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Background and aims: Smokers typically have a lower body mass index (BMI) than non‐smokers, while smoking cessation is associated with weight gain. In pre‐clinical research, nicotine in tobacco smoking suppresses appetite and influences subsequent eating behaviour; however, this relationship is unclear in humans. This study measured the associations of smoking with different eating and dietary behaviours. Design: A cross‐sectional analysis of data from health assessments conducted between 2004 and 2022. Setting: An independent healthcare‐based charity within the United Kingdom. Participants: A total of 80 296 men and women (mean ± standard deviation [SD]: age, 43.0 ± 10.4 years; BMI, 25.7 ± 4.2 kg/m2; 62.5% male) stratified into two groups based on their status as a smoker (n = 6042; 7.5%) or non‐smoker (n = 74 254; 92.5%). Measurements Smoking status (self‐report) was the main exposure, while the primary outcomes were selected eating and dietary behaviours. Age, sex and socioeconomic status (index of multiple deprivation [IMD]) were included as covariates and interaction terms, while moderate‐to‐vigorous exercise and sleep quality were included as covariates only. Findings Smokers had lower odds of snacking between meals and eating food as a reward or out of boredom versus non‐smokers (all odds ratio [OR] ≤ 0.82; P < 0.001). Furthermore, smokers had higher odds of skipping meals, going more than 3 h without food, adding salt and sugar to their food, overeating and finding it hard to leave something on their plate versus non‐smokers (all OR ≥ 1.06; P ≤ 0.030). Additionally, compared with non‐smokers, smoking was associated with eating fried food more times per week (rate ratio [RR] = 1.08; P < 0.001), eating fewer meals per day, eating sweet foods between meals and eating dessert on fewer days per week (all RR ≤ 0.93; P < 0.001). Several of these relationships were modified by age, sex and IMD. Conclusions: Smoking appears to be associated with eating and dietary behaviours consistent with inhibited food intake, low diet quality and altered food preference. Several of these relationships are moderated by age, sex and socioeconomic status. [ABSTRACT FROM AUTHOR]

Background and aims: UK‐based gambling policymakers have proposed affordability checks starting at monthly losses of £125. The present study combines open banking data with self‐reports of the Problem Gambling Severity Index (PGSI) and other relevant information to explore the harm profiles of people who gamble at different levels of electronic gambling behaviour. Design, setting and participants: This was a data fusion study in which participants consented to share their bank data via an open banking application programming interface (API) and who also completed relevant self‐report items. Hierarchical hurdle models were used to predict being an at‐risk gambler (PGSI > 0) and being a 'higher‐risk' gambler (higher PGSI scores among those with non‐zero scores) using four specifications of electronic gambling behaviour (net‐spend, outgoing expenditure, incoming withdrawals, interaction model combining expenditure and withdrawals), and by adding self‐reported data across two additional steps. The study took place in the United Kingdom. Participants were past‐year people who gamble (n = 424), recruited via Prolific. Measurements: Self‐report measures were used of gambling‐related harm (PGSI), depression [Patient Health Questionnaire 9 (PHQ‐9)], age and gender; bank‐recorded measures of income and electronic gambling behaviour. Findings Unharmed gamblers had an average monthly gambling net‐spend of £16.41, compared with £208.91 among highest‐risk gamblers (PGSI ≥ 5). Being an at‐risk gambler (PGSI > 0) was predicted significantly by all four types of gambling behaviour throughout all three steps [1.08 ≤ odds ratios (ORs) ≤ 2.92; Ps < 0.001), with only outgoing expenditure being significant in the interaction model (2.26 ≤ ORs ≤ 2.81; Ps < 0.001). Higher PHQ‐9 scores also predicted at‐risk gambling in steps 2–3 (1.09 ≤ ORs ≤ 1.10; Ps < 0.001), as did lower age (0.95 ≤ ORs ≤ 0.96; Ps < 0.001) and male gender identity in step 3 (2.51 ≤ ORs ≤ 2.95; Ps < 0.001). Being a higher‐risk gambler was predicted significantly by gambling behaviour only in the expenditure‐only (1.16 ≤ ORs ≤ 1.17; Ps ≤ 0.048) and withdrawal‐only (1.08 ≤ ORs ≤ 1.09; Ps ≤ 0.004) models, and was not predicted by income (0.98 ≤ ORs ≤ 1.14; Ps ≥ 0.601), age (0.98 ≤ ORs ≤ 0.99; Ps ≥ 0.143) or male gender identity (1.07 ≤ ORs ≤ 1.15; Ps ≥ 0.472). Conclusion: The UK government's proposed affordability checks for gamblers should rarely affect people who are not experiencing gambling‐related harm. At‐risk gambling is predicted well by different types of gambling behaviour. Novel insights about gambling can be generated by fusing self‐reported and objective data. [ABSTRACT FROM AUTHOR]

