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Psychology & Neuroscience of Addiction > Drug policy > Flashcards

Drug policy Flashcards

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1
Q

What is a population health (Kindig and Stoddart, 2003)?

A

“The health outcomes of a group of individuals,

including the distribution of such outcomes within the group.”

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2
Q

What is the place and role of policies and interventions on population health outcomes, their distribution, and the patterns of health determinants?

A

[Policies and interventions at individual and social levels]

  • influence the [patterns of health determinants over life course (independent variables)]
  • aim to break the link between these patterns of health determinants and the [health outcomes and distribution in population (dependent variables)]

e.g.:
standardised tobacco packaging impact on smoking (independent variable) and the consequent rates of heart disease (dependent variable)

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3
Q

What are determinants of health (WHO, 1998)?

A

“The range of personal, social, economic, and environmental factors which determine the health status of individuals or populations.”

  • > conditions into which people are born in, grown and live in
  • > key reason on distribution of health outcomes (why some people are healthier than others)
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4
Q

What are the categories of health determinants?

A
  1. Genetic/biological factors
  2. Social environment
  3. Physical environment
  4. Economic environment
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5
Q

What is the relationship between income, social class and infant mortality?

A

In cities with highest GDP/capita AND in higher social classes, infant mortality is lower

-> consequent distribution of health

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6
Q

What is the relationship between smoking and deprivation?

A

People who are deprived are more likely to smoke

-> determinant of health (deprivation) is related to health outcome (addiction - smoking)

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7
Q

What is the alcohol paradox?

A

People in higher social strata drink more

BUT extreme drinking associated with lower social strata

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8
Q

What do we do when we find evidence of a relation between a health determinant and outcome?

A

Health promotion

  • use policies and interventions to influence the effect of determinants of health on health outcomes
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9
Q

What does health promotion consist of (WHO, 1998)?

A
  1. Enable people to take control
    - strengthening individuals skills and capabilities
  2. Take action to change social, environmental and economic conditions
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10
Q

What are the key points of the Ottawa Charter for Health Promotion (1986)?

A

> Developed at 1986 WHO conference

> Delegates signed it on 21st November 1986

> Jakarta Declaration (1997) confirmed these strategies are relevant for all countries

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11
Q

What does the Ottawa Charter for Health Promotion (1986) consist of?

A

Building Healthy Public Policy

  • Enable
  • Mediate
  • Advocate
  1. Reorient Health Services
  2. Creative Supportive Environments
  3. Develop Personal Skills
  4. Strengthen Community Action
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12
Q

What did the two health promotion policies aimed at smokers in Malaysia (Coe et al., 2014) consist of and result in?

A
  1. Anti-smoking media campaigns - “TAK NAK”
    - 90% reported exposure to campaign

-> evidence smokers exposed were more likely to attempt to quit

  1. Smoke-free policies
    - increase in bans and in homes that do not allow smoking
  • > policies didn’t cover all public places and were not comprehensive
  • > exposure didn’t change in restaurants and other areas
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13
Q

What is the difference between national policies on tobacco and alcohol, and actions by the tobacco and alcohol industry?

A
  • National policies are legislated

- Actions by tobacco and alcohol industries are voluntary

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14
Q

What is the effectiveness of actions from the tobacco and alcohol industries?

A

Often ineffective and delay effective policy

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15
Q

What are the existing international policies on tobacco and alcohol?

A

> On tobacco:

  • WHO Framework Convention on Tobacco Control (FCTC)
  • European Union Tobacco Products Directive (EUTPD)

> No similar treaties or directives for alcohol

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16
Q

What is the Framework Convention on Tobacco Control (FCTC)?

A
  • One of world’s first health treaties
  • International treaty to reduce the demand and supply for tobacco
  • In force in February 2006
  • As of September 2016: 180 countries are parties to
17
Q

What are the key articles of the Framework Convention on Tobacco Control (FCTC) for the reduction of tobacco demand?

