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Background and aims Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents' perceptions of existing, and opinions about potential e-cigarette regulation. Methods Sixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed. Results Participants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e-cigarette regulation and endorsed restrictions on sales to minors, marketing and e-cigarette use in public places. Concern about potential health harms of e-cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation. Conclusions In focus group discussions, a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas. [ABSTRACT FROM AUTHOR]

Aim To examine whether receipt of alcohol industry sponsorship is associated with problematic drinking in UK university students who play sport. Methods University students ( n = 2450) participating in sports were invited to complete a pen-and-paper questionnaire by research staff approaching them at sporting facilities and in university settings. Respondents were asked whether they, personally, their team and/or their club were currently in receipt of sponsorship (e.g. money, free or subsidized travel or sporting products) from an alcohol-related industry (e.g. bars, liquor stores, wholesalers), and whether they had solicited the sponsorship. Drinking was assessed using the Alcohol Use Disorders Identification Test ( AUDIT). Results Questionnaires were completed by 2048 of those approached (response rate = 83%). Alcohol industry sponsorship was reported by 36% of the sample. After accounting for confounders (age, gender, disposable income and location) in multivariable models, receipt of alcohol sponsorship by a team (adjusted βadj = 0.41, P = 0.013), club (βadj = 0.73, P = 0.017), team and club (βadj = 0.79, P = 0.002) and combinations of individual and team or club sponsorships (βadj = 1.27, P < 0.002) were each associated with significantly higher AUDIT-consumption substance scores. Receipt of sponsorship by team and club [adjusted odds ratio ( aOR) = 2.04; 95% confidence interval ( CI) = 1.04-3.99] and combinations of individual and team or club sponsorships ( aOR = 4.12; 95% CI = 1.29-13.15) were each associated with increased odds of being classified a hazardous drinker ( AUDIT score >8). Respondents who sought out sponsorship were not at greater risk than respondents, or whose teams or clubs, had been approached by the alcohol industry. Conclusions University students in the United Kingdom who play sport and who personally receive alcohol industry sponsorship or whose club or team receives alcohol industry sponsorship appear to have more problematic drinking behaviour than UK university students who play sport and receive no alcohol industry sponsorship. Policy to reduce or cease such sponsorship should be considered. [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: Estimating ‘return on investment’ (ROI) from smoking cessation interventions requires reach and effectiveness parameters for interventions for use in economic models such as the EQUIPT ROI tool ( http://roi.equipt.eu). This paper describes the derivation of these parameter estimates for England that can be adapted to create ROI models for use by other countries. Methods: Estimates were derived for interventions in terms of their reach and effectiveness in: (1) promoting quit attempts and (2) improving the success of quit attempts (abstinence for at least 12 months). The sources were systematic reviews of efficacy supplemented by individual effectiveness evaluations and national surveys. Findings: Quit attempt rates were estimated to be increased by the following percentages (with reach in parentheses): 20% by tax increases raising the cost of smoking 5% above the cost of living index (100%); 10% by enforced comprehensive indoor public smoking bans (100%); 3% by mass media campaigns achieving 400 gross rating points (100%); 40% by brief opportunistic physician advice (21%); and 110% by use of a licensed nicotine product to reduce cigarette consumption (12%). Quit success rates were estimated to be increased by the following ratios: 60% by single‐form nicotine replacement therapy (NRT) (5%); 114% by NRT patch plus a faster‐acting NRT (2%);124% by prescribed varenicline (5%); 60% by bupropion (1%); 100% by nortriptyline (0%), 10) 298% by cytisine (0%); 40% by individual face‐to‐face behavioural support (2%); 37% by telephone support (0.5%); 88% by group behavioural support (1%); 63% by text messaging (0.5%); and 19% by printed self‐help materials (1%). There was insufficient evidence to obtain reliable, country‐specific estimates for interventions such as websites, smartphone applications and e‐cigarettes. Conclusions: Tax increases, indoor smoking bans, brief opportunistic physician advice and use of nicotine replacement therapy (NRT) for smoking reduction can all increase population quit attempt rates. Quit success rates can be increased by provision of NRT, varenicline, bupropion, nortriptyline, cytisine and behavioural support delivered through a variety of modalities. Parameter estimates for the effectiveness and reach of these interventions can contribute to return on investment estimates in support of national or regional policy decisions. [ABSTRACT FROM AUTHOR]

