Tobacco Midterm 1
Hanuar article
-last thing we need is more prohibition -many problems with the "War on Drugs" -prohibition of tobacco is not practical given the influence of the industry - a waste of time and energy that actually benefits the industry and makes the public health community seem extreme -focusing on "nonsmokers' rights" (smoking bans and high taxes) is more practical and effective -a culture of "rejection" rather than "prohibition"
Export Tobacco
- Dan Quayle: increase exports and trade, increase smoking in poor countries, tobacco =economic development--> products (tax), they area also consuming a part of western culture which symbolizes independence, status, freedom) -as decline in USA, export cigs outside increase
Prisons
- In usa put ppl in private prisons (owned by shareholders) -if invest $5 in prison as a shareholder and want it to turn to $10 way to do that is to increase population, gov gives prison's $ (subsidizes it) -stock in prisons increased in last two decades -ethical concerns: prisons give $$ to politicians so they are less likely to want rehab/trxtment like laws, more focus on criminalizing
Popularity of cigarettes
- Marlboro is popular now -lucky strike and camel= before hollywood era (1930s)
Avery
- Tabacum, broad leaf, bottom ripens up in July or August -harvest bottom up (start at bottom of plant) -from this plant comes biggest public health calamity
Gates Foundation and Tobacco
- by the year 2020 there will be more smokers than ever - Gate's foundation--> no effort towards tobacco even though it's the number one public health organization -why? b/c they would be taking on industry, they only take on diseases like polio, otherwise would have to organize consumer society. - so would need to change society rather than medical intervention
Michel Foucault (1926-1984)
- created problematization -simultaneous naming of problem (often official) and in naming a problem there is a process of defining the problem and what it means and how to address problem -just b/c named AIDs a problem doesn't mean successfully addressed -same with guns - can name but don't necessarily address it -king james= tobacco problem, should be prohibited (now he's problematizing it) -we all agree it's a problem, it's how you problematize it
Tobacco as Problematization: king james
- king James (1609)--> counter blast to tobacco - caution to *drinking* tobacco (ties to being drunk)
E cigarettes
- no vaporizer - tobacco -nicotine liquid - health risks not really known -electric/ battery powered -currently not regulated by government -ads for ecig promote no ash, no filth, doesn't stink •is part of new wave new nicotine products in US and Europe along with nicotine gum, etc - overall massive expansion of conventional cigarettes around the world
New England Journal of Medicine
- screened 31,567 asymptomatic persons at risk for lung cancer using CT scan from 1993 through 2005 - 88% percent survival rate in diagnosed cancer patients - "Conclusions: Annual spiral CT screening can detect lung cancer that is curable." - funded by "Foundation for Lung Cancer: Early Detection, Prevention, and Treatment" Why would tobacco fund this? if live longer, buy more cigs so reason to smoke w/out fearing sickness - unrestricted gift(funding) from Liggett and Myer's Tobacco Company -antitobacco against? b/c of funding and "what" truth you are promoting and how problematizing and shaping problem space= screening , less prevention -in a peer reviewed leading medical journal, so real data and science, robust
Li and Kranzler Article
- stigma related to word "addiction" (especially in the health professions) - psychiatry thus speaks of "substance use disorder" (no use ... abuse only... dependence) - is dependence or disorder an all-or-nothing thing - or is it a spectrum? - Kranzler and Li argue that the word "addiction" captures "the chronic, relapsing, and compulsive nature of substance use that occurs despite the associated negative consequences." - for them, "addiction" politicizes something that needs politicizing
Becker article
- takes Lindesmith's chicago school wide: -individuals exhibit some willingness to try a drug or are drawn into initiation through a social process - most pot smokers do not "get high" the first time - learning to talk about and feel "being high" - learn to experience symptoms - which might not on their own be pleasurable - as pleasurable - Habitual smokers develop a "disposition or motivation to use marijuana which was not and could not have been present when he began use."
