-8): 377-382, 2010. (17 refs.)

In the UK, mephedrone and other so-called 'legal high' derivatives have recently been classified as Class B, Schedule I under the Misuse of Drugs Act 1971. Since then, alternative products have been advertised on a number of websites. In order to obtain an immediate snapshot of the situation, 24 products were purchased online from 18 UK-based websites over a period of 6 weeks following the ban in April 2010. Qualitative analyses were carried out by gas chromatography ion trap mass spectrometry using electron- and chemical ionization modes, nuclear magnetic resonance spectroscopy, and comparison with reference standards. Overall, the purchased products consisted of single cathinones or cathinone mixtures including mephedrone, butylone, 4-methyl-N-ethylcathinone, flephedrone (4-fluoromethcathinone) and MDPV (3,4-methylenedioxypyrovalerone), respectively. Benzocaine, caffeine, lidocaine, and procaine were also detected. The emphasis was placed on 'Energy 1' (NRG-1), a product advertised as a legal replacement for mephedrone-type derivatives usually claiming to contain naphyrone (naphthylpyrovalerone, O-2482). It was found that 70% of NRG-1 and NRG-2 products appeared to contain a mixture of cathinones banned in April 2010 and rebranded as 'new' legal highs, rather than legal chemicals such as naphyrone as claimed by the retailers. Only one out of 13 NRG-1 samples appeared to show analytical data consistent with naphyrone. These findings also suggest that both consumers and online sellers (unlike manufacturers and wholesalers) are, most likely unknowingly, confronted with the risk of criminalization and potential harm.

Copyright 2010, John Wiley & Sons Ltd.

Brennan E; Cameron M; Warne C; Durkin S; Borland R; Travers MJ et al. Secondhand smoke drift: Examining the influence of indoor smoking bans on indoor and outdoor air quality at pubs and bars. Nicotine & Tobacco Research 12(3): 271-277, 2010. (31 refs.)

This study aimed to examine the influence of indoor smoking bans on indoor and outdoor air quality at pubs and bars and to assess whether secondhand tobacco smoke (SHS) drifts from outdoor smoking areas to adjacent indoor areas. Data were covertly collected from a convenience sample of 19 pubs and bars that had at least 1 indoor area with an adjacent semi-enclosed outdoor eating/drinking area. Using TSI SidePak Personal Aerosol Monitors, concentrations of SHS (PM2.5) were measured concurrently in indoor and outdoor areas before and after implementation of the indoor smoking ban. Information was collected about the number of patrons and lit cigarettes and about the enclosure of outdoor areas. Indoor PM2.5 concentrations reduced by 65.5% from pre-ban to post-ban (95% CI 32.6%-82.3%, p = .004). Outdoor exposure to PM2.5 also reduced from pre-ban to post-ban by 38.8% (95% CI 3.2%-61.3%, p = .037). At post-ban, indoor concentrations of PM2.5 were positively associated with outdoor concentrations. After adjustment for covariates, a 100% increase in geometric mean (GM) outdoor PM2.5 was associated with a 36.1% (95% CI 2.4%-80.9%) increase in GM indoor PM2.5 exposure (p = .035). Indoor smoking bans are an effective means of improving indoor and outdoor air quality in pubs and bars, although the air quality of smoke-free indoor areas may be compromised by smoking in adjacent outdoor areas. These findings require consideration in efforts to ensure adequate protection of the health of employees and patrons.

Copyright 2010, Oxford University Press

Callinan JE; Clarke A; Doherty K; Kelleher C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. (review). Cochrane Database of Systematic Reviews 4: CD005992, 2010. (248 refs.)

Background: Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of secondhand smoke (SHS). They also offer the potential to influence social norms and smoking behaviour of those populations they affect. Objectives: To assess the extent to which legislation-based smoking bans or restrictions reduce exposure to SHS, help people who smoke to reduce tobacco consumption or lower smoking prevalence and affect the health of those in areas which have a ban or restriction in place. Search strategy We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, EMBASE, PsycINFO, CINAHL, Conference Paper Index, and reference lists and bibliographies of included studies. We also checked websites of various organisations. Date of most recent search; July 1st 2009. Selection criteria: We considered studies that reported legislative smoking bans and restrictions affecting populations. The minimum standard was having a ban explicitly in the study and a minimum of six months follow-up for measures of smoking behaviour. We included randomized controlled trials, quasi-experimental studies (i.e. non-randomized controlled studies), controlled before and after studies, interrupted-time series as defined by the Cochrane Effective Practice and Organization of Care Group, and uncontrolled pre- and post-ban data. Data collection and analysis Characteristics and content of the interventions, participants, outcomes and methods of the included studies were extracted by one author and checked by a second. Because of heterogeneity in the design and content of the studies, we did not attempt a meta-analysis. We evaluated the studies using qualitative narrative synthesis. Main results: There were 50 studies included in this review. Thirty-one studies reported exposure to secondhand smoke (SHS) with 19 studies measuring it using biomarkers. There was consistent evidence that smoking bans reduced exposure to SHS in workplaces, restaurants, pubs and in public places. There was a greater reduction in exposure to SHS in hospitality workers compared to the general population. We failed to detect any difference in self-reported exposure to SHS in cars. There was no change in either the prevalence or duration of reported exposure to SHS in the home as a result of implementing legislative bans. Twenty-three studies reported measures of active smoking, often as a co-variable rather than an end-point in itself, with no consistent evidence of a reduction in smoking prevalence attributable to the ban. Total tobacco consumption was reduced in studies where prevalence declined. Twenty-five studies reported health indicators as an outcome. Self-reported respiratory and sensory symptoms were measured in 12 studies, with lung function measured in five of them. There was consistent evidence of a reduction in hospital admissions for cardiac events as well as an improvement in some health indicators after the ban. Authors' conclusions: Introduction of a legislative smoking ban does lead to a reduction in exposure to passive smoking. Hospitality workers experienced a greater reduction in exposure to SHS after implementing the ban compared to the general population. There is limited evidence about the impact on active smoking but the trend is downwards. There is some evidence of an improvement in health outcomes. The strongest evidence is the reduction seen in admissions for acute coronary syndrome. There is an increase in support for and compliance with smoking bans after the legislation.

Copyright 2010, John Wiley & Sons

Campos I. Degeneration and the origins of Mexico's war on drugs. Mexican Studies-Estudios Mexicanos 26(2): 379-408, 2010. (8 refs.)

In the early twentieth century, the concept of "degeneration" helped to turn "drugs" into a problem of national importance in Mexico. By invoking this concept, Mexico's sanitary authorities secured provisions in the Constitution of 1917 which specifically authorized a newly constituted Department of Public Sanitation to lead a nation-wide campaign against drug abuse. That Department then inaugurated Mexico's modern war on drugs when, in 1920, it declared a law governing the import and distribution of the opiates, cocaine, and marijuana nationwide. This essay examines the idea of degeneration and how it came to play this crucial role in the foundation of Mexico's modern war on drugs.

Copyright 2010, University of California Press

Cheng TC; Lo CC. Heavy alcohol use, alcohol and drug screening and their relationship to mothers' welfare participation: A temporal-ordered causal analysis. Journal of Social Policy 39(Part 4): 543-559, 2010. (49 refs.)

This longitudinal study examined the association between heavy alcohol use, alcohol- and drug-screening requirements, and social support network variables and mothers' welfare participation in the United States. The study was a secondary data analysis of 3,517 mothers. The sample was extracted from National Longitudinal Survey of Youth data gathered in 1994-2004. Results of logistic regression show welfare participation is not associated with heavy alcohol use or alcohol- and drug-screening requirements, but is associated with a history of reported heavy alcohol use, informal help with childcare, and scant human capital. Results also indicate that alcohol- and drug screening required under TANF may not exclude heavy drinking mothers from TANF participation, and that social support networks do not cancel heavy drinking's association with participation. Policy implications are discussed.

Copyright 2010, Cambridge University Press

Cohen PJ. Medical marijuana 2010: It's time to fix the regulatory vacuum. Journal of Law, Medicine & Ethics 38(3): 654-666, 2010. (21 refs.)

This article examines the history of assigning a banned status to medical marijuana; describes the politics of medical marijuana research; provides evidence of the scientifically demonstrated efficacy and safety of Cannabis for certain pathologic conditions; analyzes several vaguely worded state statutes governing the recommendation, distribution, and use of "medical marijuana" that render its use open to abuse; and recommends the development and enforcement of statutory and regulatory reforms that would bring state oversight of this drug into agreement with stringent federal regulation of other controlled substances with proven medical utility.

Copyright 2010, Wiley-Blackwell

Cunningham JK; Bojorquez I; Campollo O; Liu LM; Maxwell JC. Mexico's methamphetamine precursor chemical interventions: Impacts on drug treatment admissions. Addiction 105(11): 1973-1983, 2010. (64 refs.)

Aims: To help counter problems related to methamphetamine, Mexico has implemented interventions targeting pseudoephedrine and ephedrine, the precursor chemicals commonly used in the drug's synthesis. This study examines whether the interventions impacted methamphetamine treatment admissions -- an indicator of methamphetamine consequences. Design: Quasi-experiment: autoregressive integrated moving average (ARIMA)-based intervention time-series analysis. Interventions: precursor chemical restrictions implemented beginning November 2005; major rogue precursor chemical company closed (including possibly the largest single drug-cash seizure in history) March 2007; precursor chemicals banned from Mexico (North America's first precursor ban) August 2008. Settings: Mexico and Texas (1996-2008). Measurements: Monthly treatment admissions for methamphetamine (intervention series) and cocaine, heroin and alcohol (quasi-control series). Findings The precursor restriction was associated with temporary methamphetamine admissions decreases of 12% in Mexico and 11% in Texas. The company closure was associated with decreases of 56% in Mexico and 48% in Texas; these decreases generally remained to the end of the study period. Neither intervention was associated with significant changes in the Mexico or Texas quasi-control series. The analysis of Mexico's ban was indeterminate due largely to a short post-ban series. Conclusions: This study, one of the first quasi-experimental analyses of an illicit-drug policy in Mexico, indicates that the country's precursor interventions were associated with positive impacts domestically and in one of the Unites States' most populous states-Texas. These interventions, coupled with previous US and Canadian interventions, amount to a new, relatively cohesive level of methamphetamine precursor control across North America's largest nations, raising the possibility that the impacts found here could continue for an extended period.

Copyright 2010, Society for the Study of Addiction to Alcohol and Other Drugs

Dargan PI; Albert S; Wood DM. Mephedrone use and associated adverse effects in school and college/university students before the UK legislation change. Quarterly Journal of Medicine 103(11): 875-879, 2010. (18 refs.)

Methods: Data was collected using a questionnaire survey in schools, colleges and universities in the Tayside area of Scotland, UK in February 2010. Results: A total of 1006 individuals completed the survey [501 (49.8%) males and 505 (50.2%) females], of whom 349 classified their educational institute as a school and 657 as a college/university. Among them 205 (20.3%) reported previous use of mephedrone; 23.4% reported using only using mephedrone on one occasion previously, although 4.4% reported daily use. A total of 56% of those who had used mephedrone, reported at least one unwanted effect associated with its use. A total of 17.6% of users reported 'addiction or dependence' symptoms associated with their mephedrone use. A total of 48.8% of users sourced mephedrone from street level dealers, 10.7% from the Internet. Conclusions: We have shown in this study that the use of mephedrone among school and college/university students is common and that users found it easy to obtain. There was a high prevalence of unwanted effects associated with its use. Further work is needed to determine the impact of the recent changes in the UK legislation relating to mephedrone and other related cathinones and whether this has been effective in reducing the prevalence of mephedrone use.

