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ABSTRACT Aim This paper provides a historical overview of licensing law in Scotland. It seeks to put important contemporary policy developments into their historical context and to draw attention to key themes in licensing policy debates across the United Kingdom. Design Based on a survey of statutes, commissions of enquiry and consumption and retail data, this paper draws together historical evidence to present a synopsis of Scottish licensing history. Settings The article focuses on Scotland, but also discusses UK-wide licensing policy over a 250-year period. Findings Scottish licensing has diverged from licensing in England and Wales and has addressed some historical licensing weaknesses, including problems of accountability, overprovision and systemic oversight regarding off-sales. Distinctive features of current Scottish legislation include public health protection as a statutory licensing objective; local Licensing Forums and Licensing Standards Officers; a requirement for explicit policies on the 'overprovision' of licensed premises; mandatory restrictions on price promotions in the on- and off-trades; and limitations on opening hours for off-licences. Conclusion Scotland has developed alcohol policies several times addressing long-standing licensing weaknesses throughout the United Kingdom. Some Scottish alcohol policies have later become the norm in England and Wales. [ABSTRACT FROM AUTHOR]

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]

Background and aims: Mortality and drug treatment data suggest that the median age of people who inject drugs is increasing. We aimed to describe changes in the characteristics of people injecting drugs in the United Kingdom (UK). Design: Repeat cross‐sectional surveys and modelling. Setting: Low‐threshold services in the United Kingdom such as needle and syringe programmes. Participants: A total of 79 900 people who recently injected psychoactive drugs in the United Kingdom, recruited as part of the Unlinked Anonymous Monitoring Survey (England, Wales, Northern Ireland, 1990–2019) and Needle Exchange Surveillance Initiative (Scotland, 2008–2019). Measurements Age of people currently injecting, age at first injection, duration of injecting (each 1990–2019) and estimates of new people who started injecting (1980–2019). Findings In England, Wales and Northern Ireland between 1990 and 2019, the median age of people injecting increased from 27 (interquartile range [IQR], 24–31) to 40 (IQR, 34–46); median age at first injection increased from 22 (IQR, 19–25) to 33 (IQR, 28–39); and median years of injecting increased from 7 (IQR, 3–11) to 18 (IQR, 9–23). Values in Scotland and England were similar after 2008. The estimated number that started injecting annually in England increased from 5470 (95% prediction interval [PrI] 3120‐6940) in 1980 to a peak of 10 270 (95% PrI, 8980‐12 780) in 1998, and then decreased to 2420 (95% PrI, 1320‐5580) in 2019. The number in Scotland followed a similar pattern, increasing from 1220 (95% PrI, 740–2430) in 1980 to a peak of 3080 (95% PrI, 2160–3350) in 1998, then decreased to a 270 (95% PrI, 130–600) in 2018. The timing of the peak differed between regions, with earlier peaks in London and the North West of England. Conclusions: In the United Kingdom, large cohorts started injecting psychoactive drugs in the 1980s and 1990s and many still inject today. Relatively few people started in more recent years. This has led to changes in the population injecting drugs, including an older average age and longer injecting histories. [ABSTRACT FROM AUTHOR]

Background and Aims: Standardized tobacco packaging was introduced in the United Kingdom in May 2016, together with larger graphic warnings. This study explored young Scottish people's awareness of and perceptions about standardized tobacco packaging in the United Kingdom. Design Qualitative study using 16 focus groups conducted February–March 2017. Setting: Four schools in Scotland based in areas of differing socio‐economic status (high versus medium/low) and two levels of urbanity (large urban versus small town/other urban). Participants: Eighty‐two S2 (13–14 years) and S4 (15–16 years) students who were smokers or at‐risk non‐smokers. Measurements Focus groups explored perceptions of standardized packaging and health warnings. The qualitative data underwent thematic analysis. Findings Views about standardized packaging were generally negative. Packs were described as being unattractive, drab and less appealing than non‐standardized versions. The new health warnings generated negative affective, often aversive, responses. These varied depending on the image's perceived 'gruesomeness' and authenticity. Most participants thought that the impact would be greatest on young non/occasional smokers. There were divergent views about whether established smokers would be affected. Conclusions: The introduction of standardized tobacco packaging and new larger graphic health warnings in the United Kingdom seems have reduced the perceived attractiveness of cigarette packs among young people in the United Kingdom who smoke or are at elevated risk of becoming smokers, disrupting positive brand imagery (the brand heuristic), increasing the salience of health warnings and contributing to denormalizing smoking. [ABSTRACT FROM AUTHOR]

