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Kong AY, Qingzi Tao V, Golden SD. A thematic content analysis of 2010-2015 state tobacco control legislation in the United States: Bill rationales and priority populations. Prev Med Rep 2023; 36:102446. [PMID: 37840595 PMCID: PMC10570700 DOI: 10.1016/j.pmedr.2023.102446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/30/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Tobacco use causes numerous types of cancers, heart diseases, and chronic illnesses, and is responsible for nearly 1 in every 5 deaths in the United States (U.S.) annually. This study assessed whether tobacco control laws introduced in state legislatures between 2010 and 2015 provided a rationale for the proposed bill and/or specified priority population groups, and we then examined emerging themes in the text that did so. Methods Using LexisNexis® State Net®, we identified tobacco control bills introduced in all states and coded their bill rationales and population category. We then conducted qualitative thematic analysis on a sample of bills with rationales or specified populations. Results Of the 2815 tobacco control bills introduced in state legislatures in the analysis period, 422 (15.0%) included a bill rationale, and 1309 (46.5%) specified at least one priority population. Four overarching themes emerged: 1) Addressing tobacco-related health harms and financial costs incurred to society; 2) Protecting the public from tobacco-related harms as a government responsibility; 3) Providing services to priority populations; 4) Exempting or preempting some population groups and localities. Conclusions Rationalizing tobacco control legislation by focusing on both health and cost implications was a key feature of tobacco policy bill text we analyzed; given the history of this approach, it is likely to remain so in the future. Our study may serve as a benchmark for tracking current and future tobacco control legislation to examine whether there is a growth in prioritizing populations experiencing unjust burdens of tobacco use and related disease.
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Affiliation(s)
- Amanda Y. Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, 800 Stanton L Young Blvd., Oklahoma City, OK 73117, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, 655 Research Pkwy #400, Oklahoma City, OK 73104, USA
| | - Vivian Qingzi Tao
- Department of Health Behavior, University of North Carolina at Chapel Hill, 170 Rosenau Hall, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Shelley D. Golden
- Department of Health Behavior, University of North Carolina at Chapel Hill, 170 Rosenau Hall, 135 Dauer Drive, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA
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Nau T, Perry S, Giles-Corti B, Bellew W, Bauman A, Smith BJ. Mapping and analysis of laws influencing built environments for walking and cycling in Australia. BMC Public Health 2023; 23:108. [PMID: 36647061 PMCID: PMC9841659 DOI: 10.1186/s12889-022-14897-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/19/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Physical inactivity is a significant public health concern, with limited signs of improvement despite a global commitment to achieving the World Health Organization's target of 15% reduction by 2030. A systems approach is required to tackle this issue, involving the creation of environments that are conducive to physical activity. Laws represent an important tool for regulating the built environment for physical activity, are a mechanism for systems change, and have the capacity to reorient the goals and rules of a system. However, they are understudied and potentially underutilised for physical activity. Scientific legal mapping is a first step towards understanding how laws could impact the built environment to facilitate greater population physical activity. METHOD We conducted a legal assessment of state and territory laws in Australia, to systematically characterise how they address built environment considerations with specific relevance to walking and cycling. An interdisciplinary team of researchers with public health, law and urban planning expertise was formed to complete the multistage process. Key steps included a systematic search of laws using a combination of original legal research, consultation of secondary sources, and review and verification by an urban planning expert; development of a coding scheme; and completion of coding and quality control procedures. RESULTS Most jurisdictions in Australia do not currently embed objectives in primary legislation that would promote physical activity and support an integrated approach to land use and transport planning that encourages active and sustainable lifestyles. Only two jurisdictions addressed the large majority of evidence-based standards that promote active living. Of the standards addressed in law, few fully met evidence-based recommendations. While most jurisdictions legislated responsibility for enforcement of planning law, few legislated obligations for monitoring implementation. CONCLUSION Increasing physical activity is a systems issue, requiring actions across multiple sectors. An in-depth examination of the legal environment is an important step towards understanding and influencing the existing physical activity system, why it may not be generating desired outcomes, and potential opportunities for improvement. Our findings reveal opportunities where laws could be strengthened to promote more active environments. Updating this dataset periodically will generate longitudinal data that could be used to evaluate the impact of these laws on the built environment and physical activity behaviours.
