Influence peddling
Master Settlement Agreement (MSA) Spending and Tobacco Control Efforts
Jayani Jayawardhana et al.
PLoS ONE, December 2014
Abstract:
We investigate whether the distributions to the states from the Tobacco Master Settlement Agreement (MSA) in 1998 is associated with stronger tobacco control efforts. We use state level data from 50 states and the District of Columbia from four time periods post MSA (1999, 2002, 2004, and 2006) for the analysis. Using fixed effect regression models, we estimate the relationship between MSA disbursements and a new aggregate measure of strength of state tobacco control known as the Strength of Tobacco Control (SoTC) Index. Results show an increase of $1 in the annual per capita MSA disbursement to a state is associated with a decrease of −0.316 in the SoTC mean value, indicating higher MSA payments were associated with weaker tobacco control measures within states. In order to achieve the initial objectives of the MSA payments, policy makers should focus on utilizing MSA payments strictly on tobacco control activities across states.
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Frank Samson
Social Science & Medicine, February 2015, Pages 164–168
Abstract:
Racial resentment (also known as symbolic racism) is among the most widely tested measures of contemporary prejudice in political science and social psychological research over the past thirty years. Proponents argue that racial resentment reflects anti-black emotion obtained through pre-adult socialization. In light of affect-based models of substance use, this paper examined the association between racial resentment and smoking in a national sample of non-Hispanic white, black, and Hispanic respondents. Data come from the 2012 American National Election Study, which contained two measures of smoking. The results of ordinal logistic regression models indicate a positive association between racial resentment and smoking among non-Hispanic whites (N = 2133) that is not present among blacks (N = 693) or Hispanics (N = 660). Models controlled for age, education, income, gender, political ideology, region, and mode of interview. Furthermore, analyses indicated that a measure of race-related affect, admiration and sympathy towards blacks, partially mediated the association between racial resentment and smoking. For non-Hispanic whites, racial resentment appears to constitute a risk factor for smoking. Future studies should further specify the conditions linking substance use to the race-related affective component of racial resentment.
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The effects of responsible drinking messages on attentional allocation and drinking behavior
Antony Moss et al.
Addictive Behaviors, forthcoming
Aims: Four experiments were conducted to assess the acute impact of context and exposure to responsible drinking messages (RDM) on attentional allocation and drinking behaviour of younger drinkers and to explore the utility of lab-based methods for the evaluation of such materials.
Methods: A simulated bar environment was used to examine the impact of context, RDM posters, and brief online responsible drinking advice on actual drinking behaviour. Experiments one (n = 50) and two (n = 35) comprised female non-problem drinkers, while Experiments three (n = 80) and 4 (n = 60) included a mixed-gender sample of non-problem drinkers, recruited from an undergraduate student cohort. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess drinking patterns. Alcohol intake was assessed through the use of a taste preference task.
Results: Drinking in a simulated bar was significantly greater than in a laboratory setting in the first two studies, but not the third. There was a significant increase in alcohol consumption as a result of being exposed to RDM posters. Provision of brief online RDM reduced the negative impact of these posters somewhat; however the lowest drinking rates were associated with being exposed to neither posters nor brief advice. Data from the final experiment demonstrated a low level of visual engagement with RDMs, and that exposure to posters was associated with increased drinking.
Conclusions: Poster materials promoting responsible drinking were associated with increased consumption amongst undergraduate students, suggesting that poster campaigns to reduce alcohol harms may be having the opposite effect to that intended. Findings suggest that further research is required to refine appropriate methodologies for assessing drinking behaviour in simulated drinking environments, to ensure that future public health campaigns of this kind are having their intended effect.
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Applying Farr’s Law to project the drug overdose mortality epidemic in the United States
Salima Darakjy et al.
Injury Epidemiology, December 2014
Background: Unintentional drug overdose has increased markedly in the past two decades and surpassed motor vehicle crashes as the leading cause of injury mortality in many states. The purpose of this study was to understand the trajectory of the drug overdose epidemic in the United States by applying Farr’s Law. Farr’s “law of epidemics” and the Bregman-Langmuir back calculation method were applied to United States drug overdose mortality data for the years 1980 through 2011 to project the annual death rates from drug overdose from 2012 through 2035.
Findings: From 1980–2011, annual drug overdose mortality increased from 2.7 to 13.2 deaths per 100,000 population. The projected drug overdose mortality would peak in 2016–2017 at 16.1 deaths per 100,000 population and then decline progressively until reaching 1.9 deaths per 100,000 population in 2035.
