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  • Correlates of smoke-free home policies in Shanghai, China

    Background. Approximately 63.7% of nonsmokers in China are exposed to secondhand smoke (SHS) in their homes. The current study documents the prevalence and correlates of smoke-free home policies in Shanghai, as well as reasons for implementing such a policy and places where smoking is most commonly allowed. Methods. We conducted in-person surveys of 500 participants using a multistage proportional random sampling design in an urban and suburban district. Results. Overall, 35.3% had a smoke-free home policy. In the logistic regression, having higher income, not having smokers in the home, having children in the home, having fewer friends/relatives who permit smoking at home, and not being a current smoker were correlates of having a smoke-free home policy (P < 0.05). Concern about the health impact of SHS was reportedly the most important reason for establishing a smoke-free home. Among participants with no or partial bans, the most common places where smoking was allowed included the living room (64.2%), kitchen (46.1%), and bathroom (33.8%). Conclusions. Smoke-free home policies were in place for a minority of households surveyed. Establishing such a policy was influenced by personal smoking behavior and social factors. These findings suggest an urgent need to promote smoke-free home policies through tobacco control programs.

  • Creating Smoke-free Ceremonial Environments: Thoughts on Solutions and Policies

    In this video (6 min. 45 sec.), healers share their thoughts on how a commercial tobacco free policy might affect ceremonial practices on the Navajo Nation. Healers also highlight solutions to create healthy ceremonial environments free from commercial tobacco secondhand smoke. Healers recognize there are challenges to consider in this movement, such as sustainable harvesting of dził nát’oh and the need to create a supply of untreated tobacco for ceremonial use. The video and accompanying discussion guide for this digital story are available for download at .

  • Differences Between Commercial Tobacco and Dził Nát’oh

    This video (6 min. 39 sec.) provides an overview of healer perspectives on the differences between commercial tobacco and Dził Nát’oh, or traditional mountain smoke. Healers make strong distinctions about the purpose and meaning of commercial tobacco versus Dził Nát’oh. Commercial tobacco is believed to be harmful to health and Dził Nát’oh as restorative to health and spiritual well being. The video and accompanying discussion guide for this digital story are available for download at

  • Differential Impact of Tobacco Control Policies on Youth Sub-Populations

    Background: While previous studies have demonstrated the efficacy of tobacco control interventions in reducing tobacco use among youth overall, there have been very few studies that examine the potential differential impact of tobacco control policies on various youth subgroups, defined by socio-economic status (SES), race/ethnicity, and gender. Objective: We examined the relationship between state-level cigarette prices and smoke-free air laws and youth smoking prevalence and intensity for various youth sub-populations in the United States. Methods: We estimated a 2-part model of cigarette demand using data from the 1991 through 2010 nationally representative surveys of 8th-, 10th-, and 12th-grade students as part of the Monitoring the Future project. Findings: We found that real cigarette prices are strong determinants of youth smoking. Blacks, females, Hispanics, and low-SES subpopulations are found to have a larger price response with respect to smoking prevalence than the full sample. Smoke-free air laws are found to have a negative effect on smoking prevalence for the full sample and for the male, white, and high-SES sub-populations. Conclusions: This research concludes that higher cigarette prices will reduce smoking prevalence rates of Blacks, Hispanics, females, and low-SES subpopulations faster than the overall youth population and other youth sub-populations. Moreover, this research concludes that smoke-free air laws will reduce smoking prevalence for the overall youth population with the largest reductions in high SES and male subpopulations.

  • Diffusion of a controversial innovation: Correlates of e-cigarette awareness among U.S. adults

    Oral presentation at the Society of Behavioral Medicine Annual Meeting & Scientific Sessions, Philadelphia, PA.

  • Digital detection for tobacco control: Online reactions to the United States' 2009 cigarette excise tax increase

    Introduction: The Internet is revolutionizing tobacco control, but few have harnessed the Web for surveillance. We demonstrate for the first time an approach for analyzing aggregate Internet search queries that captures precise changes in population considerations about tobacco.Methods: We compared tobacco-related Google queries originating in the United States during the week of the State Children’s Health Insurance Program (SCHIP) 2009 cigarette excise tax increase with a historic baseline. Specific queries were then ranked according to their relative increases while also considering approximations of changes in absolute search volume.Results: Individual queries with the largest relative increases the week of the SCHIP tax were “cigarettes Indian reservations” 640% (95% CI, 472–918), “free cigarettes online” 557% (95% CI, 432–756), and “Indian reservations cigarettes” 542% (95% CI, 414–733), amounting to about 7,500 excess searches. By themes, the largest relative increases were tribal cigarettes 246% (95% CI, 228–265), “free” cigarettes 215% (95% CI, 191–242), and cigarette stores 176% (95% CI, 160–193), accounting for 21,000, 27,000, and 90,000 excess queries. All avoidance queries, including those aforementioned themes, relatively increased 150% (95% CI, 144–155) or 550,000 from their baseline. All cessation queries increased 46% (95% CI, 44–48), or 175,000, around SCHIP; including themes for “cold turkey” 19% (95% CI, 11–27) or 2,600, cessation products 47% (95% CI, 44–50) or 78,000, and dubious cessation approaches (e.g., hypnosis) 40% (95% CI, 33–47) or 2,300.Conclusions: The SCHIP tax motivated specific changes in population considerations. Our strategy can support evaluations that temporally link tobacco control measures with instantaneous population reactions, as well as serve as a springboard for traditional studies, for example, including survey questionnaire design.