Copyright 2010, Oxford University Press

Difranza JR. Commentary on Fidler & West (2010): Curtailing tobacco sales to minors. (editorial). Addiction 105(11): 1989-1990, 2010. (16 refs.)

Dills AK. Social host liability for minors and underage drunk-driving accidents. Journal of Health Economics 29(2): 241-249, 2010. (24 refs.)

Social host laws for minors aim to reduce teenage alcohol consumption by imposing liability on adults who host parties. Parents cite safety reasons as part of their motivation for hosting parties, preferring their teens and their teens' friends to drink in a supervised and safe locale. Both sides predict an effect of social host liability for minors on alcohol-related traffic accident rates for under-aged drinkers: the effects, however, work in opposite directions. This paper finds that, among 18-20 year olds, social host liability for minors reduced the drunk-driving fatality rate by 9%. I find no effect on sober traffic fatalities. Survey data on drinking and drunk driving suggest the declines resulted mostly from reductions in drunk driving and not reductions in drinking.

Copyright 2010, Elsevier Science

Dove MS; Dockery DW; Connolly GN. Smoke-free air laws and secondhand smoke exposure among nonsmoking youth. Pediatrics 126(1): 80-87, 2010. (36 refs.)

OBJECTIVES: We investigated the association between smoke-free law coverage and cotinine among nonsmoking youth (3-19 years) with and without home secondhand smoke (SHS) exposure. METHODS: We used data from the 1999-2006 National Health and Nutrition Examination Survey, a cross-sectional survey designed to monitor the health and nutritional status of the US population. Serum cotinine levels were available for 11 486 nonsmoking youth from 117 survey locations. Each location was categorized into 1 of 3 groups indicating extensive, limited, and no coverage by a smoke-free law. Cotinine was analyzed both as a dichotomous (>= 0.05 ng/mL) and as a continuous outcome. RESULTS: Among youth without home SHS exposure, those who were living in a county with extensive coverage of a smoke-free air law had an adjusted 0.61 times (95% confidence interval: 0.48-0.78) the prevalence of detectable cotinine and 0.57 (95% confidence interval: 0.41-0.79) times lower geometric mean compared with youth without a smoke-free air law. Among youth with home SHS exposure, youth with extensive coverage of a smoke-free air law had lower geometric mean cotinine compared with youth who were living in a county without a smoke-free air law, but these differences were no longer observed after adjustment for covariates. CONCLUSIONS: These results suggest that smoke-free laws are an effective strategy for reducing cotinine in youth without home SHS exposure; however, among youth with home SHS exposure, no benefit was detected.

Copyright 2010, American Academy of Pediatrics

Eisner MD. Secondhand smoke at work. (review). Current Opinion in Allergy and Clinical Immunology 10(2): 121-126, 2010. (46 refs.)

Purpose of review: Secondhand smoke (SHS) exposure in the workplace remains common and has important acute and chronic health effects. The present study reviews the recent evidence linking workplace SHS exposure with poor health and the benefits of smoke-free workplace legislation. Recent findings: Workplace SHS exposure continues to occur in many parts of the United States and around the world. Occupational SHS exposure has been linked to serious chronic health effects including lung cancer, cardiovascular disease, chronic obstructive pulmonary disease, and poor general health. Smoke-free workplace laws rapidly reduce workplace SHS exposure and improve respiratory health including symptoms and lung function. Smoke-free workplace legislation is also expected to reduce the chronic health effects of passive smoking, including cardiopulmonary disease and lung cancer. Summary: Occupational exposure to SHS has serious negative health consequences and will shorten lifespan. Smoke-free workplace legislation should be universally adopted around the world.

Copyright 2010, Lippincott, Williams & Wilkins

Elliott C; Wei YQ; Lenton P. The effect of government policy on tobacco advertising strategies. Bulletin of Economic Research 62(3): 243-258, 2010. (40 refs.)

This paper contributes to the very limited literature examining the factors determining tobacco companies' advertising strategies. The paper explores whether firms in the UK tobacco market significantly changed their advertising expenditure in the face of proposed changes to the UK and European Commission tobacco advertising legislation. The results suggest that changes in legislation have little impact on firms' advertising strategies for existing brands, but that legislative changes impact upon product launch dates. Our results also offer some information on the nature of firm interdependencies in the UK tobacco industry.

Copyright 2010, Wiley-Blackwell

Erickson PG; Hathaway AD. Normalization and harm reduction: Research avenues and policy agendas. (editorial). International Journal of Drug Policy 21(2, Special Issue): 137-139, 2010. (15 refs.)

An affinity between the evidence and arguments for drug normalization and the policy and programme directions favoured by harm reduction is often assumed but seldom critically examined. This commentary looks at parallels and contradictions emerging with respect to different cultures, social settings, types of problems and responses where the match is less than perfect. Mounting evidence of normalization has also led to backlash in some countries and the mobilization of forces reaffirming prohibition. We call for further research on normalization that focuses on substance use, risks, harms, and social context across a broader spectrum of the population, and in a variety of cultures. By emphasizing the most serious harms experienced by persons in the smallest segments of drug using populations, harm reduction often has neglected broader research and policy suggestions that might be implemented to benefit controlled, recreational drug users. Future policy development with respect to normalization will require more research and more serious discussion of its implications for informing the transition toward a global public health approach to substance use.

Copyright 2010, Elsevier Science

Farrington DP. Commentary on Pedersen and Skardhamar (2010): Does cannabis use predict non-drug offending? (editorial). American Journal on Addictions 105(1): 119-120, 2010. (7 refs.)

Ferketich AK; Liber A; Pennell M; Nealy D; Hammer J; Berman M. Clean indoor air ordinance coverage in the Appalachian region of the United States. American Journal of Public Health 100(7): 1313-1318, 2010. (27 refs.)

Objectives. We sought to quantitatively examine the pattern of, and socioeconomic factors associated with, adoption of clean indoor air ordinances in Appalachia. Methods. We collected and reviewed clean indoor air ordinances in Appalachian communities in 6 states and rated the ordinances for completeness of coverage in workplaces, restaurants, and bars. Additionally, we computed a strength score to measure coverage in 7 locations. We fit mixed-effects models to determine whether the presence of a comprehensive ordinance and the ordinance strength were related to community socioeconomic disadvantage. Results. Of the 332 communities included in the analysis, fewer than 20% had adopted a comprehensive workplace, restaurant, or bar ordinance. Most ordinances were weak, achieving on average only 43% of the total possible points. Communities with a higher unemployment rate were less likely and those with a higher education level were more likely to have a strong ordinance. Conclusions. The majority of residents in these communities are not protected from secondhand smoke. Efforts to pass strong statewide clean indoor air laws should take priority over local initiatives in these states.

Copyright 2010, American Public Health Association

Fidler JA; West R. Changes in smoking prevalence in 16-17-year-old versus older adults following a rise in legal age of sale: Findings from an English population study. Addiction 105(11): 1984-1988, 2010. (12 refs.)

Aim: To assess smoking prevalence before and after the rise in legal age of sale of cigarettes in England and Wales from age 16 to age 18 in October 2007. Design: A series of monthly cross-sectional household surveys: the 'Smoking Toolkit Study'. Setting: England. Participants: A total of 53 322 adults aged 16 and over interviewed between October 2006 and May 2009, 1136 of whom were aged 16 or 17 years. Measurements: Change in smoking prevalence from pre- to post-legislation, assessed by self-reported smoking status, among the 16-17-year-old group and older adults. Findings: The prevalence change following the legislation among those aged 16 and 17 was 7.1 percentage points (denominator = 1136) compared with 2.4 percentage points (denominator = 52 186) for older adults (odds ratio 1.36, P = 0.024, 95% confidence interval = 1.04-1.77 for the interaction). There was no difference within older age categories. Conclusions: There was a greater fall in prevalence in 16-17-year-olds following an increase in age of sale than in older age groups. This provides some support to the view that raising the age of sale can, at least in some circumstances, reduce smoking prevalence in younger age groups.

Copyright 2010, Society for the Study of Addiction to Alcohol and Other Drugs

Freckelton SCI. Mental Illness, sentencing and execution: The disturbing death of an Englishman in China. (editorial). Psychiatry, Psychology and Law 17(3): 333-344, 2010. (36 refs.)

Execution is one of the indispensable means of education. Deng Xiaoping (1904-1997) Come little rabbit Come to me, Come little rabbit Let it be, Come little rabbit Come and pray, Only one people, Only one world, Only one God. Akmal Shaikh (1956-2009) [image omitted]The tragic saga of the execution of a British citizen, Akmal Shaikh, in Urumqi in northwest China in December 2009 highlights the risks of mental illnesses such as bipolar disorders and delusional disorders being discounted or inadequately taken into account in terms of their impact upon criminal responsibility and criminal culpability. The strong evidence is that Shaikh was seriously delusional and incapable of exercising reasoned judgements in his own best interests when he was found with heroin in his possession upon entering China. Yet he was not permitted to be examined by mental health professionals and was executed, after appeals, including to the Supreme People's Court of China, failed. The Shaikh case is a warning to all legal systems that a range of mental illnesses can generate symptoms causing those with them to have little insight but which, when properly evaluated, may be exculpatory or at least significantly mitigatory.

Copyright 2010, Australian Academic Press

Gartner C; McNeill A. Options for global tobacco control beyond the Framework Convention in Tobacco Control. (editorial). Addiction 105(1): 1-3, 2010. (18 refs.)

Grant D. Dead on arrival: Zero tolerance laws don't work. Economic Inquiry 48(3): 756-770, 2010. (26 refs.)

By 1998, all states had passed laws lowering the legal blood alcohol content for drivers under 21 to effectively zero. Theory shows these laws have ambiguous effects on overall fatalities and economic efficiency, and the data show they have little effect on driver behavior. A panel analysis of the 1988-2000 Fatality Analysis Reporting System indicates that zero tolerance laws have no material influence on the level of fatalities, while quantile regression reveals virtually no change in the distribution of blood alcohol content among drivers involved in fatal accidents.

Copyright 2010, Wiley-Blackwell

Hackshaw L; McEwen A; West R; Bauld L. Quit attempts in response to smoke-free legislation in England. (review). Tobacco Control 19(2): 160-164, 2010. (19 refs.)

Objectives To determine whether England's smoke-free legislation, introduced on 1 July 2007, influenced intentions and attempts to stop smoking. Design and setting National household surveys conducted in England between January 2007 and December 2008. The sample was weighted to match census data on demographics and included 10 560 adults aged 16 or over who reported having smoked within the past year. Results: A greater percentage of smokers reported making a quit attempt in July and August 2007 (8.6%, n = 82) compared with July and August 2008 (5.7%, n = 48) (Fisher's exact=0.022); there was no significant difference in the number of quit attempts made at other times in 2007 compared with 2008. In the 5 months following the introduction of the legislation 19% (n = 75) of smokers making a quit attempt reported that they had done so in response to the legislation. There were no significant differences in these quit attempts with regard to gender, social grade or cigarette consumption; there was however a significant linear trend with increasing age (chi(2) = 7.755, df=1, p<0.005). The prevalence of respondents planning to quit before the ban came into force decreased over time, while those who planned to quit when the ban came into force increased as the ban drew closer. Conclusion: England's smoke-free legislation was associated with a significant temporary increase in the percentage of smokers attempting to stop, equivalent to over 300 000 additional smokers trying to quit. As a prompt to quitting the ban appears to have been equally effective across all social grades.

Copyright 2010, BMJ Publishing Group

Haffajee RL; Bloche MG. The FCTC and the psychology of tobacco control. Asian Journal of WTO & International Health Law and Policy 5(1): 87-113, 2010. (45 refs.)

