Internet cigarette vendors' lack of compliance with a California state law designed to prevent tobacco sales to minors.
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Adolescent↗
Biomedical subjects
Kurt M Ribisl
Publications and source records attributed to Kurt M Ribisl.
A comparison of Web and print media for physical activity promotion among adolescent girls.
PURPOSE: To compare the effectiveness of a Web-based physical activity (PA) intervention with identical content delivered in a printed workbook among a sample of adolescent girls. METHODS: Participants consisted of 319 girls with home Internet access enrolled in four middle schools within one school district. A randomized trial design was used to compare changes in PA self-efficacy and intentions after two weeks of exposure to either a Web- or print-based intervention delivered to their home. Self-reported physical activity was assessed as a secondary outcome. Analysis of covariance was conducted to determine changes between the intervention groups while controlling for baseline levels of PA constructs. RESULTS: Both Web and print groups had significant changes in physical activity self-efficacy (Web: t[155] = 2.58, p = .01; print: t[156] = 3.11, p = .002) and intentions (Web: t[157] = 2.27, p = .02; print: t[159] = 6.32, p < or = .001). The print group demonstrated significantly greater increases in intentions compared with the Web group (F [1,315] = 13.53, p < or = .001). Self-reported physical activity increased significantly in the print group only (t[159] = 3.21, p = .002). CONCLUSIONS: It cannot be assumed that new media technologies are superior to traditional media such as print for health communication to adolescents. These results suggest that a printed workbook was more effective than an identical website for increasing physical activity intentions and behavior among a sample of middle school girls.
Adolescent↗
Data to action: using formative research to develop intervention programs to increase physical activity in adolescent girls.
Formative research is used to inform intervention development, but the processes of transmitting results to intervention planners and incorporating information into intervention designs are not well documented. The authors describe how formative research results from the Trial of Activity for Adolescent Girls (TAAG) were transferred to planners to guide intervention development. Methods included providing oral and written reports, prioritizing recommendations, and cross-checking recommendations with intervention objectives and implementation strategies. Formative work influenced the intervention in many ways. For example, results indicated that middle schools offered only coeducational physical education and health education classes, so the TAAG intervention was designed to be appropriate for both sexes, and intervention strategies were developed to directly address girls' stated preferences (e.g., enjoyable activities, opportunity to socialize) and barriers (e.g., lack of skills, fear of injury) for physical activity. The challenges of using formative research for intervention development are discussed.
Adolescent↗
How new subscribers use cancer-related online mailing lists.
BACKGROUND: Online cancer-related support is an under-studied resource that may serve an important function in the information seeking, care, and support of cancer patients and their families. With over 9.8 million cancer survivors (defined as anyone living with cancer) in the United States alone and the number growing worldwide, it is important to understand how they seek and use online resources to obtain the information they need, when they need it, and in a form and manner appropriate to them. These are stated cancer communication goals of the US National Cancer Institute. OBJECTIVES: Our purposes are to (1) present background information about online mailing lists and electronic support groups, (2) describe the rationale and methodology for the Health eCommunities (HeC) study, and (3) present preliminary baseline data on new subscribers to cancer-related mailing lists. In particular, we describe subscribers' use of mailing lists, their reasons for using them, and their reactions to participating shortly after joining the lists. METHODS: From April to August 2004, we invited all new subscribers to 10 Association of Cancer Online Resources mailing lists to complete Web-based surveys. We analyzed baseline data from the respondents to examine their perceptions about cancer-related mailing lists and to describe how cancer patients and survivors used these lists in the period shortly after joining them. RESULTS: Cumulative email invitations were sent to 1368 new mailing list subscribers; 293 Web surveys were completed within the allotted time frame (21.4% response rate). Most respondents were over age 50 (n = 203, 72%), white (n = 286, 98%), college graduates (n = 161, 55%), and had health insurance (n = 283, 97%). About 41% (n = 116) of new subscribers reported spending 1 to 3 hours per day reading and responding to list messages. They used the mailing lists for several reasons. Among the most frequently reported, 62% (n = 179) strongly agreed they used mailing lists to obtain information on how to deal with cancer, 42% (n = 121) strongly agreed they used mailing lists for support, and 37% (n = 109) strongly agreed that they were on the mailing lists to help others. Smaller proportions of new subscribers strongly agreed that others on the mailing lists had similar cancer experiences (n = 23, 9%), that they could relate to the experiences of others on the lists (n = 66, 27%), and that others on the list gave them good ideas about how to cope with cancer (n = 66, 27%). CONCLUSIONS: Cancer-related online mailing lists appear to be an important resource, especially for information seeking but also for support of cancer survivors. These were the primary motivators most members reported for joining mailing lists. The modest proportion of subscribers who strongly agreed that they could relate to others' cancer experiences (as well as similar responses to other process questions) is undoubtedly due at least in part to the short duration that these subscribers were involved with the mailing lists. Emerging data, including our own, suggest that mailing lists are perhaps under-used by minority patients/survivors. These preliminary data add to a growing body of research on health-related online communities, of which online mailing lists are one variant.
