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Background There is growing evidence that common strategies are used across unhealthy commodity industries (UCIs) to influence policy decisions in line with their commercial interests. To date, there have been relatively few studies comparing corporate political activity (CPA) across UCIs, especially comparing the alcohol and gambling industries. Methods A comparative and inductive thematic analysis of alcohol and gambling industry submissions to two House of Lords (HoL) inquiries in the UK was conducted. Themes in the framing, arguments and strategies used by the alcohol and gambling industries in CPA were compared. Results Alcohol and gambling industry responses largely used the same framings, both in terms of the problems and solutions. This included arguing that harms are only experienced by a ‘minority’ of people, emphasising individual responsibility and shifting blame for harms to other industry actors. They promoted targeted or localised solutions to these harms, in place of more effective population level solutions, and emphasised the perceived harms of introducing regulation not in the industries’ interests. Conclusions These findings are consistent with previous literature suggesting that UCIs use the same framing and arguments to shape the narrative around their harms and solutions to those harms. This study also identified novel strategies such as shifting blame of harms to other industry actors. Policy makers should be aware of these strategies to avoid undue industry influence on policy decisions and understanding commonalities in strategies may help to inform more effective public health responses across all UCIs.

Children and young people (CYP) have suffered challenges to their mental health as a result of the COVID-19 pandemic; effects have been most pronounced on those already disadvantaged. Adopting a whole-school approach embracing changes to school environments, cultures and curricula is key to recovery, combining social and emotional skill building, mental health support and interventions to promote commitment and belonging. An evidence-based response must be put in place to support schools, which acknowledges that the mental health and well-being of CYP should not be forfeited in the drive to address the attainment gap. Schools provide an ideal setting for universal screening of mental well-being to help monitor and respond to the challenges facing CYP in the wake of the pandemic. Research is needed to support identification and implementation of suitable screening methods.

AIM: To examine factors influencing current and ex-smokers' decisions to use e-cigarettes or behavioural support, including potential impacts of any differences in perspectives between smokers and their local stop smoking services (SSSs). DESIGN: Semi-structured qualitative interviews followed by framework analysis, with the 'capability', 'opportunity', 'motivation' and 'behaviour' (COM-B) model of behaviour change used to frame findings. SETTING: SSSs and surrounding local areas in England. PARTICIPANTS: Interviewees (n = 46) were current or recent smokers (n = 29) and SSS staff or stakeholders (n = 17). MEASUREMENTS: Interview topic guides explored influences on smokers' choice of quit method and characteristics of support offered by local SSSs. FINDINGS: Current and ex-smokers showed a range of views on potential risks from long-term vaping, which appeared to be particularly relevant for the capability dimension of COM-B. These different attitudes to vaping appeared to be linked to variations in people's perceived capability to assess evidence around e-cigarettes' safety. Motivations for using or avoiding e-cigarettes and SSSs often appeared to overlap: attitudes to both e-cigarettes and nicotine replacement therapy from SSSs often reflected personal experiences and views on whether switching from smoking to these alternatives represented successful quitting or simply ongoing nicotine addiction. For smokers, opportunities to use e-cigarettes or SSSs appeared to be largely determined by perceived time requirements. Furthermore, interviews with SSS professionals suggested that opportunities to access SSSs for ex-smokers who were now regular vapers may be being influenced by different e-cigarette policies adopted in individual areas. CONCLUSIONS: In England, smokers' decisions to use e-cigarettes and local stop smoking services appear to be determined by varied influences across the COM-B framework. Both smokers and stop smoking service professionals display diverse views about potential risks from e-cigarettes, which has relevance for the provision of behavioural support as well as the uptake of vaping.

