The ambiguity of electronic cigarettes

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThis thesis investigates the perceptions of electronic cigarettes held by electronic cigarette users and stop smoking advisors in South East England between 2014 and 2015. This qualitative study draws on two thematically analysed datasets: 15 semi-structured interviews with electronic cigarette users and 13 semi-structured interviews with stop smoking advisors. The theoretical underpinnings of my empirical investigation are the Boundary Objects theory and Biomedicalization theory. I discuss how electronic cigarettes as boundary objects can function as both translational and facilitative objects between different actors, who construct different social meanings of electronic cigarettes. I clarify how the different social meanings attached to electronic cigarettes are impacted by the wider political, cultural and technological processes of biomedicalization. I also argue that biomedicalization processes are the outcome of divergent, but coexisting, perceptions and meanings. Electronic cigarettes bring both opportunities and threats, including the ways in which electronic cigarettes challenge contemporary social meanings of addiction and how such new innovations can prompt wider social and political changes. All my data exhibits a high level of ambiguity regarding electronic cigarettes’ status, efficacy and potential health and social risks. However, the research also shows different representations of electronic cigarettes that are related to a biomedical model of understanding and managing nicotine addiction, where individualisation and empowerment are at the core. Lastly, the data shows a potential for social change towards a socially acceptable recreational use of nicotine that mimics smoking, in spite of some electronic cigarette users’ concern about stigma potentially shifting from smokers to electronic cigarette users

Ethnic Speech and Ethnic Action as Ethnic Behavior: Part 1. Construction of the Brunel Ethnic Behavior Inventory

© 2016 Taylor & Francis.This article reports the construction of a new survey—specifically, the Brunel Ethnic Behavior Inventory (BEBI)—designed to measure ethnic speech and ethnic action as separate, yet related, aspects of individuals’ ethnic behavior. Using Tajfel’s social identity theory as a conceptual frame of reference, this study sought an answer to the research question of how many factors actually are measured by the BEBI, and tested the hypothesis that a two-factor model (i.e., Ethnic Speech and Ethnic Action as two correlated factors) would provide significantly better goodness of fit to the correlational data than would a one-factor model (i.e., Ethnic Behavior as one undifferentiated factor). Across one pilot sample (n = 101) and two main samples (n = 120 for Sample 1, n = 148 for Sample 2), the study found that not only did the BEBI measure two factors at most (i.e., Ethnic Speech and Ethnic Action) but, consistent with the hypothesis, the two-factor model yielded better goodness of fit than did the one-factor model. Implications for the conceptualization and measurement of Verkuyten’s “ways of ethnicity” are discussed

Gene × Physical Activity Interactions in Obesity: Combined Analysis of 111,421 Individuals of European Ancestry

Numerous obesity loci have been identified using genome-wide association studies. A UK study indicated that physical activity may attenuate the cumulative effect of 12 of these loci, but replication studies are lacking. Therefore, we tested whether the aggregate effect of these loci is diminished in adults of European ancestry reporting high levels of physical activity. Twelve obesity-susceptibility loci were genotyped or imputed in 111,421 participants. A genetic risk score (GRS) was calculated by summing the BMI-associated alleles of each genetic variant. Physical activity was assessed using self-administered questionnaires. Multiplicative interactions between the GRS and physical activity on BMI were tested in linear and logistic regression models in each cohort, with adjustment for age, age2, sex, study center (for multicenter studies), and the marginal terms for physical activity and the GRS. These results were combined using meta-analysis weighted by cohort sample size. The meta-analysis yielded a statistically significant GRS × physical activity interaction effect estimate (Pinteraction = 0.015). However, a statistically significant interaction effect was only apparent in North American cohorts (n = 39,810, Pinteraction = 0.014 vs. n = 71,611, Pinteraction = 0.275 for Europeans). In secondary analyses, both the FTO rs1121980 (Pinteraction = 0.003) and the SEC16B rs10913469 (Pinteraction = 0.025) variants showed evidence of SNP × physical activity interactions. This meta-analysis of 111,421 individuals provides further support for an interaction between physical activity and a GRS in obesity disposition, although these findings hinge on the inclusion of cohorts from North America, indicating that these results are either population-specific or non-causal

Gene × Physical Activity Interactions in Obesity: Combined Analysis of 111,421 Individuals of European Ancestry

