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INDEX
A
Accessibility of tobacco, 19, 199-200, 201
national reduction goals, 19, 210, 284
and price-sensitivity of adolescents, 17, 19, 108, 187-191, 266
surveillance systems, 19, 227, 285
Addiction. See Nicotine addiction/dependence
Adult tobacco use, 5-6, 7, 8, 11, 23, 63
perceived prevalence of, 14, 18, 21, 77, 78, 79
Advertising and promotions, 11, 105-114
appeal to children and youths, 18, 106, 116-122, 130-131, 245
expenditures, 11, 105, 107-108, 109, 278
impacts on child and youth tobacco use, 18, 55, 124, 131
market segmentation, 115-116
non-media promotional items, 80, 108, 110, 245-246
Old Joe Camel campaign, 116-117, 120, 129
promotional allowances, 110-111
recall studies, 123-124
research needs, 18, 133-134, 282
value-added promotions, 108, 110
women as targets, 116
Advertising restrictions, 18, 131, 132, 133
constitutional challenges to, 133
effects on smoking prevalence, 124-128
health warnings, 245
industry voluntary code, 128-130
insignia, logos, trademarks, 133, 245-246, 282
on misleading terms, 249
public support for, 12
smokeless tobacco promotions, 245
by states, 12, 17, 18, 21, 131-132, 133, 259, 283
transportation systems, 132, 282
See also Tombstone advertising formats
Advocacy organizations for tobacco control, 93-97, 268-269, 274-275
health professions, 94-95
local coalitions, 12, 17, 21, 93, 94
youth involvement, 96-97
Affective education model, 145
Affordability of tobacco products
relation to consumption, 192
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African Americans
age of onset, 106
as marketing segment, 112, 114
prevalence of smoking, 8-9, 22, 56-57, 63, 75, 98, 262, 282
Agency for Health Care Policy and Research (AHCPR), 262
daily tobacco use, 5-6, 13, 29, 30, 43, 105
and risk perception, 14-15
Agonist drug replacement, 42-43
American Cancer Society (ACS), 94, 269, 274
American Medical Association, 94, 95
SmokeLess States program, 21, 95
American Stop Smoking Intervention Study (ASSIST), 17, 20, 21, 94, 203, 259-260, 286
Anti-tobacco advertising campaigns. 17, 114, 18, 83, 97, 128, 281
youth involvement, 18, 98, 282
sponsorship restrictions, 133, 282
ASSIST. See American Stop Smoking Intervention Study
Australia, warnings and packaging policies, 243, 244
B
Behavioral risk factors, 55
smoking methods, 38-39, 248, 249, 286
Billboards and outdoor advertising, 80, 112, 114, 123
Boys
prevalence of use, 8, 10, 75, 78
sales to, 202
smokeless tobacco use, 59, 63, 106
Brand names. See Logos; Trademarks
C
California
anti-tobacco media programs, 17
Proposition 99, 94, 96, 178, 267-268
targeted control programs, 17, 150, 267
Tobacco-Related Disease Research Program, 261, 268
Canada
advertising restrictions. 125, 128
policy research, 23
pricing and taxation policies, 185, 186-187, 189-190, 192
and smuggling of tobacco products, 193, 283
tobacco-free pharmacy program, 225
warnings and packaging policies, 244
Center for Substance Abuse Prevention (CSAP), 266-267, 274
Center for Substance Abuse Treatment, 266-267
Centers for Disease Control and Prevention (CDC)
community-based program support, 220, 285
school-based prevention guidelines, 19, 144, 151, 167, 168, 283
tobacco control grants. 210, 284
Cessation of tobacco use, 22, 105, 118
desire for, 15, 50-51, 73-74, 163, 167
ethnic differences, 57
perceived ease of, 14
research needs, 19, 22, 167, 283
smokeless tobacco, 163-167
withdrawal symptoms after, 31, 33, 42, 50
Cholinergic receptors, 34
Cigarette Labeling and Advertising Act, 237
Clinic-based interventions, 161-162, 165-166
Coalition for America's Children, 92
Coalition on Smoking OR Health, 94, 269
Colorado, tobacco-free school districts, 87
Community intervention programs, 151-154
cessation, 161-162
restrictions, 87-93
and school-based programs, 15, 19, 154-155, 167, 168
smokeless tobacco use, 158
Comprehensive Smokeless Tobacco Health Education Act, 239