The Framework Convention on Tobacco Control (FCTC) is a promising public health accomplishment, but its emphasis on top-down command-and-control approaches to tobacco control puts this promise at risk. The World Health Organisation's "Guidelines for Implementation" of the FCTC prescribe restrictive regulation of artistic speech, contributions to popular culture, and even political speech, as well as constraints on promotion of tobacco products. This intrusiveness fails to take account much of what we know, from research in psychololgy and the neurosciences, about what prompts people to engage in risky behaviours and what empowes them to exercise restraint. The Guidelines (and the FCTC) start from the premise that people smoke either because they become "addicted" (rendering personal choice impossible) or because they fail to comprehend tobacco's dangers. But recent findings about the workings of mind suggest a different story, a story of risky behavior (including smoking, unhealthy eating, and unsafe sex) as the produt of competition between aspects of the self - between systems of perception and motivation that drive indulgence and restraint. We argue in this Essay that the WHO, in its "Guidelines," should pursue anti-smoking strategies that support individuals' self-restraint, rather than merely suppressing tobacco use in a coercive fashion. Alliances between governments and myriad actors that shape social and cultural norms and influence people's behavior, along with funding for research into the psychological determinants of tobacco use, will prove critical to this approach. Crude coercion, on the other hand, risks cultural backlash and even embrace of smoking as a way to express independence and rebellion.

Copyright 2010, National Taiwan University Press

Hall W. What are the policy lessons of National Alcohol Prohibition in the United States, 1920-1933? (editorial). Addiction 105(7): 1164-1173, 2010. (53 refs.)

National alcohol prohibition in the United States between 1920 and 1933 is believed widely to have been a misguided and failed social experiment that made alcohol problems worse by encouraging drinkers to switch to spirits and created a large black market for alcohol supplied by organized crime. The standard view of alcohol prohibition provides policy lessons that are invoked routinely in policy debates about alcohol and other drugs. The alcohol industry invokes it routinely when resisting proposals to reduce the availability of alcohol, increase its price or regulate alcohol advertising and promotion. Advocates of cannabis law reform invoke it frequently in support of their cause. This paper aims: (i) to provide an account of alcohol prohibition that is more accurate than the standard account because it is informed by historical and econometric analyses; (ii) to describe the policy debates in the 1920s and 1930s about the effectiveness of national prohibition; and (iii) to reflect on any relevance that the US experience with alcohol prohibition has for contemporary policies towards alcohol. It is incorrect to claim that the US experience of National Prohibition indicates that prohibition as a means of regulating alcohol is always doomed to failure. Subsequent experience shows that partial prohibitions can produce substantial public health benefits at an acceptable social cost, in the absence of substantial enforcement.

Copyright 2010, Wiley-Blackwell

Hallam C; Bewley-Taylor DR. Mapping the world drug problem: Science and politics in the United Nations drug control system. (editorial). International Journal of Drug Policy 21(1): 1-3, 2010. (6 refs.)

Copyright 2010, Elsevier Science

Hargreaves K; Amos A; Highet G; Martin C; Platt S; Ritchie D; White M. The social context of change in tobacco consumption following the introduction of 'smokefree' England legislation: A qualitative, longitudinal study. Social Science & Medicine 71(3): 459-466, 2010. (28 refs.)

Legislation implemented in England on 1st July 2007 to prohibit smoking in enclosed public places aimed primarily to limit exposure to second-hand smoke, thereby reducing smoking-related morbidity and mortality. We conducted a qualitative study between April 2007 and December 2008 in six contrasting localities in two metropolitan areas in the north and south of England, which examined the impact of the legislation on individuals, families and communities. Using a multi-level longitudinal case study design, we collected data at community and individual levels, from three months prior to the legislation to a year after its enactment through a range of methods, including semi-structured interviews with panel informants and observations in locality settings. Drawing on theoretical understandings of the relationship between structure, agency and practice, this paper examines the social and cultural contexts of change in tobacco consumption. Observations in a variety of community settings identified reduced smoking in public places post-legislation. More than half of panel informants reported decreased consumption at one year post-legislation; a minority had quit, maintained or increased their smoking levels. The dominant pattern of reduced consumption was attributed primarily to constraints imposed by the legislation. This suggests that the law may have provided an impetus for some smokers to cut down or quit. Smoking behaviour was, however, strongly influenced by the social networks in which smokers were embedded, indicating that, while individuals had the power to act, any changes they made were largely shaped by social structural factors. Our findings support the need for a comprehensive tobacco control strategy that takes account of the complex array of contextual factors that constrain and enable smoking.

Copyright 2010, Elsevier Science

Ho SY; Wang MP; Lo WS; Mak KK; Lai HK; Thomas GN et al. Comprehensive smoke-free legislation and displacement of smoking into the homes of young children in Hong Kong. Tobacco Control 19(2): 129-133, 2010. (25 refs.)

Objective To investigate the effect of comprehensive smoke-free legislation in 2007 on the exposure of children to secondhand smoke (SHS) in Hong Kong. Methods: Two cross-sectional questionnaire surveys were conducted, before (2006) and after (2008) the implementation of smoke-free legislation, among primary 2-4 students (equivalent to US grades 2-4) from 19 and 24 randomly selected schools, respectively. Adjusted ORs for SHS exposure at home and outside home post-legislation compared with pre-legislation were calculated. The strength of the association between SHS exposure and respiratory symptoms in each survey was used as an indirect indicator of the intensity of exposure. Results: Among 3243 and 4965 never smoking students in the 2006 and 2008 surveys, the prevalence of SHS exposure in the past 7 days increased both at home (from 10.2% to 14.1%) and outside home (from 19.8% to 27.2%). Post-legislation, students were 56% more likely (p<0.01) to report SHS exposure at home coupled with an insignificantly stronger association between SHS exposure and respiratory symptoms. Similarly, students were 60% more likely (p<0.001) to report SHS exposure outside home in 2008, but the association between SHS exposure and respiratory symptoms became insignificantly weaker. Parental smoking rates were similar before and after legislation. Conclusions: The prevalence of exposure to SHS at home and outside home have both increased among primary school students in Hong Kong post-legislation. Comprehensive smoke-free legislation without strong support for smoking cessation might have displaced smoking into the homes of young children.

Copyright 2010, BMJ Publishing Group

Hoffmann DE; Weber E. Medical marijuana and the law. (editorial). New England Journal of Medicine 362(16): 1453-1457, 2010. (4 refs.)

Humphreys A. Semiotic structure and the legitimation of consumption practices: The case of casino gambling. Journal of Consumer Research 37(3): 490-510, 2010. (116 refs.)

How do changes in public discourse and regulatory structure affect the acceptance of a consumption practice? Previous research on legitimacy in consumer behavior has focused on the consumer reception of legitimizing discourse rather than on the historical process of legitimation itself. This study examines the influence of changes in the institutional environment over time on the meaning structures that influence consumer perception and practice. To study legitimation as a historical process, a discourse analysis of newspaper articles about casino gambling from 1980-2007 was conducted. Results show that the regulatory approval of gambling is accompanied by a shift in the semantic categories used to discuss casinos and that journalists play a role in shaping these categories. Further, journalists shape the meaning of a consumption practice in three ways: through selection, validation, and realization. Interpreted through the lens of institutional theory, these findings suggest that studies of legitimation should consider changes in public discourse and legal regulation in addition to consumer perceptions of legitimacy.

Copyright 2010, University of Chicago Pres

Jacob KS. Alcohol and public health policies in India. (editorial). National Medical Journal of India 23(4): 224-225, 2010. (11 refs.)

Extreme policies of prohibition or the current permissive strategies are counterproductive and call for a nuanced public health approach that integrates both the regulation of availability of alcohol as well as helps in rigorously enforcing the law.

Copyright 2010, All India Institute of Medical Sciences

Jensen JA; Schillo BA; Moilanen MM; Lindgren BR; Murphy S; Carmella S et al. Tobacco smoke exposure in nonsmoking hospitality workers before and after a state smoking ban. Cancer Epidemiology, Biomarkers & Prevention 19(4): 1016-1021, 2010. (43 refs.)

Secondhand smoke exposure is estimated to account for 3,000 cancer deaths per year. Although several countries and states in the United States have passed comprehensive smoke-free laws to protect all employees, a significant number of workers are still not protected. The purpose of this study was to determine the effects of passing a comprehensive smoking ban that included bars and restaurants on biomarkers of nicotine and carcinogen exposure. The urines of nonsmoking employees (n = 24) of bars and restaurants that allowed smoking before the smoke-free law were analyzed before and after the law was passed in Minnesota. The results showed significant reductions in both total cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (free plus glucuronidated) after the ban was instituted. These results provide further support for the importance of protecting employees working in all venues.

Copyright 2010, American Association of Cancer Research

Jurgens R; Csete J; Amon JJ; Baral S; Beyrer C. HIV in people who use drugs. 6: People who use drugs, HIV, and human rights. Lancet 376(9739): 475-485, 2010. (136 refs.)

We reviewed evidence from more than 900 studies and reports on the link between human rights abuses experienced by people who use drugs and vulnerability to HIV infection and access to services. Published work documents widespread abuses of human rights, which increase vulnerability to HIV infection and negatively affect delivery of HIV programmes. These abuses include denial of harm-reduction services, discriminatory access to antiretroviral therapy, abusive law enforcement practices, and coercion in the guise of treatment for drug dependence. Protection of the human rights of people who use drugs therefore is important not only because their rights must be respected, protected, and fulfilled, but also because it is an essential precondition to improving the health of people who use drugs. Rights-based responses to HIV and drug use have had good outcomes where they have been implemented, and they should be replicated in other countries.

Copyright 2010, Elsevier Science

Kalant H. Drug classification: Xcience, politics, both or neither? Addiction 105(7): 1146-1149, 2010. (8 refs.)

Governments currently classify illicit drugs for various purposes: to guide courts in the sentencing of convicted violators of drug control laws, to prioritize targets of prevention measures and to educate the public about relative risks of the various drugs. It has been proposed that classification should be conducted by scientists and drug experts rather than by politicians, so that it will reflect only accurate factual knowledge of drug effects and risks rather than political biases. Although this is an appealing goal, it is inherently impossible because rank-ordering of the drugs inevitably requires value judgements concerning the different types of harm. Such judgements, even by scientists, depend upon subjective personal criteria and not only upon scientific facts. Moreover, classification that is meant to guide the legal system in controlling dangerous drug use can function only if it is in harmony with the values and sentiments of the public. In some respects, politicians may be better attuned to public attitudes and wishes, and to what policies the public will support, than are scientific experts. The problems inherent in such drug classification are illustrated by the examples of cannabis and of salvinorin A. They raise the question as to whether the classification process really serves any socially beneficial purpose.

Copyright 2010, Wiley-Blackwell

Kennedy RD; Elton-Marshall T; Mutti S; Dubray J; Fong GT. Understanding the impact of the Smoke-Free Ontario Act on hospitality establishments' outdoor environments: a survey of restaurants and bars. Tobacco Control 19(2): 165-167, 2010. (8 refs.)

