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.

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The public’s support for public health interventions: plain packs & MUP

YouGov have asked the public what they think about the two big public health interventions that didn’t make the Queen’s speech this year – plain packs for cigarettes and minimum unit pricing for alcohol.

There’s been some speculation as to why these policies haven’t been taken forward, was it the dark arts of lobbying, or more about the political rise of Ukip, or the failure of the policies to command the support of key ministers in the Cabinet.

What I’m interested in though is why there seems to be such different responses to these changes by the public and I’m left wondering whether it is a matter of the values messages, or just the length of time that those in tobacco control have been advocating for these sorts of interventions.

Of course it could be that one appears to be cost-free to the consumer and the other isn’t. Continue reading

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

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%