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Article

Addictions: Tobacco  

Mansoo Yu and Rachel Fischer

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.

Article

Private Enterprise, Colonialism, and the Atlantic World  

L.H. Roper

European empires would have not existed absent private enterprise both licit and illicit. Private traders, in the first instance, sustained colonies by conveying the labor and merchandise that planters required in exchange for the exports that colonies produced. Moreover, those colonies would not have existed in the first place absent private initiatives since European states in the 16th and 17th centuries customarily lacked the administrative and fiscal resources and often the inclination to oversee such projects. Individual or corporate adventurers, though, did possess such resources and inclination; legitimate operators secured government authority for their activities pursuant to charters that drew upon medieval forms and granted extraordinary powers to their recipients. Under the terms of these documents, grantees pursued public purposes—as they would be called today—that their activities entailed in conjunction with their pursuit of profit. The results of this practice included the establishment of colonies that spanned the Atlantic basin from the Madeira Islands to Newfoundland to Brazil; the emergence of colonial leaderships who pursued their own agendas while they ingratiated themselves into trans-Atlantic political cultures; and incessant conflict over territorial and commercial agendas that involved indigenous people as well as Europeans. Other operators did not bother with legitimacy as they pursued smuggling, piracy, and colonizing ventures that also contributed profoundly to imperial expansion. The domestic and international friction generated by these activities ultimately brought increased state involvement in overseas affairs and increased state ability to direct those affairs.

Article

Alcohol and Drugs in Brazil  

Henrique S. Carneiro

Brazilian native communities already knew various drugs, such as tobacco, ayahuasca, mate, or guaraná, but after the arrival of Portuguese colonizers, sugarcane became the main economic activity for production of sugar and brandy (cachaça), with tobacco ranking second. Ayahuasca became, in the 20th century, the sacrament of syncretic and mixed religions. Pharmaceutical regulations since the late 19th century, especially of painkillers and cocaine, as well as the prohibition of folk healers, tightened state controls that particularly stigmatized cannabis as an expression of an African heritage to be extirpated. Adherence to international treaties and the establishment of bodies that centralized drug policy, such as the National Commission for the Inspection of Narcotic Drugs (CNFE), in 1938 were accompanied by repressive legislation, with a large increase in criminal indictment and incarceration. Brazil’s 20th-century drug history, encompassing the sphere of pharmaceuticals and illicit and licit substances such as alcoholic, stimulants, and tobacco, reflects shifting socioeconomic, political, and cultural contexts.

Article

Defining Chinese Commodities in the Early Modern Era: A Historical and Conceptual Analysis  

Ronald C. Po

China gradually became a major political and economic power, starting from the second half of the 20th century. Today, it is an export factory that manufactures almost every imaginable product, from brass buttons and footware to computer chips and motor vehicles. While one could argue that the label “Made in China” seems to be visible and recognizable everywhere in the 21st century, this is not a recent phenomenon. A few centuries prior to the 1970s, China was already tightly connected to the global market. During the early modern era, the ideas, customs, and habits of Chinese culture were already steadily spreading across the globe through the consumption of a series of highly desirable Chinese items. Although historians have studied the global impact of a wide range of goods exported from China since the Ming dynasty, if not earlier, it remains necessary to obtain a more conceptual definition of the term “Chinese commodity” in studies of consumption and material culture. According to one definition, a “Chinese commodity” is a good that originated in and/or was manufactured in China. Yet at the same time, the idea of Chinese commodities has occasionally said more about how the non-Chinese in a foreign market imagined and conceptualized Chinese culture than the actual cultural meaning that was supposed to be connected to China. In other words, this is a multifaceted concept that requires further elaboration since it offers promising perceptions from which to explore and reflect on the interlacing of China and the world, while some of these correlations continue to generate a certain degree of social impact on our physical surroundings and imagination even to the present day.

