Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA

OBJECTIVE: To describe the extent to which comprehensive statewide tobacco control programmes in the USA have made progress toward reducing teenage smoking. DATA SOURCES: Literature search of Medline for reviews of effectiveness of programme and policy elements, plus journal articles and personal request for copies of publicly released reports and working papers from evaluation staff in each of the state programmes of California, Massachusetts, Arizona, Oregon, and Florida. STUDY SELECTION: All studies, reports, and commentaries that provided information on aspects of programme implementation and evaluation. DATA SYNTHESIS: Statewide comprehensive programmes show high levels of advertising recall and generally positive improvement in smoking related beliefs and attitudes among teenagers. More fully funded programmes lead to increased mass media campaign advertising and community initiatives; a greater capacity to implement school based smoking prevention programmes; and an increase in the passage of local ordinances that create smoke free indoor environments and reduce cigarette sales to youth. The combination of programme activity and increased tobacco tax reduce cigarette consumption more than expected as a result of price increases alone, and these effects seem to apply to adolescents as well as adults. Programmes are associated with a decline in adult smoking prevalence, with these effects observed to date in California, Massachusetts, and Oregon. Arizona and Florida have yet to examine change in adult prevalence associated with programme exposure. California and Massachusetts have demonstrated relative beneficial effects in teenage smoking prevalence, and Florida has reported promising indications of reduced prevalence. Arizona has yet to report follow up data, and Oregon has found no change in teenage smoking, but has only two years of follow up available. One of the most critical factors in programme success is the extent of programme funding, and consequent level of programme implementation, and the degree to which this is undermined by the tobacco industry and other competitors for funding. CONCLUSIONS: Despite the different strengths and combinations of programme messages and strategies used in these comprehensive programmes, there is evidence that they lead to change in factors that influence teenage smoking, and to reductions in teenage smoking.     

Community guide recommendations and state level tobacco control programmes: 1999-2004

Objective

To identify the level of effort state tobacco control programmes and partners have expended on interventions recommended by the community guide and how those efforts have changed over time between 1999 and 2004.

Design

Longitudinal study.

Setting

United States.

Participants

State tobacco control partners, including the state health department, voluntary agencies and tobacco control coalitions.

Main outcome measure

We used the Strength of Tobacco Control survey responses in 1999, 2002 and 2004 to calculate the mean proportion of state tobacco control partners working on recommended interventions and subsequently analysed changes in effort over time.

Results

The proportion of state tobacco control partners working to promote clean indoor air legislation remained at more than 70% in all three years. The proportion working to increase taxes on tobacco rose significantly between 1999 and 2002 (from 54% to 70%), and those working to reduce patient costs for tobacco cessation treatments never exceeded 31% in any year. Use of mass media targeting youths decreased significantly in all years (from 40% to 32% to 26%), and the proportion of state tobacco control partners participating in a quitline has increased steadily and significantly in all years (from 24% to 36% to 41%). The level of effort in each area varied widely between states and over time.

Conclusions

State tobacco control partners are implementing evidence based interventions, but more focus is needed on the tobacco cessation and mass media campaign components of comprehensive tobacco control programmes.     

The tobacco industry's code of advertising in the United States: myth and reality

The major American tobacco companies developed and agreed to abide by the Cigarette Advertising Code in 1964. The stated aims of the code were to prohibit advertising directed at young people, to prohibit advertising that used fraudulent health claims, and to assure compliance with the code's provisions through the establishment of an administrative arm and enforcement mechanism to prescreen and monitor all cigarette advertising. In the 32 years since the Cigarette Advertising Code's adoption, the tobacco industry has used the existence of this code and its revisions and promises of self- regulation in accordance with this code as evidence that it promotes tobacco use only in a responsible manner. The code has served as the basis of the industry's efforts to avoid further local, state, and federal regulatory oversight of its marketing activities. A historical review of cigarette advertising since 1964 indicates that the voluntary code's major provisions have been regularly violated in the spirit and the letter. The administrative and enforcement provisions of the original Cigarette Advertising Code were quietly dismantled soon after the voluntary code's adoption and were completely omitted from the revised code in 1990. The historical evidence indicates that self- regulation of cigarette advertising and promotion by the tobacco industry has been repeatedly given trials and has not worked.


