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The UK government is consulting on banning disposable e-cigarettes. This study aimed to describe trends in disposable e-cigarette use among adults in Great Britain since 2021 and establish who would currently be affected by a ban on disposables. Nationally-representative monthly cross-sectional survey. We analysed data from 69,973 adults surveyed between January 2021 and August 2023. We estimated monthly time trends in the weighted prevalence of current disposable e-cigarette use among adults and by sociodemographic characteristics and smoking status. From January 2021 to August 2023, the prevalence of disposable e-cigarette use grew from 0.1 % to 4.9 %. This rise was observed across all population subgroups but was most pronounced among younger adults (e.g. reaching 15.9 % of 18-year-olds compared with 1.3 % of 65-year-olds), those who currently smoke (16.3 %), and those who stopped smoking in the past year (18.2 %). Use among never smokers remained relatively rare (1.5 %), except among 18- to 24-year-olds (7.1 %). Use was significantly higher in England than Wales or Scotland (5.3 % vs. 2.0 % and 2.8 %) and among less (vs. more) advantaged social grades (6.1 % vs. 4.0 %), those with (vs. without) children (6.4 % vs. 4.4 %), and those with (vs. without) a history of mental health conditions (9.3 % vs. 3.1 %). A ban on disposable e-cigarettes would currently affect one in 20 adults in Great Britain (approximately 2.6 million people). The proportion who would be affected would be greatest among young people, including the 316,000 18-24 year-olds who currently use disposables but who have never regularly smoked tobacco, which may discourage uptake of vaping in this group. However, a ban would also affect 1.2 million people who currently smoke and a further 744,000 who previously smoked. It would also have a disproportionate impact on disadvantaged groups that have higher rates of smoking and typically find it harder to quit. [ABSTRACT FROM AUTHOR]

'Overweight and obesity' is the second biggest preventable cause of cancer after smoking. In 2018, Cancer Research UK launched an awareness raising campaign about the link between overweight and obesity and cancer risk. This study aimed to evaluate the reach and impact of the campaign. This study was a repeated cross-sectional online survey. The campaign consisted of six elements including the main message that 'Obesity is a cause of cancer'. UK adults and Members of Parliament (MPs) were surveyed before the campaign (W1; n = 2124 and n = 151), 1 month (W2; n = 2050 and n = 151) and 3 months after the campaign (W3; n = 2059 and MPs not surveyed). Outcome measures were campaign reach, awareness of overweight and obesity as risk factors for cancer, attitudes towards individuals who are overweight or obese, support for policies to reduce obesity and reactions to the campaign. Overall, 76.2% of MPs and just under half of the public (47.5% in W2 and 36.8% in W3) reported having seen the campaign. Unprompted awareness of obesity as a risk factor increased among the public from 17.1% at W1 to 43.3% in W2 (odds ratio 3.71, 95% confidence interval 3.18–4.33) and 30.3% in W3 (odds ratio 2.11, 95% confidence interval 1.80–2.47). A similar pattern was seen for prompted awareness and among MPs. There were no consistent changes in attitudes towards overweight individuals or support for policies to reduce obesity. This evaluation suggests that the campaign achieved the primary objective of increasing awareness of the link between obesity and cancer without increasing negative attitudes towards individuals who are overweight or obese. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the epidemiology of post-COVID conditions beyond 12 months and identify factors associated with the persistence of each condition. This was a cross-sectional questionnaire-based survey. We conducted the survey among patients who had recovered from COVID-19 and visited our institute between February 2020 and November 2021. Demographic and clinical data and data regarding the presence and duration of post-COVID conditions were obtained. We identified factors associated with the persistence of post-COVID conditions using multivariable linear regression analyses. Of 1148 surveyed patients, 502 completed the survey (response rate, 43.7%). Of these, 393 patients (86.4%) had mild disease in the acute phase. The proportion of participants with at least one symptom at 6, 12, 18, and 24 months after symptom onset or COVID-19 diagnosis was 32.3% (124/384), 30.5% (71/233), 25.8% (24/93), and 33.3% (2/6), respectively. The observed associations were as follows: fatigue persistence with moderate or severe COVID-19 (β = 0.53, 95% confidence interval [CI] = 0.06–0.99); shortness of breath with moderate or severe COVID-19 (β = 1.39, 95% CI = 0.91–1.87); cough with moderate or severe COVID-19 (β = 0.84, 95% CI = 0.40–1.29); dysosmia with being female (β = −0.57, 95% CI = −0.97 to −0.18) and absence of underlying medical conditions (β = −0.43, 95% CI = −0.82 to −0.05); hair loss with being female (β = −0.61, 95% CI = −1.00 to −0.22), absence of underlying medical conditions (β = −0.42, 95% CI = −0.80 to 0.04), and moderate or severe COVID-19 (β = 0.97, 95% CI = 0.41–1.54); depressed mood with younger age (β = −0.02, 95% CI = −0.04 to −0.004); and loss of concentration with being female (β = −0.51, 95% CI = −0.94 to −0.09). More than one-fourth of patients after recovery from COVID-19, most of whom had had mild disease in the acute phase, had at least one symptom at 6, 12, 18, and 24 months after onset of COVID-19, indicating that not a few patients with COVID-19 suffer from long-term residual symptoms, even in mild cases. [ABSTRACT FROM AUTHOR]

