Publications by authors named "Emily Brennan"

63 Publications

Mental Health and Chemical Dependency Services at US Cancer Centers.

J Natl Compr Canc Netw 2021 Mar 4:1-10. Epub 2021 Mar 4.

1Department of Psychiatry & Psychology.

Background: It is standard of care and an accreditation requirement to screen for and address distress and psychosocial needs in patients with cancer. This study assessed the availability of mental health (MH) and chemical dependency (CD) services at US cancer centers.

Methods: The 2017-2018 American Hospital Association (AHA) survey, Area Health Resource File, and Centers for Medicare & Medicaid Services Hospital Compare databases were used to assess availability of services and associations with hospital-level and health services area (HSA)-level characteristics.

Results: Of 1,144 cancer centers surveyed, 85.4% offered MH services and 45.5% offered CD services; only 44.1% provided both. Factors associated with increased adjusted odds of offering MH services were teaching status (odds ratio [OR], 1.76; 95% CI, 1.18-2.62), being a member of a hospital system (OR, 2.00; 95% CI, 1.31-3.07), and having more beds (OR, 1.04 per 10-bed increase; 95% CI, 1.02-1.05). Higher population estimate (OR, 0.98; 95% CI, 0.97-0.99), higher percentage uninsured (OR, 0.90; 95% CI, 0.86-0.95), and higher Mental Health Professional Shortage Area level in the HSA (OR, 0.99; 95% CI, 0.98-1.00) were associated with decreased odds of offering MH services. Government-run (OR, 2.85; 95% CI, 1.30-6.22) and nonprofit centers (OR, 3.48; 95% CI, 1.78-6.79) showed increased odds of offering CD services compared with for-profit centers. Those that were members of hospital systems (OR, 1.61; 95% CI, 1.14-2.29) and had more beds (OR, 1.02; 95% CI, 1.01-1.03) also showed increased odds of offering these services. A higher percentage of uninsured patients in the HSA (OR, 0.92; 95% CI, 0.88-0.97) was associated with decreased odds of offering CD services.

Conclusions: Patients' ability to pay, membership in a hospital system, and organization size may be drivers of decisions to co-locate services within cancer centers. Larger organizations may be better able to financially support offering these services despite poor reimbursement rates. Innovations in specialty payment models highlight opportunities to drive transformation in delivering MH and CD services for high-need patients with cancer.
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http://dx.doi.org/10.6004/jnccn.2020.7657DOI Listing
March 2021

Understanding the effectiveness of advertisements about the long-term harms of alcohol and low-risk drinking guidelines: A mediation analysis.

Soc Sci Med 2021 Feb 9;270:113596. Epub 2020 Dec 9.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.

Rationale: Many people overestimate the amount of alcohol that increases their risk of harm and so may not perceive any need to change their drinking behaviour. Several countries have developed low-risk drinking guidelines, yet awareness of these guidelines remains low. Furthermore, mass media campaigns about alcohol-related harms may have limited impact if people do not perceive their current consumption as potentially harmful. Integrating drinking guidelines into media campaigns about alcohol's harms can concurrently provide drinkers with information about low-risk drinking levels and compelling reasons to comply.

Objective: Our aim was to build understanding of the effectiveness of messages about the long-term harms of drinking and low-risk drinking guidelines, by testing the mediating effects of estimates of harmful drinking levels and attitudes towards drinking alcohol on subsequent intentions and behaviours.

Method: In an online experiment conducted in 2016, n = 1156 Australian adult monthly drinkers were randomly assigned to view advertisements for non-alcohol products (NON-ALC; control), advertisements featuring long-term harms of alcohol (LTH), or LTH advertisements plus a guideline message (LTH + G). Immediately following exposure, we measured estimates of harmful drinking levels and attitudes towards drinking alcohol. One week later, we measured intentions to drink less and behavioural compliance with the guideline.

Results: Compared to NON-ALC advertisements, exposure to LTH + G advertisements increased (i) the proportion of respondents who correctly estimated harmful drinking levels, which in turn, strengthened intentions to drink less (42% of the total effect was mediated), and (ii) negative attitudes, which in turn, also increased intentions to drink less (35% mediated) and behavioural compliance (24% mediated). Compared to NON-ALC, LTH advertisements increased negative attitudes, which in turn strengthened intentions to drink less (53% mediated).

