Low-Income Medicaid Beneficiaries Appreciate Physicians Giving Advice About Cessation

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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

LOOP Team Presents on Hip-Hop’s Role in Tobacco Control

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During the 2018 Tobacco-free California Projects’ Meeting in Long Beach, The LOOP’s own Godfrey Ramos and Leadership Development Program fellow, Josephine Young, collaborated on a presentation entitled, “Flava In Ya Ear: The Power of Hip-Hop Culture.” Not only was the title inspired by a 1994 track with the same name by Hip-Hop artist, Craig Mack, it was also selected to acknowledge the relationship between youth and flavored tobacco.

In their presentation, they mentioned that one of the biggest misconceptions of Hip-Hop culture is that Hip-Hop only consists of rap music. However, the workshop debunked this idea by giving an overview of the 5 Elements of Hip-Hop Culture: MCing, DJing, B-boying/B-girling, Graffiti Art, and Knowledge. Using this framework, the presenters highlighted the influence Hip-Hop culture has on society and provided innovative strategies on how to use Hip-Hop as a way to mobilize youth around tobacco control efforts.

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Godfrey Ramos’ Bio:

Godfrey Ramos is the Coordinator Specialist for The LOOP. He received his Master’s degree in sociology from San Jose State University, with an emphasis on social theory and quantitative research methods. His research project entitled, “Beats, Rhymes, and Life: A Look at Hip-Hop/Rap Music and Behavior” examines how rap music promotes resistance, communication, and social change amongst different genders, races, and classes, even though many argue that rap music is actually negative and damaging to its listeners. His other research interests include: race, class, gender, social inequality, subcultures, deviance, and social justice. Godfrey is also an adjunct Sociology professor at Diablo Valley College and San Jose State University.

If you would like any assistance regarding this topic, please reach out to Godfrey directly at godfrey.ramos@ucsf.edu.

Combustible and Electronic Tobacco Use Frequently Featured in Popular Hip-Hop Music Videos

rapper smoking

A newly published study assessed the prevalence of the appearance and use of combustible and electronic tobacco and marijuana products, including brand placement, in leading hip-hop songs.

Analysis of top 50 songs from 2013 to 2017 of Billboard magazine’s weekly Hot R&B/Hip-Hop Songs with videos that included the appearance or use of combustible tobacco and marijuana products (manufactured cigarettes, cigars, hookah or waterpipe, pipe, hand-rolled tobacco and marijuana products, marijuana buds); appearance of exhaled smoke or vapor without an identifiable source product; appearance or use of electronic tobacco and marijuana products (eg, electronic cigarettes); tobacco or marijuana brand placement; appearance or use of combustible and electronic tobacco and marijuana by main or featured artist. Data were collected from December 6, 2017, to June 4, 2018.

 

Findings included:

·               The proportion of leading hip-hop videos containing combustible use, electronic use, or smoke or vapor ranged from 40.2% (76 of 189) in 2015, to 50.7% (102 of 201) in 2016.

·               For each year, the leading category of combustible use was hand-rolled products.

·               The appearance of branded products increased from 0% in 2013 (0 of 82) to 9.9% in 2017 (10 of 101) for combustible products, and from 25.0% in 2013 (3 of 12) to 87.5% in 2017 (14 of 16) for electronic products.

·               The prevalence of combustible or electronic product use or exhaled smoke or vapor increased by quartile of total number of views: 41.9% (8700 to 19 million views) among songs in the first quartile of viewership and 49.7% among songs in the fourth quartile of viewership (112 million to 4 billion views).

 

The researchers concluded that the genre’s broad appeal, use of branded products by influential artists, and rise of electronic product and marijuana use may contribute to a growing public health concern of tobacco and marijuana use.

 

Source: Knutzen et al. (2018). Combustible and Electronic Tobacco and Marijuana Products in Hip-Hop Music Videos, 2013-2017. JAMA Internal Medicine, Oct 15. doi: 10.1001/jamainternmed.2018.4488. [Epub ahead of print]

New Study Examines Stealthy Vapor Devices Popular With Youth

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A newly published article examined stealthy vapor devices, as well as low-odor and low-vapor e-juices, via a comprehensive online search between March and June 2018. As evidence of their popularity, a search for ‘stealth vaping’ on YouTube found 18,200 videos. A variety of cleverly designed vapor devices disguised as USB sticks, pens, remote controls, car fobs, smart phones, sweatshirt drawstrings and even asthma inhalers are on the market. JUUL, which resembles a USB stick, is the archetype of these devices and is especially popular among youth. A search of ‘JUUL’ on YouTube yielded 148 000 videos with 57 videos having >100 000 views. Searches on ‘JUUL at school’ (15 500), ‘JUUL in class’ (6840), ‘hiding JUUL in school (2030) and ‘JUUL in school bathroom’ (1040) illustrate the product’s popularity among students. Some e-juices promote themselves as having low visibility plumes while others profess to be of subtle odor to avoid detection. Numerous techniques have been described to hide the exhaled vapor plume such as by swallowing it or blowing it into one’s clothing or into a backpack.

The researchers concluded that the vaping industry has demonstrated much ingenuity in devising discreet vaporizers and de-emphasizing exhaled vapor plumes and their aroma. The US market for vaping devices with stealthy characteristics is anything but inconspicuous, with JUUL alone accounting for 70.5% of sales (July 2018).

