'Between a Rock and a Hard Place' : Responses to Offending in Residential Childcare

There is current and ongoing concern regarding the potential criminalisation of looked after young people. This concern has been based on recent research across England and Wales which has identified that young people in care are more likely to be criminalised than their non-looked after peers (The Howard League for Penal Reform, 2016), with retrospective examinations of individuals in young offenders institutions and prisons finding they are disproportionately more likely to have been care experienced (Summerfield, 2011; Carnie and Broderick, 2015; Laming, 2016). In Scotland, less data is available and limited research attention has been paid to the responses by residential childcare workers to offending behaviour. To address these issues, this study aimed to: gather more data about police contact for offending by young people in children’s houses; to explore how practitioners make, and are supported to make, the decision to involve the police in incidents; and to survey what formal policies are in place within each local authority to aid decision making. This was achieved through the collation of ‘police contact data’ for young people placed in local authority run children’s houses over a period of six months; completion of an online survey by house managers asking them to describe the policy and/or practice guidance available to staff in relation to offending behaviour and police contact; and interviews with 27 residential workers, across two Scottish local authorities. In order to provide further context, the remaining Scottish local authorities were contacted and asked to provide written responses regarding guidance available to staff in their area in responding to offending behaviour

Young adult women smokers' response to using plain cigarette packaging: A naturalistic approach

Objectives: To explore young adult women smokers' cognitive and emotional response to using dark brown ‘plain' cigarette packs in natural settings and whether plain packaging is associated with any short-term change in smoking behaviour. Design: A naturalistic approach. Participants used plain cigarette packs provided to them for 1 week and for 1 week their own fully branded packs, but otherwise smoked and socialised as normal. Participants completed questionnaires twice a week. Setting: The six most populated cities and towns in Scotland. Participants: 301 young women smokers were recruited, with a final sample of 187 (62.1%). To meet the inclusion criteria women had to be between the ages of 18 and 35, daily cigarette smokers and provide a breath sample to confirm smoking status. Primary and secondary outcome measures: Pack perceptions and feelings, feelings about smoking, salience and perceptions of health warnings and avoidant and cessation behaviours. Results: In comparison to fully branded packaging, plain packaging was associated with more negative perceptions and feelings about the pack and about smoking (p<0.001). No significant overall differences in salience, seriousness or believability of health warnings were found between the pack types, but participants reported looking more closely at the warnings on plain packs and also thinking more about what the warnings were telling them (p<0.001). Participants reported being more likely to engage in avoidant behaviours, such as hiding or covering the pack (p<0.001), and cessation behaviours, such as foregoing cigarettes (p<0.05), smoking less around others (p<0.001), thinking about quitting (p<0.001) and reduced consumption (p<0.05), while using the plain packs. Results did not differ by dependence level or socioeconomic status. Conclusions: No research design can capture the true impacts of plain packaging prior to its introduction, but this study suggests that plain packaging may help reduce cigarette consumption and encourage cessation in the short term

Tobacco marketing awareness on youth smoking susceptibility and perceived prevalence before and after an advertising ban

Background: The Tobacco Advertising and Promotion Act (TAPA) was implemented in the UK in 2003, although its impact on young people has not been assessed. This study assessed smoking susceptibility (intention to smoke among never smokers) and perceived prevalence across three British cross-sectional samples (aged 11 to 16) before and after the introduction of the ban. Methods: Three in-home surveys (n = 1078, 1121 and 1121) were conducted before (1999 and 2002) and after (2004) the implementation of the TAPA. Results: Significant declines in awareness of tobacco marketing and perceived prevalence occurred across the three waves. Higher levels of awareness and perceived prevalence were associated with increased susceptibility, but direct measures of susceptibility remained stable. Conclusions: The TAPA is successfully protecting young people in the UK from tobacco marketing and reducing perceived prevalence, both of which are linked to susceptibility. The stability of susceptibility across the three waves is probably best explained by both the partial implementation of TAPA at the final survey point and the time such effects take to emerge. The evidence from this and previous studies is, however, that, ultimately, they will appear

Young women smokers' response to using plain cigarette packaging: Qualitative findings from a naturalistic study

