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PubMed2003

Youth preferences for cigar brands: rates of use and characteristics of users.

OBJECTIVE: Youth use of cigars has increased in the USA. Understanding brand preference among youth could help explain the attraction to cigars, and develop prevention strategies. This study reports on youth characteristics associated with preferences for cigar brands. DESIGN: Data are presented on 5006 students in grades 7-12 (ages 12-18 years) in classrooms administered the cigar use reasons evaluation (CURE), a questionnaire assessing alternative tobacco use (cigars, bidis, and kreteks). SETTING: Twelve middle and high schools across Massachusetts. MAIN OUTCOME MEASURES: Preferred brands of cigars. RESULTS: Cigar smoking was reported by 16.4% of the sample. The brands preferred by over 5% of cigar users were Phillies (overall prevalence: 31.0%, 95% confidence interval (CI) 27.9% to 34.3%), Black & Mild (12.3%, 95% CI 9.8% to 15.4%), Garcia y Vega (11.4%, 95% CI 9.3% to 13.8%), Swisher Sweets (9.6%, 95% CI 7.6% to 12.2%), Backwoods (6.1%, 95% CI 4.6% to 8.1%), and non-listed brands (16.4%, 95% CI 14.0% to 19.0%). Male cigar smokers were significantly more likely than females to prefer five brands: Backwoods, Dutch Masters, Garcia y Vega, Phillies, and Swisher Sweets, while females were more likely to prefer Black & Mild and non-listed brands. Brand preferences were also distinguished by self, friends' and siblings' tobacco use, race/ethnicity, parents' education and cigar use, GPA (grade point average), college plans, and community type. Urban students were more likely to prefer Black & Mild; students whose parents smoke cigars preferred non-listed brands. CONCLUSIONS: Youth prefer certain brands, most notably Phillies. Particular brands are preferred by particular youth subgroups, raising the possibility of selective marketing toward these groups.

Adolescent↗
PubMed2004

A nicotine delivery device without the nicotine? Tobacco industry development of low nicotine cigarettes.

BACKGROUND: Defining harm reduction and regulating potentially reduced exposure products (PREPs), including low nicotine products, are key issues in tobacco control policy. The US Congress has been considering legislation authorising the Food and Drug Administration (FDA) to regulate tobacco products. OBJECTIVE: To investigate tobacco industry perceptions, interests, motivations, and knowledge regarding the marketability of low nicotine tobacco products. METHODS: Qualitative analysis of internal tobacco industry documents identified in the Legacy Tobacco Documents Library between February 2002 and June 2004. Search terms included low-, no-, reduced-nicotine; denicotinization; low-, reduced- alkaloids; Next; de-nic; and key names of people, organisations, projects, and their common abbreviations and acronyms. RESULTS: The tobacco industry has made repeated efforts to develop low nicotine cigarettes. Reasons for doing so include consumer appeal and economic importance in a highly competitive cigarette market for "healthier" products. The industry considered the development of a new "denic" market segment a critical challenge. CONCLUSIONS: The tobacco industry exploits consumer misunderstanding of the health effects of nicotine in development and marketing efforts. The industry has risked the development of a less addictive product to expand the market reach of tobacco products based on perceived health benefits and appeal to quitters.

Alkaloids↗
PubMed2005

Effect of the New York State cigarette fire safety standard on ignition propensity, smoke constituents, and the consumer market.

OBJECTIVES: This study examines empirical evidence from the New York experience testing tobacco industry arguments made in opposition to fire safety standards for cigarettes. DESIGN: Percentages of cigarettes exhibiting full length burns (FLBs), cigarette sales before and following the implementation of the New York standards, a sample of retail cigarette prices, brand availability, and selected smoke constituent yields were compared between cigarettes sold in New York and two other states. Cigarette paper analysis was conducted on cigarettes sold in New York. RESULTS: New York cigarette brands averaged 10.0% FLBs as compared to 99.8% for California and Massachusetts brands. Reduced ignition propensity (RIP) appears to have been achieved by cigarette paper banding. Cigarette sales, prices, and brand availability do not appear to have been affected by the New York standards. Yields of the majority of smoke constituents tested did not differ substantially between RIP cigarettes sold in New York as compared to the same brands sold in Massachusetts. Average yields of tar, carbon monoxide, and two compounds were slightly higher, the yields of seven compounds were higher for one brand only, and nicotine was lower, among New York brands tested. CONCLUSIONS: RIP cigarette brands have been designed to meet the New York fire safety standards. Their introduction has not affected cigarette sales or prices in New York. There is no evidence that the small increases in smoke constituent yields affect the already highly toxic nature of cigarette smoke. Data on smoking caused fires, deaths, and injuries dating from after the change in law are not yet available. Such data will be able to address the question of whether the demonstrated reduced ignition standards are associated with reduced fires and injuries. Based on the New York experience, prior industry objections to producing RIP cigarettes are unfounded. Other states and nations should adopt similar standards.

