Comparing Effects of Tobacco Use Prevention Modalities: Need for Complex Systems Models
Many modalities of tobacco use prevention programming have been implemented including various policy regulations (tax increases, warning labels, limits on access, smoke-free policies, and restrictions on marketing), mass media programming, school-based classroom education, family involvement, and involvement of community agents (i.e., medical, social, political). The present manuscript provides a glance at these modalities to compare relative and combined impact of them on youth tobacco use. In a majority of trials, community-wide programming, which includes multiple modalities, has not been found to achieve impacts greater than single modality programming. Possibly, the most effective means of prevention involves a careful selection of program type combinations. Also, it is likely that a mechanism for coordinating maximally across program types (e.g., staging of programming) is needed to encourage a synergistic impact. Studying tobacco use prevention as a complex system is considered as a means to maximize effects from combinations of prevention types. Future studies will need to more systematically consider the role of combined programming.
Topics: Tobacco use / Prevalence and consumption / Tax levels and structure / Tobacco taxes revenues / Health consequences / Impact on demand / Economic impact of tobacco control / Health care costs / Tax and price / Economic consequences
Topics: Cost-effectiveness / Tobacco use / Prevalence and consumption / Health consequences / Tobacco taxes revenues / Impact on demand / Health care costs / Tax avoidance and evasion / Economic impact of tobacco control / Economic consequences / Impact on the poor / Tax and price / Tobacco control policies and programs / Jobs and productivity
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