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SCTC October 2016 Digest (archived)

October 3, 2016

 

Dear NCI SCTC Research Initiative partners,

 

Welcome to the National Cancer Institute State and Community Tobacco Control (SCTC) Research Initiative October 2016 digest.

 

This edition of the digest summarizes content of a special supplement released in the October 2016 issue of Tobacco Control, titled “Advancing the Science of State and Community Tobacco Control.” This series of papers present key findings of state and community tobacco control research to help guide state and community tobacco control policies and practices.

 

The supplement is designed for public health practitioners, researchers, advocates, and federal, state and local policy makers. The full supplement is available online at http://tobaccocontrol.bmj.com/content/25/Suppl_1.toc.

 

Thank for your support of the NCI SCTC Research Initiative.

 

Sincerely,

 

The State and Community Tobacco Control Research Initiative Coordinating Center

 

PI: Matthew C. Farrelly, PhD

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

Roeseler, A., Meaney, M., Riordan, M., Solomon, M., Herndon, S., & Hallett, C. (2016). NCI’s state and community research initiative: A model for future tobacco control research. Tobacco Control, 25(Suppl. 1), i1–i3.

Overview

Cancer is the second leading cause of death in the United States, and more than 30% of cancer deaths are attributable to smoking. Reductions in cigarette smoking over the last 40 years have reduced cancer-related disease and deaths. The National Cancer Institute (NCI) funded the State and Community Tobacco Control (SCTC) Research Initiative to provide timely and practical research into the most important questions and problems facing tobacco prevention and control today.

Value added

Written by key partners of the SCTC Research Initiative including state and local health experts, attorneys, and advocacy organizations, this editorial describes the collaboration between SCTC researchers and practitioners and provides examples of how research was used to further evidence-based policies.

Highlights

The SCTC Research Initiative was able to generate timely and useful research by:

  • Actively engaging public health and legal practitioners and the community
  • Funding collaborative development projects to respond to evolving issues
  • Promoting cross-disciplinary research
  • Fostering development of future investigators
  • Advancing data collection methods, including new social media tools
  • Widely disseminating findings across a multitude of platforms; and
  • Emphasizing the need to reduce tobacco use among vulnerable populations

Implications

Continued investment in population-based research is essential for advancing tobacco control and reducing tobacco-related disparities. The SCTC Research Initiative’s innovative vision can serve as a model for future research initiatives in tobacco control and other public health disciplines.

 

Ginexi, E. M., & Vollinger Jr., R. E. (2016). National Cancer Institute’s leadership role in promoting state and community tobacco control research. Tobacco Control, 25(Suppl. 1), i4–i5.

Overview

The National Cancer Institute (NCI) has been at the forefront of funding tobacco control research for decades. In this introductory article to the special issue, authors highlight NCI’s State and Community Tobacco Control (SCTC) Research Initiative, which was launched in 2011 to inform state and community tobacco control policy and practice.

Value added

This article describes NCI’s commitment to state and community tobacco control research efforts and the need for continued research in this area to address tobacco use.

Highlights

  • NCI has funded major efforts in tobacco control research, including the Community Intervention Trial for Smoking Cessation (COMMIT) in 1988, the American Stop Smoking Intervention Study (ASSIST) in 1991, and the Tobacco Research Initiative for State and Community Interventions in 1999.
  • In 2011, NCI funded the SCTC Research Initiative to address policy research gaps. The initiative supported large-scale research projects and time-sensitive pilot studies in response to the needs of state and community partners.
  • SCTC grantees were also tasked with developing effective strategies to disseminate their research findings to tobacco control programs, public health practitioners, researchers, and policymakers.
  • A full description of the SCTC Research Initiative is available at http://sctcresearch.org/PublicHome.
  • Over 100 publications and 285 conference presentations have been authored to date, and this special issue of Tobacco Control showcases additional findings.

Implications

State and community tobacco control research is critical for advancing the field of tobacco control. Future state and community tobacco control research will need to adapt to effectively study a complex and dynamic product and policy landscape.

 

Moreland-Russell, S., Combs, T., Schroth, K., & Luke, D. (2016). Success in the city: The road to implementation of Tobacco 21 and Sensible Tobacco Enforcement in New York City. Tobacco Control, 25(Suppl. 1), i6–i9.

