The problem of this study was to develop a valid and reliable instrument to assess the tobacco control advocacy knowledge level of high school students enrolled in the Busting Big Tobacco (BBT) program. The steps taken to examine this problem include: created a table of specifications, created the initial instrument, selected a jury of experts, a qualitative assessment by jurors, created the revised instrument, a quantitative review by jurors, revised the instrument, conducted a modified pilot test of the instrument using university students, and created the final 23 item instrument.The final instrument was administered to a group of Missouri high school students on two separate occasions a week apart. Out of the total 77 students that participated, 28 instruments were matched for data analysis. Two instrument items fell below a significant content validity ratio of .62. The mean item difficulty for the first and second administration of the final instrument was .53 and .49 respectively. The test-retest reliability was .6756 and the internal consistency reliability. 5696 for the first administration and .4815 for the second. Recommendations included: improving the confidentiality code, restructuring items into subscales, and give to BBT participants. / Department of Physiology and Health Science

There is no abstract available for this thesis. / Department of Journalism

Thesis (Ph. D.)--University of Missouri-Columbia, 1998. / Typescript. Vita. Includes bibliographical references (leaves [121]-137). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 1998. / Typescript. Vita. Includes bibliographical references (leaves [121]-137). Also available on the Internet.

Public health and social policies are often debated, designed, and adopted without implementation, sustainability, or equity in mind, which can generate profound uncertainty about how to equitably deliver them initially and over time. Although sustainability and equity considerations are sometimes considered in post-hoc policy analysis and evaluation, little is known about how to plan for and track planned and unplanned adaptations to policy implementation, as well as the ways that key sustainability factors and strategies can relate to the equitable delivery or relative effectiveness of policies on the ground and in community settings. The purpose of this dissertation was to explore the long-term sustainability and equity of tobacco control policies and programs in New York City to understand and contextualize their limited reach and impact on persistent smoking and tobacco-related health disparities in underserved Asian American communities. The specific aims were to: 1) conceptually specify an operational definition of policy sustainability and its key dimensions, including health equity, and to refine this using a mixed methods single case study of tobacco policies in New York City; 2) use the case study approach to describe the extent to which tobacco policies have been sustained and adapted in New York City; and 3) to use the case study to identify key multi-level factors that influence the long-term sustainability and equity of tobacco policies in New York City. Using a single, in-depth, convergent-parallel mixed methods case study design, data were collected, analyzed, and integrated across five key primary and secondary sources: 1) Policymaking documents – text of key tobacco bills and statutes, as well as transcripts from when they were first proposed, amended, debated, and adopted; 2) Local newspaper coverage – articles from a database of 29 major newspapers in New York State on the policies and their impacts on communities and businesses over time; 3) Key informant interviews – conducted with community members and community leaders at local health and advocacy organizations in New York City that primarily serve Asian American and immigrant communities (n = 21); 4) Direct observation periods – conducted within and around the health and advocacy organizations, as well as in majority Asian neighborhoods and Asian ethnic enclaves (n = 15); and 5) the New York City Community Health Survey (2012-2017) – conducted annually by the New York City Department of Health and Mental Hygiene. The integrated study findings point to the importance of understanding policy sustainability not as a static end goal, but rather as a dynamic set of processes and outcomes that impact health and health equity. Findings from this case study clustered across three key themes: 1) since the initial adoption of comprehensive local tobacco control measures in New York City in 2002, broad “one-size-fits-all” approaches to policy implementation and monitoring have been sustained, which have had and continue to have limited reach and impact within underserved Asian American and immigrant communities; 2) two delayed adaptation efforts were made by policymakers during the sustainability phase, one in 2012 and another in 2018, were intended to improve on prior uneven implementation to better reach Chinese-speaking communities, with the 2018 adaptation demonstrating significant improvements from the 2012 effort; and 3) community-based organizations have played a direct role in functioning not just as key stakeholders but also as key implementers to ensure that tobacco and other health policies are reaching communities that the designated or official implementers cannot reach. This suggests the need for further study of unofficial implementers in implementation science – those who have not been formally designated as the ones responsible for ensuring that implementation takes place, but are still delivering implementation strategies to ensure adoption, integration, and sustainment. Overall, this case study points to the potential for policy sustainability research to advance health equity by identifying factors and mechanisms that can be improved to maximize and sustain the equitable reach and impact of social and public health policies. By focusing on dynamic contextual factors and sustainability as a set of processes and outcomes, the findings from this case study raise critical questions about the criteria typically used to evaluate whether policy interventions are deemed evidence-based and effective by asking: 1) effective for whom?; 2) based on what evidence?; and 3) what happens as dynamic populations and contexts change over time? These questions highlight how the tobacco control success story was largely constructed around broad population-wide implementation and benefits, while overlooking underserved Asian American communities who continue to disproportionately bear the brunt of smoking and tobacco-related health disparities in New York City.