Background and aims Studies that report the relationship between alcohol consumption and disease risk have predominantly operationalized drinking according to a single baseline measure. The resulting assumption of longitudinal stability may be simplistic and complicate interpretation of risk estimates. This study aims to describe changes to the volume of consumption during the adult life-course according to baseline categories of drinking. Design A prospective observational study. Setting United Kingdom. Participants A cohort of British civil servants totalling 6838 men and 3372 women aged 34-55 years at baseline, followed for a mean 19.1 (standard deviation = 9.5) years. Measurements The volume of weekly alcohol consumption was estimated from data concerning the frequency and number of drinks consumed. Baseline categories were defined: non-current drinkers, infrequent drinkers, 0.1-50.0 g/week, 50.1-100.0 g/week, 100.1-150.0 g/week, 150.1-250.0 g/week and >250.0 g/week. For women, the highest category was defined as > 100.0 g/week. Baseline frequency was derived as 'daily or almost daily' and 'not daily or almost daily'. Trajectories were estimated within baseline categories using growth curve models. Findings Trajectories differed between men and women, but were relatively stable within light-to-moderate categories of baseline consumption. Drinking was least stable within the highest categories of baseline consumption (men: > 250.0 g/week; women: > 100.0 g/week), declining by 47.0 [95% confidence interval (CI) = 40.7, 53.2] and 16.8 g/week (95% CI = 12.6, 21.0), respectively, per 10-year increase in age. These declines were not a consequence of sudden transitions to complete abstention. Rates of decline appear greatest in older age, with trajectories converging toward moderate volumes. Conclusion Among UK civil servants, consumption within baseline drinking categories is generally stable during the life-course, except among heavier baseline drinkers, for whom intakes decline with increasing age. This shift does not appear to be driven by transitions to non-drinking. Cohorts of older people may be at particular risk of misclassifying former heavy drinkers as moderate consumers of alcohol. [ABSTRACT FROM AUTHOR]

Aims We investigate the extent of and factors associated with denial of previously reported cannabis and other illicit drug use, and assess the potential of hair testing for measuring substance use in general population samples. Design Birth cohort study. Setting United Kingdom, 1991-present. Participants A total of 3643 participants who provided hair and self-report measures of cannabis and other illicit drug use in the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 18 years. Measurements Denial of ever use of cannabis and other illicit drugs at age 18 following previously reported use. Positive hair drug tests for cannabis and other illicit drugs, and expected numbers of false positives and false negatives based on expected sensitivity and specificity. Findings Cannabis and other illicit drug use was reported by 1223 and 393 individuals, respectively, before age 18 years. Of these 176 (14.4%) and 99 (25.2%), respectively, denied use at age 18. Denial of cannabis use decreased with the reporting of other substances and antisocial behaviour. Cannabis and other illicit drug use at age 18 was reported by 547 (22.5%) and 203 (8.4%) individuals, respectively. Of these, 111 (20.3%) and 13 (6.4%) were hair-positive for cannabis and other illicit drugs, respectively. Based on hair testing for cannabis use we expect 0 [95% confidence interval (CI) = 0-169] false positives and 394 (95% CI = 323-449) false negatives compared to observed 362 potential false positives and 436 potential false negatives based on self-report. In hair-positive individuals, reporting the use of other substances and antisocial behaviour decreased the odds of a negative self-report. Conclusions Hair analysis provides an unreliable marker of substance use in general population samples. People who report more frequent substance use before age 18 are less likely to later deny previous substance use at age 18 than people who report occasional use. [ABSTRACT FROM AUTHOR]

Background and aims The concept of national drinking culture is well established in research and policy debate, but rarely features in contemporary alcohol policy analysis. We aim to demonstrate the value of the alternative concept of social practices for quantitatively operationalizing drinking culture. We discuss how a practice perspective addresses limitations in existing analytical approaches to health-related behaviour before demonstrating its empirical application by constructing a statistical typology of British drinking occasions. Design Cross-sectional latent class analysis of drinking occasions derived from retrospective 1-week drinking diaries obtained from quota samples of a market research panel. Occasions are periods of drinking with no more than 2 hours between drinks. Setting Great Britain, 2009-11. Cases A total of 187 878 occasions nested within 60 215 nationally representative adults (aged 18 + years). Measurements Beverage type and quantity per occasion; location, company and gender composition of company; motivation and reason for occasion; day, start-time and duration of occasion; and age, sex and social grade. Findings Eight occasion types are derived based primarily on parsimony considerations rather than model fit statistics. These are mixed location heavy drinking (10.4% of occasions), heavy drinking at home with a partner (9.4%), going out with friends (11.1%), get-together at someone's house (14.4%), going out for a meal (8.6%), drinking at home alone (13.6%), light drinking at home with family (12.8%) and light drinking at home with a partner (19.6%). Conclusions An empirical model of drinking culture, comprising a typology of drinking practices, reveals the dominance of moderate drinking practices in Great Britain. The model demonstrates the potential for a practice perspective to be used in evaluation of how and why drinking cultures change in response to public health interventions. [ABSTRACT FROM AUTHOR]

