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. 

Advertisements

Alcohol Problems Policy & Practice Masters Module | Kings College London | 4 – 8th Feb 2019

“It was FANTASTIC and I would strongly recommend others to attend”

Leading academics from King’s and across the 13 universities in the UKCTAS will present and discuss the latest evidence. Speakers include Sir Ian Gilmore (Alcohol Health Alliance), Professor Colin Drummond, Professor Mark Petticrew (LSHTM), Katherine Brown (Institute of Alcohol Studies) and Dr. James Nicholls (Alcohol Research UK). Many of the inputs have broader public health relevance beyond alcohol, to other health issues such as tobacco, obesity and inequalities.

After successfully running the module for three years, we are delighted to announce the module will return again in 2019 to King’s College London. In 2019 we will welcome a large number of top class speakers to discuss important areas of this public health issue. With topics ranging from alcohol and pregnancy, alcohol marketing and brief interventions, we can guarantee this course is invaluable to anyone working in this area.

MAIN AIMS OF THE MODULE:

• Enhance students’ understanding of research methods by focusing on current research in alcohol policy and interventions.
• Enable critical appraisal of evidence in alcohol policy interventions.
• Explore the role and perspectives of key stakeholders including the alcohol industry and the role of media and marketing in alcohol use.

PLACES ARE LIMITED!

Places will be allocated on a first come, first served basis. Student numbers are capped at 40 to ensure an effective learning experience and teacher-student ratio.
Early bird discounts apply until 14th December 2018.

Applications will not be taken after 1st February 2019.

If you are unsure about its suitability for your needs please contact Dr. Sadie Boniface (sadie.boniface@kcl.ac.uk).

More information: ukctas.net/alcoholmasters

Advertising for alcohol is prevalent in UK Television| Research Report

A recent study in the Journal of Public Health indicates that advertising for alcohol is common in British television, and is therefore a potential driver of alcohol use in young people.

It is estimated that the rate of alcohol consumption in those over 15 in the UK is the eighth highest in Europe. Alcohol use was responsible for at least 6813 deaths in the country in 2015, and cost the NHS £3.5 billion in 2013–14.

There is strong evidence that exposure to advertising or other alcohol imagery in the media increases subsequent use in adolescents. An estimated 28 million British households have at least one television and in 2015 the average viewing was 3 hours and 47 minutes a day. Previous studies have found that alcohol imagery appeared frequently in studies of UK television; some 40 per cent of programmes contained alcohol content.

In 2015, researchers quantified the content of all programmes and advertisements broadcast on the five, free access, national UK channels. The researchers here explored the differences in content between channels and genres, and compared these with the findings of a similar study in 2010.

A total of 611 programmes and 1140 commercials were recorded during the peak viewing hours, between 6 and 10 pm, from Monday to Sunday in three separate weeks. Alcohol imagery occurred most frequently in the news, current affairs programmes, and soap operas.

This study demonstrates that alcohol imagery is extremely common on UK television, occurring in over 50% of all programmes broadcast and almost 50% of all advertising periods between programmes. The majority of alcohol content occurred before 9 pm. Branding occurred in 18% of programmes and 11% of advertisement periods and involved 122 brands, though three brands (Heineken, Corona, and Fosters) accounted for almost half of all brand appearances.

Alcohol content shown on TV has an effect on the uptake of alcohol use in young people. This analysis shows that 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, with levels of content slightly higher than the researchers observed in the earlier analysis of programme content from 2010.

“There is strong evidence that viewing alcohol advertising or imagery has an uptake on subsequent alcohol use in young people,” says Dr Alex Barker, a UKCTAS funded Research Fellow at the University of Nottingham.

“Our study shows that alcohol imagery, including branding, is regularly broadcast on prime-time TV, when children and adolescents are likely to be watching. Tighter scheduling rules from the Advertising Standards Agency and Ofcom (broadcast regulator), such as restricting alcohol advertisements and alcohol imagery in programmes, to after the 9 p.m. watershed, could prevent children and adolescents being exposed to this content.”

