Joseph R DiFranza
Biographic Data
| ID | 5126047 |
|---|---|
| NAME | Joseph R DiFranza |
| GIVEN NAMES | Joseph R |
| FAMILY NAME | DiFranza |
| SIGNATURE | DIFRANZA J R |
| AFFILIATIONS | University of Massachusetts Chan Medical School |
| VERIFIED | No |
| TOTAL WORKS | 31 |
| TOTAL CITATIONS | 45 |
| WORKS AS AUTHOR | 31 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 1992 |
| LATEST PUBLICATION YEAR | 2018 |
| H-INDEX | 4 |
Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers
A significant proportion of adolescent waterpipe smokers progressed on ND. Venue-based policies such as limiting youth access to waterpipe cafés are warranted
Early symptoms of nicotine dependence among adolescent waterpipe smokers
Background Although waterpipe smoking is increasingly popular among youth and can lead to nicotine dependence (ND), no studies have documented how ND develops in waterpipe smokers. We examined the emerging symptoms of ND among adolescent waterpipe smokers in Lebanon. Methods Individual confidential interviews were used to evaluate ND in 160 waterpipe smokers and 24 cigarette smokers from a sample of 498 students enrolled in 8th and 9th grades in …
Retail Impact of Raising Tobacco Sales Age to 21 Years
The majority of tobacco use emerges in individuals before they reach 21 years of age, and many adult distributors of tobacco to youths are young adults aged between 18 and 20 years. Raising the tobacco sales minimum age to 21 years across the United States would decrease tobacco retailer and industry sales by approximately 2% but could contribute to a substantial reduction in the prevalence of youths’ tobacco use and dependency by limiting access
The retest reliability of nicotine dependence measures
Aim: As reliable instruments are needed for longitudinal research on the development of nicotine addiction, we evaluated the test–retest reliability of eight survey measures (three scales and five individual item measures).Methods: A paper survey was administered to convenience samples of adolescents in two schools and adults in five workplaces in Argentina and re-administered 1–2 weeks later. Test–retest reliability was assessed with Pearson cor…
The assessment of tobacco dependence in young users of smokeless tobacco
The HONC and AUTOS are highly reliable measures of dependence for adolescent users of cigarettes and smokeless tobacco. Using these measures and other indicators, no meaningful differences in dependence were found between dippers and smokers at comparable levels of lifetime use
What is the significance of experiencing relaxation in response to the first use of nicotine
Individuals who feel relaxed the first time they inhale from a cigarette are more likely to develop nicotine dependence. To determine if the relaxation response is associated only with specific aspects of dependence, a survey was administered to 1405 adolescents aged 14–18 years (mean 15.8 years) from four schools in Massachusetts. Nicotine dependence was measured with the Diagnostic and Statistical Manual (DSM-IV), and the loss of autonomy over …
Children's loss of autonomy over smoking
Two national surveys confirm previous reports of difficulty with smoking cessation with infrequent smoking. Since loss of autonomy is universally recognised as a core feature of addiction, our data indicate that young adolescents experience symptoms of nicotine addiction with infrequent tobacco use
Enforcement of underage sales laws as a predictor of daily smoking among adolescents – a national study
Federally mandated enforcement efforts by states to prevent the sale of tobacco to minors appear to have made an important contribution to the observed decline in smoking among youth in the U.S. Given similar results from long-term enforcement efforts in Australia, other countries should be encouraged to adopt the World Health Organization Framework on Tobacco Control strategies to reduce the sale of tobacco to minors
Symptoms of Diminished Autonomy over Cigarettes with Non-Daily Use
Data from a nationally representative sample of smokers (ages 12-22 years, n=2,091) was examined to investigate the prevalence of symptoms of diminished autonomy over cigarettes. Six symptoms were assessed: failed cessation, smoking despite a desire to quit, and a need or urge to smoke, irritability, restlessness, or disrupted concentration attributed to nicotine withdrawal. One or more of the six symptoms were present in 18.9% of subjects who sm…
The federal initiative to halt the sale of tobacco to children—the Synar Amendment, 1992–2000
The Synar Amendment has resulted in the universal adoption of laws prohibiting tobacco sales to minors and almost universal enforcement of those laws, resulting in dramatically reduced violation rates. Implementation was slowed significantly by a lack of good faith effort in many states and by DHHS's decision not to require states to enforce their laws by penalising lawbreakers
Genetically decreased CYP2A6 and the risk of tobacco dependence
Adolescents with 1-2 copies of CYP2A6*2 or *4 are at substantially increased risk of becoming dependent but smoke less once dependent. Genetic risk for ND may need to be considered in the conceptualisation of tobacco control programmes for adolescents
Short term patterns of early smoking acquisition
Movement to heavier, more frequent smoking is generally unidirectional, although many youths attempt to quit one or more times. The appearance of any symptom of dependence altered the subsequent pattern of smoking behaviour. Future investigators might consider using more frequent data points and a continuous timeline to track smoking behaviour
