Did You Know? Tobacco Tax Policy Alone May Not Be Enough To Increase Cessation Among African Americans


A newly published study examined the effects of cigarette price on intention to quit, quit attempts, and successful cessation among African American smokers in the U.S. and explored whether price effects differed by income level and menthol use status. Researchers analyzed cross-sectional data from 2006-2007 and 2010-2011 Tobacco Use Supplements to the Current Population Survey from 4,213 African American recent active smokers.

Findings included:

·         There was no indication that price was associated with quit attempts or successful cessation, but price was positively associated with increased odds of intending to quit among African American smokers.

·         In contrast, prices were positively associated with intention to quit and quit attempts for White smokers.

·         The association between price and intention to quit was significantly positive for African American low-income and menthol smokers but was not statistically significant for African American high-income and non-menthol smokers.

·         There was no evidence of a price effect on quit attempts and successful cessation for each subgroup of African Americans.

The researchers concluded that tobacco tax policy alone may not be enough to increase quit attempts or successful cessation among African Americans. Community-based cessation programs tailored towards African American smokers, especially low-income menthol smokers, are needed.

Source: Keeler, Max, Yerger, Yao, Wang, Ong & Sung (2018). Effects of cigarette prices on intention to quit, quit attempts, and successful cessation among African American smokers. Nicotine & Tobacco Research, Jul 18, [Epub ahead of print].

WEBINAR: “Fly Your Fans and Not Your Cigarettes: Tobacco and Its Effects”

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Date: January 25, 2019

Time: 10:00 AM – 11:00 AM PST

Guest Speaker: Jenn Awa, Deputy Director of Taulama for Tongans

Learning Objectives:
  • Knowledge of how tobacco smoke impacts Pacific Islanders
  • Knowledge of disproportionate populations that are at risk of smoking
  • Increase understanding of how tobacco affects Pacific Islanders
  • Better understanding of engagement strategies for tobacco prevention with Pacific Islanders
  • Confidence to prevent tobacco use in Pacific Islanders


Register Here!


unnamed (19)Jenn Awa, MPH

Jenn Awa, MPH is a Native Hawaiian activist of social justice and a community facilitator of change and healing. She specializes in working with some of the highest-risk and most marginalized community members in the Bay Area. For the past 20 years, she has been facilitating health information, developing curricula, designing, implementing, and evaluating programs, and creatively enriching the knowledge of her community by disseminating health information in a way that is culturally relevant.

Jenn is the Deputy Director of Taulama for Tongans an agency in San Mateo and Alameda Counties in CA, serving Pacific Islanders. She has been a core member of the Regional Pacific Islander Taskforce, partnering with San Francisco County, Alameda County and San Mateo County Departments of Health to develop partnerships in health and improve the overall health of our Pacific Islander communities and sat on the Board of Directors for Samoan Community Development Center for two years.


Due to the passage of California’s historic 2016 tobacco tax (Prop 56), California is once again taking her place as a world leader in tobacco control. Our increased funding levels and new hires are bringing resources and new life and energy to our movement. With the huge success of last year’s CTCP Tobacco University Conference, The LOOP sees the need to continue the education and onboarding of people new to tobacco control.

To that end, the Winter 2019 Leadership Development Program (LDP) will be dedicated to those people who are working in tobacco control and have been in their position for four years or less. The LOOP LDP can help you to build your capacity and increase your knowledge of tobacco control. We are actively recruiting 12-16 “Fellows” to participate in a comprehensive 8-week program. Once successful applicants complete the program, they will receive a certificate of completion from The LOOP at the University of California, San Francisco. You will also have ongoing access to a cadre of mentorship and support that can benefit your career. We want to help you develop your leadership skills and work through a lens of health equity. 

Apply Now!

APPLICATION DEADLINE: January 25, 2019 at 5pm (PST)


We look forward to you joining our SEVENTH cohort of leaders!

Please Address Questions To:

Coordinator Specialist

The LOOP Leadership Development Program

Telephone: (415) 502-3265

Email: TheLOOP@ucsf.edu

Did You Know? Youth Believe that Ads for Flavored E-Liquids Target Them

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The e-cigarette industry argues that flavors are not meant to appeal to youth, yet no study has asked youth what age group they think ads for flavored e-liquids are targeting. A newly published study asked youth which age group they thought ads for flavored e-liquids targeted. A random sample of 255 youth from across California viewed eight ads, presented in randomized order, for fruit-, dessert-, alcohol-, and coffee-flavored e-liquids and indicated the age group they thought the ads targeted: younger, same age, a little older, or much older than them.


