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Aims: To estimate recent trends in the prevalence of disposable e‐cigarette vaping in Great Britain, overall and across ages, and to measure these trends in the context of changes in smoking and vaping prevalence. Design: The Smoking Toolkit Study, a monthly representative cross‐sectional survey. Setting: Great Britain. Participants: A total of 36 876 adults (≥ 18 years) completed telephone interviews between January 2021 and April 2022. Measurements Current e‐cigarette vapers were asked which type of device they mainly use. We estimated age‐specific monthly time trends in the prevalence of current disposable e‐cigarette use among vapers and inhaled nicotine use (vaping/smoking), smoking and vaping among adults. Findings From January 2021 to April 2022, there was an 18‐fold increase in the percentage of vapers who used disposables, rising from 1.2 to 22.2% [prevalence ratio (PR) = 18.0; 95% compatibility interval (CI) = 9.18–49.0]. Growth in disposable e‐cigarette vaping was most pronounced in younger adults (interaction P‐value = 0.013): for example, the percentage of 18‐year‐old vapers using disposables rose from 0.4 to 54.8% (PR = 129; 95% CI = 28.5–4520), while it rose from 2.1 to 10.0% (PR = 4.73; 95% CI = 2.06–23.6) among 45‐year‐old vapers. However, the overall percentage of people currently using any inhaled nicotine remained stable over time both among all adults (20.0 versus 21.2%; PR = 1.06; 95% CI = 0.92–1.22) and among 18‐year‐olds (30.2 versus 29.7%; PR = 0.99; 95% CI = 0.80–1.22). In 18‐year‐olds, vaping prevalence grew (11.3 versus 17.7%; PR = 1.57; 95% CI = 1.12–2.29), and there was imprecise evidence for a decline in smoking (24.5 versus 19.5%; PR = 0.80; 95% CI = 0.63–1.04). In 45‐year‐olds, there was relatively little change in vaping (PR = 1.08; 95% CI = 0.88–1.33) or smoking prevalence (PR = 1.01; 95% CI = 0.88–1.16). Conclusions: Use of disposable e‐cigarettes in Great Britain grew rapidly between 2021 and 2022, especially among younger adults, but the overall prevalence of inhaled nicotine use was stable over time. Most young adult vapers in Great Britain now use disposable products. [ABSTRACT FROM AUTHOR]

Background and Aims: The three-question Alcohol Use Disorders Identification Test (AUDIT-C) is frequently used in healthcare for screening and brief advice about levels of alcohol consumption. AUDIT-C scores (0-12) provide feedback as categories of risk rather than estimates of actual alcohol intake, an important metric for behaviour change. The study aimed to (i) develop a continuous metric from the Extended AUDIT-C expressed in United Kingdom (UK) units (8 g pure ethanol), offering equivalent accuracy, and providing a direct estimator of weekly alcohol consumption (EWAC) and (ii) evaluate the EWAC's bias and error using the graduated-frequency (GF) questionnaire as a reference standard of alcohol consumption. Design: Cross-sectional diagnostic study based on a nationally-representative survey. Settings: Community dwelling households in England. Participants: A total of 22 404 household residents aged =16 years reporting drinking alcohol at least occasionally. Measurements: Computer-assisted personal interviews consisting of (i) AUDIT questionnaire with extended response items (the 'Extended AUDIT') and (ii) GF. Primary outcomes were: mean deviation <1 UK unit (metric of bias); root-mean-square deviation <2 UK units (metric of total error) between EWAC and GF. The secondary outcome was the receiver operating characteristic area under the curve for predicting alcohol consumption in excess of 14 and 35 UK units. Findings: EWAC had a positive bias of 0.2 UK units (95% CI = 0.08, 0.4) compared with GF. Deviations were skewed: whereas the mean error was 11 UK units/week [9.5, 11.9], in half of participants the deviation between EWAC and GF was between 0 and 2.1 UK units/week. EWAC predicted consumption in excess of 14 UK units/week with a significantly greater area under the curve (0.918 [0.914, 0.923]) than AUDIT-C (0.870 [0.864, 0.876]) or the full AUDIT (0.854 [0.847, 0.860]). Conclusions: A new estimator of weekly alcohol consumption, which uses answers to the Extended AUDIT-C, meets the targeted bias tolerance. It is superior in accuracy to AUDIT-C and the full 10-item AUDIT when predicting consumption thresholds, making it a reliable complement to the Extended AUDIT-C for health promotion interventions. [ABSTRACT FROM AUTHOR]

