West Virginia's Sugary Drink Tax Examining Print Media Frames in Local News Sources.

Introduction: Framing is an important aspect of the policy process that helps the public and decision makers sort through and resolve highly charged claims about an issue. Through slight changes in the presentation of issues, a framing effect may alter public support. The way a proposed sugary drink tax is discussed in public discourse and by the media significantly influences policy acceptance. Given the public health significance of obesity and diabetes in West Virginia (WV) the study of media frames employed to represent a sugary drink tax policy is useful. Methods: Using quantitative content analysis, this study assessed news articles-published over 7 years by news outlets in WV-to determine the frames that were employed. Results: Pro-tax arguments appeared more often in these articles. In both pro- and anti-tax arguments, a personal behavior or economic frame appeared more frequently. The more common anti-tax arguments focused on the tax being regressive and not changing personal behavior. The pro-tax arguments focused more often on increases in state revenues and people selecting healthier beverages. Implications: Given the significance of obesity and diabetes in WV, the study of media frames that represent the sugary drink tax should provide valuable guidance to inform strategies that utilize public discourse and media coverage to influence policy acceptance. However, since WV has not been able to get approval for its sugary drink tax, it may be beneficial to examine other elements of agenda setting including issue generation tactics, mobilizing structures, and political opportunities.

The role of public policies in reducing smoking prevalence in California: results from the California tobacco policy simulation model.

Tobacco control policies are examined utilizing a simulation model for California, the state with the longest running comprehensive program. We assess the impact of the California Tobacco Control Program (CTCP) and surrounding price changes on smoking prevalence and smoking-attributable deaths. Modeling begins in 1988 and progresses chronologically to 2004, and considers four types of policies (taxes, mass media, clean air laws, and youth access policies) independently and as a package. The model is validated against existing smoking prevalence estimates. The difference in trends between predicted smoking rates from the model and other commonly used estimates of smoking prevalence for the overall period were generally small. The model also predicted some important changes in trend, which occurred with changes in policy. The California SimSmoke model estimates that tobacco control policies reduced smoking rates in California by an additional 25% relative to the level that they would have been if policies were kept at their 1988 level. By 2004, the model attributes 59% of the reduction to price increases, 28% of the overall effect to media policies, 11% to clean air laws, and only a small percent to youth access policies. The model estimates that over 5000 lives will be saved in the year 2010 alone as a result of the CTCP and industry-initiated price increases, and that over 50,000 lives were saved over the period 1988-2010. Tobacco control policies implemented as comprehensive tobacco control strategies have significantly impacted smoking rates. Further tax increases should lead to additional lives saved, and additional policies may result in further impacts on smoking rates, and consequently on smoking-attributable health outcomes in the population.

Multimethod measurement of high-risk drinking locations: extending the portal survey method with follow-up telephone interviews.

Portal survey techniques involve multimodal assessments (e.g., self-report, biologic, and observational) in high-risk drinking and drug-use settings. Our investigation expanded the portal survey methodology to include follow-up assessments of emerging adult women recruited at the border as they cross to and from Mexico south of San Diego, California. The feasibility of the follow-up procedure was established, and the limitations of the technique clarified. Follow-up participants and nonparticipants did not differ by age or reported victimization. Data indicated that 8% of women experience negative events on their return to the United States after a night of binge drinking. These experiences could only be captured in a follow-up survey, as they happened after participants left the border area.

Tobacco control policies and smoking in a population of low education women, 1992-2002.

STUDY OBJECTIVE: To examine recent trends and the role of tobacco control policies associated with smoking among women of low socioeconomic status. DESIGN: Using four waves of the nationally representative tobacco use supplement to the current population survey (TUS-CPS)--(1992-2002), the study examined trends and used multivariate logistic models of smoking prevalence among low education women to examine the role of cigarette prices, clean air regulations, and tobacco control media campaigns, while controlling for other personal characteristics. SETTING: USA. PARTICIPANTS: Women ages 18 and older who report not having completed high school, compared with other women with greater educational attainment and men ages 18 and older with less than a high school degree. MAIN RESULTS: Smoking among low education women declined at a greater rate over the study period than among more highly educated women, in contrast with trends of earlier periods. Low education women were found to be particularly responsive to media messages as well as price, especially in comparison with high education women. CONCLUSIONS: The relation between health and socioeconomic status is not immutable; selected tobacco control policies, such as tax increases and media campaigns targeting low education women, may make inroads in reducing the smoking prevalence of this population.

The potential impact of a low-nitrosamine smokeless tobacco product on cigarette smoking in the United States: estimates of a panel of experts.