Aims To determine whether abstinence or relapse on a quit attempt in the previous year is associated with current depressive symptoms. Design Prospective cohort with approximately annual waves. Mixed-effect logistic regressions tested whether time 2 (T2) quitting status was associated with reporting symptoms at T2, and whether time 1 (T1) symptoms moderated this relationship. Setting Waves 5-8 of the Four-Country International Tobacco Control Study: a quasi-experimental cohort study of smokers from Canada, the United States, the United Kingdom and Australia. Participants A total of 6978 smokers who participated in telephone surveys. Measurements T1 and T2 depressive symptoms in the last 4 weeks were assessed with two screening items from the PRIME-MD questionnaire. Quitting status at T2: (1) no attempt since T1; (2) attempted and relapsed; and (3) attempted and abstinent at T2. Findings Compared with no attempt, relapse was associated with reporting T2 symptoms [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.33, 1.59]). Associations between T2 quitting status and T2 symptoms were moderated by T1 symptoms. Relapse was associated positively with T2 symptoms for those without T1 symptoms (OR = 1.71, 95% CI = 1.45, 2.03) and those with T1 symptoms (OR = 1.45, 95% CI = 1.23, 1.70). Abstinence was associated positively for those without T1 symptoms (OR = 1.37, 95% CI = 1.10, 1.71) and negatively for those with T1 symptoms (OR = 0.74, 95% CI = 0.59, 0.94). Age moderated these associations significantly. Relapse did not predict T2 symptoms for those aged 18-39 irrespective of T1 symptoms. The negative effect of abstinence on T2 symptoms for those with T1 symptoms was significant only for those aged 18-39 (OR = 0.61, 95% CI = 0.40, 0.94) and 40-55 (OR = 0.58, 95% CI = 0.40, 0.84). The positive effect of abstinence on T2 symptoms for those without T1 symptoms was significant only for those aged more than 55 (OR =1.97, 95% CI = 1.35, 2.87). Conclusions Most people who stop smoking appear to be at no greater risk of developing symptoms of depression than if they had continued smoking. However, people aged more than 55 who stop smoking may be at greater risk of developing symptoms of depression than if they had continued smoking. [ABSTRACT FROM AUTHOR]

Aims To estimate associations between smoking initiation, smoking persistence and smoking heaviness and caffeine consumption in two population-based samples from the Netherlands and the United Kingdom. Design Observational study employing data on self-reported smoking behaviour and caffeine consumption. Setting Adults from the general population in the Netherlands and the United Kingdom. Participants Participants from the Netherlands Twin Register [NTR: n = 21 939, mean age 40.8, standard deviation (SD) = 16.9, 62.6% female] and the Avon Longitudinal Study of Parents and Children (ALSPAC: n = 9086, mean age 33.2, SD = 4.7, 100% female). Measurements Smoking initiation (ever versus never smoking), smoking persistence (current versus former smoking), smoking heaviness (number of cigarettes smoked) and caffeine consumption in mg per day through coffee, tea, cola and energy drinks. Findings After correction for age, gender (NTR), education and social class (ALSPAC), smoking initiation was associated with consuming on average 52.8 [95% confidence interval (CI) = 45.6-60.0; NTR] and 59.5 (95% CI = 51.8-67.2; ALSPAC) mg more caffeine per day. Smoking persistence was also associated with consuming more caffeine [+57.9 (95% CI = 45.2-70.5) and +83.2 (95% CI = 70.2-96.3) mg, respectively]. Each additional cigarette smoked per day was associated with 3.7 (95% CI = 1.9-5.5; NTR) and 8.4 (95% CI = 6.9-10.0; ALSPAC) mg higher daily caffeine consumption in current smokers. Smoking was associated positively with coffee consumption and less strongly with cola and energy drinks. For tea, associations were positive in ALSPAC and negative in NTR. Conclusions There appears to be a positive association between smoking and caffeine consumption in the Netherlands and the United Kingdom. [ABSTRACT FROM AUTHOR]