Overview

In 2014, New York City implemented two of the most progressive point-of-sale policies in the nation. Tobacco 21 raised the minimum age to purchase tobacco, including e-cigarettes, from 18 to 21 years. Sensible Tobacco Enforcement included a comprehensive set of price-related polices that restricted price discounts, established minimum price and packaging requirements, and increased penalties for tax evasion. These two policies aim to restrict youth access and eliminate sources of cheap tobacco.

Value added

This paper provides an example of the successful passage of two tobacco control policies in a large U.S. city.

Highlights

This paper highlights research that supports these policies and describes factors that were instrumental in ensuring these policies were signed into law.

  • To understand the problem locally, the New York City Department of Health & Mental Hygiene (referred to as “the Department”) researched and conducted surveys to assess the prevalence of cheap and discounted tobacco in the city. 
  • The Department developed strong and strategic partnerships with other city government agencies, nongovernmental organizations, and local coalitions. These partners raised awareness of the problem, built support for proposed policy solutions, and testified in support of the policies at a hearing.
  • The city had anticipated and prepared for lawsuits, and ultimately prevailed in a lawsuit filed by industry and retailer associations.
  • City agencies developed and rolled out a plan to educate retailers on how to comply with the new laws.

Lessons Learned

  • Directly engage policymakers with their constituents.
  • Engage supportive retailers and maintain relationships.

Implications

Strong partnerships, substantial local data, and support from the public and elected officials were key to implementing these policies in New York City. Lessons learned from New York City’s experience can benefit other communities that are trying to enact similar point-of-sale policies.

 

Dolan Mullen, P., Savas, L. S., Bundy, Ł. T., Haardörfer, R., Hovell, M., Fernández, M. E., Monroy, J. A., Williams, R. S., Kreuter, M. W., Jobe, D., & Kegler, M. C. (2016). Minimal intervention delivered by 2-1-1 information and referral specialists promotes smoke-free homes among 2-1-1 callers: A Texas generalization trial. Tobacco Control, 25(Suppl. 1), i10–i18.

Overview

The Smoke Free Homes program is a minimally intensive program with three mailings and a single counseling telephone call, implemented in partnership with 2-1-1 social services information and referral systems. Efficacy and effectiveness trials in Georgia and North Carolina found that this program was successful in promoting home smoking bans. This study aimed to test the program’s generalizability by replicating the intervention in Texas in a more diverse population and in a region with lower smoking rates than the previous trials.

Value added

This study reports on the results of a replication trial, which are reported infrequently. The Texas trial substantiates the program’s effectiveness and generalizability and identifies possible adaptations in recruitment to increase overall reach of the program.

Highlights

  • Participants in intervention households who participated in the Smoke Free Homes program were more likely than control participants to report a full ban after 3 months and 6 months.
  • Compared with the other trials, the Texas trial included more Latinos and fewer African American participants.
  • Exploratory results of this trial showed promise for the program’s effect for English-speaking/bilingual Latinos.
  • Recruitment in the Texas trial was less than half of the other sites. Fewer callers reported having a smoker in the household, and almost twice the callers with a household smoker declined interest in the study.

Implications

This paper describes an innovative program that was successful in promoting home smoking bans in low-income households in three states. This study shows that 2-1-1 centers can be an effective partner in tobacco control and offers recommendations to improve the program’s recruitment strategies.

 

Chief, C., Sabo, S., Clark, H., Nez Henderson, P., Yazzie, A., Nahee, J., & Leischow, S. J. (2016). Breathing clean air is Są’áh Naagháí Bik’eh Hózhóó (SNBH): A culturally centered approach to understanding commercial smoke-free policy among the Dine (Navajo people). Tobacco Control, 25(Suppl. 1), i19–i25.

Overview

An Indigenous research paradigm considers the unique history and cultural teachings of the community being studied and is essential to improve health outcomes among American Indian populations. This paper describes the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik’eh Hózhóó (SNBH), a belief system that guides harmonious living, to understand Diné perspectives on smoke-free policy.

Three focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of commercial secondhand smoke and smoke-free policy.

Value added

This paper explores Indigenous opinions on smoke-free policies using an Indigenous research paradigm. This is the first study to apply SNBH to commercial tobacco research.