Commerce↗
PubMed2004

Learning by doing: 'initiated abstinence', a school-based programme for the prevention of addiction. Results of an evaluation study.

The objective of the study was to find out whether the school-based prevention programme 'Initiated abstinence' is suitable to induce pupils to change their consumer behavior and attitudes. The participants of the prevention programme commit themselves 'per contract' to abstain from or considerably reduce their consumption of at least one of their currently used substances (e.g. sweets, cigarettes) or media (TV, computer games) for a period of 2 weeks. The main goal of the programme is to sharpen their problem and health consciousness concerning addiction and pleasure seeking. The programme was evaluated by a longitudinal study. At three given times, the 12- to 15-year-old pupils of the experimental classes were interviewed by standardized self-completion questionnaires (n = 2,267). The control classes were submitted to two surveys (n = 586). The study was carried out in the areas of Innsbruck (Austria), Schleswig-Holstein (Germany) and South Tyrol (Italy). Not all pupils were able to keep their intentions submitted in their contract, but 4 of 5 pupils had at least one positive experience with the renunciation (82%). There were 'overall effects': The actual renunciation of the pupils was much higher than stated in their agreement. The experimental group showed significant reduction effects for pupils, who had successfully reduced or stopped use of a substance or medium. In a further step, it should be explored whether the programme is suitable also for older groups, i.e. for pupils older than 15 years. Moreover, the long-term effects of the programmes should be tested.

Adolescent↗
PubMed1995

A qualitative approach to assessing the effects of system change on consumers, families, and providers.

OBJECTIVE: In 1988 Vermont implemented a policy designed to reduce the state hospital census and expand community-based services. This qualitative study assessed perceptions of the policy's impact among mental health consumers, family members, and providers. METHODS: Eleven focus groups were convened, which included 94 participants from across the state. Separate groups were held for consumers, family members, and providers. Trained facilitators guided discussion of the policy's effect on quality of life, housing and vocational status, community integration, and social networks. Audiotapes of the discussion were transcribed, and content was analyzed. RESULTS: Several universal themes were noted. All participants reported that stigma was still a substantial barrier to integration and that community education to reduce stigma had not been effective. Tension between families and providers was a problem; family members felt that although providers depended on their supporting the consumer, they were not included in treatment planning. All participants noted that urban areas were better served by the policy's service packages. A lack of coordination of community services was reported to be a continuing problem across the state. In contrast to findings of previous studies, consumers in this study preferred not to live alone, which led to feelings of isolation. CONCLUSIONS: Service delivery in rural areas and system coordination throughout the state must be improved. Families' conflicting feelings of burden and isolation must be addressed. Further research should determine more clearly the range of housing preferences among consumers.

Activities of Daily Living↗
PubMed1996

Family members' ratings of the use and value of mental health services: results of a national NAMI survey.

OBJECTIVE: Data from a 1993 survey of families in the National Alliance for the Mentally Ill (NAMI) were analyzed to examine services used by consumers and families' perceptions of the services' value. Data from 1993 and 1976 were compared to document changes. METHODS: A total of 3,099 families responded to a mailed questionnaire that was first used in a 1976 local survey of 89 NAMI members. Respondents indicated which of 11 services had been used by their ill relative in the past two years and rated the services as having "no," "some," or "considerable" value. Chi square tests examined relationships between service use and value and key variables. RESULTS: In 1993 families reported nearly universal use of medications and rated them highest in value. More than 60 percent of the ill relatives had been hospitalized in the past two years, and hospitalization was rated second highest in value. Individual therapy, used by two-thirds of the consumers, also received high ratings. Community services were used by about a third of the consumers; these services were valued less highly than office-based services and medications. Respondents in 1976 reported less use of medication and residential services, more hospitalization, and more use of individual, group, and family therapies. In 1993 all services were valued more highly than in 1976. CONCLUSIONS: The 1993 survey findings showed that more consumers used office-based services and hospitalization than community-based alternatives, and that families rated the former services more highly. Value ratings of community services rose significantly between 1976 and 1993.

Adult↗
PubMed1989

"A normality for us without confinement for them": notes on the associations of families of the mentally ill.