Recent general population surveys have produced highly variable estimates of the extent of problem gambling in Great Britain, ranging from as low as 0.4% to as high as 2.7% of adults. This level of uncertainty over the true level of problem gambling creates difficulties for policy makers and those planning treatment and support services for individuals and families affected by problem gambling. In this article, we assess the extent to which differences in approaches to sampling and measurement between surveys contribute to variability in estimates of problem gambling. We compare estimates of problem gambling using the Problem Gambling Severity Index across eight different surveys conducted at approximately the same time but which use different sampling and measurement strategies. Our findings show that surveys conducted online produce substantially higher estimates of problem gambling compared with in-person interview surveys. This is because online surveys, whether using probability or non-probability sampling, overrepresent people who are more likely to gamble online and to gamble frequently, relative to the proportions of these groups in the general population. [ABSTRACT FROM AUTHOR]

Working from home where possible is important in reducing the spread of COVID-19. In early 2021, a quarter of people in England who believed they could work entirely from home reported attending their workplace. To inform interventions to reduce this, this study examined associated factors. Data from the ongoing COVID-19 Rapid Survey of Adherence to Interventions and Responses survey series of nationally representative samples of people in the UK aged 16+ years in January–February 2021 were used. The study sample was 1422 respondents who reported that they could work completely from home. The outcome measure was self-reported workplace attendance at least once during the preceding week. Factors of interest were analysed in three blocks: 1) sociodemographic variables, 2) variables relating to respondents' circumstances and 3) psychological variables. 26.8% (95% confidence interval [CI] = 24.5%–29.1%) of respondents reported having attended their workplace at least once in the preceding week. Sociodemographic variables and living circumstances significantly independently predicted non-essential workplace attendance: male gender (odds ratio [OR] = 1.85, 95% CI = 1.33–2.58); dependent children in the household (OR = 1.65, 95% CI = 1.17–2.32); financial hardship (OR = 1.14, 95% CI = 1.08–1.21); lower socio-economic grade (C2DE; OR = 1.65, 95% CI = 1.19–2.53); working in sectors such as health or social care (OR = 4.18, 95% CI = 2.56–6.81), education and childcare (OR = 2.45, 95% CI = 1.45–4.14) and key public service (OR = 3.78, 95% CI = 1.83–7.81) and having been vaccinated (OR = 2.08, 95% CI = 1.33–3.24). Non-essential workplace attendance in the UK in early 2021 during the COVID-19 pandemic was significantly independently associated with a range of sociodemographic variables and personal circumstances. Having been vaccinated, financial hardship, socio-economic grade C2DE, having a dependent child at home and working in certain key sectors were associated with higher likelihood of workplace attendance. [ABSTRACT FROM AUTHOR]