Conclusion: The projected data based on Farr’s Law suggests that drug overdose mortality in the United States will decline in the coming years and return to the 1980 baseline level approximately by the year 2034.
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Changes in Alcohol Consumption: United States, 2001-2 to 2012-13
Deborah Dawson et al.
Drug and Alcohol Dependence, forthcoming
Background: Documenting changes in alcohol consumption is critical for assessing future health service and alcohol treatment needs, evaluating efforts to modify drinking behavior and understanding the impact of shifting demographics and social norms. For the period since the year 2000, published data on drinking trends have been scarce and inconsistent.
Methods: Using data from two large, nationally representative surveys of U.S. adults (2001-2002 and 2012-2013) that contained virtually identical questions on consumption, we assessed differences by period in the prevalence of drinking, volume of intake, frequency of drinking and prevalence of ≥monthly heavy episodic drinking (HED) and determined whether changes in consumption were consistent across beverage types and in population subgroups.
Results: Between 2001-2002 and 2012-2013, the prevalence of drinking increased, as did volume and frequency of drinking and prevalence of ≥monthly HED among drinkers. Increases were greater for women than men for all measures and smaller among the formerly married for consumption among drinkers. The increase in overall drinking prevalence was magnified among all race-ethnic minorities, whereas the increase in ≥monthly HED was magnified only among Blacks (all relative to Whites).
Conclusions: Our findings are suggestive of a “wetter” drinking climate in 2012-2013 than in 2001-2002, indicating the need for continued and expanded efforts to prevent chronic and episodic heavy alcohol consumption. Given the across-the-board increases in alcohol consumption in recent years, policy efforts that address drinking at the population level are supported, even if specific drinking behaviors and subgroups of drinkers are additionally targeted for individualized approaches.
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The Combined Effects of Alcohol and Cannabis on Driving: Impact on Crash Risk
Sacha Dubois et al.
Forensic Science International, forthcoming
Background/objectives: Driving under the influence of alcohol or cannabis alone is associated with increased crash risk. This study explores the combined influence of low levels of alcohol (BAC ≤ .08) and cannabis on crash risk.
Materials and Methods: Drivers aged 20 years or older who had been tested for both drugs and alcohol after involvement in a fatal crash in the United States (1991-2008) were examined using a case-control design. Cases were drivers with at least one potentially unsafe driving action (UDA) recorded in relation to the crash (e.g., weaving); controls had none recorded. We examined the prevalence of driving under the influence of alcohol, cannabis, and both agents, for drivers involved in a fatal crash. Adjusted odds ratios of committing an UDA for alcohol alone, THC alone, and their combined effect were computed via logistic regression and adjusted for a number of potential confounders.
Results: Over the past two decades, the prevalence of THC and alcohol in car drivers involved in a fatal crash has increased approximately five-fold from below 2% in 1991 to above 10% in 2008. Each .01 BAC unit increased the odds of an UDA by approximately 9-11%. Drivers who were positive for THC alone had 16% increased odds of an UDA. When alcohol and THC were combined the odds of an UDA increased by approximately 8-10% for each .01 BAC unit increase over alcohol or THC alone.
Conclusion: Drivers positive for both agents had greater odds of making an error than drivers positive for either alcohol or cannabis only. Further research is needed to better examine the interaction between cannabis concentration levels, alcohol, and driving. This research would support enforcement agencies and public health educators by highlighting the combined effect of cannabis at low BAC levels.
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Understanding the Gradient in Children's Health: Cigarette Taxes, Asthma, and Inequality
Moiz Bhai
University of Illinois Working Paper, December 2014
Abstract:
The origins of inequality have roots in childhood. Childhood asthma, the most common disease affecting children, disproportionately affects minority and lower SES children. Decades of research shows a strong association between tobacco exposure and respiratory illnesses. By exploiting exogenous variation in cigarette taxes across states and time, I estimate the causal impact of early life tobacco exposure on measures of children’s well-being such as asthma, asthma severity, self-reported health, and school absences. I find economically and statistically significant impacts of cigarette taxes in improving children’s health: a one dollar increase in cigarette taxes reduces the prevalence of asthma by 3.4 percentage points, and raises school attendance by nearly half a day. The largest reductions in asthma are seen in children from the poorest households. Subsequently, decomposing the asthma gap reveals that differences in responses to cigarette taxes by SES can explain three quarters of the gap in asthma prevalence.
