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.

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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

 

 

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.”

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‘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

New Publication from the Sheffield Alcohol Research Group: Model-based appraisal of the comparative impact of Minimum Unit Pricing and taxation policies in Wales

Three quarters of all alcohol consumed in Wales is drunk by less than a quarter of the adult population who are hazardous or harmful drinkers and spend up to £2,882 per year on booze, research has revealed.

A report looking into the potential impact of minimum unit pricing and taxation policies in Wales was published Thursday 22nd February by the Sheffield Alcohol Research Group at the University of Sheffield.

The publication, which found that the 3% of the population who are harmful drinkers, account for 27% of all alcohol consumed, comes after the Welsh Government announced a new Bill that, if agreed by the National Assembly, will introduce a minimum price for the sale of alcohol.

The Bill, which is designed to reduce hazardous and harmful drinking would make it an offence for alcohol to be supplied below that price.

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Health Secretary, Vaughan Gething said: “People who drink alcohol at hazardous and harmful levels drink 75% of the alcohol consumed in Wales.

“The introduction of a minimum unit price would be effective in reducing alcohol consumption among these groups, as well as reducing the number of alcohol-related deaths and hospitalisations.”

The availability of cheap, strong alcohol is estimated to lead to 50,000 alcohol-related hospital admissions a year, costing the Welsh NHS £120 million annually and, in 2015, there were 463 alcohol-related deaths in Wales.

The report reveals the population of Wales buys 50% of its alcohol for less than 55p per unit, 37% for less than 50p per unit and 27% for less than 45p per unit, with heavier drinkers being more likely to buy alcohol sold below these thresholds.

Mr Gething said: “The report shows the greatest impact of a minimum unit price would be on the most deprived harmful drinkers, while moderate drinkers would experience only small impacts on their alcohol consumption and spending.

“This is because moderate drinkers tend to buy alcohol which would be subject to little or no increase in price under the policy.

“If passed, this law will potentially save lives.”

The research also shows harmful drinkers spend an average £2,882 a year on alcohol, or around £7.80 per day, compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.

The Sheffield Alcohol Research Group, commissioned by the Welsh Government in June 2017 to update a 2014 appraisal of the likely impact of a range of minimum unit pricing policies, concluded a minimum unit price set at between 35p and 70p would be effective in reducing alcohol consumption among hazardous and, particularly, harmful drinkers.

Research highlights:

  • Moderate drinkers drink an average of 211 units of alcohol per year compared to 1,236 for hazardous drinkers and 3,924 for harmful drinkers.
  • Harmful drinkers spend an average £2,882 a year on alcohol compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.
  • Alcohol-attributable deaths and hospital admissions are concentrated in hazardous and particularly harmful drinkers who are more deprived.

External news coverage:

75% of alcohol in Wales is drunk by just over a fifth of the population according to new report – ITV News

Minimum alcohol price help call for ‘hazardous’ drinkers – BBC News

75% of alcohol drunk in Wales consumed by 22% of the population, report says – Guernsey Press