Prevention of teenage smoking through negative information giving

Some German research which looked at whether delivering negative information to young people about the effects of smoking has a preventative effect caught my eye.

In their abstract the authors conclude:

Although the clinic intervention generated a significant immediate reaction, there were no significant preventive effects at follow-up. These results are in line with previous research and add further evidence for the ineffectiveness of emotionally arousing negative information giving in smoking prevention with adolescents.

I’d be interested in whether this suggests that when NICE come to review their guidance on preventing the uptake of smoking by children and young people they will need to change their view that negative information should be part of smoking prevention information and campaigns for young people.

It has to be said that the German research contrasts with the findings of a review of health messages on tobacco products which found:

The evidence also indicates that comprehensive warnings are effective among youth and may help to prevent smoking initiation. Pictorial health warnings that elicit strong emotional reactions are significantly more effective.

The Cochrane review of mass media interventions for young people has some interesting observations on what makes for a successful campaign.  The reviewers say:

Overall, effective campaigns lasted longer with a minimum of three consecutive years, and were also more intense than less successful ones for both school based lessons (minimum eight lessons per grade) and media spots (minimum 4 weeks’ duration across multiple media channels with between 167 and 350 TV and radio spots). The timing and type of broadcast made a difference to their success, with older youths in one study preferring radio to television. Implementation of combined school based curriculum/components (i.e. school posters) and the use of repetitive media messages delivered via multiple channels (i.e. newspapers, radio, television) over a minimum period of three years contributed to successful campaigns. Changes in attitudes, knowledge or intention to smoke did not generally seem to affect the long-term success of the campaigns.

Meanwhile the recent update to the Cochrane review of school based prevention of smoking suggests that schools should combine social competence and social influences interventions.

School based programmes for smoking prevention

The Cochrane Collaboration have published a review into school based smoking prevention programmes, which updates a review of the evidence base from 2002.

The headline finding is that programmes that combine life skills and a focus on social influence seem to be the most successful, with those trials that were examined showing significant effect at one year and at the longest follow-up point.

Interestingly the review finds that a trials looking at using a social influence model on its own haven’t shown a significant effect, nor have programmes that seek to combine with interventions outside the classroom, or ones that rely on information provision alone. Continue reading

UNICEF Report Card 11 – a parochial view

As my CEO, Paul, makes clear, in our media release today about funding for prevention and early intervention through the public health grant, the UNICEF report on the health and well-being of children and young people shows us just how far we still have to travel when it comes to reducing the harm that drugs and alcohol are doing to children and young people. Continue reading

Health behaviours survey shows levels of risk taking in youth

The Department of Health have published what they say will be the first in a series of reports into the core health behaviours of target groups for their social marketing strategy.

As you’d expect I’ll focus on what it has to say about the younger people and particularly the group of 11-17 year olds.  But there’s also data on adults and on pregnant women and mothers of under 2 year olds.  Again it won’t be a surprise that the core health behaviours that I’ll pay attention to are around drugs, alcohol and tobacco. Continue reading

Early Drunkenness – why government in the UK needs to take notice

New research with young people from across Europe and North America suggests that early drunkenness increases the risks for a group of adolescent problem behaviours at the age of 15.

The researchers have examined the results of the Health Behaviours in School aged Children (HBSC) survey giving them a sample of over 40,000 15 year olds from over 38 countries where the young people have had some experience of alcohol.

What they find is a positive correlation between those who had experienced early drunkenness and 5 other risky behaviours – smoking, cannabis use, injuries, fights, and low academic performance.  Interestingly they report that when a child first uses alcohol to the time they are first drunk did not predict problem behaviours – suggesting perhaps that early drunkenness, rather than the first drink itself, should be a concern for prevention practitioners.

This blog looked at the results from the HBSC survey when they were published last year and there were details about the level of drunkenness experienced by young people in Europe.  In the survey young people were asked at what age they first got drunk. The findings presented were for 15-year-olds only and show the proportions who reported first getting drunk at age 13 or younger.

Looking at the results what we see is that the UK has results that should worry our policy makers.

Scotland has the 6th highest level of drunkenness, Wales comes in 8th and England is a place behind in 9th.

HBSC - drunk

It seems to me that it is this sort of data that ought to be driving a proper prevention strategy, and is why across the UK there is a need for a commitment to proper resources for evidence based prevention, and (to be parochial) in England we need:

  • the Department of Health to publish their response to the Children’s Health Outcomes Forum which published their report in July 2012.
  • the DfE to report on their proposals for health education, first announced in November 2010; and
  • NICE to be allowed to finish their guidance on sex and relationship guidance and alcohol education, suspended in May 2010.

Tobacco: a gateway drug?

I wanted to find a nice statistic for the overlap between cigarette smokers and cannabis smokers, so I had a look at one of the tables in Smoking Drinking and Drug Use 2011. Which was interesting. The headline statistic is that among 15 year olds surveyed in 2011, of those who had smoked tobacco in the past week, half reported drug use in the past month. This compares with 4% of ‘non-smokers’ (during the past week). ‘Risk-taking behaviours’ tend not to be in isolation, and it’s unsurprising that tobacco smokers would be more likely to smoke cannabis as well (other illegal and illicit drugs are less common among young people) but this is a very stark figure.

Table showing breakdown for smoked / not smoked

Smoked Not smoked
Alcohol, not drugs 25% 19%
Drugs, not alcohol 13% 2.4%
Both alcohol and drugs 38% 2.4%
Neither 25% 76%
Total taken drugs 50% 5%
Total drank alcohol 63% 21%

Table showing breakdown for drank in past week / not drank

Alcohol Not alcohol
Smoked, not drugs 14% 6%
Drugs, not smoked 7% 3%
Both smoked and drugs 21% 3%
Neither 57% 89%
Total taken drugs 29% 6%
Total smoked tobacco 36% 8%

Finally the original figures (table 5.4 of Smoking, Drinking & Drug Use)

Smoked only 4%
Drank alcohol only 16%
Took drugs only 2%
Smoked and drank alcohol 4%
Smoked and took drugs 2%
Drank alcohol and took drugs 2%
Smoked, drank alcohol and took drugs 6%
None of these 64%