State laws on tobacco control--United States, 1998.

PROBLEM/CONDITION: State laws addressing tobacco use, the leading preventable cause of death in the United States, are summarized. Laws address smoke-free indoor air, minors' access to tobacco products, advertising of tobacco products, and excise taxes on tobacco products. REPORTING PERIOD COVERED: Legislation effective through December 31, 1998. DESCRIPTION OF SYSTEM: CDC identified laws addressing tobacco control by using an on-line legal research database. CDC's findings were verified with the National Cancer Institute's State Cancer Legislative Database. RESULTS: Since a previous surveillance summary on state tobacco-control laws published in November 1995 (covering legislation effective through June 30, 1995), several states have enacted new restrictions or strengthened existing legislation that addresses smoke-free indoor air, minors' access to tobacco, tobacco advertising, and tobacco taxes. Five states strengthened their smoke-free indoor air legislation. All states and Washington, D.C., continued to prohibit the sale and distribution of tobacco products to minors; however, 21 states expanded minors' access laws by designating enforcement authorities, adding license suspension or revocation for sale to minors, or requiring signage. Since the 1995 report, eight additional states (a total of 19 states and Washington, D.C.) now ban vending machines from areas accessible to minors. Thirteen states restrict advertising of tobacco products, an increase of four states since the 1995 report. Although the number of states that tax cigarettes and smokeless tobacco did not change, 13 states increased excise taxes on cigarettes, and five states increased excise taxes on smokeless tobacco products. The average state excise tax on cigarettes is 38.9 cents per pack, an increase of 7.4 cents compared with the average tax in the 1995 report. INTERPRETATION: State laws addressing tobacco control vary in relation to restrictiveness, enforcement and penalties, preemptions, and exceptions. ACTIONS TAKEN: The data summarizing state tobacco-control laws are available through CDC's State Tobacco Activities Tracking and Evaluation (STATE) System; the laws are collected and updated every quarter. The STATE System also contains state-specific data on the prevalence of tobacco use, tobacco-related deaths, and the costs of tobacco use. Information from the STATE System is available for use by policy makers at the state and local levels to plan and implement initiatives to prevent and reduce tobacco use. In addition, CDC is using this information to assess the ongoing impact of tobacco-control programs and policies on tobacco use.     

Perceptions of ceremonial and nonceremonial uses of tobacco by American-Indian adolescents in California

BackgroundAmerican-Indian adolescents have the highest tobacco use prevalence of all ethnic groups in the United States. Although much has been written about the role of tobacco in traditional Native-American cultures, little is known about modern-day perceptions of tobacco among American-Indian adolescents.MethodsThis study conducted focus groups of 40 American-Indian adolescents in urban and rural areas of Southern California. Participants discussed the role of traditional ceremonial tobacco use in their lives, the use of commercial tobacco as a substitute for sacred tobacco, the perceived safety of traditional versus commercial tobacco, and the perceptions of American-Indian imagery in tobacco advertising.ResultsMany American-Indian adolescents may be introduced to traditional tobacco use at early ages. Smoking is viewed as a sign of respect for the elders, but there are acceptable ways for adolescents to participate in ceremonies without inhaling smoke. Commercial cigarettes often are substituted for homegrown tobacco at ceremonies and events. Traditional tobacco was perceived as less dangerous than commercial tobacco because it does not contain chemical additives. However, respondents still perceived that smoking traditional tobacco and breathing tobacco smoke conferred health hazards. Participants found the use of American-Indian imagery in tobacco advertising offensive and stereotypical. Indian casinos were mentioned frequently as places where smoking occurred.ConclusionsContinued health education efforts are needed to decrease habitual use of commercial tobacco products and secondhand smoke exposure among American-Indian youth. Further research is needed to identify ways for American-Indian youth to participate in their cultural traditions while minimizing their risk for tobacco-related diseases.     