Aims To investigate the association between frequency of visiting shops and noticing of tobacco point-of-sale (PoS) displays and the development of susceptibility to smoking, or smoking uptake, in secondary school students. Design Two surveys of a school based cohort study carried out in 2011 and 2012. Settings Nottinghamshire, UK. Participants A total of 2270 children aged 11-16 years from eight schools in Nottinghamshire. Measurements We investigated changes in susceptibility to smoking and smoking status in relation to frequency of visiting shops and noticing PoS displays and number of tobacco brands recognized, controlling for a range of potential confounders. Susceptibility to smoking was defined using a set of three questions covering intentions to try smoking, to smoke within the next year and likelihood of smoking if a best friend offered a cigarette. For the analysis we used multinomial logistic regression. Findings Among non-susceptible never smokers, noticing PoS displays more frequently was associated independently with an increased risk of becoming susceptible to smoking [adjusted relative risk ratio (RRR) = 1.74; 99% confidence interval (CI) = 1.13-2.69], but was not associated with smoking uptake. Recognizing a higher number of brands among non-susceptible never smokers doubled the risk of becoming susceptible to smoking and of becoming a smoker, but this did not have a significant effect on transition to smoking among susceptible never smokers. Frequency of noticing tobacco PoS displays was not associated significantly with smoking uptake among those who were susceptible never smokers at baseline. Conclusions Noticing tobacco point-of-sale displays more often and recognizing a higher number of tobacco brands is associated with an increased risk of becoming susceptible to smoking among adolescents in the United Kingdom, and recognizing a higher number of brands is associated positively with an increased risk of smoking uptake. [ABSTRACT FROM AUTHOR]

Aims Alcohol problems (AP) contribute substantially to the global disease burden. Twin and family studies suggest that AP are genetically influenced, although few studies have identified variants or genes that are robustly associated with risk. This study identifies genetic and genomic influences on AP during young adulthood, which is often when drinking habits are established. Design We conducted a genome-wide association study of AP. We further conducted gene-based tests, gene ontology analyses and functional genomic enrichment analyses to assess genomic factors beyond single variants that are relevant to AP. Setting The Avon Longitudinal Study of Parents and Children, a large population-based study of a UK birth cohort. Participants Genetic and phenotypical data were available for 4304 participants. Measurements The AP phenotype was a factor score derived from items from the Alcohol Use Disorders Identification Test, symptoms of DSM-IV alcohol dependence, and three additional problem-related items. Findings One variant met genome-wide significance criteria. Four out of 22 880 genes subjected to gene-based analyses survived a stringent significance threshold ( q < 0.05); none of these have been implicated previously in alcohol-related phenotypes. Several biologically plausible gene ontologies were statistically over-represented among implicated single nucleotide polymorphisms (SNPs). SNPs on the Illumina 550 K SNP chip accounted for ~5% of the phenotypical variance in AP. Conclusions Genetic and genomic factors appear to play a role in alcohol problems in young adults. Genes involved in nervous system-related processes, such as signal transduction and neurogenesis, potentially contribute to liability to alcohol problems, as do genes expressed in non-brain tissues. [ABSTRACT FROM AUTHOR]

Aims To investigate whether the effects of family conflict on adolescent drinking differed as a function of 5-hydroxy tryptamine transporter-linked polymorphic region ( 5- HTTLPR) genotype cross-sectionally and prospectively in two independent samples of adolescents. Design Path analysis and multi-group analysis of two prospective datasets were conducted. Settings United States and United Kingdom. Participants Sample 1 was 175 adolescents in the United States (mean age = 15 at times 1 and 2 with a 6-month interval); Sample 2 was 4916 adolescents in the United Kingdon (mean age = 12 at time 1 and 15 at time 2). Measurements In both samples, demographics, tri-allelic 5- HTTLPR genotype and perceived family conflict were assessed at time 1. Alcohol use (frequency of drinking) and alcohol misuse (frequency of intoxication, frequency of drinking three or more drinks, maximum number of drinks) were assessed at times 1 and 2. Findings A significant gene-environment interaction on alcohol misuse at time 1 was found in both sample 1 (β = 0.57, P = 0.001) and sample 2 (β = 0.19, P = 0.01), indicating that the 5- HTTLPR low-activity allele carriers exposed to higher levels of family conflict were more likely to engage in alcohol misuse than non-carriers. A significant gene-environment interaction effect on change in alcohol misuse over time was found only in sample 1 (β = 0.48, P = 0.04) but not in sample 2. Conclusions Compared with non-carriers, adolescents carrying the 5- HTTLPR low-activity allele are more susceptible to the effects of family conflict on alcohol misuse. [ABSTRACT FROM AUTHOR]