Direct correct questions about the study to:
Alexander B. Barker
UK Centre for Tobacco and Alcohol Studies
Division of Epidemiology and Public Health
University of Nottingham
Clinical Sciences Building
City Hospital, Nottingham
NG5 1PB, UK
alexander.barker@nottingham.ac.uk

To request a copy of the study, please contact:
Cassie Jane Buckley
CassieJane.Buckley@oup.com

Sharing on social media? Find Oxford Journals online at @OxfordJournals
Please acknowledge the Journal of Public Health as a source in any articles.
DOI: 10.1093/pubmed/fdy142

Tobacco content still common on UK prime time TV, despite regulations | Research Report

Tobacco content still common on UK prime time TV, despite regulations

Likely to heavily influence young people’s take-up of smoking, say researchers

Tobacco content remains common on UK prime time TV,  cropping up in a third of all programmes, despite advertising and broadcasting regulations designed to protect children from this kind of exposure, reveals research published online in the journal Tobacco Control.

The amount of exposure has hardly changed in five years, and is likely to heavily influence young people’s take-up of smoking, say the researchers.

Tobacco content in film has been covered extensively, but relatively little attention has been paid to its inclusion on prime time TV, despite the fact that children are likely to spend more time watching TV than they are films, they point out.

The researchers therefore analysed the tobacco content of all programmes, adverts, and trailers broadcast on the five national free to air TV channels between 1800 and 2200 hours during the course of three separate weeks in September, October, and November 2015.

Their analysis included any actual or implied use, such as holding a cigarette without smoking it, or making a comment about smoking; smoking/tobacco paraphernalia; and presence of branding in 1 minute intervals. The results were then compared with those of a similar analysis carried out in 2010.

In all, 420 hours of broadcast footage, including 611 programmes, 909 adverts, and 211 trailers, were analysed.

Some 291 broadcasts (17% of all programmes) included tobacco content. The channel with the most tobacco content was Channel 5, and the one with the least was BBC2.

Tobacco content occurred in one in three TV programmes broadcast, and nearly one in 10 (8%) adverts or trailers.

Actual tobacco use occurred in one in eight (12%) programmes, while tobacco related content–primarily no smoking signs–occurred in just 2 percent of broadcasts. Implied use and branding were rare.

 

Although most tobacco content occurred after the 9 pm watershed, it still occurred on the most popular TV channels before then.  And comparison with the previous analysis in 2010 showed that the number of 1 minute intervals containing any tobacco content increased, rising from 731 to 751 in 2015.

Tobacco advertising, promotion and sponsorship, including paid product placement in TV adverts, is banned in the UK, but tobacco imagery in TV programmes and trailers is exempt, and covered instead by media regulator, OfCom’s, broadcasting code.

This code is designed to protect children by restricting depictions of tobacco use in children’s programmes, and preventing the glamorisation of smoking in programmes broadcast before 9 pm.

“Audiovisual tobacco content remains common in prime-time UK television programmes and is likely to be a significant driver of smoking uptake in young people,” emphasise the researchers.

“Guidelines on tobacco content need to be revised and more carefully enforced to protect children from exposure to tobacco imagery and the consequent risk of smoking initiation,” they added.

‘The number of smokers in the UK has fallen significantly since 2010 yet this research finds smoking is just as common on our screens. Given the proven link to childhood smoking Ofcom and the BBFC, which regulate TV and films, need to take the necessary steps to warn parents of the risks and protect our children from the harmful effects of tobacco imagery.’ 

Deborah Arnott, chief executive of Action on Smoking and Health.


Notes for editors:

Research:  Content analysis of tobacco content in UK television doi 10.1136/tobaccocontrol-2018-054427

Journal: Tobacco Control

Link to Academy of Medical Sciences press release labelling system: http://press.psprings.co.uk/AMSlabels.pdf

Author contact: Dr Alex Barker, Division of Epidemiology & Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK. Email: alexander.barker@nottingham.ac.uk

Other links:
Tobacco on TV influences children, study finds | iNews

Smoking scenes are still common in a THIRD of prime time TV programmes despite strict regulations to protect children, finds study | Daily Mail

“The really interesting thing we found was that vaping may also encourage people who don’t even want to stop smoking, to eventually quit” Dr Caitlin Notley | University of East Anglia

Vaping helps people stop smoking – even when they don’t want to, according to new research from the University of East Anglia. A new study, funded by CRUK published today shows that smokers who switch to vaping may be better able to stay smoke-free in the long term. And that even people who didn’t want to stop smoking, have eventually quit because they found vaping more enjoyable.