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Affiliation(s)
- Tracy Nau
- grid.1013.30000 0004 1936 834XPrevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia ,grid.507593.dThe Australian Prevention Partnership Centre, Sydney, NSW Australia
| | - Sean Perry
- grid.1013.30000 0004 1936 834XThe University of Sydney Law School, Sydney, NSW Australia
| | - Billie Giles-Corti
- grid.507593.dThe Australian Prevention Partnership Centre, Sydney, NSW Australia ,grid.1017.70000 0001 2163 3550Healthy Liveable Cities Lab, RMIT University, Centre for Urban Research, Melbourne, VIC Australia
| | - William Bellew
- grid.1013.30000 0004 1936 834XPrevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia ,grid.507593.dThe Australian Prevention Partnership Centre, Sydney, NSW Australia
| | - Adrian Bauman
- grid.1013.30000 0004 1936 834XPrevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia ,grid.507593.dThe Australian Prevention Partnership Centre, Sydney, NSW Australia
| | - Ben J. Smith
- grid.1013.30000 0004 1936 834XPrevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia ,grid.507593.dThe Australian Prevention Partnership Centre, Sydney, NSW Australia
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Greene N, Johnson RM, Rosen J, German D, Cohen JE. Exploring the relationship between the alcohol policy environment and nondiscrimination laws: Implications for binge drinking disparities among LGB adults in the United States. Drug Alcohol Depend 2021; 225:108749. [PMID: 34049096 PMCID: PMC8282708 DOI: 10.1016/j.drugalcdep.2021.108749] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Alcohol policies reduce population-level binge drinking; however, they may not reduce binge drinking disparities between different populations. We examined the association between the alcohol policy environment and binge drinking among Lesbian, Gay and Bisexual (LGB) and heterosexual adults in the presence and absence of state laws protecting LGB people from discrimination. METHODS The 2015-2018 Behavioral Risk Factor Surveillance System (BRFSS) provided information about individual-level binge drinking, sexual identity, and individual-level covariates. The Alcohol Policy Scale (APS) score measures the strength of the alcohol policy environment. Presence of state-level nondiscrimination protections based on sexual orientation came from the Movement Advancement Project. Logistic regression models were used to test whether nondiscrimination statutes modified the association between the alcohol policy environment and binge drinking and whether this interaction differed for LGB and heterosexual adults. RESULTS Among women, a 10 percentage-point increase in APS score was significantly associated with 7% lower odds of binge drinking in states with inclusive nondiscrimination laws (aOR: 0.93 [95% CI: 0.89-0.97; p = 0.0003]) but was not associated with binge drinking in states without inclusive laws (aOR: 0.98 [95% CI: 0.93-1.03] p = 0.4781). Moreover, binge drinking disparities comparing lesbian/bisexual women with heterosexual women were narrower in states with inclusive nondiscrimination laws. No significant association was found among men. CONCLUSIONS Binge drinking disparities between lesbian and heterosexual women are negligible in states with inclusive laws and strong alcohol policy environments. Inclusive nondiscrimination laws are an indicator of less structural stigma directed at lesbian and bisexual women.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Renee M. Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 624 N. Broadway Street, Baltimore, MD 21205
| | - Joanne Rosen
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Joanna E. Cohen
- Department of Health, Behavior and Society; Bloomberg School of Public Health, Johns Hopkins University; 624 N. Broadway Street, Baltimore, MD 21205
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Chriqui JF, Lin W, Leider J, Shang C, Perna FM. The harmonizing effect of Smart Snacks on the association between state snack laws and high school students' fruit and vegetable consumption, United States-2005-2017. Prev Med 2020; 139:106093. [PMID: 32305581 PMCID: PMC9437874 DOI: 10.1016/j.ypmed.2020.106093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/08/2020] [Accepted: 04/11/2020] [Indexed: 01/06/2023]
Abstract
