Independent evaluation of the California Tobacco Education Program

OBJECTIVE: To monitor the implementation of tobacco control programs and research in accordance with California's Proposition 99, approved by the voters in 1988, which increased the state's cigarette tax by 25 cents and designated one quarter of the increased revenue-approximately $100 million per year-to develop statewide media campaigns and to fund local health departments, community-based organizations, schools, and agencies working with high risk populations. METHODS: The authors evaluated the extent and the effectiveness of the implementation independently with standardized forms developed to track any tobacco-related information and activities, local media campaigns, changes in local policies and ordinances, training sessions, and prevention and cessation programs. Activities were reported on the forms to the authors monthly or quarterly. RESULTS: The evaluation indicated that local health departments, community-based organizations, and other group produced an exceedingly high volume of diverse tobacco control activities throughout the state. They reached a variety of ethnic groups and high risk populations with their programs. The data also show that local health departments and competitive grantees responded with an overall shift in their approach to tobacco control and moved from interventions focused primarily on individual people to broader, more community- and environment-oriented interventions. Additionally, analysis of the wholesale tobacco tax revenues revealed that per capita purchasing continued to decline in California at a rate greater than in the rest of the United States. CONCLUSION: The evaluation demonstrated that Proposition 99 accomplished much of what it set out to do-reducing tobacco prevalence, reaching out to underserved populations, and heightening the awareness of the dangers of environmental tobacco smoke.     

Tobacco, youth, and sports

Cigarette smoking constitutes the single largest threat to the health and longevity of American youth. Each year, almost 400,000 people die prematurely from tobacco-related diseases. Moreover, 90% of adult smokers began using tobacco before their eighteenth birthday, and each day 3,000 children and adolescents begin smoking. Smokeless tobacco use is less prevalent than cigarette smoking but has similar deleterious health effects and is often also glamorized by sports figures. This article examines the relationship between tobacco and sports and offers specific steps that physicians (specifically orthopedic surgeons and sports medicine physicians, who interact with athletes at sporting events and in schools as well as at the clinic) can take to help prevent or minimize tobacco use. Although sports have been used by the tobacco industry to promote tobacco products to young people, the authors suggest new ways to prevent its success.     

Perceptions of heterosexual bias in professional psychology programs: A survey of graduate students.

64 professional psychology student members of the American Psychological Association's Division 44 (Society for the Psychological Study of Lesbian and Gay Issues) were surveyed regarding experiences of perceived heterosexual bias and discrimination in their graduate programs. Instances of bias, discrimination, or both were reported in the following areas: (a) textbooks and other course materials, (b) instructor comments, (c) research supervision, (d) clinical practica and internships, (e) interactions with program administrators and other faculty, (f) teaching assistantships, and (g) course content. Specific examples are detailed, and educational reforms are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The thermal effect of monopolar radiofrequency energy on the properties of joint capsule. An in vivo histologic study using a sheep model

BACKGROUND: Efforts to prevent and decrease tobacco use and tobacco-related disease include improving the quality of tobacco-control laws to make them more stringent in controlling tobacco advertising, youth access, and exposure to environmental tobacco smoke (ETS). However, because there are no instruments to empirically evaluate the quality of such laws, it has been difficult to demonstrate that their quality is associated with decreased youth access or tobacco-related morbidity. We present the first instrument for empirically assessing the quality of tobacco-control policies. METHODS: Recommendations for the content of an ideal, comprehensive tobacco-control policy were used as the 55 items in the Assessment of the Comprehensiveness of Tobacco Laws Scale (ACT-L Scale). Raters evaluated 71 tobacco-control laws with the scale; 70 of these were actual California laws and 1 was a model law from Americans for Non-smokers' Rights (ANR). RESULTS: Interrater (r = 0.64-0.89) and internal-consistency (r = 0.63-0.88) reliability of the scale and subscales were high, and validity was established by demonstrating that the ANR model law received a significantly higher total score (mean = 18.75) than all actual laws (mean = 2.04). California tobacco-control laws were poor in all areas (youth access, ETS, tobacco advertising). CONCLUSIONS: The ACT-L scale can be used to compare and evaluate the quality of tobacco-control laws, highlight areas in which further policy efforts are needed, quantify improvement in such policies, and empirically demonstrate the positive health impact of high-quality tobacco-control laws.     

