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Biomedical subjects

J R DiFranza

Publications and source records attributed to J R DiFranza.

At least 37 records · Page 2Linked to original sources
PubMed1996

Tobacco industry efforts hindering enforcement of the ban on tobacco sales to minors: actions speak louder than words.

OBJECTIVE: The tobacco manufacturers state that they want to see laws that prohibit the sale of tobacco to minors enacted and enforced. Our purpose was to compare these public statements with the US tobacco industry's legislative agenda at the federal and state levels. DESIGN: A review of the industry's comments to the US Department of Health and Human Services (DHHS) regarding proposed federal regulations, and an analysis of pro-tobacco state legislation concerning tobacco sales to minors. RESULTS: The industry is strongly opposed to federal regulations requiring states to effectively enforce their laws prohibiting the sale of tobacco to minors. A food industry newsletter reports that the Tobacco Institute has circulated a model state bill concerning underage tobacco sales. Striking similarities between bills from several states would seem to confirm this report. These bills strip communities of enforcement authority while making effective enforcement by state officials virtually impossible. CONCLUSION: The evidence strongly suggests an industry strategy to undermine efforts to enforce laws prohibiting the sale of tobacco to minors. As has been the case in the past, the tobacco industry is publicly endorsing a socially responsible goal while apparently taking action behind the scenes to ensure that the goal is not achieved.

Adolescent↗
PubMed1996

Youth access to tobacco: the effects of age, gender, vending machine locks, and "it's the law" programs.

OBJECTIVES: This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. METHODS: Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in It's the Law programs. RESULTS: In communities with no requirements for lockout devices, illegal sales were far more likely from vending machines than from over-the-counter sources (odds ratio [OR] = 5.9, 95% confidence interval [CI] = 3.3, 10.3). Locks on vending machines made them equivalent to over-the-counter sources in terms of illegal sales to youths. Vendors participating in It's the Law programs were as likely to make illegal sales as nonparticipants (OR = 0.87, 95% CI = 0.57, 1.35). Girls and youths 16 years of age and older were more successful at purchasing tobacco. CONCLUSIONS: The It's the Law programs are ineffective in preventing illegal sales. While locks made vending machines equivalent to over-the-counter sources in their compliance with the law, they are not a substitute for law enforcement.

Adolescent↗
PubMed1996

Morbidity and mortality in children associated with the use of tobacco products by other people.

OBJECTIVE: To evaluate the impact of adult tobacco use on the health of children. DESIGN: A literature review identified relevant research reports. Meta-analysis was used to compute a pooled risk ratio for each condition studied. The risk ratios were combined with data on exposure rates to produce estimates of the population-attributable risk. RESULTS: Each year, among American children, tobacco is associated with an estimated 284 to 360 deaths from lower respiratory tract illnesses and fires initiated by smoking materials, more than 300 fire-related injuries, 354,000 to 2.2 million episodes of otitis media, 5200 to 165,000 tympanostomies, 14,000 to 21,000 tonsillectomies and/or adenoidectomies, 529,000 physician visits for asthma, 1.3 to 2 million visits for coughs, and in children younger than 5 years of age, 260,000 to 436,000 episodes of bronchitis and 115,000 to 190,000 episodes of pneumonia. CONCLUSIONS: The use of tobacco products by adults has an enormous adverse impact on the health of children. Although more research is needed in several areas, action to reduce the morbidity and mortality among children should not be delayed. New laws and policies are needed to grant children protection from bodily injury and death attributable to use of tobacco products by others.

Adenoidectomy↗
PubMed1995

Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome.

BACKGROUND: The purpose of this study was to estimate the annual morbidity and mortality among fetuses and infants that can be attributed to the use of tobacco products by pregnant women. METHODS: Published research reports identified by literature review were combined in a series of meta-analyses to compute pooled risk ratios, which, in turn, were used to determine the population attributable risk. RESULTS: Each year, use of tobacco products is responsible for an estimated 19,000 to 141,000 tobacco-induced abortions, 32,000 to 61,000 infants born with low birthweight, and 14,000 to 26,000 infants who require admission to neonatal intensive care units. Tobacco use is also annually responsible for an estimated 1900 to 4800 infant deaths resulting from perinatal disorders, and 1200 to 2200 deaths from sudden infant death syndrome (SIDS). CONCLUSIONS: Tobacco use is an important preventable cause of abortions, low birthweight, and deaths from perinatal disorders and SIDS. All pregnant women should be advised that smoking places their unborn children in danger. The low success rate of smoking cessation among pregnant women suggests that efforts to reduce the complications of pregnancy attributable to tobacco use by pregnant women should focus on preventing nicotine addiction among teenaged girls.

Abortion, Spontaneous↗
PubMed1992

Pharmacy promotion of tobacco use among children in Massachusetts.