Article

The Economics of Smoking Prevention  

Philip DeCicca, Donald S. Kenkel, Michael F. Lovenheim, and Erik Nesson

Smoking prevention has been a key component of health policy in developed nations for over half a century. Public policies to reduce the physical harm attributed to cigarette smoking, both externally and to the smoker, include cigarette taxation, smoking bans, and anti-smoking campaigns, among other publicly conceived strategies to reduce smoking initiation among the young and increase smoking cessation among current smokers. Despite the policy intensity of the past two decades, there remains debate regarding whether, and to what extent, the observed reductions in smoking are due to such policies. Indeed, while smoking rates in developed countries have fallen substantially over the past half century, it is difficult to separate secular trends toward greater investment in health from actual policy impacts. In other words, smoking rates might have declined in the absence of these anti-smoking policies, consistent with trends toward other healthy behaviors. These trends also may reflect longer-run responses to policies enacted many years ago, which also poses challenges for identification of causal policy effects. While smoking rates fell dramatically over this period, the gradient in smoking prevalence has become tilted toward lower socioeconomic status (SES) individuals. That is, cigarette smoking exhibited a relatively flat SES gradient 50 years ago, but today that gradient is much steeper: relatively less-educated and lower-income individuals are many times more likely to be cigarette smokers than their more highly educated and higher-income counterparts. Over time, consumers also have become less price-responsive, which has rendered cigarette taxation a less effective policy tool with which to reduce smoking. The emergence of tax avoidance strategies such as casual cigarette smuggling (e.g., cross-tax border purchasing) and purchasing from tax-free outlets (e.g., Native reservations in Canada and the United States) have likely contributed to reduced price sensitivity. Such behaviors have been of particular interest in the last decade as cigarette taxation has roughly doubled cigarette prices in many developed nations, creating often large incentives to avoid taxation for those who continue to smoke. Perhaps due to the perception that traditional policy has been ineffective, recent anti-smoking policy has focused more on the direct regulation of cigarettes and smoking behavior. The main non-price-based policy has been the rise of smoke-free air laws, which restrict smoking behavior in workplaces, restaurants, and bars. These regulations can reduce smoking prevalence and exposure to secondhand smoke among nonsmokers. However, they may also shift the location of smoking in ways that increase secondhand smoke exposure, particularly among children. Other non-tax regulations focus on the packaging (e.g., the movement towards plain packaging), advertising, and product attributes of cigarettes (e.g., nicotine content, cigarette flavor, etc.), and most are attempts to reduce smoking by making it less desirable to the actual or potential smoker. Perhaps not surprisingly, research in the economics of smoking prevention has followed these policy developments, though strong interest remains in both the evaluation of price- and non-price policies as well as any offsetting responses among smokers that may undermine the effectiveness of these regulations. While the past two decades have provided fertile ground for research in the economics of smoking, we expect this to continue, as governments search for more innovative and effective ways to reduce smoking.

Article

Sugar Cane and Agricultural Transformations in Cuba  

Reinaldo Funes Monzote

For the greater part of the 19th and 20th centuries, Cuba, the largest island in the Antilles, figured as the principal exporter of sugar cane, a product that dominated the country’s agro-industry. In this way, Cuba became illustrative of the economic, social, political, and environmental impact of basing an economy on monoculture in order to supply foreign markets. This does not mean, however, that sugar cane was the only major crop being grown in the Cuban fields, as there was no dearth of different plants destined for foreign markets, such as tobacco and coffee, or for local markets, such as yucca, plantains, corn, sweet potatoes, and rice, not to mention a long if little-known livestock tradition. However, the dominance of agro-industry almost always eclipses agricultural and economic alternatives that could become potential competitors, despite the periodic adverse circumstances that affect consumers. But, in the 1990s, the production and exportation of sugar suffered an abrupt fall, creating a vacuum that allowed diversification of land use and that prompted a search for alternative agricultural models.

Article

The Economy of Colonial British America  

Aaron Slater

Identifying and analyzing a unified system called the “economy of colonial British America” presents a number of challenges. The regions that came to constitute Britain’s North American empire developed according to a variety of factors, including climate and environment, relations with Native peoples, international competition and conflict, internal English/British politics, and the social system and cultural outlook of the various groups that settled each colony. Nevertheless, while there was great diversity in the socioeconomic organization across colonial British America, a few generalizations can be made. First, each region initially focused economic activity on some form of export-oriented production that tied it to the metropole. New England specialized in timber, fish, and shipping services, the Middle Colonies in furs, grains, and foodstuffs, the Chesapeake in tobacco, the South in rice, indigo, and hides, and the West Indies in sugar. Second, the maturation of the export-driven economy in each colony eventually spurred the development of an internal economy directed toward providing the ancillary goods and services necessary to promote the export trade. Third, despite variations within and across colonies, colonial British America underwent more rapid economic expansion over the course of the 17th and 18th centuries than did its European counterparts, to the point that, on the eve of the American Revolution, white settlers in British America enjoyed one of the highest living standards in the world at the time. A final commonality that all the regions shared was that this robust economic growth spurred an almost insatiable demand for land and labor. With the exception of the West Indies, where the Spanish had largely exterminated the Native inhabitants by the time the English arrived, frontier warfare was ubiquitous across British America, as land-hungry settlers invaded Indian territory and expropriated their lands. The labor problem, while also ubiquitous, showed much greater regional variation. The New England and the Middle colonies largely supplied their labor needs through a combination of family immigration, natural increase, and the importation of bound European workers known as indentured servants. The Chesapeake, Carolina, and West Indian colonies, on the other hand, developed “slave societies,” where captive peoples of African descent were imported in huge numbers and forced to serve as enslaved laborers on colonial plantations. Despite these differences, it should be emphasized that, by the outbreak of the American Revolution, the institution of slavery had, to a greater or lesser extent, insinuated itself into the economy of every British American colony. The expropriation of land from Indians and labor from enslaved Africans thus shaped the economic history of all the colonies of British America.

Article

Reproductive Health  

Marjorie R. Sable and Patricia J. Kelly

Reproductive health includes family planning, prenatal care, and the broader scope of primary care. Because a woman's health status at conception is as important as prenatal care, genetic screening and 20th century medical technology, reproductive health includes “the preconceptual and interconceptual periods and the menopause, and finally, not only reproductive tract problems but the wide range of risk factors that influence a woman's health in general.” Quantitative indicators of reproductive outcomes are useful for summarizing progress in reproductive health. Important indicators are discussed and reveal significant racial disparities.

Article

Media Literacy as a Consideration in Health and Risk Message Design  

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.