Vaping saves lives, we must ignore pressure to ban it | Prof. John Britton

CaptureSmoking is the UK’s biggest avoidable killer. The best thing a smoker can do for their health is to quit, saving up to a day of life for every four smoke-free days. Eradicating smoking would also be good for society, reducing pressure on the NHS, relieving poverty and increasing productivity.

Smokers are driven by an addiction to nicotine but it is the many other components of tobacco smoke that disable and kill. So the emergence of e-cigarettes, which allow smokers to inhale nicotine without smoke and hence at much-reduced risk, has been a game-changer. E-cigarettes are not safe, they are just much less harmful than smoking. A non-smoker who takes up vaping will harm their health but the smoker who switches to vaping gains massively. Health authorities have seized this opportunity by promoting vaping with great success, as smoking rates decline rapidly. Concerns that vaping might lead young people to start smoking in large numbers have proved unfounded.

So what should we make of the recent outbreak of lung disease, which includes some fatalities, among vapers in the US? The disease, lipid pneumonia, is caused by inhaling oil and it appears that the oil responsible is not a component of regular nicotine vape solutions, but cannabis oil. The US epidemic is happening primarily among people who use e-cigarettes to vape cannabis. Britain has not, despite recent press reports, been hit by a similar epidemic: among a vaping population that stands at 3.6 million there are only two known cases of lipid pneumonia.

The US outbreak has triggered radical proposals, including banning vape flavours and outlawing vaping altogether. Banning flavours appeals to those concerned at a rapid increase in vaping among young Americans that has not occurred in this country, probably because advertising and promotion are much more tightly controlled here.

A ban on flavours would make vaping much less tolerable; nicotine vapour causes irritation and can be difficult to inhale. Banning vaping altogether is irrational since it would push millions of ex-smokers back into using tobacco. It is essential to remain vigilant in detecting and preventing adverse effects from vaping but also to keep sight of the benefits. Smoking kills. Vaping saves lives.

Read original article in The Times here.

 

 

UK Prevention Research Partnership (UKPRP) funding secured by UKCTAS academics

We are delighted to announce that UKCTAS has been successful in securing future funding through a multi-funder research initiative; the UK Prevention Research Partnership (UKPRP). UKTCAS academics joined forces with new collaborators and a range of public and private sector organisations to apply to the UKPRP.

The new consortium has now been awarded £5.9 million funding over five years and is called SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harM).

spectrum-logo

UKPRP research grants aim to develop, test and 254refine new, practical and cost-effective approaches to preventing non-communicable diseases at scale, which will in turn help to reduce health inequalities across the UK. The initiative is supported by twelve funders from UK Research and Innovation research councils, charities and government. In its first round of funding, four Consortia and four network grants have been awarded.

Prof. Linda Bauld, University of Edinburgh

Linda Bauld

“SPECTRUM intends to address some of the most controversial questions facing the health of our population. To reduce diseases like cancer, heart disease, diabetes and respiratory diseases we need to address their main preventable causes. To do so means introducing and enforcing public health policies that often clash with the business interests of very profitable companies.

SPECTRUM aims to produce research that can rise to this challenge. This research will be used by our partners outside of academia, who will be active members of SPECTRUM, to make the case for effective policy and practice to improve health and address inequalities in the UK and further afield.”

The SPECTRUM Consortium is led by Professor Linda Bauld (pictured above) from the University of Edinburgh and for the last 10 years has been the deputy director of UKCTAS. Co-investigators and collaborators from 10 Universities in the UK and one in Australia are included. In addition, the Consortium brings together leading alliances that aim to improve health and reduce inequalities in the UK and further afield, along with Public Health England, Health Scotland, Public Health Wales and two independent companies specialising in statistical modelling and retail data.

SPECTRUM will aim to conduct research to prevent and address harm to health from unhealthy commodities by using systems science to identify and evaluate solutions. The focus of the new Consortium will be the commercial determinants of health and health inequalities, continuing UKCTAS’s work at the population level on tobacco and alcohol, but also extending to unhealthy food and drink products where appropriate. The research will be organised around 8 inter-related Work Packages involving new research, along with knowledge exchange, impact and public engagement activities.