Health Personnel↗
Retailer participation in cigarette company incentive programs is related to increased levels of cigarette advertising and cheaper cigarette prices in stores.
PURPOSE: The retail outlet is the cigarette companies' major marketing channel to reach present and future customers. Of the $11.2 billion spent by them to market their products in 2001, approximately 85% was spent on retailer and consumer incentives to stimulate sales. This study examines the extent of retailer participation in these incentive programs, and the relationship between participation and the amount and placement of cigarette marketing materials and products, and prices in stores. METHODS: Observational assessments of cigarette marketing materials, products, and prices were conducted in 468 stores in 15 U.S. states. Telephone interviews were conducted with store owners or managers of these stores to determine the details of their participation in incentive programs. RESULTS: Cigarette companies engaged 65% of retailers in an incentive program. Nearly 80% of participating retailers reported cigarette company control over placement of marketing materials in their stores. Stores that reported receiving over $3,000 from incentive programs in the past 3 months averaged 19.5 cigarette marketing materials, and stores receiving no money averaged only 8.2 marketing materials. In multivariate analyses, participation in incentive programs offered by Philip Morris and R.J. Reynolds was positively related to the number of cigarette marketing materials for each of these companies' brands in stores and the placement of their cigarettes on the top shelf. The price of Newports was significantly lower in stores that received incentives; no price difference was found for Marlboro. CONCLUSIONS: Stores that participate in cigarette company incentive programs feature more prominent placement of cigarettes and advertising, and may have cheaper cigarette prices.
Advertising↗
The North Carolina Youth Empowerment Study (NCYES): a participatory research study examining the impact of youth empowerment for tobacco use prevention.
This article describes the North Carolina Youth Empowerment Study (NC YES), a 3-year participatory evaluation of youth programs addressing tobacco use prevention. The study goals of NC YES were to (1) convene an advisory board comprised of lay youths and adults in a participatory research process, (2) document the characteristics of youth programs for tobacco use prevention and control in North Carolina, and (3) track the role of youth involvement in initiating and implementing 100% tobacco-free policies in local school districts. The NC YES Statewide Advisory Board helped guide the evaluation process, reviewed study protocols and data collection instruments, and helped interpret preliminary findings. Both quantitative and qualitative methods(e.g., telephone interviews and written questionnaires) were used to gather data from youth and adult leaders to achieve these aims. Lessons learned about the process of conducting participatory evaluation approaches and summary findings about the role of youths in policy advocacy efforts are presented.
Adolescent↗
Internet sales of cigarettes to minors.