Background and Aims A ban on multi-buy discounts of off-trade alcohol was introduced as part of the Alcohol Act in Scotland in October 2011. The aim of this study was to assess the impact of this legislation on alcohol sales, which provide the best indicator of population consumption. Design, Setting and Participants Interrupted time-series regression was used to assess the impact of the Alcohol Act on alcohol sales among off-trade retailers in Scotland. Models accounted for underlying seasonal and secular trends and were adjusted for disposable income, alcohol prices and substitution effects. Data for off-trade retailers in England and Wales combined ( EW) provided a control group. Measurements Weekly data on the volume of pure alcohol sold by off-trade retailers in Scotland and EW between January 2009 and September 2012. Findings The introduction of the legislation was associated with a 2.6% (95% CI = −5.3 to 0.2%, P = 0.07) decrease in off-trade alcohol sales in Scotland, but not in EW (−0.5%, 95% CI = −4.6 to 3.9%, P = 0.83). A statistically significant reduction was observed in Scotland when EW sales were adjusted for in the analysis (−1.7%, 95% CI = −3.1 to −0.3%, P = 0.02). The decline in Scotland was driven by reduced off-trade sales of wine (−4.0%, 95% CI = −5.4 to −2.6%, P < 0.001) and pre-mixed beverages (−8.5%, 95% CI = −12.7 to −4.1%, P < 0.001). There were no associated changes in other drink types in Scotland, or in sales of any drink type in EW. Conclusions The introduction of the Alcohol Act in Scotland in 2011 was associated with a decrease in total off-trade alcohol sales in Scotland, largely driven by reduced off-trade wine sales. [ABSTRACT FROM AUTHOR]

Background and Aims Sexual minority adolescents are more likely to engage in alcohol use than their heterosexual counterparts; however, the underlying reasons remain unclear and longitudinal research is limited. Owing to evidence that this group also experiences greater depressive symptoms than their peers, we aimed to (i) assess to what extent depressed mood explains the increased likelihood of engaging in alcohol use among sexual minority adolescents, and (ii) explore potential gender-specific patterns. Design Structural equation modelling was used to test the indirect relationship between sexual orientation and alcohol use through depressed mood, with heterosexuals as the reference group. Settings and Participants A total of 3710 adolescents (12% sexual minority), from the Avon Longitudinal Study of Parents and Children ( ALSPAC) study, assessed between the ages of 15 and 18 years. Measurements Sexual orientation was assessed at age 15, while alcohol use was measured using the Alcohol Use Disorders Identification Test ( AUDIT) at age 18. Depressed mood was indexed by the Short Mood and Feelings Questionnaire ( SMFQ) at age 16. Findings Sexual minority adolescents were more likely to engage in alcohol problem use compared to their heterosexual counterparts [ Btotal = 0.12, 95%confidence interval ( CI) = 0.04-0.20, P = 0.003]. Depressed mood explained 21% of the link between sexual orientation and alcohol use after adjustment for covariates and earlier measures ( Z = 3.2, P = 0.001). No gender differences were observed. Conclusions A higher prevalence of alcohol problem use in adolescents who are gay, lesbian or bisexual is partly explained by increased rates of depression in this group. [ABSTRACT FROM AUTHOR]

Aims To investigate the prevalence of awareness of the online illicit drug marketplace Silk Road ( SR), consumption of drugs purchased from SR and reasons for use and non-use of SR. Design and setting Global Drug Survey: purposive sample collected in late 2012. Participants The base sample ( n = 9470) reported recent drug purchase and resided in the United Kingdom ( n = 4315, median age 24, 76% male), Australia ( n = 2761, median age 32, 76% male) or the United States ( n = 2394, median age 21, 80% male). Measurements Online questionnaire. Findings A total of 65% of US, 53% of Australian and 40% of UK respondents had heard of SR; 18% of US, 10% of UK and 7% of Australian respondents had consumed drugs purchased through SR. Across the three countries, 3,4-methylenedioxy-N-methylamphetamine (MDMA) was the most commonly purchased drug (53-60%), followed by cannabis (34-51%), lysergic acid diethylamide (LSD) (29-45%) and the 2C family (16%-27%). The most common reasons for purchasing from SR were wider range (75-89%), better quality (72-77%), greater convenience (67-69%) and the use of vendor rating systems (60-65%). The most common reasons for avoiding SR purchase were adequate drug access (63-68%) and fear of being caught (41-53%). Logistic regressions found that, compared with people from the UK, Australians [odds ratio ( OR) = 3.37; 95% confidence interval ( CI) = 2.29, 4.97) and Americans (OR = 1.46; 95% CI = 1.10, 1.94) were more likely to use SR due to lower prices; and to avoid SR purchase due to fear of being caught ( Australia: OR = 1.65; 95% CI = 1.39, 1.96; USA: OR = 1.62; 95% CI = 1.37, 1.92). Conclusions While reasons for Silk Road use accord with broader online commerce trends (range, quality, convenience, ratings), its appeal to drug purchasers is moderated by country-specific deterrents and market characteristics. [ABSTRACT FROM AUTHOR]

