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SCTC October 2015 Digest (archived)



October 28, 2015


Dear NCI SCTC Research Initiative   partners,


Welcome to the National Cancer   Institute State and Community Tobacco Control (SCTC) Research Initiative October   2015 digest.


As a reminder, the purpose of   this digest is to inform key tobacco control partners such as yourself of our   work so that you can in turn share the information relevant to your   constituents through your normal means of communication. If you see any   released publications or products that could be useful for your constituents,   feel free to share them in your newsletters. Additionally, if you see any   upcoming publications or briefs with which you would like to coordinate   program activities or news releases, do not hesitate to get in touch with us   at the Coordinating Center or the listed authors and principal investigators.


Also, because this digest is   still new, we welcome feedback on ways we can improve its format, content,   and delivery to make it easier to use. Please send any feedback to


Thank for your support of the NCI   SCTC Research Initiative.




The State and Community Tobacco   Control Research Initiative Coordinating Center


PI: Matthew C. Farrelly, PhD

Co-PIs: Carol Schmitt, PhD, and   Todd Rogers, PhD


New Publications

Bondaryk   M, Okamoto J, Nez Henderson P, Leischow S. (2015). Master Settlement   Agreement Compliance Tobacco Directories: A tool to track tribally   manufactured cigarettes. Nicotine Tob   Res doi: 10.1093/ntr/ntv185


In   1998, 46 states, four U.S. territories, and the District of Columbia settled   with the tobacco industry in the Master Settlement Agreement (MSA). The MSA   required the tobacco industry to pay billions of dollars to the states for   their tobacco-related healthcare costs and set standards and restrictions for   the sale and marketing of tobacco products. Since 2003–2004, the settling   states have periodically released Tobacco Directories—a list of cigarette and   roll-your-own (RYO) cigarette manufacturers and brands that can be sold   legally within each participating state.

There   is limited research on the manufacturing, marketing, and sales of commercial   tobacco products on American Indian/Alaskan Native (AI/AN) tribal lands. This   topic is important because tribally manufactured cigarettes are low cost   alternatives to premium brand cigarettes, and these brands may be   disproportionately purchased by AI/AN populations, who already have high   rates of smoking.

In   this study, researchers reviewed the publicly available Tobacco Directories   from 43 states and DC to identify tribal manufacturers and brands across the United   States. Additionally, the researchers gave special attention to Colorado’s   Tobacco Directories because they have been issued on a monthly basis since   2003 and can show changes over time.

Value added

This   was the first analysis of publicly available Tobacco Directories data that   focused on tribal brands and manufacturers. Findings can effectively inform   the tobacco control community about the tribally manufactured tobacco market   in the United States.

Study findings

  •   A   total of 11 tribal manufacturers and 39 tribal cigarette brand families were   identified in the Tobacco Directories.
  •   Every   state Tobacco Directory in this study had at least one tribally manufactured   cigarette brand, and some state directories listed more than 20 brands. This   shows that tribally manufactured cigarettes are available beyond the three   states and one Canadian province where the cigarettes are manufactured (New   York, Oklahoma, Washington, and Ontario).
  •   In   Colorado, the overall number of tribal manufacturers increased from 3.2% in   2003 to 20.6% by 2014. The number of nontribal manufacturers decreased during   that time.


It   is important for practitioners to understand the manufacturing, marketing,   and sales of tribally manufactured tobacco products. Federal, state, and   tribal regulators can use information from the Tobacco Directories to track   cigarettes and RYO cigarette brands, but not other tobacco products.

Chen AT, Zhu SH, Conway M.   (2015). What online communities can tell us about electronic cigarettes and   hookah use: a study using text mining and visualization techniques. J Med Internet Res. doi:   10.2196/jmir.4517


Online   discussion forums provide a unique view of people’s experiences with tobacco   products, including products like e-cigarettes and hookah that are rising in   popularity. This study examined e-cigarette and hookah content from six   forums on three websites: Vapor Talk, Hookah Forum, and Reddit. Vapor Talk   and Hookah Forum focus specifically on e-cigarettes and hookah, respectively.   Reddit is a general platform that covers a variety of topics; this study reviewed   the e-cigarette, hookah, and Stopsmoking subreddit forums.