Kozlowski, et al: cigarettes, nicotine and health
- talks about John Langley - how soon after you wake up do you smoke your first cigarette? - do you find it hard to refrain from smoking? - how many cigarettes per day do you smoke? - do you smoke when you are sick? - nicotine is received in brain and target organs in 7 - 10 seconds - absorption through mouth lining, saliva, nose, throat, and lungs - higher heart rate with initial doses - later doses prevent withdrawal - use increases and proliferates the number of nicotine receptors in the brain as a defense mechanism against toxicity - leading to tolerance - does nicotine help people cope with stress - or is stress a symptom of withdrawal that needs nicotine for treatment? - nicotine is reinforcing and pleasurable (increases dopamine) - nicotine reduces appetite through action on serotonin, and also increases metabolism - smokers weigh 5-10 pounds less than the general population - 1988 SGR officially framed nicotine as "addiction"
RJR memos and % use of tobacco
- tobacco co sees self as drug/pharmaceutical company - drug devices: coke, coffee, red bull, gum, granola bar -> all operate neurologically the same, stimulate and withdrawal. -graph: cigarettes--> account for 30% of everyday tobacco use; cigars and hookahs: high for "rarely use" -cigarette vs elctronic cig (ecigarette) - material culture: pipe, but different context than cigarette (don't smoke alone) -pipe--> chewing tobacco--> cigar -person who utilizes cigar is not really seen as a smoker; more of an elite person
Hughes article
- tobacco is not a classic "hallucinogen," but it has been used in ritual and religious ceremonies - psychoactive plants connect the natural and supernatural worlds - "hunger" (craving) was thought to be a craving for the spiritual realm - smoking seems to have been the most popular method - and with clear connotations of spiritual connection (e.g., fire, smoke, ash) - Europeans noted that doses were far too strong and nauseating (i.e., Nicotiana rustica) - interesting accounts of abstinence ... Karuk (California) men who smoked could go for long periods of time without smoking, part of a "warrior masculinity" associated with smoking, stoicism, and self-control - tobacco use facilitated and changed after European contact
Tobacco as industry
- tobacco moves from being a plant to a public health crisis thru industrialization (mass production) -remember - we are dealing with diseases caused by the industrialization of the cigarette, one particular way of using tobacco
Viscusi Article: cig patenalism
-"paternalism," a religious fervor for public health, is behind efforts to control smoking -people know that smoking is bad for you -adult consumers are free to make informed decisions -smokers are not like heroin users - they can function in society -smokers do not cost society money since they die sooner -nonsmokers can be protected by smoking bans -increased awareness about health and risk will continue to lower the smoking rate and the smoking problem will take care of itself
Jenaro article: smart phones
-56% of ppl own smartphones -this research is nascent - studies find associations between heavy internet use and anxiety, depression, social isolation, low self-esteem, shyness, and lack of emotional and social skills - heavy cell-phone use is associated with high anxiety, being a female, and insomnia - but is it a medical "disorder," or a symptom of a broader syndrome or disorder (e.g., a mental health problem)? is the addiction an addiction to cell phones or is it to compulsive behavior in general? - "problematic internet use" used instead of "addiction" - study of 337 college students in Spain - 11% matched diagnosis of problematic cell phone use (resulting in concrete problems of attention, work, and affect in their lives) - no correlation with substance abuse - so it seems to be its own suite of symptoms and perhaps a syndrome - as explained by the National Cancer Institute (link) ... - cellphones emit radiowaves and radiation - to date, there are no robust or decisive animal or human studies that show that this radiation vector causes cancer - some studies find that the heaviest users are perhaps at higher risk for brain cancer, but there are important methodological problems related to how to assess cell phone use and the research is nascent - in 2011, the WHO classified cell phones as "possibly carcinogenic to humans" -the American Cancer Society (link) says that this classification indicates some level of concern, a need for more research, and a recommendation to limit cell phone use, especially among children
Smoking Gods book
-800 AD mayan culture in central america -tobacco is important to them,associated with ritual feasting and hierarchy -used potent rustico strand -native american codex: european representation of what seeing: cigars, cigarettes -vases in guatamala show cigars and cigarettes -deities associated with cigars, fire, smoke, tobacco (representing kingship) smoking in serpentine style -mexican codex (1530s) deities associated with smoking (cigar)
Tobacco as Drug Delivery Device
-Albert Einstein smoked pipe 1) device for getting nicotine into the body ex: like coffee for caffeine 2) material culture aspect--> way you get it changes meaning, context, use ex: 4 ppl smoking joint vs 1 person bong hits - how do it changes mood and quality -either way are still getting drug *similarity of device* *differentialization of context and use*