Highlights

By juxtaposing the Diné-centered analysis with a conventional qualitative analysis, this paper illustrates the value of incorporating Indigenous worldviews and research approaches. The Diné-centered analysis focuses on the following four areas of SNBH-defined balance:

Ethics

-          Participants expressed that it was a personal choice to work and recreate in places that allowed commercial tobacco, although some participants expressed the desire to enjoy a meal in a casino or other activities without being exposed to secondhand smoke.

-          Participants noted that individual values shifted depending on the environment – for example, casinos and bars are “open to anyone” and may not be in line with cultural values. Participants thought that people were more likely to smoke and drink in these environments, or permit behaviors they would otherwise not engage in elsewhere.

Family

-          Participants described the teachings of k’e’ (a core element of SNBH) as protective and promotive of living smoke-free and noted that these principles reinforce mutual respect among family and discourage commercial tobacco smoking, especially in the presence of elders.

Economics

-          Some participants considered smoke-free policy to be applied differently depending on the type and size of business. Participants thought that certain environments, such as casinos, were motivated by profit in making decisions about whether to allow commercial tobacco smoke.

-          Participants struggled with agendas of Diné elected officials that prioritized economic development over public health.

Environment

-          The majority of participants thought that the Navajo Nation already had a comprehensive smoking ban, even though it does not. Participants described many Diné institutions and organizations behaving in accordance with state smoke-free laws.

-          Many had concerns that existing tribal clean air protection laws were either nonexistent or not enforced on Navajo Nation.

Implications

Understanding and respecting Indigenous ideas of health and wellness will help researchers and policymakers identify what people find most valuable to them to better address health issues.

 

Nez Henderson, P., Roeseler, A., Moor, G., Clark, H. W. Yazzie, A., Nez, P., Nez, C., Sabo, S., & Leischow, S. J. (2016). Advancing smoke-free policy adoption on the Navajo Nation. Tobacco Control, 25(Suppl. 1), i26–i31.

Overview

Federally recognized American Indian tribes are sovereign and exempt from state tobacco control laws. Comprehensive smoke-free laws are effective at protecting nonsmokers and reducing tobacco use, but they are not widely adopted by tribal governments. This article describes a series of smoke-free policy initiatives on the Navajo Nation that began in 2008 and identifies key issues, successes, and challenges.

Value added

This article provides important lessons learned from smoke-free policy advocacy initiatives in Navajo Nation.

Highlights

  • Smoke-free policies in Navajo Nation must acknowledge the spiritual use of nát’oh, while discouraging secular use of commercial tobacco.
  • The grassroots coalition Team Navajo directly targeted the public and elected officials with messages about the toxicity of secondhand smoke, the need to protect nonsmokers, and respect for the role of nát’oh in Navajo culture. This strategy has been persuasive, as shown by the consideration and adoption of multiple smoke-free policy proposals beginning in 2008 that are described in further detail in this article.
  • Fears of negative economic impacts on tribal casinos have been a significant barrier to adoption of comprehensive smoke-free laws in Navajo Nation.

Implications

Tobacco control researchers and advocates must build relationships with tribal leaders and casino management to develop the business case that will take comprehensive smoke-free policies to scale throughout tribal lands.

 

DeLong, H., Chriqui, J., Leider, J., & Chaloupka, F. J. (2016). Common state mechanisms regulating tribal tobacco taxation and sales, the USA, 2015. Tobacco Control, 25(Suppl. 1), i32–i37.

Overview

As sovereign nations, Native American tribes self-govern reservation activity and are exempt from state tobacco excise taxation in the United States. Only tribal members are exempt from state excise taxation, and tribes are obligated to apply state excise taxes to purchases made by nontribal members.  States face challenges in the enforcement and collection of taxes, and differences in cigarette prices along state-tribal borders is a main incentive for tax avoidance/evasion.

This study aimed to (1) identify the types of regulatory mechanisms states use to collect excise tax on tobacco sold on tribal lands to nontribal consumers, (2) analyze the nature of state-level regulatory response, and (3) identify examples of comprehensive anti-evasion regulatory schemes at the state level.

Value added

Other studies have examined state efforts to regulate tribal tobacco sales, but this is the first to examine the issue comprehensively across all states.

