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Open Access Publications from the University of California

Scholarly Works (94 results)

  • Article
  • Peer Reviewed
UC San Diego Previously Published Works (2000)

The California Smokers' Helpline, in operation since 1992, offers all state residents free tobacco cessation services, including counseling, self-help quit kits, and cessation-related information. Services are provided in six spoken languages plus a line for the hearing-impaired. The program is promoted statewide by media campaigns, health care providers, local tobacco control programs, and the public school system. The Helpline is centrally operated through the University of California, San Diego and provides services statewide via telephone. Between 1992 and 2000, over 100,000 callers used the Helpline, which has become the chief cessation resource for California's Comprehensive Tobacco Control Program. Media was the most important referral source for Helpline callers (50%), followed by health care providers (20%). About one third of callers were ethnic minorities and 17% were 24 years old or younger. Compared to California smokers in general, callers were more dependent on nicotine and more likely to live with other smokers, but they were also more likely to have tried to quit recently and more ready to try again. Two randomized trials have demonstrated the efficacy of the Helpline counseling protocol. The California experience makes it clear that a centralized Helpline operation can be an accessible and effective service for tobacco users and should be included in any large-scale, comprehensive tobacco control program.

    Cover page: A centralised service for tobacco cessation: The California experience
    • Article
    • Peer Reviewed
    UC San Diego Previously Published Works (2002)

    A telephone counseling protocol for smoking cessation, previously shown to be efficacious, was proven effective when translated to a real-world setting. In a randomized, controlled trial of 3282 smokers, those in the treatment group (1973 callers) had abstinence rates approximately double the rates of subjects in the control group (1309 callers) at 1, 3, 6, and 12 months after quitting smoking. The success of this protocol supports Public Health Service guidelines calling for greater availability of quitlines.

      Cover page: Evidence of real-world effectiveness of a telephone quitline for smokers
      • Article
      • Peer Reviewed
      UC San Diego Previously Published Works (2021)
        Cover page: Proximity and Child-appealing Marketing Activities of Recreational Marijuana Dispensaries and Adolescents’ Marijuana Use
        • Thesis
        • Peer Reviewed
        UC San Diego Electronic Theses and Dissertations (2023)

        Background: School systems across the United States have begun implementing restorative justice practices (RJPs) to address disciplinary incidents. Previous research has found these alternatives to be effective in reducing the number of re-offenses and improving overall school connectedness, climate, and individual behavioral outcomes among students. However, there is limited research assessing the advantage of using these approaches to address drug-related incidents specifically. Objective: The aim of this study is to report findings from an intermediate evaluation of an RJP program with substance use intervention components in a rural school system. Measures of interest include changes in enrollee substance use behaviors and harm perceptions, self-responsibility, resource awareness, and the count of overall and drug-related suspensions. Methods: Data from pretest and posttest surveys, activity logs, a case management database, and publicly available discipline data were extracted and analyzed to inform the assessment of changes in individual behavioral and discipline landscape outcomes. Results: Most enrollees reported a decrease in substance use and increased resource awareness. Furthermore, decreases in the number of overall and drug-related suspensions were noted at schools implementing the restorative program. Conclusion: Findings from this intermediate evaluation reveal promising insight into the program’s effectiveness in addressing adolescent substance use behaviors and the disciplinary landscape. Nonetheless, further research is needed to examine the program-specific advantages of RJPs versus traditional punitive measures (e.g., suspensions and expulsions) to address drug-related disciplinary incidents.

          Cover page: Evaluation of a school-based restorative justice program for drug-related disciplinary incidents
          • Article
          • Peer Reviewed
          UC San Diego Previously Published Works (2017)

          Background

          The popularity and use of electronic cigarettes (e-cigarettes) has increased across all demographic groups in recent years. However, little is currently known about the readability of health information and advice aimed at the general public regarding the use of e-cigarettes.

          Objective

          The objective of our study was to examine the readability of publicly available health information as well as advice on e-cigarettes. We compared information and advice available from US government agencies, nongovernment organizations, English speaking government agencies outside the United States, and for-profit entities.

          Methods

          A systematic search for health information and advice on e-cigarettes was conducted using search engines. We manually verified search results and converted to plain text for analysis. We then assessed readability of the collected documents using 4 readability metrics followed by pairwise comparisons of groups with adjustment for multiple comparisons.

          Results

          A total of 54 documents were collected for this study. All 4 readability metrics indicate that all information and advice on e-cigarette use is written at a level higher than that recommended for the general public by National Institutes of Health (NIH) communication guidelines. However, health information and advice written by for-profit entities, many of which were promoting e-cigarettes, were significantly easier to read.