Lead researcher Dr Caitlin Notley from UEA’s Norwich Medical School said: Image result for vaping phe

“E-cigarettes are at least 95 per cent less harmful than tobacco smoking, and they are now the most popular aid to quitting smoking in the UK. However the idea of using e-cigarettes to stop smoking, and particularly long-term use, remains controversial. We wanted to find out about how people use e-cigarettes to quit smoking – and whether vaping supports long-term smoking abstinence.”

The research team carried out in-depth interviews with 40 vapers. They asked them about their tobacco smoking history and prior quit attempts, and about how they started vaping, their vape set up, preferred flavours and strength, and whether they had switched to vaping in attempt to quit smoking. They also asked them about situations and experiences that caused them to relapse into tobacco smoking.

“We found that vaping may support long-term smoking abstinence,” said Dr Notley. “Not only does it substitute many of the physical, psychological, social and cultural elements of cigarette smoking, but it is pleasurable in its own right, as well as convenient and cheaper than smoking. Our study group also felt better in themselves – they noticed better respiratory function, taste and smell. But the really interesting thing we found was that vaping may also encourage people who don’t even want to stop smoking, to eventually quit.”

While most of the sample group reported long histories of tobacco smoking and multiple previous quit attempts, a minority (17 per cent) said they enjoyed smoking and had never seriously attempted to quit.

“These were our accidental quitters,” said Dr Notley. “They hadn’t intended to quit smoking and had tried vaping on a whim, or because they had been offered it by friends. They went on to like it, and only then saw it as a potential substitute for smoking.”

“Many people talked about how they saw vaping was a no pressure approach to quitting,” she added. While most of the group switched quickly and completely from smoking to vaping, some found themselves using both cigarettes and vaping, and then sliding towards stopping smoking.

“We found that people did occasionally relapse with a cigarette, mainly due to social or emotional reasons, but it didn’t necessarily lead to a full relapse. This study suggests that vaping is a viable long-term substitute for smoking, with substantial implications for tobacco harm reduction.”

Alison Cox, director of cancer prevention at Cancer Research UK, who funded the project said: “The evidence so far shows that e-cigarettes are far safer than tobacco. E-cigarettes do still contain nicotine which is addictive, but it’s not responsible for the major harms of smoking. This is why they have great potential as an aid to help people quit smoking for good. It’s great to see this early indication that e-cigarettes could encourage smokers who weren’t originally thinking of quitting to give up. But more research is needed to understand exactly how e-cigarettes are being used by people who don’t want to stop smoking and how often this results in quitting. E-cigarettes are just one option for quitting – your local Stop Smoking Service can give you free advice on the best method for you, and with their support you’ll have the best chance of success.”

###

‘The unique contribution of e-cigarettes for tobacco harm reduction in supporting smoking relapse prevention’ is published in Harm Reduction Journal on June 20, 2018.

Original article: How vaping helps even hardened smokers quit – Eurekalert

New study finds no clear evidence that nicotine “preloading” helps smokers to quit | University of Oxford

There is insufficient evidence to show that using nicotine patches for four weeks before a quit attempt (known as “preloading”) improves long-term smoking abstinence, finds a trial published by The BMJ this week.

The researchers found that nicotine preloading reduces craving intensity and seems to make quitting easier, but that this beneficial effect may have been masked by a concurrent reduction in the use of varenicline in the period after quit day. As varenicline is the most effective smoking cessation drug, this may have undermined the benefit of preloading.

Nicotine patch

If it were possible to overcome this unintended consequence, nicotine preloading “could lead to a worthwhile increase in long term smoking abstinence,” they say.

The research was funded by the National Institute for Health Research.

Although there have been several new drugs for tobacco cessation since the 1970s, treatment has remained largely the same, with behavioural support to motivate and strengthen a person’s resolve to remain abstinent and drugs to reduce the strength of urges to smoke after quit day.

Some studies have suggested that using nicotine replacement therapy before a quit attempt is more effective than when used in the conventional way to support abstinence, while other studies suggest preloading has no effect.

