Peer crowd segmentation for targeting public education campaigns: Hip hop youth and tobacco use

This study examines the potential association between strength of Hip Hop peer crowd identification and tobacco use in one of the first large samples of Hip Hop youth in the United States. Data are from a geographically-targeted, address-based convenience sample of 2194 youths aged 12–17 who identify with the Hip Hop peer crowd collected via in-person and web interviews in 30 U.S. media markets in 2015. We examined strength of Hip Hop peer crowd identification, perceived peer tobacco use, and tobacco use outcomes. Overall, 18.3% of Hip Hop youth reported current blunt (cigar with added marijuana) use, followed by electronic cigarettes (e-cigarettes) (11.6%), cigar (without added marijuana) (8.8%), hookah (6.5%), and cigarette (5.6%) use. Stronger Hip Hop peer crowd identification was associated with increased odds of using cigarettes (OR = 2.25, p < 0.05), cigars (OR = 2.14, p < 0.05), and blunts (OR = 1.61, p < 0.05), controlling for demographic characteristics and perceived peer tobacco use. Results suggest that a Hip Hop peer crowd–targeted public education prevention campaign for youth can be promising for a variety of tobacco products.

Barriers to Mental Health Treatment Utilization in Wards 7 and 8 in Washington, DC: A Qualitative Pilot Study

Purpose: There is a paucity of data on barriers to mental health treatment utilization among residents of Wards 7 and 8 in Washington, DC, despite exposure to many environmental factors that are associated with poor mental health outcomes and the high prevalence of mental health problems among residents. The objective of this study was to examine barriers to mental healthcare utilization among residents of Wards 7 and 8.

Methods: This study included semi-structured, in-depth interviews with five key informants who lived or spent significant time in Wards 7 or 8 in Washington, DC, which are the wards served by Paving the Way MSI, a behavioral health clinic that served as a partner organization in the study.

Results: Barriers to mental health treatment utilization existed at a variety of social-ecological levels, including the individual/interpersonal level, the provider/mental health system level, the community level, and the societal level. Major barriers included fear and trust/distrust in the medical system, lack of social support, the model of mental healthcare, lack of patient-centered care, limited access to mental health services, stigma of mental illness and mental health treatment, and poverty.

Conclusion: This study highlights the need to address barriers to mental health treatment utilization at multiple social-ecological levels. Future studies should examine perspectives from residents with mental health problems in these wards to gain a more thorough understanding of the barriers to treatment. Funding is needed to support efforts to increase mental health treatment utilization among residents of Wards 7 and 8.

Public and Opinion Leader Willingness to Fund Obesity-Focused Policies in Kansas

Obesity increases the risk for leading causes of death, including cardiovascular disease and some cancers. Midwestern and southern states have the highest obesity rates-in Kansas, one in every three adults is obese. We compared the willingness of Kansas adults and opinion leaders to pay more in taxes to fund obesity prevention policies. In 2014, we asked a representative sample of 2,203 Kansas adults (response rate 15.7%) and 912 opinion leaders (response rate 55%) drawn from elected office and other sectors, including business and health, whether they would pay an additional $50 in annual taxes to support five policies that improve access to healthy foods and opportunities for physical activity. We used adjusted Wald tests to compare public and opinion leaders' responses, and regression analysis to assess whether differences in respondents' gender, age, location (urban/rural), race/ethnicity, and political stance affected results. Adjusting for demographic differences, Kansas adults were more willing than opinion leaders to pay $50 in taxes for each of the five policy interventions. This study demonstrates a willingness among residents of a fiscally conservative state to pay increased taxes for policies that could reduce population obesity rates. Health professionals, including nurses, can use these findings to educate policy makers in Kansas and geopolitically similar states about widespread public support for obesity prevention policies. Public health and other nurses could also apply our methods to assess support for obesity prevention policies in their jurisdictions.

Public Attitudes and Support for a Sugar-Sweetened Beverage Tax in America's Heartland

BACKGROUND

Policy and environmental strategies are part of a comprehensive approach to obesity prevention. We investigated the association between public attitudes about how the environment influences health and support for a sugar-sweetened beverage (SSB) tax in Kansas.

METHOD

We collected data via a 2014 representative dual-frame (cellular and landline) telephone survey of 2,203 adult Kansans regarding healthy eating policy support and beliefs about obesity causes and solutions.

RESULTS

A significant proportion of Kansas adults (40%) support an SSB tax. Support was significantly stronger among females, young people, and liberals. Causal and responsibility attributions of obesity were significantly associated with policy support. Individuals who attribute more responsibility for the solution to the obesity epidemic to environmental factors were more likely to support a tax, regardless of their political affiliation.

CONCLUSIONS

Messaging that focuses on the role of the environment in creating opportunities for health may be useful in framing discussions around SSB taxes.

Support for a ban on tobacco powerwalls and other point-of-sale displays: findings from focus groups

This study uses focus group data to document consumer perceptions of powerwall and other point-of-sale (POS) tobacco displays, and support for a ban on tobacco displays. Four focus groups were conducted in 2012 by a trained moderator. The study comprised 34 adult residents of New York State, approximately half with children under age 18 years living at home. Measures used in the study were awareness and perceptions of powerwall and other POS displays, and level of support for a ban on tobacco displays. Analysis focused on perceptions of powerwall and other POS displays, level of support for a ban on tobacco displays and reasons participants oppose a display ban. This study documents a general lack of concern about tobacco use in the community, which does not appear to be associated with support for a ban on POS tobacco displays. Although all participants had seen tobacco powerwalls and most considered them to be a form of advertising, participants were divided as to whether they played a role in youth smoking. Additional research is warranted to determine what factors individuals weigh in assigning value to a ban on POS tobacco displays and other tobacco control policies and how educational efforts can influence those assessments.