Highlights

  • Two strategies exist for regulating tribal tobacco sales: (1) regulating the actual sales of tobacco on tribal lands through the use of intergovernmental compacts negotiated between states and tribal officials, and (2) using codified laws to minimize availability of tax-free cigarettes (e.g., tax stamps, tax prepayment on cigarettes sold to tribes and tax-free quotas).
  • Only 20 of the 34 states with tribal lands address tribal tobacco sales. Fourteen states with a tribal presence have no formal strategies for nonmembers purchasing tobacco on tribal lands. Compact formation is the most commonly used strategy. Fourteen states address intergovernmental compacts, and 11 of these are tobacco-specific.
  • Within codified law, strategic use of tax stamps is the most popular strategy. Fifteen states address tribal tax stamps: 2 explicitly prohibit stamping tribally sold products, 9 stamp all products, and 4 stamp some products.
  • Twelve states require prepayment of excise tax prior to any ultimate sale: 6 on all products, 4 on products in excess of quota, and 2 on products sold by nontribal retailers.
  • Six states use quotes to limit tax-free tobacco available to tribes.

Implications

It is important for states with a tribal presence to understand the strategies available to address non-members purchasing tobacco on tribal lands. Failing to address this issue can undermine state tobacco control efforts.

 

Barker, D. C., Wang, S., Merriman, D., Crosby, A., Resnick, E. A., & Chaloupka, F. J. (2016). Estimating cigarette tax avoidance and evasion: evidence from a national sample of littered packs. Tobacco Control, 25(Suppl. 1), i38–i43.

Overview

All 50 states except North Carolina, South Carolina, and North Dakota require a stamp on cigarette packs indicating that appropriate state cigarette taxes have been paid. Some smokers, tobacco retailers, and wholesalers engage in tax avoidance or evasion, referred to as tax noncompliance.

To document tax noncompliance, the study team collected littered cigarette packs in 160 communities in 38 states in 2012 and compared whether the stamp of the littered pack matched the stamp of the jurisdiction where it was found.

Value added

To date, studies using littered packs have focused on relatively small areas, such as a city or neighborhood. This is the first national study of tax non-compliance using littered packs. 

Highlights

  • The study estimates a national tax national tax non-compliance of 18.5% with considerable variation across regions.
  • The Northeast had the highest non-compliance rate, followed by the Midwest, the West, and the South. The means of the four regions were statistically different from each other. Tax non-compliance in the Northeastern region was statistically significantly higher than in the South.
  • The study found some variation within regions. For example, within the Northeast region, the Mid-Atlantic division had a higher non-compliance rate than New England.
  • Suburban areas had lower noncompliance rates than urban areas.

Implications

Collecting littered cigarette packs to study tobacco tax non-compliance is an approach that can be scaled up and used across a wide variety of areas, including suburban and rural communities.

 

Luke, D. A., Sorg, A. A., Combs, T., Robichaux, C. B., Moreland-Russell, S., Ribisl, K. M., & Henriksen, L. (2016). Tobacco retail policy landscape: A longitudinal survey of US states. Tobacco Control, 25(Suppl. 1), i44–i51.

Overview

There are approximately 380,000 tobacco retailers in the United States, where the largest tobacco companies spend almost $9 billion per year to promote their products. In this study, authors describe state-level activity to regulate the retail environment based on surveys of state tobacco control programs in 2012 and 2014.

Value added

This longitudinal study is the first U.S. survey of state tobacco control programs about retail policy activities and describes potential policy solutions to support state and local tobacco prevention and control efforts.

Highlights

  • Over this short 2-year time period, there was a dramatic growth in state retail policy activity. By 2014, 100% of the states surveyed reported some type of retail policy activity (compared with 89% in 2012). The average level of state policy activity increased by 168% in 2 years.
  • Overall, states were most active in their efforts to regulate e-cigarettes and to reduce or restrict the number, location, density, and type of tobacco retail outlets.
    • All but two states reported policy activity focused on e-cigarettes in 2014, making it the most active policy domain of 2014. Policy activity included minimum legal age laws, policies banning self-service of e-cigarettes, establishing an excise tax, and requiring licensing for e-cigarette sales.
    • Most states reported policy activity in the licensing and retailer domain in 2014. Over half of states described having licensing fees for tobacco retailers. Over the 2 years, there was only a modest increase in nontax mechanisms to increase the price of tobacco products, despite evidence that higher prices deter tobacco use. Efforts to rapidly disseminate research findings and build capacity among tobacco control programs may help promote evidence-based policymaking in this area.
    • This study presents retail policy activity alongside other policy initiatives, such as tax and smoke-free air, to help state programs judge their readiness for new retail policy efforts. 

