Dissertation Abstracts: Policy and Public Health Edition

Editor’s note: Of potential interest to Points readers, the following drug-related dissertation abstracts were compiled as part of a running bibliography of relevant scholarship by Jonathon Erlen, History of Medicine Librarian at the University of Pittsburgh (erlen@pitt.edu). The abstracts were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Today’s batch, released one week after the conclusion of tumultuous election, deals primarily with the policy and politics of public health. 

An analysis of National Youth Tobacco Surveys: Using substantive risk predictors to target communication campaigns

Author: Hong, Moonki

Abstract: Health and communication researchers have studied tobacco related risks and behaviors, and associated variables for more than 20 years. Some of their studies have produced consistent findings, while others have produced findings that are inconsistent and complex. To address these problems, this study used a common set of comparable samples, a common set of variables, and a common set of measurement techniques that are found in the 1999, 2000, 2002, and 2004 National Youth Tobacco Surveys (NYTS). In this study, secondary analysis techniques were used to identify substantive predictors of youth susceptibility to smoking, lifetime smoking, and current smoking. When considering the NYTS sample results for adolescents ages 11 to 18, there is clear evidence that youth susceptibility to smoking has not declined since the Master Settlement Agreement in 1998. By comparison, there is good evidence that lifetime smoking and current smoking have declined, though the effect size measures for these changes are minimal. The study results further point to the utility of measures documenting peer (best friends) smoking and receptivity to pro-tobacco promotions as predictors of adolescent susceptibility to smoking. Measures of favorable attitudes toward smoking/smokers are somewhat less consistent positive predictors of smoking susceptibility. The results further confirm that age, peer smoking, and receptivity to pro-tobacco promotions are substantive, positive predictors of lifetime smoking and current smoking. A cluster analysis produced two adolescent audience segments reflecting tobacco-related risks. The first cluster represented household smoking and receptivity to pro-tobacco promotions risks and the second cluster represented peer smoking and favorable attitudes toward smoking/smokers risks. The cluster segmentation of adolescents was particularly useful in predicting lifetime and current smoking behaviors. The cluster segmentation results, however, indicate that additional variables are needed to explain and predict the sample observations. This study concludes with a discussion of factors that possibly limit the empirical findings. Several theories are identified for inclusion in future research. Recommendations are also made to focus attention on identifying the anti-tobacco campaign components that have been successful following the MSA.

Publication year: 2008

University/institution: Florida State University


Essays on drug and alcohol policies in the United States

Author: Crouch, Randall

Abstract: This dissertation consists of two essays that explore the unintended consequences of drug and alcohol control policies in the United States. They both examine policy changes at the state level using a difference-in-differences approach. These two studies shed light on outcomes that were not likely to be considered when policy decisions were made and may have important implications for future policies. In the first essay, I analyze the effect of minimum legal drinking age (MLDA) laws on non-cognitive skills. The National Longitudinal Survey of Youth 1979 (NLSY79) is used to investigate the effect of changes in MLDA on the onset of regular drinking, self-esteem and self-control. Surprisingly, I find that a legal drinking environment is associated with an increase in self-esteem for females in the short-run and long-run. Then, I test several possible channels through which self-esteem may be indirectly affected by the MLDA. These channels include alcohol and drug use, marriage, sex and childbirth. Although the MLDA has a significant effect on some of these channels for females, using the channels as controls in the self-esteem analysis does not affect the magnitude or significance of the effect of the MLDA on female self-esteem. In the second essay, I examine the effect of marijuana decriminalization in Massachusetts on the black-white gap in arrest rates for several different criminal offenses using Uniform Crime Reporting (UCR) program data. I use a difference-in-difference model that allows for a heterogeneous treatment effect by race to estimate this effect for marijuana possession and sales, non-marijuana possession and sales, violent and theft-related offenses separately for adults and juveniles. Results indicate that marijuana decriminalization leads to a decrease in the black-white gap in adult and juvenile arrest rates for marijuana possession and sales, non-marijuana sales and adult arrest rates for theft-related offenses. These findings are consistent with decriminalization leading to a shift in police resources away from areas where blacks are more likely to be arrested.