Attitudes toward anti-tobacco policy among California youth: associations with smoking status, psychosocial variables and advocacy actions

To prevent smoking and exposure to environmental tobacco smoke, California has implemented anti-tobacco policies, including laws restricting youth access to tobacco, and smoking bans in workplaces, schools, restaurants and bars. Although studies have examined adults' attitudes toward anti-tobacco policies, little is known about adolescents' awareness of and support for these policies. This study examined attitudes toward anti-tobacco policies in a sample of 6887 10th grade California adolescents. Awareness of anti-tobacco policies was highest among current smokers and lowest among susceptible never-smokers. Support for anti-tobacco policies was highest among non-susceptible never-smokers and lowest among current smokers. Policy awareness and support were significantly associated with psychosocial tobacco-related variables (e.g. perceived consequences of smoking, friends' smoking, perceived access to cigarettes, prevalence estimates of smoking among peers, cigarette offers and cigarette refusal self-efficacy). Policy awareness and support were associated with the probability of performing advocacy actions against tobacco use. Although these results cannot prove a causal association, they suggest that adolescents' attitudes toward anti-tobacco policies may play a role in their decisions about smoking. Tobacco control and education programs should include information about existing anti-tobacco policies, and should educate youth about the importance and benefits of anti-tobacco policies.     

Trends in Recall and Appraisal of Anti-Smoking Advertising Among American Youth: National Survey Results, 1997–2001

Public health efforts to reduce the harms related to tobacco use currently include a significant emphasis on anti-smoking media campaigns. This paper provides (a) data on the overall extent of exposure to anti-smoking media among American youth from 1997 to 2001, (b) an appraisal of general youth reactions to such advertising, and (c) an examination of how exposure levels and reactions vary by socio-demographic characteristics. Data were obtained from the Monitoring the Future study, an ongoing nationwide study of youth. Data were collected each year from nationally representative separate and nonoverlapping school samples of 8th, 10th, and 12th grade students (N = 29,724; 24,639; and 12,138, respectively). Self-reported levels of recalled exposure to both electronic and print anti-smoking advertising were measured, as well as the judged impact and perceived exaggeration of such advertising. Data indicate that significant increases in overall exposure to anti-smoking advertising occurred over the study time period. These increases were associated with (a) increases in the self-reported likelihood that anti-smoking advertising diminished the probability of individual smoking behaviors, and (b) increases in the perceived level to which anti-smoking advertising exaggerates the risks associated with smoking. Further, these trends were significantly associated with various characteristics—most notably, ethnicity, smoking behaviors, and residence in a state with an ongoing tobacco-control program having a media component.     

Usual sources of cigarettes for middle and high school students--Texas, 1998-1999

Persons often begin smoking when they are minors (aged <18 years), and easy access to cigarettes might contribute to this behavior. Laws and regulations were in place in Texas during 1998-1999 to reduce minors' access to cigarettes by 1) prohibiting the sale and distribution of tobacco products to minors; 2) imposing fines against retailers caught selling cigarettes to minors; 3) prohibiting minors from purchasing, possessing, or using tobacco products; 4) limiting vending machines to adult-only locations; and 5) requiring tobacco retailers to ask for proof of identification from anyone attempting to purchase tobacco who appeared to be aged <27 years. To measure progress in reducing access to cigarettes among middle and high school students in Texas, CDC analyzed self-reported data from the 1998 and 1999 Texas Youth Tobacco Survey (TYTS). This report summarizes the results of that survey, which indicate that during 1998-1999, reported access to cigarettes from stores and vending machines (commercial sources) decreased among middle school students from 13.2% to 5.3% and from 7.6% to 1.7%, respectively, but access from noncommercial and other sources (e.g., stealing cigarettes and "getting them some other way") increased from 8.3% to 12.3% and from 16.6% to 23.3%, respectively. Among high school students, most sources did not change. Educating retailers and actively enforcing laws governing youth access to tobacco as part of a comprehensive tobacco-control approach are required to reduce youth access to cigarettes.     

