Community attitudes toward public policies to control alcohol, tobacco, and high-fat food consumption

We report the results of a survey conducted in upper-midwestern communities to assess public attitudes toward policy level interventions to moderate the use of alcohol, tobacco, and high-fat food. Four hundred thirty-eight women and 383 men were asked to indicate how much they favored or did not favor 29 policy proposals. Results showed that regulatory controls in all three areas were favored by the general public. Support was strongest for alcohol and tobacco controls, less so for high-fat food. Interventions designed to protect children and youths were most strongly endorsed, followed by restrictions on advertising and direct control over conditions of sale. Women favored all interventions more than men. There was a strong positive association between age and support for measures to moderate alcohol use. Individuals reporting least personal use of alcohol, tobacco, and high-fat foods were most in favor of control policies. The results of this survey indicate specific measures that might be most readily enacted and what segments of the population are likely to be most and least receptive.     

Public attitudes about underage drinking policies: results from a national survey

We conducted a national telephone survey of 900 adults in the United States to examine the attitudes of the adult public regarding underage drinking and a series of alcohol control policies aimed at reducing it. Three versions of the survey instrument were administered, each to one-third of the sample, with the versions varying in the stipulations of the policy options. Results showed high levels of public support for most of the alcohol control policies, with relatively lower support for those that would result in restrictions on adults' access to alcohol. Respondents' support of the policy options was significantly related to their sociodemographic and attitudinal characteristics, such as sex, age, drinking frequency, and level of concern about underage drinking. The findings provide important guidelines to policymakers interested in garnering support for policies aimed at curtailing underage drinking.     

Berlin's medical students' smoking habits, knowledge about smoking and attitudes toward smoking cessation counseling

Background  

Diseases associated with smoking are a foremost cause of premature death in the world, both in developed and developing countries. Eliminating smoking can do more to improve health and prolong life than any other measure in the field of preventive medicine. Today's medical students will play a prominent role in future efforts to prevent and control tobacco use.     

Knowledge of and attitudes toward the pill: results of a national survey in Japan.

CONTEXT: After decades of debate, the oral contraceptive pill was legalized in Japan in June 1999. Because the pill had been unavailable up until then, little is known about the public's knowledge about, attitudes toward and intentions to use the pill. METHODS: In a nationwide probability sample, 630 women and men were interviewed in their homes in March 1999. Respondents were asked a range of questions to gauge their knowledge about and attitudes toward the pill. RESULTS: Most respondents (79%) could identify both the name and purpose of the birth control pill. Roughly the same proportion of respondents held an overall positive impression (44%) as held a negative impression (42%) of the pill, and 14% were undecided about the method. The pill's high level of effectiveness in pregnancy prevention was the most common reason for having a favorable impression of it (47%). Women were more concerned about side effects than were men, and they also knew more about the pill's potential side effects than did men. Only 12% of respondents said they intended to use the pill if it were approved. Roughly one-quarter (23-26%) did not correctly identify the pill's inability to protect against HIV and other sexually transmitted diseases (STDs). CONCLUSIONS: Legalization of oral contraceptives in Japan has led to an urgent need to educate both men and women on the inability of the pill to protect against STDs, including HIV Policymakers and providers need to recognize the importance of encouraging dual method use in Japan.     

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.     

The effects of tobacco control policies on smoking rates: a tobacco control scorecard.

This article reviews studies of the effect of tobacco control policies on smoking rates with the aim of providing guidance on the importance of different policies. Based on past studies, we estimate the magnitude of effects of major tobacco control policies, how their effects depend on the manner in which the policies are implemented, the relationship between the different policies, and the barriers to implementation. The most successful campaigns have implemented a combination of tobacco control policies. Of those policies, substantial evidence indicates that higher taxes and clean air laws can have a large impact on smoking rates. Evidence also indicates that media campaigns when implemented with other policies are important. Research on greater access to treatment and telephone support hotlines indicates a strong potential to increase quit rates and may be important in affecting heavier smokers. Direct evidence on the effects of advertising bans and health warnings is mixed, but these policies appear to be important in some of the countries that have had success in reducing smoking rates. School education programs and limits on retail sales are not likely to have much impact if implemented alone, but may be more important when combined with other policies.     