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More information is available on UKCTAS.net/SPECTRUM

Call for Submissions – Clinical Interventions to Increase Quit Attempts

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Nicotine & Tobacco Research intends to publish a themed issue on understanding and prompting quit attempts. The guest editors will be Matthew Carpenter and John Hughes. Smoking cessation is a function of two processes: making a quit attempt and succeeding in the quit attempt. Most clinical research on tobacco cessation has focused on the latter. This themed issue invites articles on the processes that lead to a quit attempt or methods to increase quit attempts. In addition to well-established processes that influence quit attempts (e.g., motivation, efficacy, social support), recent studies have described novel processes that might increase quit attempts (e.g., cumulative effect of cues) or decrease quit attempts (e.g., cessation fatigue). Brief advice and motivational interviewing are well-established clinical methods to prompt quit attempts but recent studies have examined novel interventions such as medication sampling, reduction in cigarettes/day, proactive messages to smokers and training relatives/friends to motivate smokers. Other studies have examined related methodological issues, such as the utility of only counting quit attempts that last 24 hours.

This themed issue of Nicotine & Tobacco Research invites articles on:

  • Studies to understand the processes of making a quit attempt
  • Studies to evaluate interventions to increase quit attempts
  • Methodological issues specific to measuring quit attempts. Both empirical studies (human laboratory, field trials, clinical trials, policy and epidemiological studies), and reviews can be submitted.
Manuscripts must be submitted through the Nicotine & Tobacco Research submission system (https://mc.manuscriptcentral.com/ntr) by October 31, 2019.
We anticipate that the themed issue will be published in 2020.

Submission of a manuscript does not guarantee its acceptance. All manuscripts will be reviewed by the Nicotine & Tobacco Research editorial staff and referees, and must meet the standards for publication in Nicotine & Tobacco Research.

Nicotine & Tobacco Research home page and instructions for authors: https://academic.oup.com/ntr

For any questions, please contact Matthew Carpenter (carpente@musc.edu) or John Hughes (john.hughes@uvm.edu).

UKCRC Final Report reveals the legacy of public health research centres

By building capacity and capability in public health research, a report shows how the legacy of a UK-wide network of centres of excellence has helped fuel future public health and prevention research.

Since 2008, partners in the UK Clinical Research Collaboration (UKCRC) have invested £37 million in a network of six Public Health Research Centres of Excellence (UKCRC centres) to increase infrastructure, build academic capacity in public health research in the UK and provide a platform to engage with policy and practice.

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The report shows how 10-years of collaborative work by these centres – based in Edinburgh, Belfast, Newcastle, Nottingham, Cambridge and Cardiff – has exceeded expectations of what was thought possible back in 2008.

The UKCRC centres have expanded the pool of early-career researchers and nurtured their talent while creating new opportunities to work across academia, policy and practice. Researchers have gone on to expand their networks and advance their careers, securing fellowships and lectureships, winning awards and promotion. The UKCRC centres have been a strong magnet for leveraging significant additional funding to increase the volume and quality of public health research.

The centres have helped change the way we think about how to align research with the needs of policymakers and practitioners. By pioneering innovative new ways of responding to public health needs and providing rapid response evaluations for policy and practice partners, their work is helping researchers and practitioners to improve public health at a local level.

At the national level, the impact has been wide-reaching, with evidence from centre research programmes influencing the government sugar tax, encouraging healthy transport policies, providing guidance on physical activity, promoting health in schools and playing a leading role in government policy on tobacco smoking and vaping.

Centre collaborations and academic-policy partnerships have changed the public health landscape, paving the way for ambitious new prevention initiatives, like the UK Prevention Research Partnership.

Professor Chris Whitty, Chair of the UKCRC Board and Chief Scientific Adviser for the Department of Health and Social Care, said: This report shows how this initiative has built research capacity in public health in the UK. Considered untried and risky in 2006, the hard work and collaborative spirit of many researchers, managers and students has strengthened evidence-based public health policy and practice. Without these sorts of achievements, it is hard to see how further ambitious investment like the UK Prevention Research Partnership would have been feasible. I am very grateful to all the research directors that drove this forward, and they should be justly proud of their contribution to the field.”

The UKCRC Centres of Excellence:

  • Centre of Excellence for Public Health Northern Ireland (CoENI), Queen’s University Belfast
  • Centre for Exercise, Diet and Activity Research (CEDAR), MRC Epidemiology Unit at the University of Cambridge
  • The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University
  • The Centre for Translational Research in Public Health in Public Health (Fuse) – a collaboration between Newcastle University, Durham University, Newcastle University, Northumbria University, the University of Sunderland and Teesside University
  • The Scottish Collaboration for Public Health Research and Policy (SCPHRP), University of Edinburgh
  • The UK Centre for Tobacco and Alcohol Studies (UKCTAS), University of Nottingham.