Use of cigarettes and other tobacco products among students aged 13-15 years--worldwide, 1999-2005

The use of tobacco in any form is a major preventable cause of premature death and disease. Globally, nearly 5 million persons die every year from tobacco-related illnesses, with disproportionately higher mortality occurring in developing countries. The Global Youth Tobacco Survey (GYTS), initiated in 1999 by the World Health Organization (WHO), CDC, and the Canadian Public Health Association, is a school-based survey that includes questions on prevalence of cigarette and other tobacco use; attitudes toward tobacco; access to tobacco products; exposure to secondhand smoke, school curricula on tobacco, media, and advertising; and smoking cessation. This report presents estimates of self-reported cigarette and other tobacco-product use during 1999-2005 in 132 different countries and the Gaza Strip/West Bank. The data are aggregated within each of the six WHO regions. GYTS data indicate that nearly two of every 10 students reported currently using a tobacco product, with no statistically significant difference between the proportion of those reporting cigarette smoking (8.9%) and other tobacco use (11.2%). Use of tobacco by adolescents is a major public health problem in all six WHO regions. Worldwide, more countries need to develop, implement, and evaluate their tobacco-control programs to address the use of all types of tobacco products, especially among girls.     

State preemption of local tobacco control policies restricting smoking, advertising, and youth access--United States, 2000-2010

Preemptive state tobacco control legislation prohibits localities from enacting tobacco control laws that are more stringent than state law. State preemption provisions can preclude any type of local tobacco control policy. The three broad types of state preemption tracked by CDC include preemption of local policies that restrict 1) smoking in workplaces and public places, 2) tobacco advertising, and 3) youth access to tobacco products. A Healthy People 2020 objective (TU-16) calls for eliminating state laws that preempt any type of local tobacco control law. A previous study reported that the number of states that preempt local smoking restrictions in one or more of three settings (government worksites, private-sector worksites, and restaurants) has decreased substantially in recent years. To measure progress toward achieving Healthy People 2020 objectives, this study expands on the previous analysis to track changes in state laws that preempt local advertising and youth access restrictions and to examine policy changes from December 31, 2000, to December 31, 2010. This new analysis found that, in contrast with the substantial progress achieved during the past decade in reducing the number of states that preempt local smoking restrictions, no progress has been made in reducing the number of states that preempt local advertising restrictions and youth access restrictions. Increased progress in removing state preemption provisions will be needed to achieve the relevant Healthy People 2020 objective.     

Crossing borders: the impact of the California Tobacco Control Program on both sides of the US-Mexico border

We examined the association between exposure to the California Tobacco Control Program and tobacco-related behaviors and perceptions among adults of Mexican descent. Three cross-sectional population-based surveys were conducted among adults in cities that represent full, partial, and no exposure to the program: San Diego, Calif, Tijuana, Mexico, and Guadalajara, Mexico, respectively. After we controlled for socioeconomic differences, we found significantly different rates of smoking, exposure to environmental tobacco smoke, and smoking bans in the 3 cities. We also observed a parallel gradient of cross-city differences in theoretical mediators of tobacco control. This suggests a significant association among the California Tobacco Control Program, tobacco-control outcomes, and theoretical mediators of these outcomes. Similar programs should be implemented in other regions; they have widespread effects on social norms and behaviors related to smoking and environmental tobacco smoke and can help achieve tobacco control across nations.     

Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study

Objectives. We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act.Methods. We surveyed a US nationally representative sample of 17 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers.Results. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors’ access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%).Conclusions. Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment.In 2009, the Family Smoking Prevention and Tobacco Control Act (FSPTCA),1 enabled the Food and Drug Administration to regulate tobacco products in the United States.2 Many provisions affect how tobacco products are sold and marketed in retail stores at the point of sale (POS). Major POS components of the FSPTCA focus on (1) youth access to tobacco, (2) regulating promotion (restricting gifts with purchase, prohibiting free samples), (3) product bans (banning cigarette flavors and a possible menthol ban), (4) advertising and labeling restrictions, and (5) graphic warnings on packs and ads. Some aspects of these regulations are controversial, such as a possible ban on menthol cigarettes.3 Tobacco industry litigation has blocked or delayed implementation of other aspects such as black-and-white text advertising and graphic warnings.4Public policy scholars provide insight into the role of public opinion in shaping tobacco-control policies. First, previous tobacco-control efforts such as efforts to raise federal cigarette excise taxes have met with failure, in part because of lack of public support.5 In addition, a recent proposal to ban sales of all tobacco products in Westminster, Massachusetts, generated public backlash and was withdrawn.6 Conversely, documenting public support for tobacco-control regulations has helped enact measures such as a tobacco tax increase in Massachusetts,7 or initial attempts to assert Food and Drug Administration jurisdiction over tobacco products.8 Public support can influence the policy agenda, decision-maker support, policy implementation, and compliance with new policies.9–11Previous studies have examined public opinions about some POS provisions, notably related to a ban on menthol cigarettes,12–14 and graphic warnings.15 Additional studies have focused on support for potential FSPTCA policies including nicotine reductions15,16 and bans on tobacco advertising.15 Another study examined support among New York City adults for emerging retail strategies such as a tobacco product display ban or limiting retailer licenses.17 But none, to date, have examined national public support for a wide range of POS provisions proposed or enacted under the FSPTCA. As a consequence, little is known about what characteristics contribute to developing supportive policy attitudes at POS where tobacco is ubiquitous and highly normative.18Previous studies have found that nonsmokers are more likely to support traditional tobacco-control regulations (e.g., tobacco taxes, indoor smoke-free laws) than are smokers,19–21 African Americans are more supportive than Whites,15,20,22 and high socioeconomic status (SES) individuals are more supportive than those of low SES.22,23 Studies also have found that policy support may increase following implementation.24–26 Policies that have already been implemented may have greater public support than proposed, but not implemented, policies. In conjunction with this, policies that have been implemented may also be the ones with the most preexisting support (i.e., “low-hanging fruit”). For example, in California, which enacted a statewide first in nation workplace smoking ban in 1995, support for smoking restrictions in public venues increased by 17 percentage points, compared with only 11 points in the rest of the nation, over 7 pre- to postban years.27 This type of finding suggests that policy implementation itself may increase support perhaps by spurring norms changes.We also identified factors associated with support for POS measures among smokers. Preserving “smokers’ rights” has often been used as an argument against new tobacco-control regulations.28 However, smokers are not a monolithic group; some smokers support regulations including advertising and promotion,19 smoke-free air restrictions,24,29 and youth access restrictions.19,30 In previous studies, intention to quit has been associated with support for smoke-free environments31–33 and advertising restrictions.31,32Beyond individual factors, support for tobacco-control regulations may vary by jurisdiction. Studies suggest that those who live in jurisdictions with stronger tobacco-control policies (e.g., higher tobacco taxes and extensive indoor smoke-free restrictions) may have stronger antismoking norms and more support for tobacco-control measures.34 Geographic region may also play a countervailing force; those living in tobacco-producing states may demonstrate less support for tobacco-control policies.34,35 As a result, statistical models should include state-level associations when one is examining public opinion nationally.The purpose of this study was to (1) identify which individual policies have the greatest support, (2) examine the overall level of support for POS policies in the FSPTCA among the general public and among smokers, and (3) identify individual respondent and state-level characteristics associated with support in the general population and among smokers.     