Keller
-American disease model - resistance in 1800s and early-1900s because of a focus on morality, sin, vice, and personal responsibility - drunkenness ("intoxication" or "poisoning") is not the same as alcoholism - alcoholism leads to chronic problematic behavior and interferes with health,social, and economic functioning - alcoholism is a chronic, relapsing disease - in 1958 the AMA began to classify alcoholism as a "disease," and patients were admitted to hospitals - renewed opposition - does alcoholism manifest anatomically, physiologically, and with consistent symptoms? - conclusions of the article... alcoholism is a disease manifested in different forms, with an unknown cause and site of origin, characterized by problematic dependency and abuse
Race, Gender, Ethnicity, Age Stats
-American indian smokes most, whites, than blacks -women smoke less -lower GED ppl smoke at a higher rate -grad students hardly smoke -by 1965 half of adult men in usa smoked -so socioeconomic status, access to health care, space involved in who smokes -14% of hs students smoke cigarettes -23% smoke all types of tobacco products
John Langley
-British physiologist -early 1900s - theory of chemical receptors through studies of cadavers -focus on nicotine as a "receptive substance," which affects brain tissue (brain receives thru reception -"drug action"- chemicals/drug work on the brain to affect function of brain thru receptors
Tastes of Paradise: Opium
-East India Company traded opium for tea - leading to widespread use in China -morphine and heroin in mid-1800s rapidly increased toxicity and addiction (synthesized from opium for medicinal use) -"Pharmacy and Poisons Act" of 1868 in UK--> one of first prohibition acts, could only purchase with a prescription at a pharmacy -eventual racism against Chinese as an "opium culture" ex: chinese exclusion act - opiates are schedule 2 b/c of harm, addiction but also bc of racial implications --> chinese bringing over opiates
Why police drugs in 1st place? Nixon, Reagan
-Johnson (Southern) vs. Nixon: nixon needed southern whites to vote for him so created phrase "law and order"; said would crack down on crime and drug use; but was it a problem in the first place?; he ended up winning the lots of southern votes -this became know as the "southern strategy" -Reagan: problem is drugs, launched war on drugs, extension of "southern strategy" - (nancy reagan)DARE didn't work- counterproductive say can't use and they do
Warning Label Paradigm
-McDonald's tells you calories - they invest in warning label paradigm b/c don't want to be prohibited -same way of problematizing fat bodies and smokers-> *they make decisions* -dominant way of problematizing tobacco
Fair Sentencing Act of 2010
-Obama, decriminalized small amnt of crack on you -massive sentencing disparity shrunk, but not eliminated -abolition of five-year mandatory minimum sentence for simple possession of crack -very limited retroactive application for people already in prison for mandatory sentences -why is there still a punishment disparity - cocaine and crack are the exact same drug in different forms? 1) crack=cheap, street drug 2) powdered= used by wall street, hedge fund==> radicalized
Cocaine
-Schedule 2 -used as numbing agent for toothaches -freud prescribed -coca-cola originally contained coke--> intellectual beverage, moderate, temperance, cure for hysteria, depression (why freud), women's prb, headaches -why illegal if can still kind've function? dope fiends
What's inside a cigarette?
-Tara Parker Pope -cigarettes include 40% filler, 60% tobacco -nicotine levels are manipulated ("boosting": add base bc nicotine is acidic to make more readily available to blood stream), similar to how cocaine users "freebase" to intensify the effects -600 ingredients and 4,000 chemical compounds, 50 cause cancer and are poisonous *acetone (nail polish remover) acetic acid (hair dye) *ammonia (cleaning products) arsenic (poison) *benzene (cement and plastics) butane (lighter fluid) *cadmium (batteries) *lead, nicotine, tar, carbon monoxide
Wayne Hall article
-To get prohibition into law said it would make cities healthier, increase economy -but then the Depression came and government needed $$ so would no longer support -"black market" may be overstated, concentrated mainly on gangster themed movies, but death and drunkenness decreased -partial prohibition may be better b/c way to balance econ, health and social benefits - the Anti-Saloon League developed a coalition by claiming that reduced alcohol consumption would produce major economic benefits - but then the Great Depression hit as a public health issue prohibition actually worked, reducing drinking, arrests for drunkenness, and deaths the eventual increase in drinking - back to pre-prohibition levels - was due to lack of enforcement and, later, the baby boom the narrative about the "black market" may be overstated, concentrated mainly in Chicago and New York, and fueled by the rise of gangster- themed movies partial prohibition might be a better way to balance economic, health, and social benefits and costs
Walgreens and Gas stations
-Walgreens pharmacy: promote health yet sell cigarettes gas stations: need money from cigarette companies -co pay lots of $ to get shelves -e cig and quitting gum sold right next to it--> buy over counter