Background:The Smoke-Free Ontario Act (SFOA) came into effect in May 2006 and included restrictions to outdoor hospitality areas by only permitting smoking on a patio if the area had no roof. Objectives (1) To assess the impact of the SFOA on the prevalence of smoke-free patios in Ontario and (2) to determine the proportion of venues where structural alterations were made rather than going smoke-free in order to achieve compliance with the SFOA. Methods: A telephone survey of 403 hospitality sector operators/owners in four clustered samples of Ontario, Canada. Results: Based on completed surveys, the SFOA resulted in an increase in prevalence of smoke-free patios, from 5% (n = 21) to 25% (n = 99). Of the patios where smoking was permitted before the SFOA (n = 382), 42% (n = 161) had physical structures that would make smoking not permissible under the new act. Operators of half of these venues (n = 80) made their patios smoke-free, with most indicating they had no choice given the costs or physical limitations to changing their outdoor environment. The other half (n = 81) reported making physical changes, including removing roof structures to achieve compliance. Conclusion: The SFOA resulted in greater protection from outdoor secondhand smoke; however, most patios still permitted smoking. Half of the venues that complied with the SFOA by going smoke-free did so involuntarily because of structural and/or financial limitations. The majority of venue operators preferred to permit smoking on their patios, and only made their patios smoke-free when they were required to do so by law.

Copyright 2010, BMJ Publishing Group

Kohler-Hausmann J. "The Attila The Hun Law": New York's Rockefeller drug laws and the making of a punitive state. Journal of Social History 44(1): 71-+, 2010. (28 refs.)

In 1973, New York's Governor Nelson Rockefeller responded to panic about soaring heroin use by renouncing his aggressive treatment programs and enacting the most punitive drug policy in the United States. His "Rockefeller Drug Laws" mandated sentences up to life in prison for selling any narcotics. These punishments, comparable to the penalties for murder, served as models for subsequent "War on Drugs" policies enacted across the nation. This article explores the ideological and political work accomplished by this high profile legislation-for policy makers, for members of the general public who clamored for "get tough" strategies, and for the drug users targeted by the statutes. The laws were a repudiation of liberal treatment programs and specialists' expertise, and provided a forum to remake the much-maligned welfare state into a stern, macho vehicle for establishing order in society. Increasingly punitive policies constricted the rights of drug users by rhetorically constructing "addicts" and "pushers" as outside of the polity and as the antithesis of full citizens. Therefore, the Rockefeller Drug Laws not only had devastating effects on drug offenders, but also were instrumental in the profound renegotiation of the state's role and responsibilities.

Copyright 2010, George Mason University

Kypri K; Langley JD; Connor J. Alcohol in our lives: A once-in-a generation opportunity for liquor law reform in New Zealand. (editorial). Drug and Alcohol Review 29(1): 1-4, 2010. (19 refs.)

Laussmann T; Meier-Giebing S. Forensic analysis of hallucinogenic mushrooms and khat (Catha edulis FORSK) using cation-exchange liquid chromatography. Forensic Science International 195(1-3): 160-164, 2010. (17 refs.)

Hallucinogenic mushrooms (e. g. Psilocybe and Panaeolus species) as well as leaves and young shoots of the khat tree (Catha edulis FORSK) are illicit drugs in many countries. The exact concentration of the hallucinogenic alkaloids psilocin and psilocybin in mushrooms and the sympathomimetic alkaloids cathinone and cathine in khat is usually essential for jurisdiction. Facing an increasing number of mushroom and khat seizures by German customs authorities, a convenient comprehensive quantitative HPLC method based on cation-exchange liquid chromatography for these rather "exotic'' drugs has been developed which avoids time-consuming multi-step sample preparation or chemical derivatization procedures. Using this method a number of different hallucinogenic fungi species and products that are mainly distributed via the internet have been analysed (dried and fresh Psilocybe cubensis SINGER as well as P. cubensis collected from "grow boxes'', Panaeolus cyanescens BERKELEY AND BROOME and so-called "philosopher stones'' (sclerotia of Psilocybe species)). Highest total amounts of psilocin have been detected in dried P. cyanescens reaching up to 3.00 +/- 0.24 mg per 100 mg. The distribution of khat alkaloids in different parts of the khat shoots has been studied. High concentrations of cathinone have not only been detected in leaves but also in green parts and barks of stalks. Additionally, the sample treatment for fresh mushroom and khat samples has been optimised. Highest amounts of alkaloids were found when fresh material was freeze-dried.

Copyright 2010, Elsevier Science

Lenton S; Allsop S. A tale of CIN-the Cannabis Infringement Notice scheme in Western Australia. (editorial). Addiction 105(5): 808-816, 2010. (59 refs.)

Aims: To describe the development and enactment of the Western Australian (WA) Cannabis Infringement Notice scheme and reflect on the lessons for researchers and policy-makers interested in the translation of policy research to policy practice. Methods: An insiders' description of the background research, knowledge transfer strategies and political and legislative processes leading to the enactment and implementation of the WA Cannabis Control Act 2003. Lenton and Allsop were involved centrally in the process as policy-researcher and policy-bureaucrat. Results: In March 2004, Western Australia became the fourth Australian jurisdiction to adopt a 'prohibition with civil penalties' scheme for possession and cultivation of small amounts of cannabis. We reflect upon: the role of research evidence in the policy process; windows for policy change; disseminating findings when apparently no one is listening; the risks and benefits of the researcher as advocate; the differences between working on the inside and outside of government; and the importance of relationships, trust and track record. Conclusions: There was a window of opportunity and change was influenced by research that was communicated by a reliable and trusted source. Those who want to conduct research that informs policy need to understand the policy process more clearly, look for and help create emerging windows that occur in the problem and political spheres, and make partnerships with key stakeholders in the policy arena. The flipside of the process is that, when governments change, policy born in windows of opportunity can be a casualty.

Copyright 2010, Society for the Study of Addiction to Alcohol and Other Drugs

Lipperman-Kreda S; Grube JW; Paschall MJ. Community norms, enforcement of minimum legal drinking age laws, personal beliefs and underage drinking: An explanatory model. Journal of Community Health 35(3): 249-257, 2010. (25 refs.)

Strategies to enforce underage drinking laws are aimed at reducing youth access to alcohol from commercial and social sources and deterring its possession and use. However, little is known about the processes through which enforcement strategies may affect underage drinking. The purpose of the current study is to present and test a conceptual model that specifies possible direct and indirect relationships among adolescents' perception of community alcohol norms, enforcement of underage drinking laws, personal beliefs (perceived parental disapproval of alcohol use, perceived alcohol availability, perceived drinking by peers, perceived harm and personal disapproval of alcohol use), and their past-30-day alcohol use. This study used data from 17,830 middle and high school students who participated in the 2007 Oregon Health Teens Survey. Structural equations modeling indicated that perceived community disapproval of adolescents' alcohol use was directly and positively related to perceived local police enforcement of underage drinking laws. In addition, adolescents' personal beliefs appeared to mediate the relationship between perceived enforcement of underage drinking laws and past-30-day alcohol use. Enforcement of underage drinking laws appeared to partially mediate the relationship between perceived community disapproval and personal beliefs related to alcohol use. Results of this study suggests that environmental prevention efforts to reduce underage drinking should target adults' attitudes and community norms about underage drinking as well as the beliefs of youth themselves.

Copyright 2010, Springer

Luty J; O'Gara C; Sessay M; Sarkhel A. A survey of community drug team prescribing policies and client views. Journal of Substance Use 15(1): 51-59, 2010. (30 refs.)

Aims and methods: A postal and telephone survey of 140 community drug teams in England and Wales was performed to survey existing prescribing policies for substitute prescriptions, including prevalence of supervised methadone consumption, use of methadone higher doses, injectables and prescribed benzodiazepines. Questionnaires were directed to the prescribing doctor. A second survey involved questionnaires distributed to clients at three community drugs teams in Essex. Participants were asked to comment on various aspects of prescribing policies. Results: Results were obtained from 120 community drug teams (86%) and 104 clients who had received substitute prescribing. Around 22% of teams reported that methadone was supervised in a minority of new patients. Low doses (under 60 mg methadone per day) were rarely used (fewer than 10 patients) in 45% of services. Buprenorphine was prescribed in 97% of services. Fewer than half of community drug teams prescribed benzodiazepines (other than alcohol detoxification) or injectable drugs. A total of 104 responses were received from service users in Essex. The majority were opposed to supervised consumptions, although they were in broad agreement with other policies. Conclusion: Regulations concerning supervised consumption of methadone are ignored in at least one-fifth of community drug teams. The opposition of service users to supervised consumption may lead to the continued popularity of methadone to take away in England and Wales. Service users in Essex were generally in agreement with other aspects of prescribing policy including the reluctance to use higher doses of methadone.

Copyright 2010, Informa Healthcare

Mackay D; Haw S; Ayres JG; Fischbacher C; Pell JP. Smoke-free legislation and hospitalizations for childhood asthma. New England Journal of Medicine 363(12): 1139-1145, 2010. (20 refs.)

Background: Previous studies have shown that after the adoption of comprehensive smoke-free legislation, there is a reduction in respiratory symptoms among workers in bars. However, it is not known whether respiratory disease is also reduced among people who do not have occupational exposure to environmental tobacco smoke. The aim of our study was to determine whether the ban on smoking in public places in Scotland, which was initiated in March 2006, influenced the rate of hospital admissions for childhood asthma. Methods: Routine hospital administrative data were used to identify all hospital admissions for asthma in Scotland from January 2000 through October 2009 among children younger than 15 years of age. A negative binomial regression model was fitted, with adjustment for age group, sex, quintile of socioeconomic status, urban or rural residence, month, and year. Tests for interactions were also performed. Results: Before the legislation was implemented, admissions for asthma were increasing at a mean rate of 5.2% per year (95% confidence interval [CI], 3.9 to 6.6). After implementation of the legislation, there was a mean reduction in the rate of admissions of 18.2% per year relative to the rate on March 26, 2006 (95% CI, 14.7 to 21.8; P<0.001). The reduction was apparent among both preschool and school-age children. There were no significant interactions between hospital admissions for asthma and age group, sex, urban or rural residence, region, or quintile of socioeconomic status. Conclusions: In Scotland, passage of smoke-free legislation in 2006 was associated with a subsequent reduction in the rate of respiratory disease in populations other than those with occupational exposure to environmental tobacco smoke.

Copyright 2010, Massachusetts Medical Society

Marin HA; Diaz-Toro E. The effect of the smoke-free workplace policy in the exposure to secondhand smoke in restaurants, pubs, and discos in San Juan, Puerto Rico. Puerto Rico Health Sciences Journal 29(3, special issue): 279-285, 2010. (26 refs.)

Background: Tobacco use and the involuntary exposition to secondhand smoke (SHS) is one of the leading causes of all cancers in the world. The objective of this study was to assess the effect of the smoke-free workplace policy implemented in March of 2007 in Puerto Rico on the exposition to secondhand smoke in restaurants, pubs, and discos of the metropolitan area of San Juan, Puerto Rico. Methods: The study used a pre-post comparison design on a random sample of 55 establishments (32 restaurants and 23 pubs and discos) in the metropolitan area of San Juan, Puerto Rico. Measurements of indoor concentrations of fine particulate matter (PM) (2.5 mm diameter, PM2.5) were taken before and after the introduction of the law banning smoking using a Side Pak AM510 Personal Aerosol Monitor (TSI Company). Also, data on the number of smokers, number of customers, and establishment area was collected. Paired t-tests and linear regression analyses were used to test any statistically significant effect of the law. Results: After the smoking ban was implemented, restaurants experienced an 83.6% (p=0.013) reduction in the mean of PM 2.5 levels, from 0.169 to 0.028 mg/m(3), and pubs and discos experienced a 95.6% (p=0.004) reduction, from 0.626 to .028 mg/m(3). Conclusion: The implementation of the smoke-free workplace policy considerably reduced the exposition to 5115 of workers and customers in the restaurants, pubs, and discos of the metropolitan area of San Juan, Puerto Rico.