Associations of families of the mentally ill arose in Italy in the early 1980s mainly in the country's northern and central regions. They denounced the inadequacies of an extramural service conceived of as an out-patient clinic filling the void left by the shutting down of asylums. The positions elaborated by these associations focus on four main themes: the distribution of the "burden of care" for the ill between services and families; the ill-conceived interpretation of the families' needs owing to the professional's alleged tendency to "point the finger of guilt" at the families themselves; the demand for greater power in regard to decisions made by the services; the interaction with the rights and liberties of the mentally ill. Two different ranges of problems are discussed. First, there is the conflict within the family between the interests and rights of its income-producing and its "dependent" members. This conflict points not to a loss but to an overload of functions shifted to the family at a time of rising expectations for the satisfaction of needs. It therefore calls for services of a new kind, i.e. services capable of making these conflicting interests and rights compatible. Second, extramural services either reject or misinterpret the asylum's labour-saving function. These services thus ascribe care for the material life of the mentally ill to the family's own resources alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Consumer Behavior↗
PubMed1992

Changes? What changes? The views of the European patients' movement.

People on the receiving end of mental health services have an increasingly important role to play in the transformation of mental health care. It is argued that user involvement in itself does not guarantee a good outcome, but we need to take the views of (ex-)patients seriously without trying to fit them into theories. Dealing with the, often uncomfortable, relationship between patients and mental health professionals, and that between patients and relatives' organisations, two main strands in the European patients' movement are identified: those who seek to abolish psychiatry (abolitionists) and those who seek to reform it (reformists).

Attitude of Health Personnel↗
PubMed1982

Consumer concerns.

Explore the source record for details and available documents.

Consumer Behavior↗
PubMedDate not supplied

Discrepancies between chained and classic utilities induced by anchoring with occasional adjustments.

BACKGROUND: Classic utility assessment uses death and perfect health as end points. Chained utility assessment uses other health states as endpoints. It has been previously noted that these 2 assessment procedures lead to different utilities. PURPOSE: The author attempts to explain these discrepancies between chained and classic assessments. METHOD: Previous data are plotted in a uniform way to facilitate comparison. Using time trade-off and paired-comparison data, the author estimates the extent to which respondents adjust their responses when end points are varied. Data were obtained in various samples: in healthy volunteers from the general public, in students, and in women at high risk for breast cancer seeking genetic counseling. RESULTS: The author obtained 741 valid data records from a total of 106 participants. The data replicate the pattern found previously. When compared to classic utilities, (1) chained utilities are smaller (larger) when the best (worst) endpoint varies and (2) the discrepancies become smaller for utilities near 0 and 1. The data reveal that there is a distinct failure to adjust responses when the end points are varied, as if the responses anchor on some master health scale. The latter finding explains the robust pattern of discrepancies. CONCLUSION: Decision analyses that use a mix of classic and chained utilities are not on firm ground. One should be wary of normative interpretations of new value assessment procedures. Alternative interpretations of the findings are discussed.

Adolescent↗
PubMed2004

How can the Internet help parents of children with rare neurologic disorders?

The objective of this study was to determine the value of an e-mail listserv for parents of children with Rett syndrome, a rare neurologic disorder. This Web-based survey was completed by parents and carers. The setting was an e-mail listserv established by the International Rett Syndrome Association for parents of children with Rett syndrome and other interested persons. The participants included members of the e-mail listserv Rettnet. The main outcome measures were the perceived advantages and disadvantages of the listserv, overall rating of usefulness, and reasons for satisfaction or dissatisfaction. Most (81.5%) of the participants felt that Rettnet provided helpful advice concerning their child's management. They also indicated that Rettnet was useful in dealing with their child's education and as a source of carer support. They rated it highly (mean 8.1 on a scale of 1 to 10), and the most common reason given for recommending the service to other parents was the emotional support provided. E-mail listservs can play an important role in disseminating information and providing networking and support to parents of children with rare disorders. Their impact and influence warrant attention from health professionals, including neurologists.

Adolescent↗
PubMed1989

Consumer use of nondispensing professional pharmacy services.

This study attempted to identify and develop an understanding of the use of 13 nondispensing services (NDSs) by consumers in the community pharmacy practice setting. A self-administered, postage prepaid questionnaire was sent to 1000 Indiana consumers randomly selected from telephone directories. A 45.5 percent response rate was achieved after one original mailing and two follow-ups. Most consumers had not used NDSs except for advice on nonprescription drugs and advice on minor health problems. Nevertheless, a substantial number of consumers expressed interest in many of the remaining services, including advice on diagnostic test kits and information on poison prevention. Consumers' past use of NDSs and their perceptions of pharmacists as providers of these services were important factors in the consumers' intention to use NDSs. Other variables significantly correlated with average intention to use NDSs were: type of pharmacy patronized, anxiety about health, age, and education. It is recommended that future investigations explore in detail consumer behavior with regard to nondispensing services.

Adult↗