Tara Parker Pope Article: Seed to Smoke
-a natural born plant that has been massively industrialized. The cigarette is not just a tobacco product anymore due to chemical manipulations and scientific changes (technoscientific/bioscientific: can do something to human bodies) -farmers across the American South - and other world regions - earn money from tobacco -growing tobacco has long been subsidized by governments and development agencies -in Malawi tobacco is the main cash crop (70% of all export revenue) - leading to food insecurity (no food production) and deforestation (clear forests for mono cropping and use timber to fire up/heat up barns to cure tobacco -this is a labor-intensive process involving undocumented Mexican and Central American migrants
Proctor Article
-abolitionist , calls openly for prohibition of tobacco -more political, rivalry with Brandt -first cancers were lip cancers in 1700s contracted as a result of oral tobacco use and pipe smoking -industrialization and globalization of cigarettes led to unprecedented levels of disease -dependence of governments on tobacco taxes has limited control -as awareness and regulation increased in wealthier countries in North America and Europe, the tobacco industry targeted developing countries *from 100 million deaths to 1 billion deaths in the 21st century*
Cancer and Death Stats
-about 400-500k die from tobacco each year. -1/3 of lung and heart cancer each attributed to smoking -alcohol is 2nd biggest killer with about 50-60k -smokers are 2x likely to get heart disease (~30% deaths attributed to tobacco) -10x as likely to get lung cancer ( ~ 80% of death attributed to tobacco) -30% of all cancer deaths attributed to tobacco
Allen book
-abt cocoa leaf (where cocaine is made, helps regulate the metabolism, get used to high altitudes, stimulation for work) -offer cocoa to gods and mother earth -chew cocoa--> connecting with social and spirtitual domain while taking drug
Transition Chart
-advanced countries are in stage 4: decrease in % of male deaths; increase in percent of female deaths(due to time lag); both genders % of smokers are decreasing -developing countries: all increasing -change in disease burden worldwide: goes from infectious to chronic, noncommunicable due to tobacco
Anti Saloon League (1913)
-against as masculine space, where workers went after work -early prohibitionist movement= led by women -increase climate hygiene and body politic of nation -dry vs wet -purity, hygiene, family health, gender empowerment= ads with children -saloon: reckless male space
Jan Rogozinski Article
-all tobacco grown in US is tabacum, 90% in the world -different strains of tabacum are used for different kinds of tobacco products (cigars, snuff, cigarettes) -tobacco has been bread to have distinctive "taste, flavor, and aroma," and these preferences have changed over time -tobacco prefers about 80 - 90 degrees, light, aerated soil with mixture of sand, humus, and limestone -can grow basically anywhere geographically -so most conducive to bad soil, other crops can't grow there -prohibition on growing tobacco in Europe in 1700s - to encourage food production (before was so profitable ppl only grew tobacco and there were food shortages) - led to tobacco boom in American South
Dose response
-amount smoked per day the greater/advanced the lung cancer
Alfred Lindesmith
-argue against moral model and moralization of drug users as corrupted, bad, flawed ppl -famous American sociologist of the "Chicago School"(learn to do things through social groups) -critic of prohibition - especially opiate and heroin (should treat someone addicted) -emphasis on changing the social and public health circumstances around drug use
tobacco as medicine
-at one end seen as devilish, on other end seen as medicinal and alluring and addicting
Global Burden of Disease
-both proximal (heart and lung cancer) and distal (mental health, congenital issues for fetus during pregnancy,etc) causes of disease related to tobacco *Tobacco affects whole global burden of disease*
The New Jim Crow
-claim:crime and drug use rates have actually declined or stayed the same - but policing, arrests, and incarceration have massively soared in recent decades -80% of black men in Chicago have a criminal record -felons are disenfranchised and suffer in employment, housing, and public services -70% of prisoners return within 3 years - the "War on Drugs" helps to fuel more poverty and crime -problematization leads to more prbs rather than amelioration
Jack Blocker Jr. Article
-common assumption that prohibition "failed" ... but prohibition did destroy the alcohol industry, close saloons, and massively reduce drinking rates -informal economy, organized criminal activity, subculture of female drinking, and new media perceptions of government overreach -prohibition ended not for public health or legal reasons, but because the government needed taxes amid the Great Depression -Alcoholics Anonymous developed in 1935 -alcohol industry began more public advertising to encourage drinking at home and counter the stereotype of the raucous saloon
Crack
-crack babies and moms were seen as problematic -1980: reagan entered, increase in prison population -reflect more crimes? or reflect increase policing? -may create more ppl in prison bc then can't get job--> repeat offenders