Findings included:

  • Most participants (94%) indicated the cupcake man flavor ad targeted an audience of people younger than they.
  • Over half felt ads for smoothy (68%), cherry (64%), vanilla cupcake (58%), and caramel cappuccino (50%) targeted their age and for no flavor ad did most feel the primary target age group was much older.
  • Youth believe ads for flavored e-liquids target individuals about their age, not older adults.


The researchers concluded that findings support the need to regulate flavored e-liquids and associated ads to reduce youth appeal, which ultimately could reduce youth use of e-cigarettes.


Source: McKelvey et al. (2018). Youth say ads for flavored e-liquids are for them. Addictive Behaviors, Aug 29. pii: S0306-4603(18)30957-2. doi: 10.1016/j.addbeh.2018.08.029. [Epub ahead of print]

Did You Know? California has Reduced Smoking Faster than the Rest of the US


Three cigarette smoking behaviors influence lung cancer rates: how many people start, the amount they smoke, and the age they quit. California has reduced smoking faster than the rest of the US and trends in these 3 smoking behaviors should inform lung cancer trends. A newly published study examined trends in smoking behavior (initiation, intensity, and quitting) in California and the rest of US by regression models using the 1974-2014 National Health Interview Surveys (n=962,174).


Findings included:

·                     Among those aged 18- 35 years, California had much larger declines than the rest of the US in smoking initiation and intensity, and increased quitting.

·                     In 2012-14, among this age group, only 19% had ever smoked; smokers consumed only 6.3 cigarettes/day; and 46% of ever-smokers had quit by age 35.

·                     Each of these metrics was at least 24% better than in the rest of the US.

·                     There was no marked California effect on quitting or intensity among seniors. From 1986-2013, annual lung cancer mortality decreased more rapidly in California and by 2013 was 28% lower than in the rest of the US.

·                     California’s tobacco control efforts were associated with a major reduction in cigarette smoking among those under age 35 years.


The researchers concluded that these changes will further widen the lung cancer gap that already exists between California and the rest of the US.


Source: Pierce et al. (2018). Trends in lung cancer and cigarette smoking: California compared to the rest of the United States. Cancer Prevention Research, Oct 10. pii: canprevres.0341.2018. doi: 10.1158/1940-6207.CAPR-18-0341. [Epub ahead of print]

Happy Holidays & Cheers to UCSF’s Acknowledgement of The LOOP’s Leaders!

The LOOP Team wishes you a happy & healthy holiday season!

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We’d like to acknowledge two of our LOOP Team members, Dr. Valerie Yerger and Carol McGruder, who were mentioned in the 2018 year-end message put out by UCSF’s Helen Diller Family Comprehensive Cancer Center this week. Congrats to both Valerie and Carol on their work to help ban the sale of flavored tobacco in San Francisco earlier this year!Check out the article below (see the “Serving the Greater Good: Population Health” section).

Read the UCSF article

A Study Examines Perceived Positive And Negative Traits Of Adolescent E-Cigarette Users

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A newly published study examined the relationship between adolescents’ positive opinions of e-cigarette users and willingness to use e-cigarettes. Participants were 578 U.S. adolescents (ages 14 to 20) recruited from ten California schools. An online survey assessed their attitudes toward and opinions of adolescents who use e-cigarettes in 2015-2016.
Findings included:
  • The majority (61%) of participants had negative overall opinions toward adolescent e-cigarette users.
  • Few participants ascribed positive traits (i.e., sexy, cool, clean, smart, and healthy) to e-cigarette users.
  • Participants who were willing to try or had used e-cigarettes endorsed positive traits more than those unwilling to try and never-users.
  • Participants sometimes endorsed negative traits (i.e., unattractive, trashy, immature, disgusting, and inconsiderate) to describe e-cigarette users.
  • Unwilling and never-users viewed negative traits as more descriptive of e-cigarette users than willing or ever-users.
Adolescents generally had somewhat negative opinions of other adolescents who use e-cigarettes. Building on adolescents’ negativity toward adolescent e-cigarette users may be a productive direction for prevention efforts, and clinicians can play an important role by keeping apprised of the products their adolescent patients are using and providing information on health effects to support negative opinions or dissuade formation of more positive ones.
Source: McKelvey et al. (2018). Adolescents have unfavorable opinions of adolescents who use e-cigarettes. PloS One, Nov 7;13(11):e0206352. doi: 10.1371/journal.pone.0206352. eCollection 2018.
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Top Reason for E-Cigarette Use Among Young Adults: “They come in flavors I like”
A newly published study examined whether strong local policies may reduce e-cigarette initiation rates by influencing the appeal of these products. Online questionnaires were completed by Southern California Children’s Health Study participants in 2015-2016 (mean age?=?18.9?years).