To contain the spread of COVID-19 within the UK over the past year, there have been a series of local and national lockdowns. These restrictions are likely to have impacted upon the health and well-being of marginalised groups who rely on now closed social and community support services to stay healthy. An understanding of the experiences of marginalised people is important; therefore, this study aimed to explore the impact of the COVID-19 restrictions on the health and well-being of marginalised groups in the UK. In summer 2020, a rapid telephone survey was conducted by trained, trusted volunteers with 76 participants who were from marginalised groups. As part of this survey, 64 participants consented to describe their experience of lockdown. These case studies were thematically analysed to identify patterns of meaning. Findings indicate that lockdown led to the deterioration of health of participants, impacted adversely on their socio-economic positions and affected access to food and essential supplies. In addition, government public health messaging was considered confusing and inadequate. This study highlights the need for pathways into services which support marginalised groups to remain accessible during periods of restrictions and essential supplies and food to be mapped and protected for marginalised individuals within our local communities. [ABSTRACT FROM AUTHOR]

In the containment phase of the response to the COVID-19 outbreak, Public Health England (PHE) delivered advice to travellers arriving at major UK ports. We aimed to rapidly evaluate the impact and effectiveness of these communication materials for passengers in the early stages of the pandemic. The study design used is the mixed-methods evaluation. A questionnaire survey and follow-up interviews with passengers arriving at London Heathrow Airport on scheduled flights from China and Singapore. The survey assessed passengers' knowledge of symptoms, actions to take, and attitudes towards PHE COVID-19 public health information; interviews explored their views of official public health information and self-isolation. One hundred and twenty-one passengers participated in the survey and 15 in follow-up interviews. Eighty three percentage of surveyed passengers correctly identified all three COVID-19 associated symptoms listed in PHE information at that time. Most could identify the recommended actions and found the advice understandable and trustworthy. Interviews revealed that passengers shared concerns about the lack of wider official action, and that passengers' knowledge had been acquired elsewhere as much from PHE. Respondents also noted their own agency in choosing to self-isolate, partially as a self-protective measure. PHE COVID-19 public health information was perceived as clear and acceptable, but we found that passengers acquired knowledge from various sources and they saw the provision of information alone on arrival as an insufficient official response. Our study provides fresh insights into the importance of taking greater account of diverse information sources and of the need for public assurance in creating public health information materials to address global health threats. [ABSTRACT FROM AUTHOR]

A public health approach to palliative care that reorientates care towards the public is advocated in global policy. The public are drivers in identifying care priorities and partners in finding solutions to care issues; however, a necessary prerequisite is that the public knows what palliative care is and what it can achieve. The aim of this study was to investigate what young adults, an important cohort of the public, know about palliative care and identify key predictors of knowledge. This is a cross-sectional online survey. A cross-sectional online survey measured knowledge of palliative care using the Palliative Care Knowledge Scale (PaCKS), with young adults (aged 18–29 years) recruited from a university in the UK. Data relating to demographic characteristics and familiarity and experience of palliative care were collected, with descriptive, bivariate and multivariate analyses undertaken to determine respondents' knowledge levels and key predictors. In total, 83% (n = 710) of respondents (n = 859) had heard of the term palliative care. The mean score on the PaCKS was 8.87 (standard deviation = 3.4, range = 0–13); men had lower levels of knowledge (P = 0.016). Most respondents were aware that palliative care is not specifically for those with cancer or exclusively for older populations. They were unsure of timing and other key aspects reporting significant levels of 'I don't 'know' responses. Linear regression analysis demonstrated that familiarity and experience of palliative care moderated demographic influences (age, gender, education level) on knowledge (β = 0.45, P < 0.001). The findings suggest that despite high levels of awareness and familiarity with the term, significant numbers of respondents indicated a lack of knowledge of palliative care rather than inaccurate knowledge. This suggests the need for public health organisations to partner with palliative care sectors to develop and disseminate clear unequivocal messaging relating to the breadth of palliative care that both informs and engages young adults. • The majority of respondents had heard of the term palliative care. • Familiarity and experience of palliative care strongly predicted knowledge scores. • Significant 'I don't 'know' responses suggest knowledge deficits not misinformation. • Public health initiatives should both engage and inform this young population. [ABSTRACT FROM AUTHOR]

