A multimodal assessment of tobacco use on a university campus and support for adopting a comprehensive tobacco-free policy.

Many college campuses now prohibit tobacco use. At a private U.S. university, the current study assessed cigarette and e-cigarette use and characterized the climate for adopting a comprehensive tobacco-free policy. Data were gathered January-August 2018 via an: environmental scan; cigarette-urn audit; and representative surveys with campus community members. Despite low prevalence of tobacco (0.5%-8%) and e-cigarette use (0.9%-6%) among all groups, campus cigarette clean-up costs exceeded $114,000 for an estimated >1 million butts left on campus annually. A majority of respondents (63% of N = 2218) favored a campus-wide tobacco-free policy, 16% opposed, and 21% abstained. Most respondents endorsed benefits of supporting health (93%), ensuring tobacco-free air to breathe (92%), reducing litter (88%), preventing tobacco use (84%) and fires (83%), and helping tobacco users quit (65%). Identified challenges included policy enforcement (69%) and stigmatization of smoking (57%); 30% viewed a policy as compromising personal freedoms. In a model explaining 35% of variance in policy support, those more likely to favor comprehensive tobacco-free campus policy were Asian respondents; diagnosed with asthma; exposed to secondhand smoke on campus; who viewed campus cigarette butt litter as problematic; and identified health, prevention, and cessation benefits of a tobacco-free campus. Those less likely in favor were students, those who smoke, and those perceiving impingement upon personal freedoms, stigmatization, and broader (slippery slope) implications. Findings indicate low tobacco use prevalence among the campus community, yet a large volume of butt litter and high tobacco clean-up costs. Predictors of policy support can inform campus outreach efforts.

Promotion of tobacco products on Facebook: policy versus practice.

BACKGROUND: Facebook has a comprehensive set of policies intended to inhibit promotion and sales of tobacco products. Their effectiveness has yet to be studied. METHODS: Leading tobacco brands (388) were identified via Nielsen and Ranker databases and 108 were found to maintain brand-sponsored Facebook pages. Key indicators of alignment with Facebook policy were evaluated. RESULTS: Purchase links (eg, 'shop now' button) on brand-sponsored pages were found for hookah tobaccos (41%), e-cigarettes (74%), smokeless (50%) and cigars (31%). Sales promotions (eg, discount coupons) were present in hookah tobacco (48%), e-cigarette (76%) and cigar (69%) brand-sponsored pages. While conventional cigarettes did not maintain brand-sponsored pages, they were featured in 80% of online tobacco vendors' Facebook pages. The requirement for age gating, to exclude those <18 from viewing tobacco promotion, was absent in hookah tobacco (78%), e-cigarette (62%) and cigar (21%) brand-sponsored pages and for 90% of online tobacco stores which promote leading cigarette brands (eg, Marlboro, Camel). Many of the brand-sponsored tobacco product pages had thousands of 'likes'. CONCLUSIONS: It is laudable that Facebook has policies intended to interdict tobacco promotion throughout its platform. Nevertheless, widespread tobacco promotion and sales were found at variance with the company's policies governing advertising, commerce, page content and under age access. Vetting could be improved by automated screening in partnership with human reviewers.

Assessment of Hearing During the Early Years of the American Otological Society.

OBJECTIVE: To describe the manner in which hearing was evaluated in American Otological Practice during the late 19th and early 20th centuries before introduction of the electric audiometer. METHODS: Primary sources were the Transactions of the American Otological Society and American textbooks, especially those authored by Presidents of the Society. RESULTS: In the era before electric audiometry multiple methods were used for evaluating the thresholds of different frequencies. Tuning forks were important for lower frequencies, whisper, and speech for mid-frequencies, and Galton's whistle and Konig's rod evaluated high frequencies. Hearing threshold was often recorded as in terms of duration of a sound, or distance from the source, rather than intensity. Hearing ability was often recorded a fraction, for example, with the distance a watch tick could be heard over the distance of a normal hearing individual. A variety of devices, such as Politzer's Acoumeter, attempted to deliver sound in a calibrated manner, thus enhancing the accuracy and reproducibility of test results. CONCLUSION: The early years of the American Otological Society were marked by a number of ingenious efforts to standardize hearing assessment despite the technical limitations. These efforts facilitated the development of the audiometer, and continue to influence clinical practice even today.

The price paid: manipulation of otolaryngologists by the tobacco industry to obfuscate the emerging truth that smoking causes cancer.

OBJECTIVES/HYPOTHESIS: Our objectives were to explore the multifaceted campaign by the tobacco industry to enlist otolaryngologists in support of their efforts to reassure consumers that cigarettes were safe, and to elucidate the incentives that led so many leading otolaryngologists to give testimony denying a causal linkage between tobacco use and head and neck cancer. STUDY DESIGN: Historical analyses. METHODS: Recent litigation has exposed for public viewing a huge trove of internal tobacco industry documents. These documents include correspondence files, internal memoranda, research solicitations, grant agreements, records of payments, marketing plans, and testimony by otolaryngologists on behalf of tobacco interests in court proceedings, before congressional committees, and at U.S. Federal Trade Commission hearings. RESULTS: Evidence shows that marketing divisions of major tobacco companies systematically sought to use the authority and prestige of otolaryngologists to support their promotional efforts. Industry documents reveal widespread collaboration by leaders in the field through conducting research and giving well-compensated testimony favorable to tobacco interests. Invariably, industry-funded research showed tobacco in a favorable light. The industry also sought to influence otolaryngologists with free cigarettes, elegant dinners, and hospitality booths at conventions. CONCLUSIONS: In revealing this unfortunate period in our history, we by no means intend to diminish the memory of distinguished leaders whose tobacco involvements were certainly more acceptable by the standards of their own time. Rather, by exposing the pervasive tobacco industry manipulation of scientific research for commercial purposes we seek to encourage vigilance by contemporary researchers who might consider seeking funding from an industry that places the pursuit of profits above the well-being of its customers.

The Fickle finger of quackery in otology: the saga of Curtis H. Muncie, Osteopath.

OBJECTIVE: Throughout history, false and outrageous cures for deafness have been abundant. Most of these false remedies were short lived and did not gain much attention. However, Curtis H. Muncie, a New York osteopathic physician, accrued vast wealth and fame over a half century career (1910-1960) with his proclaimed cure of deafness through reconstruction of the Eustachian tube with his index finger. Through creative marketing, clever manipulation of the press, and outrageous claims of efficacy, he profited handsomely from what was, no doubt, the most egregious and remunerative instance of deafness quackery in 20th century otology. DATA SOURCES: A collection of original pamphlets issued by Curtis H. Muncie between 1921 and 1960 supplemented by articles from the popular press and both osteopathic and medical journals. RESULTS: The evidence that Dr. Muncie used unscientific methods and unscrupulous business practices is overwhelming. Famously, he fraudulently claimed in 1923 and for years thereafter that he had cured a congenitally deaf Spanish Prince (Don Jaime). At the height of the depression, his magical finger earned him over half a million dollars. Even his 1942 prison sentence for tax evasion did not keep him from resuming his flimflam upon his release. CONCLUSION: The story of Curtis H. Muncie is the quintessential example of how desperate patients can be exploited by an unscrupulous practitioner whose goal is satisfying his own avarice rather than curing illness.