Background and aims: High‐potency cannabis has been associated with increased risk of psychosis, but a lack of prospective data hinders understanding of causality in this relationship. This study aimed to combine prospective report of cannabis use with retrospective report of potency to infer the potency of cannabis used in adolescence and explore whether use of cannabis, and the use of high‐potency cannabis, in adolescence is associated with incident psychotic experiences. Design: Population‐based birth cohort study. Setting: United Kingdom. Participants: n = 5570 participants who reported on any cannabis use (yes/no) age 16 and 18 years, and n = 1560 participants from this group who also retrospectively reported on cannabis potency. Measurements In questionnaires at ages 16 and 18, individuals self‐reported lifetime cannabis use, and at age 24, participants reported the type of cannabis they most commonly used in the whole time since first using cannabis. Psychotic experiences were assessed at age 24 years using the semi‐structured Psychosis‐Like Symptom Interview, with incident defined as new‐onset occurring between ages 19 and 24 years. Findings Use of high‐potency cannabis at age 16 or 18 was associated with twice the likelihood of experiencing incident psychotic experiences from age 19–24 (Odds Ratio 2.15, 95% Confidence Intervals 1.13–4.06). There was less evidence for an effect of any cannabis use on incident psychotic experiences (Odds Ratio 1.45, 95% Confidence Intervals 0.94–2.12). Conclusions: Use of high‐potency cannabis appears to be associated with increased likelihood of psychotic experiences. [ABSTRACT FROM AUTHOR]

Background and aims: Offering financial incentives is effective for smoking cessation during pregnancy. We tested the effectiveness of financial incentives for maintaining postpartum cessation, comparing 12-month and 3-month incentives with each other and with usual care (UC). Design, setting and participants: This study was a pragmatic, multi-centre, three-arm randomized controlled trial involving four English, National Health Service, stop smoking services. A total of 462 postpartum women (aged ≥ 16 years) took part, who stopped smoking during pregnancy with financial incentives, validated as abstinent from smoking at end of pregnancy or early postpartum. Interventions: Interventions comprised (i) UC; (ii) UC plus up to £60 of financial voucher incentives offered to participants and £60 offered to an optional significant-other supporter, over 3 months postpartum, contingent upon validated abstinence ('3-month incentives'); or (iii) UC plus '3-month incentives' plus £180 of vouchers offered to participants over 9 months postpartum, contingent upon abstinence ('12-month incentives'). Measurements: Primary outcome: biochemically validated abstinence at 1 year postpartum. To adjust for testing all comparisons between groups with equal precision, P < 0.017 was necessary for significance. Secondary outcomes: self-reported and validated abstinence at 3 months postpartum; self-reported abstinence at 1 year postpartum. Findings: Primary outcome ascertainment: abstinence was 39.6% (63/159) 12 months incentives, 21.4% (33/154) 3 months incentives and 28.2% (42/149) UC. Adjusted odds ratios [95% confidence interval (CI)] = 12-month versus 3-month incentives OR = 2.41 (95% CI = 1.46-3.96), P = 0.001; 12 months versus UC 1.67 (1.04-2.70), P = 0.035; 3 months versus UC 0.69 (0.41-1.17), P = 0.174. Bayes factors indicated that for 12- month versus 3-month incentives and 12 months versus UC there was good evidence for the alternative hypothesis, and for 3 months versus UC there was good evidence for the null hypothesis. Conclusions: This randomized controlled trial provides weak evidence that up to £300 of voucher incentives over 12 months is effective for maintaining smoking abstinence postpartum compared with usual care. There was good evidence that 12-month incentives are superior to those over only 3 months, for which there was no evidence of effectiveness relative to usual care. [ABSTRACT FROM AUTHOR]

