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Buying and Selling “Loosies” in Baltimore: The Informal Exchange of Cigarettes in the Community Context

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Abstract

Since the release of the first Surgeon General’s report, the proportion of adult smokers in the U.S. has been reduced by half (U.S. Department of Health and Human Services, 2004). This success has not, however, been equally felt across all social strata. Recent survey data from Baltimore show considerably elevated smoking rates within urban, African-American communities. Of particular concern was that in some communities, over half of the young adults (18–24 years old) smoke cigarettes. As yet, there has been little focus on understanding or preventing cigarette smoking among young adults, particularly for those seeking entry into the workforce rather than being engaged in higher education. In this paper, we explore community factors contributing to high young adult smoking prevalence. Our analysis is based on data from four focus groups conducted in 2004 as part of a community-based participatory research project with two urban education and job training organizations. The focus group data reflect the experiences and opinions of 28 young adult program participants (23 smokers and 5 nonsmokers). The data highlight a normalized practice of buying and selling single cigarettes (“loosies”) within the community, with participants describing buying loose cigarettes as a preferred acquisition practice. We apply theories of informal economy and suggest that this alternative purchasing option may influence the smoking behavior of these young adults. We argue that public health efforts need to more closely consider the impact of community structures on program implementation. Overlooking key community characteristics such as the availability of single cigarettes may serve to intensify health disparities.

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Notes

  1. Excerpt identification indicates the focus group that the speaker was part of and a unique identifier for the person speaking. In this instance, Male 1–2 was the fifth male to contribute in focus group no. 2.

References

  1. U.S. Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004.

  2. Centers for Disease Control and Prevention. Cigarette smoking among adults—United States, 2004. MMWR. 2005;54:1121–1124.

    Google Scholar 

  3. Liang L, Chaloupka F, Nichter M, Clayton R. Prices, policies and youth smoking, May 2001. Addiction. 2003;98 (Suppl. 1):105–122.

    Article  PubMed  Google Scholar 

  4. Poland B, Frohlich K, Haines R, Mykhaloskiy E, Rock M, Sparks R. The social context of smoking: the next frontier in tobacco control? Tob Control. 2006;15:59–63.

    Article  CAS  PubMed  Google Scholar 

  5. Ellickson P, Orlando M, Tucker JS, Klein DJ. From adolescence to young adulthood: racial/ethnic disparities in smoking. Am J Public Health. 2004;94:293–299.

    PubMed  Google Scholar 

  6. Griesler PC, Kandel DB. Ethnic differences in correlates of adolescent cigarette smoking. J Adolesc Health. 1998;23:167–180.

    Article  CAS  PubMed  Google Scholar 

  7. Chen VW. Smoking and the health gap in minorities. Ann Epidemiol. 1993;159–164.

  8. Harris RE, Zang EA, Anderson JI, Wynder EL. Race and sex differences in lung cancer risk associated with cigarette smoking. Int J Epidemiol. 1993;22:592–599.

    Article  CAS  PubMed  Google Scholar 

  9. Tessaro I, Lyna PR, Rimer BK, et al. Readiness to change smoking behavior in a community health center population. J Commun Health. 1997;22:15–31.

    Article  CAS  Google Scholar 

  10. Giovino G, Pederson L, Trosclair A. The prevalence of selected cigarette smoking behaviors by occupation in the United States. Work, smoking, and health: a NIOSH scientific workshop. June, 2000:22–27. Accessed January 20, 2007. Available from http://www.cdc.gov/niosh/docs/2002-148/2002-148pd.html.

  11. Stead M, MacAskill S, MacKintosh A, Reece J, Eadie D. It’s as if you’re locked in: qualitative explanations for area effects on smoking in disadvantaged communities. Health Place. 2001;7:333–343.

    Article  CAS  PubMed  Google Scholar 

  12. Fagan P. Smoking in young adults: a critical need for research. Centers for Disease Control and Prevention Grand Rounds Seminar. October 2003.

  13. Israel BA, Schulz AJ, Estrade-Martinez L, et al. Engaging urban residents in assessing neighborhood environments and their implications for health. J Urban Health. 2006;83:523–539.

    Article  PubMed  Google Scholar 

  14. U.S. Department of Health and Human Services. Preventing tobacco use among young people: a report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994.

  15. Backinger CL, Fagan P, Matthews E, Grana R. Adolescent and young adult tobacco prevention and cessation: current status and future directions. Tob Control. 2003;12:46–53.

