By Вen Li
A pair of recent studies about tobacco use caught our attention this week. The first meta-study examines the effectiveness of various smoking prevention measures, while the second focuses on smoking cessation on one college campus.
In a review article in the July/August issue of the Journal of Public Health Management Practice, entitled “The Effects of Tobacco Control Policies on Smoking Rates: A Tobacco Control Scorecard”, authors David Levy, Frank Chaloupka and Joseph Gitchell conclude that increases in cigarette taxes and enacting clean air laws are the most effective smoking reduction policy. After reviewing over 100 articles, the trio of authors said combining these tactics with a mass media campaign “of large enough scale and duration, has the potential to further reduce smoking prevalence by 5-10 per cent.”
The study, funded in part by GlaxoSmithKline Consumer Healthcare which manufactures smoking cessation aids, found that a 10 per cent increase in taxes or the price of cigarettes can increase quit rates by 3-5 per cent, and that a 25 per cent increase in price decreases smoking rates by 7-15 per cent, though they admit that relatively few other studies on pricing exist to back this up. The largest subgroups affected are youth and low-income smokers, characteristics applicable to a large portion of people whose occupations are located at the U of C.
Enacting clean air laws appears to decrease work site smoking by 7-8 per cent, while comprehensive bans on smoking at workplaces decrease smoking by 11 per cent. The authors note that more evidence exists regarding this as a smoking-reduction measure, but that the actual effect measured is highly variable. Clean air laws and smoking bans tend to affect high-income males and the 24-54 age demographic, but results depend on other restrictions in private places.
Media campaigns increase quit rates by 40 per cent, a conclusion supported by a moderate quantity of evidence. In conjunction with the first two methods, smoking prevalence can be decreased by a further seven per cent through a well-funded campaign. They caution, however, that such campaigns need to be of sufficient scale and duration, with a special need to focus on youth.
Other methods studied include: expanding access to cessation treatment, which increased quit rates by 5-25 per cent, and decreased smoking prevalence by 1-2 per cent; and telephone hotlines which increase quit rates by 20-40 per cent and decreased smoking prevalence by less than one per cent.
Importantly, the study also found minimal evidence that warning labels on cigarette packages decreased smoking. While the authors found one study that showed attempted quit rates doubled, they found no evidence that warning labels resulted in successful cessation, and only very weak evidence that they may decrease prevalence by up to two per cent.
They conclude that “Tobacco control policies may generally be made more effective if they are supported by government agencies and advocacy groups. Active support by these groups may increase public support and compliance with the laws.”
Of all the methods included in the meta-study, avenues available to the University of Calgary and the Students’ Union include increasing pricing, enacting bans on smoking, media campaigns, and increasing access to smoking cessation treatments.
In a separate study in the July/August issue of the Journal of American College Health entitled “Smoking Cessation and Relapse Prevention Among Undergraduate Students: A Pilot Demonstration Project,” Jim Ramsay and Anne Hoffmann examined the feasibility of peer-lead cessation and relapse-prevention programs in a single northeastern U.S. campus.
They conclude that a “fully integrated tobacco management approach may hold promise as a clinically and financially effective solution for college campuses.” Among the suggested components of the integrated approach are monthly group meetings, face-to-face individualized feedback, a proprietary smoking-cessation program called Freedom From Smoking, age-appropriate literature, and course credit for being involved in a cessation program. Facilitated use of FFS showed the greatest effect, with an 88.2 per cent quit rate among participants, but only 35 per cent of all student participants opted to receive course credit.
The researchers also found that adult learners were more highly motivated, resourceful and reflective about all learning activities, including smoking cessation, than their younger counterparts. Therefore, different cessation methodologies are required.
The authors also state that “lifestyle choices and stress-management strategies adopted by students during their college years persist into adult life; therefore, the necessity of improving existing smoking-cessation and relapse-prevention strategies for undergraduate students is self-evident.”