[Show abstract][Hide abstract] ABSTRACT: Background:
Research demonstrates that individuals in substance abuse treatment are more likely to die from tobacco addiction than from their primary addiction, yet historically substance abuse treatment has not included treatment for tobacco addiction. The purpose of our study was to (1) review the diffusion of state policies mandating the provision of tobacco cessation treatment as a condition of state licensure in substance abuse treatment facilities and psychiatric treatment centers and (2) describe the current landscape of policies relating to tobacco cessation in state-licensed substance abuse treatment facilities and psychiatric treatment centers.
We conducted a nationwide assessment of all 50 states from May 2013 - October 2014 to determine the progress each has made with developing a statewide tobacco cessation policy. We reviewed state government websites, conducted phone interviews with state regulatory agencies, and emailed state employees. Overall, 13 of 50 states (26 %) require tobacco cessation provision in alcohol, drug rehabilitation, and or mental health treatment centers, 6 states (12 %) are currently working towards a state policy, and 31 states (62 %) do not require tobacco cessation nor are working towards a state policy, though many of them have smoke free policies in both substance abuse centers and mental health wards.
Our updated review of statewide smoking cessation policies in alcoholic, drug abuse, and mental health populations reveals that while clinical findings that affect population health may be well-publicized in the research community, these findings are not necessarily translated into policy. Further research on policy diffusion is needed.
Preview · Article · Oct 2015 · Tobacco Induced Diseases
[Show abstract][Hide abstract] ABSTRACT: Many pharmacists have expressed a desire to become more involved in patient care, in part by being compensated for patient counseling, as well as by providing services traditionally offered by physicians and nurse practitioners. Recent efforts to develop collaborative care models, as well as major restructurings of US health insurance coverage, provide a unique opportunity for pharmacists to become recognized as independent health care providers and be reimbursed as primary care providers. Achieving that goal would require addressing advocacy challenges familiar to other health care professionals who have achieved provider status under existing reimbursement rules. Historically, political advocacy has not been a major part of pharmacy practice, or even viewed as necessary. However, pharmacists would be more politically effective with a single organization to speak for them as a profession, and with further education in advocacy.
[Show abstract][Hide abstract] ABSTRACT: Background:
Tobacco cessation therapy is not consistently provided for alcohol, drug abuse and mental health (ADM) populations, despite the enormous health consequences of tobacco addiction in these groups and research supporting the effectiveness of treatment. Policymakers, however, tend to rely on popular media reports rather than the scientific literature in regulating treatment. Our goal was to determine whether popular reporting accurately reflects findings from the scientific literature on tobacco cessation treatment for ADM populations in treatment.
We compared the results of systematic reviews on tobacco cessation therapy published before 2004 with articles published in traditional media and on the internet over the following 8 years. We searched LexisNexis and Google and assessed them using the Index of Scientific Quality (ISQ).
We found that popular reporting on this topic was consistent with findings reported in contemporaneous scientific literature. Our results suggest that the failure to consistently provide tobacco cessation therapy to ADM populations in treatment is not due to poor research translation.
Our findings also suggest that in this topic area, scientific research findings have diffused relatively quickly. Further study of journalism in this area may suggest new strategies for effective translation of scientific findings into popular reporting on tobacco control.
[Show abstract][Hide abstract] ABSTRACT: In the 1990s several American states passed term limits on legislators with the stated intention of reducing the influence of wealthy industries on career legislators. Although term limits in the United States do not have a direct relationship to public health, the tobacco industry anticipated that term limits could have indirect effects by either limiting or expanding industry influence. We detail the strategy of the tobacco industry in the wake of term limits using internal tobacco company documents and a database of campaign contributions made to legislators in term limited states between 1988 and 2002. Despite some expectations that term limits would limit tobacco industry access to state legislators, term limits appear to have had the opposite effect.