OBJECTIVE: To predict the impact on tobacco use in the US of a "harm reduction" policy that requires that the smokeless tobacco product meet low nitrosamine standards, but could be marketed with a warning label consistent with the evidence of relative health risks. METHODS: Low nitrosamine smokeless tobacco (LN-SLT) and cigarette use are predicted by a panel of experts using a modified Delphi approach. We specify a thought experiment to isolate the changes that would occur after the new LN-SLT policy was implemented. RESULTS: The panel predicted that the new policy would accelerate a decrease in smoking prevalence from 1.3 to 3.1 percentage points over 5 years compared to the current SLT product policy, with greater effects on males than females. Introduction of the new product was also predicted to result in modest additional use of SLT overall, with the greatest increases among males who initiated tobacco use under the new policy. CONCLUSION: An overall consensus was reached that the introduction of a new LN-SLT product under strict regulations would increase SLT use, but reduce overall smoking prevalence. This reduction would likely yield substantial health benefits, but uncertainties surround the role of marketing and other tobacco control policies.

A note on the use of passive alcohol sensors during routine traffic stops.

OBJECTIVES: To determine whether the use of a passive alcohol sensor (PAS) in routine traffic enforcement increases the driving-under-the-influence (DUI) arrest rate of alcohol-impaired drivers. METHODS: Officers in a Maryland police department were randomly assigned to one of two groups: the first with PAS devices and the second without PAS devices (the control group). Then, the PAS units were switched from the first to the second group. Arrest, PAS, and preliminary breath-test data were collected on 714 nighttime traffic stops over two enforcement periods. RESULTS: The DUI arrest rate for the officers with and without the PAS was the same, 13%. Officers who made no arrests without the PAS benefited the most from using it. Drivers stopped for an unsafe lane change, driving over the center line, and negligent driving were arrested for DUI 35% of the time. CONCLUSIONS: The PAS appears to increase the DUI arrest rate of officers who rarely make DUI arrests, but it does not increase the DUI arrest rate of officers who normally make DUI arrests without passive sensors. It appears that it could be successful in increasing the overall number of DUI arrests for a police department if issued to, and training is provided to, patrol officers who do not normally make DUI arrests.

The role of public policies in reducing smoking prevalence and deaths: the Argentina Tobacco Policy Simulation Model.

OBJECTIVES: To compare tobacco control policies independently and as a package through a simulation model to project smoking prevalence and associated future premature mortality in Argentina beginning in 2001. METHODS: A simulation model of tobacco control policies known as SimSmoke was modified using data for Argentina on population, fertility and mortality, smoking prevalence, and tobacco control policies in effect between 2001 and 2004. We used the Argentina Tobacco Policy Simulation model (ATPSM) to consider the effect on smoking prevalence of changes in taxes and prices, clean air laws, media campaigns, cessation programs, and youth access policies on smoking initiation and cessation rates. Smoking prevalence and relative risks of smoking were used to estimate smoking-attributable mortality. The ATPSM was used to project smoking prevalence and smoking-attributable deaths during the period 2001-2034. RESULTS: The largest reductions in smoking prevalence and premature mortality were predicted for a comprehensive tobacco control policy package, but relative reductions of as much as 30% were also predicted for large tax increases. Adding a media campaign along with programs to publicize and enforce clean air laws, advertising bans, and youth access laws would further reduce smoking rates by up to 45% by the year 2034, and would save almost 16 000 lives per year. CONCLUSIONS: Tobacco control policies can substantially reduce smoking rates, which can save many lives. Without such policies, deaths from smoking, and associated medical costs, will increase. The ATPSM is expected to provide guidance in filling the most important information gaps pertinent to both modeling and policy-making in Argentina, e.g., the lack of data on initiation and cessation rates, and the need for studies on the impact of policies. Similar models might be developed for other Latin American countries.

The Healthy People 2010 smoking prevalence and tobacco control objectives: results from the SimSmoke tobacco control policy simulation model (United States).

