EMBARGOED AJPH research: Smoke free laws reduce asthma; sexual minority teen alcohol-use; military sexual trauma; political impact on cigarette tax

In this month’s release find research about local smoke-free laws’ impact on asthma; patterns of alcohol-use among sexual minority adolescents; recommendations to reduce military sexual trauma; and how political leanings may impact cigarette tax rates more than the economy.

EMBARGOED UNTIL December 12, 2013, 4 p.m. (EST)

Contact: For copies of articles or full table of contents of this month’s released studies, call Kimberly Short, 202-777-2511, or email her.

American Journal of Public Health highlights:

1.    Local smoke-free laws reduce asthma incidents

2.    Sexual minority youths more likely to explore alcohol

3.    Study recommends steps to reduce military sexual trauma

4.    State political leanings impact cigarette tax rates more than the economy

Local smoke-free laws reduce asthma discharges
While state laws show no impact besides the effect of county laws or of state laws alone, county level smoke-free laws reduce the rate of asthma discharges, according to new research from the American Journal of Public Health.

The study analyzed data from the Healthcare Cost and Utilization Project state inpatient databases and the American Nonsmokers’ Rights Foundation Smoke-Free Laws database. These data, capturing information from multiple states both with and without smoke-free laws, were used to estimate changes in asthma discharge rates from hospitals before, during and after implementation of state and local smoke-free laws.

Results indicated a statistically significant association between implementation of county laws and reductions in adult and child asthma discharges. Other variables such as state smoke-free laws alone showed no similar association with the asthma discharges.

“[The] finding does not mean [all] state policy approaches are not effective. In fact, the Institute of Medicine recommends multifaceted state approaches to reduce the effects of tobacco use and exposure to [secondhand smoke],” the study’s author explains.

“My findings may indicate it is unwise to pursue state smoke-free laws where they have yet to pass. Rather, efforts might be better focused at the local level, where there is evidence of a significant impact,” the author concludes.

[“The impact of smoke-free laws on asthma discharges: A multistate analysis.” Glenn Landers, Georgia Health Policy Center, Andrew Young School of Policy Studies, Georgia State University, Atlanta.]

Sexual minority adolescents more likely to use alcohol
According to new research from the American Journal of Public Health, sexual minority youths are more likely to explore alcohol than heterosexual youths, with larger alcohol-use disparities among bisexual youths, younger sexual minority youth, and sexual minority girls.

Using data from 2005 and 2007 Youth Risk Behavior Survey samples, researchers compared alcohol behavior among youth of various sexual orientations between the ages of 13 and 17 and older. The survey assessed sexual orientation, gender of sexual partners and sexual attraction, along with onset age of drinking, frequency of use and other behaviors.

Results indicated that youth of any sexual minority (i.e., non-heterosexual) identity were more likely than heterosexual youths to report beginning drinking at younger ages and to report lifetime drinking. Furthermore, among sexual minority subgroups, youth who reported both male and female sexual partners showed greater alcohol-use disparities than those who reported only same-sex sexual partners. In addition, greater disparities were found among sexual minority girls than boys and younger sexual minority youths than those older. 

“Findings from our study provide information that can be used in the development of more effective prevention and early intervention strategies to reduce sexual-orientation alcohol-related disparities. In particular, strategies are needed that focus on delaying the initiation of alcohol use as well as preventing frequent or heavy use,” the researchers suggest.

[“Exploring alcohol use behaviors among heterosexual and sexual minority adolescents: Intersections with sex, age, and race/ethnicity.” Contact: Amelia Talley, PhD, Department of Psychology, Texas Tech University, Lubbock, Texas.] 

Study recommends steps to reduce military sexual trauma
New research from the American Journal of Public Health identifies recommendations for reducing incidents of military sexual trauma among U.S. servicewomen. Using qualitative data collected from servicewomen, the study suggests that improving the investigation and prosecution of incidents, increasing awareness among service members about regulations and services and improving access to confidential medical care, including emergency contraception, may help improve response to sexual assault or harassment during military service.

Interview responses were collected from 22 servicewomen who were deployed overseas between 2002 and 2011. Responses were collected about factors contributing to military sexual trauma, reporting sexual trauma, availability and use of sexual trauma services and suggestions for improvement.

Based on results from the qualitative study, the dynamics of deployment, military culture and lack of consequences contribute to incidents of military sexual trauma during deployment. In addition, most respondents felt that servicewomen typically do not report incidents due to concerns of negative reactions, confidentiality concerns, culture of unit cohesion and other barriers. Additional responses provided feedback on available sexual trauma services and suggestions for improvement.

The authors note, “our findings highlight challenges unique to the military context, particularly unit cohesion and the implications of ‘breaking up the team,’ as well as the fear that reporting military sexual trauma and seeking counseling could be detrimental to one’s career.”

[“Military sexual trauma among U.S. servicewomen during deployment: A qualitative study.” Contact: Bridgit Burns, MPH, Ibis Reproductive Health, Cambridge, Mass.]

State political leanings impacts cigarette tax rates more than the economy
According to new research from the American Journal of Public Health, political changes more than economic changes may influence cigarette tax increases.

In an effort to analyze economic and political influence on state tobacco tax rates, researchers compared state cigarette excise tax rates against corresponding economic, political, attitudinal and demographic characteristics for each state. Cigarette excise tax data was collected from 1981 to 2011. Additional state characteristics data was captured from various resources, including the U.S. Bureau of Labor Statistics, the General Social Survey and the U.S. Census.

Results indicate an increase in cigarette tax rates alongside tobacco control initiatives, with particular increases following the 1998 Master Settlement Agreement. Non-tobacco producing states generally have a higher tax rate than those who produce; and states in the Northeast, Midwest and West tend to have higher tax rates than southern states.

Researchers observe that state political changes may have more impact on cigarette tax rates than previously argued economic circumstantial effects. Specifically, prior to the 1998 Master Settlement Agreement, Democratic control was related to higher tax rates while Republican control had no effect and following 2000, Democratic control had no effect and Republican control was related to lower cigarette tax rates.

“State cigarette excise taxes remain one of the most promising strategies for reducing cigarette use and preventing smoking-related illness and death, yet implementing them requires policy change,” the authors explain.

“Despite suggestions that recessionary periods spark higher cigarette taxes, the speed of excise tax growth in the future may depend more on the political leanings of state legislators, and the attitudes of the people they represent, than on the economic circumstances they face,” the study concludes.

[“Economic and political influence on tobacco tax rates: A nationwide analysis of 31 years of state data.” Contact: Shelley D. Golden, PhD, Department of Health Behavior, The University of North Carolina at Chapel Hill, Chapel Hill, NC.]

The articles above will be published online Dec. 12, 2013, at 4 p.m. (EST)* by the American Journal of Public Health® under “First Look”. “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association.

The American Journal of Public Health ® is the monthly journal of the American Public Health Association, the oldest and most diverse organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Kimberly Short at APHA, 202-777-2511, or via email. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions department. If you are not a member of the press, a member of APHA or a subscriber, online single issue access is $30 and online single article access is $22. For direct customer service, call 202-777-2516, or email.

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