No preview · Article · Mar 2014 · Social Science [?] Medicine
[Show abstract][Hide abstract] ABSTRACT: Immigration has become an increasingly salient national issue in the US, and the Department of Justice recently increased federal efforts to prosecute immigration offenses. This shift, however, relies on the cooperation of US attorneys and their assistants. Traditionally federal prosecutors have enjoyed enormous discretion and have been responsive to local concerns. To consider how the centralized goal of immigration enforcement may have influenced federal prosecutors in regional offices, we review their prosecution of immigration offenses in California using over a decade’s worth of data. Our findings suggest that although centralizing forces influence immigration prosecutions, individual US attorneys’ offices retain distinct characteristics. Local factors influence federal prosecutors’ behavior in different ways depending on the office. Contrary to expectations, unemployment rates did not affect prosecutors’ willingness to pursue immigration offenses, nor did local popular opinion about illegal immigration.
No preview · Article · Jan 2013 · California Journal of Politics and Policy
[Show abstract][Hide abstract] ABSTRACT: This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effectiveness of tobacco cessation therapy offered concurrently with treatment for drug and alcohol addiction.
No preview · Article · Dec 2012 · Cohrane Database of Systematic Reviews
[Show abstract][Hide abstract] ABSTRACT: The "We Card" program is the most ubiquitous tobacco industry "youth smoking prevention" program in the United States, and its retailer materials have been copied in other countries. The program's effectiveness has been questioned, but no previous studies have examined its development, goals, and uses from the tobacco industry's perspective. On the basis of our analysis of tobacco industry documents released under the 1998 Master Settlement Agreement, we concluded that the We Card program was undertaken for 2 primary purposes: to improve the tobacco industry's image and to reduce regulation and the enforcement of existing laws. Policymakers should be cautious about accepting industry self-regulation at face value, both because it redounds to the industry's benefit and because it is ineffective.
Preview · Article · Jul 2010 · American Journal of Public Health
[Show abstract][Hide abstract] ABSTRACT: Scientific research has been increasingly involved in justifying public health policy changes relating to the use and taxation of tobacco, alcohol, pharmaceuticals, and food. In response, industries selling such products have developed research programs intended to prove they pose limited public health risks. Such research has historically been likely to find results palatable to funders, spurring intensive research regarding how financial conflicts of interest influence research findings. However, little research has considered whether this conflicted research is effective in shifting popular perceptions about what constitutes public health risks. We investigate how research on tobacco and pharmaceuticals is perceived relative to other public health risks in the context of eight training workshops designed to improve the understanding of scientific research. Workshops focus on the critical appraisal of research findings, including a discussion of what constitutes bias in research, and enroll 20-30 clinicians, consumer advocates, journalists, or parents of school-age children in each session. The workshop curriculum presents and critiques research studies. We analyze transcripts of the sessions for content regarding initial perceptions of health risks and assessments of credibility, and the extent to which beliefs change in the course of the workshop. Our findings suggest the extent to which conflicted research is embedded in popular perceptions of health risks.
[Show abstract][Hide abstract] ABSTRACT: We sought to identify factors that affect the passage of public health legislation by examining the use of arguments, particularly arguments presenting research evidence, in legislative debates regarding workplace smoking restrictions.
We conducted a case-study based content analysis of legislative materials used in the development of six state workplace smoking laws, including written and spoken testimony and the text of proposed and passed bills and amendments. We coded testimony given before legislators for arguments used, and identified the institutional affiliations of presenters and their position on the legislation. We compared patterns in the arguments made in testimony to the relative strength of each state's final legislation.
Greater discussion of scientific evidence within testimony given was associated with the passage of workplace smoking legislation that provided greater protection for public health, regardless of whether supporters outnumbered opponents or vice versa.
Our findings suggest that an emphasis on scientific discourse, relative to other arguments made in legislative testimony, might help produce political outcomes that favor public health.
[Show abstract][Hide abstract] ABSTRACT: Discuss the efforts of the tobacco industry to prevent the passage of airline smoking restrictions. They find that interest groups and lobbyists do not necessarily feel obligated to provide accurate information and that competing interest groups may not be able to prevent this misrepresentation.