The number of people testing positive for Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in the UK, particularly among young adults, is increasing. We report here on the mental health of young adults and related psychological and behavioural responses to the pandemic and consider the role of these factors in fuelling the increase in coronavirus disease 2019 (COVID-19) in this group. An online survey was completed during the first six weeks of the first UK-wide lockdown by 3097 respondents, including data for 364 respondents aged 18–24 years. The survey included measures of mental health and indices capturing related psychological and behavioural responses to the pandemic. The mental health of 18- to 24-years-olds in the first 6 weeks of lockdown was significantly poorer than that of older respondents and previously published norms: with 84% reporting symptoms of depression and 72% reporting symptoms of anxiety. Young adults also reported significantly greater loneliness and reduced positive mood, both of which were also associated with greater mental health difficulties. We contend that the combination of mental health, social and economic considerations may have contributed to the rise of COVID-19 infections in young adults, and ascribing blame to this group will not aid our efforts to regain control of the disease. • The UK has witnessed an exponential rise in coronavirus disease 2019 (COVID-19) infections, particularly among young adults. It has been assumed that this is occurring due to poorer engagement in risk reduction behaviours by young people. • We demonstrate that the mental health impact of the COVID-19 pandemic has been significantly greater in young adults and is strongly associated with increased loneliness and lower positive mood. We suggest that these factors, combined with the social and economic circumstances of young adults, have increased their risk of infection. We propose that containing the spread of COVID-19 among the young will require a recognition of these factors and is ill-served by a culture of blame. [ABSTRACT FROM AUTHOR]

To investigate factors associated with adherence to self-isolation and lockdown measures due to COVID-19 in the UK. Online cross-sectional survey. Data were collected between 6th and 7th May 2020. A total of 2240 participants living in the UK aged 18 years or older were recruited from YouGov's online research panel. A total of 217 people (9.7%) reported that they or someone in their household had symptoms of COVID-19 (cough or high temperature/fever) in the last 7 days. Of these people, 75.1% had left the home in the last 24 h (defined as non-adherent). Men were more likely to be non-adherent, as were people who were less worried about COVID-19, and who perceived a smaller risk of catching COVID-19. Adherence was associated with having received help from someone outside your household. Results should be taken with caution as there was no evidence for associations when controlling for multiple analyses. Of people reporting no symptoms in the household, 24.5% had gone out shopping for non-essentials in the last week (defined as non-adherent). Factors associated with non-adherence and with a higher total number of outings in the last week included decreased perceived effectiveness of government 'lockdown' measures, decreased perceived severity of COVID-19 and decreased estimates of how many other people were following lockdown rules. Having received help was associated with better adherence. Adherence to self-isolation is poor. As we move into a new phase of contact tracing and self-isolation, it is essential that adherence is improved. Communications should aim to increase knowledge about actions to take when symptomatic or if you have been in contact with a possible COVID-19 case. They should also emphasise the risk of catching and spreading COVID-19 when out and about and the effectiveness of preventative measures. Using volunteer networks effectively to support people in isolation may promote adherence. • 75% of those with household COVID-19 symptoms had left home in the last 24 h. • Total outings and shopping for non-essentials indicated non-adherence to lockdown. • Decreased perceived effectiveness of lockdown measures was linked to non-adherence. • Non-adherence was also linked with decreased perceived severity of COVID-19. • Perceived social norms were associated with adherence to lockdown measures. [ABSTRACT FROM AUTHOR]

The public and patients are primary contributors and beneficiaries of pandemic-relevant clinical research. However, their views on research participation during a pandemic have not been systematically studied. We aimed to understand public views regarding participation in clinical research during a hypothetical influenza pandemic. This is an international cross-sectional survey. We surveyed the views of nationally representative samples of people in Belgium, Poland, Spain, Ireland, the United Kingdom, Canada, Australia and New Zealand, using a scenario-based instrument during the 2017 regional influenza season. Descriptive and regression analyses were conducted. Of the 6804 respondents, 5572 (81.8%) thought pandemic-relevant research was important, and 5089 (74.8%) thought 'special rules' should be applied to make this research feasible. The respondents indicated willingness to take part in lower risk (4715, 69.3%) and higher risk (3585, 52.7%) primary care and lower risk (4780, 70.3%) and higher risk (4113, 60.4%) intensive care unit (ICU) study scenarios. For primary care studies, most (3972, 58.4%) participants preferred standard enrolment procedures such as prospective written informed consent, but 2327 (34.2%) thought simplified procedures would be acceptable. For ICU studies, 2800 (41.2%) preferred deferred consent, and 2623 (38.6%) preferred prospective third-party consent. Greater knowledge about pandemics, trust in a health professional, trust in the government, therapeutic misconception and having had ICU experience as a patient or carer predicted increased willingness to participate in pandemic-relevant research. Our study indicates current public support for pandemic-relevant clinical research. Tailored information and initiatives to advance research literacy and maintain trust are required to support pandemic-relevant research participation and engagement. • There is strong public support for pandemic-relevant clinical research initiatives. • Willingness to take part and to sign up under permissive approaches depends on type of research and key participant factors. • Knowledge of pandemics, trust in doctors and government, and experience of critical illness influence research participation. [ABSTRACT FROM AUTHOR]

