Presents the evidence on the effectiveness of measures enforced at the societal level to eliminate tobacco smoking and tobacco smoke from the environments where exposure takes place. This volume offers a critical review of the evidence on the economic effects and health benefits of smoke-free legislation and the adoption of voluntary smoke-free policies in households.

The "Handbook" covers how the effects of a tobacco control policy are determined, the core constructs for understanding how and why a given policy works, the potential moderator variables to consider when evaluating a given policy and the data sources that might be useful for evaluation. The "Handbook" includes logic models outlining relevant constructs for evaluating the effectiveness of policies on tobacco taxation, smoke-free environments, tobacco product regulations, limits on tobacco marketing communications, product labeling, anti-tobacco public communication campaigns and tobacco use cessation interventions.

Data suggest that exposure to secondhand smoke can result in heart disease in nonsmoking adults. Recently, progress has been made in reducing involuntary exposure to secondhand smoke through legislation banning smoking in workplaces, restaurants, and other public places. The effect of legislation to ban smoking and its effects on the cardiovascular health of nonsmoking adults, however, remains a question. Secondhand Smoke Exposure and Cardiovascular Effects reviews available scientific literature to assess the relationship between secondhand smoke exposure and acute coronary events. The authors, experts in secondhand smoke exposure and toxicology, clinical cardiology, epidemiology, and statistics, find that there is about a 25 to 30 percent increase in the risk of coronary heart disease from exposure to secondhand smoke. Their findings agree with the 2006 Surgeon General's Report conclusion that there are increased risks of coronary heart disease morbidity and mortality among men and women exposed to secondhand smoke. However, the authors note that the evidence for determining the magnitude of the relationship between chronic secondhand smoke exposure and coronary heart disease is not very strong. Public health professionals will rely upon Secondhand Smoke Exposure and Cardiovascular Effects for its survey of critical epidemiological studies on the effects of smoking bans and evidence of links between secondhand smoke exposure and cardiovascular events, as well as its findings and recommendations.

The health and economic costs of tobacco use in military and veteran populations are high. In 2007, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) requested that the Institute of Medicine (IOM) make recommendations on how to reduce tobacco initiation and encourage cessation in both military and veteran populations. In its 2009 report, Combating Tobacco in Military and Veteran Populations, the authoring committee concludes that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs.

Tobacco is reported to be the second major cause of death in the world and there is ever-increasing interest in the costs of smoking, especially in the light of evidence of the health effects of second-hand smoke. This book brings together the findings of economists on the effectiveness of price and non-price policy initiatives to combat smoking and draws conclusions regarding the efficacy of the various policy measures. The authors evaluate the relative effectiveness of price-based smoking control policies (i.e. tax) in relation to non-price strategies (including advertising restrictions, sales restrictions, territorial restrictions and health warnings). They review evidence not only from the US but also from around the world, drawing important conclusions for developing countries where smoking is on the rise. The book will be essential reading for policy makers, health practitioners and researchers in health economics.

Tobacco is reported to be the second major cause of death in the world and there is ever-increasing interest in the costs of smoking, especially in the light of evidence of the health effects of second-hand smoke. This book brings together the findings of economists on the effectiveness of price and non-price policy initiatives to combat smoking and draws conclusions regarding the efficacy of the various policy measures. The authors evaluate the relative effectiveness of price-based smoking control policies (i.e. tax) in relation to non-price strategies (including advertising restrictions, sales restrictions, territorial restrictions and health warnings). They review evidence not only from the US but also from around the world, drawing important conclusions for developing countries where smoking is on the rise. The book will be essential reading for policy makers, health practitioners and researchers in health economics.

