Reducing Underage Drinking A Collective Responsibility (2004) / Chapter Skim
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16 Youth Smoking Prevention Policy: Lessons Learned and Continuing Challenges--Paula M. Lantz
16 Youth Smoking Prevention Policy: Lessons Learned and Continuing Challenges--Paula M. Lantz
Pages 716-742
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From page 716... ...
This chapter presents a synthesis of the burgeoning literature regarding efforts to prevent or reduce youth smoking, with an emphasis on policies and intervention strategies that have parallels in efforts to reduce alcohol consumption among minors (i.e., school-based interventions; regulation regarding youth purchase, possession, and use; advertising restrictions; mass media counter-marketing campaigns; community interventions; and comprehensive tobacco control programs)
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From page 717... ...
. This chapter concludes with a discussion of key lessons learned from youth tobacco control efforts that potentially are relevant for youth alcohol policy.
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From page 718... ...
. Also, factors such as the attitudes of parents and friends/peers toward smoking, whether or not friends or peers smoke, and whether or not a parent or other family member smokes are all significantly associated with youth smoking behavior (Jacobson et al., 2001; Richter and Richter, 2001)
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From page 719... ...
MAJOR YOUTH TOBACCO CONTROL STRATEGIES AND THEIR EFFECTIVENESS School-Based Educational Interventions During the past three decades, a number of school-based tobacco use prevention programs have been implemented, primarily at the elementary school and/or middle school level. The majority of these programs have tended to be based on one of three main approaches: (1)
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From page 720... ...
enforce laws restricting the sale and distribution of tobacco products to minors, and (2) demonstrate success in reducing youth tobacco access or risk not receiving the full complement of block grant funding for substance abuse prevention and treatment.
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From page 721... ...
The majority of studies conducted in this area only explored the impact of enforcement on youth access or ability to purchase tobacco products rather than the impact on smoking rates. In studies that looked at both sales and smoking behavior, reduced sales typically did not go hand in hand with reduced smoking (Forster and Wolfson, 1998; Lantz et al., 2000)
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From page 722... ...
As with youth access laws, there is little evidence to suggest that this type of regulation has a significant impact on youth smoking behavior. As a result, some tobacco control experts have called for the shifting of research, intervention development, and advocacy resources away from this policy area (Ling, Landman, and Glantz, 2002; Fichtenberg and Glantz, 2002; Glantz, 1996)
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From page 723... ...
concluded that nearly one-third of smoking experimentation among California youth between 1993 and 1996 is attributable to tobacco industry marketing and promotional tactics. Nonetheless, the potential effects of restrictions or bans on cigarette advertising on adolescent or young adult smoking behavior remain unclear at this time.
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From page 724... ...
. Although it is difficult to evaluate the independent effects of mass media campaigns on smoking behavior, evaluation results from a number of community trials and statewide campaigns provide evidence that such interventions can be effective in reducing youth smoking.
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From page 725... ...
. Thus, a cynic might suggest that the tobacco industry -- with a primary interest in increasing industry credibility -- knows full well that this approach to youth smoking prevention is at best benign, and may actually have counterproductive effects (Jacobson et al., 2001; Novelli, 1999)
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From page 726... ...
Nonetheless, the evidence to date does suggest that tobacco excise tax increases are an effective policy strategy for reducing youth smoking. Smoke-Free Space Policies Policy efforts to restrict smoking in public spaces -- including airplanes, public/government buildings, worksites, hospitals, restaurants, bars, and hotels -- have proliferated since the 1980s.
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From page 727... ...
. Smoking Cessation Interventions In the face of rising smoking rates among adolescents, and with growing empirical evidence regarding the limitations of a number of primary prevention strategies, interest in the efficacy of youth smoking cessation interventions has grown over the past decade.
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From page 728... ...
. The Case for Community Interventions and Comprehensive Tobacco Control Programs In-depth review of the current state of youth tobacco policy suggests that a number of prevention strategies are promising, especially if conducted in a coordinated way to take advantage of potential synergies across interventions (Jacobson et al., 2001)
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From page 729... ...
In general, community interventions have multiple components that target a community at a number of different levels, including individuals, institutions, policies, and the broad social environment. Typical or common elements include an emphasis on altering the social environment or social context in which tobacco products are obtained and used, with the shared goal of creating an environment that is supportive of nonsmoking and cessation.
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From page 730... ...
To produce significant and long-lasting effects, community interventions need to be combined with taxation, strong advocacy work aimed at policy and social environment change, and strong and sustained mass media strategies. Increased understanding from community intervention studies, along with the availability of resources in most states from increases in the state tobacco excise taxes and/or from the Master Settlement Agreement, has fueled the development of coordinated state-based efforts in youth tobacco control.
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From page 731... ...
. More recently, Florida was able to increase its youth tobacco control efforts after receiving the first installment of the settlement of the Medicaid litigation with the tobacco industry.
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From page 732... ...
. DISCUSSION: LESSONS FOR YOUTH ALCOHOL POLICY The most obvious conclusion from this review is that adolescent smoking prevention efforts have had mixed results, and that there is no "magic bullet" in terms of youth tobacco control on the horizon (Jacobson et al., 2001)
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From page 733... ...
A number of different strategies -- aimed at individual, family, institutional, community, and policy levels -- need to be implemented simultaneously. As mentioned earlier, CDC recommends several components as critical in a comprehensive youth tobacco control program, all of which have parallels in efforts to reduce underage drinking.
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From page 734... ...
As mentioned, enforcement of regulations and policies on the books is considered a critical component of a comprehensive state tobacco control program. However, there is little evidence that reduced access to tobacco through enforcement of purchase, use, or possession laws has a concomitant reduction on adolescent smoking behavior.
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From page 735... ...
At this point, tobacco use prevention messages are irrelevant. Given the cost-effectiveness of smoking cessation interventions for adults, and the large number of addicted teenagers, cessation programs tailored to youth are seen as a critical part of a comprehensive tobacco control program.
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From page 736... ...
The tobacco control community has learned a great deal from efforts made in other areas of substance abuse, including youth alcohol control. Hopefully, some of the knowledge gained by the ongoing and intensive efforts made in youth smoking prevention -- knowledge gained from intervention development and evaluation, other types of research, litigation, advocacy work, and political struggles -- will be instructive for youth alcohol policy as well.
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From page 737... ...
. A meta-analysis of adolescent smoking prevention programs.
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From page 738... ...
. Youth access interventions do not affect youth smoking.
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From page 739... ...
. Investing in youth tobacco control: A review of smoking prevention and control strategies.
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From page 740... ...
. Innovative approaches to youth tobacco control: Teen smoking cessation.
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From page 741... ...
. College smoking policies and smoking cessation programs: Results of a survey of college health center directors.
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From page 742... ...
. Tobacco policy and the role of law enforcement in prevention: The value of understanding context.
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