Findings

Sobering

Kevin Lewis

May 08, 2012

Effects of Welfare Reform on Illicit Drug Use of Adult Women

Hope Corman et al.
Economic Inquiry, forthcoming

Abstract:
Exploiting changes in welfare policy across states and over time and comparing relevant population subgroups within an econometric difference-in-differences framework, we estimate the effects of welfare reform on adult women's illicit drug use from 1992 to 2002, the period during which welfare reform unfolded in the United States. The analyses are based on all available and appropriate national data sets, each offering unique strengths and measuring a different drug-related outcome. We investigate self-reported illicit drug use (from the National Household Surveys on Drug Abuse and National Surveys on Drug Use and Health), drug-related prison admissions (from the National Corrections Reporting Program), drug-related arrests (from Federal Bureau of Investigation Uniform Crime Reports), and drug-related emergency department episodes (from the Drug Abuse Warning Network). We find robust evidence that welfare reform led to a 10%-21% decline in illicit drug use among women at risk of relying on welfare, as well as associated declines in drug-related arrests (6%-7%), drug-related hospital emergency department episodes (7%-11%), and possibly drug-related prison admissions (11%-19%). The findings indicate that an appropriately designed welfare system with sufficient job opportunities for those who are able to work can result in both increases in employment and decreases in drug use.

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Judging Cheaters: Is Substance Misuse Viewed Similarly in the Athletic and Academic Domains?

Tonya Dodge et al.
Psychology of Addictive Behaviors, forthcoming

Abstract:
The present study examines how individuals judge others who use performance-enhancing drugs in two different domains - the athletic domain and the academic domain. Approximately 1,200 males in their freshman year of college completed a questionnaire that included two scenarios. One scenario described an athlete who misused anabolic steroids to help him succeed at a sporting event. The other described a college student who misused Adderall to help him succeed on his midterm exams. Participants rated the extent to which they thought the target had cheated and the extent to which they felt the substances were necessary for success. Results showed participants believed the athlete was more of a cheater than the student, and this difference got larger as past prescription stimulant misuse increased. Results also demonstrated that participants felt Adderall was more necessary than anabolic steroids for bringing about success. Contributions to the literature on zero-sum and non-zero-sum domains are discussed. Implications for future research and efforts to prevent substance misuse are described.

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OxyContin® as currency: OxyContin® use and increased social capital among rural Appalachian drug users

Adam Jonas et al.
Social Science & Medicine, May 2012, Pages 1602-1609

Abstract:
Studies have shown that position within networks of social relations can have direct implications on the health behaviors of individuals. The present study examines connections between drug use and individual social capital within social networks of drug users (n = 503) from rural Appalachian Kentucky, U.S.A. Respondent driven sampling was used to recruit individuals age 18 and older who had used one of the following drugs to get high: cocaine, crack, heroin, methamphetamine, or prescription opioids. Substance use was measured via self-report and social network analysis of participants' drug use network was used to compute effective size, a measure of social capital. Drug network ties were based on sociometric data on recent (past 6 month) drug co-usage. Multivariate multi-level ordinal regression was used to model the independent effect of socio-demographic and drug use characteristics on social capital. Adjusting for gender, income, and education, daily OxyContin® use was found to be significantly associated with greater social capital, and daily marijuana use was associated with less social capital. These results suggest that in regions with marked economic disparities such as rural Appalachia, OxyContin® may serve as a form of currency that is associated with increased social capital among drug users. Interventions focusing on increasing alternate pathways to acquiring social capital may be one way in which to alleviate the burden of drug use in this high-risk population.

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Effects of acute nicotine and alcohol on the rating of attractiveness in social smokers and alcohol drinkers

Angela Attwood et al.
Drug and Alcohol Dependence, forthcoming

Background:
Nicotine and alcohol are often consumed together. Previous research suggests that both can independently increase the perceived attractiveness of social stimuli, which may be a mechanism that drives continued use. This study examined whether there was an additive effect of nicotine and alcohol on perceived attractiveness of social and environmental stimuli.