Background: Smokefree legislation is just one of a number of tobacco control policies introduced in the UK in the last decade in an attempt to curb the harm caused by smoking. Whilst such legislation is known to have reduced non-smokers' exposure to environmental tobacco smoke, less is known about whether the introduction of a smoking ban encourages existing smokers to attempt to quit and to seek support to do so from appropriate sources such as their general practitioner. High quality data are needed to evaluate the effectiveness of legislation in prompting smokers to change their smoking behaviour, and data collected routinely in primary care may provide such an opportunity. However, there is little contemporary evidence about the quality of the smoking data recorded in primary care, nor how best to analyse these data, which must be addressed before the resource can be used to evaluate the effectiveness of tobacco control policies. Methods: Initially, a systematic review was undertaken to assess the impact of national comprehensive smokefree legislation on population smoking prevalence, cigarette consumption and quitting behaviour. Then, the quality of smoking status and cessation intervention recording in The Health Improvement Network (THIN) database, a large database of UK primary care records, was investigated using indirect standardisation to compare rates of recording with external data sources. Having identified Autoregressive Integrated Moving Average (ARIMA) interrupted time series analysis as an appropriate method to assess the impact of smokefree legislation on measures of smoking-related clinical activity recorded in THIN data, several sensitivity analyses were untaken to assess the impact of decisions that must be taken during the data analysis process. In the light of this knowledge, ARIMA models were used to investigate changes in the rate of recording of patients' smoking status, delivery of cessation advice, referral of smokers to specialist cessation services and prescribing of smoking cessation medications in the months leading up to, and after, the introduction of smokefree legislation. Results: The findings of the systematic review provide some evidence that in populations where well-enforced, comprehensive smokefree policies have been implemented quitting activity increased in the run up to, and/or following, the introduction of the legislation. Assessment of the quality of the smoking information recorded in THIN showed that the data have improved in recent years, such that the recorded prevalence of smoking is now similar to that reported in national surveys. Some uncertainty does, however, remain about the quality of recording of the delivery of cessation advice or referral of smokers to cessation services. ARIMA modelling highlighted a 6.2% increase in Nicotine Replacement Therapy (NRT) prescribing in the six months before smokefree legislation was introduced in England, and a 13.2% increase in bupropion prescribing in the three months pre-ban. A 5.5% decline in NRT prescribing and a 13.7% decline in bupropion prescribing were seen in the nine months post-legislation, declines which were offset to an extent, but not completely, by prescribing of varenicline which was first available on prescription in December 2006. Similar, though non-statistically significant, patterns were seen in Scotland, Wales and Northern Ireland, where the smaller number of practices in THIN in these countries reduced the power to detect small changes in prescribing. In England, the patterns of change in prescribing did not differ with patient sex, age group, medical history or social class. Conclusions: The improved quality of the smoking data recorded in the THIN dataset suggests that primary care data may be a valuable resource with which to evaluate the effectiveness of tobacco control policies such as smokefree legislation. The significant increases in prescribing of NRT and bupropion in the run-up to the introduction of smokefree legislation in the UK suggest that smokers looking to quit may seek support to do so from primary care, though the decline in rates of prescribing post-legislation suggests that this positive change may not be sustained. This may represent a missed opportunity to maximise the impact of smoking bans by ensuring that smokers are aware of, and indeed access, cessation support available through primary care both before and after legislation is enacted, and should be noted by policy makers planning the introduction of smokefree legislation elsewhere. Ensuring that smokers are aware of, and indeed access, the effective support that is available through primary care to help them quit may be one way to maximise the positive impacts of smokefree legislation and reduce the health and economic burdens of continued tobacco use.

Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes. Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research.

Alcohol use by young people is extremely dangerous - both to themselves and society at large. Underage alcohol use is associated with traffic fatalities, violence, unsafe sex, suicide, educational failure, and other problem behaviors that diminish the prospects of future success, as well as health risks â€" and the earlier teens start drinking, the greater the danger. Despite these serious concerns, the media continues to make drinking look attractive to youth, and it remains possible and even easy for teenagers to get access to alcohol. Why is this dangerous behavior so pervasive? What can be done to prevent it? What will work and who is responsible for making sure it happens? Reducing Underage Drinking addresses these questions and proposes a new way to combat underage alcohol use. It explores the ways in which may different individuals and groups contribute to the problem and how they can be enlisted to prevent it. Reducing Underage Drinking will serve as both a game plan and a call to arms for anyone with an investment in youth health and safety.