Crack Cocaine vs. Powdered cocaine
-crack policed more, but more powdered use -crack problematized more stringently -blacks use crack, and they get more prison time -whites use powdered more and get less prison time
Tobacco and Public Health
-defining paradigm in medicine and public health -infectious diseases, epidemics, plagues: this causes this, just need to find what causes it and interrupt disease transmission, tobacco is chronic and doesn't show up till later -chronic diseases caused by consumerism: culture and society itself create disease. why warning label paradigm makes sense: IT'S UP TO YOU; you buy. - why is ebestos not labelled?... instead it's illegal, so why isn't tobacco one of them
serpents as symbolism
-deity figure, association with smoke that represents a kind of serpent. smoke is here and now but looks celestial, but since in present it bridges both worlds -see mexican pipe in shape of serpent
Tastes of Paradise (Alcohol)
-distillation of gin in 1700s rapidly increased toxicity and ease of intoxication -"Gin Craze" in London--> can take shot of small amount of alf ad become intoxicated -inns - evolve into restaurants and "bars" by 1800s -moralizing of gin--> decline of family (in context of industrialization and urbanization) -drinking associated with domestic abuse,etc -alcohol is cause of domestic abuse they say, so policing and new forms of regulation and buacracy -problematized as threatening to women and children
Civil War and Tobacco
-during the civil war tobacco was low--> industrialization makes tobacco use increase
How Did the Science of Smoking Impact the Study of Human Health?
-focus on the population - but in conjunction with bench science and clinical studies -from "sufficient cause" (not sufficient to cause but contributes to lung cancer) to "contributory cause" -spectrum of risk (1 cigarette = low exposure; 4 cigs= more exposure--> more risk) -expansion of the meaning of "health" beyond individual medicine and the physician
Green Tobacco Sickness (GTS)
-harvest tobacco when wet - thru osmosis the nicotine gets thru skin and poisons you - with GTS you feel like you've smoked 20 cigarettes all at once -public health issues in tobacco have to do with policy, migrants,etc (not just smoking) Ex: many workers are illegal and refuse to get help in case they are deported
Nichter Article
-how structural and social factors lead you to smoke or quit -if addiction is disease- how deal? - we'd never incarcerate someone with cancer,etc
Warner and MacKay Article
-increase trxtment deaths go down -still not enough attention paid to tobacco - by far -the industry is the "vector" of a "pandemic" -arguments that tobacco boosts economies are flawed - tobacco costs so much money in healthcare and lost productivity -6-10% of all healthcare in US is spent on tobacco-related diseases -60% of all Congress members are funded by the tobacco industry Singapore banned all tobacco advertising and has exorbitant taxes - lowest smoking rate in the world
Ernest Wynder
-interviews with hundreds of lung cancer patients all over the country - compared to hundreds of controls -possible environmental exposures (e.g., jobs) and history of lung diseases -when smoking began, how much, what brand -alcohol consumption -family history of disease ** very few non-smokers in cancer group ** no difference in cancer incidence across gender
Ancient Mayan Bible Popul Vuh
-sacred text -fire and tobacco were stolen from demons of underworld and recuperated to ppl on land as gift from the lords/gods -protection thru underworld - link to ancestors and heroes
British Study: Hill and Doll
-like Wynder's research except in the UK -increase in cancer -dramatic rise in lung cancer deaths in England between 1922 and 1947 -what is the cause? - better diagnosis, increase in population, or an environmental or behavioral cause? -study of thousands of lung cancer patients and controls in 20 London hospitals -smokers had much more lung cancer -heavy smokers had highest rates -less cancer among pipe smokers due to inhalation and use levels (not smoked as much and goes to mouth not lungs)
Physiological effects of quitting
-long term and immediate effects ex: after 20 mins:• Reduced blood pressure • Normal pulse ex: after 10 yrs:•Lung cancer death rate back to normal •Precancerous cells are replaced •All cancer incidence decreases
Altman, Slater, Albright, Maccoby Article
-looked at youth/women; youth/men; old/women; old/men and how many tobacco ads present in magazines and who read those magazines -looked at how advertisements target groups -ilegal to smoke before 18 - yet in Glamour where have one direction stuff you see ads for tobacco- so targeting ppl that is illegal to target 1930 tobacco documents available to public now: -young smokers more likely to smoke -RJR --> need to get hands on young - Phillip Morris says teenagers are most likely to smoke -Tobacco Institute (1989)-->tobacco industry is for profit, tobacco co execs don't necessarily smoke, they reserve that just for the youth, poor, blacks, and the stupid
Leshner article: brain disease