     

基于公共信息服务平台构建行业协同供应链的探讨

面向消费者的现代营销体系本质上是以提升客户价值为核心、以有效响应市场需求为导向的行业协同供应链的建设.基于当前社会经济和行业发展背景,研究探讨了如何通过构建行业公共信息服务平台有效支持行业供应链协同运行,设想以卷烟产品的市场生态系的角度,基于行业公共信息服务平台来支持按订单组织生产、工商协同营销、推行电子商务和卷烟市场精准营销等策略的实现.     

烟田除草地膜的研制及防除杂草的效果

研制了双草克膜,高效盖草能膜,都捕净膜４种除草地膜并对烟田杂草防除效果进行了试验。结果表明,不同除草地膜对烟田杂草的防效存在显著差异,都尔膜和双草克膜对烟田杂草的防效显著高于拿捕净膜和高效盖草能膜。随着烟株的生育进展,除草地膜对杂草的防效在上升。     

一类具有时滞和干扰的单种群生态模型的定性分析

研究了一类具有时滞和干扰的单种群模型的稳定性与Hopf分支问题.由特征值理论得到模型的正平衡态局部无条件渐进稳定的充要条件;以时滞τ为参数,得出模型存在Hopf分支的条件及分支值,并讨论了分支值处模型的正平衡态的稳定性;最后根据实例利用Matlab画出模型的数值解的图像,结合图像讨论了各参数变化对分支周期解的影响.     

Arizona's tobacco control initiative illustrates the need for continuing oversight by tobacco control advocates

BACKGROUND: In 1994, Arizona voters approved Proposition 200 which increased the tobacco tax and earmarked 23% of the new revenues for tobacco education programmes. OBJECTIVE: To describe the campaign to pass Proposition 200, the legislative debate that followed the passage of the initiative, and the development and implementation of the tobacco control programme. DESIGN: This is a case study. Data were collected through semi-structured interviews with key players in the initiative campaign and in the tobacco education programme, and written records (campaign material, newspapers, memoranda, public records). RESULTS: Despite opposition from the tobacco industry, Arizonans approved an increase in the tobacco tax. At the legislature, health advocates in Arizona successfully fought the tobacco industry attempts to divert the health education funds and pass preemptive legislation. The executive branch limited the scope of the programme to adolescents and pregnant women. It also prevented the programme from attacking the tobacco industry or focusing on secondhand smoke. Health advocates did not put enough pressure at the executive branch to force it to develop a comprehensive tobacco education programme. CONCLUSIONS: It is not enough for health advocates to campaign for an increase in tobacco tax and to protect the funds at the legislature. Tobacco control advocates must closely monitor the development and implementation of tax-funded tobacco education programmes at the administrative level and be willing to press the executive to implement effective programmes.     

"Accommodating" smoke-free policies: tobacco industry's Courtesy of Choice programme in Latin America

Objective

To understand the implementation and effects of the Courtesy of Choice programme designed to “accommodate” smokers as an alternative to smoke‐free polices developed by Philip Morris International (PMI) and supported by RJ Reynolds (RJR) and British American Tobacco (BAT) since the mid‐1990s in Latin America.

Methods

Analysis of internal tobacco industry documents, BAT “social reports”, news reports and tobacco control legislation.

Results

Since the mid‐1990s, PMI, BAT and RJR promoted Accommodation Programs to maintain the social acceptability of smoking. As in other parts of the world, multinational tobacco companies partnered with third party allies from the hospitality industry in Latin America. The campaign was extended from the hospitality industry (bars, restaurants and hotels) to other venues such as workplaces and airport lounges. A local public relations agency, as well as a network of engineers and other experts in ventilation systems, was hired to promote the tobacco industry''s programme. The most important outcome of these campaigns in several countries was the prevention of meaningful smoke‐free policies, both in public places and in workplaces.

