Preventive medicine
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Preventive medicine · Dec 2022
Association between race, shooting hot spots, and the surge in gun violence during the COVID-19 pandemic in Philadelphia, New York and Los Angeles.
Gun violence rates increased in U. S. cities in 2020 and into 2021. Gun violence rates in U. ⋯ In this paper, we examine the extent to which the increase in shooting victimization in Philadelphia, New York, and Los Angeles during the 2020-2021 pandemic was concentrated in gun violence hot spots, and how the increase impacted race and ethnic disparities in shooting victimization rates. We find that 36% (Philadelphia), 47% (New York), and 55% (Los Angeles) of the increase in shootings observed during the period 2020-2021 occurred in the top decile of census block groups, by aggregate number of shootings, and that the race/ethnicity of victims in these gun violence hot spots were disproportionately Black and Hispanic. We discuss the implications of these findings as they relate to racial disparities in victimization and place-based efforts to reduce gun violence.
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Preventive medicine · Dec 2022
Randomized Controlled TrialLeveraging the cigarette purchase task to understand relationships between cumulative vulnerabilities, the relative reinforcing effects of smoking, and response to reduced nicotine content cigarettes.
We examined if the relative-reinforcing effects of smoking increase with greater cumulative vulnerability and whether cumulative vulnerability moderates response to reduced nicotine content cigarettes. Participants were 775 adults from randomized clinical trials evaluating research cigarettes differing in nicotine content (0.4, 2.4, 15.8 mg/g). Participants were categorized as having low (0-1), moderate (2-3), or high (≥4) cumulative vulnerability. ⋯ The only evidence of moderation was on demand Persistence (F[8867] = 2.00,p = .04), with larger reductions at the 0.4 mg/g compared to 15.8 mg/g doses among participants with low compared to moderate or high cumulative vulnerability. The relative-reinforcing effects of smoking clearly increase with greater cumulative vulnerability. Reducing nicotine content would likely reduce demand Amplitude across cumulative-vulnerability levels but reductions in demand Persistence may be more limited among those with greater cumulative vulnerability.
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Preventive medicine · Dec 2022
EditorialBehavior Change, Health, and Health Disparities 2022: Innovations in Tobacco Control and Regulatory Science to Decrease Cigarette Smoking.
This Special Issue of Preventive Medicine (PM) is the 9th in a series on behavior change, health, and health disparities. This topic is critically important to improving population health. Unhealthy lifestyles including substance misuse, unhealthy food choices, physical inactivity, and non-adherence with medical regimens are important preventable causes of chronic disease and premature death. ⋯ We discuss important innovations in tobacco control (e.g., digital text-based interventions, ENDS-assisted cessation, financial incentives) and regulatory science (e.g., nicotine reduction in cigarettes, flavor bans). Throughout, attention is given to the important topic of disparities in terms of understanding the uneven adverse impacts of cigarette smoking and efforts to eliminate it, and the critical importance of researching vulnerable populations. Across these topics we have recruited contributions from accomplished investigators, clinicians, and policymakers to acquaint readers with recent advances while also noting knowledge gaps and unresolved challenges.
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Preventive medicine · Dec 2022
Centering equity in flavored tobacco ban policies: Implications for tobacco control researchers.
To achieve equity in protection from poor health outcomes due to tobacco use, tobacco control policies and interventions need to affect socially disadvantaged groups more strongly than advantaged groups. Flavored tobacco bans have been seen as a policy with this potential. However, tobacco control researchers, in close concert with policy advocates, need to consider how to center equity throughout the policy process to achieve equitable outcomes from banning flavored tobacco. ⋯ Specifically, we focus on recommendations for tobacco control researchers to center equity including partnering with communities in agenda setting, examining how various policy formulations or exemptions may increase or decrease disparities, determining where flavor policies need to reach and whether policies are equitably reaching all populations disproportionately burdened by flavored tobacco, assessing whether policy implementation/enforcement is carried out equitably to maximize policy benefits, and evaluating policy impact with as much granularity as possible. Considering the entire policy process is central to enhancing equitable outcomes from banning flavored tobacco. Tobacco control researchers can play a key role in ensuring that these policies are viewed through an equity lens to, not just improve population health, but also to reduce harms to those disproportionately burdened by use of flavored products.
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Preventive medicine · Dec 2022
Using an experimental tobacco marketplace to pilot test the substitutability of JUUL e-cigarettes and other alternative nicotine and tobacco products for conventional cigarettes among vulnerable populations.
The Experimental Tobacco Marketplace (ETM) is an online research marketplace where increasing the cost of cigarettes is used to investigate the substitutability of other fixed-price tobacco products such as electronic nicotine delivery systems (ENDS). The ETM is useful for modeling effects of potential policy changes on use of various concurrently available products. To our knowledge, the ETM has not been used to investigate substitutability of newer generation e-cigarettes or populations at increased risk for smoking, heavy smoking, nicotine dependence, and smoking-attributable adverse effects. ⋯ When ENDS were unavailable, LCCs did not substitute (ps ≥ 0.48). In all sessions, participants rarely purchased other products (e.g., snus). Overall, ENDS were the most robust substitute for cigarettes, further underscoring the potential importance of ENDS availability on the impact of tobacco regulatory policies.