The objective of this study was to understand the extent to which public health practitioner registration is encouraged by UK employers through recruitment, i.e. by including registration as an essential or desirable criterion in job descriptions and person specifications. A repeated survey was conducted on two main UK public health job websites. Data were collected via a repeated structured search of all public health practitioner posts advertised in two specified weeks in March and September 2018 on two main UK public health jobs websites: local government jobs and National Health Service (NHS) jobs. Fifty-six posts were identified for inclusion in the study. Only one post (2% of the total) required UK Public Health Register (UKPHR) registration or working towards registration. It was more common but still a minority (13% or 23%) of posts to require registration with any relevant register (e.g. UKPHR, Nursing and Midwifery Council or Health and Care Professions Council). Most employers demonstrated a desire for flexibility with none requiring an MSc Public Health and a majority requiring any relevant degree or equivalent experience (46% or 82%). Evidence of continuing professional development was also commonly required (34% or 61%). There is currently a mismatch between UK national policy support for public health practitioner registration and the value that registered practitioners place on it and the recruitment polices of many UK public health employers. • UK public health policy increasingly supports the registration of public health practitioners. • Research has demonstrated registered practitioners value the confirmation of their public health skills and competencies. • This research suggests that UK public health employers value continuing professional development more than registration. • There is a mismatch between UK policy support for practitioner registration and recruitment polices of UK employers. [ABSTRACT FROM AUTHOR]

Adolescents are at risk of developing detrimental health behaviours that will affect their adult health. The aim was to estimate prevalence of health risk behaviours (HRB), comparing young people (12–18 years old) in Wiltshire (UK) who are vulnerable (looked after children, special education needs and disabilities, young carers and military dependents) to those who are not vulnerable and assess whether these behaviours are associated with protective factors (e.g. friendship groups). Secondary analysis of cross-sectional survey data (n = 4129). In total, 900 vulnerable young people were compared with 3229 non-vulnerable young people. Differences between the two groups were assessed using Chi-squared tests, and associations with possible protective factors were assessed using logistic regression (adjusting for confounding factors). Vulnerable young people have a higher prevalence of smoking tobacco (15% vs 9%, P < 0.001), using cannabis (7% vs 5%, P = 0.03) and self-harming (16% vs 9%, P < 0.001) monthly or more compared with the rest of the Wiltshire adolescent population. Whilst vulnerable young people have many shared protective factors with non-vulnerable young people, there are also differences between the two groups. There are shared protective factors across HRB that can build on the resilience of a young person, impacting their current and future health. Therefore, we should focus our attention on developing protective factors that promote health and well-being, not solely delivering specialist interventions targeted at specific risks. Further consideration should be given to identifying and promoting protective factors specifically for vulnerable people as they have higher levels of HRB and experience protective factors differently. • Vulnerable young people experience higher prevalence of health risk behaviours. • Shared protective factors are associated with reductions in multiple health risk behaviours. • There is some evidence that vulnerable young people may respond differently to protective factors. • Prevention strategies and interventions to reduce adolescent risk-taking behaviours should take this into account. [ABSTRACT FROM AUTHOR]

