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Minimum unit pricing for alcohol (MUP) came into effect on 1st May 2018 in Scotland, raising the price of the cheapest shop-bought alcohol. Small retailers are a key source of alcohol for communities, often located in areas of high alcohol-related harm. We sought to examine their experiences of MUP implementation and impact. We conducted semi-structured interviews in-store with 20 small retailers in central Scotland at two time points: October – November 2017 (6–7 months pre-implementation); and October – November 2018 (5–6 months post-implementation). Prior to implementation, some retailers did not understand MUP, including how prices would link to product strength, or were concerned about anticipated implementation burden. Several expressed support for reducing 'problem' drinking or suggested that MUP would increase alcohol prices in supermarkets bringing them into line with small retailers. Despite initial concerns, small retailers reported minimal disruption following implementation of MUP, which was generally straightforward. Compliance was taken seriously and price calculations relatively manageable. Few/no negative reactions from customers were reported. Some felt that the measure enabled them to better compete with larger retailers/supermarkets. Concerns about MUP expressed by some trade bodies prior to implementation were largely not borne out in the experiences of small retailers. [ABSTRACT FROM AUTHOR]

Background: The ActWELL randomised controlled trial assessed the effectiveness of a weight management programme delivered by volunteer lifestyle coaches (LCs) in women attending breast clinics. The intervention focused on caloric intake and physical activity, utilising behavioural change techniques including a weight awareness plan (WAP). The current work is a secondary analysis of the ActWELL data and aims to examine the response to the weight self‐awareness plan (used as part of the intervention programme). Methods: The LCs invited participants (n = 279) to undertake an implementation intention discussion to formulate a self‐weighing (SW) plan. Bodyweight scales were offered, and recording books provided. The physical activity component of the intervention focused on a walking plan assessed by accelerometers. The LCs contacted participants by telephone monthly and provided personalised feedback. Mann–Whitney tests and chi‐squared analysis were used to examine the effect of SW on weight change. A qualitative evaluation utilising semi‐structured interviews was also undertaken. Results: Most participants (96.4%) agreed to set a weekly SW goal and 76 (27%) requested scales. At 12 months, 226 (81%) returned for follow up. The median (interquartile range) weight change for those who self‐ reported at least one weight (n = 211) was −2.3 kg (−5.0 to 0.0) compared to −1.2 kg (−5.0 to 0.03) in those who did not (n = 14). Participants who reported weights on more than eight occasions (39%) were significantly more likely (p = 0.012) to achieve 5% weight loss compared to those who weighed less often. Low numbers of accelerometers were returned that did not allow for significance testing. Qualitative data (n = 24) indicated that many participants found the WAP helpful and motivating. Conclusions: Greater adherence to the WAP initiated by volunteer coaches is associated with achieving 5% weight loss. Key points: Volunteer coaches successfully supported women to lose weight in the ActWELL trial.Secondary analysis demonstrated that adherence to a weight awareness programme was associated with achieving 5% weight loss. [ABSTRACT FROM AUTHOR]

Introduction: The advertising of e-cigarettes in the UK is regulated through the revised EU Tobacco Products Directive and the Tobacco and Related Products Regulations, with further rules set out in the Advertising Standards Authority (ASA) Committees of Advertising (CAP) Code. Focusing on the ASA CAP Code Rules, we examined e-cigarette advertising regulation compliance in traditional advertising channels and on social media.Methods: We conducted a content analysis of UK e-cigarette and related product advertising using a randomly selected sample (n = 130) of advertising in traditional channels and on Instagram which appeared between January and December 2019. All ads were independently double-coded to assess compliance with each CAP Code Rule.Results: In traditional channels, our sample of advertising had largely good compliance. Only very small numbers of these ads appeared to be clearly in breach of any of the ASA rules (5% were in breach of Rule 22.7; 2% of Rule 22.9; and 1% of Rule 22.10). In contrast, we judged that all of the Instagram sample (n = 30) was in breach of Rule 22.12. For some rules, it was not possible to make definitive judgments about compliance, given uncertainty regarding how a rule should be interpreted and applied.Conclusions: We found overall good compliance for advertising in traditional channels, but assessed all of our social media advertising samples was in breach of regulations. Current guidance on e-cigarette advertising could be improved to facilitate e-cigarette advertising assessment and regulation. It would be beneficial to bring consumer perspectives into the assessment of regulation compliance.Implications: The regulation of e-cigarette advertising is a global concern. The UK Government has a statutory obligation to review the Tobacco and Related Products Regulations by May 2021. This study assessed compliance with current UK e-cigarette advertising regulations on placement and content. We identified areas where greater clarity is needed and outlined implications for future regulation. [ABSTRACT FROM AUTHOR]