Implications

Understanding retail policy activity across the country can help state and local tobacco control programs make decisions about whether they are ready to pursue retail policies and which policies would best complement their existing efforts. 

 

Huang, J., Chriqui, J. F., DeLong, H., Mirza, M., Diaz, M. C., & Chaloupka, F. J. (2016). Do state minimum markup/price laws work? Evidence from retail scanner data and TUS-CPS. Tobacco Control, 25(Suppl. 1), i52–i59.

Overview

Increasing cigarette taxes is one of the most effective ways to reduce cigarette consumption, but in many cases, it is not feasible to do so for a number of reasons, including lack of political will. The tobacco control community has proposed minimum markup/price laws (MPLs) as an alternative nontax pricing strategy to reduce tobacco use and access. This study examines the association between MPLs and cigarette prices.

Value added

To date, there is limited evidence on the effectiveness of MPLs in increasing cigarette prices. This study fills this gap in the literature by providing evidence on the impact of MPLs on cigarette prices.

Highlights

  • The study team compiled MPLs relating to the pricing of cigarettes or tobacco products for each of the 50 states and the District of Columbia from 2006 to 2014. These laws were linked to cigarette price data from Nielsen retail scanner data from the Nielsen Company and self-reported cigarette prices from a national survey, the Tobacco Use Supplement of the Current Population Survey.
  • This study found that MPLs were associated with higher cigarette prices.
  • Certain components of MPLs were particularly effective in increasing cigarette prices. Cigarette prices were higher beyond the higher price resulting from MPLs in states that prohibit below-cost combination sales, do not allow any distributing party to use trade discounts to reduce the base cost of cigarettes, prohibit distributing parties from meeting the price of a competitor, and prohibit distributing below-cost coupons to the consumer.

Implications

Cigarette excise taxes and minimum price laws can and should be used as part of a coordinated strategy to increase cigarette prices. Policymakers and practitioners should consider MPLs as an effective strategy to counteract the impact of the price-reducing promotions by the industry.

 

Golden, S. D., Farrelly, M. C., Luke, D. A., & Ribisl, K. M. (2016). Comparing projected impacts of cigarette floor price and excise tax policies on socioeconomic disparities in smoking. Tobacco Control, 25(Suppl. 1), i60–i66.

Overview

Reviews have indicated that increasing the price of tobacco products shows promise for reducing socioeconomic disparities. A new type of MPL sets a minimum price below which cigarette packs cannot be sold.  To date, a floor price MPL has only been implemented in one city (New York City in 2014). In this study, authors use simulations to project the impact that floor price MPLs could have on prices and cigarette consumption, compared with taxes designed to raise average prices by the same amount. Authors hypothesize that floor MPL prices may be more effective than excise taxes at reducing tobacco consumption, especially among lower income smokers.

This study used data on smoking behavior and cigarette prices from a nationally representative survey, the 2010-2011 Tobacco Use Supplement of the Current Population Survey. The final sample in this study consisted of 23,524 adult respondents who were current smokers.

Value added

This the first study designed to quantify the potential impact of cigarette MPLs on smoking consumption in comparison to what may be expected from a tax increase designed to raise average prices by the same amount.

Highlights

  • Projections indicate state MPLs set at the average reported pack price would raise prices by $0.33 and reduce cigarette consumption by about 4%; a similar $0.37 tax increase only reduces consumption by 2.3%.
  • An MPL that set a larger price increase of more than $2.00 would result in a nearly 16% decline in cigarette consumption, compared to a 13.5% decline from a corresponding state tax increase. 
  • Projections showed that both policies would reduce income-based smoking disparities, but in every model, MPLs resulted in larger drops in consumption among lower income smokers than comparable taxes did.

Implications

MPLs with minimum prices set at or above what consumers report paying may be an effective strategy to reduce tobacco use and socioeconomic disparities in smoking. States and communities should consider pairing tax and MPL strategies while also offering free or low-cost cessation services to minimize the extent to which these policies may place additional burden on low-income smokers.