Objectives: Using data from an international collaborative research project on youth resilience in the context of migration, this study aims to investigate how different acculturation patterns (i.e. integration, assimilation, separation and marginalization) influence the mental health of migrant youth, and whether resilience might function as a mediator in the association between acculturation and mental health. Study design: A cross-sectional pilot study conducted in six countries employing a common survey questionnaire. Methods: The study sample was 194 youths aged 10-17 years (median = 13.6) from six countries (Australia, Canada, China, New Zealand, South Africa, and United Kingdom) and included cross-border and internal migrants. Mental health and well-being was measured by the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Resilience was measured by the Child and Youth Resilience Measure-28 (CYRM-28). Acculturation was assessed using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA). Multivariate regression and path analysis were performed to examine the hypothesized mediation model. Results: Resilience scores correlated strongly with mental health and well-being. Acculturation exerted no significant direct effects on the mental health of migrant youths. Nevertheless, compared to youths who were integration-oriented, assimilation-oriented youths tended to exhibit lower levels of resilience, resulting in poorer mental health. Compared to youths from other countries, migrant youths from China also reported lower levels of resilience, which led to poorer mental health outcome. Conclusion: Acculturation plays a significant role in the mental health of migrant youth, with different acculturative orientations exhibiting different influences through the mediation effect of resilience. Fostering resilience and facilitating integration-oriented acculturation are recommended public health strategies for migrant youth. [ABSTRACT FROM AUTHOR]

Objective: High prevalence of sedentary behaviour is seen in most immigrant groups in Western countries, particularly in those from the Indian subcontinent. The primary objective of this study was to determine the sociocognitive associations with intention to undertake physical activity (PA) among separate groups of Indian, Pakistani and Bangladeshi older adults aged ≥60 years in the North West of England, UK. Study design: Cross-sectional survey Methods: Using a cross-sectional survey, informed by the Theory of Planned Behaviour (TPB), 138 of 964 South Asian (SA) older adults completed a mailed questionnaire that assessed self-reported PA and TPB variables. Results: Associations were seen in beliefs about PA and the amount of PA undertaken (rho = 0.18, P = 0.04). Attitude was correlated with intention (rho = 0.29, P = 0.01) and amount of PA undertaken (rho = 0.21, P = 0.02). Subjective norm was correlated with intention to undertake PA (rho = 0.21, P = 0.02). Between-group differences were seen between (1) Indian and Pakistani group's in subjective norm; (2) all ethnicities in intention to undertake PA; and (3) in the amount and attitude to undertaking PA between men and women. Comorbidity was associated with beliefs about PA uptake. Conclusions: Subgroup differences between Indian, Pakistani and Bangladeshi older adults in subjective norm and intention to undertaking PA highlight the importance of tailoring interventions to accommodate for subgroup differences when developing culturally appropriate PA interventions aimed at increasing uptake and adherence. [ABSTRACT FROM AUTHOR]

Objective There is a need to increase HIV testing rates in the UK. One approach is to increase access to testing through general health checks (GHCs) in the workplace. However, it is unclear whether GHCs are routinely offered by organisations, and employer perceptions of HIV testing are largely unknown. Study design Online survey to assess attitudes towards and provision of general health checks and HIV testing in the workplace. Methods Ninety-eight employers from 25 job sectors completed an online survey. Employers were 61 small and medium-sized enterprises (SME), 37 large organisations; 86% employing mobile workers, 77.6% employing migrant workers and 51.7% of employees were male workers. Items included employer attitudes around workplace health, GHC provision, content and delivery and attitudes towards workplace HIV testing including perceived benefits and barriers to HIV testing. Results Only one company offered opt-in workplace HIV testing. Seventy-eight companies (80%) did not provide any form of workplace GHC for employees. Decisions about health check provisions were not commonly informed by staff consultation (n = 6) or national guidelines (n = 4). Overall, 100% of companies (n = 98) reported at least one benefit of HIV testing and 68 (69%) believed that HIV testing should be offered in the workplace. Perceived barriers to HIV testing in the workplace were: [a] not having enough knowledge about HIV and testing; [b] not having trained staff to undertake HIV testing; and, [c] not knowing how to access HIV testing kits. Fifty-six companies (57.14%) would consider HIV testing as a future provision at their organisation. Sixty-seven companies (68.37%) would like further guidance on workplace HIV testing. Conclusions Few employers offer general health testing for employees, and opt-in HIV testing is exceptionally rare, despite positive attitudes towards it. There is a need to provide evidence-based guidance and support for employers around HIV testing in the workplace. [ABSTRACT FROM AUTHOR]

