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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.

Purpose: Lesbian, gay, and bisexual (LGB) young adults smoke at rates much higher than the general population. Young adults, in general, are less likely to seek medical help for smoking cessation and LGB individuals are less likely to seek health care generally. Alternative methods to encourage smoking cessation are necessary. This research seeks to establish whether LGB young adults in California would be willing to use social media for smoking cessation.

Approach: We conducted 41 qualitative interviews among LGB young adults in the San Francisco Bay Area and Los Angeles in Fall 2014.

Findings: The results suggest that our participants were interested in a LGB-focused social media intervention, as long as the intervention was private or anonymous and moderated. Further, across topical areas our participants spoke extensively about the import of social connections. We may be able to leverage these connections to encourage cessation.

Research Limitations: This is a qualitative, non-generalizable dataset from a fairly limited geographic area.

Public Health Implications: Online smoking cessation interventions aimed at young adults would benefit from further testing with LGB young adults to ensure efficacy among this population. In addition, states and localities concerned about young adult LGB smoking might benefit from investing in an online socially mediated cessation forum. Online interventions could be scalable and might be useful for other groups who regularly face discrimination, stigma, or other stressors that make successful smoking cessation difficult.

Purpose: The public health burden caused by tobacco is heavy among first-generation Chinese immigrant men whose home country has significantly higher smoking rates than the United States. The current study is part of a larger effort to pilot an mHealth tobacco cessation intervention using MMS (graphic) mobile phone technologies to target East Asian immigrant populations. Grounded in the Extended Parallel Process Model (EPPM), our specific aims were to determine what message themes, level of graphic intensity, and types of efficacy information are most appropriate and useful for mHealth interventions targeting this population.

Methodology/Approach: A qualitative study utilizing a series of focus groups (k = 5) was conducted with male adult smokers who were born in China and currently reside in the United States. The primary aim of the focus groups was to solicit reactions to a series of preliminary messages developed by the research team. A secondary aim was to gauge receptivity to the use of MMS as a vehicle for smoking cessation intervention. Participants (n = 32) were recruited from local Chinese communities in a large Mid-Atlantic metropolitan area.

Findings: Opinions about different message strategies were mixed. However, participants tended to rate messages more positively when they focused on the impact of smoking on family and loved ones, particularly children. Messages with fear-arousing images were also perceived to be effective at low frequency of exposure, but there were concerns that they may backfire at high exposure. Awareness of and interest in Quitline were low, and concrete quitting tips were perceived as more effective. Participants reported a preference for receiving messages a few times a week, and an MMS message platform was generally preferred to WeChat (a Chinese social media platform).

Implications: Our results suggest that graphic MMS messaging holds promise as an effective intervention method for this population and that EPPM is an appropriate framework to develop, test, and analyze mHealth intervention messages. While messages that focused primarily on impact on children, health, and specific quitting tips were generally found to be more effective, a mix of different types of messages that address a wide range of issues may be most appropriate for this population.

Originality/Value: This study is the first to explore the utility of graphic text messaging as an intervention method to promote smoking cessation among male Chinese immigrants. Findings from the study provide important insights for future intervention work targeting this underserved population.

This chapter examines how people weigh and discuss opportunities for collective action to improve community health. Drawing from research on civic and social movement engagement, it focuses specifically on how cultural logics of pragmatism, activism, and cynicism are invoked in such debates.

Qualitative data come from four focus group discussions of strategies for reducing tobacco use in Atlanta’s lesbian, gay, bisexual, and transgender (LGBT) communities. Participants included 36 self-identified community members.

Pragmatic logics were used most often in evaluating the tobacco control strategies, with activist logics second and cynicism a distant third. This echoes prior research, but our participants used these logics in unexpected ways: they combined pragmatism and activism, downplaying the former’s emphasis on individual self-interest and the latter’s emphasis on contentious confrontation. In addition, use of the logics varied by focus group and strategy, but not with individual speaker’s identities.

Though limited by a narrow demographic focus and small convenience sample, our study suggests that public support for community health initiatives will likely depend on how they are framed and on the interactional dynamics and shared identities of the groups they are presented to.

Logics of pragmatism, activism, and cynicism inform debate over community health initiatives, as with other forms of civic action. However, use of these logics is not uniform but varies with the groups and issues at hand. Our study participants’ mutual LGBT identification gave them a sense of shared community and a familiarity with the politicization of personal life that led them to combine pragmatist and activist logics in novel ways.