A research team from the UK Centre for Tobacco and Alcohol Studies, led by Professor Paul Aveyard at the University of Oxford, set out to examine the effectiveness of a nicotine patch worn for four weeks before a quit attempt. Continue reading

Serving smaller alcoholic drinks could reduce the UK’s alcohol consumption | Research Report | University of Liverpool

New research published in Addiction, conducted by researchers from the Universities of Liverpool and Sheffield, highlights the potential benefits of reducing the standard serving size of alcoholic beverages.

It is well known that alcohol consumption contributes to premature death and ill health, and alcohol-related harm places a substantial burden on society. Many drinkers find it hard to cut down and attempts to cut down often do not lead to actual reductions in alcohol consumption. Therefore, changes to the environment that make it easier for people to drink less could have a substantial impact on public health.

One potential environmental influence on alcohol consumption is serving size. Nutrition research consistently shows that portion sizes affect how much a person eats. People eat more if they are given a relatively large portion of food compared to smaller portions, but they do not compensate for this by eating less later on. However, the effect that serving size has on alcohol consumption has not been examined until now. The present research aimed to investigate if reducing the serving size of alcoholic beverages would reduce alcohol consumption.

alcohol1.jpg

Standard vs Reduced serving sizes:

The researchers, led by Dr Inge Kersbergen from the University of Liverpool, tested the effects of reducing the serving size of alcohol on how much alcohol participants drank in two studies.

In the first study, participants were randomized to consume alcohol from standard or reduced serving sizes whilst watching a one-hour TV programme in a laboratory that looks like a living room. Standard serving sizes contained 2.07 units per serving (equivalent to a pint of weak lager) and reduced serving sizes contained 25% less than the standard serving.

In the second study, participants were invited to one of four pub quiz nights in a local bar which only sold standard vs. reduced serving sizes. Standard servings were pints and 175ml of wine (‘typically served as a medium glass in pubs’) and reduced servings were 2/3 pints and 125ml of wine (‘small glass’). Drink prices were adjusted to make sure that the standard and reduced serving sizes were the same value for money. Researchers observed how much alcohol each participant drank.

In both experiments, participants could order as many drinks as they wanted for the duration of the experiment. This means that participants drinking from reduced servings could compensate for the smaller serving size by ordering more drinks if they wanted to.

The researchers found that participants who were served relatively smaller servings drank less alcohol in a single drinking session than participants who were served standard servings. In the first study, reduced serving sizes led to a 20.7% – 22.3% decrease in alcohol consumption over a one-hour drinking period in the ‘living room’ lab. In the second study, reduced serving sizes led to a 32.4% – 39.6% decrease alcohol consumption over a longer drinking period (up to three hours) during the real-life pub quiz.

Based on the results the researchers used the Sheffield Alcohol Policy Model to estimate that reducing the standard serving size of beer, wine and cider in bars and restaurants by a quarter would lead to 1,400 fewer deaths and 73,000 fewer hospital admissions every year.

Public health intervention:

Dr Kersbergen, said: “These studies are the first to demonstrate that reducing the serving size of alcoholic beverages prompts reductions in alcohol consumption.

The typical serving size of beer in the UK of a pint is larger than many other countries and the size of wine servings in UK bars and restaurants has increased in recent decades, so there is room for serving sizes to be reduced without making them unrealistically small. Reducing the standard serving size of alcohol in bars and restaurants may be an effective way to reduce alcohol consumption at the population level and improve public health.”

Professor Matt Field, who leads the Addiction research group within the Department of Psychological Sciences at the University of Liverpool, added: “Reducing the standard serving size of alcoholic drinks could automatically prompt people to drink less, even if they are not motivated to cut down. But at the same time, the total amount that people consume would remain completely their own choice”.

Dr Eric Robinson, a University of Liverpool researcher who was also involved in the study, said: “Our research showed that people do not seem to compensate for the smaller servings by ordering more drinks on a single night and it seems unlikely that any further compensation would happen, but future research is needed to find out if people may compensate in other ways, such as drinking more often or getting stronger drinks.”

The full study, entitled ‘Reducing the standard serving size of alcoholic beverages prompts reductions in alcohol consumption’, can be found here and was funded in part by an MRC research grant awarded to Dr Eric Robinson.

Original post 14/05/2018: University of Liverpool News