The role of public policies in reducing smoking and deaths caused by smoking in Vietnam: results from the Vietnam tobacco policy simulation model

A simulation model is developed for Vietnam to project smoking prevalence and associated premature mortality. The model examines independently and as a package the effects of five types of tobacco control policies: tax increases, clean air laws, mass media campaigns, advertising bans, and youth access policies. Predictions suggest that the largest reductions in smoking rates will result from implementing a comprehensive tobacco control policy package. Significant inroads may be achieved through tax increases. A media campaign along with programs to publicize and enforce clean air laws, advertising bans and youth access laws would further reduce smoking rates. Tobacco control policies have the potential to make large dents in smoking rates, which in turn could lead to many lives saved. In the absence of these measures, deaths from smoking will increase. The model also helps to identify information gaps pertinent both to modeling and policy-making.     

Prevalence and patterns of environmental tobacco smoke exposures among California teachers

PURPOSE: This study describes the prevalence and patterns of environmental tobacco smoke (ETS) exposure in a large, well-defined cohort of professional, female school employees in California. DESIGN: This is a cross-sectional study based on survey responses from members of the California Teachers Study (CTS) cohort. SUBJECTS: The analyses focused on lifetime nonsmokers (N = 61,899) in the CTS cohort who responded to detailed questions on lifetime ETS exposures in the home, workplace, and other social settings. MEASURES: Demographic characteristics, smoking status, and ETS exposure were based on self-reported data from two mailed surveys. Prevalence estimates within the cohort were compared with those from the California Behavioral Risk Factor Survey and the California Adult Tobacco Survey. RESULTS: ETS exposures were highest for never smokers born in the 1930s (78% in the home, 66% in the workplace, and 48% in other social settings) and steadily declined among participants born in later years. ETS exposure from spousal smoking peaked during the 1950s (37%). In the 1980s, the workplace (28%) replaced the household (19%) as the primary exposure setting. CONCLUSIONS: Consideration of these patterns in the prevalence of ETS exposures is important in the interpretation and design of tobacco-related health studies.     

The Association between Point-of-Sale Advertising Bans and Youth Experimental Smoking: Findings from the Global Youth Tobacco Survey (GYTS)

Background and Objectives: while existing research has demonstrated a positive association between exposure to point-of-sale (POS) tobacco advertising and youth smoking, there is limited evidence on the relationship between POS advertising restrictions and experimental smoking among youth. This study aims to fill this research gap by analyzing the association between POS advertising bans and youths'' experimental smoking. Methods: Global Youth Tobacco Surveys from 130 countries during 2007–2011 were linked to the WHO “MPOWER” tobacco control policy measures to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and experimental smoking using weighted logistic regressions. All analyses were clustered at the country level and controlled for age, parents'' smoking status, GDP per capita, and country-level tobacco control scores in monitoring tobacco use, protecting people from smoke, offering help to quit, warning about the dangers of tobacco, enforcing promotion/advertising bans, and raising taxes on tobacco. Results: The results suggest that a POS advertising ban is significantly associated with reduced experimental smoking among youth (OR = 0.63, p < 0.01), and that this association is seen for both genders (boys OR = 0.74, p < 0.1; girls OR = 0.52, p < 0.001). Conclusions: POS advertising bans are significantly associated with reduced experimental smoking among youth. Adopting POS advertising bans has the potential to reduce tobacco use among their youth in countries currently without such bans.     

Results of the Global Youth Tobacco Survey and implementation of WHO Framework Convention on Tobacco Control in former Soviet Union countries

Objectives

We used data from the Global Youth Tobacco Survey (GYTS) to monitor articles of the World Health Organization Framework Convention on Tobacco Control in Former Soviet Union (FSU) countries.

Methods

The GYTS is a school-based survey, which uses a two-stage sample design to produce representative, independent, cross-sectional estimates. The GYTS was conducted in 10 out of 12 FSU countries from 1999 to 2008.

Results

The prevalence of ever smoking and current smoking, smoking initiation, and exposure to second-hand smoking decreased over time. Overall, willingness to stop smoking, supporting smoking bans, and receiving information about the dangers of smoking increased over time.

