The Effects of Spousal Health on the Decision to Smoke: Evidence on Consumption Externalities, Altruism and Learning Within the Household

Married individuals are healthier than single individuals though the reasons are not well understood. Individuals with spouses/or partners are less likely to smoke. We explore the relationship between health and marital status by analyzing three potential channels through which marriage affects smoking, i.e., consumption externalities (one spouse's smoking affects the other spouse's welfare), altruism (one spouse reduces smoking in response to the other spouse's bad health), and learning about risks of smoking from the health experience of one's spouse. We find spousal health does not affect smoking due to altruism or learning within the household but do find evidence for consumption externalities.     

Smoking during pregnancy,stigma and secrets: Visual methods exploration in the UK

BackgroundMoral judgements are commonly directed towards mothers through reference to health behaviour in pregnancy, and working-class mothers are particularly subject to this moral gaze.AimTo gain an in-depth understanding of the health issues affecting 10 low income pregnant women from deprived areas of south Wales, UK.MethodsParticipants completed visual activities (timelines, collaging or thought bubbles and dyad sandboxing) prior to each interview. Participants’ visual representations were used in place of a topic guide, to direct the interview. Guided by feminist principles, 28 interviews were completed with 10 women. Data were analysed thematically.FindingsSmoking was discussed at length during interviews, and this paper focuses on this issue alone. Five of the participants had smoked during pregnancy. Negative reactions were directed towards pregnant women who smoked in public, resulting in maternal smoking being undertaken in private. Participants also reported awkward relationships with midwives and other health professionals, including receipt of public health advice in a judgemental tone.DiscussionSmoking during pregnancy is a particularly demonised and stigmatised activity. This stigma is not always related to the level of risk to the foetus, and instead can be seen as a moral judgement about women. We urgently need to move from individualised neo-liberal discourses about the failure of individual smokers, to a more socio-ecological view which avoids victim blaming.ConclusionStigma from friends, family, strangers and health professionals may lead to hidden smoking. This is a barrier to women obtaining evidence based stop smoking support.     

Interdependency among addictive behaviours and time/risk preferences: Discrete choice model analysis of smoking, drinking, and gambling

This paper simultaneously measures the rate of time preference and the coefficient of risk aversion, as well as investigates the interdependencies of four addictive behaviours: smoking, drinking, pachinko (a popular Japanese form of pinball gambling), and horse betting among a sample of the Japanese population. We reach two main conclusions. First, there are significant interdependencies among the four addictive behaviours, in particular between smoking and drinking and between gambling on pachinko and the horses. Second, we conclude that the higher the time preference rate and the lower the risk aversion coefficient becomes, the more likely individuals smoke, drink frequently, and gamble on pachinko and the horses.     

Environmental Tobacco Smoke: Science vs. Rhetoric

After an extensive review and analysis of the scientific evidence on the respiratory health effects of passive smoking, the U.S. Environmental Protection Agency concluded that environmental tobacco smoke causes lung cancer in adult nonsmokers and increases the risk of a variety of non-cancer respiratory disorders, especially in children. This article is a response to claims in Dr. Gio Gori's article "Policy Against Science: The Case of Environmental Tobacco Smoke," appearing in the same issue of this journal, that such conclusions are unwarranted. This response focuses only on the respiratory health effects of environmental tobacco smoke.     

Research note: The consequences of different methods for handling missing network data in stochastic actor based models

Although stochastic actor-based models (e.g., as implemented in the SIENA software program) are growing in popularity as a technique for estimating longitudinal network data, a relatively understudied issue is the consequence of missing network data for longitudinal analysis. We explore this issue in our research note by utilizing data from four schools in an existing dataset (the AddHealth dataset) over three time points, assessing the substantive consequences of using four different strategies for addressing missing network data. The results indicate that whereas some measures in such models are estimated relatively robustly regardless of the strategy chosen for addressing missing network data, some of the substantive conclusions will differ based on the missing data strategy chosen. These results have important implications for this burgeoning applied research area, implying that researchers should more carefully consider how they address missing data when estimating such models.     