Comprehensive Smoking Education Act, 236-237, 238
Consumer Product Safety Act, 233, 246
Controlled Substances Act, 246
Cooperative agreements, 21
Counter-advertising. See Anti-tobacco advertising campaigns
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Cultural events and facilities, 82, 120
tobacco-free policies, 97, 281
D
Daily tobacco use
age of onset, 5-6, 13, 29, 30, 43, 105
smokeless tobacco, 8
Deaths from tobacco use, 3, 4, 5, 15, 105
Decision-making skills, of adolescents, 13-15
Department of Defense, 76, 89, 98, 267, 282
Department of Education, 267
Department of Health and Human Services
health warning research and regulation, 245, 286
proposed tobacco-control agency, 247
Developmental factors, 13, 106, 118-119
E
Econometric studies, 124
Educational programs
hazards of tobacco use and smoke, 97, 281
and tobacco ads and promotion, 17
tobacco industry campaigns, 129
youth access laws, 167, 202-203, 219, 285
See also School-based prevention programs
and commercial restrictions, 133, 282
Environmental risk factors, 54-55, 63
Environmental tobacco smoke (ETS), 22, 76-77, 267
educational programs and messages on, 97, 281
and workplace restrictions, 88-89
Epidemiologic studies, 22, 261-262, 264
Ethnic groups
advertising and promotional responsiveness, 18, 106, 114, 133, 282
age of onset, 106
cessation among, 57
nicotine addiction, 56-58, 63, 64
norms of tobacco use, 20, 262-263, 286
prevalence of smoking, 8-9, 18, 74-75, 262
smokeless tobacco use, 8-9, 18, 58, 59
Ethnographic studies, 134
Experimentation with nicotine
transition to addiction, 43, 64, 281
F
Fagerström Tolerance Questionnaire, 40
Fairness Doctrine, 83, 128, 238
Fast-food restaurants, 22, 90-91, 97, 281
Federal Cigarette Contraband Act, 179
Federal Communications Commission (FCC),
Fairness Doctrine, 83, 128, 238
Federal Hazardous Substances Act, 233
Federal Trade Commission (FTC), 237, 238, 259
Filters and filtration, 62, 121, 248
Finland, advertising restrictions, 125
Food, Drug, and Cosmetics Act (FDCA), 234-235, 246
Food and Drug Administration (FDA). 234-235, 246, 247, 250-251, 259
Foreign government policies
advertising restrictions. 124-128
tar reduction, 250
taxes. 17, 19, 184, 192, 193, 283
warnings and packaging, 244
Free sample distribution, 19, 61, 113, 216-217, 226, 285
G
Gender differences
advertising and promotional responsiveness, 18, 133, 282
age of onset, 106
ease of purchase, 202
Girls
nicotine dependence, 50
prevalence of use, 10, 59, 75, 78, 116
sales to, 202
Government buildings, tobacco-free policies, 12, 98, 281-282
Grassroots political action, 12, 269
H
Health policies and programs
and excise taxes, 12, 190-191, 192, 283
national child health policy, 19, 168, 283
and prevention policies, 11, 23, 251
and product regulation, 21, 236-237, 246-247, 249, 251, 285-286
to reduce number of initiates, 15
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tax revenues earmarked for, 17
and tobacco constituent reduction, 250
Healthy People 2000, 8, 15, 86-87, 89, 144, 258-259, 276, 287
High School Seniors Survey, 159
Hispanics
cultural event sponsorships, 82
prevalence of tobacco use, 56, 57, 58, 75
I
Image advertising, 119-122, 123
common themes, 21, 55, 58, 120, 131
counter-advertisements, 18, 83, 97, 128, 281
safety and healthfulness, 121-122, 129
and social norms, 21, 55, 80-83, 117-118, 120-121
Indian Health Service, 267
Information-deficit model, 144-145
Informed-choice model, 13
Initiation of tobacco use, 5-6
individual susceptibility, 55-56, 63
price barrier to, 17
reduction goals, 15
research needs, 20, 265, 286, 287
smokeless tobacco products, 15, 58
and tar and nicotine reduction, 250
See also Age of onset
Insignia, restrictions on use, 133, 245-246, 282
Interagency Committee on Smoking and Health, 275-276, 287
International Union Against Cancer, tar reduction policy, 250
Interstate regulation of ads and promotions, 18, 133, 282
L
Labeling. See Warning labels
Latent censorship, 114