Background and aims: The relationship between alcohol consumption and age‐related diseases is inconsistent. Biological age (BA) serves as both a precursor and a predictor of age‐related diseases; however, longitudinal associations between alcohol consumption and BA in middle‐aged and older people remain unclear. We measured whether there was a longitudinal association between drinking frequency and pure alcohol intake with BA among middle‐aged and older people. Design and setting and participants: This study involved two prospective cohort studies, set in Southwestern China and the United Kingdom. A total of 8046 participants from the China Multi‐Ethnic Cohort study (CMEC) and 5412 participants from the UK Biobank (UKB), aged 30–79 years, took part, with complete data from two waves of clinical biomarkers. Measurements: BA was calculated by the Klemera Doubal's method. Accelerated BA equalled BA minus chronological age. Drinking frequency and pure alcohol intake were obtained through self‐reported questionnaires. Drinking frequency in the past year was classified as current non‐drinking, occasional (monthly drinking) and regular (weekly drinking). Findings: Compared with consistent current non‐drinkers, more frequent drinkers [CMEC: β = 0.46, 95% confidence interval (CI) = 0.13–0.80; UKB: β = 0.65, 95% CI = 0.01–1.29)], less frequent drinkers (CMEC: β = 0.62, 95% CI = 0.37–0.87; UKB: β = 0.54, 95% CI = −0.01–1.09), consistent occasional drinkers (CMEC: β = 0.51, 95% CI = 0.23–0.79; UKB: β = 0.63, 95% CI = 0.13–1.13) and consistent regular drinkers (CMEC: β = 0.56, 95% CI = 0.17–0.95; UKB: β = 0.46, 95% CI = 0.00–0.91) exhibited increased accelerated BA. A non‐linear relationship between pure alcohol intake and accelerated BA was observed among consistent regular drinkers. Conclusions: In middle‐aged and older people, any change in drinking frequency and any amount of pure alcohol intake seem to be positively associated with acceleration of biological ageing, compared with maintaining abstinence. [ABSTRACT FROM AUTHOR]

Background and aims: The relationship between alcohol consumption and age-related diseases is inconsistent. Biological age (BA) serves as both a precursor and a predictor of age-related diseases; however, longitudinal associations between alcohol consumption and BA in middle-aged and older people remain unclear. We measured whether there was a longitudinal association between drinking frequency and pure alcohol intake with BA among middle-aged and older people. Design and setting and participants: This study involved two prospective cohort studies, set in Southwestern China and the United Kingdom. A total of 8046 participants from the China Multi-Ethnic Cohort study (CMEC) and 5412 participants from the UK Biobank (UKB), aged 30-79 years, took part, with complete data from two waves of clinical biomarkers. Measurements: BA was calculated by the Klemera Doubal's method. Accelerated BA equalled BA minus chronological age. Drinking frequency and pure alcohol intake were obtained through self-reported questionnaires. Drinking frequency in the past year was classified as current non-drinking, occasional (monthly drinking) and regular (weekly drinking). Findings: Compared with consistent current non-drinkers, more frequent drinkers [CMEC: β = 0.46, 95% confidence interval (CI) = 0.13-0.80; UKB: β = 0.65, 95% CI = 0.01-1.29)], less frequent drinkers (CMEC: β = 0.62, 95% CI = 0.37-0.87; UKB: β = 0.54, 95% CI = -0.01-1.09), consistent occasional drinkers (CMEC: β = 0.51, 95% CI = 0.23-0.79; UKB: β = 0.63, 95% CI = 0.13-1.13) and consistent regular drinkers (CMEC: β = 0.56, 95% CI = 0.17-0.95; UKB: β = 0.46, 95% CI = 0.00-0.91) exhibited increased accelerated BA. A non-linear relationship between pure alcohol intake and accelerated BA was observed among consistent regular drinkers. Conclusions: In middle-aged and older people, any change in drinking frequency and any amount of pure alcohol intake seem to be positively associated with acceleration of biological ageing, compared with maintaining abstinence. [ABSTRACT FROM AUTHOR]