The   research team compared website content to determine which forums had the most   discussion about contextual factors related to product use. The research team   also identified common topics that appeared in forums about combustible   cigarette, e-cigarette, and hookah use to highlight the similarities and   differences in how people discussed their experiences using these products,   health concerns, and other themes.

Value added

This   study describes innovative methods researchers can use to mine social media   websites for information on how and why people are using products like   e-cigarettes and hookah.

Study findings

  •   The   Vapor Talk Health & Safety and Stopsmoking subreddit forums had the   richest discussions of contextual information, such as settings (e.g., home,   party, bar), time of day, social relationships, and the sensory experience of   product use.
  •   Content   on the Stopsmoking subreddit and Vapor Talk Health & Safety forums showed   that those who attempt to quit smoking combustible tobacco and those who use   e-cigarettes have very different experiences.
  •   Vapor   Talk and Hookah Forum members were mostly enthusiastic users interested in   sharing information about their e-cigarette and hookah experiences.
  • Discussions in the Stopsmoking subreddit        largely covered psychological aspects of quitting.
  • Discussions in Vapor Talk Health & Safety        largely covered symptoms people experienced while vaping and did not        focus on the psychology of quitting.
  • There were similar        conversations in both groups about buying and selling equipment and        techniques for how to use the products.

The   most notable difference between the two groups was that the e-cigarette forum   focused more on equipment (that is, discussing the different types and parts   of e-cigarettes), while the hookah forum focused more on the experience (such   as discussing the flavors and the “buzz”).


The   tobacco control community can use this research to develop effective programs   and policies that address e-cigarette and hookah use. Understanding   differences in people’s experiences of using these products may help   practitioners tailor programs to more effectively address behavior change.

Emory K, Kim Y, Buchting F, Vera L, Huang J, Emery S. (2015).   Intragroup variance in lesbian, gay, and bisexual tobacco use behaviors:   Evidence that subgroups matter, notably bisexual women. Nicotine Tob Res doi: 10.1093/ntr/ntv208


Emerging   evidence suggests that bisexual populations are at greater risk for a number   of health problems (tobacco, alcohol, drug use, and suicide) in comparison to   lesbian and gay populations. Research often focuses on lesbian, gay, and   bisexual (LGB) populations as a single group and has shown that LGB   populations in the United States smoke cigarettes at a higher rate than the   general population. Little is known about differences in smoking rates among   LGB subpopulations and about their use of other tobacco products, beyond   cigarette smoking.

The   goal of this study was to address some of those gaps by focusing on the   tobacco use rates for both cigarettes and other tobacco products within   subgroups of the LGB population (e.g., gay, lesbian, bisexual females, and   bisexual males). Data were obtained from the Tobacco Use in a Changing Media   Environment survey—a 2013 nationally representative online survey of a large   U.S. population.

Value added

Rather   than looking at LGB populations as a whole, this study focuses on tobacco use   rates among LGB subgroups and examines differences by gender. This study adds   to the limited body of research available on LGB tobacco use patterns,   particularly among bisexual populations.

Study findings

  •   LGB   adults had significantly higher levels of tobacco use than non-LGB adults.
  •   Among   LGB subpopulations, bisexual adults reported the highest levels of current   use of any tobacco products (42.1%), cigarettes (36.6%), e-cigs (11.3%), and   small cigars (18.4%).
  •   Bisexual   and lesbian women had greater odds of using any tobacco products than   heterosexual women.
  •   Gay   men had lower odds of cigar use than heterosexual men.
  • Any tobacco (cigarettes, e-cigs, regular        cigars, small cigars)—LGB: 35.7% vs. non-LGB: 24.7%
  • Cigarettes—LGB: 32.0% vs. non-LGB: 20.2%
  • E-cigs—LGB: 8.9% vs. non-LGB: 4.8%
  • Small cigars—LGB: 11.6% vs. non-LGB: 6.2%


Practitioners   may want to consider tailoring their tobacco control efforts to different LGB   subpopulations to better address LGB tobacco-related health disparities.   Special emphasis could be given to the populations more aggressively targeted   by tobacco industry marketing.