Smoking cessation care during pregnancy: A qualitative exploration of midwives’ challenging role

ProblemThe majority of South Australian pregnant women who smoke do not quit during pregnancy. Additionally, the prevalence of smoking is higher among pregnant women living in socially disadvantaged areas.BackgroundUnderstanding challenges in midwives’ provision of smoking cessation care can elucidate opportunities to facilitate women’s smoking cessation.AimWe aimed to understand midwives’ perspectives on current practices, perceived barriers and facilitators to delivery of smoking cessation care, and potential improvements to models of smoking cessation care.MethodsAn exploratory qualitative research methodology and thematic analysis was used to understand the perspectives of midwives in five focus groups.FindingsFour themes were generated from the data on how midwives perceived their ability to provide smoking cessation care: Tensions between providing smoking cessation care and maternal care; Organisational barriers in the delivery of smoking cessation care; Scepticism and doubt in the provision of smoking cessation care; and Opportunities to enable midwives’ ability to provide smoking cessation care.DiscussionA combination of interpersonal, organisational and individual barriers impeded on midwives’ capacities to approach, follow-up and prioritise smoking cessation care. Working with women living with disadvantage and high rates of smoking, the midwife’s role was challenging as it balanced delivering smoking cessation care without jeopardising antenatal care.ConclusionProviding midwives with resources and skills may alleviate the sense of futility that surrounds smoking cessation care. Provision of routine training and education could also improve understandings of the current practice guidelines.     

Dynamics of adolescent friendship networks and smoking behavior

The mutual influence of smoking behavior and friendships in adolescence is studied. It is attempted to disentangle influence and selection processes in reciprocal and non-reciprocal friendships. An actor-based model is described for the co-evolution of friendship networks and smoking behavior. This model considers alternative selection and influence mechanisms, and models continuous-time changes in network and behavior. The data consists of a longitudinal sample of 1326 Finnish adolescents in 11 high schools. Findings suggest that selection as well as influence processes play an important role in adolescent smoking behavior. Selection had a relatively stronger role than influence, in particular when selecting non-reciprocal friends. The strength of both influence and selection processes decreased over time.     

Tobacco Control and Smoking Cessation Efforts in an Inner-City African American Community

This paper describes the conceptual framework that guided the development and implementation of a large-scale, community-based health initiative to lower the prevalence of smoking in an urban African American community. This project developed culturally-sensitive approaches to reducing smoking in the community and to promoting tobacco control efforts developed and implemented by community members. A randomized clinical-trial methodology was used to test the efficacy of the culturally-sensitivey community-developed smoking cessation interventions in lowering smoking rates as compared with a self-help approach. Two theoretical models guided the intervention strategies: a macro-level model applicable to the community as a whole, and a psychological process model applicable to individuals. The community model was based on community systems theory and incorporated the Readiness for Change Model which was applied in both the individual and organizational models. In addition, culturally-sensitive data collection methods were developed to improve the reliability and validity of project data, especially in determining the smoking prevalence rates and smoking behaviors of hard-to-reach, inner-city African Americans. Since the health of individuals is related to the health of their communities, smoking cessation and tobacco control activities that are integrated into the framework of the community (Le., churches, city-council, housing developments, community organizations), and incorporate culturally-relevant and specific interventions can be effective methods for achieving behavioral and societal change.     

The role of tobacco taxes in starting and quitting smoking: Duration analysis of British data

The annual 5% increase in tobacco taxes in real terms proposed in the recent White Paper on smoking has reaffirmed the commitment of successive UK Governments to above-inflation increases in tobacco taxation to encourage people to stop smoking. This paper presents evidence on the determinants of starting and quitting smoking by using data from the British Health and Lifestyle Survey and is the first to identify tax elasticities for starting and quitting smoking using British data. Self-reported individual smoking histories are coupled with a long time series for the tax rate on cigarettes to construct a longitudinal data set. Estimates are obtained for the effect of above-inflation tax rises on the age of starting smoking and the number of years of smoking. The estimates of the tax elasticity of the age of starting smoking are 0.16 for men and 0.08 for women. The estimates of the tax elasticity of quitting are −0.60 for men and −0.46 for women. These are robust to different specifications.