Background and Aims Research into craving is hampered by lack of theoretical specification and a plethora of substance-specific measures. This study aimed to develop a generic measure of craving based on elaborated intrusion ( EI) theory. Confirmatory factor analysis ( CFA) examined whether a generic measure replicated the three-factor structure of the Alcohol Craving Experience ( ACE) scale over different consummatory targets and time-frames. Design Twelve studies were pooled for CFA. Targets included alcohol, cigarettes, chocolate and food. Focal periods varied from the present moment to the previous week. Separate analyses were conducted for strength and frequency forms. Setting Nine studies included university students, with single studies drawn from an internet survey, a community sample of smokers and alcohol-dependent out-patients. Participants A heterogeneous sample of 1230 participants. Measurements Adaptations of the ACE questionnaire. Findings Both craving strength [comparative fit indices ( CFI = 0.974; root mean square error of approximation ( RMSEA) = 0.039, 95% confidence interval ( CI) = 0.035-0.044] and frequency ( CFI = 0.971, RMSEA = 0.049, 95% CI = 0.044-0.055) gave an acceptable three-factor solution across desired targets that mapped onto the structure of the original ACE (intensity, imagery, intrusiveness), after removing an item, re-allocating another and taking intercorrelated error terms into account. Similar structures were obtained across time-frames and targets. Preliminary validity data on the resulting 10-item Craving Experience Questionnaire ( CEQ) for cigarettes and alcohol were strong. Conclusions The Craving Experience Questionnaire (CEQ) is a brief, conceptually grounded and psychometrically sound measure of desires. It demonstrates a consistent factor structure across a range of consummatory targets in both laboratory and clinical contexts. [ABSTRACT FROM AUTHOR]

Background and aims British alcohol consumption and abstinence rates have increased substantially in the last 3 decades. This study aims to disentangle age, period and birth cohort effects to improve our understanding of these trends and suggest groups for targeted interventions to reduce resultant harms. Design Age, period, cohort analysis of repeated cross-sectional surveys using separate logistic and negative binomial models for each gender. Setting Great Britain 1984-2009. Participants Annual nationally representative samples of approximately 20 000 adults (16+) within 13 000 households. Measurements Age (eight groups: 16-17 to 75+ years), period (six groups: 1980-84 to 2005-09) and birth cohorts (19 groups: 1900-04 to 1990-94). Outcome measures were abstinence and average weekly alcohol consumption. Controls were income, education, ethnicity and country. Findings After accounting for period and cohort trends, 18-24-year-olds have the highest consumption levels (incident rate ratio = 1.18-1.15) and lower abstention rates (odds ratio = 0.67-0.87). Consumption generally decreases and abstention rates increase in later life. Until recently, successive birth cohorts' consumption levels were also increasing. However, for those born post-1985, abstention rates are increasing and male consumption is falling relative to preceding cohorts. In contrast, female drinking behaviours have polarized over the study period, with increasing abstention rates accompanying increases in drinkers' consumption levels. Conclusions Rising female consumption of alcohol and progression of higher-consuming birth cohorts through the life course are key drivers of increased per capita alcohol consumption in the United Kingdom. Recent declines in alcohol consumption appear to be attributable to reduced consumption and increased abstinence rates among the most recent birth cohorts, especially males, and general increased rates of abstention across the study period. [ABSTRACT FROM AUTHOR]

Aims To examine how changes in social roles, particularly in the family, predict rises and falls in alcohol consumption from ages 16 to 50 years. Design Longitudinal data from the National Child Development Study. Setting The birth cohort includes 99% of British infants born in 1 week in 1958. Participants After initial assessment of 17 415 infants, the cohort was interviewed at ages 7, 11, 16, 23, 33, 42, 46, and 50. This study uses the six adolescent to adult waves ( n = 7212 women, 7377 men). Measurements Alcohol use [i.e. quantity consumed in past week and heavy-daily drinking), symptoms of problem drinking (i.e. Cut-down, Annoyed, Guilt, Eye-opener ( CAGE)] and social roles (i.e. union formation, parenthood and employment). Findings Estimates from fixed-effects models demonstrate that alcohol use is lower when women reside with child(ren) under age 5, compared to occasions when they do not [estimate = −0.38, 95% confidence interval ( CI) = −0.43, −0.32 for past week units; odds ratio ( OR) = 0.47, CI = 0.36, 0.62 for heavy-daily drinking; OR = 0.66, CI = 0.50, 0.87 for CAGE symptoms]. Associations are similar for men (estimate = −0.29, CI = −0.36, −0.23; OR = 0.64, CI = 0.53, 0.77; OR = 0.69, CI = 0.51, 0.94, respectively). When women and men are married, working and residing with young child(ren), past week units (estimate = −0.51, CI = −0.61, −0.41 for women; estimate = −0.34, CI = −0.44, −0.25 for men), heavy-daily drinking ( OR = 0.49, CI = 0.30, 0.79 for women; OR = 0.47, CI = 0.35, 0.64 for men) and CAGE ( OR = 0.44, CI = 0.23, 0.83 for women; OR = 0.39, CI = 0.18, 0.82 for men) are lower compared to occasions when they are not in these roles. Conclusions From late adolescence to mid-life, women and men in Britain are most at risk for higher levels of alcohol consumption and problem drinking when family roles are absent. [ABSTRACT FROM AUTHOR]