          Conclusions

          A substantial proportion of potential and current e-cigarette users are likely to have difficulty in fully comprehending Web-based health information regarding e-cigarettes, potentially hindering effective health-seeking behaviors. To comply with NIH communication guidelines, government entities and nongovernment organizations would benefit from improving the readability of e-cigarettes information and advice.
            • Article
            • Peer Reviewed
            UC San Diego Previously Published Works (2018)

            Background

            The electronic cigarette (e-cigarette) industry has grown in size and organizational complexity in recent years, most notably with the entry of major tobacco companies in 2012 and the proliferation of vape shops. Many brands maintain retail websites that present e-cigarette marketing claims and sell directly to consumers. Understanding of the evolving composition of different types of e-cigarette brand websites is currently underdeveloped.

            Objective

            This paper presents how e-cigarette brand websites surveyed in 2013-2014 evolved by 2016-2017, and how the websites run by different types of e-cigarette producers currently differ.

            Methods

            In 2016-2017, we revisited 466 e-cigarette brand websites surveyed in 2013-2014, 288 of which were extant, and identified 145 new English-language websites. We compared product designs, marketing claims, and age-based warnings presented by types of e-cigarette producers: major tobacco companies, independent vape shops, and independent internet-only companies.

            Results

            Among the 433 websites examined in 2016-2017, 12 were owned by major tobacco companies, 162 operated a physical vape shop, and 259 were internet-only operations. Closed-system product designs were sold by 83% (10/12) of tobacco-owned brands. In comparison, 29.0% (47/162, P<.001) of vape shop and 55.2% (143/259, P=.06) of internet-only brands sold closed-system designs. Compared with vape shop and internet-only brands, tobacco-owned brands offered a smaller set of product models (P values <.001) and a narrower range of flavors (P values <.01), with greater emphasis on the traditional combustible cigarette flavors of tobacco and menthol (P values <.001). Tobacco-owned brands also offered a narrower range of nicotine options than the vape shops (P=.002) and were less likely to offer nicotine-free e-liquid compared with internet-only and vape shop brands (P values <.001). Finally, 83% (10/12) of tobacco-owned brand websites featured age verification pop-up windows. In comparison, only 50.2% (130/259) of internet-only brands (P=.01) and 60.5% (98/162) of vape shop brands (P=.06) featured age verification windows. Websites surveyed in both 2013-2014 and 2016-2017 became more likely to sell open-system mods (P<.001) and sold an increased number of product models (P<.001), flavors (P<.001), and nicotine options (P<.001). Prevalence of several types of claims decreased significantly, including indirect claims regarding smoking cessation (P<.001), claims regarding e-cigarettes as healthier (P<.001), less expensive (P<.001), and usable in more places (P<.001) compared with combustible cigarettes.

            Conclusions

            The number of e-cigarette brands has not appeared to increase since 2014, even as website messaging evolved, with brands owned by tobacco companies and vape shops pulling in opposite directions. Brands owned by tobacco companies offered a limited range of e-cigarette products, whereas brands owned by vape shops emphasized a panoply of flavor and nicotine options. Furthermore, the Food and Drug Administration's regulatory action may influence the types of e-cigarette products offered and the market shares of various companies.
              • Article
              • Peer Reviewed
              UC San Diego Previously Published Works (2015)

              Background

              The rise in popularity of electronic cigarettes (e-cigarettes) and hookah over recent years has been accompanied by some confusion and uncertainty regarding the development of an appropriate regulatory response towards these emerging products. Mining online discussion content can lead to insights into people's experiences, which can in turn further our knowledge of how to address potential health implications. In this work, we take a novel approach to understanding the use and appeal of these emerging products by applying text mining techniques to compare consumer experiences across discussion forums.

              Objective

              This study examined content from the websites Vapor Talk, Hookah Forum, and Reddit to understand people's experiences with different tobacco products. Our investigation involves three parts. First, we identified contextual factors that inform our understanding of tobacco use behaviors, such as setting, time, social relationships, and sensory experience, and compared the forums to identify the ones where content on these factors is most common. Second, we compared how the tobacco use experience differs with combustible cigarettes and e-cigarettes. Third, we investigated differences between e-cigarette and hookah use.

              Methods

              In the first part of our study, we employed a lexicon-based extraction approach to estimate prevalence of contextual factors, and then we generated a heat map based on these estimates to compare the forums. In the second and third parts of the study, we employed a text mining technique called topic modeling to identify important topics and then developed a visualization, Topic Bars, to compare topic coverage across forums.