The effect of carotid sinus denervation on fetal heart rate variation in normoxia, hypoxia and post-hypoxia in fetal sheep

BACKGROUND: Previous reports documented high rates of tobacco use among Alaska Natives (Eskimos, Indians, and Aleuts). In this population, tobacco use is the leading preventable cause of death. Lung cancer is the leading cause of cancer death among Alaska Natives and tobacco is responsible for over one-third of all cancer deaths in this population. Until recently there has been no systematic surveillance of the prevalence of tobacco use in this high-risk population. Data that did exist were not readily available to those primarily responsible for the health care of this population. This is the first time since 1990 that data on Alaska Natives have been collected in one analysis; this permits a more representative evaluation of tobacco use. METHODS: Data on tobacco use were obtained and analyzed from national and state surveys and selected research projects from 1988 to 1993. RESULTS: Alaska Natives have high prevalence of tobacco use, including both cigarettes and smokeless tobacco. Tobacco use prevalence among Alaska Natives exceeds that of Alaska non-Natives, U.S. whites, and American Indians/Alaska Natives in the United States outside of Alaska. Smoking prevalence among Alaska Native women is twice that of non-Native women in Alaska and nearly twice as high among pregnant Alaska Natives than pregnant non-Natives. Overall, prevalence of smokeless tobacco use was four times higher among Alaska Natives than comparative state and national populations. CONCLUSION: Because this population has such high rates of tobacco use, it is important to public health that monitoring and educational programs be in place and that data specific to Alaska Natives be made available.     

Tobacco smoking, cancer and social class

Consumption of tobacco products, both by smoking and by other means, has long been causally connected with cancers of the lung, larynx, mouth and pharynx, oesophagus, bladder, and many other sites. Tobacco is the main specific contributor to total mortality in many developed countries and has become a major contributor in the developing countries as well. In most industrialized countries, prevalence of cigarette smoking is currently higher in low than in high social classes, although in some industrialized countries smoking was more frequent in high social classes during the first half of this century. The latter pattern of tobacco consumption is more likely to apply to developing countries. To formulate and carry out effective tobacco control activities it is essential to assess the relative incidence of tobacco-related cancers in different social strata and the prevalence of tobacco use across strata. Despite many years of data gathering the information base is far from complete, especially in developing countries where tobacco use is increasing rapidly, and where aggressive marketing by the transnational tobacco industry is occurring. A critical question is the extent to which tobacco usage can 'explain' the observed social class differences in cancer risk. Class differences in lung cancer are likely to be mostly related to the unequal distribution of tobacco smoking between social classes, and in some fairly simple situations this has been satisfactorily demonstrated. Nevertheless, there are many unresolved issues, especially with regard to the role of collateral exposures, such as hazardous occupations, poor diet, and limited access to health care. The question of whether tobacco use 'explains' socioeconomic differences in one or more of the cancers that it causes has rarely been directly addressed in epidemiological studies.     

Teaching high school students to use heuristics while reading historical texts.

The purpose of this study was to test the effectiveness of different types of instruction and texts on high schools students' learning of (a) history content and (b) a set of heuristics that historians use to think critically about texts. Participants for the study were 128 male and 118 female students, ages 16 and 17 years, from 2 high schools in the western United States. Eight history classrooms were randomly assigned to 1 of 4 interventions: (a) traditional textbooks and content instruction, (b) traditional textbooks and heuristic instruction, (c) multiple texts and content instruction, or (d) multiple texts and heuristic instruction. The heuristic instruction explicitly taught sourcing, corroboration, and contextualization. Students were administered pretests on their content knowledge and their use of heuristics. After an intervention of 3 weeks, students were readministered the content knowledge and heuristics posttests. A mixed-model analysis of covariance indicated that across all conditions, students who read multiple texts scored higher on history content and used sourcing and corroboration more often than students who read traditional textbook material. Findings highlight the importance of reading multiple texts to deepen content knowledge and facilitate the use of heuristics that historians typically use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of health education among secondary schools--School Health Education Profiles, 1996