Subject: Economics

Publication year: 2015

Advisors: Juhn, Chinhui; Lin, Elaine

University/institution: University of Houston


A community trial to speed the diffusion of smoke-free policies in multiunit housing

Author: Gentzke, Andrea Susan

Abstract: Given the regional and socioeconomic differences in the smoke-free housing movement, we set out to implement a community-based educational intervention trial aimed at increasing the adoption of smoke-free policies in multiunit housing (MUH). Methods: This dissertation provides the results of two distinct projects. The first project is the community-based educational intervention trial conducted in 3 pairs of communities (1 intervention (I), 1 control (C)) across the U.S.: Bismarck (I) and Grand Forks (C), ND, Charleston (I) and Columbia (C), SC, and Fort Collins (I) and Pueblo (C), CO. This project included three primary data collection efforts: (1) a baseline survey of knowledge, attitudes, and experiences with secondhand smoke and smoke-free policies among MUH residents living in these communities, (2) a baseline survey of knowledge, attitudes, and experiences with smoke-free policies among MUH operators in these communities, and (3) a follow-up survey among MUH residents (from baseline) to assess changes over time in secondhand smoke exposures, smoke-free rules in the home and building, and attitudes toward smoke-free policies. Between baseline and follow-up, a multi-faceted educational intervention was disseminated to key stakeholders in our intervention communities. We worked with local community partners to create and disseminate all materials involved in the intervention. We hypothesized that exposure to the educational intervention would have resulted in faster rates of adoption of smoke-free policies compared to what was observed in the control communities. The second project is an environmental assessment of secondhand smoke (SHS) and thirdhand smoke (THS) exposures inside smoke-free and smoke-permitted subsidized MUH buildings. Data were collected between December 2014 and June 2015 in two large subsidized housing buildings near Buffalo, NY (Fredonia, NY and Batavia, NY). During the assessment periods, we collected data on particulate matter (PM), airborne nicotine, and surface nicotine, a marker of thirdhand smoke contamination. These markers were compared between buildings and units with varying smoking rules, and were also compared with each other to determine the best marker(s) to assess tobacco smoke pollution in these environments. Results: From the baseline survey, 76% of residents enforced smoke-free home rules, but a substantial proportion (50%) of these individuals reported SHS incursions into their units in the previous 12 months. The majority of residents overall (67%) reported there were no rules about smoking set by the MUH operator inside the building where they lived. Preferences toward smoke-free building policies were high (56% overall), but were mostly restricted to non-smoker residents. Differences in these outcomes were noted by community, indicating the importance of utilizing locally collected data in intervention materials. Results of the operator baseline survey found that 38% of operators across all communities reported having at least one smoke-free building. However, among those without smoke-free policies, many were reluctant to implement a policy citing concerns about resident resistance or the potential for higher vacancy rates. Positive effects of smoke-free policies were cited by those who had implemented a smoke-free policy, but operators without policies generally lacked this knowledge. At follow-up, we did not observe any statistically significant findings over time contingent on our intervention. However, we did find positive changes over time in each outcome overall, suggesting that the temporal trends in the smoke-free housing movement may have outweighed the effects of our intervention. We also found that enforcement of smoke-free policies remained an important issue over time. The results of this follow-up survey suggest that disparities in SHS exposures may be widening due to smoke-free policies in MUH. Over time, subsidized housing residents were significantly less likely to implement/enforce smoke-free home rules, and were also less likely to report the implementation of smoking rules inside their buildings. The results of the environmental assessments found significant differences between levels of SHS and THS exposures between buildings and units with smoke-free home rules. These results also indicate that voluntary smoke-free home rules do not confer full protection from tobacco smoke exposures. Comparing units occupied by non-smokers across buildings, levels of particulate matter, airborne nicotine, and surface nicotine were all higher among units in the smoke-permitted building compared to the smoke-free building. Discussion and Public Health Impact: Although we did not observe any significant changes over time due to our educational intervention, these findings are not in vain. Overall, important data and themes were gleaned from this study which can be utilized in future campaigns that are aimed at smoke-free policy adoption and enforcement. Moreover, these results indicate that there is positive momentum in the smoke-free housing movement. Although these temporal trends may have outweighed our intervention, there will likely be strong gains in public health due to reduced SHS exposures in the home as well as in changing social norms regarding smoking due to this momentum.

Publication year: 2016

Advisor: Hyland, Andrew

University/institution: State University of New York at Buffalo

Department: Epidemiology and Environmental Health