Public Education Can Be Used to Increase Support for Equity in Cannabis Policy.

Objectives: States that are legalizing cannabis for adult use are increasingly focused on equity, with the goal of repairing some of the harm caused by the War on Drugs. This study explains and describes the emphasis states are placing on equity and assesses whether public education can be used to increase public support for equity-focused cannabis policies. Methods: We conducted an online survey of 893 New Jersey adults in August and September of 2021, just as state's Cannabis Regulatory Commission was publishing the first set of regulations for the legal sale and use of cannabis for adults age 21 and older. The study included an experimental design, in which half of respondents viewed an educational message about equity-focused cannabis policies before answering survey questions, and the other half did not. Results: Few participants (24.9%) were familiar with the concept of equity in cannabis policy, and a substantial proportion-from about 20% to 35%-provided a "neutral" or "don't know" response when asked about support for specific policies. Exposure to an educational message was associated with greater perceived importance of equity in cannabis policy (p < 0.05) and greater support for equity-focused policies. Specifically, participants who saw an educational message had greater agreement that New Jersey should provide priority licensing (p < 0.01) and grants (p < 0.001) to people who have been arrested for cannabis, and who now want to participate in the legal cannabis industry. Conclusions: Cannabis regulators, public health professionals, and people working to advance racial justice may be able to advance state equity goals and remedy some of the harm from the War on Drugs by expanding public education campaigns to include equity messages.

Estimating the return on investment of the Bureau of Tobacco Free Florida tobacco control programme from 1999 to 2015.

OBJECTIVE: To assess the return on investment (ROI) of the Florida tobacco control programme, the Bureau of Tobacco Free Florida (BTFF), in terms of healthcare expenditure savings and mortality cost saved as a result of reduced mortality due to the programme from 1999 to 2015. METHODS: We use a synthetic control method to estimate the impact of the BTFF on smoking-attributable mortality, years of life lost (YLL), healthcare expenditures, and the economic value of premature mortality due to smoking in Florida from 1999 through 2015. We calculated an ROI for healthcare expenditures and for the value of life years saved. RESULTS: From 1999 to 2015, adult smoking prevalence in Florida averaged 0.98 percentage points lower than prevalence in the synthetic control states (19.6% vs 20.6%). The ROI over the period from 1999 to 2015 was 9.61 for healthcare expenditures and 112.44 for premature mortality. These ROIs suggest that for every US$1 of expenditure by BTFF, smoking-attributable healthcare expenditures decreased by almost US$11 and reductions in the economic costs associated with YLL due to smoking-attributable mortality totaled approximately US$113. CONCLUSIONS: Our results suggest the BTFF resulted in fewer YLL, substantial healthcare cost savings and substantial savings in terms of mortality costs. The positive ROIs for healthcare expenditures and premature mortality suggest that the BTFF is a good investment of public funds.

Effect of a Statewide Media Campaign on Smoking Cessation Among Florida Adults.

INTRODUCTION: Since December 2010, Florida's Bureau of Tobacco Free Florida has aired a statewide tobacco education campaign to encourage smoking cessation. The Tobacco Free Florida campaign consists of evidence-based advertisements primarily characterized by strong emotional content and graphic imagery designed to increase awareness of the health risks of tobacco use. We evaluated the effect of the media campaign on population-level quit attempts by using a statewide representative sample of Florida adults aged 18 or older. METHODS: We examined data from 5,418 Florida adult cigarette smokers and recent quitters aged 18 or older from the Florida Adult Tobacco Survey, an annual, cross-sectional survey conducted from 2011 through 2018. The primary outcome was incidence of quit attempts in the previous 12 months. We used multivariable logistic regression models to estimate the odds of making a quit attempt as a function of advertising levels across state media markets. Rates of quit attempts in Florida were also estimated. RESULTS: Approximately 66% of smokers in the study made at least 1 quit attempt. Exposure to the campaign was associated with increased odds of a quit attempt in the previous 12 months (odds ratio = 1.25; P = .02) among smokers and recent quitters. The Tobacco Free Florida campaign was associated with an estimated 332,604 additional smokers making quit attempts per year during the study period. CONCLUSION: The Tobacco Free Florida campaign affected cessation-related behaviors in Florida over an 8-year period. Evidence-based state tobacco education campaigns can accelerate progress toward the goal of reducing adult smoking.