Conclusions

Courtesy of Choice remains an effective public relations campaign to undermine smoke‐free policies in Latin America. The tobacco companies'' accommodation campaign undermines the implementation of measures to protect people from second‐hand smoke called for by the World Health Organization Framework Convention on Tobacco Control, perpetuating the exposure to tobacco smoke in indoor enclosed environments.Latin Americans are highly exposed to second‐hand tobacco smoke (SHS) both in public places and in workplaces.^1,2 In 2001, the Pan American Health Organization launched its “Smoke Free Americas” initiative³ to “raise awareness of the harm caused by secondhand tobacco smoke, and support efforts to achieve more smoke‐free environments in the Americas.” There is longstanding strong public concern over the effects of SHS in Latin America. In 1997, research conducted for Philip Morris International (PMI) showed that about 80% of respondents in four Latin American countries agreed that “Other people''s tobacco smoke poses a long term health risk to nonsmokers.”⁴ These results reflect a stronger consensus that SHS is hazardous than Philip Morris (PM) found in the US in 1989—62% of non‐smokers and 32% of smokers—as the movement for smoke‐free workplaces and public places was beginning to accelerate them.⁵ A 2001 survey conducted for the World Health Organization (WHO) in the main urban areas of Argentina showed strong public support (94%; 96% non‐smokers and 89% smokers) for the creation of smoke‐free places to avoid SHS.⁶ Public opinion polls conducted in 2006 in Argentina⁷ and Uruguay⁸ reported that 92% of respondents agreed that “SHS is dangerous for nonsmokers'' health”, showing an increase in public concern about SHS by 12% since 1997.The main barrier to progress in implementing smoke‐free policies in Latin America has been the efforts by two transnational tobacco companies, PMI and British American Tobacco (BAT), which control almost the entire cigarette market in the region through their subsidiaries (PMI 40%, BAT 60%). Similar to the voluntary self‐regulating advertising codes, which the tobacco companies use to fight restrictions on tobacco advertising,^9,10 the tobacco industry has orchestrated public relations campaigns in Latin America since the mid‐1990s to avoid legislated smoke‐free policies.^11,12 As in the US, beginning in the late 1980s,¹¹ this effort mobilised the hospitality industry to block meaningful tobacco control legislation to preserve the social acceptability of smoking and to protect industry profits. These programmes, known as Accommodation in the US and Courtesy of Choice in most parts of the rest of the world,^11,13,14,15 encourage the voluntary creation of smoking and non‐smoking sections in the hospitality industry as an alternative to legislation requiring 100% smoke‐free environments. Also, as in the US, the tobacco industry sought to present ventilation as the “solution” to SHS.¹⁶As of April 2007, 12 Latin American countries (Bolivia, Brazil, Chile, Ecuador, Guatemala, Honduras, Mexico, Panama, Paraguay, Peru, Uruguay and Venezuela) had ratified the WHO Framework Convention on Tobacco Control (FCTC). The FCTC, the first international public health treaty, calls for the implementation of “effective legislative, executive, administrative or other measures … at the appropriate governmental level to protect all persons from exposure to tobacco smoke” (Article 4.1) “in indoor workplaces, public transport, indoor public places and, as appropriate, other public places.” (Article 8).¹⁷ Given the fact that the only truly effective protection from SHS is the creation of 100% smoke‐free environments,¹⁸ in 2003, Venezuela approved a state law (in Monagas¹⁹) and between 2005 and 2006, Argentina passed and regulated two provincial laws (in Santa Fe and Tucumán) to establish 100% smoke‐free public places and workplaces. In March 2006, Uruguay became the first 100% smoke‐free country in the Americas. In response to this movement, one can expect the tobacco industry to accelerate its Accommodation efforts as a way of undermining such effective smoke‐free policies to implement FCTC.     

How tobacco companies ensure prime placement of their advertising and products in stores: interviews with retailers about tobacco company incentive programmes

Background: About 81% of cigarette manufacturers' marketing expenditures in the USA is spent to promote cigarette sales in stores. Relatively little is known about how these expenditures help the manufacturers achieve their marketing goals in stores. A better understanding of how tobacco companies influence the retail environment would help researchers and tobacco control activists to monitor industry presence in stores.     

烟草植株静态虚拟模型的研究

应用FastSCANTM三维激光扫描系统对田间生长烟株的叶片进行了测定,误差分析结果表明所采集的数据能精确描述烟叶几何形态。通过构建算法解决了烟叶褶皱区域坐标数据缺失的问题。由于测定烟株各叶片时采用了同一坐标系,因而获取的数据也反映了烟株叶片间实际的空间位置关系,使得基于采集的数据所构建的两个品种不同生长阶段的烟株静态虚拟模型,能够精确地表征田间烟株的形态结构特征。该研究为进行烟株冠层空间辐射分布模拟、烟草理想株型的定量化评估等建立了基础。