Background and aims: Xylazine is a non‐opioid sedative which has spread rapidly throughout the US illicit drug supply. This study aimed to describe the spread of xylazine throughout the UK illicit drug supply. Methods: Xylazine detections in human biological samples were collated from toxicology laboratories operating in the United Kingdom with the date, location, case type, xylazine concentration and co‐detected drugs (with quantifications where performed) detailed, where permitted, by the corresponding coroner. Drug‐testing cases positive for xylazine were collated from the Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) drug‐testing postal service with the date, location, purchase intent and co‐detected drugs detailed. Drug seizures made by UK law enforcement were communicated by the Office for Health Improvement and Disparities with the date and location detailed. Results: By the end of August 2023, xylazine was detected in 35 cases from throughout toxicology, drug‐testing and drug seizure sources covering England, Scotland and Wales. There were no cases reported from Northern Ireland. Xylazine was detected in biological samples from 16 people. In most cases where full toxicology results were provided, xylazine was detected with heroin and/or a strong opioid (n = nine of 11), but this polydrug use pattern was not evident in all cases (n = two of 11), suggesting a wider circulation of xylazine in the UK illicit drug market beyond heroin supplies. Evidence from WEDINOS supports this claim, as all 14 drug samples (100%) submitted from across the UK contained xylazine; however, in none of these cases was heroin the purchase intent but rather counterfeit prescription medication tablets (n = 11 of 14), tetrahydrocannabinol (THC) vapes (n = two of 14) or white powder (n = one of 14). Additional evidence for the spread of illicit xylazine comes from five drug seizures made by law enforcement. Conclusions: Xylazine has penetrated the UK illicit drug market and is not limited to heroin supplies. [ABSTRACT FROM AUTHOR]