Methods: Male and female (n = 96) social alcohol consumers and light cigarette smokers (no more than 14 cigarettes per week) were randomized to smoke either a nicotinized or denicotinized cigarette and drink either an alcoholic or non-alcoholic (placebo) beverage. The primary outcome was attractiveness ratings of facial and landscape stimuli. Secondary outcomes were self-report mood and craving.

Results: There was a main effect of drink (p = .031) and a trend toward a main effect of cigarette (p = .057) with higher ratings of attractiveness after alcohol compared to placebo and after a nicotinized cigarette compared to a denicotinized cigarette. Nicotine and alcohol appeared to work additively on ratings of attractiveness, with the highest ratings in the nicotine/alcohol group. There were no interactions between drink, cigarette and stimulus type.

Conclusions: When co-administered, nicotine and alcohol consumption resulted in the highest perceptions of attractiveness across all stimulus types. This additive effect may be a mechanism by which administration of one drug reinforces use of the other, and which leads to an increased likelihood of habitual consumption and relapse.

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Fiscal and Policy Implications of Selling Pipe Tobacco for Roll-Your-Own Cigarettes in the United States

Daniel Morris & Michael Tynan
PLoS ONE, May 2012

Background: The Federal excise tax was increased for tobacco products on April 1, 2009. While excise tax rates prior to the increase were the same for roll-your-own (RYO) and pipe tobacco, the tax on pipe tobacco was $21.95 per pound less than the tax on RYO tobacco after the increase. Subsequently, tobacco manufacturers began labeling loose tobacco as pipe tobacco and marketing these products to RYO consumers at a lower price. Retailers refer to these products as "dual purpose" or "dual use" pipe tobacco.

Methods: Data on tobacco tax collections comes from the Alcohol and Tobacco Tax and Trade Bureau. Joinpoint software was used to identify changes in sales trends. Estimates were generated for the amount of pipe tobacco sold for RYO use and for Federal and state tax revenue lost through August 2011.

Results: Approximately 45 million pounds of pipe tobacco has been sold for RYO use from April 2009 to August 2011, lowering state and Federal revenue by over $1.3 billion.

Conclusions: Marketing pipe tobacco as "dual purpose" and selling it for RYO use provides an opportunity to avoid paying higher cigarette prices. This blunts the public health impact excise tax increases would otherwise have on reducing tobacco use through higher prices. Selling pipe tobacco for RYO use decreases state and Federal revenue and also avoids regulations on flavored tobacco, banned descriptors, prohibitions on shipping, and reporting requirements.

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From Neural Responses to Population Behavior: Neural Focus Group Predicts Population-Level Media Effects

Emily Falk, Elliot Berkman & Matthew Lieberman
Psychological Science, forthcoming

Abstract:
Can neural responses of a small group of individuals predict the behavior of large-scale populations? In this investigation, brain activations were recorded while smokers viewed three different television campaigns promoting the National Cancer Institute's telephone hotline to help smokers quit (1-800-QUIT-NOW). The smokers also provided self-report predictions of the campaigns' relative effectiveness. Population measures of the success of each campaign were computed by comparing call volume to 1-800-QUIT-NOW in the month before and the month after the launch of each campaign. This approach allowed us to directly compare the predictive value of self-reports with neural predictors of message effectiveness. Neural activity in a medial prefrontal region of interest, previously associated with individual behavior change, predicted the population response, whereas self-report judgments did not. This finding suggests a novel way of connecting neural signals to population responses that has not been previously demonstrated and provides information that may be difficult to obtain otherwise.

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Education, Cognition, Health Knowledge, and Health Behavior

Naci Mocan & Duha Tore Altindag
NBER Working Paper, March 2012

Abstract:
Using data from the NLSY97 we analyze the impact of education on health behaviors, measured by smoking and heavy drinking. Controlling for health knowledge does not influence the impact of education on health behaviors, supporting the productive efficiency hypothesis. Although cognition, as measured by test scores, appears to have an effect on the relationship between education and health behaviors, this effect disappears once the models control for family fixed effects. Similarly, the impact of education on smoking and heavy drinking is the same between those with and without a learning disability, suggesting that cognition is not likely to be a significant factor in explaining the impact of education on health behaviors.