Golden SD, Smith MH, Feighery EC, Roeseler A, Rogers T, Ribisl KM.   (2015). Beyond excise taxes: a systematic review of literature on non-tax   policy approaches to raising tobacco product prices. Tob Control doi: 10.1136/tobaccocontrol-2015-052294


Increasing   the price of tobacco through excise tax policies is an evidence-based   approach to reducing tobacco use. However, tobacco companies can still keep   the cost of tobacco low through price promotions and discounts. In what is   known as price dispersion, different price tiers for tobacco products (high   premium prices and low discounted prices) make the products affordable even for   price-sensitive consumers like youth. Policies other than taxation may be   needed to help maintain high tobacco prices and reduce price dispersion.

This   study was a systematic review of literature describing non-tax policies that governments   are exploring to raise tobacco prices. The review included 56 peer-reviewed   articles and agency reports.

Value added

This   investigation summarizes how non-tax tobacco price policies are currently   described, recommended, and evaluated in the scientific literature and   highlights the need for further research on the impact of these policies. It   presents a framework to show how these policies may influence overall price   and price dispersion.

Study findings

  •   The   most common policies addressed in the literature were price promotion   restrictions (n = 41) and minimum price policies (n = 27). Only a handful of   articles addressed fee-based policies (n = 6) and price capping laws (n = 4).  
  •   Nearly   half of the articles (n = 26) described political or legal issues related to   price policies.
  •   Most   articles (n = 46) discussed the potential   of non-tax policies to reduce tobacco prices. However:
  •   Only   six articles explicitly evaluated the impact of price promotion restrictions   or minimum price laws to isolate the effect of these components, providing   limited evidence that non-tax policies can raise average prices.
    •   No   study examined the impact of non-tax policies on dispersion of prices within   and across product price tier groups.


Non-tax   tobacco price policies often supplement excise tax policies, but additional   research is needed to understand the impact of these policies on price, price   dispersion, and tobacco use. This research includes resources that may help   practitioners decide which policies to pursue and how to craft strong   policies that avoid some legal pitfalls.

Kegler MC,   HaardÓ§rfer R, Berg C, Escoffery C, Bundy L, Williams R Mullen PD. (2015).   Challenges in enforcing home smoking rules in a low-income populations:   implications for measurement and intervention design. Nicotine Tob Res doi: 10.1093/ntr/ntv165


The   home is often the main source of secondhand smoke for children and   nonsmokers, particularly among those living with a smoker. Although smoke-free   home policies have become more popular in recent years, relatively little is   known about how well these policies are enforced.

The   purpose of this study was to describe enforcement challenges faced in   households with newly adopted smoke-free rules. The study analyzed data from   a smoke-free homes intervention. Participants were callers to the United Way   of Greater Atlanta 2-1-1 who allowed smoking in their home at baseline and   reported either a full or partial smoking ban in their home after 6 months.

Value added

This   study adds to the literature by describing common exceptions to household   smoking rules and situations that present enforcement challenges.   Practitioners can use this information to improve smoke-free home interventions.

Study findings

  •   Households   with full bans (FB) were more likely to adhere to home rules than households   with partial bans (PB). Participants reported that their rules were:
  •   Bad   weather and parties were the most commonly cited exceptions to the rules.
  •   Smoking   occurred most often in bathrooms, family/living rooms, and bedrooms.
  •   Households   with partial smoking bans, three or more smokers, or nonsmokers had greater   challenges with enforcement.
  • never broken—FB: 52.6% vs. PB: 34.1%
  • sometimes broken—FB: 15.5%; PB: 21.8%
  • broken very often—FB: 4.3%; PB: 9.4 %


Practitioners   may want to improve smoke-free home interventions by offering potential   solutions to enforcement challenges. Practitioners may also consider   extending intervention support to households after a home smoking policy is   initially established to improve the likelihood that rules are enforced fully   and without exceptions.