Copyright 2010, University of Puerto Rico Medical Sciences Campus

Martinez JA; Sher KJ. Methods of "fake ID" obtainment and use in underage college students. Addictive Behaviors 35(7): 738-740, 2010. (12 refs.)

Fake IDs are highly prevalent among underage college students, and are strongly associated with heavy drinking. However it is not currently known how exactly fake IDs are most commonly obtained and used, and how often individuals are caught. Such information could aid law enforcement and school personnel in their enforcement responsibilities, and might further elucidate the extent and means by which students "make ethical compromises" to gain illegal access to alcohol. A cross-sectional online survey of 1098 underage students at a large Midwestern university indicated that comparable to previous findings, 21.0% reported possessing a fake ID (which was strongly associated with past-month frequent heavy drinking: OR=4.84, 95% CI=3.41-6.86). Of those with fake IDs, 93.5% reported having used them, and 29.1% reported having been caught. Greek (i.e.. fraternity/sorority) members were more likely than others to obtain them through a Greek organization (OR=8.02, 95% CI=1.81-35.54). Also, men were more likely than women to buy (OR=2.74, 95% CI=1.57-4.77), yet less likely to be given them (OR=0.53, 95% CI=0.31-0.90). Future studies might examine whether and how fake ID capture reduces (or exacerbates) drinking over time.

Copyright 2010, Elsevier Science

Meyer AS; Mcwey LM; McKendrick W; Henderson TL. Substance using parents, foster care, and termination of parental rights: The importance of risk factors for legal outcomes. Children and Youth Services Review 32(5): 639-649, 2010. (80 refs.)

Using mixed methods, we compared appellate court foster care cases where parents' rights were terminated to those in which decisions to terminate parental rights were reversed or remanded to better understand the experiences of parents struggling with alcohol and drug use. A content analysis of 60 cases was conducted, 30 cases in which parental rights were terminated, and 30 where decisions to terminate parental rights were overturned or remanded to the lower court. Parents whose rights were terminated were more likely to have mental health problems and experienced incarceration. In addition, when a composite score of risk factors was analyzed, parents whose rights were terminated had significantly more risk factors. For both groups, poverty was an equally common risk factor. Implications include universal assessments for alcohol and drug abuse for parents involved in the child welfare system and timely refeirals to appropriate treatment. Further, collaboration between mental health providers, substance use treatment programs, and caseworkers to address the integration of potential risk factors may help promote successful outcomes for parents whose children are in foster care.

Copyright 2010, Elsevier Science

Morgan CJA; Muetzelfeldt L; Muetzelfeldt M; Nutt DJ; Curran HV. Harms associated with psychoactive substances: Findings of the UK National Drug Survey. Journal of Psychopharmacology 24(2): 147-153, 2010. (6 refs.)

Nutt and colleagues' 'rational' scale to assess the harms of commonly used drugs was based on ratings by a panel of experts. This survey aimed to assess drug users' views of the harms of drugs using the same scale. As users' drug choices are not solely based on harms, we additionally assessed perceived benefits. The survey was hosted at http: UK residents reported their experience of 20 commonly used substances; those with direct experience of a substance rated its physical, dependence-related and social harms as well as benefits. A total of 1501 users completed the survey. There was no correlation between the classification of the 20 drugs under the Misuse of Drugs Act and ranking of harms by users. Despite being unclassified substances, alcohol, solvents and tobacco were rated within the top ten most harmful drugs. There was a remarkably high correlation (r = 0.896) overall between rankings by users' and by experts. Ecstasy, cannabis and LSD were ranked highest by users on both acute and chronic benefits. These findings imply that users are relatively well informed about the harms associated with the drugs they use. They also suggest that the current UK legal classification system is not acting to inform users of the harms of psychoactive substances.

Copyright 2010, Sage Publications

Muggli ME; Lockhart NJ; Ebbert JO; Jimenez-Ruiz CA; Miranda JAR; Hurt RD. Legislating tolerance: Spain's national public smoking law. Tobacco Control 19(1): 24-30, 2010. (96 refs.)

While Spain's national tobacco control legislation prohibits smoking in many indoor public places, the law provides for an exception to the prohibition of smoking by allowing separate seating sections and ventilation options in certain public places such as bars and restaurants, hotels and airports. Accordingly, Spain's law is not aligned with Article 8 Guidelines of the World Health Organization's Framework Convention on Tobacco Control, which requires parties to ensure universal protection against secondhand smoke exposure in all enclosed public places, workplaces and on all means of public transport. Spain's law is currently being promoted by the tobacco companies in other countries as a model for smoke-free legislation. In order to prevent weakening of smoke-free laws in other countries through industry-supported exceptions, we investigated the tactics used by the tobacco companies before the implementation of the new law and assessed the consequences of these actions in the hospitality sector. Internal tobacco industry documents made public through US litigation settlements dating back to the 1980s were searched in 2008-9. Documents show that tobacco companies sought to protect hospitality venues from smoking restrictions by promoting separate seating for smokers and ineffective ventilation technologies, supporting an unenforceable voluntary agreement between the Madrid local government and the hospitality industry, influencing ventilation standards setting and manipulating Spanish media. The Spanish National Assembly should adopt comprehensive smoke-free legislation that does not accommodate the interests of the tobacco industry. In doing so, Spain's smoke-free public places law would be better aligned with the Framework Convention on Tobacco Control.

Copyright 2010, BMJ Publishing

Nadelmann E. Obama Takes a crack at drug reform: A new law narrows the gap in cocaine sentencing and signals a broad realignment of priorities. Nation 291(11): 23-24, 2010. (0 refs.)

The article discusses the reform of the U.S. drug policy. The focus of the article is a disparity in the 2010 Fair Sentencing Act, which increases the amount of crack cocaine that can result in a five-year sentence. Topics include an in-depth examination on the broader significance of the law including U.S. President Barack Obama's commitment to ease up on the drug war through reform to the U.S. drug policies, the prioritization of criminal justice reform by civil rights leaders, and level of bipartisanship regarding fair sentencing.

Copyright 2010, Nation Co., Inc.

Neuberger JS; Davis K; Nazir N; Dunton N; Winn K; Jacquot S et al. Indoor smoking ordinances in workplaces and public places in Kansas. Nicotine & Tobacco Research 12(8): 828-833, 2010. (27 refs.)

Introduction: The purpose of this study was to investigate the preferences of elected city officials regarding the need for a statewide clean indoor air law and to analyze the content of local smoking ordinances. Methods: A survey of elected officials in 57 larger Kansas cities obtained information on the perceived need for statewide legislation, venues to be covered, and motivating factors. Clean indoor air ordinances from all Kansas cities were analyzed by venue. Results: The survey response rate was 190 out of 377 (50.4%) for elected officials. Over 70% of the respondents favored or strongly favored greater restrictions on indoor smoking. Sixty percent favored statewide legislation. Among these, over 80% favored restrictions in health care facilities, theaters, indoor sports arenas (including bowling alleys), restaurants, shopping malls, lobbies, enclosed spaces in outdoor arenas, and hotel/motel rooms. Officials who had never smoked favored a more restrictive approach. Employee and public health concerns were cited as influential by 76%-79% of respondents. Thirty-eight ordinances, covering over half of the state's population, were examined. They varied considerably in their exemptions. Discussion: Official's attitudes toward smoking regulations were associated with their smoking status. The examination of existing ordinances revealed a piecemeal approach to smoking regulations.

Copyright 2010, Oxford University Press

Nimpitakpong P; Dhippayom T; Chaiyakunapruk N; Aromdee J; Chotbunyong S; Charnnarong S. Compliance of drugstores with a national smoke-free law: A pilot survey. Public Health 124(3): 131-135, 2010. (13 refs.)

Objectives: To examine the outcome of the recent implementation of a smoke-free policy in drugstores in Thailand, comparing participants and non-participants of the 100% smoke-free drugstore campaign promoted by the Thai Pharmacy Network for Tobacco Control (TPNTC). Study design: A cross-sectional survey of 3600 drugstores in Thailand. Method: Smoking prevalence on the premises, the number of stores displaying no-smoking signs, and the number of stores selling cigarettes were examined. Results: In total, 1001 questionnaires were returned (27.8% response rate). Smoking prevalences inside and outside drugstores in the past month were 26.4% and 84.7%, respectively. Seven percent of drugstores had at least one staff member who smoked tobacco. Overall, 63.3% of drugstores displayed no-smoking signs, as required by law. Compared with non-participating drugstores, those which participated in the TPNTC smoke-free campaign more frequently reported that they had asked smokers to stop smoking/leave the premises, in addition to possessing and displaying no-smoking signs. Conclusion: Approximately one-third of drugstores in this survey did not meet the terms of the recent smoke-free regulation. The TPNTC campaign improved the compliance of drugstores with the law in various aspects. This study was considered a pilot study, and despite the low response rate, the findings suggest a need for further action to ensure that all drugstores comply with the law and are 100% smoke-free.

Copyright 2010, The Royal Society for Public Health

Nordt C; Stohler R. Combined effects of law enforcement and substitution treatment on heroin mortality. Drug and Alcohol Review 29(5): 540-545, 2010. (17 refs.)

Introduction and Aims. To explore the combined effects of street-level law enforcement and substitution treatment programs on drug-related mortality, taking into account prevalence of heroin use and changes in injecting behaviour. Design and Methods. Time trend analysis using annual police reports and case register data of opioid substitution treatments in Switzerland, 1975-2007. Results. Drug-related mortality increased during times of more intense street-level law enforcement [odds ratio (OR) 1.32, 95% confidence interval (95% CI) 1.15-1.51], and the number of drug-related deaths predicted the number of heroin possession offences 2 years later (r = 0.97, P < 0.001). Substitution treatment had a protective effect on drug-related mortality (OR 0.23, 95% CI 0.18-0.30). Surprisingly, the number of drug-related deaths was substantially biased by an oscillation period of 14 years (OR 1.24, 95% CI 1.17-1.32). Discussion and Conclusions. Our analysis revealed that the amount of police resources allocated to law enforcement was determined rationally, however, on biased grounds and with untoward consequences. Substitution treatment of heroin users reduced drug-related mortality in the long run, but different factors masked its impact for several years. Therefore, the introduction-or the expansion-of opioid substitution treatment programs should not be promoted with the argument of an immediate reduction of drug-related deaths in a country.

Copyright 2010, Wiley-Blackwell

Pawson R; Owen L; Wong G. Legislating for health: Locating the evidence. Journal of Public Health Policy 31(2): 164-177, 2010. (35 refs.)

This article examines the timorous courtship between public health law and evidence-based policy. Legislation, in the form of direct prescriptions or proscriptions on behaviour, is perhaps the most powerful tool available to the public health policymaker. Increasingly, the same policymakers have striven to ensure that interventions are based soundly on a secure evidence base. The modern mantra is that the policies to follow are the ones that have been demonstrated to work. Legislative interventions, involving trade-offs between public benefit and private interests, present formidable challenges for the evaluator. Systematic reviews of their overall efficacy, the main tool of evidence-based policy, are in their infancy. The article presents a design for such reviews using the example of a forthcoming synthesis on the effectiveness of banning smoking in cars carrying children.

Copyright 2010, Palgrave MacMillan

Pedersen W; Skardhamar T. Cannabis and crime: Findings from a longitudinal study. Addiction 105(1): 109-118, 2010. (51f refs.)