Despite national guidelines recommending daily fruit and vegetable (FV) consumption, intake of FV among adolescents is low. Over the past 10-15 years, state and federal laws have reduced the availability of junk foods in schools. This study examined the association between state snack laws and high school (HS) student FV consumption. The overall sample included 99,785 HS students (outcome samples ranged from 96,209-97,328) included in the Youth Risk Behavior Survey (YRBS). National Cancer Institute Classification of Laws Associated with School Students' data for 2004-2016 were lagged on to 2005-2017 YRBS data. Separate analyses examined the state law-youth FV consumption relationship pre- and post-federal Smart Snacks standards (effective school year 2014-2015). Analyses were conducted between 2018 and 2020. Overall, state laws were associated with any vegetable, salad, and other vegetable consumption. The relationship between state laws and vegetable consumption primarily occurred pre-Smart Snacks. Pre-Smart Snacks, state laws were associated with higher odds of youth consumption of any vegetable, salad, carrots, and other vegetables (all compared to students in states without snack laws). The only association post-Smart Snacks was between strong state laws and salads. This study illustrates the important role that standards restricting the availability of junk foods in schools can have on increasing student vegetable consumption. Given current efforts to roll-back federal school meal standards, findings from this study illustrate how federal standards harmonized the patchwork of state laws that existed prior to Smart Snacks and the important role that consistent national standards can play in supporting student consumption of vegetables.
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Affiliation(s)
- Jamie F Chriqui
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Chicago, IL 60608, USA; Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor Street, M/C 923, Chicago, IL 60612, USA.
| | - Wanting Lin
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Chicago, IL 60608, USA.
| | - Julien Leider
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Chicago, IL 60608, USA.
| | - Ce Shang
- Department of Internal Medicine, The Ohio State University, USA.
| | - Frank M Perna
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, USA.
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Roberts SCM, Berglas NF, Subbaraman MS, Mericle A, Thomas S, Kerr WC. Racial differences in the relationship between alcohol/pregnancy policies and birth outcomes and prenatal care utilization: A legal epidemiology study. Drug Alcohol Depend 2019; 201:244-252. [PMID: 31255852 PMCID: PMC6774667 DOI: 10.1016/j.drugalcdep.2019.04.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES State policies regarding alcohol use during pregnancy (alcohol/pregnancy policies) have been in effect for more than 40 years. Previous research finds some policies increase adverse birth outcomes and decrease prenatal care utilization. This research examines whether effects of alcohol/pregnancy policies vary by race; the general hypothesis is that health benefits of policies are concentrated among White women and health harms of policies are concentrated among Black women. METHODS This study uses 1972-2015 Vital Statistics data and policy data from NIAAA's Alcohol Policy Information System and original legal research. The dataset includes more than 150 million singleton births. Outcomes are preterm birth (PTB), low birthweight (LBW), and prenatal care utilization. Logistic regression models include raceXpolicy interaction terms as main predictors, adjust for individual- and state-level controls, include fixed effects for state, year and state-specific time trends, and account for clustering by state. RESULTS The impact of alcohol/pregnancy policies varied by race for preterm birth, varied in a few cases for low birthweight, and generally did not vary for prenatal care utilization. The hypothesis regarding the direction of differential effects was not supported. Six policies had an adverse impact on PTB and/or LBW for White women. Findings differed for Black women; for Black women, four policies had a beneficial impact for PTB and one had an adverse impact for LBW. CONCLUSIONS The impact of alcohol/pregnancy policies on birth outcomes varies by race. Future research should explore why some policies appear to have opposite effects for White v. Black women.
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Affiliation(s)
- Sarah C M Roberts
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, United States.
| | - Nancy F Berglas
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, United States
| | - Meenakshi S Subbaraman
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, United States
| | - Amy Mericle
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, United States
| | - Sue Thomas
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, United States
| | - William C Kerr
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, United States
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