Association of retail tobacco marketing with adolescent smoking.
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A survey of 2125 middle-school students in central California examined adolescents' exposure to tobacco marketing in stores and its association with self-reported smoking. Two thirds of sixth-, seventh-, and eighth-grade students reported at least weekly visits to small grocery, convenience, or liquor stores. Such visits were associated with a 50% increase in the odds of ever smoking, even after control for social influences to smoke. Youth smoking rates may benefit from efforts to reduce adolescents' exposure to tobacco marketing in stores. (+info)
Undoing an epidemiological paradox: the tobacco industry's targeting of US Immigrants.
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OBJECTIVES: We sought to ascertain whether the tobacco industry has conceptualized the US immigrant population as a separate market. METHODS: We conducted a content analysis of major tobacco industry documents. RESULTS: The tobacco industry has engaged in 3 distinct marketing strategies aimed at US immigrants: geographically based marketing directed toward immigrant communities, segmentation based on immigrants' assimilation status, and coordinated marketing focusing on US immigrant groups and their countries of origin. CONCLUSIONS: Public health researchers should investigate further the tobacco industry's characterization of the assimilated and non-assimilated immigrant markets, and its specific strategies for targeting these groups, in order to develop informed national and international tobacco control countermarketing strategies designed to protect immigrant populations and their countries of origin. (+info)
The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts.
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A nine-membered panel of experts was asked to determine expert opinions of mortality risks associated with use of low-nitrosamine smokeless tobacco (LN-SLT) marketed for oral use. A modified Delphi approach was employed. For total mortality, the estimated median relative risks for individual users of LN-SLT were 9% and 5% of the risk associated with smoking for those ages 35 to 49 and > or =50 years, respectively. Median mortality risks relative to smoking were estimated to be 2% to 3% for lung cancer, 10% for heart disease, and 15% to 30% for oral cancer. Although individual estimates often varied between 0% and 50%, most panel members were confident or very confident of their estimates by the last round of consultation. In comparison with smoking, experts perceive at least a 90% reduction in the relative risk of LN-SLT use. The risks of using LN-SLT products therefore should not be portrayed as comparable with those of smoking cigarettes as has been the practice of some governmental and public health authorities in the past. Importantly, the overall public health impact of LN-SLT will reflect use patterns, its marketing, and governmental regulation of tobacco products. (+info)
Evidence based? Caveat emptor!
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Medical practices, clinical practice guidelines, clinical performance measures and measurements, and a variety of health care-related administrative decisions, such as insurance coverage decisions, are claiming to be "evidence based" with increasing frequency. In this paper we examine the "evidence based" label; discuss how evidence ought to have been assembled, evaluated, and synthesized; and when evidence is sufficient for the "evidence-based" moniker to rightfully apply. We also highlight several considerations other than the strength of evidence that are relevant to several common types of health care-related administrative decisions and that influence the extent to which the resulting decisions are truly evidence based. (+info)
Skin and colon cancer media campaigns in Utah.
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The mission of the Utah Cancer Action Network is to reduce cancer incidence and mortality in Utah. Established in 2003, the network selected skin and colon cancers as the first priorities in its comprehensive plan. In its first year of operation, the network planned and implemented a cancer awareness campaign that was organized along two tracks: 1) marketing research, consisting of two telephone surveys, and 2) two advertising/awareness campaigns, one for colon cancer and one for skin cancer. The first telephone survey was conducted in January 2003 to obtain a baseline measurement of the Utah population's knowledge, attitudes, and behaviors. The advertising campaigns were launched in April 2003, and the second telephone survey was conducted in May. In January 2003, 18% of survey respondents reported seeing or hearing skin cancer prevention or sun protection announcements; in May, this percentage increased to 76%. In January, 36% indicated they had seen, read, or heard colorectal cancer early detection announcements; in May, this percentage increased to 79%. (+info)
Teaching appropriate interactions with pharmaceutical company representatives: the impact of an innovative workshop on student attitudes.