-mesocorticolimbic dopamine system -drugs work on this - causes more dopamine to be released, overflow synapse -less receptors in obese and coke brains -meth user can regain receptors if quit -drugs either mimic the functioning of neurotransmitters (e.g., dopamine) or induce excessive amounts -brain responds by routinely producing less dopamine ... "plastic changes" in brain lead to less dopamine sensitivity and reduced numbers of dopamine receptors as a means to manage over-stimulation -drug use creates a "new normal," flattening affect, producing negative affect, resulting in depression -neural circuits are impacted by all forms of drugs and all forms of drugs share a common pathway (the mesolimbic reward system) -addicts and non-addicts have different brains ... but this science has not yet translated into public opinion or policy because of stigma and moralization a-ddiction - however it starts - is a brain disease of chronic compulsion -does it make sense to incarcerate someone who has a disease? -does it matter how someone got HIV? - they have a disease and need treatment -harm reduction - rather than abstinence or a "cure" - might be the goal given high rates of relapse and difficulties of abstinence
Views of addiction
-moral - personal choice and flaw • temperance - moderation is needed • "American Disease" - disease model • educational - lack of information or education • characterological - personality rooted in childhood • conditioning - use is associated with positive experiences • biological - genetic and physiological dispositions • social learning - peer environment • general systems - family and group dynamics • sociocultural - broad societal and cultural factors • public health - interrelationship of biological, psychological, and environmental factors *Scientific knowledge and expertise on addiction and harm DO NOT reflect legal status or current regulatory systems
Wood article: video game addiction
-more people play World of Warcraft on a regular basis (8 million) than live in Denmark - is this a "problem"? -no current diagnostic category of video game "addiction" - but much media hype, parental concern, doctor consultations, and self-reported symptoms -isn't there a difference between high levels of "engagement" and "addiction"? -problematic comparison with gambling - these are different forms of "play" with different things at stake and different consequences -time loss - good (stress relief) or bad (lost productivity) -desire to "cut back" - is a habit or compulsion always an "addiction" or a "disorder" -is the video game itself the problem - or are there underlying mental health or social problems that lead to "escape"? -in the article, one case study escaped bullying and found friends online - but parents took away the video game
Drug Scheduling
-most regulated: marijuana and heroin ---> schedule 1: illegal (seen as on same level with same addictive effect; but why same designation as something like heroin?)
Tobacco as Pop Culture
-movies,etc. ADVERTISEMENTS -Camel crush--> if crush get mint flavor, if don't like a regular cigarette -complicated reasoning for why not directly mint flavor in cigarette but tiny ball that consumer can crush--> transfers responsibility from tobacco companies
American Spirits
-natural and native american -embodies native american spirit (natural)
interventions
-nicotine gum, inhaler, nasal spray, lozenge, or patch - prescription medications (bupronion or Chantix) - are e-cigarettes an effective medical intervention? - brief clinical interventions (e.g., informal advice from health professionals) - individual or group therapy (e.g., 12-step program) - alternative and complementary medicine
Tobacco as a plant
-part of the nightshade family, like tomatoes, potatoes, eggplants, and bell peppers -all contain nicotine -large concentrations of nicotine are found in tobacco -lower concentrations found in tomatoes,etc -naturally nicotine is a neurotoxin that protects against insects (insecticide)
Bloomberg Article
-partially prohibit soft drinks in NYC -shot down, resistance from food and drink industry (similar to tobacco industry) -dictator, nanny state, can't tell us what to do -public health is it in jurisdiction to regulate what ppl can consume? -state says no to heroin, yes to budweiser
Epidemiology
-pattern for exposure and outcome -research on distribution of disease - not a random distribution -analysis of patterns informs theories of causation -one possible explanation for a pattern is a relationship between an "exposure" and an "outcome"
Dope fiends
-prohibition wrapped up in antiblack southern men "threatening" women -leads to jim crow system, drugs became new form of social control -why alc and tobacco legal when problem more dangerous than coke -racism is key
Marijuana
-racial politics to marijuana legalization--> white culture of publicly consuming, but at same time is criminalized -whites consume most, blacks second, 3rd=latinos - arrests: 1) blacks 2) Latinos 3) whites - Why illegal in first place? 1) associated with mexicans in past - mexican drug trafficking -2) "reefer madness" --> catholic church -gendered, affects family, sexuality, crime,
History of tobacco problematization
-shift away from temperance (1800s) & prohibition (early-1900s) -the rise of "control" as an approach and not prohibition -focus on biosciences (study it), clinical medicine (therapy), epidemiology (who's using), public health programs and interventions -the "warning label" as paradigm--> now we problematize obesity; consumer chooses risk like camel crush, you crush, not us, we aren't promoting flawed cigarettes -Food and Drug Administration (FDA) -convergence of market & medical values and approaches
