Effective, Evidence Based Messaging

The December edition of the journal Adolescent Health includes an important study regarding effective messaging for tobacco initiation. The paper, The Perception of Secondhand Smoke Risks Predict Future Adolescent Smoking Initiation , concludes that “perceptions of personal second-hand smoke risks and parental second-hand smoke risks significantly deterred adolescent smoking initiation”. This current research may not be novel but it is impressive in showing that perceptions about the dangers of secondhand smoke have triple the effect on smoking initiation among youth compared to peers’ smoking. And this conclusion is revealing because focusing on peer pressure is a mainstay of industry funded campaigns ostensibly aimed at reducing youth addiction to nicotine. The 2007 CDC Best Practices on Health Communication Interventions cites research showing that these campaigns not only are ineffective they actually can increase youth initiation (p 32). The Best Practices also notes that the most effective media campaigns created a negative reaction to the tobacco industry itself (p 34).

Those campaigns reliant on no evidence base will not be interested in this. But sincere efforts at reducing smoking prevalence in Arkansas can take advantage of this research to fashion campaigns that will not only be effective but also can be crafted to work toward rectifying seriously flawed clean indoor air laws.

Currently Arkansas’ Stamp Out Smoking tobacco prevention media is capitalizing on the recent state and federal tobacco tax increases to promote the 1-800 QUIT NOW cessation services. This may well be justified for a time but should not miss opportunities for long term effective tobacco prevention policies.

Cranford Johnson Robinson Woods, the firm that holds the SOS account, has in the past cited market research showing a high degree of brand recognition as evidence of a successful campaign. In 2008 CJRW announced it was becoming an affiliate of the PR monolith Burson Marsteller. With longtime ties to the tobacco industry, BM is responsible for creating the National Smokers’ Alliance and the Accommodation Program as front groups to oppose tobacco taxes and clean indoor air laws.

This tremendous conflict of interest becomes most suspicious when media campaigns do not take advantage of evidence based research for effective prevention. At some point attention should be given to the differences between effective branding and effectively reducing the influences of the tobacco industry on our communities.

Gambling Addiction

Oregon Lottery addicted to big losses of gambling addicts

"Addictions," says Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse (NIDA), "are repetitive behaviors in the face of negative consequences, the desire to continue something you know is bad for you."

http://www.time.com/time/magazine/article/0,9171,1640436,00.html

It is intriguing that researchers have actually found that gambling excites the same dopamine activity that other behaviors, or substances, do in the brain. MRI work at Cal Tech in 2006 surprised a lot of folks and of course the DSM IV has criteria distinguishing gambling addiction. The point is that there are actual physiological differences between an addiction and a habit, like how you like your eggs, etc.

Now what interests me is of course related to nicotine addiction and genetics. Ever wonder why some people find it easy to quit smoking and some go to their grave clutching a fag? Well an important part of that is how the body metabolizes nicotine in the liver and that enzyme is inherited.

I don’t really have a dog in this hunt but, if problem gambling is inherited and the government is exploiting that genetic makeup to fund the bulk of whatever it is they fund w a lottery, an ethical quandary comes into play. It seems analogous to taxing redheads for no other reason than the color of their hair. This is one reason the article interested me.

A fellow at UAMS, Warren Bickel just got a couple of million $ from NIH I believe to study what he’s calling behavioral economics and meth addiction. I heard him speak a few years ago and the short of it is that addicts don’t have the same concept of long term and short term rewards. You and i may contribute to an IRA for long term goals but an addict my think of a long term goals as scoring tomorrow’s fix today. That’s over simplified but not much. ( This comes into play w nicotine addiction and children. Kids just do not recognize long term health benefits. We were all immortal once.)

Anyway, that’s a little bit about the difference and similarity between being unable to stop smoking, or feeding the ponies at the race track, and how you like your eggs.

E cigarettes, NRT, and Distraction

The Wall Street Journal reports that tobacco giant Reynolds American International is involved in talks to purchase Niconovum the Swedish manufacturer of Nicotine Replacement Therapy products. NRT is of course a popular method for tobacco cessation. At first blush this seems a truly strange union. Is RJR trying to sabotage tobacco cessation efforts? Or is this simply revealing what we have known all along about tobacco marketing? It is nicotine dependent.

"We are, then in the business of selling nicotine, an addictive drug effective in the relief of stress mechanisms." RJR July 17, 1963. Bates 1802.05

And if we suspect Niconovum’s/RJR’s nicotine products why then should we not be suspicious of others that profit from the sale of nicotine like Pfizer et al. Is it because we question RJR’s intent and not the drug companies that have made a huge business out of cessation products?

E cigarettes are being promoted as smoking cessation devices by everyone except the E cigarette companies. That classification would give the FDA more authority to regulate the devices, the nicotine. More than anecdotal evidence is required to show that nicotine delivery in this fashion is harmless or effective.

The best evidence that E cigarettes pose no competitive threat is demonstrated by a lack of opposition from the tobacco cartel. If tobacco companies thought nicotine vapor threatened their profit, we’d know because they would swoop down and buy the tiny businesses that are producing these vaporizers. And they may yet just as RJR is eyeballing NRT manufacturer Niconovum. In the meanwhile big tobacco is content to let E cigarettes play the spoiler for the myth of a safe cigarette. The poor will never get their fix as cheaply as the traditional cigarette and the few who can afford to switch to taking their nicotine in a vapor will reaffirm nicotine addiction as a normal part of the day. But at the end of the day as long as it contains nicotine big tobacco has nothing to lose.