The study investigated three aspects related to smoking, namely, smoking behaviour, risk perception and attitudes to anti-smoking legislation. The theoretical framework of the study was the Information-Motivation-Behavioural (IMB) skills model. The study was a quantitative one, making use of a cross-sectional survey design to obtain data about the three variables of interest. Responses to statements about risk perception and attitudes to anti-smoking legislation in the questionnaire were arranged on a three-point Likert scale. The inferential statistics used were one-sample ttests and Chi-square analyses. The results showed an overall smoking prevalence of 16%, with twice as many females than males being smokers in the sample. ‘Coloured’ students in both genders had the highest smoking rate compared to all other race groups. The knowledge of the health risks of smoking were very high, however smokers had a lower perception of risk compared to non-smokers. Moreover, while there was a fair amount of support for anti-smoking legislation among smokers, smokers tended to show less support for legislation than non-smokers, especially to those parts of the legislation that affect them more directly. The results of the study indicate a clear connection between smoking behaviour and the effect it has on both risk perception as well as attitudes to anti-smoking legislation in individuals.

The study investigated three aspects related to smoking, namely, smoking behaviour, risk perception and attitudes to anti-smoking legislation. The theoretical framework of the study was the Information-Motivation-Behavioural (IMB) skills model. The study was a quantitative one, making use of a cross-sectional survey design to obtain data about the three variables of interest. Responses to statements about risk perception and attitudes to anti-smoking legislation in the questionnaire were arranged on a three-point Likert scale. The inferential statistics used were one-sample ttests and Chi-square analyses. The results showed an overall smoking prevalence of 16%, with twice as many females than males being smokers in the sample. ‘Coloured’ students in both genders had the highest smoking rate compared to all other race groups. The knowledge of the health risks of smoking were very high, however smokers had a lower perception of risk compared to non-smokers. Moreover, while there was a fair amount of support for anti-smoking legislation among smokers, smokers tended to show less support for legislation than non-smokers, especially to those parts of the legislation that affect them more directly. The results of the study indicate a clear connection between smoking behaviour and the effect it has on both risk perception as well as attitudes to anti-smoking legislation in individuals.

Magister Artium (Psychology) - MA(Psych) / The study investigated three aspects related to smoking, namely, smoking behaviour, risk perception and attitudes to anti-smoking legislation. The theoretical framework of the study was the Information-Motivation-Behavioural (IMB) skills model. The study was a quantitative one, making use of a cross-sectional survey design to obtain data about the three variables of interest. Responses to statements about risk perception and attitudes to anti-smoking legislation in the questionnaire were arranged on a three-point Likert scale. The inferential statistics used were one-sample t-tests and Chi-square analyses. The results showed an overall smoking prevalence of 16%, with twice as many females than males being smokers in the sample. 'Coloured' students in both genders had the highest smoking rate compared to all other race groups. The knowledge of the health risks of smoking were very high, however smokers had a lower perception of risk compared to non-smokers. Moreover, while there was a fair amount of support for anti-smoking legislation among smokers, smokers tended to show less support for legislation than non-smokers, especially to those parts of the legislation that affect them more directly. The results of the study indicate a clear connection between smoking behaviour and the effect it has on both risk perception as well as attitudes to anti-smoking legislation in individuals. / South Africa