Source: Ramamurthi et al. (2018). JUUL and other stealth vaporizers: hiding the habit from parents and teachers. Tobacco Control, Sep 15. pii: tobaccocontrol-2018-054455. doi: 10.1136/tobaccocontrol-2018-054455. [Epub ahead of print]

To Those Affected by the Recent Wildfires

Dear LOOP Community, 
We are heartbroken by the widespread devastation of the ongoing fires in Northern and Southern California. The Camp Fire in Butte County has claimed many precious lives and is the deadliest and most destructive wildfire in California history. The Woolsey Fire, in Ventura County, is being called one of the largest fires to strike Los Angeles in more than 100 years.

We encourage you to monitor the air quality of your own community on the Environmental Protection Agency’s AirNowsite.

Our thoughts go out to all those affected by these wildfires, especially to those who have lost family and friends, and to those who have been displaced. We also are extremely thankful for the tireless efforts of the many hard-working firefighters, first responders, and volunteers.

We wish for the continued safety of all of our LOOP community members and their families, as well as all Californians.
Sincerely,
The LOOP Team

Congrats to The LOOP’s Bettina Friese, PhD!

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Our LOOP team member, Bettina Friese, was recently awarded the title of “Community Leader”on Partners’ InfoHub for having 100+ posts!!
The LOOP plays an active role in sharing out recent research study abstracts and data as it relates to priority populations on InfoHub. We believe it is important to engage with colleagues around the state by providing information that could be helpful to their tobacco control and prevention efforts.
Check out Bettina’s posts in the Health Equity section of InfoHub across various priority population categories!
CONGRATS, BETTINA!

Did You Know? Tobacco Use Is A Major Cardiovascular Risk Factor For American Indians

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Heart disease is the leading cause of death in American Indians (AIs). A newly published study examined cardiovascular risk factors in Northern Plains American Indians undergoing coronary artery bypass grafting surgery. AI patients presented with increased risk factors, including higher rates of diabetes mellitus (AI 63.5% vs. non-AI 38.7%) and smoking/tobacco use (AI 60.8% vs. non-AI 20.0%). The researchers concluded that AIs presented with significantly more risk factors for cardiovascular disease compared with the general population, with especially high rates of insulin-dependent diabetes and active tobacco use.

Source: Anderson et al. (2018). Disparities in Cardiovascular Risk Factors in Northern Plains American Indians Undergoing Coronary Artery Bypass Grafting. Health Equity, Aug 1;2(1):152-160.

Did You Know? Rural Residents Less Supportive Of Secondhand Smoke Restrictions

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A newly published study compared support for secondhand smoke (SHS) restrictions across rural and urban areas. Smoking inside the home was assessed along with attitudes toward smoking in bars, casinos, playgrounds, cars, and cars with kids.

Findings included:

·         Urban respondents were significantly more supportive of all SHS policies: (e.g. smoking in bars [57.9% vs. 51.4%]; support for kids in cars [94.8% vs. 92.5%].

·         Greatest difference between urban-rural residents was in Mid-Atlantic (bar restrictions) and Southeast (home bans): almost 10% less supportive.

·         Rural residents were least likely to support SHS in homes, in cars, on playgrounds and in bars.

·         South Central rural residents were significantly less likely to support SHS policies-home bans, smoking in cars with kids, on playgrounds, in bars and casinos; while Heartland rural residents were significantly more supportive of policies restricting smoking in cars, cars with kids and on playgrounds.

Source: Stillman et al. (2018). Variations in support for secondhand smoke restrictions across diverse rural regions of the United States. Preventive Medicine, Sep 24;116:157-165. doi: 10.1016/j.ypmed.2018.09.014. [Epub ahead of print]

Read the paper at: https://www.sciencedirect.com/science/article/pii/S0091743518302925?via%3Dihub

JUUL on eBay

juul

The novel e-cigarette product JUUL has experienced rapid market growth. The online auction site eBay has been mentioned as a source of JUUL access for youth, and the US Food and Drug Administration (FDA) notified eBay to remove JUUL listings in April 2018. A newly published study sought to characterize the sale of JUUL products on eBay prior to the FDA’s request, document the impact of this request and explore ways in which eBay vendors bypassed this effort. The researchers searched eBay for JUUL-branded products sold by US vendors in March 2018, yielding a sample of 197 listings for devices and/or pods. Each listing was coded for product, listing and youth access content. Following FDA action, each listing was revisited to determine its status, and each vendor’s page was searched for JUUL and other vaping content.

Findings included:

  • Of 197 eBay listings, 189 were for JUUL kits and 13 were for pods.
  • Prices were on average higher than those on the official JUUL store, and language about age restrictions was rare.
  • Following FDA contact, most listings were no longer active. However, 3.4% of these vendors still sold JUUL devices or pods and 15.5% were selling other vaporizers or nicotine products.

The researchers concluded that online platforms may lack the will or expertise to effectively monitor content for tobacco products, while vendors quickly adapt to minor changes with simple strategies such as spelling variations. Accurate identification of online e-cigarette vendors is essential to the enforcement of policy and may benefit from cross-sector partnerships.

Source: Laestadius & Wang (2018). Youth access to JUUL online: eBay sales of JUUL prior to and following FDA action. Tobacco Control, Sep 5. pii: tobaccocontrol-2018-054499. doi: 10.1136/tobaccocontrol-2018-054499. [Epub ahead of print]

Read the abstract at: https://www.ncbi.nlm.nih.gov/pubmed/30185531