No preview · Article · Nov 2008 · Political Science Quarterly
[Show abstract][Hide abstract] ABSTRACT: Literature suggests that 'negative advertising' is an effective way to encourage behavioral changes, but it has enjoyed limited use in public health media campaigns. However, as public health increasingly focuses on non-communicable disease prevention, negative advertising could be more widely applied. This analysis considers an illustrative case from tobacco control. Relying on internal tobacco industry documents, surveys and experimental data and drawing from political advocacy literature, we describe tobacco industry and public health research on the American Legacy Foundation's "truth" campaign, an example of effective negative advertising in the service of public health. The tobacco industry determined that the most effective advertisements run by Legacy's "truth" campaign were negative advertisements. Although the tobacco industry's own research suggested that these negative ads identified and effectively reframed the cigarette as a harmful consumer product rather than focusing solely on tobacco companies, Philip Morris accused Legacy of 'vilifying' it. Public health researchers have demonstrated the effectiveness of the "truth" campaign in reducing smoking initiation. Research on political advocacy demonstrating the value of negative advertising has rarely been used in the development of public health media campaigns, but negative advertising can effectively communicate certain public health messages and serve to counter corporate disease promotion.
Preview · Article · Nov 2008 · Health Education Research
[Show abstract][Hide abstract] ABSTRACT: In this study we analyze recent tobacco industry youth smoking prevention efforts to demonstrate corporate social responsibility. In the wake of successful tobacco control initiatives, tobacco companies have developed widely-publicized efforts to control the distribution of cigarettes and information about smoking. Many tobacco control advocates have suggested these industry efforts were developed to forestall more effective policies. Using tobacco industry documents released as part of the 1998 Master Settlement Agreement (MSA), we review the development and use of two programs developed in the wake of the MSA. We analyzed the documents iteratively to produce these linked case studies. In keeping with research on self-regulation drawn from economics, we find that these programs were extensively focus group-tested to improve the image of the tobacco industry, and drew much of their success by co-opting the reputations of independent organizations such as the National Institutes of Health. Industry appraisals suggest that these efforts have been successful in improving the image of tobacco companies and reducing the perceived need for additional regulation of tobacco. Our findings suggest that policymakers should be cautious about accepting self-regulatory behavior from industry at face value, both because it rebounds to the benefit of its sponsors and because it is far less effective than is socially optimal.
[Show abstract][Hide abstract] ABSTRACT: Regulatory theory suggests that providing agencies with multiple sanctioning options allows them to dispose promptly of less serious matters and thereby conserve resources to pursue serious offenders. However, agencies dependent on third-party monitoring may have their enforcement agendas skewed toward more trivial violations. We consider these competing expectations by analyzing enforcement actions at the US Federal Election Commission (FEC) from 1999 to 2004. The FEC – an agency heavily dependent on third-party monitoring – expanded its enforcement options in 2000 by creating two new programs to pursue low-level offenders, while leaving its monitoring strategy unchanged. We hypothesized that more sanctioning options would allow the FEC to allocate its resources more efficiently, and thus deal more effectively with the skew created by third-party monitoring. We found instead that although the FEC disposed more promptly of low-level infractions, it was no more effective at focusing on serious violations. Our results suggest that for many agencies, expanding enforcement options without addressing monitoring has limited ability to resolve enforcement problems.
Preview · Article · Jun 2008 · Regulation & Governance
[Show abstract][Hide abstract] ABSTRACT: Objectives. Describe the tobacco industry's relationships with and influence on homeless, mentally ill, and injection drug using smokers, and organizations providing services to them. Methods. We analyze internal tobacco industry documents and journal articles. Results. The tobacco industry has marketed cigarettes to the homeless, seriously mentally ill, and recovering injection drug users, part of its "downscale" market, and has developed relationships with homeless shelters, treatment centers, and advocacy groups for these populations, gaining positive media coverage and political support. Discussion. Tobacco control advocates and public health organizations should consider how to target programs to marginalized individuals. Education of service providers about tobacco industry efforts to cultivate this market may help in reducing smoking in these populations.