              Results

              In the first part of the study, we identified two forums, Vapor Talk Health & Safety and the Stopsmoking subreddit, where discussion concerning contextual factors was particularly common. The second part showed that the discussion in Vapor Talk Health & Safety focused on symptoms and comparisons of combustible cigarettes and e-cigarettes, and the Stopsmoking subreddit focused on psychological aspects of quitting. Last, we examined the discussion content on Vapor Talk and Hookah Forum. Prominent topics included equipment, technique, experiential elements of use, and the buying and selling of equipment.

              Conclusions

              This study has three main contributions. Discussion forums differ in the extent to which their content may help us understand behaviors with potential health implications. Identifying dimensions of interest and using a heat map visualization to compare across forums can be helpful for identifying forums with the greatest density of health information. Additionally, our work has shown that the quitting experience can potentially be very different depending on whether or not e-cigarettes are used. Finally, e-cigarette and hookah forums are similar in that members represent a "hobbyist culture" that actively engages in information exchange. These differences have important implications for both tobacco regulation and smoking cessation intervention design.
                • Article
                • Peer Reviewed
                UC San Diego Previously Published Works (2023)
                Our aim in this work is to apply text mining and novel visualization techniques to textual data derived from online health discussion forums in order to better understand consumers experiences and perceptions of electronic cigarettes and hookah.
                  Creative Commons 'BY-NC' version 4.0 license
                  • Article
                  • Peer Reviewed
                  UC San Diego Previously Published Works (2019)
                  Receiving offers of cigarettes or e-cigarettes can contribute to the progression from intention to actual use. However, there is a lack of data about the prevalence or characteristics of youth being offered cigarettes or e-cigarettes. A random sample of 91 high schools in the state of California (with 40,137 students) participated in the 2015⁻16 California Student Tobacco Survey. Offers of cigarettes and e-cigarettes in the last 30 days were assessed. Separate multilevel logistical regression models identified student characteristics associated with being offered cigarettes and e-cigarettes. On average, 11.1% and 16.1% of all students reported being offered cigarettes and e-cigarettes in the last 30 days, respectively. Among those who received offers of cigarettes, 45.5% were never smokers. Among those who received offers of e-cigarettes, 29.6% were never vapers. Male students were more likely to report being offered an e-cigarette than female students (Adjusted Odds Ratio (AOR) 1.13), as were students with friends that used e-cigarettes (AOR 5.14⁻23.31) and those with high sensation seeking tendencies (AOR 1.33). Similar characteristics were associated with offers of cigarettes. Including measures of offers of cigarettes and e-cigarettes in surveillance systems could help identify those at risk of future cigarette and e-cigarette use.
                    • Article
                    • Peer Reviewed
                    UC San Diego Previously Published Works (2020)

                    Purpose

                    After marijuana commercialization, the presence of recreational marijuana dispensaries (RMDs) was rapidly increasing. The point-of-sale marketing poses concerns about children's exposure. This study examined advertising and promotions that potentially appeal to children and access restrictions in RMDs around California schools.

                    Methods

                    This was a cross-sectional and observational study conducted from June to September 2018. Trained fieldworkers audited retail environments in 163 RMDs in closest proximity to 333 randomly sampled public schools in California.

                    Results

                    About 44% of schools had RMDs located within 3 miles. Regarding interior marketing, 74% of RMDs had at least one instance of child-appealing products, packages, paraphernalia, or advertisements. RMDs closer to a school had a higher proportion with interior child-appealing marketing. More than three fourths of RMDs had generic promotional activities; particularly, 28% violated the free-sample ban. Regarding exterior marketing, only 2% of RMDs had those appealing to children. More than 60% of RMDs had exterior signs indicative of marijuana. Approximately, one-third had generic advertisements, and 13% had advertisements bigger than 1,600 square inches. Regarding access restrictions, almost all RMDs complied with age verification, but 84% had no age limit signs, and only 40% had security personnel.

                    Conclusions

                    Despite minimal point-of-sale marketing practices appealing to children on the exterior of RMDs around California schools, such practices were abundant on the interior. Marketing practices not specifically appealing to children were also common on both the interior and exterior of RMDs. Dispensaries' violation of age verification law, lack of security personnel, and presence of child-appealing marketing should be continuously monitored and prevented.
                      Cover page: Point-of-Sale Marketing in Recreational Marijuana Dispensaries Around California Schools
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