Research support for effective state and community tobacco control programme response to electronic nicotine delivery systems

Objective

To identify unmet research needs of state and community tobacco control practitioners pertaining to electronic nicotine delivery systems (ENDS or e-cigarettes) that would inform policy and practice efforts at the state and community levels, and to describe ENDS-related research and dissemination activities of the National Cancer Institute-funded State and Community Tobacco Control Research Initiative.

Methods

To determine specific research gaps relevant to state and community tobacco control practice, we analysed survey data collected from tobacco control programmes (TCPs) in all 50 US states and the District of Columbia (N=51). Survey items covered a range of ENDS issues: direct harm to users, harm of secondhand vapour, cessation, flavours, constituents and youth access.

Results

There is no ENDS topic on which a majority of state TCP managers feel very informed. They feel least informed about harms of secondhand vapour while also reporting that this information is among the most important for their programme. A majority (N=31) of respondents indicated needs for research on the implications of ENDS products for existing policies.

Conclusions

TCP managers report that ENDS research is highly important for practice and need research-based information to inform decision making around the inclusion of ENDS in existing tobacco control policies. For optimal relevance to state and community TCPs, research on ENDS should prioritise study of the health effects of ENDS use and secondhand exposure to ENDS vapour in the context of existing tobacco control policies.

The Haverstraw experience: the first tobacco product display ban in the United States

In April 2012, the village of Haverstraw, New York, passed the first tobacco retail display ban in the United States. Community groups funded by the New York State Department of Health Tobacco Control Program mobilized community members to support an initiative to protect youths in their area from tobacco marketing via methods consistent with a community transformation framework. The law was soon rescinded after 7 tobacco companies and the New York Association of Convenience Stores filed a federal lawsuit against the village that challenged the law's constitutionality. We discuss lessons learned and next steps for adoption of local point-of-sale policies.

Public and policy maker support for point-of-sale tobacco policies in New York

PURPOSE

To compare public and policy maker support for three point-of-sale tobacco policies.

DESIGN

Two cross-sectional surveys--one of the public from the New York Adult Tobacco Survey and one of policy makers from the Local Opinion Leader Survey; both collected and analyzed in 2011.

SETTING

Tobacco control programs focus on educating the public and policy makers about tobacco control policy solutions.

SUBJECTS

Six hundred seventy-six county-level legislators in New York's 62 counties and New York City's five boroughs (response rate: 59%); 7439 New York residents aged 18 or older. Landline response rates: 20.2% to 22%. Cell phone response rates: 9.2% to 11.1%.

MEASURES

Gender, age, smoking status, presence of a child aged 18 years or younger in the household, county of residence, and policy maker and public support for three potential policy solutions to point-of-sale tobacco marketing.

ANALYSIS

t-tests to compare the demographic makeup for the two samples. Adjusted Wald tests to test for differences in policy support between samples.

RESULTS

The public was significantly more supportive of point-of-sale policy solutions than were policy makers: cap on retailers (48.0% vs. 19.2%, respectively); ban on sales at pharmacies (49.1% vs. 38.8%); and ban on retailers near schools (53.3% vs. 42.5%).

LIMITATIONS

cross-sectional data, sociodemographic differences, and variations in item wording.

CONCLUSIONS

Tobacco control programs need to include information about implementation, enforcement, and potential effects on multiple constituencies (including businesses) in their efforts to educate policy makers about point-of-sale policy solutions.

The changing marketing of smokeless tobacco in magazine advertisements

INTRODUCTION

Concerns about secondhand smoke, increasing indoor smoking bans, and health concerns regarding cigarettes are contributing to the development of new smokeless tobacco (ST) products by the tobacco industry and the repositioning of traditional ST products. The objective of this research was to systematically document the changing advertising strategies and themes of the ST industry.

METHODS

Using descriptive content analysis, this study analyzed 17 nationally circulated magazines for ST advertisements (ads) from 1998-1999 and 2005-2006, recording both magazine and advertisement characteristics (e.g., themes, selling proposition, people portrayed, and setting/surroundings.) Ninety-five unique ads were found during the two time periods-occurring with total frequency of 290 ad placements in 816 issues. One hundred ninety-one ads were found in the 2005-2006 sample, while 99 were found in the 1998-1999 magazines.

RESULTS

Significant differences in ST ads were identified between time periods and magazine types. A greater percentage of ads were found in the latter time period, and the average number of ads per issue increased (0.24 in 1998-1999 and 0.49 in 2005-2006, p < .001). More recent magazines and general adult magazines contained a greater proportion of flavored products, "alternative to cigarette" messages, and indoor settings when compared with earlier magazines and men's magazines, respectively.

CONCLUSIONS

While continuing to advertise in men's magazines with themes appealing to men and "traditional" ST users, the ST industry appears to be simultaneously changing its message placement and content in order to include readers of general adult magazines who may not currently use ST.