Objective: In 2006, food industry self-regulatory efforts aimed to balance the mix of food advertisements to limit children's exposure to unhealthy food products. An update to these efforts proposed to eliminate all unhealthy advertisements during peak child viewing times and implement uniform nutrition criteria by December, 2013. Marketing techniques are not currently addressed in self-regulatory efforts. The food industry's pledge prompted researchers to conduct a content analysis to assess nutritional quality and presence of persuasive marketing techniques in child-directed food and beverage advertisements. Study design: Content analysis. Methods: 32 h of children's television programming were recorded in February, 2013. Three independent coders assessed the nutritional content of food and beverage advertisements using the UK Nutrition Profiling System and assessed presence of persuasive techniques (PTs) using a rating form developed for this study. Results: Overall, 13.75% of advertisements promoted a food or beverage product. Most food advertisements, 54.6%, represented unhealthy products and 95.48% of food advertisements contained at least one PT. The number of PTs was not significantly different for healthy (M = 4.98, SD = 2.07) and unhealthy food advertisements (M = 4.66, SD = 1.82) however food advertisements aimed at children used significantly more PTs (M = 5.5, SD = 1.43) than those targeting adults (M = 1.52, SD = 1.54), t (153) = 11.738, P < 0.0001. Saturday morning children's programming showed significantly fewer food advertisements compared to weekday morning children's programming. Conclusions: While a majority of food-related advertisements represented unhealthy items, advertisements airing during Saturday morning programming featured fewer food advertisements overall and were more frequently for healthier items compared to weekdays. Industry self-regulation may not be effective for reducing overall unhealthy ad exposure but may play a role in reduced exposure on weekends. Despite policy efforts, additional changes are needed to improve ad exposure experienced by children with a focus on addressing the persistent use of persuasive marketing techniques in food advertising intended for children. [ABSTRACT FROM AUTHOR]

Objectives: Members of the public are often sceptical about warnings of an impending public health crisis. Breaking through this scepticism is important if we are to convince people to take urgent protective action. In this paper we explored correlates of perceiving that 'too much fuss' was being made about the 2009/10 influenza A H1N1v ('swine flu') pandemic. Study design: A secondary analysis of data from 39 nationally representative telephone surveys conducted in the UK during the pandemic. Methods: Each cross-sectional survey (combined n = 42,420) collected data over a three day period and asked participants to state whether they agreed or disagreed that 'too much fuss is being made about the risk of swine flu.' Results: Overall, 55.1% of people agreed or strongly agreed with this sentiment. Perceiving that too much fuss was being made was associated with: being male, being white, being generally healthy, trusting most in a primary care physician to provide advice, not knowing someone who had contracted the illness, believing you know a lot about the outbreak, not wishing to receive additional information about the outbreak and possessing worse factual knowledge about the outbreak than other people. Conclusions: In future disease outbreaks merely providing factual information is unlikely to engage people who are sceptical about the need to take action. Instead, messages which challenge their perceived knowledge and which present case studies of people who have been affected may prove more effective, especially when delivered through trusted channels. [ABSTRACT FROM AUTHOR]

Objectives: The recent growth in the market for electronic cigarettes (e-cigarettes) has led to concerns over their use by young people. It is therefore important to examine trends in the perception and use of e-cigarettes and conventional cigarettes in this group. Study design: Two-wave cross-sectional survey design. Methods: Young people aged 11-18 in Great Britain were surveyed online by YouGov in 2013 and 2014. Use of e-cigarettes, together with perceived health harms and intention to use were assessed and compared in relation to cigarette smoking history, age and gender. Results: Ever-use of e-cigarettes increased significantly from 4.5% (95% Cl 3.8-5.7) in 2013 to 8.2% (95% Cl 7.0-9.6) in 2014. Monthly or more use of e-cigarettes increased from 0.9% (95% Cl 0.5-1.5) to 1.7 (1.2-2.4), but remained rare in never-smokers at under 0.2%. The proportion of young people who perceived e-cigarettes to be less harmful to users than cigarettes fell from 73.4% (95% Cl 71.0-75.8) to 66.9% (95% Cl 64.5-69.2), while the proportion who considered e-cigarettes to cause similar levels of harm increased from 11.8% (95% Cl 10.0-13.5) to 18.2% (95% Cl 16.3-20.1). Of the 8.2% of e-cigarette ever-users in 2014, 69.8% (95% Cl 62.2%-77.3%) had smoked a cigarette prior to using an e-cigarette, while 8.2% (95% Cl 4.1%-12.2%) first smoked a cigarette after e-cigarette use. Conclusions: A growing proportion of young people in Great Britain believe e-cigarettes are as harmful as smoking tobacco. Use of e-cigarettes by young people is increasing, but is largely confined to those who smoke. [ABSTRACT FROM AUTHOR]

