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Tobacco Cessation Videos on YouTube
As part of its New Media Initiative, the Youth Tobacco Cessation Collaborative (YTCC) recently analyzed tobacco cessation content in videos on YouTube. Young adult tobacco users, like most young adults, seek out information differently than the older adult population and are more likely to get cessation information from non-traditional sources. Young adults aged 18-24 years old are more likely to use the internet, use instant messaging, and visit social networking sites, than the rest of the adult population. In order to determine the types of cessation messages that young adults may be accessing through these channels, YTCC decided to conduct an initial analysis of tobacco cessation content in videos on YouTube. YouTube, created in 2005, is a video sharing website where users can upload, view and share video clips. The site displays a wide variety of user-generated video content, including movie clips, TV clips and music videos, as well as amateur content such as videoblogging and short original videos. YouTube has steadily risen in popularity since its inception. In January 2008 alone, nearly 79 million users had made over 3 billion video views. For the analysis, a variety of search terms were used to identify videos containing tobacco cessation content on YouTube, including "stop smoking," "smoking cessation," "tobacco cessation," and "quit smoking." Only videos that contained specific content on tobacco cessation treatment methods were included in the analysis. Other content related to tobacco, such as health effects of tobacco use, prevention messages or reasons to quit, were excluded. The top 50 relevant videos that focused on cessation were analyzed for the most common evidence-based and non-evidence based treatments including:
The videos were coded based on whether or not the specific treatments were mentioned and whether the mention was positive or negative. This initial research revealed that non-evidence based treatments are most often depicted positively while evidence-based treatments, such as NRT and prescription medications, are often depicted negatively. Out of 70 positive mentions of treatment methods in the 50 videos, there were 40 positive descriptions/recommendations for non-evidence based treatments compared to 30 for evidence-based treatments. The most commonly recommended non-evidence based treatments were hypnosis (13 positive descriptions), acupuncture (8 positive descriptions), and other methods (14 positive descriptions). Telephone counseling was the most commonly recommend evidence-based treatment with 10 recommendations. In addition, there were no negative mentions of non-evidence
based treatments in the videos. Only evidence-based treatments
were depicted negatively. Out of the 79 cessation treatment mentions
in the videos, there were 9 negative mentions for evidence-based
treatments. Nicotine replacement therapy received 5 negative descriptions
and prescription medications received 4 negative descriptions.
This brief analysis indicates that anyone, including young adult tobacco users, searching for cessation information on YouTube will encounter mixed messages or even misleading information about safe, effective ways to quit. To follow-up on these initial findings, NCI and YTCC will conduct a more rigorous and in-depth analysis of the cessation content on YouTube to make stronger conclusions and recommendations about the messages being communicated through this channel. For more information, contact Jessica Nadeau at jnadeau@aed.org. New Study Finds California's Tobacco Control Program Has Saved Billions in Medical Costs California's state tobacco control program saved $86 billion -- in 2004 dollars -- in personal health care costs in its first 15 years, according to a study by researchers at the University of California, San Francisco. During the same period, the state spent only a total of $1.8 billion on the program, a 50-to-1 return on investment, according to study findings. The study is the first that has been able to quantifiably connect tobacco control to health care savings, say its authors. The health care savings occurred because the program prevented 3.6 billion packs of cigarettes -- worth $9.2 billion to the tobacco industry -- from being smoked between 1989, when the state-funded California Tobacco Control Program began, and 2004, when this study ended. Findings are published in the August 25 online issue of the journal PLoS Medicine. "The benefits of the program accrued very quickly and are very large," says Stanton Glantz, PhD, senior author on the paper and director of the UCSF Center for Tobacco Control Research and Education. Glantz, a UCSF professor of medicine, says the reason that the California program had such large and rapid benefits in terms of health care costs was the fact that it is directed at adults, not youth. "When adults stop smoking, you see immediate benefits in heart disease, with impacts on cancer and lung diseases starting to appear a