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Crystal Clear? The Relationship Between Methamphetamine Use and Sexually Transmitted Infections
Hugo Mialon, Erik Nesson & Michael Samuel
Health Economics, forthcoming
Abstract:
Public health officials have cited methamphetamine control as a tool with which to decrease HIV and other sexually transmitted infections, based on previous research that finds a strong positive correlation between methamphetamine use and risky sexual behavior. However, the observed correlation may not be causal, as both methamphetamine use and risky sexual behavior could be driven by a third factor, such as a preference for risky behavior. We estimate the effect of methamphetamine use on risky sexual behavior using monthly data on syphilis diagnoses in California and quarterly data on syphilis, gonorrhea, and chlamydia diagnoses across all states. To circumvent possible endogeneity, we use a large exogenous supply shock in the US methamphetamine market that occurred in May 1995 and a later shock stemming from the Methamphetamine Control Act, which went into effect in October 1997. While the supply shocks had large negative effects on methamphetamine use, we find no evidence that they decreased syphilis, gonorrhea, or chlamydia rates. Our results have broad implications for public policies designed to decrease sexually transmitted infection rates.
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An Extended Swedish National Adoption Study of Alcohol Use Disorder
Kenneth Kendler et al.
JAMA Psychiatry, forthcoming
Objective: To determine to what extent genetic and environmental factors contribute to the risk for AUD.
Design, Setting, and Participants: Follow-up in 8 public data registers of adoptees, their biological and adoptive relatives, and offspring and parents from stepfamilies and not-lived-with families in Sweden. In this cohort study, subtypes of AUD were assessed by latent class analysis. A total of 18 115 adoptees (born 1950-1993) and 171 989 and 107 696 offspring of not-lived-with parents and stepparents, respectively (born 1960-1993).
Results: Alcohol use disorder in adoptees was significantly predicted by AUD in biological parents (odds ratio, 1.46; 95% CI, 1.29-1.66) and siblings (odds ratio, 1.94; 95% CI, 1.55-2.44) as well as adoptive parents (odds ratio, 1.40; 95% CI, 1.09-1.80). Genetic and environmental risk indices created from biological and adoptive relatives acted additively on adoptee AUD liability. Results from biological and adoptive relatives were replicated and extended from examinations of, respectively, not-lived-with parents and stepparents. Multivariate models in these families showed that AUD in offspring was significantly predicted by AUD, drug abuse, psychiatric illness, and crime in not-lived-with parents and by AUD, drug abuse, crime, and premature death in stepparents. Latent class analyses of adoptees and offspring of not-lived-with parents with AUDs revealed 3 AUD classes characterized by (1) female preponderance and high rates of psychiatric illness, (2) mild nonrecurrent symptoms, and (3) early-onset recurrence, drug abuse, and crime. These classes had distinct genetic signatures in the patterns of risk for various disorders in their not-lived-with parents and striking differences in the rates of recorded mood disorders.
Conclusions and Relevance: Parent-offspring transmission of AUD results from both genetic and environmental factors. Genetic risk for AUD reflects both a specific liability to AUD and to other externalizing disorders. Environmental risk reflects features of both parental psychopathology and other aspects of the rearing environment. Alcohol use disorder is a heterogeneous syndrome and meaningful subtypes emerged from latent class analysis, which were validated by patterns of disorders in biological parents and specific psychiatric comorbidities. The general population contains informative family constellations that can complement more traditional adoption designs in clarifying the sources of parent-offspring resemblance.
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Smoking is associated with mosaic loss of chromosome Y
Jan Dumanski et al.
Science, 2 January 2015, Pages 81-83
Abstract:
Tobacco smoking is a risk factor for numerous disorders, including cancers affecting organs outside the respiratory tract. Epidemiological data suggest that smoking is a greater risk factor for these cancers in males compared to females. This observation, together with the fact that males have a higher incidence of and mortality from most non–sex-specific cancers, remains unexplained. Loss of chromosome Y (LOY) in blood cells is associated with increased risk of nonhematological tumors. We demonstrate here that smoking is associated with LOY in blood cells in three independent cohorts [TwinGene: odds ratio (OR) = 4.3, 95% CI = 2.8–6.7; ULSAM: OR = 2.4, 95% CI = 1.6–3.6; and PIVUS: OR = 3.5, 95% CI = 1.4–8.4] encompassing a total of 6014 men. The data also suggest that smoking has a transient and dose-dependent mutagenic effect on LOY status. The finding that smoking induces LOY thus links a preventable risk factor with the most common acquired human mutation.
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Do alcohol taxes in Europe and the US rightly correct for externalities?