Aim: To examine the association between cannabis use during adolescence and young adulthood, and subsequent criminal charges. Methods: Data were obtained from the Young in Norway Longitudinal Study. A population-based sample (n = 1353) was followed from 13 to 27 years of age. Data were gathered on cannabis use, alcohol consumption and alcohol problems, and use of other illegal substances such as amphetamines, cocaine and opiates. In addition, extensive information on socio-demographic, family and personal factors was collected. This data set was linked to individual-level information from official Norwegian crime statistics. Findings: We found robust associations between cannabis use and later registered criminal charges, both in adolescence and in young adulthood. These associations were adjusted for a range of confounding factors, such as family socio-economic background, parental support and monitoring, educational achievement and career, previous criminal charges, conduct problems and history of cohabitation and marriage. In separate models, we controlled for alcohol measures and for use of other illegal substances. After adjustment, we still found strong associations between cannabis use and later criminal charges. However, when eliminating all types of drug-specific charges from our models, we no longer observed any significant association with cannabis use. Conclusions The study suggests that cannabis use in adolescence and early adulthood may be associated with subsequent involvement in criminal activity. However, the bulk of this involvement seems to be related to various types of drug-specific crime. Thus, the association seems to rest on the fact that use, possession and distribution of drugs such as cannabis is illegal. The study strengthens concerns about the laws relating to the use, possession and distribution of cannabis.

Copyright 2010, Society for the Study of Addiction to Alcohol and Other Drugs

Polednak AP. Trends in mortality from COPD in selected US states differing in tobacco control efforts. Journal of Chronic Obstructive Pulmonary Disease 7(1): 63-69, 2010. (31 refs.)

U.S. state tobacco control programs have been associated with both temporal increases in smoking cessation rates in young adults and temporal declines in tobacco-related chronic diseases, but mortality from chronic obstructive pulmonary disease apparently has not been studied. Annual percent change (APC) (1990-2005) in age standardized mortality rate at ages 35-64 and 65+ years from this cause was analyzed for California (which started a comprehensive tobacco control program in 1989), the "U.S. exclusive of California," New Jersey and New York (which had relatively high cigarette prices in the 1990s), and a group of six southern tobacco-growing states (which had limited tobacco control efforts and low cigarette prices in the 1990s). Declines in mortality rates from 1990-2005 for age 35-64 were larger and statistically significant in California (annual % change -1.6%) and New Jersey-New York (annual % change -1.8%), while declines the "U.S. exclusive of California" (annual % change -0.5%) and in six southern tobacco-growing states (annual % change -0.3%). Declines in mortality at age 65+ years were small or nonexistent. The geographic differences in mortality for age 35-64 years after 1990 were not a continuation of earlier trends (in 1980-89), and may be related to differences in tobacco control efforts. This suggests that states should increase their tobacco-control efforts, to reduce chronic obstructive pulmonary disease mortality in the entire U.S.

Copyright 2010, Informa Healthcare

Ratschen E; Britton J; Doody G; Mcneill A. Smoking attitudes, behaviour and nicotine depdendence among mental health acute inpatients: An exploratory study. International Journal of Social Psychiatry 56(2): 107-118, 2010. (29 refs.)

Background: In 2008, mental health units in England went smoke-free by law. This study explores inpatients' experience with a smoke-free policy, their smoking behaviour, dependence, withdrawal and related issues. Material: Semi-structured interviews in a criterion sample of 15 inpatient smokers. Discussion: Patients generally approved of the smoke-free policy, provided they could smoke outside. Most participants had changed their smoking behaviour following admission. Most had little knowledge of nicotine dependence, reported a lack of structured support for smoking cessation, and a general interest in this being made available. Nicotine dependence was reportedly lower in the ward than in the home setting. Conclusions: More structured support is needed to ensure that opportunities for health promotion in a vulnerable population are not being missed.

Copyright 2010, Sage Publications

Ritchie D; Amos A; Martin C. "But it just has that sort of feel about it, a leper"-Stigma, smoke-free legislation and public health. Nicotine & Tobacco Research 12(6): 622-629, 2010. (28 refs.)

The Scottish smoke-free legislation has had considerable success, with high compliance resulting in significant health benefits and the increased denormalization of smoking. International literature on the impact of smoke-free legislation has mostly focused on the success of such policies. Relatively little consideration has been given to the potentially negative, albeit unintended, consequences of smoke-free policies within different social and cultural contexts, in particular the increased stigmatization of smokers. A 3-wave longitudinal qualitative study in 4 localities in Scotland using repeat in-depth interviews. Participants comprised a panel of 40 current and recent ex-smokers, interviewed before and after implementation of the legislation in 2 socioeconomically advantaged and 2 disadvantaged localities in Scotland. Smokers perceived the smoke-free legislation to have increased the stigmatization of smoking. By separating, albeit temporarily, those who were smoking from those who were not had led to increased felt stigma. This had led to a social milieu that fostered self-labeling and self-stigmatization by smokers of their own smoking behavior, even when they were not smoking. While there was little reported direct discrimination, there was a loss of social status in public places. Smokers attempted to ameliorate stigmatization by not smoking outside, reducing going out socially, joining in the stigmatization of other smokers, and/or acknowledging the benefits of smoke-free environments. The unintended negative consequences of smoke-free legislation for some suggest that tobacco control strategies need to consider how smokers who experience increased stigma are supported by public health to address their smoking while continuing to create smoke-free environments.

Copyright 2010, Oxford University Press

Ritter A. Illicit drugs policy through the lens of regulation. International Journal of Drug Policy 21(4): 265-270, 2010. (75 refs.)

The application of regulatory theory to the problem of illicit drugs has generally been thought about only in terms of 'command and control'. The international treaties governing global illicit drug control and the use of law enforcement to dissuade and punish offenders have been primary strategies. In this paper I explore the application of other aspects of regulatory theory to illicit drugs primarily self-regulation and market regulation. There has been an overreliance on strategies from the top of the regulatory pyramid. Two other regulatory strategies - self-regulation and market regulation - can be applied to illicit drugs. Self-regulation, driven by the proactive support of consumer groups may reduce drug-related harms. Market strategies such as pill-testing can change consumer preferences and encourage alternate seller behaviour. Regulatory theory is also concerned with partnerships between the state and third parties: strategies in these areas include partnerships between police and pharmacies regarding sale of potential precursor chemicals. Regulatory theory and practice is a rich and well-developed field in the social sciences. I argue that governments should consider the full array of regulatory strategies. Using regulatory theory provides a rationale and justification to strategies that are currently at the whim of politics, such as funding for user groups. The greater application of regulatory approaches may produce more flexible and structured illicit drug policies.

Copyright 2010, Elsevier Science

Robinson J; Amos A. A qualitative study of young people's sources of cigarettes and attempts to circumvent underage sales laws. Addiction 105(10): 1835-1843, 2010. (31 refs.)

Aims: To explore how young people continue to access cigarettes following an increase of the age of sale to 18 years and the implications for future smoking prevention policy and practice. Design: Qualitative study using 14 focus groups. Setting: Schools and community projects in disadvantaged areas of Birmingham, UK. Participants: Eighty-five smokers and non-smokers aged 12-15 years. Measurements: Focus group topic guides. Findings: While young people did use social sources to access cigarettes, most obtained cigarettes from small local shops. Smoking and non-smoking participants knew which shops sold to underage children and what strategies to employ, suggesting a widespread acceptance of underage sales in some communities. Some young people bought directly from retailers, reporting that the retailers did not ask for identification. Some young people reported that retailers were complicit, knowingly selling to underage smokers. Young people waited outside shops and asked strangers to buy them cigarettes (proxy sales). Young people expressed cynicism about some shopkeepers' motives, who they believed knew that they were selling to under-18s, but did not care as long as they made a profit. Conclusions: The ban in selling cigarettes to those under 18 in the United Kingdom appears to be easily circumvented, and one important route appears to be 'proxy sales' in which young people approach strangers outside retailers and ask them to purchase cigarettes on their behalf.

Copyright 2010, Society for the Study of Addiction to Alcohol and Other Drugs

Room R. Prohibition of cannabis. (editorial). British Medical Journal 341: c5492, 2010. (11 refs.)

A new report, Tools for Debate: US Federal Government Data on Cannabis Prohibition, focuses on the effects of the enforcement of drug prohibition in recent decades in the United States.1 It shows that efforts to suppress the selling and use of cannabis increased substantially. Adjusting for inflation, the US federal antidrug budget increased from about $1.5bn (0.95bn; 1.1bn) in 1981 to more than $18bn in 2002. Between 1990 and 2006, annual cannabis related arrests increased from fewer than 350?000 to more than 800?000 and annual seizures of cannabis from less than 500?000 lb (226?798 kg) to more than 2?500?000 lb. In the same period the availability of illicit cannabis and the number of users rose: the retail price of cannabis decreased by more than half, the potency increased, and the proportion of users who were young adults went up from about 25% to more than 30%. Intensified enforcement of cannabis prohibition thus did not have the intended effects. The report then turns to "unintended consequences" of prohibition, arguing that both in the US and in countries supplying the markets of affluent countries, drug prohibition contributed to increased rates of violence because enforcement made the illicit market a richer prize for criminal groups to fight over. The report concludes with a brief discussion of the alternatives to prohibition-decriminalisation and legalisation-arguing that experience with regulation of alcohol and tobacco offers many lessons on how a regulated market in cannabis might best be organised. The report's conclusions on the ineffectiveness in the US of "supply control" (the conventional term for enforcement of drug prohibition) are in line with reviews of the evidence from a global perspective. The evidence from Tools for Debate is not only that the prohibition system is not achieving its aims, but that more efforts in the same direction only worsen the results. The challenge for researchers and policy analysts now is to flesh out the details of effective regulatory regimes, as was done at the brink of repeal of US alcohol prohibition.

Copyright 2010, BMJ Publishing Group

Room R. The long reaction against the wowser: The prehistory of alcohol deregulation in Australia. Health Sociology Review 19(2): 151-163, 2010. (36 refs.)

The cultural and historical background of the substantial deregulation of alcohol sales in Australia in the last quarter century is described and discussed. Drinking and intoxication was contested ground in Australian history, stereotypically split between the heavy-drinking male world of primary industries and the more feminine world of the suburb. In the temperance era of the late 19th and early 20th century, restrictions on alcohol sales gained ground, epitomised by six o'clock closing adopted during World War I. Alcohol's cultural position shifted after World War II: alcohol problems were redefined in terms of alcoholism, a personal failing, and a cultural-political movement led by the Sydney Bulletin led a successful cultural-political movement to caricature and derogate 'wowsers'. Meanwhile, the alcohol industry moved to identify itself with high-valued features of Australian life. By the 1960s, a dynamic of relaxation of alcohol controls had started, starting with repeal of six o'clock closing and continuing to the present day.

Copyright 2010, Econtent Management

Rothstein MA. The Hippocratic Bargain and Health Information Technology. Journal of Law, Medicine & Ethics 38(1): 7-13, 2010. (21 refs.)

The shift to longitudinal, comprehensive electronic health records (EHRs) means that any health care provider (e.g., dentist, pharmacist, physical therapist) or third-party user of the EHR (e.g., employer, life insurer) will be able to access much health information of questionable clinical utility and possibly of great sensitivity. Genetic test results, reproductive health, mental health, substance abuse, and domestic violence are examples of sensitive information that many patients would not want routinely available. The likely policy response is to give patients the ability to segment information in their EHRs and to sequester certain types of sensitive information, thereby limiting routine access to the totality of a patient's health record. This article explores the likely effect on the physician-patient relationship of patient-directed sequestration of sensitive health information, including the ethical and legal consequences.

Copyright 2010, Wiley-Blackwell

Roy K; Miller M. Parity and the medicalization of addiction treatment. Journal of Psychoactive Drugs 42(2): 115-120, 2010. (0 refs.)