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The tobacco industry's past role in weight control related to smoking

Semira Gonseth et al.
European Journal of Public Health, April 2012, Pages 234-237

Background: Smoking is thought to produce an appetite-suppressing effect by many smokers. Thus, the fear of body weight gain often outweighs the perception of health benefits associated with smoking cessation, particularly in adolescents. We examined whether the tobacco industry played a role in appetite and body weight control related to smoking and smoking cessation.

Methods: We performed a systematic search within the archives of six major US and UK tobacco companies (American Tobacco, Philip Morris, RJ Reynolds, Lorillard, Brown & Williamson and British American Tobacco) that were Defendants in tobacco litigation settled in 1998. Findings are dated from 1949 to 1999.

Results: The documents revealed the strategies planned and used by the industry to enhance effects of smoking on weight and appetite, mostly by chemical modifications of cigarettes contents. Appetite-suppressant molecules, such as tartaric acid and 2-acetylpyridine were added to some cigarettes.

Conclusion: These tobacco companies played an active and not disclaimed role in the anti-appetite effects of smoking, at least in the past, by adding appetite-suppressant molecules into their cigarettes.

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‘A real man smells of tobacco smoke' - Chinese youth's interpretation of smoking imagery in film

Gareth Davey & Xiang Zhao
Social Science & Medicine, May 2012, Pages 1552-1559

Abstract:
Previous studies have associated youth's exposure to filmic images of smoking with real-life smoking acquisition; initial research in low- and middle-income countries confirms this relationship. The present study in Yunnan, southwest China sought answers to the following questions: How do young people in China make sense of smoking imagery they have seen in film? How are these perceptions shaped by the cultural and social context of images? How do these understandings relate to real-life tobacco use? A study with focus groups and grounded theory was conducted in 2010 and 2011 (Sept-Jan) with middle-school students ages 12 and 13 (n = 68, focus groups = 12, schools = 6). Films and media literacy were important means through which knowledge about smoking was constructed and communicated. Film representations of smoking concurred with Chinese social behaviour (Confucian social networks, face-making, and the notion of society as a harmonious social unit), and were interpreted as congruent with real-life smoking. This pattern, in turn, was intertwined with perceived gender identities of smokers, gender-specific social behaviour, and willingness of girls to explore issues of gender equity. These findings lend new insights into interaction between smoking imagery in film and Chinese youth's smoking beliefs. Tobacco control programs in China should consider young people's interpretations of smoking and the ways they are nested in cultural and social milieu.

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State Patty's Day: College Student Drinking and Local Crime Increased on a Student-constructed Holiday

Eva Lefkowitz et al.
Journal of Adolescent Research, May 2012, Pages 323-350

Abstract:
College student alcohol consumption is a major concern, and is known to increase during the celebration of special events. This study examined a student-constructed holiday, State Patty's Day, at a university with a dominant drinking culture using three sources of data - coded data from Facebook groups, daily web surveys from first-year students (N = 227, 51% male, age 18 to 20; 27.3% Hispanic/Latino; of non-Hispanic/Latino, 26.9% of sample European American/White, 19.4% Asian American/Hawaiian/Pacific Islander, 15.9% African American/Black, 10.6% more than one race), and criminal offense data from police records. Results indicated that messages about State Patty's Day on Facebook focused on drinking and social aspects of the holiday, such as the social context of drinking, a sense of belonging to a larger community, and the social norms of drinking. These messages were rarely about consequences and rarely negative. On State Patty's Day, 51% of students consumed alcohol, compared to 29% across other sampled weekend days. Students consumed more drinks (M = 8.2 [SD = 5.3] drinks per State Patty's Day drinker) and were more likely to engage in heavy drinking on State Patty's Day, after controlling for gender, drinking motives, and weekend, demonstrating the event-specific spike in heavy drinking associated with this holiday. The impact of this student-constructed holiday went beyond individual drinking behavior; alcohol-specific and other crime also peaked on State Patty's Day and the day after. Event-specific prevention strategies may be particularly important in addressing these spontaneous, quickly-constructed, and dynamic events.

