Ted T. L. Chen

A multi-city community based smoking research intervention project in the African-American population.

Objective: To carry out a community-based research approach to determine the most effective educational interventions to reduce smoking among African-American smokers. The intervention included preparation of the community, planning and developing a model of change, and developing a community-based intervention. The study population consisted of 2,544 randomly selected adult African-American smokers residing in four sites in the northeastern and southeastern parts of the United States. The research design provided a comparison of active intervention sites with passive control sites as well as low income and moderate income areas. Major Outcome Measures: Point prevalence of non-smoking at the time of interview; Period prevalence of non-smoking at the time of interview; Period prevalence of quit attempts in the prior six months; Number of smoke-free days in the prior six months; Number of cigarettes smoked daily at the time of interview. Results: Based upon a survey eighteen months after baseline data was collected, all four measures of cigarette smoking behavior showed a strong statistically significant reduction of personal smoking behavior among those receiving active interventions versus the passive group. On the basis of process variable analysis, direct contact with the project staff in the prior six months was significantly higher in the active intervention areas. There was only a small non-significant increase in personal smoking behavior in moderate income groups as opposed to low income groups. Conclusion: An analysis of process variables strongly suggests that, within this African-American Community, “hands on” or “face to face” approaches along with mass media, mailings, and other less personal approaches were more effective in reducing personal smoking behavior than media, mailings, and other impersonal approaches alone addressed to large audiences.

Mass Media Usage among Black Smokers: A First Look

This article discusses preliminary results of a National Cancer Institute-sponsored pilot baseline survey in 1989 of smoking knowledge, attitude and habits among black smokers in four major U.S. cities: two in the North (Springfield, Massachusetts and Hartford, Connecticut) and two in the South (Durham, North Carolina and Columbia, South Carolina). It focuses on mass media readership, viewing and listening habits and a preliminary discussion of their application to practice.

Cancer Prevention (Smoking) in the Black Population: A Community Research/Intervention Model

There is evidence of a strong relationship between certain cancers and cigarette smoking. The incidence rates for important smoking-related cancers of the lung, esophagus, larynx, and pancreas are higher in Blacks than in Whites in the United States, and a greater proportion of Blacks smoke cigarettes.

APACT: Its Organization and Impact on Resistance to U.S. Tobacco Imperialism.

This article presents a case study of the formation and first year activities of the Asia Pacific Association for the Control of Tobacco Products (APACT). The case study is organized around five key concepts that address the organizing activity that led this coalition of antismoking groups to create a multinational association in the Asia Pacific region. These concepts are need, team building, funding, management and program development. APACT was born out of the need for Asia Pacific anti-smoking groups to resist US trade sanctions. Sanctions which the US threatened to apply to a number of Asia Pacific nations if those nations refused to eliminate trade barriers to US tobacco marketing and sales. The development of APACTs social action program and its impact is presented for the year 1989–90. Also included is a brief statement of APACTs five-year plan for controlling tobacco related diseases.

The Effect of Tax Reform on School Health Education Programs

A number of Massachusetts schools implemented a health course as a result of passage of a 1974 law requiring teaching of health. This surge of health teaching now appears to be in danger in 1982 because of the passage of a recent tax referendum (Proposition 2½). To determine projected impact of this tax reform on school health education, a questionnaire was sent to administrators of 200 school districts. The results showed that there was a significant increase in the number of schools implementing health courses since 1974. However, the tax referendum produced severe pressure for many newly developed programs to lay-off health teachers or eliminate health courses. School administrators recommended several coping strategies, including: employment of dual-major teachers, shifting required courses to electives, and marshalling support of the program through a viable School Health Advisory Committee. It was observed that Massachusetts serves as a case study forecasting impending fiscal crisis in other states.

A survey of eating/dieting attitudes and bulimic behavior among university undergraduate women.

A random sample of female undergraduates at a large New England state university was surveyed by mail in 1983 to determine their attitudes and behavior relating to eating, dieting, and body weight. Results indicated dissatisfaction with and negative attitudes about eating habits and body weight. Forty-five percent had ever experienced uncontrolled binge-eating; 18 percent had a combination of bulimia symptoms, and 10 percent had used self-induced vomiting for weight control. The health education needs and interests of these students also were assessed and recommendations for university programs were made.

Community Health Education Literature from the Seventies: A Faculty Survey

Faculty teaching in accredited graduate programs of community health education in U.S. universities were surveyed by mail to determine which articles published during the 1970s they would recommend that their colleagues read. The suggested readings were collected and abstracted and are presented herewith in annotated bibliographic form. The second phase of the study, a comparable survey of field practitioners, is being analyzed for a future issue of the journal.

Eating Attitudes, Dieting, and Bulimia among Junior High School Students

Students in a western New England (U.S.) junior high school (ages 11–15) were surveyed in 1986 to identify attitudes and behaviors about eating and dieting which might foster disordered eating habits. Although few students met official criteria for disordered eating habits, at least 12 percent did practice dieting and 28 percent were frequently preoccupied with the desire to be thinner and/or were terrified of being overweight. One-quarter of girls (vs. only 3.2% of boys) mistakenly classified themselves overweight. Perception of ones own weight seems to be more highly correlated with measures of eating attitude and behavior than does actual weight. Differences also were found in how males and females viewed their own weight although both dieted to about the same extent. Females also were more interested in having school classes on eating and dieting. Recommendations were made for prevention and education regarding eating disorders among this age group.

Guest editorial: the impact of u.s. Policy on tobacco trade with taiwan.

U.S. tobacco consumption has been declining steadily since World War 11. In 1944, when the first nationwide survey on tobacco consumption in the United States was taken, 41 percent of the U.S. population were smokers. In 1975, at the closing of the Vietnam War, the rate of smoking in the United States was 33.3 percent. In 1986, a C.D.C. telephone survey showed that only 26.5 percent of the nation’s population were smokers [ 11 . While U.S. tobacco sales are weakening, the U.S. government is also experiencing a frighteningly high budget deficit that is partially fueled by the record high trade deficit. The U.S. trade deficit to Taiwan was about 13.6 billion in 1986 and close to 20 billion in 1987 [2]. In order to reduce the trade deficit, the Reagan administration has selected tobacco as one of the products to push for export to Taiwan, one that has strong lobbying power politically and is increasingly experiencing selling difficulties domestically. Accordingly, the U.S. Trade Representative, Clayton Yeuter, was sent to negotiate with the Taiwan government in 1985 for tobacco trade with Section 301 of the U.S. Congressional Trade Act as a possible retaliatory weapon. After lengthy and difficult negotiation, U.S. tobacco sales began on a large scale in Taiwan in January 1987.

Community Health Education Literature from the Seventies: A Field Practitioner Survey

A national sample of community health education practitioners in the United States was surveyed by mail and asked to select five articles published during the 1970s they would recommend that their colleagues read. The study was conducted in late 1979 after a comparable national survey of university health education faculty by Cernada and Chen (International Quarterly of Community Health Education, 1:2 and 2:1). The recommended readings were collected and abstracted, and are presented in annotated bibliographic form. A comparison of practitioner and academic selections is in preparation.