Tobacco use is a major public-health concern in the United States. Intervention and prevention strategies for tobacco use are an urgent public-health priority because tobacco use is the single most preventable cause of death. To help social workers better understand tobacco use problems, this entry presents an overview, including definitions of terms, the scope and impact of tobacco use problems in terms of different segments of the population (that is, age, gender, race or ethnicity, geographic location, and education level or socioeconomic status), etiology of tobacco use (for example, biological or genetic; psychiatric; psychosocial; or environmental or sociocultural factors), policy history, tobacco prevention, clinical issues (such as cessation desire, treatment and success, or screening tools for tobacco use disorder and tobacco withdrawal), and practice interventions for tobacco use problems. Based on the information, the roles of social workers will be addressed.
Mansoo Yu and Rachel Fischer
Yvonnes Chen and Joseph Erba
Media literacy describes the ability to access, analyze, evaluate, and produce media messages. As media messages can influence audiences’ attitudes and behaviors toward various topics, such as attitudes toward others and risky behaviors, media literacy can counter potential negative media effects, a crucial task in today’s oversaturated media environment. Media literacy in the context of health promotion is addressed by analyzing the characteristics of 54 media literacy programs conducted in the United States and abroad that have successfully influenced audiences’ attitudes and behaviors toward six health topics: prevention of alcohol use, prevention of tobacco use, eating disorders and body image, sex education, nutrition education, and violent behavior. Because media literacy can change how audiences perceive the media industry and critique media messages, it could also reduce the potential harmful effects media can have on audiences’ health decision-making process. The majority of the interventions have focused on youth, likely because children’s and adolescents’ lack of cognitive sophistication may make them more vulnerable to potentially harmful media effects. The design of these health-related media literacy programs varied. Many studies’ interventions consisted of a one-course lesson, while others were multi-month, multi-lesson interventions. The majority of these programs’ content was developed and administered by a team of researchers affiliated with local universities and schools, and was focused on three main areas: reduction of media consumption, media analysis and evaluations, and media production and activism. Media literacy study designs almost always included a control group that did not take part in the intervention to confirm that potential changes in health and risk attitudes and behaviors among participants could be attributed to the intervention. Most programs were also designed to include at least one pre-intervention test and one post-intervention test, with the latter usually administered immediately following the intervention. Demographic variables, such as gender, age or grade level, and prior behavior pertaining to the health topic under study, were found to affect participants’ responses to media literacy interventions. In these 54 studies, a number of key media literacy components were clearly absent from the field. First, adults—especially those from historically underserved communities—were noticeably missing from these interventions. Second, media literacy interventions were often designed with a top-down approach, with little to no involvement from or collaboration with members of the target population. Third, the creation of counter media messages tailored to individuals’ needs and circumstances was rarely the focus of these interventions. Finally, these studies paid little attention to evaluating the development, process, and outcomes of media literacy interventions with participants’ sociodemographic characteristics in mind. Based on these findings, it is recommended that health-related media literacy programs fully engage community members at all steps, including in the critical analysis of current media messages and the production and dissemination of counter media messages. Health-related media literacy programs should also impart participants and community members with tools to advocate for their own causes and health behaviors.