Health care professionals' attitudes toward licensure, national certification, and continuing education requirements: results of a Texas survey

Health care professionals are challenged to not only maintain their skills but take them to new levels. Continuing education (CE), mandated by licensure and national certification, is one means of working toward this goal. This study examined the opinions and attitudes of professionals in regard to these issues. The majority of the survey respondents supported the need for licensure and certification and perceived that they benefited personally. A significant percentage indicated that existing CE systems might not meet their intended purposes and goals and might not be the best criteria for renewal. Many had difficulty finding appropriate and convenient programs, and some programs did not deliver as advertised. The results suggest an opportunity to improve both CE systems and CE programs offered to health care professionals.     

Attitudes towards smoking policies and tobacco control measures in relation to smoking status and smoking behaviour

BACKGROUND: To examine support for various smoking policies and tobacco control measures among lifetime smokers in a country with weak anti-smoking legislation and an underdeveloped anti-smoking climate. METHODS: Current (n = 624) and former smokers (n = 131) from a general population survey filled in the 30-item Smoking Policy Index (SPI). Structural equation modelling was used to confirm the SPI factorial structure and to test whether smoking status and smoking behaviour variables were related to the six dimensions of the SPI. RESULTS: The dimension with the highest support was penalties for sales to minors. Sanctions against smokers had the lowest support. Current smokers compared with former smokers showed lower support on the taxes/fees, public education, and environmental restrictions dimensions while controlling for gender, age, and social status. Within current smokers, unfavourable smoking behaviours were associated with lower support. CONCLUSION: Even in a country with poor tobacco control conditions, lifetime smokers including smokers with highly unfavourable smoking behaviours strongly support smoking policies and tobacco control measures concerning penalties and advertising/promotion. These measures should be used to promote anti-smoking legislation, and strict law enforcement of these measures is expected to be accepted by all smokers. For measures that are not supported by all lifetime smokers, interventions may be useful to increase acceptability. A limitation of the present study is the absence of never-smokers as a comparison group.     

State legislators' attitudes and voting intentions toward tobacco control legislation.

OBJECTIVES: This study describes state legislators' knowledge, attitudes, and voting intentions with regard to tobacco-related issues. METHODS: A cross-sectional survey of state legislators was conducted in North Carolina, Texas, and Vermont in 1994. RESULTS: Most legislators agreed that secondhand smoke can cause lung cancer in nonsmokers, and a majority believed that smokers are addicted to nicotine. More than 75% stated that they would support a measure to enforce laws preventing tobacco sales to youth. A majority of Texas and Vermont legislators supported an increase in the state cigarette excise tax; 43% of North Carolina legislators would support an increase if revenues were directed toward tobacco farmer diversification. CONCLUSIONS: State legislators believe tobacco to be addictive, and they support policies to protect youth from tobacco. Support for other legislative measures differs significantly across states.     

Prevalence and determinants of smoking in Belarus: A national household survey, 2000

A clear, up-to-date picture of smoking prevalence and its determinants is needed to inform the development of effective tobacco control policy in Belarus and other parts of the former Soviet Union. It is particularly important in view of the way the tobacco industry has targeted this region since transition. A nationally representative household survey designed to explore smoking behaviour and its determinants was undertaken in Belarus in April 2000. Data were available on 1090 individuals aged 18 years and over (response rate 53.4%). Respondents were similar demographically to the population of Belarus. Fifty three percent of men and 9% of women are current smokers and an additional 18% and 7% respectively are ex-smokers. Differences in smoking habits between successive generations were identified. These included a ninefold higher rate of ever-smoking amongst 18–29 years old women compared with those aged over 60 years (p < 0.0001) and a higher proportion of current smokers starting in childhood amongst those aged 18–29 years compared with older smokers (p = 0.0005). Smoking in public places, particularly the workplace where 65% smoke, is common. Smokers are more likely than non-smokers to have positive beliefs about the health impact of active and passive smoking (p < 0.0001). Amongst women the odds of smoking is 13 times higher in those living in large cities compared with those living in villages. In men, disadvantage and a positive attitude to the west appear to increase the likelihood of smoking. To date policy responses have been inadequate. Unless effective tobacco control policies are introduced, tobacco will continue to make an increasingly large contribution to premature morbidity and mortality in Belarus.     