PROBLEM/CONDITION: School health education (e.g., classroom training) is an essential component of school health programs; such education promotes the health of youth and improves overall public health. REPORTING PERIOD: February-May 1996. DESCRIPTION OF SYSTEM: The School Health Education Profiles monitor characteristics of health education in middle or junior high schools and senior high schools. The Profiles are school-based surveys conducted by state and local education agencies. This report summarizes results from 35 state surveys and 13 local surveys conducted among representative samples of school principals and lead health education teachers. The lead health education teacher is the person who coordinates health education policies and programs within a middle or junior high school and senior high school. RESULTS: During the study period, almost all schools in states and cities required health education in grades 6-12; of these, a median of 87.6% of states and 75.8% of cities taught a separate health education course. The median percentage of schools that tried to increase student knowledge on certain topics (i.e., prevention of tobacco use, alcohol and other drug use, pregnancy, human immunodeficiency virus [HIV] infection, other sexually transmitted diseases, violence, or suicide; dietary behaviors and nutrition; and physical activity and fitness) was > 72% for each of these topics. The median percentage of schools that tried to improve certain student skills (i.e., communication, decision making, goal setting, resisting social pressures, nonviolent conflict resolution, stress management, and analysis of media messages) was > 69% for each of these skills. The median percentage of schools that had a health education teacher coordinate health education was 33.0% across states and 26.8% across cities. Almost all schools taught HIV education as part of a required health education course (state median: 94.3%; local median: 98.1%), and more than half (state median: 69.5%; local median: 82.5%) had a written policy on HIV infection among students and school staff. A median of 41.0% of schools across states and a median of 25.8% of schools across cities had a lead health education teacher with professional preparation in health and physical education, and < 25% of schools across states or cities had a lead health education teacher with professional preparation in health education only. Across states, the median percentage of schools, whose lead health education teacher had received in-service training on certain health education topics, ranged from 15.6% for suicide prevention to 51.4% for HIV prevention; across cities, the median percentage ranged from 26.2% for suicide prevention to 76.1% for HIV prevention. A median of 19.7% of schools across states and 18.1% of schools across cities had a school health advisory council. Of the schools that received parental feedback (state median: 59.1%; local median: 54.2%), > 78% reported receiving positive feedback. INTERPRETATION: More than 75% of schools have a required course in health education to help provide students with the knowledge and skills they need to adopt healthy lifestyles. ACTIONS TAKEN: The School Health Education Profiles data are being used by state and local education officials to improve school health education and HIV education.     

Psychology in nineteenth century high schools.

"Psychology as a teaching subject in high schools has been a topic of active discussion by groups and individuals for the past decade." In the writer's collection of textbooks by American authors published prior to 1890, "there are seven which the authors claim are intended for use in high schools, although in two cases it is made clear that the texts are intended for teachers and not pupils." "While we have no data on the amount of use made of these textbooks in secondary schools, the fact that they were issued for such use suggests that the teaching of psychology in high schools has been considered possible for over a century." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two-year behavior outcomes of project towards no tobacco use.

Presents a 2-year follow-up data from a school-based tobacco use prevention project designed to test the effectiveness of 3 primary components in social influence programs. The components either teach refusal skills, awareness of social value misperceptions, or physical consequences. Curricula were tested with a randomized experiment involving 48 junior high schools. Data suggested that a physical-consequences curriculum is successful at attenuating increases in adolescent smokeless tobacco use, cigarette experimentation may be attenuated by various approaches, and a comprehensive program with all 3 components was necessary to attenuate increases in weekly use of both forms of tobacco. These results also indicate that school-based tobacco use interventions can be effective at least 2 years postprogram, after students make their transition to high school. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Graduate Education in Construction Management