Abstract: Background and aim: The introduction of the Alcohol Act in Scotland on 1 October 2011, which included a ban on multi‐buy promotions, was probably associated with a fall in off‐trade alcohol sales in the year after its implementation. The aim of this study was to test if the same legislation was associated with reduced levels of alcohol‐related deaths and hospital admissions in the 3‐year period after its introduction. Design: A natural experiment design using time–series data to assess the impact of the Alcohol Act legislation in Scotland. Comparisons were made with unexposed populations in the rest of Great Britain. Setting: Scotland with comparable data obtained for geographical control groups in other parts of Great Britain. Participants: For alcohol‐related deaths, a total of 17 732 in Scotland and 88 001 in England and Wales throughout 169 4‐week periods between January 2001 and December 2013 and for alcohol‐related hospital admissions, a total of 121 314 in Scotland and 696 892 in England throughout 182 4‐week periods between January 2001 and December 2014. Measurements: Deaths and hospital admissions in Scotland and control groups that were wholly attributable to alcohol for consecutive 4‐week periods between January 2001 and December 2014. Data were obtained by age, sex and area‐based socio‐economic position. Findings: There was no evidence to suggest that the Alcohol Act was associated with changes in the overall rate of alcohol‐related deaths [incidence rate ratio (IRR) = 0.99, 95% confidence interval (CI) = 0.91–1.07)] or hospital admissions (IRR = 0.98, 95% CI = 0.95–1.02) in Scotland. In control group analyses, the pseudo intervention variable was not associated with a change in alcohol‐related death rates in England/Wales (IRR = 0.99, 95% CI = 0.95–1.02), but was associated with an increase in alcohol‐related hospital admission rates in England (IRR = 1.05, 95% CI = 1.03–1.07). In combined models, the interaction analysis did not provide support for a ‘net effect’ of the legislation on alcohol‐related deaths in Scotland compared with England/Wales (IRR 0.99, 95% CI = 0.95–1.04), but suggested a net reduction in hospital admissions for Scotland compared with England (IRR = 0.93, 95% CI = 0.87–0.98). Conclusion: The implementation of the Alcohol Act in Scotland has not been associated clearly with a reduction in alcohol‐related deaths or hospital admissions in the 3‐year period after it was implemented in October 2011. [ABSTRACT FROM AUTHOR]

Aims To estimate (1) the immediate impact; (2) the cumulative impact; and (3) the duration of impact of Scottish tobacco control TV mass media campaigns (MMCs) on smoking cessation activity, as measured by calls to Smokeline and the volume of prescribed nicotine replacement therapy (NRT). Design Multivariate time-series analysis using secondary data on population level measures of exposure to TV MMCs broadcast and smoking cessation activity between 2003 and 2012. Setting and participants Population of Scotland. Measurements Adult television viewer ratings (TVRs) as a measure of exposure to Scottish mass media campaigns in the adult population; monthly calls to NHS Smokeline; and the monthly volume of prescribed NRT as measured by gross ingredient costs (GIC). Findings Tobacco control TVRs were associated with an increase in calls to Smokeline but not an increase in the volume of prescribed NRT. A 1 standard deviation (SD) increase of 194 tobacco control TVRs led to an immediate and significant increase of 385.9 [95% confidence interval (CI) = 171.0, 600.7] calls to Smokeline (unadjusted model) within 1 month. When adjusted for seasonality the impact was reduced, but the increase in calls remained significant (226.3 calls, 95% CI = 37.3, 415.3). The cumulative impact on Smokeline calls remained significant for 6 months after broadcast in the unadjusted model and 18 months in the adjusted model. However, an increase in tobacco control TVRs of 194 failed to have a significant impact on the GIC of prescribed NRT in either the unadjusted (£1361.4, 95% CI = -£9138.0, £11860.9) or adjusted (£6297.1, 95% CI = -£2587.8, £15182.1) models. Conclusions Tobacco control television mass media campaigns broadcast in Scotland between 2003 and 2012 were effective in triggering calls to Smokeline, but did not increase significantly the use of prescribed nicotine replacement therapy by adult smokers. The impact on calls to Smokeline occurred immediately within 1 month of broadcast and was sustained for at least 6 months. [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]

The article offers world news briefs related to addiction. New research on meta-analyses have called for a revision on the PRISMA statement and the inclusion of the risk of bias assessments. Six health organisations have refused to support the British government's public health responsibility deal. The fifth anniversary of public smoking ban is celebrated in Scotland.

Effective overdose education and naloxone distribution programs must reduce opioid-related deaths without further stigmatizing and distancing vulnerable and underserved populations from comprehensive health-care services, including emergency care. [ABSTRACT FROM AUTHOR]