  • Do fear appeals work? Using Twitter to evaluate emotion in CDC's Tips from Former Smokers

    Szczypka G. Oral presentation at the Society for Research on Nicotine and Tobacco (SRNT), Podium Session 4, Paper Session 21, Friday, February 27.

  • Do Partial Home Smoking Bans Signal Progress toward a Smoke-Free Home?

    Understanding who establishes partial home smoking bans, what these bans cover, and whether they are an intermediate step in going smoke-free would help to inform smoke-free home interventions. Participants were recruited from United Way of Greater Atlanta's 2-1-1 contact center. Data were collected at baseline, 3 and 6 months via telephone interview. Participants (n = 375) were mostly African American (84.2%) and female (84.3%). The majority (58.5%) had annual household incomes <$10 000. At baseline, 61.3% reported a partial smoking ban and 38.7% reported no ban. Existence of a partial ban as compared with no ban was associated with being female, having more than a high school education, being married and younger age. Partial bans most often meant smoking was allowed only in designated rooms (52.6%). Other common rules included: no smoking in the presence of children (18.4%) and smoking allowed only in combination with actions such as opening a window or running a fan (9.8%). A higher percentage of households with partial bans at baseline were smoke-free at 6 months (36.5%) compared with households with no bans at baseline (22.1%). Households with partial smoking bans may have a higher level of readiness to go smoke-free than households with no restrictions.

  • Do smokers support smoke-free laws to help themselves quit smoking? Findings from a longitudinal study

    Background A growing number of smokers support smoke-free laws. The theory of self-control provides one possible explanation for why smokers support laws that would restrict their own behaviour: the laws could serve as a self-control device for smokers who are trying to quit.Objective To test the hypothesis that support for smoke-free laws predicts smoking cessation.Methods We used longitudinal data (1999–2000) from a US national sample of adult smokers (n=6415) from the Current Population Survey, Tobacco Use Supplements. At baseline, smokers were asked whether they made a quit attempt in the past year. They were also asked whether they thought smoking should not be allowed in hospitals, indoor sporting events, indoor shopping malls, indoor work areas, restaurants, or bars and cocktail lounges. At 1-year follow-up, smokers were asked whether they had quit smoking.Findings Smokers who supported smoke-free laws were more likely to have made a recent quit attempt. At 1-year follow-up, those who supported smoke-free laws in 4–6 venues were more likely to have quit smoking (14.8%) than smokers who supported smoke-free laws in 1–3 venues (10.6%) or smokers who supported smoke-free laws in none of the venues (8.0%). These differences were statistically significant in multivariate analyses controlling for demographics.Conclusions Support for smoke-free laws among smokers correlates with past quit attempts and predicts future quitting. These findings are consistent with the hypothesis that some smokers support smoke-free laws because the laws could help them quit smoking.

  • Do State Minimum Markup/Price Laws Work? Evidence from Retail Scanner Data and TUS-CPS

    Background: Minimum markup/price laws (MPLs) have been proposed as an alternative non-tax pricing strategy to reduce tobacco use and access. However, the empirical evidence on the effectiveness of MPLs in increasing cigarette prices is very limited. This study aims to fill this critical gap by examining the association between MPLs and cigarette prices. Methods: State MPLs were compiled from primary legal research databases and were linked to cigarette prices constructed from the Nielsen retail scanner data and the self-reported cigarette prices from the Tobacco Use Supplement to the Current Population Survey. Multivariate regression analyses were conducted to examine the association between MPLs and the major components of MPLs and cigarette prices. Results: The presence of MPLs was associated with higher cigarette prices. In addition, cigarette prices were higher, above and beyond the higher prices 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. Moreover, states that had total markup rates >24% were associated with significantly higher cigarette prices. Conclusions: MPLs are an effective way to increase cigarette prices. The impact of MPLs can be further strengthened by imposing greater markup rates and by prohibiting coupon distribution, competitor price matching, and use of below-cost combination sales and trade discounts.