Settlement-funded tobacco control in Texas: 2000-2004 pilot project effects on cigarette smoking

Because settlement proceeds allocated for tobacco control in Texas are insufficient for statewide activity at federally recommended funding levels, the Texas Department of State Health Services has used the available funds in quasi-experimental pilot studies in which varying amounts of support are provided for selected parts of the state. Trends in tobacco use were measured in telephone surveys of 7,998 (2000), 5,150 (2002), and 5,721 (2004) adults. Prevalence of cigarette smoking declined by almost one-third in the pilot area where comprehensive and sustained pilot activities to reduce tobacco use were organized at close to the federally recommended funding level. Significantly smaller reductions were observed in other parts of the state. In the group with the highest use, white non-Hispanic men, cigarette consumption declined by half in the pilot area. It is reasonable to expect similar reductions in tobacco use if funds are provided for statewide expansion of the pilot activities.     

Attachment to parents, parental tobacco smoking and smoking among Year 10 students in the 2005 New Zealand national survey

AIMS: To assess whether low attachment to parents is a consistent risk factor for adolescent smoking or is modified by ethnicity and parental smoking. METHODS: A national, cross-sectional multi-ethnic 2005 survey of 28,395 Year 10 students aged 14 and 15 years (18,934 Europeans, 4,769 Maori, 2,795 Asians, 1,897 Pacific Islanders). Students answered an anonymous questionnaire including measures of attachment to parents from the Inventory of Parent and Peer Attachment. RESULTS: The prevalence of adolescent smoking > or = monthly, going from the lowest to the highest quartile of parent attachment score, was 28%, 16%, 12% and 10%. The relative risk of smoking > or = monthly for students in parent attachment quartile 1, compared to quartile 4, was increased in all ethnic groups, being 4.37 (95% confidence interval 3.00, 6.38) in Asian, 3.12 (2.77, 3.51) in European, 1.97 (1.45, 2.67) in Pacific Island, and 1.36 (1.23, 1.51) in Maori students, adjusting for sex and school socioeconomic decile. The ethnic variation in relative risk was explained mostly by a variable smoking prevalence in the reference category (quartile 4) which ranged from 3% in Asian students to 29% in Maori. A similar pattern was seen when students were categorised by parental smoking, with students in the lowest parent attachment quartile having a significantly (p<0.05) raised relative risk of smoking > or = monthly compared to the highest quartile, regardless of whether their parents smoked or not. CONCLUSIONS & IMPLICATIONS: Low parent attachment score is associated with an increased risk of adolescent smoking regardless of ethnicity and parental smoking.     

Ethnic disparities in youth access to tobacco: California statewide results, 1999-2003

The authors examined the role of youth ethnicity in youth access to tobacco with large, random samples of stores and large samples of ethnically diverse youths for the first time. From 1999 through 2003, White, Black, Latino, and Asian youths made 3,361 cigarette purchase attempts (approximately 700 per year) statewide. Analyses revealed that Black youths had significantly higher access than other youths and that access rates for Black and Asian (but not Latino or White) youths exceeded the Synar-mandated < or = 20%. Clerks who failed to demand youth proof of age identification (ID) sold 95% of the tobacco that youths received and sold significantly more often to minorities and to girls, whereas clerks who demanded youth ID sold equally infrequently to all youths. These findings highlight significant ethnic disparities in youth access to tobacco and imply that those might be eliminated by policies and interventions that increase clerk demands for youth ID.     

Support for smoke-free policies in a pro-smoking culture: findings from the European survey on tobacco control attitudes and knowledge

Objectives  

To assess support for tobacco control policies between smokers and non-smokers, and the effects of nicotine dependence on smokers’ policy support in a country with high smoking rates and pro-smoking norms.     

Use of tobacco in Kenya: sources of information, beliefs and attitudes toward tobacco control measures among primary school students.

The purpose of this study was to present preliminary data on sources of and exposure to pro- and anti-tobacco messages. A questionnaire was administered to 1130 Kenyan primary schoolchildren. Forty-seven percent had received risk information from broadcast media and 88% was exposed to tobacco advertisements. Nonsmokers held more favorable attitudes toward control policies and were less frequently exposed to pro-and anti-tobacco messages. Adolescents receive risk information mainly from the broadcast media. Advertising is an important risk factor of smoking status in this developing country.