A

> Art. 6: Price and tax measures
-> raise tobacco price

> Art. 8: Protection from second-hand smoking
- (e.g. smoke free policies in public spaces)

> Art. 9 and 10: Tobacco product regulation

> Art. 11: Packaging and labelling of tobacco products

> Art. 12: Education, communication, training and public awareness

> Art. 13: Tobacco advertising, promotion and sponsorship

> Art. 14: Tobacco dependence and cessation

18
Q

What is one of the most effective policies to reduce tobacco and alcohol demand/use?

A

Raising the price
- e.g. raising taxes, minimum pricing, banning promotions

  • > related to reductions in tobacco consumption
  • > shown to reduce harmful use of alcohol
19
Q

What is WHO’s tax recommendation on tobacco?

A

Minimum 75%

20
Q

What are the key articles of the Framework Convention on Tobacco Control (FCTC) for the reduction of tobacco supply?

A

> Art. 15: illicit trade in tobacco products

> Art. 16: Sales to and by minors

> Art. 17: Provisions of support for economically viable alternative activates
- e.g. helping farmers convert to another crop

21
Q

What does the effectiveness of policies normally depend on?

A

How well and fully they’re implemented

  • e.g. comprehensive bans on advertising
  • consider affordability when raising prices
22
Q

What is the evidence on the effectiveness of a national policy on health warning labels on tobacco packs?

A

Large graphic health warning shown to be effective for educating about risks AND encouraging quitting

23
Q

What is the evidence on the effectiveness of a national policy on alcohol?

A

Poor evidence
- less developed policy area, research ongoing

  • few studies suggest exposures to warnings could increase risk-perceptions
  • little evidence for effects of content labelling
    (e. g. calories, ingredients, drinks)
24
Q

What is the effectiveness of bans on misleading information on tobacco packaging?

A

Ineffective due to circumvention
- tobacco industries find ways around it

  • e.g. “light cigarettes” become “blue cigarettes”
25
Q

What is the effectiveness of tobacco advertising restrictions?

A

Advertising bans are effective in reducing tobacco use

BUT must be comprehensive

26
Q

What is the effectiveness of alcohol advertising restrictions?

A

Advertising bans may be effective in reducing harmful use

27
Q

What is the evidence on a national policy for educating people about tobacco?

A
  • Well-designed campaigns can be effective
    BUT are expensive
  • tobacco advertising generally illegal
28
Q

What is the evidence on a national policy for educating people about alcohol?

A

Anti-driving campaigns are most popular

- little/no evidence of effectiveness

29
Q

How can tobacco products be regulated with national policies?

A
  • Additive restrictions
    (all additives banned in Brazil)
  • Flavour restrictions
    (flavoured tobacco use high among youth)
30
Q

How can alcohol products be regulated with national policies?

A
  • Minimum alcohol content to be considered alcohol
  • Alcohol content limits
  • growing research on reducing alcohol strength in some products
31
Q

What is the evidence on the effectiveness on minimum age laws for buying and selling tobacco?

A
  • Some evidence of effectiveness if enforced
  • Momentum for raising minimum age
  • Laws against consumption not favoured because they target addicts
32
Q

What is the evidence on the effectiveness on minimum age laws for buying and selling alcohol?

A

Some evidence of effectiveness

33
Q

What is the evidence for national policies on tobacco availability?

A

> Some countries restrict sales in certain places
(e.g. pharmacies, vending machines)

> Restrictions on number and place of outlets

> Restrictions on smoking in certain places of use:

  • smoke-free public and workplaces reduce exposure to secondhand smoke
  • > key policy to reduce harms from tobacco use
  • evidence of reduced consumption
34
Q

What is the evidence for national policies on alcohol availability?

A

> State monopoly and/or Licensing

-> Government control can reduce alcohol related harm

> Some countries restrict public consumption

  • less attention given
  • creation of special drinking areas at events
35
Q

What is the consequence of few policies in place or their inadequate implementation?

A

Advertising and the environment in general may influence us to make bad choices

36
Q

What is the consequence of good policies that are effectively implemented?

A

Many environmental triggers for unhealthy lifestyle habits disappear

Psychology & Neuroscience of Addiction (14 decks)

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