Combating Teen Smoking: Research and Policy Strategies - Softcover

Jacobson, Peter D.; Warner PhD, Kenneth Edgar; Lantz PhD, Paula M.; Wasserman PhD, Jeffrey; Pollack, Harold Alexander; Ahlstrom, Alexis Kristiana

9780472067718: Combating Teen Smoking: Research and Policy Strategies

Softcover

ISBN 10: 0472067710 ISBN 13: 9780472067718

Publisher: University of Michigan Press, 2001

Every year, more than 400,000 Americans die prematurely because of tobacco use. Most began smoking during their teen years. Adolescent tobacco use remains our nation's most preventable threat to life and health. This public health crisis has generated widespread debate over how best to prevent young people from initiating smoking or using other tobacco products. Combating Teen Smoking is an invaluable guide for policymakers and communities on the front lines of this prevention effort.
Synthesizing recent research regarding the prevention and control of adolescent smoking, this book offers the reader a convenient compendium of what is known about adolescents and tobacco use; it also highlights areas where additional research is needed. Based on their assessment of the considerable amount of information presented, the authors recommend various ways to help slow--or even reverse--the recent rise in teenage smoking. A comprehensive antitobacco program might include, for example, antismoking media campaigns based on social marketing strategies, clean indoor air laws, and the increase of cigarette prices.
Combating Teen Smoking will appeal to a broad spectrum of readers concerned about the problem of adolescent tobacco use, including policymakers who are actively seeking ways to help reduce teen smoking.
Peter D. Jacobson is Associate Professor, University of Michigan School of Public Health. Paula Lantz is Assistant Professor, University of Michigan School of Public Health. Kenneth Warner is Richard D. Remington Collegiate Professor of Public Health and Director, University of Michigan Tobacco Research Network. Jeffrey Wasserman is Consultant, the RAND Corporation and Senior Project Director, The MEDSTAT Group. Harold Pollack is Assistant Professor, University of Michigan School of Public Health. Alexis Ahlstrom is Research Associate, University of Michigan School of Public Health.

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From The New England Journal of Medicine:

Readers might turn to this book seeking answers to three obvious questions about smoking among teenagers. Why do teenagers smoke? How can we prevent them from smoking? And how can we help them to quit? Unfortunately, the evidence carefully assembled and reviewed in this book cannot answer these questions with certainty -- a reflection of the current state of this vexing public health problem. The book offers a research agenda to remedy the gaps in our knowledge and calls for comprehensive strategies for controlling smoking by young people, but it can only suggest a menu of possible options. The authors, tobacco-control veterans, are optimistic and pragmatic, and they appropriately propose action in spite of uncertainty even as research and surveillance provide further insights.

Readers seeking an up-to-date picture of teenage smoking will find the book useful. Its chapters cover the full spectrum of data relevant to the topic. They are based on a comprehensive review of the literature and a detailed characterization of the current picture of teen smoking from survey data. An introductory chapter sets out the policy context, which has continually evolved, most recently with the Master Settlement Agreement between the states and the tobacco industry. As a consequence of that agreement, an unprecedented level of funding is now available for tobacco control, at the state and local level through funds received by the states and at the national level through the American Legacy Foundation. The second chapter offers a detailed and troubling picture of the continued high rate of teenage smoking, which declined but then increased during the 1990s before falling back in the past several years. Risk factors for teenage smoking have been identified, and these risk factors offer points for intervention: smoking among peers, parental smoking and other familial influences, latent susceptibility, and beliefs, attitudes, and self-image. The substantial body of evidence on prevention methods and the far more limited data on cessation provide a gloomy picture of mixed evidence in spite of decades of research. Readers may be surprised to learn of the limited success of health education in schools.

The foundation for the control of teenage smoking through antismoking interventions in the mass media, tax increases, and regulation is set out in three separate chapters. Although the authors conclude that research does not definitively link advertising by the tobacco industry to the initiation of smoking by young people, they suggest that we should learn from the tobacco industry and develop mass-media campaigns based on social marketing principles. Increases in the price of cigarettes are thought to have the potential for only minor effects on teenage smoking, whereas regulation is viewed as having good potential.

The evidence presented in these chapters is the foundation for recommendations for a comprehensive tobacco-control program with elements matching the needs of the locale, whether at the state or the community level. The authors are hopeful that a variety of interventions, through synergy, would have an enhanced effect. The menu of elements for the comprehensive strategy is offered, but without principles for selecting among the options. And, of course, more research is needed, as pointed out in the last chapter.

The authors' frustration with mixed evidence and uncertainty shows, but with a dynamic public health problem such as teenage smoking, evidence can never be definitive and policies must always evolve to match the context. The authors' documentation of the strategies of the tobacco industry highlights one element of the challenge: a successful intervention seems to be followed inevitably by a new tactic to ensure that no decrease in sales occurs. And, over the decades covered in this book, the factors affecting teenage smoking, ranging from personal to societal, have changed continually. We need sustained research to support evidence-based policies and continued evaluation and surveillance to redirect strategies for control as necessary.

Jonathan Samet, M.D.
Copyright � 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

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