Purpose – With reference to the long-term struggle to confirm cigarette smoking as a manifestation of nicotine addiction, this chapter explores the extent to which new understandings of addictions as ‘appetitive disorders’ rather than ‘dependence disorders’ derive from treatment technology development as well as advances in basic scientific research.

Approach – Through historical analysis it is discussed how cigarette smoking only became widely accepted as a real drug problem in the 1980s after it had been shown to be amenable to treatment as such through the use of novel nicotine replacement therapies.

Findings – These replacement therapies succeeded in showing that the same drug that drew users into addiction could be redeployed to help draw up them out of it. Nicorette® could serve as at least the partial antidote to nico-wrong (cigarettes). However, as relapse to smoking has remained the most likely outcome of any smoking cessation attempt, so medicinal nicotine has also served to demonstrate that nicotine addiction is ultimately a problem of an uncontrollable appetite for cigarettes in excess of drug dependence.

Implications – Pharmaceutical incursion on cigarette smoking commencing in the late 1970s pointed to the need for a new mental disease model of drug-related problems while also providing valuable new tools and insights for ensuing brain research.

This chapter examines whether the European Union or the United States set the parameters in the field of consumer protection and environmental regulations. The analysis points out that there is no straightforward answer because leadership rotates or fluctuates depending on the extent to which societies and decision makers feel strongly about a particular issue. Examples are tobacco control and regulations with regards to genetically modified crops and food. The US identified the risks related to the wide availability of cigarettes before the EU, while the EU highlighted the risks related to the introduction of GM crops/products in the absence of similar American concerns. Both cultural and institutional developments account for this divergence. A unique combination of factors heightened the salience of anti-smoking measures in the US, while an equally distinctive matrix of developments highlighted the social, economic, health, and safety challenges of genetically modified organism (GMO). However, in spite of different constellations of institutional and cultural factors, the EU has embraced tobacco control and the American private sector is slightly more cautious about pushing GM crops onto the market.

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.

In Chapter 3, the author will problematise the youth smoking epidemic within SEA, in order to justify why the regional impacts of the tobacco trade on youths are worrisome. The author will present the major youth smoking trends in SEA, for the purpose of illustrating how the presence of tobacco products has adversely affected regional youths to a concerning degree. The author, next, will highlight the causes of the youth smoking epidemic, namely susceptibility and positive advertising. The author follows by emphasising the national and regional costs of youth smoking, by arguing how such a lifestyle results in negative consequences in relation to the delinquency itself. Lastly, the author will recommend policies for tobacco control that SEA governments should consider to contain the epidemic of youth smoking. It is noteworthy that all SEA governments have some degree of tobacco control policies in place. However, many lack the implementation of comprehensive national tobacco control strategic plans and tightened law enforcement endeavours to specifically target the problem of youth smoking. Therefore, the outputs of this chapter should contain scholarly values that are conducive to the betterment of policy-making.

Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the contributing factors to these disparities, proven and promising approaches through strengths-based methods, barriers to implementation of prevention and treatment efforts, and future recommendations for effective programs and research.

Approach – We have conducted a thorough literature review of relevant research studies, as well as a review of government, tribal, and community-based curricula and resources. This review of programs is not exhaustive but provides several examples of best practices in the field and suggestions for future directions.

Social implications – We strongly advocate that to accurately explore the true etiology of substance abuse and to respond to the concerns that AI/AN have prioritized, it is necessary to utilize a strengths-based approach and draw upon traditional AI/AN perspectives and values, and active community participation in the process. More specifically, prevention and treatment programs should use methods that incorporate elders or intergenerational approaches; foster individual and family skills-building; promote traditional healing methods to recognize and treat historical, cultural, and intergenerational and personal trauma; focus on early intervention; and tailor efforts to each Native nation or community.

Value – Ultimately, to reduce substance abuse disparities in AI/AN youth, we must find better ways to merge traditional Native practices with western behavioral health to ensure cultural competency, as well as to develop mechanisms to effect system- and policy-level changes that reduce barriers to care and promote the well-being of AI/AN youth, families, and communities.

This chapter shows the prevalence, trends and heterogeneity in maternal smoking around birth in the United Kingdom (UK), focussing on the war and post-war reconstruction period in which there exists surprisingly little systematic data on (maternal) smoking behaviours. Within this context, the authors highlight relevant events, the release of new information about the harms of smoking and changes in (government) policy aimed at reducing smoking prevalence. The authors show stark changes in smoking prevalence over a 30-year period, highlight the onset of the social gradient in smoking as well as genetic heterogeneities in smoking trends.