Background: Usage of electronic gaming machines (EGMs) and on‐line gambling is strongly associated with gambling‐related harm. Player‐tracking systems can monitor a gambler's activity across multiple sessions and/or operators, providing a clearer picture of the person's risk of harm with respect to these gambling formats and enabling harm reduction efforts. The Finnish and Norwegian state monopolies have player‐tracking systems in place, while the United Kingdom is implementing an operator‐led system called 'single customer view' for on‐line gambling, and Australian states are proposing similar 'player cards' for land‐based EGMs. Argument: Player tracking can advance harm reduction efforts in three ways. First, player tracking improves our understanding of gambling‐related harm by providing data on how the population gambles, which can potentially be linked with operator, government and/or prevalence data sets. Secondly, player tracking can be used to implement harm reduction measures such as expenditure limits, self‐exclusion and age verification. Thirdly, player tracking can provide a platform to evaluate harm reduction measures via gold‐standard field trials. These potential benefits need to be weighed against various practical and ethical issues. Conclusions: The potential benefits of player‐tracking systems would be maximized via systems administered independently of the gambling industry and implemented universally across all gambling in a given jurisdiction. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to present an enhanced cannabis timeline followback (EC‐TLFB) enabling comprehensive assessment of cannabis use measures, including standard tetrahydrocannabinol (THC) units, and to validate these against objectively indexed urinary 11‐nor‐9‐carboxy‐tetrahydrocannabinol (THC‐COOH) concentrations. Design: We used cross‐sectional baseline data from the 'CannTeen' observational longitudinal study. Setting: The study was conducted in London, UK. Participants: A total of 147 participants who used cannabis regularly took part in the study (n = 71 female, n = 76 male; mean age = 21.90, standard deviation = 5.32). Measurements The EC‐TLFB was used to calculate frequency of cannabis use, method of administration, including co‐administration with tobacco, amount of cannabis used (measured with unaided self‐report and also using pictorial aided self‐report) and type of cannabis product (flower, hash) which was used to estimate THC concentration (both from published data on THC concentration of products and analysis of cannabis samples donated by participants in this study). We calculated total weekly standard THC units (i.e. 5 mg THC for all cannabis products and methods of administration) using the EC‐TLFB. The outcome variable for validation of past week EC‐TLFB assessments was creatinine‐normalized carboxy‐tetrahydrocannabinol (THC‐COOH) in urine. Findings All measures of cannabis exposure included in this analysis were positively correlated with levels of THC‐COOH in urine (r = 0.41–0.52). Standard THC units, calculated with average concentrations of THC in cannabis in the UK and unaided self‐report measures of amount of cannabis used in grams showed the strongest correlation with THC‐COOH in urine (r = 0.52, 95% bias‐corrected and accelerated = 0.26–0.70). Conclusions: The enhanced cannabis timeline followback (EC‐TLFB) can provide a valid assessment of a comprehensive set of cannabis use measures including standard tetrahydrocannabinol units as well as and traditional TLFB assessments (e.g. frequency of use and grams of cannabis use). [ABSTRACT FROM AUTHOR]

Background and Aim: Drinking alcohol may cause harm to an individual's health and social relationships, while a drinking culture may harm societies as it may increase crime rates and make an area feel less safe. Local councils in Greater Manchester, UK, developed the Communities in Charge of Alcohol (CICA) intervention, in which volunteers were trained to give alcohol‐related advice to the public and taught how to influence policies to restrict when, where and how alcohol is sold. As part of a larger study, the aim of the current project is to measure the impact of CICA on health and crime outcomes at the lower super output (LSOA) geographical aggregation. Design: Quantitative evaluation using four time series analytic methods (stepped‐wedge design, and comparisons to local controls, national controls and synthetic controls) with findings triangulated across these methods. A cost–benefit analysis was carried out alongside the effectiveness analysis. Setting and Participants: The general public in Greater Manchester, UK, between 2010 and 2020. Measurements: The primary outcome of interest was alcohol‐related hospital admissions. Secondary outcomes were accident and emergency (A&E) attendances, ambulance callouts, recorded crimes and anti‐social behaviour incidents. Findings Triangulation of the results did not indicate any consistent effect on area‐level alcohol‐related hospital admissions, A&E attendances, ambulance callouts, reported crimes or anti‐social behaviour associated with the implementation of CICA. The primary stepped‐wedge analysis indicated an increase in alcohol‐related hospital admissions following the implementation of CICA of 13.4% (95% confidence interval −3.3%, +30.1%), which was consistent with analyses based on other methods with point estimates ranging from +3.4% to 16.4%. Conclusion: There is no evidence of a measurable impact of the Communities in Charge of Alcohol (CICA) programme on area‐level health and crime outcomes in Greater Manchester, UK, within 3 years of the programme start. The increase in alcohol‐related hospital admissions was likely the result of other temporal trends rather than the CICA programme. Possible explanations include insufficient follow‐up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions or that the intervention has no direct impact on the selected outcomes. [ABSTRACT FROM AUTHOR]