Evan Herrnstadt, Ian Parry & Juha Siikamäki
International Tax and Public Finance, February 2015, Pages 73-101
Abstract:
We develop an analytical framework for assessing corrective taxes and other policies to reduce alcohol-related externalities and apply it to the US, UK, Sweden, and Finland. The corrective tax estimates for the European countries fall short of current taxes and vice versa for the US (where drunk-driving externalities are larger and current taxes smaller). Alcohol sales restrictions are more difficult to justify on efficiency grounds as (unlike taxes) they involve large, first-order deadweight losses. For all countries, the efficiency case for stiffer drunk driver fines seems strong (though the same does not necessarily apply to non-pecuniary penalties).
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M. Shankleman et al.
Public Health, forthcoming
Objective: To investigate whether standardised cigarette packaging increases the time spent looking at health warnings, regardless of the format of those warnings.
Study design: A factorial (two pack styles x three warning types) within-subject experiment, with participants randomised to different orders of conditions, completed at a university in London, UK.
Methods: Mock-ups of cigarette packets were presented to participants with their branded portion in either standardised (plain) or manufacturer-designed (branded) format. Health warnings were present on all packets, representing all three types currently in use in the UK: black & white text, colour text, or colour images with accompanying text. Gaze position was recorded using a specialised eye tracker, providing the main outcome measure, which was the mean proportion of a five-second viewing period spent gazing at the warning-label region of the packet.
Results: An opportunity sample of 30 (six male, mean age = 23) young adults met the following inclusion criteria: 1) not currently a smoker; 2) <100 lifetime cigarettes smoked; 3) gaze position successfully tracked for > 50% viewing time. These participants spent a greater proportion of the available time gazing at the warning-label region when the branded section of the pack was standardised (following current Australian guidelines) rather than containing the manufacturer's preferred design (mean difference in proportions = 0.078, 95% confidence interval 0.049 to 0.106, p < 0.001). There was no evidence that this effect varied based on the type of warning label (black & white text vs. colour text vs. colour image & text; interaction p = 0.295).
Conclusions: During incidental viewing of cigarette packets, young adult never-smokers are likely to spend more time looking at health warnings if manufacturers are compelled to use standardised packaging, regardless of the warning design.
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Young adult cannabis users report greater propensity for risk-taking only in non-monetary domains
Jodi Gilman et al.
Drug and Alcohol Dependence, forthcoming
Background: Though substance use is often associated with elevated risk-taking in real-world scenarios, many risk-taking tasks in experimental psychology using financial gambles fail to find significant differences between individuals with substance use disorders and healthy controls. We assessed whether participants using marijuana would show a greater propensity for risk-taking in distinct domains including, but not limited to, financial risk-taking.
Methods: In the current study, we assessed risk-taking in young adult (age 18–25) regular marijuana users and in non-using control participants using a domain-specific risk-taking self-report scale (DOSPERT) encompassing five domains of risk-taking (social, financial, recreational, health/safety, and ethical). We also measured behavioral risk-taking using a laboratory monetary risk-taking task.
Results: Marijuana users and controls reported significant differences on the social, health/safety, and ethical risk-taking scales, but no differences in the propensity to take recreational or financial risks. Complementing the self-report finding, there were no differences between marijuana users and controls in their performance on the laboratory risk-taking task.
Conclusions: These findings suggest that financial risk-taking may be less sensitive than other domains of risk-taking in assessing differences in risky behavior between those who use marijuana and those who do not. In order to more consistently determine whether increased risk-taking is a factor in substance use, it may be necessary to use both monetary risk-taking tasks and complementary assessments of non-monetary-based risk-taking measures.
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Cigarette price variation around high schools: Evidence from Washington DC
Jennifer Cantrell et al.
Health & Place, January 2015, Pages 193–198
Abstract:
This study examines lowest cigarette prices in all tobacco retail outlets in Washington D.C. (n=750) in relation to the type and number of high schools nearby, controlling for confounders. The lowest overall and Newport menthol prices were significantly lower at outlets near public non-charter and charter schools compared with outlets near private schools. Given higher smoking prevalence and more price-sensitive youth subgroups in U.S. public schools, exposure to low prices may contribute to tobacco-related health disparities in minority and low-income populations. Tobacco taxes combined with policies to minimize the increasing use of price as a marketing tool are critical.
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Substance-Abuse Treatment and Mortality
Isaac Swensen
Journal of Public Economics, February 2015, Pages 13–30
Abstract:
Drug-overdose deaths, which have more than doubled over the past decade, represent a growing public-health concern. Though substance-abuse treatment may be effective in reducing drug abuse, evidence for a causal effect of treatment on drug-related mortality is lacking. I analyze the effect of substance-abuse treatment on mortality by exploiting county-level variation in treatment facilities driven by facility openings and closings. The estimates indicate that a 10-percent increase in facilities lowers a county’s drug-induced mortality rate by 2 percent. The estimated effects persist across individual and county characteristics and further indicate that spillovers of treatment reduce other related causes of death.