Conclusions: When paired with effective alcohol harm reduction television advertisements, messages promoting low-risk drinking guidelines can increase drinkers' intentions to reduce their alcohol consumption and compliance with low-risk drinking guidelines.
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http://dx.doi.org/10.1016/j.socscimed.2020.113596DOI Listing
February 2021

Fine-mapping of the non-coding variation driving the Caucasian LRRK2 GWAS signal in Parkinson's disease.

Parkinsonism Relat Disord 2021 Feb 11;83:22-30. Epub 2021 Jan 11.

Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA; Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, USA. Electronic address:

Introduction: Genome-wide association studies (GWAS) have confirmed the leucine-rich repeat kinase 2 (LRRK2) gene as a susceptibility locus for idiopathic Parkinson's disease (PD) in Caucasians. Though the rs1491942 and rs76904798 variants have shown the strongest associations, the causal variant(s) remains unresolved. Therefore, the aim of this study was to identify variants that may be driving the LRRK2 GWAS signal by sequencing the entire LRRK2 gene in Caucasian PD patients and controls.

Methods: A discovery series (287 PD patients, 294 controls) and replication series (362 PD patients, 168 controls) were included. The entire LRRK2 gene as well as 10 Kb upstream/downstream was sequenced. Candidate potential causal variants were considered to be those that (a) were in at least weak linkage disequilibrium with the two GWAS-nominated variants (rs1491942 and rs76904798), and (b) displayed an association odds ratio (OR) that is stronger than the two GWAS variants.

Results: Thirty-four candidate variants (all intronic/intergenic) that may drive the LRRK2 PD GWAS signal were identified in the discovery series. However, examination of the replication series for these variants did not reveal any with a consistently stronger OR than both PD GWAS variants. Evaluation of public databases to determine which candidate variants are most likely to have a direct functional effect on LRRK2 expression was inconclusive.

Conclusion: Though our findings provide novel insights into the LRRK2 GWAS association, a clear causal variant was not identified. The identified candidate variants can form the basis for future experiments and functional studies that can more definitively assess causal LRRK2 variants.
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http://dx.doi.org/10.1016/j.parkreldis.2020.12.016DOI Listing
February 2021

Pharmacological Prevention of Noise-induced Hearing Loss: A Systematic Review.

Otol Neurotol 2021 Jan;42(1):2-9

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.

Objective: This study aims to explore and determine the effectiveness of current pharmacologic agents for the prevention of noise-induced hearing loss (NIHL) via a systematic review.

Databases Reviewed: The PubMed, Scopus, ClinicalTrials.gov, and Cochrane Library databases were searched from inception through February 6, 2020.

Methods: Full-text, English-language articles detailing prospective randomized and nonrandomized clinical trials with pharmacological interventions administered to prevent NIHL were included in accordance with PRISMA guidelines. The detailed search terms are included in the Appendix, http://links.lww.com/MAO/B67.

Results: Eleven articles were included in this review with 701 patients receiving a pharmacologic prevention for various noise exposures. Various regimens included administration of alpha-lipoic acid, ambient oxygen, beta-carotene, carbogen, ebselen, Mg-aspartate, N-acetylcysteine, and vitamins C, E, and B12. A number of studies demonstrated statistically significant amelioration of NIHL with pharmacologic intervention. Two studies demonstrated significantly better hearing outcomes for pharmacological prophylaxis with carbogen or ebselen as compared with placebo for the 4 kHz frequency, where the noise-notch is most likely to be encountered. Given the considerable heterogeneity in agents and methodologies, however, it was not possible to conduct a meta-analysis.

Conclusions: While several heterogenous articles demonstrated promising results for Mg-aspartate, carbogen, vitamin B12, and alpha-lipoic acid, the clinical significance of these pharmaceuticals remains unclear. Initial data from this study alongside future clinical trials might potentially contribute to the generation of clinical practice guidelines to prevent NIHL.