Aims To investigate trends in volatile substance abuse ( VSA) deaths over 25 years. Design A national mortality surveillance programme with standardised data collection procedures. Setting The UK and islands. Participants/Measurements All VSA deaths, 1983-2007. Findings In the five quinquennia from 1983 to 2007 the numbers of VSA deaths were 499, 609, 378, 349 and 258 respectively. There were gradual increases in the mean age at death in males and females and in the number of VSA deaths in women. Coincident with the 1992 Department of Health Advertising Campaign, VSA deaths in boys and girls (<18 years of age) fell by an estimated 56% (95% CI: 36%-70%) and 64% (20%-84%), respectively, from the underlying trend, but there was no evidence of any similar step change in either group following the 1999 Legislation prohibiting sales of cigarette lighter refills containing butane to those under the age of 18 years. Between 1983-1987 and 2003-2007, the ratio of aerosol to gas fuel deaths fell by an estimated 80% (57% to 91%) in adults, while the ratio of glue to gas fuel deaths fell by an estimated 95% (89% to 97%) in adults and an estimated 87% (−1% to 98%) in children. Conclusions Between 1983 and 2007, in the United Kingdom, the numbers of deaths associated with volatile substance abuse peaked in the early 1990s and fell to their lowest level in the mid-2000s. The age at death increased in both males and females. There was a fall in the proportion of volatile substance abuse deaths involving glues and a rise, particularly in adults, in the proportion involving gas fuels. [ABSTRACT FROM AUTHOR]

Aims Although smoking prevalence among people with severe mental illness is high, it remains largely unaddressed. This pragmatic pilot project aimed to develop and implement a tailored tobacco dependence service in mental health settings and to assess its impact, as well as barriers and facilitators to implementation. Design An integrative service model, spanning acute, rehabilitation and community services, including the design of tailored instruments and referral pathways, delivered by two mental health professionals. Setting and participants Four adult acute and two rehabilitation wards (129 beds), and the community recovery team (2038 cases) of the United Kingdom's largest Mental Health Trust. Measurements Audit of smoking information in patient notes; service uptake; quit attempts; smoking cessation and reduction; qualitative data on implementation barriers/facilitators. Findings A total of 110 patients attended at least one support session: 53 inpatients (23% of inpatient smokers) and 57 community (of unknown number of community smokers, as recording of smoking status is not mandatory). Thirty-four of these (31%) made a quit attempt; 17 (15%) stopped smoking and 29 (26%) reduced cigarette consumption by up to 50% at the final contact. Barriers to service implementation related to: (i) trust policy, systems and procedures, (ii) staff knowledge and attitudes and (iii) illness-related factors. Conclusions Despite the strong anti-smoking climate in the United Kingdom, including a law requiring smoke-free policies in mental health settings, establishing a smoking cessation treatment service for people with mental illness proved difficult, due to complex systemic barriers. However, there is clearly a demand, by patients, for such a service. [ABSTRACT FROM AUTHOR]

