Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. Researchers from UKCTAS at the University of Nottingham trialed a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking.
This was an open-label, parallel, randomised controlled trial carried out in deprived communities around Nottingham City and County.
The trial worked with caregivers who live in Nottingham City and County in England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home.
The research compared a complex intervention that combined personalised feedback on home air quality, behavioural support and nicotine replacement therapy for temporary abstinence with usual care.
The primary outcome was change in air quality in the home, measured as average 16–24 hours levels of particulate matter of <2.5 µm diameter (PM2.5), between baseline and 12 weeks. Secondary outcomes included changes in maximum PM2.5, proportion of time PM2.5 exceeded WHO recommended levels of maximum exposure of 25 µg/mg3, child salivary cotinine, caregivers’ cigarette consumption, nicotine dependence, determination to stop smoking, quit attempts and quitting altogether during the intervention.
Geometric mean PM2.5 decreased significantly more (by 35.2%; 95% CI 12.7% to 51.9%) in intervention than in usual care households, as did the proportion of time PM2.5 exceeded 25 µg/mg3, child salivary cotinine concentrations, caregivers’ cigarette consumption in the home, nicotine dependence, determination to quit and likelihood of having made a quit attempt.
The team concluded that by reducing exposure to SHS in the homes of children who live with smokers unable or unwilling to quit, this intervention offers huge potential to reduce children’s’ tobacco-related harm.
Just as vapers in several countries began to feel like events may finally be turning in favor of e-cigarettes as a harm reduction tool, the harsh realities of the global public health movement shattered any optimism.
The World Health Organization is just wrapping its Conference of the Parties to the Framework Convention on Tobacco Control, known as COP7, in India and according to professor John Britton, Chair of the Tobacco Advisory Group at the Royal College of Physicians in Britain (RCP), the future for vaping looks bleak.
The RCP, Public Health England and the UK Centre for Tobacco and Alcohol Studies have all endorsed e-cigarettes as a vital tool in the battle to end the tobacco epidemic.
Tune in to this special edition of RegWatch and learn why officials from England’s top public health organizations fear that pending WHO regulatory action on e-cigarettes could kill millions of people.
Images and references to alcohol and tobacco in popular video games may be influencing UK teens who play the games and the age restriction system is not working, according to a new study.
Experts from the UK Centre for Tobacco and Alcohol Studies at The University of Nottingham have carried out the first ever analysis of best-selling video games to find out the extent to which the games include this content and to assess the link between playing the games and drinking and smoking behaviour.
They found that teenagers who play video games featuring alcohol and tobacco references appeared to be directly influenced because they were twice as likely to have tried smoking or drinking themselves.
‘Cut scenes’ on YouTube
The research examined the content of 32 UK best-selling video games of 2012/2013 and carried out a large online survey of adolescents playing games with alcohol and tobacco content. An analysis of ‘cut scenes’ uploaded by gamers to YouTube from the five most popular games was also carried out. All the games studied were from the genres of stealth, action adventure, open world, shooter and survival/horror because they involve avatars that look and act like real people.
The study, published in the journal Cyberpsychology, Behavior and Social Networking, found alcohol and tobacco content in 44% of the most popular video games. They also found this content was not reported by the official regulator, the Pan-European Games Information (PEGI) system which informs the Video Standards Council age ratings that help parents decide whether game content is suitable for their children.
The researchers used YouGov survey tools to ask 1,094 UK adolescents aged 11-17 whether they had played any of the most popular video games identified as containing either tobacco or alcohol imagery. They were also asked whether and to what extent they smoked or drank alcohol. The study found that adolescents who had played at least one game with tobacco or alcohol content were twice as likely to have tried smoking or consumed alcohol themselves.
Out of the top five most popular games, Grand Theft Auto V & VI contained the highest level of alcohol and smoking content using fictitious brands only. The other top games containing these references were Call of Duty:Black Ops II, Call of Duty:Modern Warfare 3 and Assassin’s Creed III. There was no electronic cigarette content.
Psychologist Dr Joanne Cranwell from the UK Centre for Tobacco and Alcohol Studies, said:
”Although around 54% of UK adolescents play video games online, parental concern over exposure to inappropriate content while playing video games seems to be lower than for other media, like movies for example. While 80% of children aged 10-15 play packaged or online video games with an age rating higher than their age, more than half of British parents are unaware of the harmful content this exposes them to.
Video games are clearly attractive to adolescents regardless of age classification. It appears that official PEGI content descriptors are failing to restrict youth access to age inappropriate content. We think that the PEGI system needs to include both alcohol and tobacco in their content descriptors. Also, game developers could be offered incentives to reduce the amount of smoking and drinking in their games or to at least reference smoking and drinking on their packaging and websites.
As a child protection method it is naïve for both the games industry and the Interactive Software Federation of Europe, who regulate the PEGI system, to rely on age ratings alone. Future research should focus on identifying the levels of exposure in terms of dose that youth gamers are exposed to during actual gameplay and the effects of this on long- term alcohol and smoking behaviour.”
Our findings provide strong evidence that smoking in prisons in England is a source of high second-hand smoke exposure for staff members and prisoners. We are pleased that these findings have been instrumental in the National Offender Management Service (NOMS) decision to start their smoke-free roll out throughout prisons in England and Wales from next month. The harms of second-hand smoke are well established, this move will improve the health and well-being of those who live and work in prisons in England and Wales.
It is estimated that around 80% of the prison population smoke and we appreciate that this is the start of a long journey towards a completely smoke-free prison estate in the UK. However, we know that Young Offender Institutes and Mental Health Units in England, and prisons in other countries with similar penal systems have all implemented similar smoke-free policy and it often soon becomes the norm.
UKCTAS will continue our collaborative work with NOMS and work closely with the four pilot prisons in the South-West to evaluate their move towards becoming smoke-free in 2016. NOMS have outlined a phased approach for all remaining prisons in England to go smoke-free in the future.