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The implementation of smoke free legislation presents a huge opportunity to improve the health of people who use mental health services, as well as that of the staff working with them, say Jane Bremner and Nerys Edmonds. Here they outline how stop smoking support has been developed for mental health service users in West Surrey.

Although smoking is a major health problem among forensic psychiatric inpatient populations, a multitude of factors (motivational, environmental, procedural and psychiatric) militate against effective treatment. Despite this, few studies have reported on the use of population‐appropriate treatment approaches. This pilot study reports the results of group and individual treatments involving combination nicotine replacement therapy (NRT), motivational enhancement therapy (MET) and cognitive behavioural treatment. The importance of selecting patients with some skills in emotional regulation is highlighted, along with ways of reducing institutional obstacles to change and maximising environmental support for quit attempts.

Introduction. This study examined the association between self-rated physical and oral health, cigarette smoking, and history of criminal justice contact (i.e., never arrested; arrested, but never incarcerated; or incarcerated in reform school, detention, jail, or prison) among African American men and women. Methods. We conducted descriptive statistical, linear regression, and multinomial regression analyses of the African American subsample (n = 3,570) from the National Survey of American Life (2001–2003). Results. Overall, African American women reported lower arrest rates and histories of incarceration than African American men. Additionally, we found that criminal justice contact was associated with lower self-rated physical health and oral health and higher levels of smoking for both men and women. African American women who had been arrested and detained in facilities other than jail had more chronic health problems than their male counterparts. Furthermore, having been arrested or spent time in a reform school, detention center, jail, or prison significantly increased the odds of African American men being a current smoker. Lastly, among African American women, those who had any level of criminal justice contact were likely to be current smokers and former smokers compared to those without a history of criminal justice contact. Conclusion. Addressing the health of African Americans with criminal justice contact is a critical step in reducing health disparities and improving the overall health and well-being of African American men and women. Furthermore, attention to differences by gender and specific types of criminal justice contact are important for a more precise understanding of these relationships.

Smoking initiation by adolescents has been analyzed by economists as a choice reflecting prices, tastes, and subjective evaluation of the long-term risks of addiction and disease. What is missing from this account is the fact that smoking is a social activity and is subject to peer influence. Peers may serve as a source of information about why and how to smoke, and how to obtain cigarettes. Peers also serve as an audience, observing and evaluating others’ behavior. This evaluation is mediated by the long association in popular culture between smoking and a variety of attributes prized by adolescents. Like choice of fashion in hair and clothing, body piercing, comportment, and so forth, smoking by adolescents connotes information about identity. Knowing this, the decision of whether to smoke is partly a decision of what identity to project.

This chapter compares smoking among American women employed outside the home with those of full-time homemakers at two points in time: 1979 and 2014.

Data are from the 1979 National Household Survey on Drug Abuse (NHSDA) and from the 2014 National Survey on Drug Use and Health (NSDUH). The NHSDA is the precursor to the present-day NSDUH and part of the same continuum of nationwide surveys on drug use. The analysis uses logistic regression models and the survey suite of commands in Stata 13 to include 1979/2014 sample weights and adjustments for the complex sample design.

Results show that smoking is most prevalent among homemakers in small communities. This outcome supports earlier studies citing smoking as a major causal factor for the decline in female life expectancy among less-educated white women in certain low-income and rural counties in the United States. The premise that female smoking is strongly associated with the workplace appears to be no longer true.

These data provide only a limited test of health lifestyle theory because many of the model’s structural variables are not included. Otherwise the findings support the model.

This study finds that smoking is greatest among women who are full-time homemakers in medium and especially small towns. This is a new development and suggests the locus of smoking among women has moved away from its association with the job in cities to the home in less populated areas.

This chapter estimates the negative effect of smoking on earnings in the context of a developing country. Using data from the 2005 Albania Living Standards Measurement Survey, models are estimated by parametric and semi-parametric methods to account for the effect of observable and unobservable characteristics that could affect individual smoking decisions and earnings. Information on the smoking behaviour of parents is used to address the endogeneity of the smoking decision. The results show that, after controlling for observed individual characteristics and parental education and taking into account unobserved heterogeneity in personal characteristics, smoking is found to have a substantial negative impact on earnings. The main results are robust to a range of alternative specifications. On average, smokers’ earnings are 19–23 percent lower than the earnings of similar non-smokers.

We explore the simultaneous influence of activist organizations and corporations on institutional change. Focusing on protests, campaign contributions, and lobbyists as the strategies used by activist organizations and corporations to influence institutional change, we study the dynamics between movements and counter-movements and their influence on the probability of institutional change. In the context of the US tobacco industry, the results shed light on the effectiveness of these strategies and uncover potential moderators of this relationship. Overall, we demonstrate the simultaneous and asymmetric effects of activist organizations and corporations that use conspicuous and inconspicuous strategies to change institutions.

The U.S. 2009 Tobacco Control Act opened the door for new antismoking policies by giving the Food and Drug Administration broad regulatory authority over the tobacco industry. We develop a behavioral welfare economics approach to conduct cost-benefit analysis of FDA tobacco regulations. We use a simple two-period model to develop expressions for the impact of tobacco control policies on social welfare. Our model includes: nudge and paternalistic regulations; an excise tax on cigarettes; internalities created by period 1 versus period 2 consumption; and externalities from cigarette consumption. Our analytical expressions show that in the presence of uncorrected internalities and externalities, a nudge or a tax to reduce cigarette consumption improves social welfare. In sharp contrast, a paternalistic regulation might either improve or worsen social welfare. Another important result is that the social welfare gains from new policies do not only depend on the size of the internalities and externalities, but also depend on the extent to which current policies already correct the problems. We link our analytical expressions to the graphical approach used in most previous studies and discuss the information needed to complete cost-benefit analysis of tobacco regulations. We use our model as a framework to reexamine the evidence base for strong conclusions about the size of the internalities, which is the key information needed.

Recent changes in smoking laws have influenced gambling behaviour at electronic gaming machine (EGM) venues. In this chapter, we review the literature that examines the interrelationship between gambling, problem gambling, and smoking in order to gauge the indirect effects of smoking bans in gaming venues. We then perform an analysis on the consequences of a smoking ban in Victoria, Australia, that was instituted on 1st September 2002. This analysis investigates the nature of the pattern of drops in local EGM revenue and the impact on the state tax revenue.

In recent policy discussions, the conventional wisdom is that adolescent smoking is substantially more tax- or price-responsive than adult smoking.¹ In a previous study, we used data from the first three waves of the National Education Longitudinal Study (NELS) to estimate the impact of taxes and prices on smoking initiation during adolescence (DeCicca, Kenkel, & Mathios, 2002). Contrary to the conventional wisdom, we found weak or non-existent tax/price effects in our models of the onset of adolescent smoking between 1988 and 1992. In this study, we use data from the 2000 wave of NELS, when most respondents were about 26 years old. Although cigarette prices increased by almost 40% in real terms between 1992 and 2000, smoking prevalence among the NELS respondents also increased from 18% to 23%, about the same increase observed in other cohorts over these ages.