Suggestions for the Creation and Implementation of Tobacco Policy

When making policy suggestions regarding tobacco use, it is important to consider why tobacco use has proved such a difficult behavior to eradicate. The articles in this issue have identified a number of variables that we would be well served to consider when creating tobacco policy. First, tobacco use has been difficult to eradicate because of the addictive nature of nicotine. Even though many smokers wish to quit, the addictive nature of the product makes this difficult. A second variable that compounds this problem is that tobacco addiction typically begins in adolescence. The decision-making process used by adolescents that may lead to tobacco use may be particularly difficult to alter, thus making smoking initiation a difficult process in which to intervene. Finally, it is important to consider the political power of the tobacco industry and to identify promising methods of overcoming this power when creating policy. These might include innovative legal strategies and searching for compromises that can reduce tobacco use while protecting important tobacco constituencies.     

Expectancies and Mental Models as Determinants of Adolescents' Smoking Decisions

Cigarette smoking has been identified as the single most preventable source of mortality and morbidity in the United States. Experimentation with tobacco typically begins in adolescence, and smoking during this period is one of the strongest and most consistent predictors of adult smoking status. In the present paper, we review several prominent decision models that have been applied to adolescent smoking, and point out important limitations of these models. We then propose a new process-oriented framework of decision-making based on the concept of mental models, and discuss the implications of this framework for developing effective smoking prevention and cessation interventions for adolescents.     

“Habits of employees”: smoking, spies, and shopfloor culture at Hammermill Paper Company

As cigarette smoking expanded dramatically during the early twentieth century, it brought more and more workers into conflict with the policies and demands of the manufacturers who employed them. As this paper shows, addiction to nicotine ignited daily struggles over workers’ shopfloor rights and the ability of employers to set rules, establish discipline, and monitor behavior. A specific set of records from the archives of the Hammermill Paper Company, a paper manufacturer once based in Erie, Pennsylvania, provide a unique opportunity to explore the impact of cigarette consumption on labor relations during the era of mass production, as two nosy factory spies probed and documented worker actions and attitudes in the summer of 1915. As a result of their intelligence gathering, the spies discovered a factory-wide work culture rooted in the addictive pleasure of cigarette smoke. This discovery worried them. Worker-smokers needed to dampen their hunger for nicotine with frequent, and often clandestine, breaks from work, typically in defiance of “no-smoking” rules, employer designations for the uses of factory space, and bosses’ demands for continuous production. Highlighting the intersections of the histories of labor, smoking, and addiction, this paper argues that cigarettes were a key battleground in workers’ and managers’ intensifying struggles over who really controlled the industrial shopfloor during the early 1900s.     

An Introduction to the Controversy Over Tobacco

The tobacco industry has a long history of denying any harmful effects produced by its products. This strategy was first developed to deny any health risks associated with smoking, and has recently been extended to the denial of the risks of environmental tobacco smoke (ETS), the addictive nature of nicotine, and the targeting of adolescents by tobacco advertisements. This has served to divert discussion of how society should address the risks of tobacco use to whether society should address tobacco use at all. If we move past these diversions and consider how society should address tobacco risks, the social sciences in general and psychology in particular have a number of insights regarding how to answer the question. The purpose of this issue of JSI is to examine some of these perspectives in an attempt to suggest how we should approach the important question of how to deal with tobacco use in our society.     

Historical Overview of Tobacco Legislation and Regulation

In this paper we describe the legislative and regulatory history of tobacco control efforts and discuss ways in which the debate over tobacco control has been framed. From a regulatory perspective, primary concern is how to balance the individual's legal use of tobacco products with society's obligation to limit the use of a lethal product. Our review demonstrates the progress tobacco control advocates have made in enacting statewide legislation and local ordinances, especially during the past fifteen years, to restrict both smoking in public places and youth access to tobacco products. Nevertheless, this progress may be threatened by a powerful and determined tobacco industry. We discuss various strategies for determining how and where to allocate tobacco control resources.     