 

Henriksen, L., Ribisl, K. M., Rogers, T., Moreland-Russell, S., Barker, D. M., Sarris Esquivel, N., Loomis, B., Crew, E., & Combs, T. (2016). Standardized Tobacco Assessment for Retail Settings (STARS): Dissemination and implementation research. Tobacco Control, 25(Suppl. 1), i67–i74.

Overview

The Standardized Tobacco Assessment for Retail Settings (STARS) was designed to increase state and local capacity to conduct retail tobacco marketing surveillance to inform policy change. The tool can be used to assess the availability, placement, promotion, and price of tobacco products in stores.

This study describes the collaborative process to develop the STARS instrument and examines the implementation and dissemination of STARS among state tobacco control leaders and other users.

Value added

STARS is the first tobacco marketing surveillance tool for practitioners that was designed to inform policy change. This standardized and accessible tool allows for comparisons within and between jurisdictions.

Highlights

Dissemination Reach

  • The study team conducted a telephone survey of individuals who registered to download STARS from the SCTC website. Within 6 months of the STARS release, 21% of respondents reported using STARS, and 35% were likely/very likely to use it in the next 6 months. This subset of respondents reported three primary uses for STARS: 32% would use the data to inform policy change or educate decision makers, 21% to raise awareness about retail tobacco marketing, and 19% to conduct retailer surveillance.

Implementation Fidelity

  • The study team compared data collected by self-trained volunteers and trained professionals in New York State. In a convenience sample of 160 stores, most STARS measures had high or moderate reliability, with data collected by self-trained observers yielding values consistent with those of trained, professional data collectors.

Diffusion

  • Results from a survey of state tobacco control program leaders found that 64% now use or plan to use STARS.
  • Among the 17 states that first conducted tobacco retail marketing surveillance since STARS was released in 2014, 12 reported they currently used STARS or planned to use it in the future.

Implications

Monitoring tobacco industry activity in the retail environment is essential to evidence-based policymaking and enforcement. STARS is a rapidly deployable, low-cost method that assesses tobacco product marketing in stores to inform state and local tobacco control policy efforts.

 

Kostygina, G., Tran, H., Shi, Y., Kim, Y., & Emery, S. (2016). “Sweeter Than a Swisher”: Amount and themes of little cigar and cigarillo content on Twitter. Tobacco Control, 25(Suppl. 1), i75–i82.

Overview

Despite increases in little cigar and cigarillo (LCC) use, there is limited research on the targeted strategies tobacco companies use to market these products to youth and communities of color. This study analyzes tweets to understand the amount or content of LCC messages users see on Twitter.

Value added

This study reveals that Twitter is a major information-sharing and marketing platform for LCCs.

Highlights

  • Keyword filters captured more than 4,372,293 LCC-related tweets, which is more than twice as many tweets over a 3-month period as the number of posts about e-cigarettes over a 5-year time frame described in other research.
  • One percent of accounts posting about LCCs were overtly commercial. Although most LCC tweets appeared to be organic, almost 17% of accounts posting LCC content were influencers, such as hip-hop or rap celebrities. These influencers were almost 30% more likely to mention specific LCC brands and 33% more likely to post promotional messages than regular users.
  • Approximately 83% of LCC tweets included references to marijuana. 

Implications

Tobacco control prevention initiatives should include efforts to prevent and reduce LCC use and must take into account social media’s role as a major marketing platform for these products.

 

Lisha, N. E., Jordan, J. W., & Ling, P. M. (2016). Peer crowd affiliation as a segmentation tool for young adult tobacco use. Tobacco Control, 25(Suppl. 1), i83–i89.

Overview

Young adults use tobacco at high rates, but few studies examine the role of identity and social cultures, such as peer crowd affiliation, despite their common use in marketing campaigns to promote tobacco use. This study conducted cross-sectional surveys among young adult bar patrons in three California cities and examined whether peer crowd affiliation (such as Hipster or Hip Hop culture) was associated with tobacco use of five products (cigarettes, e-cigarettes, hookah, cigars, and smokeless tobacco).

Value added

This study shows that affiliation with peer crowds is associated with smoking, independent of race/ethnicity and other demographic variables.