CONTEXT: There is growing concern that the Internet might become a source of tobacco products for minors. Although researchers have studied tobacco sales to minors at retail outlets for more than a decade, there are no published studies of tobacco sales to minors via the Internet. OBJECTIVE: To determine the proportion of Internet cigarette vendors that will sell cigarettes to minors. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study conducted in April-July 2001. Under adult supervision, 4 adolescents aged 11 to 15 years attempted to purchase cigarettes via 55 Internet cigarette vendors located in 12 states. These minors made a total of 83 purchase attempts, paying by credit card (n = 47) and by money order (n = 36). MAIN OUTCOME MEASURE: Proportion of Internet cigarette vendors that sold cigarettes to minors. RESULTS: Minors successfully received cigarettes for 93.6% of credit card purchase attempts and for 88.9% of money order purchase attempts. Age was never verified for any of these deliveries. Internet vendors sent a total of 1650 packs of cigarettes to the underage adolescents in this study. CONCLUSION: Minors appear to have easy access to cigarettes via the Internet because many Internet vendors have weak or nonexistent age verification procedures.
Adolescent↗
Passage of 100% tobacco-free school policies in 14 North Carolina school districts.
Though comprehensive tobacco-free school policies constitute an important component of state tobacco control efforts, little research exists about their adoption process. In the past two years, efforts occurred in North Carolina to increase the number of school districts adopting 100% tobacco-free school policies. As part of the North Carolina Youth Empowerment Study (NC-YES), researchers developed a school tobacco policy interview guide to conduct interviews with 40 key people (e.g., school board member, principal, etc.) in each of 14 school districts that adopted a 100% tobacco-free school policy by the end of 2001. Results showed seven districts adopted their school policy in the past two years. Seven themes emerged: 1) Catalysts: Local adult and youth "champions" facilitated policy change; 2) Process of Adoption: Most school policies were adopted with an administrator or other adult initiating the change, but youth involvement increased in recent years; 3) Methods of Adoption: Advocates personalized health concerns by focusing on children and role modeling by adults; 4) Political Leadership: Governors of North Carolina, through letters to school districts and a policy summit, played an important role in stimulating policy change; 5) Barriers to Adoption: Concerns expressed before policy adoption, about teacher attrition or inability to enforce the policy, did not occur as feared; 6) Enforcement Issues: A key to policy enforcement involved being consistent, supportive, and firm; and 7) Economics of Tobacco Farming/Manufacturing: Though a local tobacco economy did little to influence policy adoption, districts that adopted policies were not located in counties with heavy tobacco production. Public health advocates may use this information to encourage school districts to adopt 100% tobacco-free school policies.
Adult↗
A content analysis of Web sites promoting smoking culture and lifestyle.
The present study examined smoking culture and lifestyle Web sites listed on Yahoo!, a popular Internet search catalog, to determine whether the sites were easily accessible to youth, featured age or health warnings, and mentioned specific tobacco brands. A content analysis of photographs on these sites assessed the demographics of individuals depicted and the amount of smoking and nudity in the photographs. The sample included 30 Web sites, all of which were accessible to youth and did not require age verification services to enter them. Cigarette brand names were mentioned in writing on 35% of the sites, and brand images were present on 24% of the sites. Nearly all of the photographs (95%) depicted smoking, 92% featured women, and 7% contained partial or full nudity. These results underscore the need for greater research and monitoring of smoking-related Internet content by health educators and tobacco control advocates.
Adolescent↗
An assessment of the quality and usability of smoking cessation information on the Internet.
Little is known about the quality and usability of on-line health information. This analysis evaluated smoking cessation Web sites' content quality and usability. Thirty sites were analyzed to determine their adherence to established tobacco cessation guidelines and their accessibility, usability, credibility, and currency. Most explained addiction (86.7%) and mentioned nicotine replacement therapy (NRT) (93.3%) and social support (93.3%). However, few explained potential side effects of NRT (33.3%) or which smokers should avoid using NRT (30.0%). Two sites advocated substituting smokeless tobacco or herbal cigarettes when quitting, and 16 (53.3%) provided information written at greater than an eighth-grade level. Few sites provided a search mechanism (40.0%) or offered text-only versions (30.0%), and most (83.3%) failed to indicate when content pages were last updated. Most sites adhered to established cessation guidelines. A small subset offered erroneous and potentially harmful information. Applying fundamental design principles would improve accessibility, usability, credibility, and currency.
Bibliometrics↗
Comprehensiveness of substance use prevention programs in U.S. middle schools.