Level Of Evidence: 2.
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http://dx.doi.org/10.1097/MAO.0000000000002858DOI Listing
January 2021

Australian smokers' experiences and perceptions of recessed and firm filter cigarettes.

Tob Control 2020 Oct 28. Epub 2020 Oct 28.

Colorado School of Public Health, University of Colorado, Denver, Colorado, USA.

Background: While cigarette filter modifications have long been used to increase product appeal and assuage health concerns, tighter marketing restrictions, including plain packaging, have further spurred the growth of filter variants. We explored and assessed experiences and perceptions of smokers who had tried and/or currently use recessed filter cigarettes (RFCs) and firm filter cigarettes (FFCs).

Method: In November 2018, we undertook eight exploratory focus groups of Australian adult factory-made cigarette smokers (total n=56). In July 2019, we surveyed 999 smokers aged 18-69 years to quantify ever and current use of these products and associated beliefs and sensory experiences.

Results: Focus group and survey findings were consistent. Among 988 smokers who had at least tried factory-made cigarettes, 28.9% had tried FFCs and 11.1% currently smoked these, while 36.4% had tried RFCs and 7.5% currently smoked these. Smokers in both studies believed these filters may reduce harm and that FFCs increase appeal. In the survey, 58.9% of RFC triers agreed these hide the filter's brown stain and 48.9% agreed that RFCs keep harmful substances away from the mouth. Similarly, 58.4% of FFC triers agreed these trap more harmful substances than standard filters. Relative to standard filter cigarettes, more smokers experienced FFCs and RFCs as feeling clean (p=0.03) and more current FFC users experienced these as feeling smooth (p=0.01).

Conclusion: RFCs and FFCs undermine plain packaging legislation, which aims to reduce appeal and minimise misperceptions about the relative harms of different tobacco products. Like other filter modifications, these filter variants should be disallowed.
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http://dx.doi.org/10.1136/tobaccocontrol-2020-055725DOI Listing
October 2020

Comparing responses to public health and industry-funded alcohol harm reduction advertisements: an experimental study.

BMJ Open 2020 09 28;10(9):e035569. Epub 2020 Sep 28.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.

Objectives: Conduct a head-to-head experimental test of responses to alcohol harm reduction advertisements developed by alcohol industry Social Aspects/Public Relations Organisations (SAPROs) versus those developed by public health (PH) agencies. We hypothesised that, on average, SAPRO advertisements would be less effective at generating motivation (H1) and intentions to reduce alcohol consumption (H2) but more effective at generating positive perceptions of people who drink (H3).

Design: Online experiment with random assignment to condition.

Participants: 2923 Australian adult weekly drinkers (49% high-risk drinkers) recruited from an opt-in online panel.

Interventions: Participants viewed 3 of 83 advertisements developed by PH agencies (n=2174) or 3 of 28 advertisements developed by SAPROs (n=749).

Primary Outcome Measures: Participants reported their motivation to reduce the amount of alcohol consumed; behave responsibly and/or not get drunk; and limit their drinking around/never supply to minors, as well as intentions to avoid drinking alcohol completely; reduce the number of drinking occasions; and reduce the amount of alcohol consumed per occasion. Participants also reported their perceptions of people who drink alcohol on six success-related items and four fun-related items.

Results: Compared with drinkers exposed to PH advertisements, those exposed to SAPRO advertisements reported lower motivation to reduce the amount of alcohol consumed (β=-0.091, 95% CI -0.171 to -0.010), and lower odds of intending to avoid alcohol completely (OR=0.77, 0.63 to 0.94) and to reduce the amount of alcohol consumed per occasion (OR=0.82, 0.69 to 0.97). SAPRO advertisements generated more favourable fun-related perceptions of drinkers (β=0.095, 0.013 to 0.177).

Conclusions: The alcohol harm reduction advertisements produced by alcohol industry SAPROs that were tested in this study were not as effective at generating motivation and intentions to reduce alcohol consumption as those developed by PH organisations. These findings raise questions as to whether SAPROs should play a role in alcohol harm reduction efforts.
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http://dx.doi.org/10.1136/bmjopen-2019-035569DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523211PMC
September 2020

Evaluation of literature searching and article selection skills of an evidence-based practice team.