Mental imagery manipulations are used to treat several psychological disorders, but their utility in treating cocaine use disorder (CUD) is unknown. Using prompted re‐experiences and simulations with contrasting valence, we assessed the acute impact of a deliberate mental imagery task on cocaine craving. Design A quantitative–qualitative 'mixed‐methods' analysis of data collected for a randomized controlled trial that was stopped prematurely. Setting: UK National Health Service addictions treatment clinic and outpatient clinical research facility (laboratory). Participants: Adults with CUD. The original target sample was 120. All participants enrolled at the point the original trial was stopped were included (38 enrolled, 31 completed study). Interventions: Personalized (3‐minute) cue–exposure (handling cocaine paraphernalia and watching video of drug preparation), immediately followed by a single 5‐minute, audio‐recorded, self‐guided and verbally described imagery task with random assignment to one of four conditions: two mental imagery memory re‐experiences (positive image before initiation to cocaine use or a negative image of a 'worst time' adverse cocaine use episode) or two future simulations (positive theme of recovery from CUD or negative theme of worsened CUD). Measurements Task transcripts were rated for imagery detail using five dimensions using a six‐point scale of imagery detail (ID) (total score = 0–25) and thematically coded. The outcome measure was cocaine craving using the Craving Experiences Questionnaire—strengths version (CEQ–S11; score = 0–110) reported at baseline, arrival at the laboratory, and immediately after the cue–exposure and mental imagery tasks. Findings A mixed‐effects, longitudinal, restricted linear regression, with the past‐positive imagery condition as referent, showed main effects of reduced craving after the imagery task (b = –29.2, 95% confidence interval (CI) = –45.3 to −13.1, P‐value < 0.001) and increased craving for the future‐negative task (b = 14.2, 95% CI = 0.1–28.4, P‐value 0.049). There was a future‐negative task by post‐imagery craving interaction (b = 28.1, 95% CI = 0.1–56.1, P‐value 0.049). A theory‐driven, deductive/inductive qualitative analysis of the transcripts revealed six major themes: sensory characteristics, CUD vicious cycle, self‐care, emotions and appraisals, social role and CUD recovery. Positively themed simulations included interpersonal connections and rewarding activity; negative images included personal adversity, with appraisals of self‐criticism and hopelessness. Transcripts with more imagery detail were not associated with significantly greater reductions in craving in the positive or negative imagery task (r = –0.32, 95% CI = –0.69 to 0.13 and r = 0.06, 95% CI = –0.58 to 0.53, respectively). Conclusion: In people with cocaine use disorder, after cue–exposure, a self‐guided imagery task with positive themes reduced craving, whereas mental imagery simulating worsened cocaine use disorder did not appear to. [ABSTRACT FROM AUTHOR]

Background and aim: Reducing alcohol misuse by male prisoners is an important global issue. Control of drinking behaviour could be a useful target for intervention in this population, and locus of control could be a causal factor in this. We aimed to assess the effect of a clinical psychologist‐facilitated group intervention on male prisoners' locus of control of drinking behaviour. Design A two‐arm, single‐site, open, randomized controlled trial. Setting: A category B local training prison in South Wales, housing about 770 mainly sentenced men. Participants: Prisoners serving less than 2 years who met inclusion criteria for pre‐imprisonment alcohol misuse, alone or with drug misuse. A total of 119 were allocated to the intervention arm and 119 to the control arm; 104 and 87, respectively, completed the post‐randomization baseline interview and 68 and 60 completed a second interview approximately 4 weeks later, respectively, after intervention or treatment as usual (TAU) alone. Intervention: Nine clinical psychologist‐facilitated groups in the prison over 3 weeks. Range of participants per session was one to seven, with three to five most usual. Measures: The primary outcome was locus of control of behaviour (LCB); secondary outcomes included mental state generally (comprehensive psychiatric rating scale/CPRS) and specifically (Beck Depression Inventory/BDI). An integral process evaluation was conducted. Findings LCB scores decreased during the study, but without significant intervention effect [−1.7, 95% confidence interval (CI) = –5.1 to 1.6, P = 0.329]. Change among completers in the control group was from a mean score of 37.4 [standard deviation (SD) = 10.0] to 33.7[SD = 11.7] and in the intervention group from 37.4 (SD = 11.6) to 31.9 (SD = 11.8). Secondary outcomes, including change in mental state, did not differ between arms, but 686 (64%) sessions were lost, most because of 'prison issues'. Conclusions: A clinical psychologist‐facilitated group intervention did not have a statistically significant effect on sense of control of drinking behaviour among men with pre‐imprisonment alcohol misuse serving less than 2 years in a South Wales prison. The study proved coterminous, however, with 40% prison staff cuts which seem likely to have contributed to the high loss of group sessions and possibly overwhelmed any treatment effect. Intervention completion failures, previously cited as harmful, had no effect here, so the trial should be repeated when the prison climate improves. [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 determine whether web-based tailored cessation advice, based on social cognitive theory and the perspectives on change model, was more effective in aiding a quit attempt than broadly similar web-based advice that was not tailored. Design Participants were allocated randomly to one of two groups, to receive either a cessation advice report and progress report that were tailored to individual-level characteristics or a cessation advice report that presented standardized (non-tailored) content. Tailoring was based on smoking-related beliefs, personal characteristics and smoking patterns, self-efficacy and outcome expectations. Setting Participant enrolment and baseline assessments were conducted remotely online via the study website, with the advice reports presented by the same website. Participants Participants ( n = 1758) were visitors to the QUIT website who were based in the United Kingdom, aged 18 years or over and who smoked cigarettes or hand-rolled tobacco. Measurements Follow-up assessments were made at 6 months by telephone interview. The primary outcome measure was self-reported 3 months prolonged abstinence, and secondary outcomes were 1 month prolonged abstinence, 7-day and 24-hour point prevalence abstinence. Findings The intervention group did not differ from the control group on the primary outcome (9.1% versus 9.3%; odds ratio = 1.02 95% confidence interval 0.73-1.42) or on any of the secondary outcomes. Intervention participants gave more positive evaluations of the materials than control participants. Conclusions A web-based intervention that tailored content according to smoking-related beliefs, personal characteristics and smoking patterns, self-efficacy and outcome expectations, was not more effective than web-based materials presenting broadly similar non-tailored information. [ABSTRACT FROM AUTHOR]