year or two later." The study found evidence of health cost reductions in the first year after the start of the California program, which focused on adults and social norm change, rather than the more common approach of focusing on adolescent use prevention. These cost savings also occurred despite a substantial diversion of funding during the mid-1990s and the fact that inflation has eroded the purchasing power of the 5-cent per pack cigarette tax that funds the program. The researchers estimate that if the funding had been maintained at the same level of intensity as in the program's early years ($4.76 per capita, about $80 million per year), total health care cost savings over 15 years would have increased from $86 billion to $156 billion. Large state tobacco control programs have previously been shown to reduce smoking, heart attacks and cancer, Glantz says, but this is the first time researchers have been able to quantify the effects on health costs. He says the breakthrough came by teaming up with James Lightwood, PhD, assistant adjunct professor in the UCSF School of Pharmacy who specializes in mathematical modeling, health economics, and statistics. Lightwood used methods known as "co-integrating regressions," which were developed to analyze financial markets, to account for the changing nature of the determinants of smoking behavior, medical technology and costs. Using the approach of co-integrating regressions, the researchers modeled the relationship between per capita tobacco control expenditures, per capita cigarette consumption and health care expenditures across the study time frame. They compared those results in California to 38 control states that did not have comprehensive tobacco control programs before 2000. The work was supported in part by grants from the National Cancer Institute. For more information, see web link:
ER Visits for Asthma Drop After Lexington, KY Smoking Ban Asthma-related emergency room visits dropped sharply after Lexington's smoking ban took effect in 2004, according to a University of Kentucky study. The study, which researchers believe to be the first of its kind, assessed visits to emergency departments in four Lexington hospitals 40 months before the smoking ban and 32 months afterward, finding an average 22 percent decline in asthma visits -- 24 percent for adults and 18 percent for children up to 19 years old. "We can't say smoke-free laws cause these declines. We can say there's a significant relationship," said University of Kentucky nursing professor Ellen Hahn, one of seven authors of the study to be published in the September issue of the Journal of Allergy and Clinical Immunology. "This adds to the growing body of evidence that we have significant health benefits from smoke-free laws." The study says there were 14,839 asthma-related visits from 2001 through 2006. Researchers determined age-adjusted rates of such visits, adjusted for seasonal and other factors and compared them for periods before and after the smoking ban went into effect. The U.S. Environmental Protection Agency says secondhand smoke can trigger asthma episodes and increase the severity of attacks, irritating chronically inflamed bronchial passages. Kentucky has the nation's highest adult smoking rate -- 28.6 percent -- and nearly 93,000 children and 262,000 adults with asthma, according to the American Lung Association of Kentucky. "Think of how many asthmatics can benefit from smoke-free laws," said Mike Kuntz, senior director of advocacy for the association. "This sounds like groundbreaking research." Hahn said she believes findings would be similar in other places with smoking bans. She said Louisville might see an even bigger drop in ER visits because it prohibits smoking in public buildings and workplaces, while Lexington's ban exempts workplaces closed to the general public. Hahn said her study is partially funded by the Miami-based Flight Attendant Medical Research Institute, established as a result of a class action lawsuit against the tobacco industry, and has limitations. For example, researchers did not have a control group to compare trends in a population without a smoking ban, and did not measure actual exposure of individuals to secondhand smoke. Despite the limitations, researchers said the study has important clinical implications about the impact smoking bans can have on emergency visits for asthma. "Hopefully, there will be other studies," Hahn said. "Asthma is a concern all over the country." For more information, see web link:
Smoking Addiction Could Be In Your Genes Researchers from the University of Michigan, Washington University School of Medicine, as well as from the University of North Carolina discovered that the chances of a person to become addicted to smoking could be in his/her genes. Researchers identified a gene variant that is more present in people who become addicted. The same gene variant has been implicated in the development of lung cancer as well, the researchers said in the August 8 issue of the journal Addiction. "If you have this variant, you are going to like your earliest experiences with smoking. What they don't realize is if they have this kind of genetic make-up, they are on their way to dependency," Ovide Pomerleau, professor of psychiatry at the University of Michigan Medical School and lead author of the study, said. The research is the more important as it may help development of anti-smoking drugs. For the study, Pomerlau and colleagues analyzed the association between initial smoking experience, current smoking patterns, and a specific variant in a nicotine receptor gene known as CHRNA5 in 435 smokers and nonsmokers. Nonsmokers in the study had smoked at least one cigarette during their lives but had never become addicted. Smokers had smoked at least five cigarettes a day for the past five years or longer. The researchers discovered that smokers were eight times more likely to report their first cigarettes gave them a pleasurable buzz compared to nonsmokers. Also smokers were more likely to have the variant of the CHRNA5 gene (rsl16969968) that has been linked with increased susceptibility to nicotine addiction. "People with this genetic makeup find smoking pleasurable from that first cigarette and they are more likely to get addicted and develop lung cancer," Pomerleau said. However, genes alone aren't responsible for smoking, which is a complex interaction of social and environmental triggers, the researchers said. They are now trying to figure out the way the genetic, behavioral, and environmental components influence smoking and addiction. The findings could lead to the development of new therapies that could help smokers quit the habit much easier than the current treatments for smoking cessation. However, it will take years to develop such a therapy, Pomerleau said. For more information, see web link:
Studies Show Smoking Declining in Arkansas New research shows that Arkansas is making definite headway in its fight against tobacco use in the state. Three separate studies indicate positive outcomes, including significant reductions in adult smoking, lower hospitalization rates for diseases related to tobacco use, and positive results for youth smoking. "From the beginning, Arkansas has pledged its tobacco-settlement funds strictly to health programs, and these are the benefits of that investment," Governor Mike Beebe said. "Continuing this trend can help curb the spiraling costs of health care for Arkansans." A new study shows that there were 84,000 fewer smokers in Arkansas in 2007 than if smoking rates in 2002 had continued unchanged to 2007. Since 2002 the percentage of adults in Arkansas who smoke decreased from 26.3 percent to 22.4 percent in 2007. "What this tells us is that our programs are all working together to bring rates of tobacco use down," said Paul K. Halverson, DrPH, FACHE, State Health Officer and Director of the Arkansas Department of Health (ADH). "The drop in the adult rate is very encouraging, because it is most difficult to change that rate. Evidence has shown that only a comprehensive approach to tobacco control can do that." A smaller number of adult smokers is already translating into a significant reduction in hospitalization rates for heart disease, stroke, emphysema and bronchitis, according to a study on hospitalization costs done by ADH. Using hospitalization charges for these conditions, the bottom line savings amounts to $22 million dollars in 2006 alone. "It's important to note that these projections apply to only one year, but we are really contemplating a lifetime of savings, and in fact, lives saved for many years to come," said Joe Bates, MD, Deputy State Health Officer and Chief Science Officer. "As we continue to reduce the numbers of young people who never start smoking, the financial impact on our state is very, very positive." The news is even better for reductions in youth smoking. Since 2001 the rate of current cigarette smoking has dropped from 34.7 percent to 20.7 percent in 2007 among Arkansas high school students, according to the Youth Risk Behavior Surveillance Survey (YRBSS). Dr. Joe Thompson, Director of the Arkansas Center for Health Improvement and Arkansas's Surgeon General said, "This is encouraging news and we're definitely headed in the right direction, but tobacco use continues to place too great a burden on our state." According to Thompson, the Centers for Disease Control and Prevention estimates that smoking-caused health costs and productivity losses total $10.28 per pack sold. In Arkansas, that amounts to more than $2 billion a year. Dr. Paul Halverson said, "Evidence points to the fact that all the different intervention programs must be in place for the best outcomes. Combined cessation and prevention programs are the key to our continued success." For more information on how the Arkansas Tobacco Prevention and Cessation Program works to reduce tobacco use in Arkansas, visit the website at: www.stampoutsmoking.com. For more information, see web link:
Hospital Admissions Fall 17 Percent After Scottish Law Enacted A new study from Scotland provides what public-health experts in the U.S. say is the strongest evidence yet that public bans on smoking improve health by reducing exposure to secondhand smoke. According to the study, which appears in the New England Journal of Medicine, hospital admissions for heart attacks and acute coronary problems fell 17 percent overall in the year after Scotland banned smoking in public places, compared with an overall 3 percent annual decrease seen over the entire decade before. When they compared this rate to England, which has no such ban on smoking, they found a 4 percent decrease. The study found that nonsmokers accounted for 67 percent of the overall reduction in heart-disease hospitalizations, said Jill Pell, the University of Glasgow professor who led the study. Nonsmokers saw a 20 percent reduction in their hospital admissions following the ban. Smokers' admissions were down 14 percent. Investigators examined first- and secondhand smoking histories in all patients admitted to nine Scottish hospitals for acute coronary syndromes (overt heart attacks and unstable chest-pain episodes due to blockage of heart arteries) for the 10 months before and after the institution of the smoking ban. These nine hospitals account for almost two-thirds of all Scottish hospitalizations for those diagnoses. This isn't the first study published on the health impact of smoking bans -- the 17 percent decrease in hospitalizations among Scots was comparable to rates recorded in previous research. But these findings "should add considerable oomph to the pressure for smoking bans" elsewhere, because of the study's rigor and use of blood tests, said Edith Balbach, director of the Community Health Program at Tufts University and president of Americans for Nonsmokers' Rights. Researchers found that nonsmokers with heart disease
had higher levels of cotinine than the general population but
lower levels than before the ban, a sign that their exposure to
secondhand smoke had decreased but was still a factor in their
heart damage. For more information, see web link:
Adult Smoking Rate Plunges in Massachusetts Nearly eight percent fewer Massachusetts adults smoked in 2007 than the year before, the steepest decline in cigarette use in more than a decade, state health authorities recently reported. The drop coincided with the revival of the state's tobacco-control program, which was slashed under the recent administrations. The Department of Public Health, for example, in boosting its spending by 50 percent, resurrected in-your-face television ads starring former smokers whose health was affected by cigarettes. At the same time, the state's quest to insure nearly every resident, which has extended coverage to more than 350,000 adults, may have contributed to the decline. "When we looked at studies about who influenced decisions about ending smoking, the primary-care doctor was at the top of the list," said John Auerbach, the state's public health commissioner. The law establishing near-universal coverage also ordered the state's medical program that insures the poor to pay for smoking cessation counseling and nicotine replacement patches. Even as the state's smoking rate reached a historic low of 16.4 percent in 2007, there are strong hints that the decline is accelerating this year. When cigarette taxes increased by $1 a pack at the start of this month, it spawned a flurry of calls to the state hotline that helps smokers. In a typical month, that service gets 400 or 500 calls. More than 7,000 people had called in July, compelling the state to extend a nicotine replacement patch giveaway through August to meet demand. That two-month campaign is costing $500,000. Overall, the state spent close to $13 million on tobacco control in the budget year that just ended. At its high point, in 2001, spending stood at $50.5 million; within a few years, it had plunged to $2.5 million. Tobacco-control specialists not connected with the state cautioned that it can be risky to draw too many conclusions from one year's worth of data. But they also acknowledged that Massachusetts' smoking rates have been plunging for two decades. The one-year decline in smoking has been even more pronounced among adolescents, previously released figures showed. In 2007, 17.7 percent of adolescents said they smoked regularly, down from 20.5 percent the year before. The adult smoking rates emerged from an annual survey conducted by the state that asks thousands of residents about behaviors related to their health. Only California, Connecticut, and Utah have lower smoking rates. For more information, see web link:
Fresher, Cleaner Air in Charleston, SC