As complex environments within which individuals and populations operate, universities present important contexts for understanding and addressing health issues. The healthy university is an example of the settings approach, which adopts a whole system perspective, aiming to make places within which people, learn, live, work and play supportive to health and well-being. The UK Healthy Universities Network has formulated an online toolkit, which includes a Self-Review Tool, intended to enable universities to assess what actions they need to take to develop as a healthy university. This paper presents findings from consultative research undertaken with students from universities in England, Scotland and Wales, which explored what they believe, represents a healthy university. Methods: Student surveys and focus groups were used to collect data across eleven universities in England, Scotland and Wales. A priori themes were used to develop our own model for a healthy university, and for the thematic coding phase of analysis. Findings: A healthy university would promote student health and well-being in every aspect of its business from its facilities and environment through to its curriculum. Access to reasonably priced healthy food and exercise facilities were key features of a healthy university for students in this study. The Self-Review Tool has provided a crucial start for universities undertaking the journey towards becoming a healthy university. In looking to the future both universities and the UK Healthy Universities Network will now need to look at what students want from their whole university experience, and consider how the Self-Review Tool can help universities embrace a more explicit conceptual framework. Conclusion: The concept of a healthy university that can tailor its facilities and supportive environments to the needs of its students will go some way to developing students who are active global citizens and who are more likely to value and prioritise health and well-being, in the short and long term through to their adult lives. [ABSTRACT FROM AUTHOR]

Objectives: Smoking is the leading risk factor for disability-adjusted life-years, yet evidence with which to establish the smoking rates of people with different ethnic backgrounds and how they are changing in relation to recent migration is lacking. The objective is to provide current information on the changing risk profiles of the UK population. Study design: Observational study using cross-sectional surveys. Methods: Data from the Integrated Household Survey (pooled for the years 2009/10-2011/12), obtained under Special Licence, and the GP Patient Survey (2012) have been used to establish smoking prevalence in a wider range of ethnic groups in England and Wales, including the 'mixed' groups and amongst East European migrants, and how such prevalence differs across socio-economic classes. Results: Smoking prevalence is substantially higher amongst migrants from East European countries (that for males exceeding 50% from three such countries and for females over 33% from four countries) and from Turkey and Greece, compared with most other non-UK born groups, and amongst ethnic groups is elevated in the 'mixed' groups. Rates are highest in the Gypsy or Irish Traveller group, 49% (of 162) and 46% (of 155) for males and females respectively. Across ethnic groups, rates are almost always higher in the UK born than non-UK born population with the notable exception of the 'White Other' group, with Prevalence Ratios (PRs) indicating a larger migrant-non-migrant differential amongst females (e.g. Indians 2.95 (2.33-3.73); Black Caribbeans 3.28 (2.73-3.94). Age-adjusted rates show the persistence of these differentials in females across age groups, though young males (18-29) in seven minority ethnic groups show lower rates in the UK-born groups. The 'White' and 'Chinese' groups show a strong socio-economic gradient in smoking which is absent in the South Asian groups and diminished in the 'mixed' and black groups. Conclusions: Given the evidence that smoking behaviour is significantly different in some of the new groups, notably East European migrants, stop smoking services are failing to optimize the acceptability and, consequently, favourable outcomes for these programmes. These services need to be adapted to the particular patterns of smoking behaviour and language skills within different communities of descent. [ABSTRACT FROM AUTHOR]