To track smokers' responses to the increasing price of cigarettes after a tax increase, and assess socio-demographic differences in responses.
The Cancer Institute NSW's Tobacco Tracking Survey (CITTS) is a continuous tracking telephone survey. Weekly data were collected between May and September 2010.
New South Wales, Australia.
A total of 834 smokers and 163 recent quitters (quit in last 12 months).
Responses to the price increase included smoking-related changes (tried to quit, cut down) and product-related changes (changed to lower priced brands, started using loose tobacco, bought in bulk). Recent quitters were asked how much the increasing price of cigarettes influenced them to quit.
Overall, 47.5% of smokers made smoking-related changes and 11.4% made product-related changes without making smoking-related changes. Multinomial logistic regressions showed that younger smokers (versus older) were more likely to make product-related changes and smoking-related changes in comparison to no changes. Low- or moderate-income smokers (versus high-income) were more likely to make smoking-related changes compared to no changes. Highly addicted smokers (versus low addicted) were more likely to make product-related changes and less likely to make smoking-related changes. The proportion of smokers making only product-related changes decreased with time, while smoking-related changes increased. Recent quitters who quit after the tax increase (versus before) were more likely to report that price influenced them.
The effect of increasing cigarette prices on smoking does not appear to be mitigated by using cheaper cigarette products or sources. These results support the use of higher cigarette prices to encourage smoking cessation.
"These results are consistent with previous nonhuman primate (Czoty et al, 2005; Nader et al, 1992; Negus, 2003; Woolverton et al, 1997) and human laboratory (Greenwald and Hursh, 2006; Stoops et al, 2012) studies examining the behavioral determinants of drug choice. Moreover, our preclinical results may be analogous to epidemiological evidence for the price sensitivity of drug consumption, which provides a rationale for both governmental policies and more targeted contingency management strategies designed to reduce drug consumption by increasing drug price or facilitating access to nondrug alternatives (Dunlop et al, 2011; Grossman, 2005; Xu and Chaloupka, 2011). Notably, though, in the present study relatively large changes in the response requirement produced relatively modest shifts in cocaine choice. "
[Show abstract][Hide abstract] ABSTRACT: Behavioral and pharmacotherapeutic approaches constitute two prominent strategies for treating cocaine dependence. This study investigated interactions between behavioral and pharmacological strategies in a preclinical model of cocaine vs food choice. Six rhesus monkeys, implanted with a chronic indwelling double-lumen venous catheter, initially responded under a concurrent schedule of food delivery (1-g pellets, fixed-ratio (FR) 100 schedule) and cocaine injections (0-0.1 mg/kg/injection, FR 10 schedule) during continuous 7-day treatment periods with saline or the agonist medication phenmetrazine (0.032-0.1 mg/kg/h). Subsequently, the FR response requirement for cocaine or food was varied (food, FR 100; cocaine, FR 1-100; cocaine, FR 10; food, FR 10-300), and effects of phenmetrazine on cocaine vs food choice were redetermined. Decreases in the cocaine FR or increases in the food FR resulted in leftward shifts in the cocaine choice dose-effect curve, whereas increases in the cocaine FR or decreases in the food FR resulted in rightward shifts in the cocaine choice dose-effect curve. The efficacy of phenmetrazine to decrease cocaine choice varied systematically as a function of the prevailing response requirements, such that phenmetrazine efficacy was greatest when cocaine choice was maintained by relatively low unit cocaine doses. These results suggest that efficacy of pharmacotherapies to modulate cocaine use can be influenced by behavioral contingencies of cocaine availability. Agonist medications may be most effective under contingencies that engender choice of relatively low cocaine doses.Neuropsychopharmacology advance online publication, 12 September 2012; doi:10.1038/npp.2012.193.
Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 09/2012; 38(3). DOI:10.1038/npp.2012.193 · 7.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Area-level indicators of socio-economic variation are frequently included in models of individual health outcomes. Area disadvantage is linearly related to smoking prevalence, but its relation to cessation outcomes is less well understood.
To explore the relationship between area-level disadvantage and prospective data on smoking cessation.
The Australian cohort of the International Tobacco Control Four-Country Survey (N = 3503) was used to prospectively examine the contribution of area-level socio-economic disadvantage to predicting three important smoking-cessation outcomes: making a quit attempt, achieving 1 month abstinence and achieving 6 month abstinence from smoking, while controlling for individual-level socio-economic indicators and other individual-level covariates related to smoking cessation.
Only two independent associations were observed between socio-economic disadvantage and cessation outcomes. Area-level disadvantage was related to 1 month abstinence in a non-linear fashion, and the individual experience of smoking-induced deprivation was associated with a lower likelihood of making quit attempts.
Despite the documented higher prevalence of smoking among the more disadvantaged and in more disadvantaged areas, socio-economic disadvantage was not consistently related to making quit attempts, nor to medium-term success. Nevertheless, indirect effects of disadvantage, like its impact on psychological distress, cannot be ruled out, and considering smokers' individual psychosocial circumstances is likely to aid cessation efforts.
Socio-economic disadvantage, particularly at the area level, poses few direct barriers to smoking cessation.
Drug and Alcohol Review 03/2012; 31(5):653-63. DOI:10.1111/j.1465-3362.2012.00427.x · 1.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media.
Pediatric Clinics of North America 06/2012; 59(3):533–587. DOI:10.1016/j.pcl.2012.03.025 · 2.12 Impact Factor
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