Rose SW,   Emery SL, Ennett S, McNaughton Reyes HL, Scott JC, Ribisl KM. (2015). Public   support for Family Smoking Prevention and Tobacco Control Act point-of-sale   provisions: results of a national study. Am   J Public Health doi: 10.2105/AJPH.2015.302751


Public   opinion can play a role in shaping tobacco control policies. Public support   has contributed to successful efforts to pass new policies and strengthen   existing policies, and lack of support has been a factor in why efforts to   pass other policies have failed.

In   2009, the Family Smoking Prevention and Tobacco Act (FSPTCA) gave the Food   and Drug Administration authority to regulate tobacco products in the United   States. Many provisions affect how tobacco products are sold and marketed in   retail stores at the point of sale (POS).

This   study surveyed a nationally representative sample of U.S. adults to measure   support for enacted and proposed POS policies under the FSPTCA. Investigators   focused on five major types of POS policies and examined support for two   provisions within each:

  •   Youth   access—(1) Fines   for merchants who sell to youth; (2) Increased fines for merchants repeating   youth sales
  •   Advertising   and labeling—(1)   Black-and-white advertising; (2) Plain packaging on tobacco packs
  •   Warnings—(1) Graphic warning on ads; (2)   Graphic warning on packs
  •   Promotion—(1) Bans on branded nontobacco   items; (2) Bans on gifts with purchase
  •   Product—(1) Bans on flavored cigarettes;   (2) Bans on menthol cigarettes

Value added

Previous   studies have examined support for some FSPTCA provisions, but this study is   the first to focus on national support for a wide range of provisions.   Understanding support for POS policies can help determine whether additional   efforts are needed to educate the public on key POS policies.

Study findings

  •   Overall,   nonsmokers were more supportive of POS policies than smokers.
  •   Regardless   of smoking status, African Americans, Hispanics, women, and older adults were   more supportive of these policies than whites, males, and younger adults.
  •   Support   varied by policy type:
    • Support was highest for youth   access policies (> 80%).
    • Advertising and labeling policies   received the least amount of support (26% for black and white ads and 23% for   plain packaging).
    • Nearly half of the sample (45%)   supported graphic warnings on packs and ads.
    •   Over   one-third of the sample (36%) supported a ban on menthol cigarettes.


In   comparison to other areas of tobacco control, like smoke-free air policies,   public support for POS policies is relatively low. Practitioners may want to   consider enhancing public education efforts around POS policies as a strategy   to increase public support. Public support for POS policies can help   advocates who are working to implement new and maintain existing POS policies   at the federal, state, and local levels.




SCTC         Investigators at APHA (November 2015)






Session           details








4:30 PM –


5:30 PM


Poster           presentation, Board 8;


Electronic           cigarettes: Use, perceived harm, marketing and taxation


Impact of e-cigarette use on smoking combustible cigarettes:           Evidence from a large national survey


Huang J, Kim           Y, Shi Y, Emery SL


4:30 PM –


5:30 PM


Poster presentation, Board           1;  


Tobacco countermarketing           across media platforms


Check out that #Rollgame: Amounts and themes of little cigar           and cigarillo content on Twitter


Kostygina G, Tran H, Szczypka G, Binns S, Emery SL


4:30 PM –


5:30 PM


Poster presentation, Board           8;


Supporting the Finish It           generation


Using a social prioritization index to predict young adult smoking


Lisha N, Neilands T, Jordan J, Holmes L, Ling P


4:30 PM –


5:30 PM


Poster presentation, Board           3;  


Tobacco countermarketing           across media platforms


It’s like           smoking a piece of gum: Perceptions of menthol cigarettes among Twitter           users


Rose S, Jo C, Binns S, Buenger M, Ribisl KM, Emery SL


4:30 PM –


5:30 PM


Poster           presentation, Board 9;


