ABSTRACTS

Volume 4, Number 2
April-June 1999

Vol. 4, Num 2: Contents | Editorial | Up Front | Abstracts

Do Cigarette Warnings Warn? Understanding What It Will Take to Develop More Effective Warnings
       Krugman, D.M, Fox, R. & Fischer, P.M.

Warnings in cigarette advertisements have been the principal method mandated by the federal government to educate consumers about the risks of smoking.  Warnings have been required in all cigarette ads for 30 years and have remained largely unchanged during this time.

The current warning program was neither developed nor implemented with specific communication goals in mind. Instead, it was negotiated by the government and tobacco industry representatives.  The warning program has served the tobacco industry well by providing it with a key argument in tobacco litigation:  "warned you."  It has, however, failed as a public health strategy, since much research has shown that the current warnings are ineffective communication devices.

If Congress is to be effective in its efforts to educate consumers about the risks of smoking, it needs to rethink the warning strategy while making use of knowledge regarding how warnings work.  The paper draws from current studies in order to develop realistic cigarette warning objectives and points out the considerations necessary to create such warnings.  To be effective, warnings must be developed, targeted, tested, and revised over time.

The Perceived Influence of Cigarette Advertisements and Smoking Susceptibility among Seventh Graders
       Borzekowski, D.L.G., Flora, J.E., Feighery, E., & Schooler, C.

A perceptual bias, the third person effect, has been observed where individuals believe themselves to differ from others regarding the perceived influence of media messages. Given the frequency with which youth encounter prosmoking messages and the reported negative effects of these messages, it is of value to study whether youth perceive cigarette advertisements to influence themselves and their friends and peers.  This study examined the associations between exposure to social and information prosmoking environments, the perceived influence of cigarette advertisements on self, best friends, and other youth, and smoking susceptibility.  A sample of 571 seventh graders completed surveys on tobacco advertisements and promotions.  Using student-t, chi-square, ANOVA tests and proportional odds models, we found significant associations between perceived influence of cigarette advertisements and exposure to social and information prosmoking environments as well as smoking susceptibility.  These data suggest that youth be taught that everyone is vulnerable to the tobacco industry's strategies and be given skills to resist prosmoking advertising.

Reading and Re-Forming Breast Self-Examination Discourse: Claiming Missed Opportunities for Empowerment
       Kline, K.N.

For close to 45 years breast self-examination (BSE) has had nearly uncontested support as depicted in mass media accounts. Just recently, however, a number of breast cancer activists have spoken out against the practice. The claim that BSE is oppressive and fosters victim blaming, which simply is not in the best interests of women.  Judging by the media reports I reviewed, these activists may have a valid point.  The discourse of the popular media articles that constitutes the issue of BSE for the average woman blames women for not doing their part to reduce high breast cancer mortality statistics, establishes the locus of all reasons for refraining from the activity with the woman, and chastises these women for failing to engage in the activity.    Moreover, in addition to being an agency-robbing discourse, these media reports provide minimal (if any) substantive rationale that there is any benefit to BSE.  It appears, then, that women are subjected to an agency-robbing discourse and, as it is currently enacted, practice for what appears to be little reason.  However, this does not mean that BSE is an inefficacious means of early detection or that women cannot be empowered by participating in the discursive process and the physical act itself. Rather, in the discussion of this essay I provide a number of suggestions for reforming BSE rhetoric such that it facilitates a more therapeutic and individually empowering self-help activity.

EDUCATION & EVALUATION
Assessing Physicians' Interpersonal Skills via Videotaped Encounters:  A New Approach for the Royal College of General Practitioners Membership Examination
       Tate, P., Foulkes, J., Neighbour, R., Campion, P. & Field, S.

The Royal College of General Practitioner's Membership examination, the only postgraduate qualification in family medicine in the UL, has developed a direct assessment of candidates' interpersonal skills performance suing videotaped consultations of the actual doctor-patient encounters.  At present about 1,200 doctors are examined each year.  The methodology has been developed and piloted over a period of eight years.  The central tenet of the methodology is a clear definition, which is known both to the candidate and to the examiner, of the clinical and consulting competencies that are required to be demonstrated in order to pass the examination.  The candidate is required to provide evidence of his or her competence usually by selecting appropriate patient encounters that demonstrate the fulfillment of the required performance criteria, effectively producing a portfolio of his or her communicative competence.  The methodology is intended to encourage the learning and teaching of communication skills by making it part of an important examination and clearly defining the competencies required to pass.  Reliability has been demonstrated to be satisfactory and refinement of the marking processes is likely to improved this further.

FORUM
A Critical Perspective on the Drug Czar's Antidrug Campaign
       DeJong, W. & Wallack, L.

The U.S. government's Office of National Drug Control Policy (ONDCP) launched its new antidrug media campaign in July 1998.  The campaign is likely to increase awareness of the youth drug problem, but shortcomings in the campaign's early implementation raise questions about its potential for changing behavior.  Short-comings include: a) the first wave of ONDCP's television advertisements are focused on reinforcing problem awareness but do not model skills or provide other information necessary for behavior change; b) the campaign provides insufficient focus on promoting drug treatment and citizen involvement in local prevention activities, including political action; c) the campaign is being implemented without a major new investment in drug-treatment programs or community-based prevention programs; d) the campaign does not substantively address alcohol and tobacco, which pose a clear threat to health and serve as a "gateway" to illicit drug use; and e) the first wave of television advertisements use exaggerated fear appeals, a strategy shown by research rarely to be successful. Only time will tell whether the ONDCP media campaign will succeed or fail. Using past research as a guide, there is legitimate reason for concern that the campaign will not live up to expectations.

BOOK REVIEW
U.S.-Mexico Border Health: Issues for regional and Migrant Populations
       By Power, J.G. & Byrd, T.
       Reviewed by L.D. Dixon