Construction management has become a vital aspect of the construction process over the years. This paper reviews the Master’s programs in construction engineering and management (CEM) offered by departments of civil engineering in the United States. The findings indicate that only 20% of the American educational institutions, which offer accredited civil engineering programs, offer Master’s programs in CEM. Most of the Master’s programs in CEM constitute an effort to convey information to students on mainly six categories, namely, contract administration, project management, scheduling, equipment management, construction technology, and CEM research. It seems that the Master’s programs in CEM do not differ much from program to program in terms of content. When the trends in course offerings are compared in 1982, 1996, and 2008, there seems to be minimal change except for the number of courses in project management that went up significantly while the number of courses in cost estimating went down. The trends in the remaining courses have been stable. Even though contents and trends in CEM programs appear to be relatively stable, there seems to be some variability in the concentration of the course offerings. Some CEM programs concentrate on some of the categories at the expense of other categories. A close relationship and a sound dialogue between construction educators and the industry are likely to lead to Master’s programs that are in sync with the expectations of the industry.     

Deadly targeting of women in promoting cigarettes

The history of tobacco marketing portrays a strong relationship between cigarette advertising targeted to women and the rise in the prevalence of women smoking. This article describes how tobacco companies crafted their marketing strategies to obfuscate the growing evidence of the health hazards of tobacco and to circumvent attempts to regulate cigarette advertising. It shows how the tobacco industry understood and capitalized on the women's liberation movement to sell cigarettes as symbols of freedom and emancipation, tracing the creation and promotion of Virginia Slims as a case study. And it documents the unfortunate success of these marketing strategies as reflected in the trends of tobacco use, especially among underage girls, and the commensurate increase in tobacco-related disease and death among women.     

European medical schools and tobacco

Following a survey in 19 European countries of the habits, attitudes and knowledge of medical students regarding tobacco, World Health Organisation European Office and the International Union against Tuberculosis and Lung Disease jointly circulated to the Deans of all European medical schools a summary of the results, including figures for mortality for smoking-related diseases in their countries and a brief questionnaire concerning faculty action on the tobacco problem. The response rate was just over 50%, higher in Northern Europe (66%) than in Southern (35%) or Eastern (38%). Only 8% of faculties had a specific teaching module on tobacco. In most it was either systematically (35%) or unsystematically (55%) integrated in other teaching. Teaching hospitals, teaching areas and faculty meetings were said to be smokefree by over 90%; figures were lower for other areas. Seventy-seven per cent of Deans intended to discuss our approach with their teaching staff; 72% gave the name of a staff member with a particular tobacco interest.     

Current State of Highway Safety Education: Safety Course Offerings in Engineering and Public Health

There is a need to investigate educational offerings in highway safety available through engineering, public health, and injury prevention programs at universities in the United States. A series of surveys was distributed to universities and transportation engineering research centers throughout the United States from March 2004 to March 2005, requesting information about safety course availability and content (e.g., course outline, syllabus, references, and notes). Of 117 engineering programs contacted, 29 safety courses were identified at 25 universities; of 34 public health programs, only seven indicated traffic safety content. A detailed assessment of course content and syllabi revealed that many use reference materials drawn from other areas of transportation (e.g., design and operations); few use educational references reflecting contemporary scientific analyses of safety. Existing course content was compared with safety core competencies developed by a Transportation Research Board Subcommittee to provide an indication of adequacy of course content. The comparison indicated relative strengths in identifying origins and characteristics of crash data and safety management systems, but persistent weaknesses in describing highway safety as a field with underlying scientific principles, which drive how analysis is conducted and decisions are made. The courses also lacked a systemic multidisciplinary perspective, important for success in today’s safety management field. While safety is a primary responsibility of transportation engineers, there is a lack of complete and consistent coverage of this topic at the university level.     