Conclusions

Overall, our study shows that FSU countries had positive changes in tobacco-use prevalence and perception among youth over time. Our findings should be used as baseline measures for future tobacco-control interventions aimed at reducing tobacco use among youth. Moreover, our results call for the enforcement of restricting advertising for tobacco products.     

Predictors of government officials' support for youth tobacco control policies.

Preventing youth access to tobacco products is a crucial public health goal. This study examines support by elected city and county officials in Colorado for enacting youth tobacco control policies in the State of Colorado. Participating city and county officials (n = 684) were surveyed regarding their attitudes and opinions on tobacco-related issues and policy control efforts. The officials surveyed were generally supportive of efforts to restrict youth access to tobacco. A number of predictors of support for youth tobacco control policies were identified, including official's perceptions of community norms, their political party, the presence of citizen anti-tobacco events, educational background of the officials, and their attitudes about tobacco. Recommendations for theory and citizen action are provided.     

Mexico SimSmoke: how changes in tobacco control policies would impact smoking prevalence and smoking attributable deaths in Mexico

We examined the effect of tobacco control policies in Mexico on smoking prevalence and smoking-related deaths using the Mexico SimSmoke model. The model is based on the previously developed SimSmoke simulation model of tobacco control policy, and uses population size, smoking rates and tobacco control policy data for Mexico. It assesses, individually, and in combination, the effect of six tobacco control policies on smoking prevalence and smoking-related deaths. Policies included: cigarette excise taxes, smoke-free laws, anti-smoking public education campaigns, marketing restrictions, access to tobacco cessation treatments and enforcement against tobacco sales youth. The model estimates that, if Mexico were to adopt strong tobacco control policies compared to current policy levels, smoking prevalence could be reduced by 30% in the next decade and by 50% by 2053; an additional 470,000 smoking-related premature deaths could be averted over the next 40 years. The greatest impact on smoking and smoking-related deaths would be achieved by raising excise taxes on cigarettes from 55% to at least 70% of the retail price, followed by strong youth access enforcement and access to cessation treatments. Implementing tobacco control policies in Mexico could reduce smoking prevalence by 50%, and prevent 470,000 smoking-related deaths by 2053.     

大学生控烟自我效能及对控烟态度的影响

目的了解大学生控烟自我效能及其对控烟态度的影响,为进一步深入进行大学生控烟健康干预提供科学依据。方法采用自行设计的问卷,对方便抽取的南京市2所高校大学生开展调查,内容包括个人一般情况、控烟自我效能及大学生对主要控烟措施的态度。结果受访大学生的控烟自我效能普遍比较高(高分组占69.0%)。大学生对控烟措施普遍持赞成态度。大学生控烟态度受控烟自我效能的影响。自我效能高的大学生中有更多人赞成公共场所禁烟(OR=1.61),禁止吸烟广告(OR=2.69),实施无烟校园政策(OR=2.33),禁止学生吸烟(OR=2.08)。结论大学生控烟态度受控烟自我效能的影响,应加强针对提高大学生自我效能的综合性干预,促进学生对控烟决策的积极态度。     

Tobacco‐Control Policies in Tobacco‐Growing States: Where Tobacco Was King

Context

The 5 major tobacco-growing states (Kentucky, North Carolina, South Carolina, Tennessee, and Virginia) are disproportionately affected by the tobacco epidemic, with higher rates of smoking and smoking-induced disease. These states also have fewer smoke-free laws and lower tobacco taxes, 2 evidence-based policies that reduce tobacco use. Historically, the tobacco farmers and hospitality associations allied with the tobacco companies to oppose these policies.

Methods

This research is based on 5 detailed case studies of these states, which included key informant interviews, previously secret tobacco industry documents (available at http://legacy.library.ucsf.edu), and media articles. This was supplemented with additional tobacco document and media searches specifically for this article.