Highlights

  • To measure peer crowd affiliation, participants were asked to select images of young adults who would best fit into their friend group. Peer crowds included Hipster, Country, Hip Hop, Partier, Homebody, and Young Professional groups, but these informal names did not appear in the survey and are only used for reporting purposes.
  • Results show that peer crowd affiliation is independently associated with use of a variety of tobacco products in bar-going young adults, independent of demographics.
  • Respondents who affiliated with Hip Hop and Hipster peer crowds reported significantly higher rates of tobacco use. Overall, the Hip Hop group appeared to have the highest use rates compared to most of the other peer crowds. Hipsters were more likely to use e-cigarettes than Young Professionals and Homebodies and exhibited higher cigar use compared to Young Professionals.

Implications

Peer crowd segmentation can be an innovative way to identify high-risk tobacco users. Tobacco control and other public health professionals can use information on peer crowd affiliation to develop targeted health campaigns that reflect group membership and values.

 

Zhuang, Y.-L., Cummins, S. E., Sun, J. Y., & Zhu, S.-H. (2016). Long-term e-cigarette use and smoking cessation: A longitudinal study with US population. Tobacco Control, 25(Suppl. 1), i90–i95.

Overview

Most e-cigarette users are current smokers. The common pattern of dual use raises concerns that prolonged dual use may prevent or delay attempts to quit cigarette smoking. This study examined the relationship between long-term use of e-cigarettes and smoking cessation in a 2-year period. Specifically, the study examined the effect of long-term e-cigarette use by comparing long-term users with short-term users, and comparing both groups against non-users.

Value added

This longitudinal study is the first to examine the long-term use of e-cigarettes and its association with quitting in a nationally representative sample of US smokers.

Highlights

  • Forty-four percent of baseline dual users in 2012 were still using e-cigarettes 2 years later.
  • Long-term e-cigarette users had a significantly higher quit attempt rate than non-users, but the difference between short-term and non-users was not significant.
  • Long-term e-cigarette use was associated with a higher smoking cessation rate than non-users, regardless of whether the participant intended to quit at baseline. Short-term e-cigarette use was not associated with a lower rate of smoking cessation.
  • Dual use of e-cigarettes and cigarettes was not associated with a lower smoking cessation rate.
  • Long-term e-cigarette users were more likely to perceive e-cigarettes as less harmful than cigarettes when compared to short-term e-cigarette users.
  • Although both long-term and short-term e-cigarette users believed e-cigarettes were harmful, long-term users were more likely to perceive e-cigarettes as less harmful than cigarettes.

Implications

Findings from this study can help the tobacco control community understand the issue of dual use and the impact of e-cigarette use on quitting smoking. This information can inform cessation programs and other policies related to e-cigarette use.

 

McDonald, E. A., Popova, L., & Ling, P. M. (2016). Traversing the Triangulum: The intersection of tobacco, legalized marijuana and electronic vaporizers in Denver, Colorado. Tobacco Control, 25(Suppl. 1), i96–i102.

Overview

In the United States, young adults 18-25 have the highest rates of current marijuana use compared to other age groups and in 2014, young adults in Colorado had the highest marijuana use. Further, the rates of dual and poly use are high with tobacco and marijuana use.

This study conducts semistructured interviews with 32 young adults in Denver, Colorado, in 2015 to understand the beliefs and practices related to the use of tobacco, marijuana, and vaporizers.

Value added

This study is the first in-depth qualitative study exploring the triangulum of tobacco, marijuana, and electronic vaporizers among young adults in Colorado, the first state with legal retail marijuana.

Highlights

  • There was widespread ambiguity about whether “to smoke” refers to the use of tobacco or marijuana products.
  • Smoking marijuana blunts (the emptied shell of a tobacco cigarillo or tobacco wrap filled with marijuana) was common, but few interpreted this as tobacco use.
  • Marijuana vaporizers were used to avoid public consumption laws.
  • Young adults considered secondhand tobacco smoke dangerous, but secondhand marijuana smoke was seen as benign and its use indoors is common.

Implications

Tobacco, marijuana, and electronic vaporizers are frequently used together and should be studied together to inform policy. Further research is needed to document the complexities of perceptions of tobacco and marijuana in varying legal contexts.