There is a growing body of evidence that environmental management
(EM) strategies, which seek to change the environment in which
individual decisions are made about behaviors such as the
use of tobacco and alcohol, are effective prevention measures.
The following are samples of the research that highlights
the effectiveness of environmental management approaches.
| General
EM Strategies |
| |
| Workplace
Smoking Bans |
| • |
A 1997
study published in the Annual Review of Public Health
concluded that workplace smoking bans reduced exposure
to environmental tobacco smoke (ETS) for nonsmokers,
reduced smoking intensity and prevalence among smokers,
and had cost savings for employers. |
| |
Brownson R, Eriksen M, Davis R, and
Warner K. “Environmental Tobacco Smoke: Health
Effects and Policies to Reduce Exposure.” Annual
Review of Public Health. 18(1997): 163-185.
|
| • |
A three-year study comparing hospitals
where smoking had been banned to other community workplaces
without smoking bans found that cessation rates were
significantly higher among employees of smoke-free workplaces.
Workplace smoking bans were identified as a prime strategy
to prevent adult smoking. |
| |
Longo D, Johnson J, Kruse R, Brownson
R, and Hewett J. “A Prospective Investigation
of the Impact of Smoking Bans on Tobacco Cessation
and Relapse.” Tobacco Control. 10(2001):267-72.
Full text available online at:
http://tc.bmjjournals.com/cgi/content/full/10/3/267
|
| • |
A survey of 100,000 workers in the early
1990s found that workplaces that are 100% smoke-free
reduce the prevalence of smoking by 6% and daily cigarette
consumption by 14%. |
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| State
Tobacco Control Policies and Price Increases |
Studies have consistently
found that extensive state tobacco control policies
and higher cigarette prices and are associated with
lower youth smoking rates. |
| • |
A long-term national study found that
higher state tobacco control expenditures were linked
with reduced cigarette sales. Researchers found that
increases in state tobacco control programs reduce tobacco
sales. Between 1990 and 2000 tobacco sales decreased
the most (average 43%) in the four states that spend
the most on tobacco control programs: Arizona, California,
Massachusetts and Oregon. The average decrease in sales
for all states was 20% during the same time period. |
| |
Farrelly M, Pechacek T, and Chaloupka
F. “The Impact of Tobacco Control Program Expenditures
on Aggregate Cigarette Sales 1981-2000.” Journal
of Health Economics. 22:5 (2003):843-859. Abstract
is available online at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=
PubMed&list_uids=12946462&dopt=Abstract
Or order a free copy of the paper from the CDC, Office
on Smoking and Health by emailing tobaccoinfo@cdc.gov
or by telephoning 770-488-5493.
|
| • |
A national study of tobacco policies
and youth smoking rates reported that states with more
extensive tobacco control policies had significantly
lower youth smoking rates. These include policies to
reduce youth access to both tobacco products and tobacco
advertising. |
| |
Luke D, Stamatakis K, and Brownson
R. “State Youth-Access Tobacco Control Policies
and Youth Smoking Behavior in the United States.”
American Journal of Preventive Medicine.
19:3 (2000): 180-187.
|
| • |
A national study examining effects of
cigarette price on youth smoking rates concluded that
higher cigarette prices result in substantial reduction
in both smoking and cigarette consumption. The study
reports, “If a state average price rises by $0.50,
youth cigarette demand can decline by 17.8 to 19.1%;
participation would drop from 31.4 to 28.5%, and the
average monthly consumption among smokers would decrease
from 163 to 157 or 154 cigarettes.” |
| |
Ross H, and Chaloupka F. “The
Effect of Cigarette Prices on Youth Smoking.”
Health Economics. 12 (2003): 217-230. Full
text available online at: http://www.uic.edu/orgs/impacteen/generalarea_PDFs/
pricepaperFebruary2001.pdf
|
| • |
A 1997 study published in the American
Journal of Public Health found that, compared to
Canadian provinces with strict nonsmoking bylaws, in
provinces where nonsmoking bylaws were infrequent, individuals
were 21% more likely to be smokers. In provinces where
cigarettes were inexpensive due to lack of excise taxes,
individuals were 26% more likely to be smokers than
individuals in provinces with cigarette excise taxes.
This held true after controlling for factors such as
age, sex, education, and marital status. |
| |
Stephens P, Pederson L, Koval J,
and Kim C. “The Relationship of Cigarette Prices
and No-Smoking Bylaws to the Prevalence of Smoking
in Canada.” American Journal of Public Health.
87:9 (1997): 1519-1521.
Abstract available online at:
http://www.ajph.org/cgi/content/abstract/87/9/1519
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| Campus
EM Strategies |
| |
| Smoke-free
Residence Halls |
| • |
Results from the Harvard College Alcohol
Study reveal that smoke-free college residence halls
may help prevent students who are not regular smokers
at the start of college from becoming smokers in college.
The likelihood of becoming a smoker in college is reduced
by 30% if individuals live in smoke-free residence halls. |
| |
Wechsler H, Lee JE, and Rigotti N.
“Cigarette Use by College Students in Smoke-Free
Housing: Results of a National Study.” American
Journal of Preventive Medicine. 20:3 (2001):
202-207.
Full text available online at:
http://www.hsph.harvard.edu/cas/Documents/smoke_free/ajpm620.pdf
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| Tobacco
Product Price Increases |
| • |
A 2001 study found that tobacco use
among college students depends on the cost of tobacco
products. The study reported that a 10% increase in
cigarette prices reduces smoking prevalence by 2.6%
among college students, and reduces the amount that
current college smokers smoke by 6.2%. |
| |
Czart C, Pacula R, Chaloupka F, and
Wechsler H. “The Impact of Prices and Control
Policies on Cigarette Smoking Among College Students.”
Contemporary Economic Policy. 19:2 (2001):
135-149. Full text available online at: http://repositories.cdlib.org/tc/reports/YO2/
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| Policy
Enforcement as a Determinant of Behavior Change |
| • |
Research suggests that without enforcement,
EM approaches to tobacco prevention have little effect.
Strict enforcement of smoking policies is associated
with a decrease in smoking prevalence. A 2001 study
reports that college students’ smoking behaviors
are only influenced when smoking restrictions reach
some threshold levels that make it difficult for smokers
to evade these policies. |
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Czart C, Pacula R, Chaloupka F, and
Wechsler H. “The Impact of Prices and Control
Policies on Cigarette Smoking Among College Students.”
Contemporary Economic Policy. 19:2 (2001):
135-149. Full text available online at: http://repositories.cdlib.org/tc/reports/YO2/
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| Alcohol
and Other Drug Prevention |
| • |
Research on the efficacy of EM strategies
for tobacco prevention is still limited, but there is
substantial evidence that EM strategies are effective
in reducing alcohol and other drug use on college campuses.
Campus alcohol policies, social norms marketing campaigns,
reducing the number of alcohol outlets near campus,
and increasing the price of alcohol are just some of
the EM approaches that have research data showing that
they are effective in reducing high-risk drinking. |
| • |
A full, annotated bibliography of research
demonstrating the efficacy of EM in AOD prevention can
be found on the Higher Education Center for Alcohol
and Other Drug Prevention website:
http://www.edc.org/hec/pubs/annotated-bib.html
and at:
http://www.edc.org/hec/ta/lit-review/ |
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