Findings

The tobacco companies were particularly concerned about blocking tobacco-control policies in the tobacco-growing states by promoting a pro-tobacco culture, beginning in the late 1960s. Nevertheless, since 2003, there has been rapid progress in the tobacco-growing states’ passage of smoke-free laws. This progress came after the alliance between the tobacco companies and the tobacco farmers fractured and hospitality organizations stopped opposing smoke-free laws. In addition, infrastructure built by National Cancer Institute research projects (COMMIT and ASSIST) led to long-standing tobacco-control coalitions that capitalized on these changes. Although tobacco production has dramatically fallen in these states, pro-tobacco sentiment still hinders tobacco-control policies in the major tobacco-growing states.

Conclusions

The environment has changed in the tobacco-growing states, following a fracture of the alliance between the tobacco companies and their former allies (tobacco growers and hospitality organizations). To continue this progress, health advocates should educate the public and policymakers on the changing reality in the tobacco-growing states, notably the great reduction in the number of tobacco farmers as well as in the volume of tobacco produced.     

Tobacco use, access, and exposure to tobacco in media among middle and high school students--United States, 2004

Two of the national health objectives for 2010 are to reduce the prevalence of any tobacco use during the preceding month to < or =21% and the prevalence of current cigarette use to < or =16% among high school students (objectives 27-2a and 27-2b). The National Youth Tobacco Survey (NYTS), conducted by CDC in 2004, provided estimates of current use of tobacco products and selected indicators related to tobacco use, including youth exposure to tobacco-related media and access to cigarettes. This report summarizes data from the 2004 NYTS and describes changes in tobacco use and indicators related to tobacco use since 2002. During 2002-2004, middle school students reported decreases in pipe use, seeing actors using tobacco on television or in movies, and seeing advertisements for tobacco products on the Internet. Among high school students, no changes were observed in the use of tobacco or in access to tobacco products; however, seeing actors using tobacco on television or in movies declined slightly, and seeing advertisements for tobacco products on the Internet increased. The lack of substantial decreases in the use of almost all tobacco products among middle and high school students underscores the need to fully implement evidence-based strategies (e.g., increasing the retail price of tobacco products, implementing smoking-prevention media campaigns, and decreasing minors' access as part of comprehensive tobacco-control programs) that are effective in preventing youth tobacco use.     

Tabaco y publicidad. Revisión de los estudios publicados entre 2000 y 2008

ObjectiveTo evaluate the influence of tobacco advertising on consumer habits.DesignSystematic review.Data sourcesPubMed, Ovid, Scielo, Mediclatina, Elsevier-Doyma, Isooc (CSIC) (January 2000-September 2008)MethodsA total of 44 national and international articles, linking the consumption of tobacco with any promotional or advertising practice. Articles not focused on the impact of advertising and promotion of cigarettes and research on prevention, intervention, plans and laws were removed.ResultsAdvertising influences tobacco consumption. Publicity leads to starting smoking (5 articles) and maintaining the habit (3 articles). It uses the relationship between advertising and smoker's image and concept (5 articles) and different advertising strategies (22 articles).ConclusionsThe advertising developed by the tobacco industry uses different strategies of influence on the consumption of cigarettes in the population.     

Evaluating the effects of enforcements and fines on youth smoking

Restricting access to retail sources of tobacco and fining minors for possession of tobacco products were evaluated as possible strategies to reduce the rising rates of teenage smoking. Four towns were assigned to enforce both tobacco minimum-age-of sales laws and tobacco possession laws (P). The remaining four towns were assigned to enforce only tobacco minimum-age-of sales laws (NP). Tobacco use among sixth-, seventh- and eighth-grade students was assessed. White youth who lived in communities with strict enforcement of tobacco sales and possession laws had significantly fewer increases in tobacco use than those living in communities with only moderate enforcement of tobacco sales laws. Public health interventions that involve police fining minors along with very high merchant compliance rates might decrease rates of tobacco use of white youth during a developmental time when they are susceptible to experimentation and use of tobacco products.