Indian totems
-shop keepers had signs that told you wha was outside bc largely illiterate in past -native american is iconic figure of tobacco bc important to their societies. -tobacco exchanged for indians to colonial americans -indigenous to new world prior to 1500
Ambrose Article
-smoke inflames blood vessels and limits nitric oxide (NO), a free radical which helps keep arteries clear -plaque deposits form on artery walls, restricting blood flow smokers have higher cholesterol levels -smoking increases risk for heart attacks, stroke, blood clot formation, and erectile dysfunction -exact causal mechanisms are extremely complex, and there is debate about a dose-response relationship
Causes of diseases (tobacco,etc)
-smoking and alc---> top of disease burden (legal!) - maybe b/c it's legal - but if methanphetamine is made legal would it lead to more use? -illegal causes less disease -2nd highest chunk: due to food - yet pushback too -current prohibition policies in USA don't make a lot of sense in what causes disease.
Perinatal and Postnatal Health
-smoking causes entopic pregnancy, placenta formation, miscarriage toxins from tobacco go to fetus and significantly reduce fetal air supply 33% increased risk for birth defects or stillbirth -50% increased risk of low birth weight -10% of all infant mortality -cognitive problems, clefts, clubfoot, asthma, heart conditions, ear infections, chronic bronchitis -18% of native american moms smoke during pregnancy -12% white -2% hispanic -7% black -likelihood that women will quit during pregnancy increases with increased edu -but 52% in general pop don't quit but this says more about how hard the drugs are to quit and less about moms.
SEC filing
-states that if change drug laws, we (prison) won't make as much of a profit
Biological Plausibility
-studies of mice exposed to cigarette smoke "The production of tumors in lab animals offered a powerful indicator that something in cigarette smoke could account for the epidemiological findings" (Brandt). - proved not individual thing but biological
Wynder Article
-study was groundbreaking because in the 1940s and 1950s there was complete apathy in the public health and medical communities - doctors even promoted cigarette use -the tobacco industry influenced medicine and many doctors smoked -eventually the industry created the impression of a "controversy" (actually wasn't, just was early evidence) -doubts were raised about whether epidemiology can prove causation -Wynder himself took four years to switch from "association" to "cause" in his wording
DSM-5
-substance use is a disease. what started w/alcohol now used for all drugs
2 varieties of tobacco: 1) Nicotiana rustica
-this tobacco is not found in cigarettes - potents levels of nicotine and other chemicals cause hallucinations, why not used in cigarettes -9% nicotine (high), other tobacco varieties contain only 1% (low) -traditional uses in native North America
New World
-tobacco given as a gift upon europeans entering new world -1599 was the discovery of america--> tobacco portrayed as exotic landscape: new beasts, animals, persons (savages) and plants (substances with psychoactive properties: chocolate, tobacco), shows foreigness, nakedness of person in contrast to civil adornment of crew -columbus comments on dried qualities of leaves; eventually will be used to text wet diseases (mucus, runny nose) -was given as a prestigious sacred gift
Hall and West article
-tobacco's legality is an "anomaly borne out of historical precedent and perpetuated by powerful commercial and political self-interest." -if discovered or invented today, cigarettes would be banned but prohibition might result in a "black market" -de facto: by fact or by course of action (rather than de jure: by law) prohibition involves strong tobacco-control policies that aim to reduce use rates to zero -advertising bans, high taxes, smoking bans, reduction in nicotine levels, and the deregulation of smokeless or nicotine products (gum/vapes, so anyone who wants to switch can--> limits black market bc still access to nicotine
Cancers, specifically Lung (tobacco)
-toxicity is such that as carcinogens processed it travels throughout body -not contributing to all but some cancers, contributes 78% to lung cancer -57% are usually diagnosed at stage IV of lung cancer, 4% survival rate -lower survival in III and IV
2 varieties of tobacco: 2) Nicotiana tabacum
-traditional uses in native Central and South America - used in modern industrial cigarette and tobacco production
World Consumption
-world consumption rose 1% each year since 1980 -1.1 billion smokers (30% of all adults) -12% of all adult deaths (24% by 2020) -47% of all men, 12% of women -60% of men in Korea, China, Russia, former Soviet republics, Turkey, Bangladesh, and some Caribbean countries -30% of women in Scandinavia, parts of Eastern Europe, Israel, and Russia Only 4% of all women in Asia smoke (but 50% of men do)
Surgeon General
1) Cigarettes and other forms of tobacco are addicting 2)Nicotine is the drug in tobacco that causes addiction. 3)The pharmacological and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine.