Parity, the idea that insurance coverage for the treatment of addiction should be on a par with insurance coverage for the treatment of other medical illnesses, is not a new idea, but the path to achieving "real parity" has been a long, hard and complex journey. Action by Congress to pass major parity legislation in 2008 was a huge step forward, but does not mean that parity has been achieved. Parity has required a paradigm shift in the understanding of addiction as a biological illness: many developments of science and policy changes by professional organizations and governmental entities have contributed to that paradigm shift. Access to adequate treatment for patients must acknowledge the paradigm shift reflected in parity as it has evolved to the current point: that this biological illness is widespread, that it is important that it be treated effectively, that appropriate third party payment for physician-provided or physician-supervised addiction treatment is critical for addiction medicine to become a part of the mainstream of our nation's healthcare delivery system, and that medical specialty care provides the most effective and cost effective benefit to patients and therefore to our society.

Copyright 2010, Haight-Ashbury

Saade G; Seidenberg AB; Rees VW; Otrock Z; Connolly GN. Indoor secondhand tobacco smoke emission levels in six Lebanese cities. Tobacco Control 19(2): 138-142, 2010. (25 refs.)

Background:To date, Lebanon has failed to enact comprehensive clean indoor air laws despite ratification of the Framework Convention on Tobacco Control (FCTC), which calls for the protection of non-smokers from exposure to secondhand tobacco smoke (SHS). Complicating the problem of SHS exposure in Lebanon is the widespread use of the tobacco water-pipe. While most research on SHS has involved cigarette smoking as a source of emissions, other sources, including tobacco water-pipes, may be an important contributor. Methods: PM2.5 concentrations (mu g/m(3)) were measured in a sample of 28 public venues located in six major Lebanese cities. Active smoker density (number of smokers/100 m(3)) was calculated for both water-pipe and cigarette smokers. Venues were then categorised as having higher density of water-pipe smokers or higher density of cigarette smokers, and resultant emission levels were compared between the two groups. Results: Cigarette and water-pipe smoking was observed in 14 venues, while cigarette smoking only and water-pipe smoking only were found in 12 venues and one venue, respectively. Among all smoking-permitted venues, the mean PM2.5 concentration was 342 mu g/m(3). Venues with a higher density of water-pipe smokers (n = 14) showed a similar median PM2.5 concentration (349 mu g/m(3)) compared with venues with a higher density of cigarette smokers (n = 13; 241 mu g/m(3); p=0.159). The mean PM2.5 concentration in the single venue with a voluntary smoke-free policy was 6 mu g/m(3). Conclusions: Despite ratification of the FCTC in 2005, both cigarette and water-pipe smoking are commonly practised in enclosed public places throughout Lebanon, leading to unsafe levels of indoor particulate pollution. Smoke-free policies are needed in Lebanon to protect the public's health, and should apply to all forms of tobacco smoking.

Copyright 2010, BMJ Publishing Group

Saner H. Impact of national and regional smoking bans on hospital admission for acute coronary syndromes. (editorial). Swiss Medical Weekly 140(9-10): 126-127, 2010. (11 refs.)

Schoj V; Alderete M; Ruiz E; Hasdeu S; Linetzky B; Ferrante D. The impact of a 100% smoke-free law on the health of hospitality workers from the city of Neuquen, Argentina. Tobacco Control 19(2): 134-137, 2010. (31 refs.)

Objectives The objective of this study was to evaluate the impact of 100% smoke-free environment legislation on respiratory and sensory irritation symptoms and respiratory function among bar and restaurant workers from the city of Neuquen, Argentina. Methods: Pre-ban and post-ban studies without a comparison group in an Argentinean city were conducted. A baseline survey and spirometric measurements were performed with a total of 80 bar and restaurant workers 1 month before (October 2007) and 3 months after (March 2008) the implementation of the new 100% smoke-free legislation. Results: A significant reduction in secondhand smoke exposure was observed after the enactment and enforcement of the new legislation, and an important reduction in respiratory symptoms (from a pre-ban level of 57.5% to a post-ban level of only 28.8%). The reduction of sensory irritation symptoms was even higher. From 86.3% of workers who reported at least one sensory irritation symptom in October 2007, only 37.5% reported the same symptoms in March 2008. Also, data obtained by spirometry showed a significant forced vital capacity increase. Conclusions: Consistent with other studies, 100% smoke-free legislation improved short-term health outcomes in the sample and should be implemented nationwide. Furthermore, undertaking this study has been highly important in promoting 100% smoke-free environment legislation at the workplace as a legitimate right of hospitality workers, and in reducing social acceptance of designated smoking areas in bars and restaurants.

Copyright 2010, BMJ Publishing Group

Shahab L; West R. Public support in England for a total ban on the sale of tobacco products. Tobacco Control 19(2): 143-147, 2010. (28 refs.)

Background:This study aimed to determine the level of support for a sales ban on tobacco in England to provide a benchmark against which any changes over time can be assessed. Methods: 8735 people from England who participated in one of five monthly cross-sectional household surveys in 2008 were asked to indicate whether they would support the statement that 'the government should work towards banning the sale of tobacco completely within the next 10 years'. In addition, sociodemographic and smoking characteristics were assessed. Results: A substantial proportion of the total sample (44.5%; 95% CI 43.5% to 45.6%) would support a move towards a complete ban. While never smokers (OR 2.02; 95% CI 1.82 to 2.25) and ex-smokers (OR 1.41; 95% CI 1.21 to 1.65) were more likely to support this idea, even among current smokers, a third would favour moving towards a sales ban of tobacco products. Adjusting for other background characteristics, younger, female participants, those living in London and those from lower socioeconomic groups were most likely to support a ban. Among smokers, a higher cigarette consumption, smoking enjoyment and contentment with being a smoker were associated with opposition to a ban, while feeling uncomfortable being a smoker, wanting to be a non-smoker and being worried about future health consequences of smoking were associated with support for a ban. Conclusion: Support for movement towards a ban on the sale of tobacco is higher than might be imagined. It is conceivable that as smoking prevalence falls further and smoking becomes more socially unacceptable, support might grow to a point where such a policy could become feasible.

Copyright 2010, BMJ Publishing Group

Sheridan J; Butler R. "They're legal so they're safe, right?" What did the legal status of BZP-party pills mean to young people in New Zealand? International Journal of Drug Policy 21(1): 77-81, 2010. (10 refs.)

Background: The legislation on psychoactive substances has a role to play with regard to shaping social values and influencing the normalisation of drug use. In New Zealand from 2005 to 2008, benzylpiperazine-containing 'legal' party pills (BZP-party pills) were legally available for purchase, subject to controls around a minimum purchase age of 18 years, and prohibitions on free of charge distribution and advertising in certain media. This paper explores what their legal status communicated to young users. Methods: Interviews and group discussions with young people (n = 58) who had used BZP-party pills in the preceding 6 months. Results: Data were collected between June and December 2006 via a series of interviews with individuals, 'friendship' pairs, and groups comprised of participants known to each other. Young people saw BZP-party pills as 'safe' and of good quality as they were legal/government sanctioned, but also thus of inferior strength, suggesting they could take more of them. However, after using them they often reviewed their view of their safety and quality due to varied experiences. Being legal for some people meant they could use the substances without breaking the law, or having to go to 'dealers'. Their legal status also meant they were easily accessible and were seen to be 'socially acceptable', with some young people indicating they would be happy to discuss their use with their parents. However, social acceptability was, for some, a reason not to use them. Conclusion: These data provide a unique insight into the tension between positive and negative harm reduction messages relating to the legal nature of psychoactive drugs and as such begin to fill an information void in this area. The legal status of these 'party pills' conveys mixed messages to young people and whilst being seen as potentially safe and of good quality, this often leads to higher than 'recommended' doses being used. Nevertheless, not breaking the law or having to access BZP-party pills from 'dealers', and being able to discuss their use with their parents are all potentially positive harm reduction issues. [NB. In respect to effects, benzylpiperazine is an amphetamine-like drug]

Copyright 2010, Elsevier Science

Simons-Morton B; Pickett W; Boyce W; ter Bogt TFM; Vollebergh W. Cross-national comparison of adolescent drinking and cannabis use in the United States, Canada, and the Netherlands. International Journal of Drug Policy 21(1): 64-69, 2010. (41 refs.)

Background: This research examined the prevalence of drinking and cannabis use among adolescents in the United States, Canada, and the Netherlands, countries with substantially different laws and policies relating to these substances. Methods: Laws regarding drinking and cannabis use were rated for each country. Substance use prevalence data among 10th graders from the Health Behaviour in School-Aged Children Survey conducted in each country in 2005-2006 were examined. Results: Laws regarding alcohol and cannabis were found to be strictest in the United States, somewhat less strict in Canada, and least strict in the Netherlands. On most measures of drinking, rates were lower in the United States than in Canada or the Netherlands. With United States as the referent, relative risks (RR) for monthly drinking were 1.30 (1.11-1.53) for Canadian boys and 1.55 (1.31-1.83) for girls, and 2.0 (1.73-2.31) for Dutch boys and 1.92 (1.62-2.27) for Dutch girls. Drunkenness was also higher among Canadian boys and girls and Dutch boys. However, rates of cannabis use did not differ between the countries, except that Dutch girls were less likely to use cannabis in the past year (RR = .67; .46-96). Conclusions: The lower prevalence of adolescent drinking and drunkenness (except among Dutch girls) in the United States is consistent with the contention that strict drinking policies may limit drinking among 10th graders. However, the finding that cannabis use rates did not differ across countries is not consistent with the contention that prohibition-oriented policies deter use or that liberal cannabis policies are associated with elevated adolescent use. Based on these findings, the case for strict laws and policies is considerably weaker for cannabis than for alcohol.

Copyright 2010, Elsevier Science

Smith DE; Lee DR; Davidson LD. Health care equality and parity for treatment of addictive disease. Journal of Psychoactive Drugs 42(2): 121-126, 2010. (32 refs.)

Substance abuse represents a significant underlying cause of the health issues faced in the United States, which severely impacts the nation's health care system and economy. Recently enacted parity legislation mandates that benefits for addiction and mental health treatment be provided on an equal footing with those for treatment for physical health. Diversion and abuse of prescription medications is growing in young people, with much of the diversion occurring between family and friends. Addiction has been accepted by mainstream medicine as a brain disease, and is associated with many other medical disorders. Early intervention and treatment for addiction provides extraordinary cost-benefit outcomes. Additional training for addiction professionals will be necessary. Stigmatization of substance abusers continues to exist at the state and federal levels, although research during the past 10 years indicates that patient compliance and relapse rates for substance abusers are not significantly different than those for individuals with other chronic diseases, e.g. diabetes, hypertension, and cardiac issues. While parity for addiction treatment has become policy at the federal level, great challenges lie ahead in funding access, facilities, and training, as well as redirecting societal perceptions and legislated penalties.

Copyright 2010, Haight-Ashbury

Sohler NL; Li X; Kunins HV; Sacajiu G; Giovanniello A; Whitley S et al. Home- versus office-based buprenorphine inductions for opioid-dependent patients. Journal of Substance Abuse Treatment 38(2): 153-159, 2010. (22 refs.)

Recent legislation permits the treatment of opioid-dependent patients with buprenorphine in the primary care setting, opening doors for the development of new treatment models for opioid dependence. We modified national buprenorphine treatment guidelines to emphasize patient self-management by giving patients the opportunity to choose to have buprenorphine inductions at home or the physician's office. We examined whether patients who had home-based inductions achieved greater 30-day retention than patients who had traditional office-based inductions in a study of 115 opioid-dependent patients treated in an inner-city health center. Retention was similar in both groups: 50 (78.1%) in office-based group versus 40 (78.4%) in home-based group, p = .97. Several patient characteristics were associated with choosing office- versus home-based inductions, which likely influenced these results. We conclude that opioid dependence can be successfully managed in the primary care setting. Approaches that encourage patient involvement in treatment for opioid dependence can be beneficial.