Read the full UKCRC report (PDF, 4.21MB).

The MRC is a member of the UKCRC, which brings together the NHS, research funders, industry, regulatory bodies, royal colleges, patient groups and academia in a UK-wide environment that facilitates and promotes high-quality clinical research for the benefit of patients. For more information, visit the UKCRC website.

The UKCRC centres funding partners are the MRC, the British Heart Foundation, Cancer Research UK, NIHR, Economic and Social Research Council, the Public Health Agency, Health and Care Research Wales, Welsh Government, the Scottish Government Chief Scientist Office and Wellcome.

See original post on MRC website.

A content analysis of tobacco and alcohol content in Netflix and Amazon Prime original programmes accessed from the UK | Research Report

Quantifying tobacco and alcohol imagery in Netflix and Amazon Prime instant video original programming accessed from the UK: a content analysis.

Alexander B BarkerJordan SmithAbby HunterJohn BrittonRachael L Murray

Exposure to tobacco and alcohol content in audio-visual media is a risk factor for smoking and alcohol use in young people. Previous UK research has quantified tobacco and alcohol content in films and broadcast television but not that of video-on-demand (VOD) services such as Netflix and Amazon Prime. Furthermore, it is not clear whether regulation by Dutch (Netflix) or UK (Amazon Prime) authorities results in differences in content. We report an analysis of tobacco and alcohol content in a sample of episodes from the most popular programmes from these two VOD providers, and compare findings with earlier studies of UK prime-time television content.

Content analysis of a sample of 50 episodes from the five highest rated series released on Netflix and Amazon Prime in 2016, using 1 min interval coding of any tobacco or alcohol content, actual or implied use, paraphernalia and branding.

bmjopen-2019-February-9-2--F1.medium
Number of 1 min intervals containing tobacco and alcohol content by coding category.

Of 2704 intervals coded, any tobacco content appeared in 353 (13%) from 37 (74%) episodes. Any alcohol content appeared in 363 (13%) intervals in 47 (94%) episodes. There were no significant differences between the two services, however the proportion of episodes containing tobacco and alcohol was significantly higher in VOD original programmes than those recorded in an earlier study of prime-time UK television.

bmjopen-2019-February-9-2--F2.medium
Alcohol branding seen in Netflix and Amazon prime instant video original programming.

Audio-visual tobacco and alcohol content is common in VOD original programmes and represents a further source of exposure to imagery causing smoking uptake and alcohol use in young people. This appears to be equally true of services regulated in the UK and The Netherlands. Given that VOD services are consumed by a global audience, it appears likely that VOD content is an important global driver of tobacco and alcohol consumption.

Strengths and Limitations of this study:

  • This study is the first to explore alcohol and tobacco content in video-on-demand (VOD) programmes.
  • Established methods were used to explore the content in VOD original content.
  • This study provides a comparison of VOD alcohol and tobacco content to UK broadcast television content.
  • This study is limited to a sample of programmes and episodes on each VOD service.
  • As viewing figures are not available for VOD original content, we could not estimate exposure to tobacco and alcohol content.

Correspondence to Dr Alex Barker; alexander.barker@nottingham.ac.uk

 

 

Are young people under the influence of alcohol content on TV? – Research Report

Alex Barker, University of Nottingham Research Fellow.

Ofcom’s 9pm watershed might not be fit for purpose, argues Alex Barker.

Alcohol use at a young age is a strong risk factor for dependence in later life, and it is important to identify avoidable causes of alcohol consumption in young people. There is strong evidence to suggest that exposure to alcohol advertising or other alcohol imagery in the media increases use in adolescents.

Whilst the Ofcom Broadcasting code protects under-18s by restricting alcohol use in TV programmes made for children and preventing the glamorisation of alcohol use in programmes broadcast before the 9pm watershed or in programmes likely to be viewed by children, a previous study from 2010 found that there is a large amount of alcohol shown on prime-time UK television. We aimed to provide contemporary data on the amount of alcohol content shown in prime-time UK television.

In our study, A content analysis of alcohol content in UK television, published in the Journal of Public Health, we investigated the amount of alcohol content shown on UK television. We recorded free-to-air prime-time TV across the five main channels (BBC1, BBC2, ITV, Channel 4 and Channel 5) between the hours of 6pm-10pm during three separate weeks in September, October and November 2015. We then recorded the amount and types of alcohol content shown using 1-minute interval coding, which involves recording any alcohol content shown in every 1-minute period in the following categories; any alcohol content, actual alcohol use, implied alcohol use, alcohol related content (such as beer pumps or bottles), and alcohol branding.