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Intoxication Levels of Bar Patrons at an Organized Pub Crawl in a College Campus Community

Virginia Dodd, David Khey & Maureen Miller
American Journal of Criminal Justice, June 2012, Pages 246-257

Abstract:
This field study examined whether participants of a traditional, end-of-semester pub crawl in a college campus community had higher levels of intoxication than non-participating bar patrons on the same night as the event. A total of 693 bar patrons participated in the study. Anonymous interview and breath alcohol concentration (BrAC) data were collected from pedestrians in a bar district at the end point of the pub crawl route between 10:00 p.m. and 3:00 a.m. on the night of the event during three different semesters (November, 2007, May, 2008, and May, 2009). A multivariate model adjusting for participant demographics and drinking variables showed that participation in the pub crawl was associated with a 70% reduced risk of being highly intoxicated (i.e., BrAC ≥ 0.08 g/210 L). The lower intoxication levels among pub crawl participants may have implications for harm reduction practices at high-risk drinking events. These implications are discussed.

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Undercontrolled Temperament at Age 3 Predicts Disordered Gambling at Age 32: A Longitudinal Study of a Complete Birth Cohort

Wendy Slutske et al.
Psychological Science, forthcoming

Abstract:
Using data from the large, 30-year prospective Dunedin cohort study, we examined whether preexisting individual differences in childhood temperament predicted adulthood disordered gambling (a diagnosis covering the full continuum of gambling-related problems). A 90-min observational assessment at age 3 was used to categorize children into five temperament groups, including one primarily characterized by behavioral and emotional undercontrol. The children with undercontrolled temperament at 3 years of age were more than twice as likely to evidence disordered gambling at ages 21 and 32 than were children who were well-adjusted at age 3. These associations could not be explained by differences in childhood IQ or family socioeconomic status. Cleanly demonstrating the temporal relation between behavioral undercontrol and adult disordered gambling is an important step toward building more developmentally sensitive theories of disordered gambling and may put researchers in a better position to begin considering potential routes to disordered-gambling prevention through enhancing self-control and emotional regulation.

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Marlboro and other usual brand choices by youth smokers in Middle Eastern countries

Randy Page
Journal of Youth Studies, forthcoming

Abstract:
This study analyzed data from 118,743 adolescents completing 30 different Global Youth Tobacco Surveys conducted in 15 different Middle Eastern countries between 1999 and 2007 to determine the proportion of young smokers who usually smoked Marlboro, other cigarette brands, or no usual brand smoked in these countries. Marlboro was the most prevalent brand smoked in 7 of the 15 Middle Eastern countries examined, the second most common brand smoked in four Middle Eastern countries, and the third most common in eight of the countries. Marlboro smokers were found to exhibit stronger commitment to smoking, to smoke more frequently, to have more close friends who smoke, to score higher on beliefs that smoking is attractive, and to score lower on the belief that smoking is harmful in comparison to other brand smokers. Understanding youth smokers' brand preferences and choices is advantageous because it provides insight into what influences young people to start and continue to smoke, and subsequently may inform smoking prevention and control strategy development. This information can be incorporated into targeted mass media campaigns and other interventions to counter advertising and marketing messages.

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Young adult smokers' perceptions of illicit tobacco and the possible impact of plain packaging on purchase behavior

Crawford Moodie, Gerard Hastings & Luk Joossens
European Journal of Public Health, April 2012, Pages 251-253

Abstract:
Plain (unbranded) packaging for cigarettes is at the top of the tobacco control agenda in both Australia and Europe. The evidence suggests that it will benefit public health by decreasing the appeal of tobacco products and increasing the power of the health warning. The tobacco industry instead argues that plain packaging would make it easier to counterfeit cigarettes, which would both confuse consumers and reduce price; thereby increasing consumption. Using focus group research we examined young adult smokers (N = 54) perceptions of, and ability to recognize, illicit tobacco and the possible impact of plain packaging on illicit tobacco purchasing behaviour. We found that the pack has no impact on the decision to buy illicit tobacco. Smokers were easily able to identify counterfeit cigarettes, not least by the pack, and buy it knowingly and in the full expectation that it will be inferior in quality. Illicit tobacco purchase, including that for counterfeit tobacco, was instead driven by availability and price. Given the extremely low manufacturing cost, per pack, of certain types of illicit cigarettes, it is difficult to envisage how plain packaging would alter the price of illicit tobacco in any meaningful way. The findings therefore suggest that a move to plain packaging would have no impact on young adult smokers' purchase behaviour.

