A cohort study investigating the effects of first stage of the English tobacco point-of-sale display ban on awareness, susceptibility and smoking uptake among adolescents

Objective: A prospective evaluation of the effect of 2012 point-of-sale (PoS) display ban in supermarkets in England on perceived exposure to PoS displays, and on changes in susceptibility and smoking uptake among young people. Design: Cohort study Settings: Seven schools in Nottinghamshire, England Participants: 1,035 11-16 year-old schoolchildren Primary and secondary outcome measures: Changes in reported exposure to PoS displays before and after prohibition, and the association between exposure to and awareness of PoS displays and change in susceptibility to smoking and smoking status between 2011 and 2012 (before the ban) and 2012 and 2013 (after the ban). Results: The proportion of children noticing tobacco PoS displays in supermarkets most or every time they visited a shop changed little between 2011 and 2012 (59.6% (95% confidence interval 56.6%- 62.6%) and 58.8% (95% confidence interval 55.8%- 61.8%), respectively); but decreased by about 13 percentage points to 45.7% (95% confidence interval 42.7%-48.7%) in 2013, after the ban. However, after adjusting for confounders, implementation of the first stage of the PoS ban in 2012 did not result in significant changes in the relation between susceptibility to smoking and smoking status and exposure to and awareness of PoS displays. Conclusions: Prohibition of PoS in large supermarkets resulted in a decline in the proportion of young people noticing PoS displays in large shops, but little or no change in smoking uptake or susceptibility. It remains to be seen whether extension of the PoS ban to all shops in 2015 has a more marked effect

Whither tobacco product regulation?

Despite decades of industry innovation and regulatory efforts, the harmfulness of conventional cigarettes has not changed. There are several pitfalls in this area, including the long time lag before health impacts of product regulatory changes become apparent, the danger of consumers deriving false reassurance of lesser harm in the interim period, the lack of relevant expertise and the lack of an internationally agreed and evidencebased strategic approach. Articles 9 and 10 of the Framework Convention on Tobacco Control provide the potential for such a global strategy, and knowledge and research has increased significantly over recent years. However, there are huge opportunity costs in implementing product disclosure and regulatory strategies: most national regulators have very limited human and financial resources, which should be focused on other evidence-based tobacco control interventions. We believe therefore that it is now time to abandon the notion of safe or safer cigarettes while moving consumers towards cleaner nicotine products as soon as possible. In parallel to this, we recommend a number of other strategies be implemented including: reducing the appeal of all tobacco products, forbidding new tobacco products or brand variants being marketed without evidence of reduced harm, appeal or addictiveness, and developing a tobacco industry resourced, but industry independent, Framework Convention on Tobacco Control global repository to assist national regulators in understanding and regulating the products on their markets

Threshold electrolyte concentration for dispersive soils in relation to CROSS

Sodium salts tend to dominate salt-affected soils and groundwater in Australia; therefore, sodium adsorption ratio (SAR) is used to parameterise soil sodicity and the effects of sodium on soil structure. However, some natural soils in Australia, and others irrigated with recycled water, have elevated concentrations of potassium and/or magnesium. Therefore, there is a need to derive and define a new ratio including these cations in place of SAR, which will indicate the dispersive effects of Na and K on clay dispersion, and Ca and Mg on flocculation. Based on the differential dispersive effects Na and K and the differential flocculation powers of Ca and Mg, we propose the concept of 'cation ratio of soil structural stability' (CROSS), analogous to SAR. This paper also gives the results of a preliminary experiment conducted on three soils varying in soil texture on hydraulic conductivity using percolating waters containing different proportions of the cations Ca, Mg, K, and Na. The relative changes in hydraulic conductivity of these soils, compared with the control treatment using CaCl2 solution, was highly correlated with CROSS. Clay dispersion in 29 soils treated with irrigation waters of varying cationic composition was highly correlated with CROSS rather than SAR. It was also found that CROSS measured in 1:5 soil/water extracts was strongly related to the ratio of exchangeable cations. These results encourage further study to investigate the use of CROSS as an index of soil structural stability in soils with different electrolytes, organic matter, mineralogy, and pH

Contrasting snus and NRT as methods to quit smoking. an observational study

Background: Snus is considerably less hazardous to health than cigarettes. Recent data from Scandinavia have indicated that many smokers use snus as a method for quitting smoking. Methods: Data from five repeated cross-sectional surveys of Norwegian men and women aged 16-74 were pooled (N = 6 262). Respondents were asked about current and former smoking and snus use. Former daily smokers (N = 1219) and current daily smokers who had tried to quit at least once (N = 1118) were asked about the method they had used at their latest quit attempt and how many quit attempts they had made. Former smokers were also requested to report what year they had made their final quit attempt. Results: Snus was the most common method used for quitting smoking among men, while NRT was most often used among women. Stratifying the data according to year of quitting smoking (1945-2007) indicated a significant increase in use of the methods for quitting asked about over time. Among men, this was largely due to an increase in the use of snus. Among male quitters under the age of 45 years, 45.8 % of those who had used snus on their last attempt to quit were current non-smokers (OR = 1.61, CI 1.04-2.29), while 26,3 % of those who had used NRT were current non-smokers. 59.6 % of successful quitters and 19.5 % of unsuccessful quitters who had used snus as a method for quitting smoking had continued to use snus on a daily basis after quitting. Conclusion: Norwegian men frequently use snus as a method for quitting smoking whereas women are more likely to use NRT. The findings indicate that switching to snus can be an effective method for quitting smoking

Did hardening occur among smokers in England from 2000 to 2010?

Aims To assess trends in the prevalence of ‘hardcore’ smoking in England between 2000 and 2010, and to examine associations between hardcore smoking and socio-demographic variables. Design Secondary analysis of data from the United Kingdom's General Lifestyle Survey (GLF) and the Health Survey for England (HSE). Setting Households in England. Participants Self-reported adult current smokers resident in England aged 26 years and over. Measurements Hardcore smokers were defined in three ways: smokers who do not want to quit (D1), those who ‘usually’ smoke their first cigarette of the day within 30 minutes of waking (D2) and a combination of D1 and D2, termed D3. Multivariable logistic regression was used to explore associations between these variables and calendar year, age, sex and socio-economic status, and P-values for trends in odds were calculated. Findings The odds of smokers being defined as hardcore according to D3 increased over time in both the GLF (P < 0.001) and HSE (P = 0.04), even after adjusting for risk factors. Higher dependence (D2) was noted in men [odds ratio (OR): 1.19, 95% confidence interval (CI): 1.13–1.24], those of 50–59 years (OR: 1.94, 95% CI: 1.80–2.09) and smokers in lower occupational groups (OR: 2.11, 95% CI: (1.97–2.26). Lack of motivation to quit (D1) increased with age and was more likely in men. Conclusions The proportion of smokers in England with both low motivation to quit and high dependence appears to have increased between 2000 and 2010, independently of risk factors, suggesting that ‘hardening’ may be occurring in this smoker populatio