We found that alcohol content is extremely common, occurring in 14% of intervals we coded, with alcohol content being seen in 67% of programmes and 47% of advertisement/trailer periods. We found alcohol use in 2% of the total intervals, implied use in 7% of intervals and alcohol related content, such as beer pumps, in 10% of intervals. Whilst branding was uncommon, 3% of intervals, 122 brands were identified, with three brands (Heineken, Corona and Fosters) accounting for almost half of all brand occurrences. The programme genres containing the most alcohol content were ‘Cookery’ (all cookery programmes included alcohol content), ‘Soap Opera’ (99% included alcohol content) and ‘Drama’ (94% included alcohol content). The majority of alcohol content was shown before the 9pm watershed, when programmes unsuitable for children are allowed to be broadcast. The amount of alcohol content was slightly higher than in the previous study.

The majority of branding occurred through the sponsorship of programmes, such as comedy on Channel 4 (sponsored by Fosters). Advertisements are regulated by the Advertising Standards Authority (ASA) and are expected to conform to the UK Code of British Advertising (BCAP code). According to the code, alcohol ‘may not be advertised in or adjacent to children’s programmes or programmes commissioned for, principally directed at or likely to appeal particularly to audiences below the age of 18’. However, programmes popular with or watched by large numbers of young people are not necessarily made specifically for them. Branding was also commonly featured in coverage of sports events, such as Heineken, which featured predominantly during the Rugby World Cup footage. The ASA’s definition of advertising does not include sponsorship of programmes or pitch side advertisements at televised sporting events. Exemption of prime-time television and sports programmes from alcohol advertising regulations has the potential to lead to significant exposure among young people during peak viewing hours.

Television remains a major source of alcohol exposure to young people in the UK and is likely to continue to be a contributor to alcohol uptake by young people. Our results suggest that the Ofcom 9pm watershed, designed to protect children and young people from harm, is currently not fulfilling its purpose in relation to commercial advertising and alcohol content in programmes. This has the potential to lead to significant exposure among young people during peak viewing hours, when approximately 4.5 million 7–14 year olds watch television. Tighter scheduling rules from Ofcom and the ASA, such as restricting alcohol content to after the 9pm watershed, could prevent children and adolescents being exposed to alcohol content and advertising.

Written by Alex Barker, research fellow in Epidemiology and Public Health, University of Nottingham. Originally posted on ias.org.uk on 4th Feb 2019.

Electronic cigarettes: First time on a Priority Setting Partnership Group

Louise Ross – Clinical Consultant, National Centre for Smoking Cessation and Training.

When I first got the invitation to join the Priority Setting Partnership (PSP) on electronic cigarettes, I had no idea what a PSP was or did, nor had I ever heard of the James Lind Alliance (JLA), the organisation that runs the PSPs.

Electronic cigarettes for smoking cessation image Thumbnail

However, because of what I do, I’m intensely interested in e-cigarettes as a means of stopping smoking and staying stopped, so I read on…

What an opportunity it has been! It’s early days yet, but already we have formed an interactive and lively group – academics, people with lived experience, researchers and practitioners. Our task? To find out what the public want to know about e-cigarettes and vaping.

When I say ‘the public’, this includes anyone who is curious to know more through research – it could be GPs, hospital doctors, vapers, smokers, policy-makers, pregnant women, homeless people, prisoners, stop smoking practitioners – anyone who has thought ‘I really would like to see research done about xxx to do with vaping/e-cigarettes’ can respond to the survey we are sending out in January.

We haven’t got long to road-test the survey, but the team at JLA (who told us at the first meeting about some of the other PSPs they’ve been working on – who knew all this public participation was going on in research circles?) have skilfully guided us through the early steps.

So in early 2019, we will launch the survey and sit back and wait for lots of replies.

Long-term health effects? Useful for stopping smoking? Second-hand vapour? Improvements in asthma?

If you have a burning question that you’d like to see included in the list of research priorities, do fill in the survey.

Then the real work will begin, sifting through the suggestions, and deciding which are the most crucial to answer. I’m confident that we have a well-balanced, engaged and knowledgeable group to tackle this task, and I’m proud to have been included.

Original post on the James Lind Alliance website.