Aims To evaluate the effect of tobacco control media campaigns and pharmaceutical company-funded advertising for nicotine replacement therapy ( NRT) on smoking cessation activity. Design Multiple time series analysis using structural vector autoregression, January 2002- May 2010. Setting England and Wales. Data sources Tobacco control campaign data from the Central Office of Information; commercial NRT campaign data; data on calls to the National Health Service ( NHS) stop smoking helpline from the Department of Health; point-of-sale data on over-the-counter ( OTC) sales of NRT; and prescribing data from The Health Improvement Network ( THIN), a database of UK primary care records. Measurements Monthly calls to the NHS stop smoking helpline and monthly rates of OTC sales and prescribing of NRT. Findings A 1% increase in tobacco control television ratings ( TVRs), a standard measure of advertising exposure, was associated with a statistically significant 0.085% increase in calls in the same month ( P = 0.007), and no statistically significant effect in subsequent months. Tobacco control TVRs were not associated with OTC NRT sales or prescribed NRT. NRT advertising TVRs had a significant effect on NRT sales which became non-significant in the seasonally adjusted model, and no significant effect on prescribing or calls. Conclusions Tobacco control campaigns appear to be more effective at triggering quitting behaviour than pharmaceutical company NRT campaigns. Any effect of such campaigns on quitting behaviour seems to be restricted to the month of the campaign, suggesting that such campaigns need to be sustained over time. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To assess longer-term outcomes of a drop-in rolling-group model of behavioural support for smoking cessation and the factors that influence cessation outcomes. Design Prospective observational cohort study. Setting Fag Ends NHS Stop Smoking Service in Liverpool and Knowsley, UK. Participants A total of 2585 clients, aged 16 or over, setting a quit date. Measurements Routine monitoring data were collected from Fag Ends service users and were supplemented by survey data on socio-economic circumstances, smoking-related behaviour and self-report and carbon monoxide (CO)-validated smoking status at 52-week follow-up. Findings The CO-validated prolonged abstinence rate at 52 weeks for smokers attending the groups was 5.6%, compared with 30.7% at 4 weeks (a relapse rate of 78.2%). The sample was particularly disadvantaged: 68% resided in the most deprived decile of the English Index of Multiple Deprivation. Higher socio-economic status within the sample was a predictor of quitting. Other predictors of long-term cessation in multivariate analysis included older age, being female, lower levels of nicotine dependence, having a live-in partner, stronger determination to quit and use of varenicline versus other medication. Conclusions A wholly state-reimbursed clinical stop-smoking service providing behavioural support and medication in a region of high economic and social disadvantage has reached a significant proportion of the smoking population. Long-term success rates are lower than are found typically in clinical trials, but higher than would be expected if the smokers were to try and quit unaided. Research is needed into how to improve on the success rates achieved. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim To identify predictors of short-term smokeless tobacco cessation in Bangladeshi women resident in the United Kingdom. Design Prospective cohort study. Setting A tobacco cessation service offering culturally tailored smokeless tobacco cessation support. Participants A total of 419 Bangladeshi women chewing paan with tobacco. Measurements Demographics, tobacco use and dependence and cessation attempt process and outcomes. Findings Client mean age was 48.92 [95% confidence interval (CI) 47.5, 50.34] years and the mean area social deprivation score was 3.65 (95% CI 3.33, 3.97). Mean daily smokeless tobacco intakes, as paan, was 9.96 (95% CI 9.22, 10.7); 69.8% were recruited from primary care, 78.8% received behavioural support and nicotine replacement therapy (NRT) and the remainder behavioural support alone. Self-reported 4-week continuous abstinence was 58.3%, predicted by NRT use [odds ratio (OR) = 4.93, 95% CI 2.02, 12.00], community recruitment (OR = 1.84, 95% CI 1.01, 3.35) and relatively lower social deprivation (IMD) score (OR = 1.98, 95% CI 1.18, 3.33). Conclusion Bangladeshi women in the UK attending clinics to help cessation of paan with tobacco appear to be more likely to be successful in the short term if they use nicotine replacement therapy, are recruited via the community and have relatively lower levels of social deprivation. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Depressive symptomatology can increase risk of development of alcohol problems in young people. Tension reduction and family interactional theories may explain the relationship between depression and problematic alcohol use in youth. This study addresses the nature of the longitudinal relationship between these two behaviours. The available literature is currently inconclusive about whether there are gender differences in these relationships; this is also examined. Design The association between childhood depressive behaviours and adolescence problematic alcohol use was examined using ordered logistic regression models. Evidence of gender differences and the impact of relevant covariates on these relations were examined. Missing data were imputed using a Multiple Imputation by Chained Equation (MICE) approach. Settings The Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK population-based birth cohort. Participants A total of 4220 British boys and girls. Measurements Depressive symptomatology was assessed in childhood (mean age = 10.6, SD = 0.2) using the Short Mood and Feelings Questionnaire (SMFQ). Problematic alcohol use was assessed from several questions queried in adolescence (mean age = 13.8, SD = 0.2). Findings Childhood depressive symptoms were associated with increased risk of problematic alcohol use in early adolescence for girls [odds ratio (OR) = 1.14, P = 0.016] but not boys. This association for girls weakened (OR = 1.12, P = 0.058) when a priori selected covariates were taken into account, particularly the family and greater social environment. Conclusions Problematic alcohol use in girls (but not boys) is associated with prior depressive symptoms. This association may be attributable to several family and social environment factors, suggesting that a family interactional theoretical model may explain these findings. [ABSTRACT FROM AUTHOR]