Submitted by Rodrigo Zingales Oller do Nascimento (zingales@zgadv.com.br) on 2012-03-14T14:41:41Z No. of bitstreams: 1 Dissertação Final - Publicada.pdf: 4563422 bytes, checksum: cbb36d8289303a5dfb89127251830a30 (MD5) / Approved for entry into archive by Gisele Isaura Hannickel (gisele.hannickel@fgv.br) on 2012-03-14T17:37:43Z (GMT) No. of bitstreams: 1 Dissertação Final - Publicada.pdf: 4563422 bytes, checksum: cbb36d8289303a5dfb89127251830a30 (MD5) / Made available in DSpace on 2012-03-14T18:01:24Z (GMT). No. of bitstreams: 1 Dissertação Final - Publicada.pdf: 4563422 bytes, checksum: cbb36d8289303a5dfb89127251830a30 (MD5) Previous issue date: 2012-02-15 / Neste trabalho faz-se uma análise crítica sobre a atual política antitabagista brasileira e propõe-se sua reformulação de forma a compatibilizar, de um lado, os interesses de saúde pública e arrecadatórios e, de outro, os interesses dos agentes econômicos instalados no mercado, especialmente aqueles de pequeno e médio porte, de forma a se evitar a monopolização privada do setor e incentivar a inovação de produtos que não façam mal à saúde dos indivíduos. Para contextualizar a análise, faz-se uma revisão histórica sucinta do crescimento do consumo de cigarro em nível mundial, dos efeitos desse consumo à saúde pública e das principais medidas implementadas em nível global para o combate ao consumo, fabricação e comercialização de cigarros, explicitadas na Convenção-Quadro da Organização Mundial da Saúde de 2003, e que conta atualmente com a adesão de mais de 170 países. Apresenta-se também a política brasileira para erradicação do consumo de cigarro, que contempla, dentre outras medidas, restrições à propaganda e venda de cigarros, à entrada de novos fabricantes, ao teor de nicotina, alcatrão e de monóxido de carbono liberado, ao consumo em locais públicos e, ainda, medidas de natureza fiscal para elevação do preço do bem e o combate ao contrabando. Discutem-se as consequências das políticas antitabagistas brasileiras na estrutura de mercado e na dinâmica competitiva doméstica, destacando-se os efeitos anticompetitivos decorrentes das restrições à publicidade de cigarros e da adoção de um sistema de tributação fixa para o Imposto sobre Produtos Industrializados - IPI, incidente sobre a fabricação e comercialização de cigarro. Analisam-se criticamente os modelos teóricos para o desenvolvimento de políticas públicas que objetivam uma intervenção direta do Estado nas atividades de fabricação e distribuição de cigarro. Finalmente, nesse estudo propõem-se, para discussão e debate, ajustes na atual política brasileira antitabagista, que compatibilizem as preocupações com saúde pública, arrecadação, competição e inovação, recomendando para tanto a criação de uma agência reguladora para coordenar os agentes do setor e, em especial, para a fixação de um preço mínimo de revenda para os cigarros; de um sistema de quotas máximas por fabricante, para produção de cigarros; e, ainda, a divulgação de marcas de cigarros que reduzissem ou até mesmo eliminassem os problemas à saúde dos indivíduos. / In this work, a critical analysis of the present Brazilian antismoking policy is presented along with the proposal of its reformulation aiming at harmonizing public health and tax revenue collection, and, simultaneously, meeting the interests of economical agents, specifically those of small and medium size companies, in order to avoid the private monopolization of this sector and to improve research and development of “good” cigarettes. To contextualize the analysis, an overviewed historical revision of the global growth of the tobacco consumption, its effects on public health, and the main measures implemented globally to reduce the consumption, manufacturing and sales of cigarettes are presented. These measures are specified in the WHO Framework Convention on Tobacco Control, issued in 2003 by the World Health Organization, and followed by more than 170 countries. We also introduce the Brazilian policy for the eradication of cigarette consumption, which contemplate, among others, restrictions to: propaganda and cigarette sales, entry of new manufacturers in the local market, nicotine and tar cigarette content and carbon monoxide liberation, and smoking in public places. Additionally, tax measures to increase the cigarette price and to combat cigarette smuggling are also specified. In this piece of work we discuss the consequences of the adoption of the Brazilian antismoking policies on the domestic market structure and competitive dynamics, emphasizing the anticompetitive effects resultant from restrictions to cigarette advertisement and the adoption of a specific excise tax system. Theoretical models to the development of public policies aiming a direct intervention of the State in the manufacturing and distribution of cigarettes are critically analyzed. Finally, for discussion and debate, we propose adjustments in the present Brazilian antismoking policy that reconcile, on the one hand, public health themes and tax revenues and, on the other, a competitive environment, which ensures the existence of efficient small and medium companies and free competition, and the recommendation for the creation of a regulatory agency to coordinate the agents of the tobacco sector, and, particularly, to set a minimum price for cigarette resale; a system of maximum shares per cigarette manufacturer; as well as, the release of cigarette brands and advertisements only for products that have reduced or even eliminated the the individuals’ health problems.