Top substance use disorder drugs
1) alcohol (legal)- associated with most psychiatric morbidity (~60%) 2)marijuana (~15%) 3) prescription opioids (oxicotton) (7.5%)
Bartal Article
1. addiction characterized by nicotine dependence 2. individual variation (genetics, in utero) 3. dose-response relationship 4. time-lag mortality gap ... smokers are 2-3 times as likely to die in middle-age, and 30% as likely to die in old age ** apart from impact on poor countries, Bartal does not mention disparities smoking and mental health comorbidities 80% schizophrenia (why? smoking helps dampen their symptoms) 50% depression (.5 ppl who smoke have depression) 50-80% alcoholism 50-70% all substance abuse problems 44% of all smokers have co-occurring psychiatric or substance- abuse disorders
Establishing Causal Inference
1. group association (population studies find more cigarette consumption and more lung cancer) 2. individual association (ind and controls match for jobs, edu,etc) 3. cause precedes effect (how know smoking wasn't a response to cancer in body? Well, look at ppl over time finds smoking often precedes cancer 4. altering cause alters effect (observe quitters over time and see disease rates go down) 5. supportive criteria (dose, plausibility)
Proctor Article con,
1. inherently defective (harmful when used as intended) 2. tobacco production causes great harm to workers and the natural environment 3. immense cost to taxpayers--> medicare, medicaid, 4. smokers do not like their habit and want to quit - there would be no "black market"--> smokers don't like habit, part of being a smoker is willing to eventually not smoke. 5. tobacco companies themselves have admitted that they should be put out of business
Smoking cessation
47 million former smokers in America realities of trying to quit - 70% have tried, 40% in any given year resources & methods - 7% using gum, 10% using comprehensive methods are successful @ 6 months 44% using psychotropic and comprehensive methods are successful @ 3 months dozens of attempts is common brain changes, learned behaviors, associations
Surgeon General's Report (1964)
Luther Terry -front-page news coverage - but none of it was new information (tobacco causes cancer!) -tobacco is not so much a "problem" as a "problematization" (specific style used in making a problem) - problematizes it legally b/c fed gov steps in through regulation,science,etc -
Volstead Act of 1920
Prohibition of possession, manufacture, use and sale of alcohol
Abolition
abolishing something by law ex: slavery
Jellinek
disease model, most influential book
prohibition
prohibit the manufacturing, possession, and sale of a drug---> can prohibit one and not the other -alcohol and tobacco is partially prohibited--> age limits, after can drink, can't drink and drive (regulations on driving) -even consensual sex is regulated 17+ -behaviors associated with risk are partially prohibited
Quitting cycle
smoker--> contemplation phase--> quit-->relapse do all over again until successful cesassation
Temperance Movement
• 1820s, linked to Protestantism • early focus on hard liquor and moral reforms ("temperance") rather than abolition • "teetotalism" - total abstinence from alcohol - emerged in Catholic England in 1830s during struggles for universal male suffrage (to extend the vote to the working classes- if abstained looked more deserving of right to vote) • by the late 1800s, several organizations (including the Salvation Army) saw prohibition as a means of improving the lives of the poor, women, and children • interesting overlap between moral, religious, and progressive political objectives and visions
Drugs are Bad
• what counts as a "drug"? • why are certain drugs prohibited and not others? -pharmaceuticals are drugs but aren't bad -is food? alcohol? sugar? -Are some drugs bad in certain way? -tied to family, gender, class, race dynamics • prohibition - control - treatment -can prohibit heroin, it's illegal in our society -can control/regulate tobacco and alc? But can possess, sell, etc -trxtment--> incarcerate for heroin or treat them as having disorder or disease • policing - decriminalization - legalization -police something prohibited--> arrest ppl involved in trafficking -decriminalize ---> not make legal, but just don't arrest, don't do anything -legalize--> can sell, traffic, transport