Numerous obesity loci have been identified using genome-wide association studies. A UK study indicated that physical activity may attenuate the cumulative effect of 12 of these loci, but replication studies are lacking. Therefore, we tested whether the aggregate effect of these loci is diminished in adults of European ancestry reporting high levels of physical activity. Twelve obesity-susceptibility loci were genotyped or imputed in 111,421 participants. A genetic risk score (GRS) was calculated by summing the BMI-associated alleles of each genetic variant. Physical activity was assessed using self-administered questionnaires. Multiplicative interactions between the GRS and physical activity on BMI were tested in linear and logistic regression models in each cohort, with adjustment for age, age2, sex, study center (for multicenter studies), and the marginal terms for physical activity and the GRS. These results were combined using meta-analysis weighted by cohort sample size. The meta-analysis yielded a statistically significant GRS × physical activity interaction effect estimate (Pinteraction = 0.015). However, a statistically significant interaction effect was only apparent in North American cohorts (n = 39,810, Pinteraction = 0.014 vs. n = 71,611, Pinteraction = 0.275 for Europeans). In secondary analyses, both the FTO rs1121980 (Pinteraction = 0.003) and the SEC16B rs10913469 (Pinteraction = 0.025) variants showed evidence of SNP × physical activity interactions. This meta-analysis of 111,421 individuals provides further support for an interaction between physical activity and a GRS in obesity disposition, although these findings hinge on the inclusion of cohorts from North America, indicating that these results are either population-specific or non-causal

A case-only study to identify genetic modifiers of breast cancer risk for BRCA1/BRCA2 mutation carriers

Abstract: Breast cancer (BC) risk for BRCA1 and BRCA2 mutation carriers varies by genetic and familial factors. About 50 common variants have been shown to modify BC risk for mutation carriers. All but three, were identified in general population studies. Other mutation carrier-specific susceptibility variants may exist but studies of mutation carriers have so far been underpowered. We conduct a novel case-only genome-wide association study comparing genotype frequencies between 60,212 general population BC cases and 13,007 cases with BRCA1 or BRCA2 mutations. We identify robust novel associations for 2 variants with BC for BRCA1 and 3 for BRCA2 mutation carriers, P < 10−8, at 5 loci, which are not associated with risk in the general population. They include rs60882887 at 11p11.2 where MADD, SP11 and EIF1, genes previously implicated in BC biology, are predicted as potential targets. These findings will contribute towards customising BC polygenic risk scores for BRCA1 and BRCA2 mutation carriers

A case-only study to identify genetic modifiers of breast cancer risk for BRCA1/BRCA2 mutation carriers

Breast cancer (BC) risk for BRCA1 and BRCA2 mutation carriers varies by genetic and familial factors. About 50 common variants have been shown to modify BC risk for mutation carriers. All but three, were identified in general population studies. Other mutation carrier-specific susceptibility variants may exist but studies of mutation carriers have so far been underpowered. We conduct a novel case-only genome-wide association study comparing genotype frequencies between 60,212 general population BC cases and 13,007 cases with BRCA1 or BRCA2 mutations. We identify robust novel associations for 2 variants with BC for BRCA1 and 3 for BRCA2 mutation carriers, P < 10−8, at 5 loci, which are not associated with risk in the general population. They include rs60882887 at 11p11.2 where MADD, SP11 and EIF1, genes previously implicated in BC biology, are predicted as potential targets. These findings will contribute towards customising BC polygenic risk scores for BRCA1 and BRCA2 mutation carriers

Knowledge, attitudes and beliefs towards e-cigarettes among e-cigarette users and stop smoking advisors in South East England:a qualitative study

Aim To explore how e-cigarettes are perceived by a group of e-cigarette users and a group of Stop Smoking Advisors (SSAs), what are the risks and benefits they associate with e-cigarettes and how do these understandings shape participants’ attitude towards e-cigarettes? Method Face-to-face and phone interviews were conducted with 15 e-cigarette users and 13 SSAs in South East England between 2014 and 2015. Transcribed data were analysed inductively through thematic analysis. Findings E-cigarettes were used as a therapeutic aid to stop or cut down smoking and as a smoking substitute. A prominent theme is the uncertainty e-cigarettes have generated. This included ambiguity of e-cigarettes’ status and efficacy, and ambiguity of e-cigarettes’ physical and social risks. Different attitudes towards e-cigarettes were identified. Conclusion E-cigarettes’ benefits and risks should be continuously evaluated, put into perspective and circulated to avoid ambiguity. Stop smoking services need to recognise the benefits that can be gained by using e-cigarettes as a harm reduction tool. </jats:sec

The association between uncertainty and mental health: a scoping review of the quantitative literature.

BACKGROUND: The current moment is characterised by deep-rooted uncertainties, such as climate change and COVID-19. Uncertainty has been reported to be associated with negative mental health outcomes, such as stress and anxiety. However, no comprehensive review on the association between uncertainty and mental health exists. AIM: The aim of the current scoping review was to systematically explore and describe the literature on the link between uncertainty and mental health. METHODS: A scoping review was undertaken following guidelines by Arksey and O'Malley (2005). RESULTS: One hundred and one papers addressing the association between uncertainty and mental health were identified. Most were cross-sectional studies (67%) conducted in the fields of medicine or nursing (59%), in high-income countries, among adult populations (74%), and in medical settings. Substantial heterogeneity was identified in the measurements of uncertainty and mental health. Most studies (79%) reported a positive association between uncertainty and mental health problems. CONCLUSIONS: Research is needed in more diverse contexts and populations. More robust designs are required to provide insight into the directionality and strength of the association between uncertainty and mental health. Few studies reported how individuals coped with uncertainty. Future studies should address the identified gaps and investigate interventions to address uncertainty and its determinants