Lautenberg amendment, 87
Legislation and statutes, 16
federal preemption of state ad regulation, 12, 17, 18, 131-132, 282
interstate regulation of ads and promotions, 18, 133, 282
mail order distribution, 226, 285
school tobacco ban, 87
tax increase proposals, 17, 19, 193, 283
tobacco products regulation, 20, 246-247, 259, 285-286
on warning labels, 20, 245-246, 286
See also State governments: Youth access laws
"Less hazardous" cigarettes, 247-248
Licensing of tobacco retailers, 19, 210-212, 223, 284, 285
fees earmarked for enforcement, 19, 211-212, 284
Life expectancy, losses, 3
Light and occasional smokers, 37
"Light" cigarettes, 121-122, 248, 249
Local governments, 20
advertising and promotion regulation, 12, 17, 18, 132, 282
tobacco-control programs, 12, 17, 21
See also Youth access laws
accompanying warning labels, 245-246, 286
restrictions on use, 133, 245-246, 282
Longitudinal studies, 84, 134, 261-262
Low-yield cigarettes, 37-38, 61-62, 63-64, 121-122, 248
M
Magazine advertisements, 80-81, 111, 122
interstate restrictions, 133, 282
and latent censorship, 114
Mail order distribution, 19, 113-114, 217, 225- 226, 285
Marijuana, 167
Maryland, anti-tobacco media programs, 17
Massachusetts
anti-tobacco media programs, 17
targeted control programs, 17, 267
Mass media, restrictions on brand identification, 133, 282. See also Advertising and promotions
Men
lifetime medical costs, 5
Michigan
targeted control programs, 17
tobacco-free pharmacy program, 225
Military personnel
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Military stores, 76, 179, 193, 283-284
Model law, 203-204, 213, 220, 224
school-based prevention, 144-148, 168, 283
youth access law, 203-204, 213, 220, 224
Monitoring the Future Study, 8, 14, 50, 75
Mortality. See Deaths from tobacco use
Music videos, commercial restrictions, 133, 282
N
National Cancer Institute (NCI), 265, 266
ASSIST program, 17, 20, 21, 94, 203, 259-260, 286
National Household Surveys on Drug Abuse, 105-106
National Institutes of Health, 193, 265
Newspaper advertisements, 111
commercial restrictions, 133, 282
New Zealand
advertising restrictions, 125, 128
pricing policies, 192
Nicotine addiction/dependence, 5-6, 18, 22, 29-31, 63
and cessation of tobacco use, 18, 50-52, 63
and characteristics of tobacco products, 18, 58, 60-63, 64, 281
compared to drug addiction, 40-43
definitions and criteria, 30-31, 32
early stages, 18, 29, 43-45, 64, 281
individual susceptibility, 18, 55, 63, 64, 281
and nicotine content reduction, 249-250
perceptions of, 14-15, 63, 122
pharmacologic aspects, 30, 31-37, 45, 49-50, 55
and rationality of personal choice, 13, 41
research needs, 18, 22, 64, 281
and smokeless tobacco use, 39-40, 63
and smoking behavior, 37-38, 38-39, 62, 248
tolerance, 30, 31, 35, 40, 42, 45
and treatment strategies, 63
withdrawal, 30, 31, 33, 35, 37, 50
Nicotine content and delivery
consumer information, 249, 286
control by manufacturers, 60, 62, 63-64, 249
low-yield cigarettes, 37-38, 63-64, 248, 249-250
measurement of yields, 20, 248-249, 286
minimum addiction levels, 64, 250
regulation, 20, 21, 64, 246-251, 286
of smokeless tobacco, 39-40
"Nicotine delivery systems"
in regulatory vocabulary, 251
substitution of, 250
Nicotine replacement therapy, 42-43, 165
Non-media promotional items, 80, 108, 110, 245-246
Norms, 71-73
community enforcement, 87-88
and prevalence of use among African-Americans, 9, 98, 282
research needs, 20
tobacco-free, 18, 22, 23, 73-77, 131
Norway, advertising restrictions, 125
O
Occupational Safety and Health Administration (OSHA), 89, 259
Office of Smoking and Health (OSH)
coordination role, 20, 275-277, 287
Interagency Committee on Smoking and Health, 275-276, 287
Old Joe Camel campaign, 116-117, 120, 129
Oral cancer, 3
Organizations. See Advocacy organizations for tobacco control; Youth organizations
Outdoor advertising. See Billboards and outdoor advertising
P
nicotine content statement, 249