Findings included:

  • The top reason for e-cigarette use was “They come in flavors I like” (57%).
  • Using e-cigarettes to quit smoking was uncommon (13%).
  • Participants in jurisdictions with weaker tobacco retail licensing ordinances were more likely to report use of e-cigarettes because they are less harmful than cigarettes (50% vs. 36%), more acceptable to non-tobacco users (38% vs. 25%), and because they can use e-cigarettes in places where smoking is prohibited (31% vs. 18%).
The study authors recommend targeted policy that conveys the adverse impact of e-cigarettes, and restricts use in public places may reduce e-cigarette use among adolescents and young adults.
Source: Hong et al. (2018). The impact of local regulation on reasons for electronic cigarette use among Southern California young adults. Addictive Behaviors, Nov 16. pii: S0306-4603(18)31329-7. doi: 10.1016/j.addbeh.2018.11.020. [Epub ahead of print]

Low-Income Medicaid Beneficiaries Appreciate Physicians Giving Advice About Cessation


Smoking is highly prevalent among low-income Medicaid beneficiaries and tobacco-cessation benefits are generally available. A newly published study examined the extent to which physicians provide advice to Medicaid patients about quitting. Data from the 2014-2015 Nationwide Adult Medicaid Consumer Assessment of Health Plans survey were merged with state Medicaid policy variables and analyzed.


Findings included:

·                  Almost one third (29%) of adult Medicaid beneficiaries smoke.

·                  Almost four fifths of smokers with a personal doctor (77%) say their doctor at least sometimes advised quitting and almost half of smokers discussed cessation medications (48%), or another strategy, such as counseling (42%).

·                  Smokers’ ratings of satisfaction with their physicians and their health plans rose as the frequency of smoking recommendations increased.

·                  Those in Medicaid managed care plans smoked more, but received less advice about cessation medications than those in fee-for-service care.


The researchers concluded that findings indicate that patients value prevention-oriented advice and give better ratings to physicians and health plans that offer more support and advice about cessation.


Source: Holla et al. (2018). Physicians’ Recommendations to Medicaid Patients About Tobacco Cessation. American Journal of Preventive Medicine, Oct 18. pii: S0749-3797(18)32126-3. doi: 10.1016/j.amepre.2018.07.013. [Epub ahead of print]

Our Tailored Assistance Trainers


A major feature of The LOOP is the provision of tailored assistance responsive to grantees’ requests, enabling them to implement more effectively their local tobacco control interventions and initiatives. This is a free service provided to statewide CTCP grantees. Subject matter experts have been identified and recruited to provide trainings and tailored assistance that cover a range of tobacco control topics, as well as other areas pertinent to reaching and serving California’s diverse populations.
You can currently make a request for tailored assistance by contacting us at theloop@ucsf.edu. This is a partial list of our tailored assistance trainers and their expertise.

Tobacco Advertising                      American Indian Casinos                            Advertising

Advocacy                                         Educational Materials Development         Evaluation

Community Organizing                Housing and Urban Development             Budget/Fiscal

Faith-Based Organizations           Outdoor Dining, Beaches, Parks                Coalition Build.

Grant Writing                                 Smokeless Tobacco/Cigars                           Fundraising

Health Disparities                          Health Policy Development                        Legal Issues

Leadership Development             Multi-Cultural Issues                                    Social Media

Multi-Unit Housing                        Social Marketing Campaigns                      Tobacco Litter

Research                                          Social Media                                                   Stake Act

Youth Coalition                               Tobacco Control Funding                            Harm Reduction