    Google Scholar 

  16. Hammond D. Smoking behavior among young adults: beyond youth prevention. Tob Control. 2005;14:181–185.

    Article  CAS  PubMed  Google Scholar 

  17. Ling PM, Glantz SA. Why and how the tobacco industry sells cigarettes to young adults: evidence from industry documents. Am J Public Health. 2002;92:908–916.

    PubMed  Google Scholar 

  18. Lantz P. Smoking on the rise among young adults: implications for research and policy. Tob Control. 2003;12:60–70.

    Article  Google Scholar 

  19. U.S. Department of Health and Human Services. Tobacco use among U.S. racial/ethnic minority groups-African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1998.

  20. Sepe E, Ling P, Glantz S. Smooth moves: bar and nightclub tobacco promotions that target young adults. Am J Public Health. 2002;92:414–419.

    PubMed  Google Scholar 

  21. Rigotti NA, Levesque DA, Weschsler H. U.S. college student’s use of tobacco products: results of a national survey. JAMA. 2000;284:699–705.

    Article  CAS  PubMed  Google Scholar 

  22. Wiltshire S, Amos A, Haw S, McNeill A. Image, context and transition: smoking in mid-to-late adolescence. J Adolesc. 2005;28:603–617.

    Article  PubMed  Google Scholar 

  23. Resnick MD, Bearman PS, Blum RW, et al. Protecting adolescents from harm. Findings from the National longitudinal study on adolescent health. JAMA. 1997;278:823–832.

    Article  CAS  PubMed  Google Scholar 

  24. Stanton W, Oei T, Silva P. Socio-demographic characteristics of adolescent smokers. Int J Addict. 1994;29:913–925.

    CAS  PubMed  Google Scholar 

  25. Valois RF, Dunham ACA, Jackson KL, et al. Association between employment and substance abuse behavior among public high school adolescents. J Adolesc Health. 1999;25:256–263.

    Article  CAS  PubMed  Google Scholar 

  26. Bone LR, Levine DM, Hill MN, Stallings R, Gelber A, Barker A, et al. Community health survey in an urban African American neighborhood: distribution and correlates of elevated blood pressure. Ethn Dis. 2000;10:88–95.

    Google Scholar 

  27. Belin PL, Young JH, Stanton L. Integrating a health component within the young adult population of Sandtown-Winchester through community based participatory research: Part II. 131st Annual American Public Health Association Meeting, San Francisco, CA. 2003.

  28. Stillman F, Bone L, Avila-Tang E, Smith K, Yancey N, Street C. Barriers to Cessation in 18-24 Year Old Inner City African Americans. American Journal of Public Health. 2007; (in Press).

  29. Tyas S, Pederson L. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control. 1998;7:409–420.

    CAS  PubMed  Google Scholar 

  30. Wilcox P. An ecological approach to understanding youth smoking trajectories: problems and prospects. Addiction. 2003;98 (Suppl. 1):57–77.

    Article  PubMed  Google Scholar 

  31. Campaign for Tobacco-Free Kids (CTFK). State cigarette tax rates and rankings. (Fact Sheet). Accessed January 20, 2007. Available from http://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf

  32. American Lung Association. State Legislated Actions on Tobacco Issues (SLATI), 2005. Accessed January 20, 2007. Available from, http://lungaction.org/reports/tobacco-control04.html

  33. U.S. Census Bureau: State and County QuickFacts. Baltimore City, Maryland. Accessed January 20, 2007. Available from http://quickfacts.census.gov/qfd/states/24/24510.html

  34. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.

    Article  CAS  PubMed  Google Scholar 

  35. Bowie J, Farfel M, Moran H. Community experiences and perceptions related to demolition and gut rehabilitation of houses for urban redevelopment. J Urban Health. 2005;82:532–542.

    PubMed  Google Scholar 

  36. Landrine H, Klonoff E, Alcaraz R. Minors’ access to single cigarettes in California. Prev Med. 1998;27:503–505.

    Article  CAS  PubMed  Google Scholar 

  37. Klonoff E, Fritz J, Landrine H, Riddle R, Tully-Payne L. The problem and sociocultural context of single-cigarette sales. JAMA. 1994;271:618–620.

    Article  CAS  PubMed  Google Scholar 

  38. Malone R, Yerger V, McGruder C, Froelicher E. It’s like Tuskegee in reverse: a case study of ethical tensions in institutional review board review of community-based participatory research. Am J Public Health. 2006;96:1914–1919.