See also Warning labels
Parental involvement
in community programs, 167
reactions to tobacco use, 18, 84, 98, 282
Parental smoking, 12, 54-55, 84
Peer tobacco use, 13, 54, 85-86
perceived prevalence of, 14, 18, 21, 77, 78, 79-80
Perceptions about tobacco use
addiction potential, 14-15, 63, 122
benefits of, 13-14, 81-83, 123
effects of packaging regulations, 249
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overestimates of prevalence, 14, 18, 21, 63, 77-80
as socially unacceptable, 76-77
tobacco-related norms, 14
Pharmacies, tobacco sale ban, 224, 225, 285
Point of sale promotions, 108, 111
Policy research, 19, 20, 22-23, 95, 193, 226-227, 262, 266, 269, 287
Prevalence of tobacco use, 73
among youths, 7-9, 11, 45, 46, 47, 63, 73, 105-106, 278
effects of advertising restrictions, 124-128
smokeless tobacco products, 8, 58, 59, 106
Prevention policies and programs
advertising restrictions' role in, 133
as health policy tool, II, 23, 251
research needs, 20, 22-23, 168, 264-266. 283, 286, 287
Prices, 11
price-sensitivity of adolescents, 17, 19, 108, 187-191, 266
See also Taxes on tobacco products
interstate advertising restrictions, 133, 282
Productivity losses, 5
Promotions. See Advertising and promotions; Advertising restrictions
Public facilities, tobacco-free policies, 12, 18, 97-98, 281-282
Public Health Cigarette Smoking Act, 238
Pulmonary disease, 3
Q
Quitting. See Cessation of tobacco use
R
Regional differences
norms of tobacco use, 20, 59, 262-263, 286
smokeless tobacco use, 58
Regulation of tobacco products, 16, 20, 21, 233-236, 246
constituents, 20, 21, 246-251, 286
as health policy tool, 21, 236-237, 246-247, 249, 251, 285-286
packaging, 20, 21, 245, 249, 286
proposed agency, 21, 236, 246-250, 285-286
research needs, 20, 248-250, 286
See also Advertising restrictions; Warning labels; Youth access laws
Religious organizations, 93-94
Research programs and methods
advertising recall studies, 123-124
advertising responsivity, 133-134
biochemical markers of exposure, 37, 63, 248
federal support, 20, 261-266, 286-287
interventions, 262-265
multicultural, 262-263, 264-265
policy oriented, 19, 20, 22-23, 95, 193, 226-227, 262, 266, 269, 287
school-based programs, 148-151
smokeless tobacco addiction levels, 39-40
tobacco constituents measurement, 248-249, 286
youth-centered, 263-265
See also Model programs; Surveys
Restaurants, tobacco-free policies, 12, 22, 97, 281
Risk-factor analyses, 22
Robert Wood Johnson Foundation
Join Together Project, 93
policy research, 23, 95, 266, 269
SmokeLess States program, 21, 95
Rural areas, smokeless tobacco use, 39, 58
S
Sales to minors, 19, 201-202. See also Vending machines; Youth access laws
School-based prevention programs, 15-16, 81, 143-151
adequacy of resources, 19, 143-144, 168
CDC guidelines, 19, 144, 151, 167, 168, 283
cessation programs, 160-161
and drug abuse prevention, 167, 168, 283
model programs, 144-148, 168, 283
refusal skills training, 19, 148, 167
smokeless tobacco, 156-157
tobacco-free policies, 19, 22, 86-87, 97, 224-225, 285, 281
Self-help programs, 164-165
Self-service displays, 110-111, 214
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Smoke, chemistry and byproducts of, 60, 61, 247. See also Environmental tobacco smoke
Smokefree Educational Services (SES), 96, 269
Smokeless tobacco (SLT) products, 60-61
cessation interventions, 163-167
and cigarette smoking, 40, 58, 166
prevention interventions, 155-159
reduction of toxins in, 249
Smoking Control Advocacy Resource Center (SCARC), 95, 269. See also SCARCNet
Smoking machine tests. 61, 62, 63, 248
Smuggling
between Canada and the United States, 193, 283
Social cognitive theory, 118-119
Social costs of tobacco use, 4
and advertising appeal, 117-119
resistance model, 146-147
See also Norms
Socioeconomic factors
advertising and promotional responsiveness, 18, 106, 133, 282
Sports and athletics, 21, 58, 80, 81, 82, 112-113, 123, 129, 132