Parent’s Socioeconomic Status, Adolescents’ Disposable Income, and Adolescents’ Smoking Status in Massachusetts
Objectives. This study examined the association between parental socioeconomic status (SES) and adolescent smoking. Methods. We conducted telephone interviews with a probability sample of 1308 Massachusetts adolescents aged 12 to 17 years. We used multiple-variable-adjusted logistic regression models. Results. The risk of adolescent smoking increased by 28% with each step down in parental education and increased by 30% for each step down in paren…
Assessment of nicotine dependence symptoms in adolescents
All five indicators performed well psychometrically. Until the meaning, relative importance, and usefulness of each scale is clarified in longitudinal work, decisions regarding which scale(s) are most informative will depend more on the content of the scales, the need for a multi- or unidimensional indicator, and whether or not the scale is theory based
Development of symptoms of tobacco dependence in youths
Symptoms of tobacco dependence commonly develop rapidly after the onset of intermittent smoking, although individuals differ widely in this regard. Girls tend to develop symptoms faster. There does not appear to be a minimum nicotine dose or duration of use as a prerequisite for symptoms to appear. The development of a single symptom strongly predicted continued use, supporting the theory that the loss of autonomy over tobacco use begins with the…
Sources of tobacco for youths in communities with strong enforcement of youth access laws
Recommended actions include raising the minimum age for the purchase of tobacco to 21 years, and prohibiting individuals less than 21 years of age from selling tobacco
Is the standard compliance check protocol a valid measure of the accessibility of tobacco to underage smokers
Commonly used compliance check protocols are too artificial to reflect accurately the experience of underage smokers. The validity of compliance checks might be improved by having youths present ID, and by employing either tobacco users, or non-tobacco users who are sufficiently experienced to mimic the self confidence exhibited by tobacco users in this situation. Consideration should be given to prohibiting the sale of tobacco by individuals und…
Initial symptoms of nicotine dependence in adolescents
The first symptoms of nicotine dependence can appear within days to weeks of the onset of occasional use, often before the onset of daily smoking. The existence of three groups of individuals-rapid onset, slower onset, and resistant-distinguishable from one another by their susceptibility to nicotine dependence, is postulated
Impediments to the enforcement of youth access laws
Suggestions for addressing the problems include obtaining support from the community, keeping elected and court officials informed about plans for merchant education and law enforcement, using efficient enforcement protocols, setting merchant compliance goals, and advising the public and government officials about progress towards those goals, using older youths to make purchase attempts, and testing all merchants frequently
State and federal revenues from tobacco consumed by minors
OBJECTIVES: The purpose of this study was to estimate the value of cigarettes consumed in 1997 by youths younger than 18 years. METHODS: Price, population, and consumption data were used to compute conservative and comprehensive estimates, which were then averaged. RESULTS: An estimated 3.76 million daily smokers aged 12 through 17 years consume an estimated 924 million packs of cigarettes per year, generating $222 million in federal tax revenues…
Notes from the Field
Tobacco industry efforts hindering enforcement of the ban on tobacco sales to minors
The evidence strongly suggests an industry strategy to undermine efforts to enforce laws prohibiting the sale of tobacco to minors. As has been the case in the past, the tobacco industry is publicly endorsing a socially responsible goal while apparently taking action behind the scenes to ensure that the goal is not achieved
Youth access to tobacco
OBJECTIVES. This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. METHODS. Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in…
Does the Joe Camel campaign preferentially reach 18 to 24 year old adults
Correspondence to: Dr Joseph DiFranza Abstract Objective To determine if the Joe Camel advertising campaign is preferentially reaching 18 to 24 year olds as asserted by the RJ Reynolds Tobacco Company. Design Cross sectional study conducted in 1994 comparing individuals who were 18-24 years old when the Joe Camel campaign was launched to those not in this target group. Setting Randomly selected public schools and community colleges in Mas sachuse…
Active enforcement of minors' access laws
Parent’s Socioeconomic Status, Adolescents’ Disposable Income, and Adolescents’ Smoking Status in Massachusetts
Objectives. This study examined the association between parental socioeconomic status (SES) and adolescent smoking. Methods. We conducted telephone interviews with a probability sample of 1308 Massachusetts adolescents aged 12 to 17 years. We used multiple-variable-adjusted logistic regression models. Results. The risk of adolescent smoking increased by 28% with each step down in parental education and increased by 30% for each step down in paren…
Youth access to tobacco
OBJECTIVES. This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. METHODS. Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in…
The Tobacco Institute's "It's the Law" campaign