Background and Aims: Heavy alcohol use and depression commonly co‐occur. However, health and social care services rarely provide coordinated support for these conditions. Using relational autonomy, which recognizes how social and economic contexts and relational support alter people's capacity for agency, this study aimed to (1) explore how people experience formal care provision for co‐occurring alcohol use and depression, (2) consider how this context could lead to adverse outcomes for individuals and (3) understand the implications of these experiences for future policy and practice. Design: Semi‐structured qualitative interviews underpinned by the methodology of interpretive description. Setting: North East and North Cumbria, UK. Participants: Thirty‐nine people (21 men and 18 women) with current or recent experience of co‐occurring heavy alcohol use ([Alcohol Use Disorders Identification Test [AUDIT] score ≥ 8]) and depression ([Patient Health Questionnaire test ≥ 5] screening tools to give an indication of their current levels of alcohol use and mental score). Measurements Semi‐structured interview guide supported in‐depth exploration of the treatment and care people had sought and received for heavy alcohol use and depression. Findings Most participants perceived depression as a key factor contributing to their heavy alcohol use. Three key themes were identified: (1) 'lack of recognition' of a relationship between alcohol use and depression and/or contexts that limit people's capacity to access help, (2) having 'nowhere to go' to access relevant treatment and care and (3) 'supporting relational autonomy' as opposed to assuming that individuals can organize their own care and recovery. Lack of access to appropriate treatment and provision that disregards individuals' differential capacity for agency may contribute to delays in help‐seeking, increased distress and suicidal ideation. Conclusions: Among people with co‐occurring heavy alcohol use and depression, lack of recognition of a relationship between alcohol use and depression and formal care provision that does not acknowledge people's social and economic context, including their intrinsic need for relational support, may contribute to distress and limit their capacity to get well. [ABSTRACT FROM AUTHOR]

Background and aims: Opioids are now the most cited class in fatal overdoses. However, the antidote for opioid overdose—naloxone—is not always readily available. Our aim was to evaluate the feasibility of naloxone transit via drone to provide rapid access at the point of care. Methods and findings: Real‐world data pertaining to opioid overdoses, which occurred in the Teesside area of the UK 2015–2019, were extracted from the National Programme on Substance Abuse Deaths (NPSAD). The original locations of these opioid overdoses were used to compare the projected response times of ambulances with that of drones when considering the impacts of actual traffic and weather conditions, respectively; 58 cases were identified where a bystander—who could have called for and administered emergency naloxone—was likely present. Results: In 78% of cases (n = 45/58) a class C1 commercial‐off‐the‐shelf drone carrying naloxone could have reached the overdose location in 7 min—the benchmark time for the arrival of emergency services for Category 1 calls in England. With the implementation of recent advances in drone engineering, such as increased speeds and temperature‐controlled cargo cradles, it is estimated that 98% of overdoses could have been reached in this timeframe (n = 57/58). Ambulances were able to reach a significantly lower number of cases in 7 min, even when considering best‐case scenario traffic conditions (14%, n = 8/58, χ2P < 0.001). Conclusions: This study provides proof‐of‐concept that, in the Teesside area of the UK, drones are more likely than ambulance to get naloxone to the site of an opioid overdose in 7 min. [ABSTRACT FROM AUTHOR]

