Suchergebnisse

OBJECTIVES: To determine the extent and nature of local ordinances to regulate tobacco sales to minors, the level of enforcement of local and state laws concerning tobacco availability to minors, and sanctions applied as a result of enforcement. DESIGN: Tobacco control ordinances were collected in 1993 from 222 of the 229 cities greater than or equal to 2000 population in Minnesota, United States. In addition a telephone survey with the head of the agency responsible for enforcement of the tobacco ordinances was conducted. MAIN OUTCOME MEASURES: Presence or absence of legislative provisions dealing with youth and tobacco, including licensure of tobacco retailers, sanctions for selling tobacco products to minors, and restrictions on cigarette vending machines, self-service merchandising, and point-of-purchase advertising; and enforcement of these laws (use of inspections and "sting" operations, and sanctions imposed on businesses and minors). RESULTS: Almost 94% of cities required tobacco licences for retailers. However, 57% of the cities specified licences for cigarettes only. Annual licence fees ranged from $10 to $250, with the higher fees adopted in the previous four years. More than 25% of the cities had adopted some kind of restriction on cigarette vending machines, but only six communities had banned self-service cigarette displays. Three cities specified a minimum age for tobacco sales staff. Fewer than 25% of police officials reported having conducted compliance checks with minors or in-store observations of tobacco sales to determine if minors were being sold tobacco during the current year. Police carrying out compliance checks with youth were almost four times as likely to issue citations as those doing in-store observations. More than 90% of police reported enforcement of the law against tobacco purchase or possession by minors, and nearly 40% reported application of penalties against minors. CONCLUSIONS: Almost 75% of the cities have done nothing to change policies or enforcement practices to ...

The World Health Organization's Health Promoting Schools (HPS) framework is a whole-school approach to promoting health that recognizes the intrinsic relationship between health and education. Our recent Cochrane systematic review found HPS interventions produced improvements in a number of student health outcomes. Here we reflect on what this review was not able to tell us: in other words, what evidence is missing with regard to the HPS approach. Few HPS interventions engage with schools' "core business" by examining impacts on educational outcomes. Current evidence is dominated by obesity interventions, with most studies conducted with children rather than adolescents. Evidence is lacking for outcomes such as mental or sexual health, substance use, and violence. Activities to engage families and communities are currently weak and unlikely to prompt behavioral change. The HPS approach is largely absent in low-income settings, despite its potential in meeting children's basic health needs. Intervention theories are insufficiently complex, often ignoring upstream determinants of health. Few studies provide evidence on intervention sustainability or cost-effectiveness, nor in-depth contextual or process data. We set out an agenda for future school health promotion research, considering implications for key stakeholders, namely, national governments, research funders, academics, and schools.