Copyright 2010, Elsevier Science

Steentoft A; Simonsen KW; Linnet K. The frequency of drugs among Danish drivers before and after the introduction of fixed concentration limits. Traffic Injury Prevention 11(4): 329-333, 2010. (15 refs.)

Objective: Until July 2007, the driving under the influence of drugs (DUID) legislation in Denmark was based on impairment, evaluated on the basis of a clinical investigation and toxicological analyses, but in 2007 fixed concentration limits were introduced into the Danish traffic legislation. The objective for this study was to investigate the prevalence of medication and illicit drugs among Danish drivers before and after 2007. Methods: Blood samples from drivers suspected of being under the influence of medication and/or illicit drugs were investigated as requested by the police. The results for a 10-year period before and for one year after the introduction of fixed concentration limits are presented. Results: A total of 2340 blood samples were analyzed for the presence of medications and/or illicit drugs for the period 1997-2006. The average number of cases per year was 234 (213-283), and on average 87 percent of the investigated cases were positive for one or more drugs. For 2008 the number of investigated traffic cases was increased to 1176. Seventy-three percent of the cases from 2008 were positive for one or more drugs. Benzodiazepines, cannabis (THC), amphetamine, heroin/morphine, methadone, cocaine, and ecstasy were the most frequently detected drugs for the period 1997-2006 and also in 2008. The number of these cases in which an ethanol level was detected above 0.5 mg/g (the Danish legal limit) was on average 18 percent (9-26%) for the period 1997-2006 and 19 percent for 2008. The average age of the drivers ranged from 31 to 34 years for the period 1997-2006 and was 31 years for 2008. The percentage of females per year ranged from 3 to 20 percent. Conclusion: The number of traffic cases investigated for substances other than ethanol were consistently low, in the range of 200 to 300 per year during the period from 1997 to 2006, but after the introduction of fixed concentration limits in 2007 a 5-fold increase was seen already in 2008.

Copyright 2010, Taylor & Francis

Thrasher JF; Perez-Hernandez R; Swayampakala K; Arillo-Santillan E; Bottai M. Policy support, norms, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. American Journal of Public Health 100(9): 1789-1798, 2010. (42 refs.)

Objectives. We assessed attitudes and beliefs about smoke-free laws, compliance, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. Methods. Trends and odds of change in attitudes and beliefs were analyzed across 3 representative surveys of Mexico City inhabitants: before implementation of the policy (n=800), 4 months after implementation (n=961), and 8 months after implementation (n=761). Results. Results indicated high and increasing support for 100% smoke-free policies, although support did not increase for smoke-free bars. Agreement that such policies improved health and reinforced rights was high before policy implementation and increased thereafter. Social unacceptability of smoking increased substantially, although 25% of nonsmokers and 50% of smokers agreed with smokers' rights to smoke in public places at the final survey wave. Secondhand smoke exposure declined generally as well as in venues covered by the law, although compliance was incomplete, especially in bars. Conclusions. Comprehensive smoke-free legislation in Mexico City has been relatively successful, with changes in perceptions and behavior consistent with those revealed by studies conducted in high-income countries. Normative changes may prime populations for additional tobacco control interventions.

Copyright 2010, American Public Health Association

Trachsel LD; Kuhn MU; Reinhart WH; Schulzki T; Bonetti PO. Reduced incidence of acute myocardial infarction in the first year after implementation of a public smoking ban in Graubuenden, Switzerland. Swiss Medical Weekly 140(9-10): 133-138, 2010. (25 refs.)

Objective: On March 1(st), 2008 a smoking ban in public buildings became effective in the Canton of Graubuenden, Switzerland. The aim of our study was to investigate, whether implementation of this new regulation was followed by a decrease in the incidence of acute myocardial infarction (AMI). Patients and methods: The Kantonsspital Graubuenden serves as a tertiary care hospital, possessing the only cardiac catheterization laboratory in the Canton of Graubuenden. Based on an excellent functioning network including all hospitals in the Canton of Graubuenden, virtually all patients experiencing an AMI in the Canton of Graubuenden are transferred to our hospital for either acute or early coronary angiography. Data of all patients with AMI undergoing coronary angiography at our hospital between March 1(st), 2008 and February 28(th), 2009 were collected prospectively. The data were then compared with those of the two corresponding 12-month periods preceding implementation of the public smoking ban. Results: In the two years before adoption of smoke-free legislation, the number of patients with AMI was 229 and 242, respectively (p = ns). In the 12 months after implementation of the public smoking ban, the number of AMI patients dropped to 183 (p < 0.05 vs. each of the previous 12-month periods), representing an overall 22% reduction in the AMI incidence within the first year after enactment of the new regulation. This reduction was driven by a significant decrease in the AMI incidence in men, nonsmokers, and individuals with established coronary artery disease, including those with prior AMI or prior percutaneous coronary intervention. Conclusions: Similar to other countries in Europe and various regions of the USA and Canada, implementation of a public smoking ban was followed by a significant early decline in the incidence of AMI in the Canton of Graubuenden, Switzerland.

Copyright 2010, EMH Swiss Medical Publishers

Voas RB; Tippetts SS; Fisher D; Grosz M. Requiring suspended drunk drivers to install alcohol interlocks to reinstate their licenses: Effective? Addiction 105(8): 1422-1428, 2010. (11 refs.)

Aims: To evaluate a new method being used by some states for motivating interlock installation by requiring it as a prerequisite to reinstatement of the driver's license. Design: The driving records of Florida DWI offenders convicted between July 2002 and June 2008 were analyzed to determine the proportion of offenders subject to the interlock requirement who installed interlocks. Setting: Most driving-while-impaired (DWI) offenders succeed in avoiding state laws requiring the installation of a vehicle alcohol interlock. Participants: A total of 82,318 Florida DWI offenders. Findings: Due to long periods of complete suspension when no driving was permitted and the failure to complete all the requirements imposed by the court, only 21,377 of the 82,318 offenders studied qualified for reinstatement, but 93% of those who qualified did install interlocks to be reinstated. Conclusions: Because of the lengthy license suspensions and other barriers that the offenders face in qualifying for reinstatement, it is not clear that requiring a period on the interlock as a prerequisite to reinstating will greatly increase the current installment rate.

Copyright 2010, Wiley-Blackwell

Waldman HB; Perlman SP; Rader R. Analysis of the Uniform Accident and Sickness Policy Provision Law: Lessons for social work practice, policy, and research. Social Work in Health Care 49(7): 618-629, 2010. (35 refs.)

The Uniform Accident and Sickness Policy Provision Law (UPPL) is a state statute that allows insurance companies in 26 states to deny claims for accidents and injuries incurred by persons under the influence of drugs or alcohol. Serious repercussions can result for patients and health care professionals as states enforce this law. To examine differences within the laws that might facilitate amendments or reduce insurance companies' ability to deny claims, a content analysis was carried out of each state's UPPL law. Results showed no meaningful differences between each state's laws. These results indicate patients and health professionals share similar risk related to the UPPL regardless of state.

Copyright 2010, Taylor & Francis

Wood E; Kerr T. Could a United Nations organisation lead to a worsening of drug-related harms? Drug and Alcohol Review 29(1): 99-100, 2010. (15 refs.)

The intimate link between illicit injection drug use and the spread of the human immunodeficiency virus (HIV) represents a global public health emergency. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that syringe sharing among illicit injection drug users (IDU) contributes to approximately one-third of new HIV infections outside of sub-Saharan Africa. Addressing this requires collaboration between both illicit drug control and public health systems. The authors point out that there are international agencies which continue to ignore this reality, with the most worrisome being the International Narcotics Control Board. Although various international consensus documents have highlighted the value of sterile syringe distribution programs, such as needle exchange the INCB's reluctance to support this evidence-based approach to HIV prevention has been well described. It is noted that drug control conventions should not support policy decisions which can lead to worsening of the global HIV epidemic.

Copyright 2010, Australian Medical and Professional Society on Alcohol and Other Drugs

Yildiz AN; Karadag O; Gonen MO; Gurel F; Ilhan B; Inel M et al. Knowledge and attitude of taxi drivers on the new legislation for smoke-free taxis: An occupational health perspective. Pakistan Journal of Medical Sciences 26(1): 111-116, 2010. (15 refs.)

Objective: Taxi drivers carry significant risks related to occupational health and safety. Exposure to second-hand tobacco smoke is known to be one of those health risks. As legislations for smoke-free taxis become more widespread throughout the world, this study aimed to assess knowledge and attitude of taxi drivers on the new legislation for tobacco control introduced in Turkey recently. Methodology: The study population consisted of 135 taxi drivers from 22 different taxi stations in Ankara Turkey. Data of the descriptive study was collected in October, 2008 through face-to-face interviews with a standart questionnaire. Descriptive statistics were used to summarize data, whereas chi-square was used to compare groups. Results: All the study participants were male with a mean age of 47.2+/-11.8 years. More than half of the taxi drivers (59.3%) were found to be current smokers. Although level of knowledge and attitude of taxi drivers on the new legislation were favorable in general, some difficulties and barriers were found to be present in implementation of the ban. Most of the smoking drivers were found to continue smoking in their taxis. About 80.0% of the drivers stated their concern of losing out on clients' satisfaction if they restrict smoking in their taxis. Conclusion: Taxi drivers and clients' knowledge, attitudes and behaviors are important determinants in successful implementation of legislations for smoke-free taxis.

Copyright 2010, Professional Medical Publications

Young WF; Szychowski J; Karp S; Liu L; Diedrich RT. Economic impacts of the Pueblo Smokefree Air Act. American Journal of Preventive Medicine 38(3): 340-343, 2010. (13 refs.)

Background: On July 1, 2003, the city of Pueblo CO enacted a smokefree ordinance (Pueblo Smoke-Free Air Act [PSFAA]) that prohibited smoking in public places and workplaces, including taverns and restaurants. Opponents to this ordinance argued that it would have a negative impact on tavern and restaurant sales. Purpose: The purpose of this study was to determine whether the PSFAA had a negative economic impact on tavern and restaurant sales tax revenues. Methods: with data gathered in 2007, this study implemented an interrupted time-series model in 2008, using 42 months of pre- and post-intervention sales tax revenue data for Pueblo to determine whether implementation of this ordinance had an effect on tavern and restaurant sales tax revenues. Ratios of tavern and restaurant openings to closings were also computed for the pre- and post-intervention periods. Results: Pre-post sales tax revenue data showed slight losses in sales tax revenue for taverns, and gains for restaurants, which more than offset the tavern losses. After adjusting for the consumer price index, the city of Pueblo experienced a 20.3% gain in combined tavern and restaurant sales tax revenues from the pre-ordinance period to the post-ordinance period. The ratio of tavern openings to closings improved from 1:1 pre-period to 3.3:1 post-period and the restaurant ratio remained unchanged at approximately 1.78:1 from pre- to post-period. Conclusions: There is no evidence that the PSFAA had a negative economic impact on consumer price index-adjusted tavern and restaurant sales tax revenues. From a fiscal policy perspective, this ordinance may have contributed to a net increase in sales tax revenues for the city of Pueblo. The business openings/closings data suggest that the confidence Pueblo's business sector had in the local hospitality industry was not negatively influenced by the PSFAA.

Copyright 2010, Elsevier Science