Mary V Modayil

Assessing the relationship between ad volume and awareness of a tobacco education media campaign.

Background The relation between aided ad recall and level of television ad placement in a public health setting is not well established. We examine this association by looking back at 8 years of the Californias Tobacco Control Programs (CTCP) media campaign. Methods Starting in July 2001, Californias campaign was continuously monitored using five telephone series of surveys and six web-based series of surveys immediately following a media flight. We used population-based statewide surveys to measure aided recall for advertisements that were placed in each of these media flights. Targeted rating points (TRPs) were used to measure ad placement intensity throughout the state. Results Cumulative TRPs exhibited a stronger relation with aided ad recall than flight TRPs or TRP density. This association increased after log-transforming cumulative TRP values. We found that a one-unit increase in log-cumulative TRPs led to a 13.6% increase in aided ad recall using web-based survey data, compared to a 5.3% increase in aided ad recall using telephone survey data. Conclusions In California, the relation between aided ad recall and cumulative TRPs showed a diminishing return after a large volume of ad placements These findings may be useful in planning future ad placement for CTCPs media campaign.

Culturally Specific Tobacco Use and South Asians in the United States: A Review of the Literature and Promising Strategies for Intervention

Over the past two decades, the United States has attracted large South Asian populations, who have imported tobacco products previously unique to the native subcontinent. South Asian cigarette use prevalence is consistently lower than other U.S. Asian subgroups; however, most surveys fail to capture smokeless products accurately. In part because of the pervasive use of popular smokeless cultural products resulting in greater population attributable risk of oral malignancies, many countries outside the United States have developed surveillance systems to capture these products and implemented effective population-level or community-based intervention strategies. This minority population in the United States continues to be “at risk” of suffering from a disproportionate burden of diseases, which are plausibly linked to the use of these products. The primary focus of this article is to provide an exhaustive literature review of tobacco use patterns and existing tobacco control strategies among South Asians in the United States. Framed within the social ecological model, the article suggests that there needs to be more detailed assessment of cultural tobacco products, a concurrent increase in cultural competencies of health care providers and provision of cessation resources outside the clinical setting. At the policy level, future efforts should adequately regulate these products and oversight must include such products in efforts to reduce rates of use. Concurrently, community-based efforts are needed to change social norms related to perceived health benefit and lack of stigma. This will help ensure that appropriately framed messages around use rates and burden of disease are addressed through culturally valued institutions and leaders.

Testing antismoking messages for Air Force trainees

Introduction Young adults in the military are aggressively targeted by tobacco companies and are at high risk of tobacco use. Existing antismoking advertisements developed for the general population might be effective in educating young adults in the military. This study evaluated the effects of different themes of existing antismoking advertisements on perceived harm and intentions to use cigarettes and other tobacco products among Air Force trainees. Methods In a pretest–post-test experiment, 782 Airmen were randomised to view antismoking advertisements in 1 of 6 conditions: anti-industry, health effects+anti-industry, sexual health, secondhand smoke, environment+anti-industry or control. We assessed the effect of different conditions on changes in perceived harm and intentions to use cigarettes, electronic cigarettes, smokeless tobacco, hookah and cigarillos from pretest to post-test with multivariable linear regression models (perceived harm) and zero-inflated Poisson regression model (intentions). Results Antismoking advertisements increased perceived harm of various tobacco products and reduced intentions to use. Advertisements featuring negative effects of tobacco on health and sexual performance coupled with revealing tobacco industry manipulations had the most consistent pattern of effects on perceived harm and intentions. Conclusions Antismoking advertisements produced for the general public might also be effective with a young adult military population and could have spillover effects on perceptions of harm and intentions to use other tobacco products besides cigarettes. Existing antismoking advertising may be a cost-effective tool to educate young adults in the military.

An evaluation of the California community intervention

Aim We conducted this study to determine key community-level factors associated with higher tobacco control programme performance. Methods A combination of surveys, administrative and fiscal data were collected to measure local county-level health department performance over a 7-year period. Longitudinal analyses were performed using generalised estimating equations to examine whether counties that exerted higher effort were successful in creating more tobacco retail licensing (TRL) and secondhand smoke policies. Several social, political and contextual factors were examined as confounders. Results Local county health departments (CHDs) that demonstrated high effort on their work plans increased the proportion of residents covered by TRL policies (7.2%; 95% CI −1.7 to 16.1%) compared to CHDs with lower levels of effort. Having legislators who voted in favour of tobacco control bills was found to significantly increase the passage of local TRL policies. CHDs demonstrating higher efforts also increased the proportion of residents covered by secondhand smoke policies (9.2%; 95% CI −3.5 to 21.9%). Conclusion There was strong evidence that higher county-level efforts predicted an increasing number of local tobacco control policies. Evaluations using integrated designs are recommended as effective strategies to provide a more accurate assessment of how well community-level interventions catalyse community-wide change.

Paan (pan) and paan (pan) masala should be considered tobacco products

Two products indigenous to the Indian subcontinent and popular among South Asians globally - paan and paan masala - are inconsistently categorised as tobacco by researchers, clinicians, program planners and policymakers. This article calls for a universally standard classification of these smokeless carcinogenic products as tobacco products and thus, subject to the same public health and clinical protections applied to other forms of tobacco. This recommendation is guided by scientific evidence strongly indicating the common presence of tobacco in paan and paan masala. Inclusion of these two products in population-level surveillance, clinical screening, as well as public health program planning and policy interventions may have considerable impact on preventing and reducing tobacco-related disparities among South Asians around the world.

Cost-effective smoke-free multiunit housing media campaigns: connecting with local communities.

Presented are cost-effective paid media strategies to educate Californians to advocate for stronger smoke-free multiunit housing (SF-MUH) policies between 2006 and 2008. Included is a summary of general market and specific ethnic market costs that correspond to SF-MUH attitudes and home smoking bans. Statewide questionnaires indicated that half of the intended general market saw an antitobacco TV ad and half of the intended ethnic markets heard radio ads. Analyses indicated that it cost

Features of hepatocellular carcinoma in Hispanics differ from African Americans and non-Hispanic Whites

0.67 and

Moving toward a true depiction of tobacco behavior among Asian Indians in California: Prevalence and factors associated with cultural smokeless tobacco product use

0.78 per person to see Caution Tape and Apartment TV ads, respectively. Slightly higher per capita costs corresponded with positive attitudes toward SF-MUH:

Racial differences in patients with hepatocellular carcinoma: A large single-institution experience.

0.87 for Caution Tape and

Individual and family factors associated with intention to quit among male Vietnamese American smokers: Implications for intervention development

1.00 for Apartment. Lessons learned from this campaign included effectiveness of specific ads in ethnic markets, impact on SF-MUH work plan policy objectives, and the need for collaborations among state and local partners throughout the message development process.