sponsorship restrictions, 133, 245, 282
tobacco-free policies, 91-92, 97, 281
State governments, 20
advertising restrictions, 12, 17, 18, 21, 131-132, 133, 283
industry lobbying efforts, 12, 267-268
self-service display bans, 19, 214-215, 284
vending machine restrictions, 19, 212-214, 284
Stop Teenage Addiction to Tobacco (STAT), 95-96, 214, 269
Stop Tobacco Access for Minors Project (STAMP), 96, 269
Stores
licensing programs, 19, 210-212, 223, 284, 285
promotional allowances, 110-111
tobacco-free policies, 12, 91, 97, 281
youth access law enforcement and compliance, 167, 210, 284
Student Coalition Against Tobacco (SCAT), 96-97
Surveys
High School Seniors Survey, 159
National Household Surveys on Drug Abuse, 105-106
smoking restrictions, 76-77
Teenage Attitudes and Practices Survey (TAPS), 14, 15, 58, 74, 159
Teen Lifestyle Study, 74, 78, 82, 85
tobacco control policies. 12
Youth Risk Behavior Survey (YRBS), 13, 43-44, 159
Synar Amendment, 199, 204-205, 207-208, 213, 221, 224, 246
T
Taco Bell, 91
Tar content, 61
consumer information, 249, 286
international reduction policies. 250
low yield cigarettes, 37, 61-62, 63, 248, 249, 250
measurement of yields, 20, 248-249, 286
regulation, 20, 21, 246-250, 286
Taxes on tobacco products
and alternative products use, 19, 193, 283
consumption impacts, 17, 19, 181-183, 185-190, 192, 193, 283
earmarking of revenues, 17, 19, 178, 269, 273
economic impacts, 191-192
federal, 17, 19, 177-178, 183, 192, 193, 283
as health policy tool, 12, 190-191, 192, 283
increases, 11, 17, 19, 193, 283
and inflation, 19, 182-183, 193, 283
research needs, 193
and smuggling, 19, 178, 193, 283
state and local, 19, 178-180, 192, 283
Technical assistance, 21, 259-261, 266-267
community-based programs, 220, 285
Teen Lifestyle Study, 74, 78, 82, 85
Teenage Attitudes and Practices Survey (TAPS), 14, 15, 58, 74, 159
Television advertising, 83, 128, 133, 282
Theory of reasoned action, 117-118
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ethical foundation, 12-15
federal support, 17, 21, 210, 284
outlet reduction, 224, 225, 285
state and local programs, 12, 17, 21, 91, 92, 210, 284
tax revenues earmarked for, 12, 17, 19, 269, 273, 287
Tobacco Policy Coordinating Committee, 275
Tombstone advertising formats, 132, 133
interstate restrictions, 133, 282
state and local restrictions, 18, 132
Toxic Substances Control Act, 233
Trademarks, 119-120, 133, 245-246, 282, 286
Transportation systems
advertising restrictions, 132, 282
tobacco-free policies, 97, 281
U
Union of American Hebrew Congregations, 94
United Kingdom
pricing policies, 192
V
Value-added promotions, 108
Vending machines, 201, 202, 212
partial restrictions, 213-214
Videotapes and videodiscs, 133, 282
Visual media, regulation of, 17, 133, 282
W
Warning labels, 20, 236-239, 245-246, 286
effectiveness of, 20, 240-244, 245, 286
on non-media promotional items, 245-246, 286
and smokeless tobacco, 239-241, 245
Washington State, workplace tobacco ban, 89
Whites
age of onset, 106
daily smoking prevalence, 8, 56
prevalence of tobacco use, 56-57, 75, 262
Withdrawal symptoms, 30, 35, 37, 45
after cessation of use, 33, 31, 42, 50
Women
as advertising targets, 116
lifetime medical costs, 5
prevalence of use, 78
Workplaces, tobacco-free policies, 22, 88-90, 98, 282
World Health Organization, tar reduction policy, 250
Y
Years of potential life lost, 3
Youth access laws, 200-205, 207, 220-222, 285
circumvention of, 19
community involvement, 167, 219-220, 285
education programs, 167, 202-203, 219, 285
enforcement and compliance, 17, 19, 167, 201-202, 210, 222, 227, 284, 285
model law, 203-204, 213, 220, 224
penalties under, 220, 222-223, 285
proposed federal information agency, 210, 284
research needs, 19, 226-227, 285
self-service display bans, 19, 214-215, 284
single cigarette sale bans, 216, 284-285
Synar Amendment, 199, 204-205, 207-208, 213, 221, 224, 246
vending machine restrictions, 19, 212-214, 284