Background: The aim of this study was to explore in-depth the response of young women smokers (18-35 years) to using dark brown ‘plain' cigarette packs in naturalistic settings. Methods: Participants were recruited in six towns and cities in Scotland to take part in a naturalistic study, where they used plain cigarette packs for a week. Participants completed a number of questionnaires during the study period (reported elsewhere), and a sub-sample participated in post-study telephone interviews to explore their experiences of using the plain packs. Of the 187 participants who completed the study, 23 were randomly selected to participate in the post-study interviews. Within the interviews a semi-structured topic guide was used to assess perceptions of the plain pack, feelings created by the pack, feelings about smoking, and avoidant and smoking behaviour. Results: The brown (plain) packs were perceived negatively due to the colour, the  undesirable image the pack conveyed, and the reaction from others. The plain packs were  also associated with negative feelings, such as embarrassment, discomfort and guilt. Some participants also commented that they felt differently about the product, considered to be less enjoyable or more harmful, when using the plain packs, and were less interested in, or felt more negatively about, smoking. A number of participants said that they had engaged in avoidant behavior with the plain packs, such as hiding it, due to their negative thoughts about the packs and the reaction of others. Some participants also mentioned cessation-related behaviours when using the plain packs, such as forgoing cigarettes, stubbing cigarettes out early and thinking about quitting, largely due to the decreased enjoyment of smoking. Conclusions: The experience of using cigarettes in plain packs prompted a range of negative responses from young women smokers, who are a crucial target group for tobacco control interventions

How adolescents perceive cigarette packaging and possible benefits of plain packaging

Surveys in secondary schools in Scotland show 3% of 13 year olds to be regular smokers, i.e. smoke one or more cigarettes a week, with this number rising to 13% for 15 year olds (Black et al., 2011). While smoking prevalence is in long-term decline in Scotland, and indeed most of Europe, these figures are concerning given that trying a single cigarette increases the risk that an adolescent will become a later smoker, even after a gap of not smoking for up to three years (Fidler et al., 2006). Furthermore, the earlier that adolescents start smoking regularly, the greater the risk of developing tobaccorelated cancers and other diseases (International Agency for Research on Cancer, 2004; Muller, 2007). For smoking prevention to be effective a coordinated approach is required. This may include policy measures such as increasing taxation on tobacco products to keep prices high, and non-policy measures such as providing health advice to parents and carers, as well as promoting smoke-free domestic environments and encouraging smoking cessation (Muller, 2007). School-based interventions can also play a key role in helping prevention efforts (NICE, 2010)

Adolescent girls and young adult women's perceptions of superslims cigarette packaging: a qualitative study

Objectives: To explore perceptions of superslims packaging, including compact ‘lipstick’ packs, in line with 3 potential impacts identified within the impact assessment of the European Union (EU) Tobacco Products Directive: appeal, harm perceptions and the seriousness of warning of health risks.  Design: Qualitative focus group study. SettingInformal community venues in Scotland, UK.  Participants: 75 female non-smokers and occasional smokers (age range 12–24).  Results: Compact ‘lipstick’-type superslims packs were perceived most positively and rated as most appealing. They were also viewed as less harmful than more standard sized cigarette packs because of their smaller size and likeness to cosmetics. Additionally, ‘lipstick’ packs were rated as less serious in terms of warning about the health risks associated with smoking, either because the small font size of the warnings was difficult to read or because the small pack size prevented the text on the warnings from being displayed properly. Bright pack colours and floral designs were also thought to detract from the health warning.  Conclusions: As superslims packs were found to increase appeal, mislead with respect to level of harm, and undermine the on-pack health warnings, this provides support for the decision to ban ‘lipstick’-style cigarette packs in the EU and has implications for policy elsewhere

Did independent and convenience (small) retailers comply with standardised tobacco packaging in the UK?

First paragraph: The United Kingdom (UK) Standardised Packaging of Tobacco Products Regulations 2015 and Tobacco and Related Products Regulations 2016 require cigarettes (factory-made and rolling tobacco) to be sold in standardised packs with a drab brown colour and pictorial health warnings covering at least 65% of the principal display areas [1]. Tobacco companies and retailers were given from 20th May 2016 to 20th May 2017 to comply with the legislation. Research from Australia, the first country to introduce standardised packaging, has explored several factors which may mitigate the impact of this measure, including illicit tobacco use [2], pricing [3], and product development [4,5]. No studies, however, have measured compliance among retailers. Given the value of such research in gauging the effectiveness of retailer-related tobacco policy [6], we examined independent and convenience (small) retailer compliance with standardised packaging legislation in the UK. Small retailers are an important group for investigation as reportedly half of their consumers purchase tobacco and over two-thirds consider tobacco necessary to maintain footfall [7].Output Type: Lette