Current tobacco policies in U.S. adult male prisons☆

The current national trend in the restriction of smoking and use of tobacco products is extending to the prison system. At the same time that city, state and the federal governments are limiting smoking in public places and businesses, state and federal prison systems are limiting use in correctional facilities. The data for this paper was collected by mail from departments of correction in the fifty states, the District of Columbia and the federal Bureau of Prisons. The results show a continuing trend in tobacco limitation policies at male prisons within the U. S. Several states totally ban all tobacco and only a few still allow generally unlimited use. Limitation policies range from segregation into smoking and nonsmoking areas to the banishment of inmates and staff to smoking areas outside prison buildings.While many see a nonsmoking prison system as the wave of the future, use of tobacco in prisons is still common. This research examines the official reason given for changes in tobacco policy and the alterations in prison operations that developed after restrictions were implemented. Increased tensions developed among inmates, staff and administration as a result of the new policies. For those prison systems that banned tobacco, an active black market operation developed eclipsing other contraband problems.     

Judicial Approaches to Tobacco Control: The third Wave of Tobacco Litigation as aTobacco Control Mechanism

Tobacco products liability litigation is one of the most potentially effective means of controlling the sale and use of tobacco. Recent factual developments—concerning (1) the addictiveness of nicotine, (2) tobacco industry knowledge of this addictiveness, and (3) the industry's efforts to conceal its knowledge from the public while making its products more addictive—make it unlikely that the tactics used successfully by the tobacco industry in the first (1954 to 1973) and second (1983 to 1992) waves of tobacco litigation will succeed in the third wave of tobacco litigation. Victory in any of these cases would result in a transfer of costs from injured states or individuals to the tobacco industry. Such a transfer of costs would likely have the immediate impact of raising cigarette prices and thereby lowering cigarette consumption. The long-term effects of a victory would probably be much more devastating to the industry.     

Evaluating the Impact of Statewide Anti-Tobacco Campaigns: The Massachusetts andCalifornia Tobacco Control Programs

Despite more than 30 years of public health programs to reduce tobacco use, smoking is still the leading preventable cause of death in the United States. In response to this continuing epidemic, voters in California (1988), Massachusetts (1992), Arizona (1994), and Oregon (1996) approved ballot initiatives that established statewide tobacco control programs funded by cigarette excise tax revenues. Evaluating these innovative public health interventions is important, both to improve existing programs and to guide other states in developing and implementing similar interventions. In this paper we describe the methods being used to evaluate the statewide anti-tobacco campaigns in California and Massachusetts, and review the findings of process and outcome evaluations of both programs.
Our review suggests that both programs have had a substantial impact on the public's health by reducing cigarette consumption and stimulating the development of policies to reduce environmental tobacco smoke exposure. However, it does not appear that either program has reduced smoking initiation among adolescents. Our evaluation suggests three problems in program implementation that future anti-tobacco campaigns must avoid in order to produce long-term, sustained effects: (1) the gradual erosion of program funding by the state legislatures and governors; (2) the lack of a consistent, supportive constituency within state government; and (3) inconsistency in campaign themes, messages, and programs. We conclude by offering recommendations to correct these problems so that statewide cigarette-tax-funded anti-tobacco campaigns can realize their potential to become one of the most effective public health interventions available.     

The association of smoking with drinking pattern may provide opportunities to reduce smoking among students

There is evidence that smoking and alcohol consumption are paired behaviours among university students, but we know little about how New Zealand students engage in these behaviours. We estimated prevalence of daily and occasional smoking among university students, and associations of smoking with drinking patterns, demographics and smokefree policies of the university. This research was conducted with 2822 university students, aged 17–25, from five New Zealand universities who participated in an online health survey in 2013. Fourteen percent reported they currently smoke occasionally, and 3% reported smoking on a daily basis. Increasing age, living situation, drinking more often, and drinking more alcohol during drinking occasions were all associated with greater levels of smoking. Understanding patterns of smoking in relation to alcohol consumption may help efforts to further reduce smoking prevalence. Specifically, policy makers should consider approaches that de-couple tobacco and alcohol consumption, such as expanding the smokefree perimeter of bars and disallowing the sale of tobacco at premises licensed to sell alcohol.     

The development of emotion regulation in adolescence: What do we know and where to go next?