Tobacco policy: Domestic and international perspectives


Association between tax structures and price variability –           Evidence from a large number of countries


Shang C,           Chaloupka FJ




10:30 AM – 12:00 PM


Roundtable, Table 3;


Public health strategies           to advance Native health research, ethics, & policy


“Dzil           nat’oh is the traditional healer’s tobacco”: The history, impact and           role of culturally relevant policies to curb the use of commercial           tobacco in the Navajo ceremonial setting


Yazzie A, Sabo S, Clark H, Chief C, Nez Henderson P, Leischow           S, Nahee J, Wilcox D




12:30 PM –


 1:30 PM


Poster           presentation, Board 9;


Second-           and third-hand smoke: Successes and lessons learned


Secondhand           smoke exposure in the workplace: A lingering hazard for young adults           in California


Holmes           L, Ling P


12:50 PM –


 1:10 PM


Oral           presentation;


Moving           towards tobacco health equity


Use of other           tobacco products among sexual minority young adult bar patrons


Fallin           A, Lisha N, Ling P


4:30 PM – 5:30 PM


Poster presentation, Board           3;


Tobacco policy, advocacy,           and point-of-sale issues


Standardized Tobacco Assessment for Retail Settings           (STARS): Dissemination & implementation research


Johnson T,           Crew E, Parikh N, Sarris Esquivel N, Byerly K, Combs T, Walsh           H, Rogers T, Henriksen L, Moreland-Russell S, Ribisl KM


4:30 PM – 5:30 PM


Poster           presentation, Board 5;


Tobacco policy, advocacy, and point-of-sale issues


Trends in the retail tobacco marketplace, 1999-2012


Liu Y, Barker D, Quinn CM, Slater SJ, Huang J, Chaloupka FJ


4:30 PM – 5:30 PM


Poster presentation, Board           6;  


Tobacco policy, advocacy, and point-of-sale issues


Reliability           of self-trained data collection for tobacco retail surveillance:           STARS dissemination and implementation research


Sarris Esquivel N, Liedtke C, Watson K, Loomis BJ, Parikh N,           Barker D, Rogers T


4:56 PM – 5:09 PM


Oral           presentation; Trans/gender-variant people’s public health


Transgender           tobacco use in a national sample of adults


Emory K, Emery SL, Buchting F, Kim Y


5:00 PM – 5:15 PM


Oral presentation;


Mass media and pop culture           in health communication (organized by HCWG)


Smoke it           up: Exploring the themes and prevalence of tobacco rap lyrics on           Twitter


Kostygina G, Aly E, Tran H, Szczypka G, Emery SL


5:42 PM – 6:00 PM


Oral presentation;


Late breakers           in epidemiology and public health research—From disparities in           childhood vaccination to social media and Internet usage by sexual           orientation


Social           media, television, radio, and Internet usage by sexual orientation           and smoking status: A nationally representative study, USA, 2013


Seidenberg AB,           Jo CL, Ribisl KM, Emery SL




8:30 PM – 9:30 AM


Poster           presentation, Board 4;


Domestic and international tobacco issues


Smoke-free           multiunit housing: A review of the conference abstracts,           theses/dissertations and online resources


Kegler MC,           Haardörfer R, Liang S, Jordan J, McDonald B


8:50 AM – 9:10 AM


Oral           presentation;


Tobacco and smoking policies: Addressing addiction,           disparities, and youth


Reactions           to smoke-free policies in the Southeastern U.S. and to messaging           strategies in support and opposition


Berg CJ,           Thrasher JF, HaardÓ§rfer R, O’Connor J, Kegler MC


8:50 AM – 9:10 AM


Oral           presentation;          


Tearing down the power walls: Point of sale tobacco control           strategies


Standardized Tobacco Assessment for Retail Settings (STARS): Comparative           data for U.S. stores


Ribisl KM, Golden S, Byerly K, D’Angelo H, Luke D, Henriksen L