Journal of public health dentistry
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J Public Health Dent · Jan 1990
ReviewPsychosocial factors in the use of smokeless tobacco and their implications for P.L. 99-252.
This article briefly reviews the prevalence of smokeless tobacco use by males in the United States, the relationship of smokeless tobacco use to cigarette use, and patterns of use that include dosage, topography, products, and function of use. The primary focus of the article is to describe the concurrent and predictive factors associated with onset, use, and cessation of smokeless tobacco. The implications of P. L. 99-252, the Comprehensive Smokeless Tobacco Act of 1986, are discussed in the context of what is known about the psychosocial variables associated with the use of smokeless tobacco.
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J Public Health Dent · Jan 1990
An epilogue to evaluating the impact of P.L. 99-252 on decreasing smokeless tobacco use.
In a previous paper, "Evaluating the Impact of P. L. 99-252 on Decreasing Smokeless Tobacco Use," the context of this law and the theoretical framework for an evaluation plan for measuring its impact were described. ⋯ This discussion includes the identification of the six indicators considered to be the most relevant, valid, reliable, accessible, and practical for measuring the impact of this law on decreasing smokeless tobacco use, as well as a report on the feasibility analysis of three of these indicators. Pilot data on two indicators--pounds of smokeless tobacco sold and incidence rates of tobacco-induced leukoplakia--are presented and analyzed.
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This paper examines ways in which standard economic analysis may be used to predict and evaluate the impact of P. L. 99-252, the Comprehensive Smokeless Tobacco Health Education Act of 1986. Simple supply and demand models are used to illustrate the range of possible effects of the act. ⋯ The impact on supply is more ambiguous, but it is possible that restrictions on advertising might lower the smokeless tobacco producers' costs in ways that would lead to an increase in supply. Several suggestions for empirical measurement of impact are made. Three other issues are identified and discussed: potential negative consequences of the act's required health warnings (as a liability defense for firms); the importance of point of view in dealing with the costs of smokeless tobacco use; and a comparison of the act to alternative strategies to reduce smokeless tobacco use, such as taxation.
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J Public Health Dent · Jan 1990
P.L. 99-252 and the roles of state and local governments in decreasing smokeless tobacco use.
Evaluation of the impact of the Comprehensive Smokeless Tobacco Health Education Act of 1986 (P. L. 99-252) will help determine the level of progress being made to reduce smokeless tobacco use and will help determine changes or new strategies needed to prevent or reduce smokeless tobacco use. Indicators of progress made toward implicit goals and explicit provisions of P. ⋯ Proposed indicators involve monitoring the development and availability of programs, materials and media, monitoring research and dissemination of findings, and monitoring technical assistance and grants available. Possible measurement and evaluation strategies are discussed. Survey methodology seems most suitable for monitoring level and type of anti-smokeless tobacco activity in which health agencies engage and for determining awareness of resources available through the law.
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J Public Health Dent · Jan 1989
Randomized Controlled Trial Clinical TrialEffects of flossing on plaque and gingivitis in third grade schoolchildren.
The purpose of this investigation was to determine whether flossing, as an adjunct to toothbrushing, performed in a school-based program can contribute significantly to a reduction in gingivitis. Four volunteer third grade classrooms (n = 112) were randomly assigned to finger-floss, looped-floss, flossholder, and brushing-only control group. Measures taken at baseline and in four weeks included gingival (GI), plaque (PI), and flossing dexterity indices (FDI). ⋯ A repeated measures ANOVA revealed that the finger-floss group improved gingivitis scores most over time, while the flossholder group improved scores the least. The ANCOVA results with FDI showed that at the final measurement, looped-floss manual dexterity was rated significantly better than finger-floss and that both groups were rated better than flossholder. Final indications are that toothbrushing alone can produce clinical results similar to use of a combination of toothbrushing and flossing.