Introduction of standardized tobacco packaging during a 12-month transition period: Findings from small retailers in the United Kingdom

Introduction: Factory-made cigarettes (FMC) and roll-your-own (RYO) tobacco have had to be produced in standardised packaging since 20th May 2016 in the United Kingdom, with a minimum pack size of 20 sticks for FMC and 30 grams for RYO. Manufacturers and retailers were given a 12-month transition period.  Methods: An observational study was conducted using monthly Electronic Point of Sale data from 500 small retailers in England, Scotland, and Wales, between May 2016 and May 2017. The 20 top selling tobacco products (15 FMC, 5 RYO) were monitored to observe when standardised packs were first introduced, the proportion of retailers selling each fully branded and standardised product, and the average number of monitored fully branded and standardised products sold by each retailer. The number of unique tobacco-related product codes sold by each retailer was also recorded each month.  Results: Eighteen of the fully branded products continued to be sold throughout the transition period and no standardised variants were sold in the first five months. It was not until month eleven that the average number of standardised products sold by retailers exceeded the fully branded products. The average number of unique tobacco-related product codes sold by each retailer decreased by a third over the transition period.  Conclusions: Tobacco companies used the transition period to delay the removal of fully branded products and gradually introduce standardised variants. This staggered introduction may have mitigated some of the immediate intended effects of the legislation by desensitising consumers to new pack designs

Cigarette pack design and adolescent smoking susceptibility: A cross-sectional survey

Objectives: To compare adolescents' responses to three different styles of cigarette packaging: novelty (branded packs designed with a distinctive shape, opening style or bright colour), regular (branded pack with no special design features) and plain (brown pack with a standard shape and opening and all branding removed, aside from brand name). Design: Cross-sectional in-home survey. Setting: UK. Participants: Random location quota sample of 1025 never smokers aged 11-16 years. Main outcome measures: Susceptibility to smoking and composite measures of pack appraisal and pack receptivity derived from 11 survey items. Results: Mean responses to the three pack types were negative for all survey items. However, ‘novelty' packs were rated significantly less negatively than the ‘regular' pack on most items, and the novelty and regular packs were rated less negatively than the ‘plain' pack. For the novelty packs, logistic regressions, controlling for factors known to influence youth smoking, showed that susceptibility was associated with positive appraisal and also receptivity. For example, those receptive to the innovative Silk Cut Superslims pack were more than four times as likely to be susceptible to smoking than those not receptive to this pack (AOR=4.42, 95% CI 2.50 to 7.81, p<0.001). For the regular pack, an association was found between positive appraisal and susceptibility but not with receptivity and susceptibility. There was no association with pack appraisal or receptivity for the plain pack. Conclusions: Pack structure (shape and opening style) and colour are independently associated, not just with appreciation of and receptivity to the pack, but also with susceptibility to smoke. In other words, those who think most highly of novelty cigarette packaging are also the ones who indicate that they are most likely to go on to smoke. Plain packaging, in contrast, was found to directly reduce the appeal of smoking to adolescents

Mindfulness and therapeutic relationships: insights from a phenomenological study of occupational therapists' practices

Background A well-established body of literature highlights the importance of the therapeutic relationship when working with children and youth. A growing body of literature points to the potential of mindfulness to enhance the quality of relationships, including the therapeutic relationship. To date, little attention has been paid to this topic within the profession of occupational therapy. Aim The aim of this study was to inquire into paediatric occupational therapists’ experiences of mindfulness in the therapeutic relationship with children and youth.  Methods Heideggerian-informed hermeneutic phenomenology was employed as the methodological approach. Two key Heideggerian concepts of being-with and care served as theoretical underpinnings of the study. Semi-structured interviews were completed with eight North American occupational therapists to elicit their first-hand accounts of mindfulness in the therapeutic relationship with their paediatric clients. Interviews were transcribed verbatim and analyzed using a phenomenological approach. Results Four key themes were identified and include: fostering a safe space, enhancing presence, being authentic, and cultivating acceptance. Conclusions The findings offer insights regarding the potential affordances of mindfulness to support clinicians as they form of therapeutic relationships with children and youth. This study highlights research priorities for future inquiry.&nbsp