A survey of tobacco retailers was conducted to evaluate the efficacy of the Tobacco Institute's "It's the Law" program, which has the goal of eliminating the illegal sale of tobacco to minors. Only 4.5% (7) of the 156 retailers surveyed were participating in the "It's the Law" program. Eighty-six percent of the retailers who were participating in the program were willing to illegally sell cigarettes to children, compared with 88% (131/149) of the…
Retail Impact of Raising Tobacco Sales Age to 21 Years
The majority of tobacco use emerges in individuals before they reach 21 years of age, and many adult distributors of tobacco to youths are young adults aged between 18 and 20 years. Raising the tobacco sales minimum age to 21 years across the United States would decrease tobacco retailer and industry sales by approximately 2% but could contribute to a substantial reduction in the prevalence of youths’ tobacco use and dependency by limiting access
State and federal revenues from tobacco consumed by minors
OBJECTIVES: The purpose of this study was to estimate the value of cigarettes consumed in 1997 by youths younger than 18 years. METHODS: Price, population, and consumption data were used to compute conservative and comprehensive estimates, which were then averaged. RESULTS: An estimated 3.76 million daily smokers aged 12 through 17 years consume an estimated 924 million packs of cigarettes per year, generating $222 million in federal tax revenues…
Report of the Tobacco Policy Research Study Group on Access to Tobacco Products in the United States
There are many factors that influence young people to start and to continue smoking
Reducing youth access to tobacco
Report of the Tobacco Policy Research Study Group on Tobacco Litigation
Litigation is useful for both enforcing existing rights, and for showing the implications of legal principles derived from other types of cases to tobacco products. Thus
The Tobacco Institute's "It's the Law" campaign
A survey of tobacco retailers was conducted to evaluate the efficacy of the Tobacco Institute's "It's the Law" program, which has the goal of eliminating the illegal sale of tobacco to minors. Only 4.5% (7) of the 156 retailers surveyed were participating in the "It's the Law" program. Eighty-six percent of the retailers who were participating in the program were willing to illegally sell cigarettes to children, compared with 88% (131/149) of the…
Tobacco acquisition and cigarette brand selection among youth
Objective -To study the acquisition of tobacco and the development of cigarette brand selection among youth. To com pare four methods of measuring brand preference among underage smokers. Design - Individual interviews were con ducted with youths to elicit their past and present experiences with tobacco. Setting - A high school and public places in Massachusetts, USA. Subjects-A convenience sample of 721 youths, aged 10-17 years. Results - Friend…
Does the Joe Camel campaign preferentially reach 18 to 24 year old adults
Correspondence to: Dr Joseph DiFranza Abstract Objective To determine if the Joe Camel advertising campaign is preferentially reaching 18 to 24 year olds as asserted by the RJ Reynolds Tobacco Company. Design Cross sectional study conducted in 1994 comparing individuals who were 18-24 years old when the Joe Camel campaign was launched to those not in this target group. Setting Randomly selected public schools and community colleges in Mas sachuse…
Active enforcement of minors' access laws
RJ Reynolds' Camel Cash
Objective - The Camel Cash promotion is a programme marketed by the RJ Reynolds Tobacco Company in the United States, which rewards purchasers of Camel cigarettes with a coupon, called Camel Cash or C-notes. The aim of this study was to determine the level of knowledge of and participation in the Camel Cash promotion among adoles cents in 1992. Design - School survey Subjects - A total of 616 students (mean age = 15.5 years) in two high schools, …
Tobacco industry efforts hindering enforcement of the ban on tobacco sales to minors
The evidence strongly suggests an industry strategy to undermine efforts to enforce laws prohibiting the sale of tobacco to minors. As has been the case in the past, the tobacco industry is publicly endorsing a socially responsible goal while apparently taking action behind the scenes to ensure that the goal is not achieved
Youth access to tobacco
OBJECTIVES. This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. METHODS. Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in…
Notes from the Field
Impediments to the enforcement of youth access laws
Suggestions for addressing the problems include obtaining support from the community, keeping elected and court officials informed about plans for merchant education and law enforcement, using efficient enforcement protocols, setting merchant compliance goals, and advising the public and government officials about progress towards those goals, using older youths to make purchase attempts, and testing all merchants frequently
State and federal revenues from tobacco consumed by minors
OBJECTIVES: The purpose of this study was to estimate the value of cigarettes consumed in 1997 by youths younger than 18 years. METHODS: Price, population, and consumption data were used to compute conservative and comprehensive estimates, which were then averaged. RESULTS: An estimated 3.76 million daily smokers aged 12 through 17 years consume an estimated 924 million packs of cigarettes per year, generating $222 million in federal tax revenues…
Initial symptoms of nicotine dependence in adolescents