Emotion regulation is critical for adolescent functioning. Theories on the subject have evolved rapidly in recent years and have led to a more contextualized and dynamic conceptualization of emotion regulation processes. In this paper, based on the distinction between emotion regulation strategies and abilities, we propose future directions for research on emotion regulation development in adolescence. We first present evidence that emotional, cognitive, and social changes that occur in adolescence are central in emotion regulation development. We then review empirical findings on emotion regulation development by tying them to their conceptual foundations. We discuss their limitations and argue that building better conceptual clarity is essential to study emotion regulation. Because current knowledge on recent concepts that emerged in adult-based models remains limited and contested in adolescence, we end this article by discussing new research perspectives to provide a better understanding of the topic. We stress the need for researchers in the field to adopt a more contextualized and person-oriented approach, to combine different time scales and methods, and examine the predictors of emotion regulation as well as its outcomes.     

Socioeconomic Distinction, Cultural Tastes, and Cigarette Smoking

OBJECTIVES: The inverse relationship between socioeconomic status (SES) and smoking is typically seen in terms of the greater economic and social resources of advantaged groups, but it may also relate to cultural resources. This study aims to test theories of symbolic distinction by examining relationships between smoking and ostensibly unrelated cultural preferences. METHODS: Using the 1993 General Social Survey, ordinal logistic regression models, and a three-category dependent variable (never, former, and current smoker), the analysis estimates relationships of musical likes and dislikes with smoking while controlling for SES and social strain. RESULTS: Preferences for classical music are associated with lower smoking, while preferences for bluegrass, jazz, and heavy metal music are associated with higher smoking. CONCLUSIONS: The results suggest that SES groups may use smoking, like other cultural tastes, to distinguish their lifestyles from those of others.     

Challenging the generational transmission of tobacco smoking: a novel harm reduction approach in vulnerable families

Anti‐smoking measures have been effective in reducing smoking in the general population but have been less effective with people in lower economic quintiles. The effects of parental smoking on children are adverse, long reaching and increase the likelihood of smoking in adulthood. Thus, persistent tobacco smoking is often a feature in generational patterns of poverty and marginalization. In this project, the researcher, a social worker, developed a hypothesis about how links between poverty, smoking and its impact on children at risk could be challenged. A literature review was conducted to explore the hypothesis and the findings were used to develop a strategy to work with impoverished, marginalized parents of children considered at risk by the Child Protection system. The strategy was applied as an exploratory study using qualitative methods to garner insights into factors that changed smoking behaviour at home. Quantitative methods were used to measure change. The study indicated that the strategy is promising, with all parents either ceasing or significantly reducing daily smoking. The number of children exposed to tobacco smoke at home was reduced from 36 to 5. The promising results of this study may enhance the range of solution behaviours for parents and social workers seeking to improve the health and well‐being of vulnerable children.     

Friendships and Violent Behavior During Adolescence

This study investigated the extent to which interpersonal processes within male friendships are associated with violent behavior patterns during adolescence. At ages 13-14, 15-16, and 17-18, we observed the participants (206 boys) in our laboratory discussing problem solving situations with a close friend. Although the boys typically brought in different friends for each of the three assessments, we found considerable continuity in the boys' behaviors, most notably in the topics discussed. In particular, the tendency of a dyad to engage in deviant and violent talk was uniquely associated with violence in adolescence, controlling for childhood antisocial behavior and coercive discipline practices in the home. These findings suggest that adolescent violence is embedded within enduring social interactional patterns of friendships, where the faces change but the process remains the same.     

Abstracts of theses: July, 1952 Smith college School for social work

Abstract

This article examines models of addiction and heroin treatment outcomes as well as the history of xenophobia, racial scapegoating, and misinformation in the promotion of narcotics prohibition in the United States. The moral model of addiction holds that punishment of the addict will be effective deterrence, yet punishment has not prevented heroin use, and narcotics control costs continue to spiral. The medical model of addiction, the dominant philosophical underpinning for current treatment methods, is shown to lack scientific corrobora‐tion and therefore to be inappropriate as a basis for policy on heroin use and inadequate to govern options in heroin addiction treatment. The discouraging outcomes of all modes of heroin addiction treatment indicate that treatment will not end the demand for the drug. Gradual legalization of heroin, while instituting formal and informal social structures geared to controlled use, is recommended.     