OBJECTIVES: Healthy People 2010 (HP2010) set a goal of reducing the adult smoking prevalence to 12% by 2010. Smoking prevalence rates do not appear to be declining at or near the rate targeted in the HP2010 goals. The purpose of this paper is to examine the attainability of HP2010 smoking prevalence objectives through the stricter tobacco control policies suggested in HP2010. METHODS: A tested dynamic simulation model of smoking trends, known as SimSmoke, is applied. Smoking prevalence evolves over time through initiation and cessation, behaviors which are in turned influenced by tobacco control policies. We consider the effect of changes in taxes/prices, clean air laws, media campaigns, cessation programs and youth access policies on projected smoking prevalence over the period 2003-2020, focusing on the levels in 2010. RESULTS: The SimSmoke model projects that the aging of older cohorts and the impact of policies in years prior to 2004 will yield a reduction in smoking rates to 18.4% by 2010, which is substantially above the 2010 target of 12%. When policies similar to the HP2010 tobacco control policy objectives are implemented, SimSmoke projects that smoking rates could be reduced to 16.1%. Further reductions might be realized by increasing the tax rate by $1.00. CONCLUSIONS: The SimSmoke model suggests that the HP2010 smoking prevalence objective is unlikely to be attained. Although we are unlikely to reach the goals by meeting the HP2010 policy objectives, they could get us much closer to the goal. Emphasis should be placed on meeting the tax, clean air, media/comprehensive campaigns, and cessation treatment objectives.

The role of public policies in reducing smoking prevalence and deaths: the Argentina Tobacco Policy Simulation Model

OBJECTIVES: To compare tobacco control policies independently and as a package through a simulation model to project smoking prevalence and associated future premature mortality in Argentina beginning in 2001. METHODS: A simulation model of tobacco control policies known as SimSmoke was modified using data for Argentina on population, fertility and mortality, smoking prevalence, and tobacco control policies in effect between 2001 and 2004. We used the Argentina Tobacco Policy Simulation model (ATPSM) to consider the effect on smoking prevalence of changes in taxes and prices, clean air laws, media campaigns, cessation programs, and youth access policies on smoking initiation and cessation rates. Smoking prevalence and relative risks of smoking were used to estimate smoking-attributable mortality. The ATPSM was used to project smoking prevalence and smoking-attributable deaths during the period 2001-2034. RESULTS: The largest reductions in smoking prevalence and premature mortality were predicted for a comprehensive tobacco control policy package, but relative reductions of as much as 30 percent were also predicted for large tax increases. Adding a media campaign along with programs to publicize and enforce clean air laws, advertising bans, and youth access laws would further reduce smoking rates by up to 45 percent by the year 2034, and would save almost 16 000 lives per year. CONCLUSIONS: Tobacco control policies can substantially reduce smoking rates, which can save many lives. Without such policies, deaths from smoking, and associated medical costs, will increase. The ATPSM is expected to provide guidance in filling the most important information gaps pertinent to both modeling and policy-making in Argentina, e.g., the lack of data on initiation and cessation rates, and the need for studies on the impact of policies. Similar models might be developed for other Latin American countries.

OBJETIVOS: Se compararon las políticas de control del tabaco, independientemente y en su conjunto, mediante un modelo de simulación para proyectar la prevalencia de tabaquismo y la mortalidad prematura futura asociada con ese hábito en Argentina a partir de 2001. MÉTODOS: Se modificó un modelo de simulación de políticas de control del tabaco, conocido como SimSmoke, con los datos de población, fertilidad, mortalidad, prevalencia de tabaquismo y de las políticas de control del tabaco en efecto en Argentina entre 2001 y 2004. Se utilizó el modelo de simulación de políticas antitabáquicas de Argentina (MSPAA) para predecir el efecto sobre la prevalencia de tabaquismo que tendrían los cambios impositivos y de precios, las leyes de ambientes libres de humo, las campañas mediáticas y los programas para abandonar el hábito de fumar, y de las políticas de control del acceso de los jóvenes al tabaco sobre las tasas de inicio y abandono del tabaquismo. La prevalencia del hábito de fumar y los riesgos relativos de fumar se utilizaron para estimar la mortalidad atribuible al tabaquismo. Se empleó el MSPAA para proyectar la prevalencia de tabaquismo y las muertes atribuibles a este hábito durante el período 2001-2034. RESULTADOS: Las mayores reducciones en la prevalencia de tabaquismo y en la mortalidad prematura asociada con ese hábito se estimaron para un paquete de políticas integradas de control del tabaco, aunque se predijeron reducciones relativas de hasta 30 por ciento por grandes aumentos impositivos. La adición de campañas mediáticas junto a programas para difundir y aplicar las leyes de ambientes libres de humo, la prohibición de anuncios promocionales y las leyes que controlan el acceso de los jóvenes al tabaco podrían reducir las tasas de tabaquismo hasta en 45 por ciento para el año 2034 y salvarían casi 16 000 vidas anualmente. CONCLUSIONES: Las políticas de control del tabaco pueden reducir considerablemente las tasas de tabaquismo,...