    Article  PubMed  Google Scholar 

  39. Forster J, Wolfson M. Youth access to tobacco: policies and politics. Annu Rev Public Health. 1998;19:203–235.

    Article  CAS  PubMed  Google Scholar 

  40. Lomnitz LA. Informal exchange networks in formal systems: a theoretical model. Am Anthropol. 1988;90:42–55.

    Article  Google Scholar 

  41. Light DW. From migrant enclaves to mainstream: reconceptualizing informal economic behavior. Theory Soc. 2004;33:705–737.

    Article  Google Scholar 

  42. Hart K. Small scale entrepreneurs in Ghana and development planning. J Dev Stud. 1970;6:104–120.

    Google Scholar 

  43. Hart K. Informal income opportunities and urban employment in Ghana. J Mod Afr Stud. 1973;11:61–89.

    Article  Google Scholar 

  44. Croghan E, Aveyard P, Griffin C, Cheng KK. The importance of social sources of cigarettes to school students. Tob Control. 2003;12:67–73.

    Article  CAS  PubMed  Google Scholar 

  45. Wiltshire S, Bancroft A, Amos A, Parry A. They’re doing people a service—qualitative study of smoking, smuggling, and social deprivation. Br Med J. 2001;323:203–207.

    Article  CAS  Google Scholar 

  46. Cross JC. Street vendors, modernity and postmodernity: conflict and compromise in the global economy. Int J Sociol Soc Policy. 2000;20:30–52.

    Google Scholar 

  47. Wallace C. Household strategies: their conceptual relevance and analytical scope in social research. Sociology. 2002;36:275–292.

    Article  Google Scholar 

  48. U.S. Department of Health and Human Services. Reducing tobacco use: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000.

  49. Hopkins DP, Briss PA, Ricard CJ, et al. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med. 2001;20:16–66.

    Article  CAS  PubMed  Google Scholar 

  50. Chaloupka F, Cummings KM, Morley CP, Horan JK. Tax, price and cigarette smoking: evidence from the tobacco documents and implications for tobacco company marketing strategies. Tob Control. 2002;11 (Suppl.1):i62–i72.

    Article  PubMed  Google Scholar 

  51. World Bank. Curbing the Epidemic: Governments and the Economics of Tobacco Control. Washington, DC: The World Bank, 1999.

    Google Scholar 

  52. Chaloupka FJ, Warner K. The economics of smoking. In: Culyer AJ, Newhouse JP, eds. Handbook of Health Economics. Amsterdam: Elsevier Science; 2000:Vol 1B, 1539–1627.

    Google Scholar 

  53. Chaloupka FJ, Wechsler H. Price, tobacco control policies and smoking among young adults. J Health Econ. 1997;16:359–373.

    Article  CAS  PubMed  Google Scholar 

  54. Evans WN, Ringel JS, Stech D. Tobacco taxes and public policy to discourage smoking. Tax Policy Econ. 1999;13:1–56.

    Google Scholar 

  55. Hyland A, Higbee C, Li Q, et al. Access to low-taxed cigarettes deters smoking cessation attempts. Am J Public Health. 2005;95:994–995.

    Article  PubMed  Google Scholar 

  56. Gerxhani K. The informal sector in developed and less developed countries: a literature survey. Public Choice. 2004;120:267–300.

    Article  Google Scholar 

  57. Chaloupka F. Macro-social influences: the effects of prices and tobacco-control policies on the demand for tobacco products. Nicotine Tob Res. 1999;1 (Suppl.2):s77–s81.

    Article  Google Scholar 

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Acknowledgement

We would like to thank our focus group moderator, Bernie Carey, and all of the focus group participants. We also are very grateful for the contributions of our advisory committee members to the work reported in this project.

This research was supported by a grant from Maryland’s Cigarette Restitution Fund entitled “Cancer Prevention in African-American Young Adults” (PI: Frances Stillman).

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Correspondence to Katherine Clegg Smith.

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Smith, Bone, and Kromm are with the Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Stillman is with the Institute for Global Tobacco Control, Bloomberg School of Public Health, Baltimore, MD, USA; Stillman is with the Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA; Yancey and Price are with the Urban Youth Corps, Community Building in Partnership, Inc., Baltimore, MD, USA; Belin is with the Public Health Program, Morgan State University, Baltimore, MD, USA.

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Smith, K.C., Stillman, F., Bone, L. et al. Buying and Selling “Loosies” in Baltimore: The Informal Exchange of Cigarettes in the Community Context. J Urban Health 84, 494–507 (2007). https://doi.org/10.1007/s11524-007-9189-z

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