The role played by pharmacies in the promotion and distribution of tobacco to children was assessed in a survey of 100 pharmacies. Of the 100 surveyed, 95 sold tobacco products, 50 advertised tobacco, 42 advertised the cigarette brands that are most appealing to children, and 23 displayed the Camel cartoon advertisements that have been identified as being targeted specifically at children. Candy tobacco products were sold in 22% of the pharmacies. Of the pharmacies selling tobacco, 81% were willing to sell it to minors illegally. The five pharmacies that did not carry tobacco products were independent stores. When compared to chain pharmacies, independent pharmacies more frequently advertised tobacco (p less than 0.05) but were not more likely to sell it to children. The authors contend that pharmacists who sell tobacco violate the profession's Code of Ethics and play an important role in the promotion of tobacco use among children.

Adolescent↗
PubMed1992

The Tobacco Institute's "It's the Law" campaign: has it halted illegal sales of tobacco to children?

A survey of tobacco retailers was conducted to evaluate the efficacy of the Tobacco Institute's "It's the Law" program, which has the goal of eliminating the illegal sale of tobacco to minors. Only 4.5% (7) of the 156 retailers surveyed were participating in the "It's the Law" program. Eighty-six percent of the retailers who were participating in the program were willing to illegally sell cigarettes to children, compared with 88% (131/149) of the retailers who were not participating.

Adolescent↗
PubMed1992

Preventing teenage tobacco addiction.

Tobacco use remains a major health problem among children and adolescents. Restrictive school policies on tobacco use and enforcement of laws prohibiting the sale of tobacco to minors can produce substantial reductions in tobacco use among this population. This article provides practical, step-by-step instructions to help physicians get these policies implemented in their communities.

Adolescent↗
PubMed1991

RJR Nabisco's cartoon camel promotes camel cigarettes to children.

OBJECTIVES: To determine if RJR Nabisco's cartoon-theme advertising is more effective in promoting Camel cigarettes to children or to adults. To determine if children see, remember, and are influenced by cigarette advertising. DESIGN: Use of four standard marketing measures to compare the effects of Camel's Old Joe cartoon advertising on children and adults. SUBJECTS: High school students, grades 9 through 12, from five regions of the United States, and adults, aged 21 years and over, from Massachusetts. OUTCOME MEASURES: Recognition of Camel's Old Joe cartoon character, product and brand name recall, brand preference, appeal of advertising themes. RESULTS: Children were more likely to report prior exposure to the Old Joe cartoon character (97.7% vs 72.2%; P less than .0001). Children were better able to identify the type of product being advertised (97.5% vs 67.0%; P less than .0001) and the the Camel cigarette brand name (93.6% vs 57.7%; P less than .0001). Children also found the Camel cigarette advertisements more appealing (P less than .0001). Camel's share of the illegal children's cigarette market segment has increased from 0.5% to 32.8%, representing sales estimated at $476 million per year. CONCLUSION: Old Joe Camel cartoon advertisements are far more successful at marketing Camel cigarettes to children than to adults. This finding is consistent with tobacco industry documents that indicate that a major function of tobacco advertising is to promote and maintain tobacco addiction among children.

Adolescent↗
PubMed1990

Alcoholism and smoking.

A case-control study compared the natural history of cigarette smoking in alcoholic and nonalcoholic populations to determine why alcoholism and smoking are closely associated. Eighty-three percent of alcoholics were smokers compared to 34% of the nonalcoholic subjects. Compared to other children, children who later became alcoholic were more likely to become regular users of tobacco once they had tried it. Only 7% of alcoholic smokers were successful in their attempts to quit smoking compared to 49% of the nonalcoholic smokers. More research comparing the smoking cessation efforts of alcoholics and nonalcoholics is needed to confirm these findings. Alcoholism is estimated to be 10 times more common among smokers than among nonsmokers. Possible explanations for this include a susceptibility on the part of some individuals to addictive drugs in general, and/or for some individuals tobacco smoking and alcoholism are both sequelae of a propensity to behave irresponsibly.

Adolescent↗
PubMed1987

Legislative efforts to protect children from tobacco.

Public health laws intended to prevent children from smoking have been enacted in many states. We surveyed the relevant laws in all states and the District of Columbia. The efficacy of one such law prohibiting the sale of tobacco to individuals under the age of 18 years was assessed with the cooperation of an 11-year-old girl. She was successful in 75 of 100 attempts to purchase cigarettes. On the basis of this experience and a review of existing laws, we have made recommendations for a model law. These include a prohibition of the possession of tobacco by minors, a prohibition of the sale of tobacco to minors, a requirement for a warning sign at the point of sale, a ban on cigarette vending machines, and a reward for individuals reporting violators of vending laws.

Adolescent↗