Background and aims: People with alcohol use disorder (AUD) often have co‐occurring psychiatric conditions. The association between psychiatric conditions and AUD relapse has not yet been fully explored. This study aimed to quantify different psychiatric comorbidities as risk factors for first and multiple AUD rehospitalizations in patients already hospitalized once for AUD. Methods: We used a nation‐wide routine health‐care database in Scotland, UK, between 2010 and 2019. Individuals with a first hospitalization for AUD (codes F10.0‐9 in the ICD‐10 codes) were checked for previous hospitalizations where the main or co‐occurring cause was a psychiatric condition (any other F0‐F99 code in ICD‐10). The final cohort included 23 529 patients, 18 620 of whom did not have a history of any other psychiatric comorbidity. First, individuals with a history of any previous psychiatric hospitalization were grouped and compared with those without on the basis of time to AUD rehospitalization. Then, individuals with different histories of psychiatric hospitalization were compared with each other. Cox and Prentice, Williams and Peterson gap‐time models were used for single and multiple AUD rehospitalizations, respectively. Results: The AUD rehospitalization rate in individuals with a previous psychiatric hospitalization was 8% higher compared with those without [hazard ratio (HR) = 1.08, 95% confidence interval (CI) = 1.01–1.14]. The difference in rehospitalization rate reduced following the first rehospitalization (HR at second rehospitalization from first: 0.95, 95% CI = 0.87–1.04 and HR at third rehospitalization from second: 0.94, 95% CI = 0.84–1.07). Mood disorders and neurotic, stress‐related and somatoform disorders were associated with a 54% (HR = 1.54, 95% CI = 1.38–1.72) and 39% (HR = 1.39, 95% CI = 1.17–1.66) increase in the risk of a first AUD rehospitalization. Other conditions, such as disorders due to psychoactive substance use or schizophrenia, were associated with decreases in future AUD rehospitalization (HR = 0.89, 95% CI = 0.82–0.97 and HR = 0.82, 95% CI = 0.58–1.16, respectively). Conclusions: Patients with AUD appear to have different rates of AUD rehospitalization based on different co‐occurring psychiatric conditions. Addiction‐related characteristics may be more relevant risk indicators for multiple AUD readmission than psychiatric comorbidities. [ABSTRACT FROM AUTHOR]

The author comments on a study by C. Copeland and colleagues on evidence of xylaxine in the United Kingdom illicit drug market beyond heroine supplies. Topics discussed include lessons from other heroin supply disruptions including a prior Taliban opium ban in 2000 to 2001, examples that may represent evidence of a broader shift toward synthetic drugs replacing agricultural products in Europe, and observation on the widespread barriers to accessing social and health services in North America.

The authors relate a discussion with R. M. Heirene about the need for direct evaluation of the United Kingdom's (UK's) gambling affordability checks policy. Topics include a better way of evaluating risk checks based on discussion, how regulation in technology-focused domains such as gambling can be effective, and the limited evidence in the gambling policy space.

The author comments on an article by D. Zendle and P. Newall which provides evidence for understanding the link between gambling spending and harm using novel methods. He discusses why Zendle and Newall's article provides an important contribution to the gambling literature, concern on the net-spend values computed by the authors, and basis of the authors' conclusion that affordability checks will not impact no-/low-risk gamblers.

The article stresses the need for online-specific gambling marketing regulations in the United Kingdom (UK). It argues that current advertising codes are ill-equipped to deal with online gambling advertising techniques and cautions about the enforcement challenges brought by advancements in artificial intelligence (AI). It calls for policymakers to restrict gambling marketing and establish a database where online gambling advertisements are stored.

The authors comment on a study by M. Ussher and colleagues which hypothesized that continuing to provide incentives postpartum to participants who had successfully quit smoking when offered incentives antepartum would maintain abstinence. Topics discussed include the evidence that financial incentives delivered to pregnant participants contingent on biochemically-validated abstinence prompts antepartum smoking cessation and importance of the use of the devices postpartum.

The authors offer a response to commentaries made on their article on how player-tracking technologies could enhance stakeholders' ability to understand and reduce gambling-related harm. Topics include the benefits that can be yielded by linking self-report and naturalistic data together, how all gambling provision models raise their own issues, and important points concerning user privacy and points to features of operator data that make for strong makers of harm.

The author comments on an article by P. Newall and T. Swanton on how to reduce gambling harm via player tracking. Topics include the mandatory gambling cards issued in Finland and some other countries for player tracking, the need for additional measures to ensure that player tracking reduces the harm as effectively as possible, and availability of the technology required for digital identification and its use by the gambling industry.

The article shares views about the Office for Health Improvement and Disparities' consultation on clinical guidelines about harmful drinking and alcohol dependence in Great Britain. Topics discussed include the overlook of alcohol treatment funding in the country, the lack of political will to address the social determinants of alcohol problems, and the call on stakeholders to support a public first approach to addressing alcoholic drinking problems.