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Change in Smoking, Diet, and Walking for Exercise in Blacks

Carla Berg et al.
Health Education & Behavior, April 2012, Pages 191-197

Abstract:
Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors.

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Effects of binge drinking on infant growth and development in an Inuit sample

Sarah Fraser et al.
Alcohol, May 2012, Pages 277-283

Abstract:
Prenatal exposure to an average of 0.5 oz absolute alcohol per day (the equivalent of 7 standard drinks per week) during pregnancy has been found to be associated with numerous adverse effects on pre- and postnatal development. In the animal model, concentrated alcohol exposure has been found to lead to more adverse effects than exposure to the same total quantity of alcohol ingested in smaller doses over a longer period of time. The primary aim of this study is to determine whether, in a population where binge drinking is common but total alcohol consumption across pregnancy is low, prenatal exposure to alcohol is associated with effects on prenatal growth, visual acuity and cognitive development during infancy. The second aim is to determine which of several indicators of alcohol consumption best predicts pre- and postnatal outcomes. Data were collected from 216 Inuit women and their infants living in Nunavik, the northern region of Québec. Maternal interviews were conducted during mid-pregnancy and at 1 and 6 months postpartum. Birth weight, length, and head circumference were assessed at delivery. Visual acuity and cognitive development were assessed at 6 months of age. In this population in which infrequent heavy episodic drinking is common, even occasional binge exposure was associated with reduced prenatal growth and poorer visual acuity at 6 months of age. A simple dichotomous measure of binge drinking during pregnancy provided the best predictor of fetal growth and 6-month acuity. The population studied here is unusual in terms of its pattern of binge alcohol consumption. To our knowledge, this is the first study to observe effects of binge drinking during pregnancy on infant growth and development in a sample where the average daily alcohol intake is low (<0.5 ounces).

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Smoking, childhood IQ, and cognitive function in old age

Janie Corley et al.
Journal of Psychosomatic Research, forthcoming

Objectives: To examine the association between smoking history and cognitive function in old age, and whether it remains after controlling for childhood cognitive ability (IQ) and adult socioeconomic status (SES).

Methods: In the Lothian Birth Cohort 1936 Study, 1080 men and women, who previously participated in a nationwide IQ-type test in childhood, were followed up at age 70. The associations between smoking history and age 70 IQ, general cognitive ability (g), processing speed, memory, and verbal ability were assessed.

Results: Lower childhood IQ was associated with a higher risk of becoming a smoker and continuing to smoke in late life, and with reduced lung function (FEV1) in late life. Current smokers scored significantly lower than ex-smokers and never smokers on tests of age 70 IQ, general cognitive ability, and processing speed, but not memory or verbal ability. After controlling for childhood IQ and SES, current smoking at age 70 (but not pack years of smoking) was associated with impairments in general cognitive ability and processing speed.

Conclusion: Smoking in old age makes a small, independent contribution to cognitive performance in old age.

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What Works in Substance Abuse Treatment Programs for Offenders?

Stephen Bahr, Amber Masters & Bryan Taylor
Prison Journal, June 2012, Pages 155-174

Abstract:
The purpose of this article is to review current empirical research on the effectiveness of drug treatment programs, particularly those for prisoners, parolees, and probationers. The authors reviewed empirical research published after the year 2000 that they classified as Level 3 or higher on the Maryland Scale. Participants in cognitive-behavioral therapy (CBT), therapeutic communities, and drug courts had lower rates of drug use and crime than comparable individuals who did not receive treatment. Several different types of pharmacological treatments were associated with a reduced frequency of drug use. Those who received contingency management tended to use drugs less frequently, particularly if they also received cognitive-behavioral therapy. Finally, researchers reported that drug use and crime were lower among individuals whose treatment was followed by an aftercare program. Effective treatment programs tend to (a) focus on high-risk offenders, (b) provide strong inducements to receive treatment, (c) include several different types of interventions simultaneously, (d) provide intensive treatment, and (e) include an aftercare component.


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