Background Since May 2017, standardized packaging has been mandatory in the UK, with packs required to display an 'information message' explaining that there are more than 70 carcinogens in tobacco smoke. Methods Three waves of a longitudinal online survey in the UK with smokers pre-standardized packaging (Wave 1: April–May 2016) and followed up post-standardized packaging (Wave 2: September–November 2017, Wave 3: May–July 2019). Of the 6233 smokers at Wave 1, 4293 responded at Wave 2 and 3175 at Wave 3. We explored knowledge of the number of carcinogens in smoke, and whether knowing that smoke contains more than 70 carcinogens mediated change in the belief that the dangers of smoking are exaggerated (risk perception), stubbing out cigarettes, quit intentions and quitting. As the information message is larger on roll-your-own packs than on cigarette packs, as the packs are larger, we also explored whether there was any difference in knowing that smoke contains more than 70 carcinogens between exclusive cigarette smokers and exclusive roll-your-own smokers. Results Knowledge that there are over 70 carcinogens in smoke increased among smokers across waves, with the increase from Waves 1 to 3 greater for exclusive roll-your-own smokers than exclusive cigarette smokers (adjusted odds ratio=1.44; 95% CI 1.03–2.03). Knowledge that there are over 70 carcinogens in smoke mediated higher risk perception but not stubbing cigarettes out, quit intentions or quitting. Conclusions The information message improved knowledge of how many carcinogens are in smoke, particularly among exclusive roll-your-own smokers, and this was linked to higher risk perception. [ABSTRACT FROM AUTHOR]

Introduction: Standardized packaging was phased in between May 2016 and May 2017 in the United Kingdom and July 2017 and July 2018 in Norway. In both countries, the health warnings on packs prior to standardized packaging being implemented were from the former Tobacco Products Directive library of warnings (text warnings covering 43% of the pack front and pictorial warnings covering 53% of the pack reverse). The warnings on packs, postimplementation, were from the current Tobacco Products Directive library of warnings (novel pictorial warnings covering 65% of the pack front and reverse) for the United Kingdom but unchanged in Norway.Aims and Methods: Longitudinal online surveys were conducted prior to standardized packaging (United Kingdom: April-May 2016; Norway: May-June 2017) and postimplementation (United Kingdom: September-November 2017 and May-July 2019; Norway: August-September 2018). We explored smokers' response to the on-pack warnings (salience, cognitive reactions, and behavioral reactions).Results: In the United Kingdom, noticing warnings on packs, reading or looking closely at them, thinking about them, thinking about the health risks, avoidant behaviors, forgoing cigarettes, and being more likely to quit due to the warnings significantly increased from waves 1 to 2, and then decreased from waves 2 to 3, but remained higher than at wave 1. In Norway, noticing warnings, reading or looking closely at them, thinking about them, thinking about the health risks, and being more likely to quit due to the warnings significantly decreased from waves 1 to 2; avoidant behaviors and forgoing cigarettes remained unchanged.Conclusions: The inclusion of large novel pictorial warnings on standardized packs increases warning salience and effectiveness.Implications: Two longitudinal online surveys in the United Kingdom and Norway explored the impact of standardized packaging on warning salience and effectiveness. That warning salience and effectiveness only increased in the UK postimplementation, where standardized packaging was implemented alongside new larger pictorial warnings on the pack front and reverse, and not in Norway, where standardized packaging was introduced but older smaller text warnings (pack front) and pictorial warnings (pack reverse) were retained, highlights the importance of removing full branding and introducing stronger warnings simultaneously. [ABSTRACT FROM AUTHOR]