Taxation and anti-smoking campaigns: Complementary policies in tobacco control

We examine the optimal design of policies directed at regulating tobacco consumption through two types of instruments: taxation and anti-smoking mass media campaigns. We find that the main role of taxation is to correct for the population-average internal costs of smoking, while anti-smoking campaigns serve a complementary role. Namely, they add to the social welfare benefits of tobacco regulation as they are relatively more effective than taxation at discouraging smoking by individuals characterized by low degrees of self-control and high smoke-related health     

How Good a Deal Was the Tobacco Settlement?: Assessing Payments to Massachusetts

We estimate the increment in Massachusetts Medicaid program costs attributable to smoking from December 20, 1991 to 1998. We describe how our methods improve upon earlier estimates of analogous costs at the national level. Current costs to the Massachusetts Medicaid program approximate the payments to Massachusetts under the tobacco settlement of November 1998. Whether these payments are viewed as appropriate compensation for Medicaid costs over time depends upon the rate of increase in future health care costs, the rate of decline in smoking, the proportion of smoking that should be attributed to the actions of the tobacco companies and the likelihood the state would have prevailed at trial. The costs to the Medicaid program are dwarfed by the internal costs to smokers themselves.     

Tobacco Advertising Bans: Some Thoughts

This paper examines some of the evidence concerning tobacco advertising and tobacco consumption and discusses the imposition of various bans on tobacco advertising. Important examples of such bans are the 1971 electronic media ban in the U.S.A., the 1976 Australian electronic media ban and the recently introduced magazine and newspaper ban in Australia. The evidence is not totally convincing that tobacco advertising bans reduce tobacco consumption. However, this does not preclude a total ban as part of any future Australian comprehensive smoking control policy.     

"We mentally ill smoke a lot": identity, smoking, and mental illness in America

Most of the history of the tobacco industry over the last few decades has focused on the conflicts between tobacco industry leaders who promoted smoking and tobacco control advocates who warned of the health consequences. Yet a view of this conflict from the perspective of smokers who are also mentally ill raises questions about how to frame public health policy for these individuals. Mentally ill consumers wrote to the tobacco industry between the 1970s and 1990s and expressed their commitment to smoking and to cigarette companies, despite their awareness of the health risks. This paper explores the relationship between mentally ill consumers, the tobacco industry, and public health in the United States through letters written by mentally ill smokers.     

Cognitive reappraisal and need to belong predict prosociality in Mexican-origin adolescents

This 2-year longitudinal study examined Mexican-origin adolescents’ need to belong and cognitive reappraisal as predictors of multiple forms of prosocial behavior (i.e., general, emotional, and public prosocial behaviors). Prosocial behaviors, which are actions intended to benefit others, are hallmarks of social proficiency in adolescence and are influenced by intrapersonal abilities and motivations that typically develop during adolescence. Yet, few studies of Mexican-origin or other U.S. Latinx youths have examined whether such individual difference characteristics, specifically social motivation and emotion regulation skills, support prosocial behavior. In a sample of 229 Mexican-origin youth (M_age = 17.18 years, SD = .42, 110 girls), need to belong, cognitive reappraisal, and general prosocial behaviors were assessed at ages 17 and 19. Emotional and public forms of prosociality also were assessed at age 19. Cognitive reappraisal was positively associated with concurrent general prosociality at age 17, whereas need to belong was positively associated with concurrent public prosociality at age 19. Moderation analyses revealed that general and emotional types of prosocial behaviors at age 19 were lowest for youth with both lower need to belong and less use of cognitive reappraisal at 19 years. Greater cognitive reappraisal skills and need to belong may reflect distinct motivations for engaging in varying forms of prosocial behavior in late adolescence.     

PUBLIC WEALTH,PUBLIC HEALTH,AND PRIVATE STEALTH: EXAMINING THE BLACK MARKET IN CIGARETTES IN AUSTRALIA

Taxes on tobacco provide a significant income for the Australian government — $5.1 billion in 2001. At the same time, health officials are making strenuous efforts to reduce smoking, particularly among teenagers. Some economists suggest that raising taxes on tobacco will produce more revenue while at the same time lowering smoking rates, particularly among youths who have less discretionary spending power than adults. But a by‐product of excise tax in Australia has been the emerging market in “chop‐chop,” tobacco diverted from legal channels by growers who receive considerably higher prices for a part of their yield than they can obtain from legal manufacturers. The article details this situation and suggests that only bold solutions may be able to reduce tensions in tax policies, smoking rates and the “chop‐chop” black market.