A recent study showed that air pollution in Charleston, SC decreased 94 percent in 34 area bars and restaurants after the smoking ban was initiated. Although not surprising, the numbers are striking, said lead researcher Matthew Carpenter, an assistant professor and clinical psychologist at the Medical University of South Carolina who specializes in addictive behaviors and smoking cessation. Ten venues were surveyed in North Charleston, which does not have a no-smoking ordinance, and particulate levels registered three times the maximum allowable level set by the U.S. Environmental Protection Agency, Carpenter said. The study began in 2006, when the researchers analyzed air quality in 23 venues that allowed smoking in Charleston and 11 in Mount Pleasant. The venues were tested again in 2008 after local smoke-free ordinances took effect. In 2006 in Charleston and Mount Pleasant, the average of the fine particulate air pollution in surveyed venues was, respectively, 369 and 118 micrograms per cubic meter. The EPA's maximum daily allowable exposure is 35. After the smoking bans in those municipalities went into effect, Charleston dropped to 14 and Mount Pleasant to 20. The restaurants and bars surveyed in North Charleston averaged 186 micrograms per cubic meter in 2006, and 109 in 2008. Researchers used a discreet monitor small enough to fit in a purse and stayed in each business for at least 30 minutes. The device draws in air from the surrounding environment and measures pollution. Business names were not released because the survey was done without owners' knowledge. The findings were independently reviewed by Roswell Park Cancer Institute in Buffalo, N.Y. The S.C. African American Tobacco Control Network sponsored the study, paying $2,000 for analysis and $1,000 for food and beverage costs of testers. Carpenter did not receive payment for his work. "The reason (the network) is concerned is because African-Americans are disproportionately impacted by secondhand smoke," said Dan Carrigan, consultant to the group. "A lot of that exposure occurs on the work site." For more information, see web link:
Major Government Report Concludes That Tobacco Marketing and Smoking in Movies Promote Youth Smoking Leaders from the federal government and the nation's public health community recently announced the release of an authoritative National Cancer Institute report that reaches the government's strongest conclusion to date that tobacco marketing and depictions of smoking in movies promote youth smoking. The report, "The Role of the Media in Promoting and Reducing Tobacco Use," presents definitive conclusions that a) tobacco advertising and promotion are causally related to increased tobacco use, and b) exposure to depictions of smoking in movies is causally related to youth smoking initiation. The report also concludes that mass media campaigns can reduce smoking, especially when combined with other tobacco control strategies. However, youth smoking prevention campaigns sponsored by the tobacco industry have been generally ineffective and may actually have increased youth smoking. This report provides the most current and comprehensive analysis of more than 1,000 scientific studies on the role of the media in encouraging and discouraging tobacco use. The report is Monograph 19 in the National Cancer Institute's Tobacco Control Monograph series examining critical issues in tobacco prevention and control. "The media have been used to promote cigarettes and smoking through infamous advertising icons - such as the Marlboro Man and Joe Camel - and through tobacco images in Hollywood movies. The media have also been used to increase smoking cessation and reduce smoking initiation, through paid advertising campaigns and public service announcements about the dangers of smoking. This monograph presents the most current and comprehensive analysis of the scientific evidence on the impact of these forces, and other media exposures, on beliefs, attitudes, and behaviors concerning tobacco use," said Ronald M. Davis, M.D., senior scientific editor, director of the Henry Ford Health System's Center for Health Promotion and Disease Prevention, and Immediate Past President of the American Medical Association. The monograph also concludes that:
The editors of the monograph outline several steps that have been proposed to reduce use of the media in promoting tobacco use and increase its use in discouraging tobacco use, including:
"This report sends a loud and clear message to policy-makers: We need less tobacco company marketing and more anti-tobacco advertising," said William V. Corr, Executive Director of the Campaign for Tobacco-Free Kids. "It shows why we need strong regulation of tobacco products and their marketing to prevent tobacco companies from continuing to target our children. It also should prompt states to fully fund tobacco prevention and cessation campaigns that are proven to work. And it should spur governments worldwide to implement the international tobacco control treaty, which calls on governments to ban all tobacco advertising, promotion and sponsorship and fund effective public education campaigns." For more information or to order this monograph, go to http://www.cancercontrol.cancer.gov/tcrb/monographs/19/index.htm. To order a free copy, call the NCI Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) and ask for NIH Publication No. 07-6242. For more information, see web link:
Songs from the current truth® advertising campaign are getting a new twist this summer, with nine innovative and well-known DJs and bands putting new spins on the songs by re-mixing them in styles from house and hip-hop to electro. As part of the truth® "ReMix" project, DJs and bands such as Cobra Starship, Diplo, Kaskadee and more will re-mix songs from the "Sunny Side of truth®" - the current advertising campaign from the nation's largest youth smoking prevention campaign. The ReMix music tracks will then be packaged as a special CD compilation and available on the truth® tour as well as for download online. The ReMix project is part of a comprehensive effort to reach more of the teen audience through technology and alternative media & entertainment outlets already popular with teens. "Many of the life-saving messages around the truth® campaign are designed to be spread peer-to-peer," said Dr. Cheryl Healton, President & CEO of the American Legacy Foundation. "With the ReMix project, we're pairing the innovative talents of an impressive lineup of DJs and bands, with the use of newer media outlets where teens already go to be entertained, share information, and connect with friends. It's just another creative way that truth® is evolving as a way to continue to stay relevant and cool with teens, and get our life-saving information top of mind." The truth® ReMix project is part of the campaign's overall strategy to reach teens where they live and play, including on the truth® summer tour, as well as on digital music platforms like iTunes and Napster, social networking sites like MySpace and Facebook and TV networks popular with youth, such as G4 and VH1. Teens will be able to share the ReMixes on their cell phones by using a special widget that gives users the ability to send ReMix songs to their friends' phones with a personalized message included. Podcasts will be created in order to allow viewers to get a behind-the-scenes look at the artists' creating the songs and discussing their motivation for being part of the program. "All of these extensions of ReMix speak to how we are able to use today's rich media toolbox to reach teens on their own terms," said Eric Asche, SVP of Marketing at the American Legacy Foundation. "Our life-saving messages stay the same, but we constantly refresh our media delivery channels to make sure today's teens get our messages quickly and easily in ways that resonate with them." Also, starting July 9th, ReMix songs have been playing on various radio stations across the country, including KTEG-FM (104.7) in Albuquerque, NM and KPLN-FM (106.7) in Billings, MT. More information about ReMix, including bios of the DJs and bands as well as the MP3 versions of their remixes are available at www.thetruth.com/remix. For more information, see web link:
SAMHSA Announces New Smoke-Free Meeting Policy The Substance Abuse and Mental Health Services Administration (SAMHSA) recently announced a new policy requiring that all meetings and conferences organized or primarily sponsored by SAMHSA be held in a state, county, city, or town that has adopted a comprehensive smoke-free policy, unless specific circumstances justify an exemption. This policy is based on extensive scientific data, summarized in the U.S. Surgeon General's report, "The Health Consequences of Involuntary Exposure to Tobacco Smoke," indicating that secondhand smoke (also known as environmental tobacco smoke) causes premature death and disease in children and in adults who do not smoke. "SAMHSA recognizes that secondhand smoke exposure poses serious health risks to nonsmokers. An estimated 50,000 nonsmoking Americans die each year as a result of exposure to secondhand smoke," said SAMHSA Administrator Terry L. Cline, Ph.D. "This Smoke-Free Conference Policy will help protect our employees and other conference participants from the adverse effects associated with secondhand smoke." In adopting the Smoke-Free Conference Policy, SAMHSA joins three other federal agencies which have already implemented this policy - the National Cancer Institute, National Institute on Drug Abuse, and Centers for Disease Control and Prevention. To identify smoke-free jurisdictions, SAMHSA conference planners will be using the list of smoke-free jurisdictions found at http://meetings.smokefree.gov. More information on SAMHSA's Smoke-Free Conference
Policy can be found at www.samhsa.gov/smokefree.
AAFP Ask and Act Podcasts Provide Tips for Helping Patients Become Tobacco-free The AAFP has released four of five planned podcasts in its "Ask the Expert" tobacco cessation podcast series. The podcasts are part of the Academy's Ask and Act tobacco cessation program, which encourages family physicians to ask all patients about tobacco use and then act to help them quit. Each of the brief audio interviews with clinical content experts covers a specific tobacco-related topic. New
Public Health Service Clinical Practice Guidelines (11:16-minute
MP3 file) Pharmacotherapy
for Tobacco Dependence (11:58-minute MP3 file) |
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