[Show abstract][Hide abstract] ABSTRACT: We consider how industries use front groups to combat public health measures by relating the history of “Get Government Off
Our Back”, a coalition created by the tobacco industry to fight government regulation. Using tobacco industry documents, contemporaneous
media reports, journal articles, and press releases, we review the establishment by RJ Reynolds of an industry front group,
Get Government Off Our Back (GGOOB) in 1994. The group’s goal was to advocate against U.S. federal regulation of tobacco.
By keeping its involvement secret, RJ Reynolds was able to draw public and legislative support toward limiting government
regulation of tobacco without having to address the tobacco industry’s reputation for misrepresenting evidence. Unfortunately,
the tobacco industry”s use of front groups is not unique; other industries use front groups to fight measures designed to
protect public health. Research on the background and funding of advocacy organizations could help identify industry front
groups and make them less useful to their creators.
No preview · Article · Jul 2007 · Journal für Verbraucherschutz und Lebensmittelsicherheit
[Show abstract][Hide abstract] ABSTRACT: We investigated how industries use front groups to combat public health measures by analyzing tobacco industry documents, contemporaneous media reports, journal articles, and press releases regarding "Get Government Off Our Back," a coalition created by the tobacco industry. RJ Reynolds created Get Government Off Our Back in 1994 to fight federal regulation of tobacco. By keeping its involvement secret, RJ Reynolds was able to draw public and legislative support and to avoid the tobacco industry reputation for misrepresenting evidence. The tobacco industry is not unique in its creation of such groups. Research on organizational background and funding could identify other industry front groups. Those who seek to establish measures to protect public health should be prepared to counter the argument that government should not regulate private behavior.
Preview · Article · Apr 2007 · American Journal of Public Health
[Show abstract][Hide abstract] ABSTRACT: In this paper we review the relationship between participation in legislative hearings, the use of ideological arguments, and the strength of public health legislation using a theoretical construct proposed by E. E. Schattschneider in 1960. Schattschneider argued that the breadth and types of participation in a political discussion could change political outcomes.
We test Schattschneider's argument empirically by reviewing the efforts of six states to pass Clean Indoor Air Acts by coding testimony given before legislators, comparing these findings to the different characteristics of each state's political process and the ultimate strength of each state's legislation.
We find that although greater participation is associated with stronger legislation, there is no clear relationship between the use and type of ideological arguments and eventual outcomes.
These findings offer validation of a long-standing theory about the importance of political participation, and suggest strategies for public health advocates seeking to establish new legislation.
Preview · Article · Feb 2007 · Health Research Policy and Systems
[Show abstract][Hide abstract] ABSTRACT: Using campaign contributions to legislators as an indicator of member influence, we explore the impact of term limits on the distribution of power within state legislatures. Specifically, we perform a cross-state comparison of the relative influence of party caucus leaders, committee chairs, and rank-and-file legislators before and after term limits. The results indicate that term limits diffuse power in state legislatures, both by decreasing average contributions to incumbents and by reducing the power of party caucus leaders relative to other members. The change in contribution levels across legislators in different chambers implies a shift in power to the upper chamber in states with term limits. Thus, the impact of term limits may be attenuated in a bicameral system.
[Show abstract][Hide abstract] ABSTRACT: To describe the tobacco industry's relationships with and influence on homeless and mentally ill smokers and organisations providing services to them.
Analysis of internal tobacco industry documents and journal articles.
The tobacco industry has marketed cigarettes to the homeless and seriously mentally ill, part of its "downscale" market, and has developed relationships with homeless shelters and advocacy groups, gaining positive media coverage and political support.
Tobacco control advocates and public health organisations should consider how to target programmes to homeless and seriously mentally ill individuals. Education of service providers about tobacco industry efforts to cultivate this market may help in reducing smoking in these populations.