THREE POLICY CHANGES TO REDUCE SMOKING

Three Policy Changes To Reduce Smoking

Three Policy Changes To Reduce Smoking

Introduction

The prevention of cigarette smoking and other forms of tobacco use is among the world's leading public health priorities. Tobacco use continues to be the leading preventable cause of death in the United States. Smoking and spit tobacco use begins early in life; currently, about one third of high school-age adolescents in the United States use tobacco. Adolescence is the critical time period for prevention and early cessation efforts; given both the highly addictive nature of the substance and that the vast majority of smokers begin smoking before the age of 18. If interventions can keep youth tobacco free through adolescence, the chances of their initiating smoking after high school are much smaller.(Forest,2007)

For the development of effective interventions, it is necessary to examine environmental, psychological, and behavioral variables that affect adolescent tobacco use. Such variables may be relatively distal or proximal to actual smoking behavior. Distal factors do not always have a direct or immediate impact on smoking, nor is their causal pathway necessarily well known.(Sussman, 2005) Proximal influences in contrast may demonstrate an immediate and obvious influence, but in turn may be caused by or mediate the impact of the distal factors. Influences must be examined not only in terms of regular smoking outcomes but also in the context of movement along a continuum of smoking uptake, from not considering smoking, to not smoking but being susceptible to the possibility of being offered a cigarette in the future, to less and then more frequent experimentation, and finally, to regular smoking.

Socioeconomic status, for example, comprises an important distal predictor of adolescent substance use. Children from single-parent homes or poor families are more likely to initiate smoking during adolescence. Mass media may also be influential in adolescent tobacco use.(Sussman, 2005) Cigarette advertising appears to have an indirect effect on legitimizing tobacco use, while concurrently directly affecting adolescents' perceptions of smoking prevalence, the esteem in which smoking is held, and attitudes about the function of smoking. Since these cognitive factors represent psychosocial risks for smoking, advertising may have a direct impact on the initiation of tobacco use.

Plicies Changes To Reduce Smoking

School-Based Educational Interventions

School-based educational interventions traditionally focus on cognitive and affective responses among youth, in attempts to influence knowledge, beliefs, attitudes, intentions, and subjective norms related to smoking. In general, these approaches appear to be ineffective when not accompanied by direct behavior change efforts. A second typical educational intervention evolved more recently, emphasizing peer pressure resistance or “social inoculation.” Brief interventions center around social inoculation activities, which through role-plays teach refusal skills for resisting prompts to smoke.(Forest,2007) These role-plays are placed in the context of realistic mock situations, in which peers or others play the part of the friend, sibling, or adult trying to convince the participant to try a cigarette. Social inoculation programs have been shown to be at least somewhat effective in reducing smoking onset.(Lantz,2009)

School Policies and Penalties for Possession and Use

Educational efforts alone are probably ...