PURPOSE: To assess how current practice in middle school substance use prevention programs compares with seven recommended guidelines adapted from the Centers for Disease Control and Prevention guidelines for school-based tobacco use prevention programs. METHODS: Substance use prevention practice was analyzed using data from a 1999 mailed questionnaire of a nationally representative sample of 1496 public and private schools with middle school grades that reported having a substance use prevention program. Respondents answered questions about substance use prevention education and activities in the whole school and in their own classroom. Weighted prevalence estimates for the seven recommendations are presented, and multiple regression was used to analyze correlates of implementation of the recommendations. RESULTS: An estimated 64.2% of schools met four or more of the recommendations for school-based substance use prevention practice; 4.0% met all seven recommendations. Schools were most likely to report having and enforcing substance use prevention policies (84.3%) and least likely to report training teachers in substance use prevention (17.9%). More recommendations were implemented in schools that were public and had larger enrollments, greater perceived availability of resources, greater school board and parental support for substance use prevention, and had hired a school substance use prevention coordinator. CONCLUSIONS: The low prevalence of comprehensive substance use prevention programs in U.S. middle schools may limit the potential impact of school programs on the prevalence of youth substance use.
Adolescent↗
Are the sales practices of internet cigarette vendors good enough to prevent sales to minors?
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Adolescent↗
Independent evaluation of the California Tobacco Control Program: relationships between program exposure and outcomes, 1996-1998.
OBJECTIVES: This study sought to determine the effects of the California Tobacco Control Program on tobacco-related attitudes and behaviors. METHODS: In 1996 and 1998, a telephone survey was conducted among adults in randomly selected households in 18 California counties. Tenth-grade youths in 84 randomly selected high schools completed a written survey. In analyses conducted at the county level, differences in outcomes were regressed on an index of program exposure. RESULTS: Among adults, program exposure was associated with decreased smoking prevalence rates, increased no-smoking policies in homes, and decreased violations of workplace no-smoking policies. Among youths, there was no effect of program exposure on outcomes. CONCLUSIONS: These results suggest that the California Tobacco Control Program may have reduced adult smoking prevalence rates and exposure to environmental tobacco smoke.
Adolescent↗
Smokers' beliefs and attitudes about purchasing cigarettes on the Internet.
OBJECTIVES: Our objectives were to explore qualitatively how smokers find out about Internet cigarette sales and what factors motivate them to purchase cigarettes on-line, and to quantitatively describe the Internet cigarette purchasing behaviors and attitudes of Internet cigarette buyers. METHODS: Qualitative in-depth telephone interviews were conducted with 21 adult smokers who had purchased or contemplated purchasing cigarettes online. Findings from the qualitative study were used to develop a survey module on Internet cigarette purchasing behavior that was administered to 187 New Jersey adult smokers. RESULTS: Smokers who purchased cigarettes on-line were primarily motivated by lower prices, which occur because Internet vendors generally sell cigarettes without paying excise taxes for the destination state. Most Internet cigarette buyers first learned about on-line cigarette sales from interpersonal sources who had purchased on-line. New Jersey adult smokers who purchased cheaper cigarettes from the Internet and other lower-taxed sources significantly increased their consumption over time, compared to smokers who reported paying full-price at traditional bricks-and-mortar retail stores. CONCLUSIONS: Policies that have the effect of equalizing Internet cigarette prices with those at retail stores will likely deter smokers from purchasing cigarettes on-line. Internet cigarette vendors should be required to comply with the same provisions that apply to bricks-and-mortar retail vendors and charge appropriate state and local cigarette excise taxes. In the absence of such policies, the sales of cheaper, tax-free cigarettes on-line will undermine the public health benefit of raising cigarette prices.
Attitude↗
The role of peer social network factors and physical activity in adolescent girls.
OBJECTIVE: To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls. METHODS: Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school. RESULTS: Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses. CONCLUSIONS: Frequency of PA with friends was an important correlate of PA among the peer network variables for adolescent girls.
Adolescent↗