The first symptoms of nicotine dependence can appear within days to weeks of the onset of occasional use, often before the onset of daily smoking. The existence of three groups of individuals-rapid onset, slower onset, and resistant-distinguishable from one another by their susceptibility to nicotine dependence, is postulated
Sources of tobacco for youths in communities with strong enforcement of youth access laws
Recommended actions include raising the minimum age for the purchase of tobacco to 21 years, and prohibiting individuals less than 21 years of age from selling tobacco
Is the standard compliance check protocol a valid measure of the accessibility of tobacco to underage smokers
Commonly used compliance check protocols are too artificial to reflect accurately the experience of underage smokers. The validity of compliance checks might be improved by having youths present ID, and by employing either tobacco users, or non-tobacco users who are sufficiently experienced to mimic the self confidence exhibited by tobacco users in this situation. Consideration should be given to prohibiting the sale of tobacco by individuals und…
Assessment of nicotine dependence symptoms in adolescents
All five indicators performed well psychometrically. Until the meaning, relative importance, and usefulness of each scale is clarified in longitudinal work, decisions regarding which scale(s) are most informative will depend more on the content of the scales, the need for a multi- or unidimensional indicator, and whether or not the scale is theory based
Development of symptoms of tobacco dependence in youths
Symptoms of tobacco dependence commonly develop rapidly after the onset of intermittent smoking, although individuals differ widely in this regard. Girls tend to develop symptoms faster. There does not appear to be a minimum nicotine dose or duration of use as a prerequisite for symptoms to appear. The development of a single symptom strongly predicted continued use, supporting the theory that the loss of autonomy over tobacco use begins with the…
Parent’s Socioeconomic Status, Adolescents’ Disposable Income, and Adolescents’ Smoking Status in Massachusetts
Objectives. This study examined the association between parental socioeconomic status (SES) and adolescent smoking. Methods. We conducted telephone interviews with a probability sample of 1308 Massachusetts adolescents aged 12 to 17 years. We used multiple-variable-adjusted logistic regression models. Results. The risk of adolescent smoking increased by 28% with each step down in parental education and increased by 30% for each step down in paren…
Genetically decreased CYP2A6 and the risk of tobacco dependence
Adolescents with 1-2 copies of CYP2A6*2 or *4 are at substantially increased risk of becoming dependent but smoke less once dependent. Genetic risk for ND may need to be considered in the conceptualisation of tobacco control programmes for adolescents
Short term patterns of early smoking acquisition
Movement to heavier, more frequent smoking is generally unidirectional, although many youths attempt to quit one or more times. The appearance of any symptom of dependence altered the subsequent pattern of smoking behaviour. Future investigators might consider using more frequent data points and a continuous timeline to track smoking behaviour
The federal initiative to halt the sale of tobacco to children—the Synar Amendment, 1992–2000
The Synar Amendment has resulted in the universal adoption of laws prohibiting tobacco sales to minors and almost universal enforcement of those laws, resulting in dramatically reduced violation rates. Implementation was slowed significantly by a lack of good faith effort in many states and by DHHS's decision not to require states to enforce their laws by penalising lawbreakers
Symptoms of Diminished Autonomy over Cigarettes with Non-Daily Use
Data from a nationally representative sample of smokers (ages 12-22 years, n=2,091) was examined to investigate the prevalence of symptoms of diminished autonomy over cigarettes. Six symptoms were assessed: failed cessation, smoking despite a desire to quit, and a need or urge to smoke, irritability, restlessness, or disrupted concentration attributed to nicotine withdrawal. One or more of the six symptoms were present in 18.9% of subjects who sm…
Enforcement of underage sales laws as a predictor of daily smoking among adolescents – a national study
Federally mandated enforcement efforts by states to prevent the sale of tobacco to minors appear to have made an important contribution to the observed decline in smoking among youth in the U.S. Given similar results from long-term enforcement efforts in Australia, other countries should be encouraged to adopt the World Health Organization Framework on Tobacco Control strategies to reduce the sale of tobacco to minors
What is the significance of experiencing relaxation in response to the first use of nicotine
Individuals who feel relaxed the first time they inhale from a cigarette are more likely to develop nicotine dependence. To determine if the relaxation response is associated only with specific aspects of dependence, a survey was administered to 1405 adolescents aged 14–18 years (mean 15.8 years) from four schools in Massachusetts. Nicotine dependence was measured with the Diagnostic and Statistical Manual (DSM-IV), and the loss of autonomy over …
Medicine (28 works) · Smoking Behavior and Cessation (27 works) · Environmental health (20 works) · Business (16 works) · Political science (14 works) · Psychology (14 works) · Advertising (13 works) · Law (12 works) · Tobacco use (11 works) · Law (10 works)