Objectives: Policy responses to the COVID-19 pandemic in 2020 led to behaviour changes in the UK's population, including a sudden shift towards working from home. These changes may have affected overall exposure to fine particulate matter (PM2.5), an air pollutant and source of health harm. We report the results of a simulation model of a representative sample of the UK's population, including workers and non-workers, to estimate PM2.5 exposure before and during the pandemic. Methods: PM2.5 exposure was simulated in April and August 2017–2020 for 10,000 individuals across the UK drawn from the 2011 nationwide census. These data were combined with data from the UK's ambient PM2.5 monitoring network, time use data and data on relevant personal behaviour before and during the first stage of the pandemic (such as changes in smoking and cooking). Results: The simulated exposures were significantly different between each year. Changes in ambient PM2.5 resulted in regional and temporal variation. People living in homes where someone smoked experienced higher exposure than those in smoke-free homes, with an increase of 4 µg/m3 in PM2.5 exposure in 2020. Conclusions: Changes in PM2.5 exposure were minimal for most individuals despite the simulated increases in cooking activity. Those living in smoking homes (estimated to be around 11% of the UK population) experienced increased exposure to PM2.5 during COVID lockdown measures and this is likely to have increased mortality and morbidity among this group. Government policy should address the risk of increased exposure to second-hand smoke in the event of future COVID-19-related restrictions. [ABSTRACT FROM AUTHOR]

Objective: Since November 2019, Ireland has restricted alcohol advertising at the cinema and outdoors (e.g., near schools) and banned alcohol advertising on public transport. Although awareness of such advertising had decreased 1 year after the restrictions, measures to limit COVID-19 transmission complicated interpretation. We examined (a) changes in awareness 2 years after restrictions, when COVID-19 mitigation measures had eased, and (b) how changes in Ireland compared with Northern Ireland, where the restrictions did not apply. Method: Repeat cross-sectional surveys were conducted with adults recruited from nonprobability online panels, with three waves in Ireland (October 2019 [before restrictions] and October 2020/2021 [after restrictions]; n = 3,029) and two in Northern Ireland (October 2020/2021; n = 1,011). Participants self-reported past-month awareness of 13 alcohol marketing activities, including public transport, cinema, and outdoor advertising (coded as any past-month awareness, no awareness, or not sure). Results: In Ireland, the odds of reporting no past-month awareness (vs. any) were higher in both 2021 and 2020 versus 2019 for all restricted advertising activities (e.g., 2021 vs. 2019 for public transport: adjusted OR = 1.88, 95% CI [1.53, 2.32]). Interactions between wave and jurisdiction indicated that in 2021, compared with 2020, the odds of reporting no past-month awareness of public transport and cinema advertising (vs. any) were higher in Ireland than in Northern Ireland, despite increased opportunities for exposure in both jurisdictions through eased pandemic mitigation measures. There was no interaction for outdoor advertising, suggesting between-wave trends did not differ by jurisdiction. Conclusions: Ireland's restrictions have reduced past-month awareness of alcohol advertising at the cinema and on public transport but not outdoors. Continued monitoring is required. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic necessitated unprecedented changes in alcohol availability, including closures, curfews and restrictions. We draw on new data from three UK studies exploring these issues to identify implications for premises licensing and wider policy., Methods: (i) Semi-structured interviews (n = 17) with licensing stakeholders in Scotland and England reporting how COVID-19 has reshaped local licensing and alcohol-related harms; (ii) semi-structured interviews (n = 15) with ambulance clinicians reporting experiences with alcohol during the pandemic; and (iii) descriptive and time series analyses of alcohol-related ambulance callouts in Scotland before and during the first UK lockdown (1 January 2019 to 30 June 2020)., Results: COVID-19 restrictions (closures, curfews) affected on-trade premises only and licensing stakeholders highlighted the relaxation of some laws (e.g. on takeaway alcohol) and a rise in home drinking as having long-term risks for public health. Ambulance clinicians described a welcome break from pre-pandemic mass public intoxication and huge reductions in alcohol-related callouts at night-time. They also highlighted potential long-term risks of increased home drinking. The national lockdown was associated with an absolute fall of 2.14 percentage points [95% confidence interval (CI) -3.54, -0.74; P = 0.003] in alcohol-related callouts as a percentage of total callouts, followed by a daily increase of +0.03% (95% CI 0.010, 0.05; P = 0.004)., Discussion and Conclusions: COVID-19 gave rise to both restrictions on premises and relaxations of licensing, with initial reductions in alcohol-related ambulance callouts, a rise in home drinking and diverse impacts on businesses. Policies which may protect on-trade businesses, while reshaping the night-time economy away from alcohol-related harms, could offer a 'win-win' for policymakers and health advocates., (© 2021 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)