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BACKGROUND: Pharmaceutical company representatives (PCRs) influence the prescribing habits and professional behaviour of physicians. However, the skills for interacting with PCRs are not taught in the traditional medical school curriculum. We examined whether an innovative, mandatory workshop for third year medical students had immediate effects on knowledge and attitudes regarding interactions with PCRs. METHODS: Surveys issued before and after the workshop intervention solicited opinions (five point Likert scales) from third year students (n = 75) about the degree of bias in PCR information, the influence of PCRs on prescribing habits, the acceptability of specific gifts, and the educational value of PCR information for both practicing physicians and students. Two faculty members and one PCR led the workshop, which highlighted typical physician-PCR interactions, the use of samples and gifts, the validity and legal boundaries of PCR information, and associated ethical issues. Role plays with the PCR demonstrated appropriate and inappropriate strategies for interacting with PCRs. RESULTS: The majority of third year students (56%, 42/75) had experienced more than three personal conversations with a PCR about a drug product since starting medical school. Five percent (4/75) claimed no previous personal experience with PCRs. Most students (57.3%, 43/75) were not aware of available guidelines regarding PCR interactions. Twenty-eight percent of students (21/75) thought that none of the named activities/gifts (lunch access, free stethoscope, textbooks, educational CD-ROMS, sporting events) should be restricted, while 24.0% (8/75) thought that students should be restricted only from sporting events. The perceived educational value of PCR information to both practicing physicians and students increased after the workshop intervention from 17.7% to 43.2% (chi square, p = .0001), and 22.1% to 40.5% (p = .0007), respectively. Student perceptions of the degree of bias of PCR information decreased from 84.1% to 72.9% (p = .065), but the perceived degree of influence on prescribing increased (44.2% to 62.1% (p = .02)). CONCLUSIONS: Students have exposure to PCRs early in their medical training. A single workshop intervention may influence student attitudes toward interactions with PCRs. Students were more likely to acknowledge the educational value of PCR interactions and their impact on prescribing after the workshop intervention. (+info)
An extremely compensatible cigarette by design: documentary evidence on industry awareness and reactions to the Barclay filter design cheating the tar testing system.
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BACKGROUND: The Barclay cigarette (Brown & Williamson) was introduced in 1980 in the USA in the most expensive launch in history. In the USA and around the world, Barclay was later determined to have a grooved filter design that was compromised by human smokers in the normal act of smoking, but that was measured as ultra-low tar using the standard tar testing protocol. OBJECTIVES: To evaluate whether Brown & Williamson knew of the compensatability of Barclay during the design process and before it was released; to evaluate initial responses of competing tobacco companies to Barclay, before complaints were made to the Federal Trade Commission in 1981. METHODS: Internet databases of industry documents (Tobacco Documents Online, Legacy Tobacco Documents Library, Brown & Williamson Litigation discovery website, Guildford and major company websites) were searched using key words, key dates, and targeted searches. Documents related specifically to the development, evaluation and release of the Barclay cigarette and related to the responses by competing tobacco companies were examined. RESULTS: Documents indicate the manufacturer was aware of Barclay design problems and was planning, before release, to respond to criticism. Competing companies quickly detected the filter groove stratagem and considered developing their own similar filter, but eventually backed off. CONCLUSION: The design problems with Barclay were readily understood by cigarette manufacturers, including the maker of Barclay, before official governmental evaluations occurred. Testing involving measured exposures to human smokers may in the end be crucial to identifying problems with novel cigarette designs. (+info)
Market and product assessment of probiotic/prebiotic-containing functional foods and supplements manufactured in South Africa.
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OBJECTIVES: Probiotic and prebiotic products manufactured in South Africa were identified and health and content claims stated on the labels were evaluated according to available scientific evidence, the proposed South African regulations in the Foodstuffs, Cosmetics and Disinfectants Act (Act No. 54 of 1972, www.doh.gov.za), and microbial assessment. RESULTS: The range of products identified included probiotic- and/or prebiotic-containing supplements (capsules), food items fortified with probiotics and/or prebiotics, and fermented food containing probiotics, e.g. dairy products. Most of the health-related claims on the labels of the identified products do not comply with proposed South African regulations. However, results also indicate that the proposed South African regulations should be reconsidered to include an additional 5 claims, for which scientifically sound evidence is available. The claims regarding probiotic strains, viable cell numbers, prebiotic type and concentration stated on the labels of the products are mostly in line with the proposed South African regulations. The actual viable cell content of 3 out of 5 probiotic supplements readily available on the South African market did not comply with the content claim stated on the label. However, this problem did not seem to affect the inhibitory activity of the probiotic strains against indicator strains isolated from faeces of patients diagnosed with AIDS. To validate this finding in vivo assessments should be implemented before considering the need to include a wider range of prescribed viable cell numbers in the proposed South African regulations. CONCLUSIONS: The proposed South African regulations regarding probiotic- and prebiotic-containing products should be revised based on the results of this research, and the manufacturers of these products should be held responsible for providing the consumer with scientifically sound and legally correct information. (+info)