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Eric Stice et al.
Appetite, February 2015, Pages 155–159
Objective: Although young women often report smoking for weight control purposes, no prospective study has tested whether smokers subsequently gain less weight over time than non-smokers. As this is an important lacuna because smoking results in greater mortality than obesity, the present study addresses this question.
Method: Female college students (N = 398; M age = 18.4, SD = 0.6; M BMI = 23.7, SD = 4.3) recruited for a body acceptance intervention trial provided data on smoking behavior and had their body mass measured at baseline and at 1-mo, 6-mo, 1-yr, and 2-yr follow-ups.
Results: Counter to the belief that smoking is an effective weight control strategy, baseline smokers (n = 29) gained significantly more weight (r = .29) than baseline non-smokers (n = 304), controlling for baseline BMI, parental obesity status, socio-economic status, and intervention condition; over 2-yr follow-up smokers gained 2.9 kg versus 0.9 kg for non-smokers. Descriptive data indicated that weight gain was greater for young women who quit smoking during follow-up (n = 13; M = 4.8 kg) than for persistent smokers (n = 16; M = 1.4 kg), though both groups gained more weight than non-smokers.
Conclusions: Results challenge the widely held belief that smoking is an effective weight control strategy, ironically suggesting that smokers gain more weight than non-smokers during young adulthood, though non-experimental prospective studies do not establish causal relations and future research with larger representative samples is needed.
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Uses and Abuses of Drug Decriminalization in Portugal
Hannah Laqueur
Law & Social Inquiry, forthcoming
Abstract:
In 2001, Portugal decriminalized the acquisition, possession, and use of small quantities of all psychoactive drugs. The significance of this legislation has been misunderstood. Decriminalization did not trigger dramatic changes in drug-related behavior because, as an analysis of Portugal's predecriminalization laws and practices reveals, the reforms were more modest than suggested by the media attention they received. Portugal illustrates the shortcomings of before-and-after analysis because, as is often the case, the de jure legal change largely codified de facto practices. In the years before the law's passage, less than 1 percent of those incarcerated for a drug offense had been convicted of use. Surprisingly, the change in law regarding use appears associated with a marked reduction in drug trafficker sanctioning. While the number of arrests for trafficking changed little, the number of individuals convicted and imprisoned for trafficking since 2001 has fallen nearly 50 percent.
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Jan Marcus & Thomas Siedler
Journal of Public Economics, forthcoming
Abstract:
Excessive alcohol consumption among young people is a major public health concern. On March 1, 2010, the German state of Baden-Württemberg banned the sale of alcoholic beverages between 10pm and 5am at off-premise outlets (e.g., gas stations, kiosks, supermarkets). We use rich monthly administrative data from a 70 percent random sample of all hospitalizations during the years 2007-2011 in Germany in order to evaluate the short-term impact of this policy on alcohol-related hospitalizations. Applying difference-in-differences methods, we find that the policy change reduces alcohol-related hospitalizations among adolescents and young adults by about seven percent. There is also evidence of a decrease in the number of hospitalizations due to violent assault as a result of the ban.
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Persistence and desistance in heavy cannabis use: The role of identity, agency, and life events
Nienke Liebregts et al.
Journal of Youth Studies, forthcoming
Abstract:
Many cannabis users ‘mature out’ of their drug use, and factors of cannabis use cessation have been identified. However, very little in-depth knowledge is available about the mechanisms underlying this phenomenon. Criminological studies have gained interesting insights in desistance from crime, yet these perspectives are rarely used in drug research. This qualitative, three-year longitudinal study explored the processes involved in desistance from frequent cannabis use for young adults. Using a narrative approach, desisters (frequent users who successfully quit their cannabis use) and persisters (frequent users with a persistent desire and unsuccessful attempts to quit) were compared. In the course of the study, desisters mainly exhibited increasing agency and goal setting, established strategies to achieve these goals, and could envision another self. Desistance was generally induced by life events that became turning points. Persisters experienced largely similar events, but lacked goals and strategies and held external factors responsible for their life course and failed quit attempts. Identity change is at the core of desistance from frequent cannabis use, and the meaning-giving to life events and experiences is essential. Agency is a necessary ingredient for desistance, develops over time and through action, and leads to a new drug-free identity with desistance in turn increasing agency.