Objective To assess whether electronic cigarette (e-cigarette) awareness, ‘ever use’ and current use vary significantly between different sociodemographic groups. Design Systematic review. Data sources Published and unpublished reports identified by searching seven electronic databases (PubMed, MEDLINE, Web of Science, EMBASE, Global Health, PsycINFO, CINAHL Plus) and grey literature sources. Study selection Systematic search for and appraisal of cross-sectional or longitudinal studies that assessed e-cigarette awareness, ‘ever use’ or current use, and included subgroup analysis of 1 or more PROGRESS Plus sociodemographic groups. No geographical or time restrictions imposed. Assessment by multiple reviewers, with 17% of full articles screened meeting the selection criteria. Data extraction Data extracted and checked by multiple reviewers, with quality assessed using an adapted tool developed by the Joanna Briggs Institute. Data synthesis Results of narrative synthesis suggest broadly that awareness, ‘ever use’ and current use of e-cigarettes may be particularly prevalent among older adolescents and younger adults, males, people of white ethnicity and—particularly in the case of awareness and ‘ever use’—those of intermediate or high levels of education. In some cases, results also varied within and between countries. Conclusions E-cigarette awareness, ‘ever use’ and current use appear to be patterned by a number of sociodemographic factors which vary between different countries and subnational localities. Care will therefore be required to ensure neither the potential benefits nor the potential risks of e-cigarettes exacerbate existing health inequalities.

Two contrasting viewpoints by Stimson and Chapman in this edition illustrate the divisions in the public health community over e-cigarettes. Stimson argues that we should embrace and promote e-cigarettes, while Chapman highlights the pitfalls of this simplistic approach. Such contrasting views are perhaps inevitable given the infant evidence base surrounding this rapidly emerging technology, but the consequent uncertainty about the population impacts of e-cigarettes should preclude an overly firm stance either for or against—as we outline below, it is simply too early to know. Two key questions surround this debate: are e-cigarettes an opportunity or threat to public health and how can we ensure benefits are maximized and harms minimized? As Michael Russell wrote in 1976, ‘people smoke for the nicotine but they die from the tar’. E-cigarettes deliver the nicotine without the tar, as their use involves no combustion. Common sense therefore dictates that e-cigarettes are significantly less harmful than cigarettes, and for the individual smoker who cannot or does not want to quit, there is little doubt that switching to e-cigarettes will be beneficial. The population-level impacts, however, are far less certain. If taken up only by smokers or those who would otherwise have taken up smoking and if effective as a cessation aid, e-cigarettes will undoubtedly be a force for good. Conversely, if the heavy marketing of e-cigarettes, which has been found …

Objectives To determine the feasibility of collecting population-based patient-reported outcome measures (PROMs) in assessing quality of life (QoL) to inform the development of a national PROMs programme for cancer and to begin to describe outcomes in a UK cohort of survivors. Design Cross-sectional postal survey of cancer survivors using a population-based sampling approach. Setting English National Health Service. Participants 4992 breast, colorectal, prostate and non-Hodgkin9s lymphoma (NHL) survivors 1–5 years from diagnosis. Primary and secondary outcome measures Implementation issues, response rates, cancer-specific morbidities utilising items including the EQ5D, tumour-specific subscales of the Functional Assessment of Cancer Therapy and Social Difficulties Inventory. Results 3300 (66%) survivors returned completed questionnaires. The majority aged 85+ years did not respond and the response rates were lower for those from more deprived area. Response rates did not differ by gender, time since diagnosis or cancer type. The presence of one or more long-term conditions was associated with significantly lower QoL scores. Individuals from most deprived areas reported lower QoL scores and poorer outcomes on other measures, as did those self-reporting recurrent disease or uncertainty about disease status. QoL scores were comparable at all time points for all cancers except NHL. QoL scores were lower than those from the general population in Health Survey for England (2008) and General Practice Patient Survey (2012). 47% of patients reported fear of recurrence, while 20% reported moderate or severe difficulties with mobility or usual activities. Bowel and urinary problems were common among colorectal and prostate patients. Poor bowel and bladder control were significantly associated with lower QoL. Conclusions This method of assessing QoL of cancer survivors is feasible and acceptable to most survivors. Routine collection of national population-based PROMs will enable the identification of, and the support for, the specific needs of survivors while allowing for comparison of outcome by service provider.

Axisymmetric equilibrium reconstruction using magnetohydrodynamic equilibrium solutions to the Grad-Shafranov equation has long been an important tool for interpreting tokamak experiments. This paper describes recent results in non-axisymmetric (three-dimensional) equilibrium reconstruction of nominally axisymmetric plasmas (tokamaks and reversed field pinches (RFPs)), and fully non-axisymmetric plasmas (stellarators). Results from applying the V3FIT code to CTH and HSX stellarator plasmas, RFX-mod RFP plasmas and the DIII-D tokamak are presented.