The effectiveness of a tobacco prevention program with adolescents living in a tobacco-producing region

OBJECTIVES: This study investigated the efficacy of a social-influences tobacco prevention program conducted with adolescents living in a high tobacco production area. METHODS: Students in 10 experimental schools completed the tobacco prevention program and a booster intervention. Control students received health education as usual. RESULTS: After 2 years of treatment, smoking rates in the treatment group (vs the control group) were lower for 30-day, 7-day, and 24-hour smoking. The intervention had more of an impact on those who were involved in raising tobacco than it did on those not involved in raising tobacco. CONCLUSIONS: Although modest, effects were achieved with minimal intervention time in a high-risk group, indicating that social-influences prevention programs may be effective in such groups.     

Antiproteinuric effect of ciclosporin A in adriamycin nephropathy in rats

Nicotine is absorbed in substantial quantities from smokeless tobacco and could contribute to the adverse consequences of smokeless tobacco use. Chronic systemic exposure to nicotine could contribute to accelerated coronary artery disease, acute cardiac ischemic events, and hypertension. Systemic absorption of sodium and mutagenic chemicals from smokeless tobacco could aggravate hypertension or cardiac failure, or contribute to cancer, respectively. Information concerning the potential hazards of nicotine and other systemically absorbed toxins may be incorporated into educational programs to discourage the use of smokeless tobacco.     

The prevalence of Helicobacter pylori gastritis in patients with reflux oesophagitis: a case-control study

Head and neck cancers (HNCs) are malignancies that can be induced by tobacco use, although host-specific factors such as the DNA repair capacity (DRC) may modulate individual susceptibility to tobacco carcinogenesis. To test the hypothesis that genetically determined DRC modulates HNC susceptibility, we measured the DRC in the peripheral blood lymphocytes of 55 patients with newly diagnosed, previously untreated HNC and 61 healthy controls by the host-cell reactivation assay using a reporter gene damaged by benzo(a)pyrene diol epoxide, an ultimate tobacco-related carcinogen. The mean DRC was significantly lower in cases (8.6%) than it was in controls (12.4%; P < 0.001). The DRC was an independent risk factor for HNC (P < 0.01); those in the middle and lowest tertiles of DRC had increased odds ratios [2.17 (95% confidence interval, 0.74-6.39) and 4.27 (confidence interval, 1.45-12.5), respectively] for HNC. These findings suggest that individuals with reduced DRC may be at increased risk of developing HNC.     

Prolonged duration of craving, mood, and autonomic responses elicited by cues and imagery in smokers: Effects of tobacco deprivation and sex.

Increases in self-reported craving and changes in autonomic functioning are reliably elicited when smokers are exposed to tobacco-related stimuli compared with neutral stimuli. However, few studies have reported the time course of cue-elicited craving or have directly compared the effectiveness of smoking cues versus imagery to evoke a craving response. In addition to these two issues, we investigated the influence of tobacco deprivation and sex on craving, mood, and autonomic responses. Sixty cigarette smokers (30 men, 30 women) were tested in two counterbalanced sessions, one after overnight tobacco deprivation and one during ad libitum smoking. At each session, participants were exposed to four randomized experimental trials: smoking imagery, neutral imagery, smoking cues, and neutral cues. Tobacco craving and mood were assessed repeatedly and physiological measures were recorded continuously for 30 min after imagery or cue exposure. Compared with neutral trials, smoking cues and smoking imagery reliably increased tobacco craving, negative mood, heart rate, and blood pressure and decreased positive mood ratings. Changes were observed immediately after cue and imagery presentation and remained unchanged for 30 min. Responding was greater in the nondeprived condition, and cues elicited more robust responding than imagery for most measures. Women responded more robustly to smoking cues only in the nondeprived condition, whereas imagery evoked greater responses in men during both conditions. These findings provide new data on the time course, magnitude, and tobacco deprivation effects on elicited craving. Sex differences were dependent on stimulus type and deprivation condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the external iliac vein for temporary percutaneous access

The enactment of an effective national tobacco control policy is a needed first step toward reducing smoking, controlling the tobacco industry, and significantly reducing tobacco-related disease and death. Dr. Seffrin, Chief Executive Officer of the American Cancer Society, outlines the critical public health measures that the ACS is working to see included in comprehensive federal tobacco control legislation.