J Med Libr Assoc 2020 Jul;108(3):487-493

Senior Evidence-Based Practice Analyst, Value Institute, MUSC Health, Medical University of South Carolina, Charleston, SC.

Background: An evidence-based practice (EBP) team at an academic medical center supports the development of evidence-based hospital policies and protocols via "Evidence Briefs." An early career librarian was added to the EBP team to meet increased requests for Evidence Briefs, which provided an opportunity to initiate a quality improvement (QI) analysis, improve work flow, and cross-train staff on literature searching and article selection skills.

Case Presentation: This QI project evaluated literature searching and article selection skills of an early career librarian (less than 2 years' experience), a mid-career librarian (more than 10 years' experience), and a critical appraisal expert. This project examined 10 Evidence Brief requests completed within a 6-month period. Analysis of each individual's performance of literature searching and article selection was completed for each Evidence Brief. Across all Evidence Brief requests, the mid-career librarian performed the most comprehensive literature searches and captured the highest number of articles that ultimately ended up being included in Evidence Briefs (75%). The critical appraisal expert performed best on the article selection portion of the project and identified the highest number of relevant articles that were included in Evidence Briefs (74%).

Conclusions: This project provided a formalized method of assessing the literature searching and article selection skills of each member of the EBP team. This project illustrated the skill level of each individual and led to improvements in the Evidence Brief request work flow.
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http://dx.doi.org/10.5195/jmla.2020.865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441910PMC
July 2020

Introducing a health information literacy competencies map: connecting the Association of American Medical Colleges Core Entrustable Professional Activities and Accreditation Council for Graduate Medical Education Common Program Requirements to the Association of College & Research Libraries Framework.

J Med Libr Assoc 2020 Jul;108(3):420-427

Associate Dean, Library Services & Archives, Duke University Medical Center, Durham, NC.

Background: Librarians teach evidence-based medicine (EBM) and information-seeking principles in undergraduate, graduate, and post-graduate medical education. These curricula are informed by medical education standards, medical education competencies, information literacy frameworks, and background literature on EBM and teaching. As this multidimensional body of knowledge evolves, librarians must adapt their teaching and involvement with medical education. Identifying explicit connections between the information literacy discipline and the field of medical education requires ongoing attention to multiple guideposts but offers the potential to leverage information literacy skills in the larger health sciences education sphere.

Methods: A subgroup of the Association of Academic Health Sciences Libraries Competency-Based Medical Education Task Force cross-referenced medical education documents (Core Entrustable Professional Activities and 2017-2018 Liaison Committee on Medical Education Functions and Structures of a Medical School) with the Association of College & Research Libraries Framework for Information Literacy for Higher Education using nominal group technique.

Results: In addition to serving as a vocabulary, the map can also be used to identify gaps between and opportunities for enhancing the scholarly expectations of undergraduate and graduate medical education standards and the building blocks of information literacy education.
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http://dx.doi.org/10.5195/jmla.2020.645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441909PMC
July 2020

Managing dissociative symptoms following the use of esketamine nasal spray: a case report.

Int Clin Psychopharmacol 2021 Jan;36(1):54-57

Department of Psychiatry, The Medical Research Network LLC, New York, New York, USA.

Patients with treatment-resistant depression (TRD) treated with esketamine nasal spray commonly experience transient symptoms of dissociation. Manifestations of dissociation, such as feelings of detachment from the environment, can cause considerable anxiety for patients. Nonpharmacologic interventions may help clinicians to manage associated anxiety and confusion due to dissociation following administration of esketamine nasal spray. We present the case of a 64-year-old woman with major depressive disorder who participated in a clinical trial evaluating the efficacy and safety of esketamine nasal spray in conjunction with an oral antidepressant for TRD. The patient received flexible doses of esketamine nasal spray (56 or 84 mg) twice weekly for 4 weeks. On treatment day 1, the patient was administered 56 mg of esketamine nasal spray using two nasal spray devices (28 mg per device). Twenty minutes after the first esketamine nasal spray device was administered, the patient experienced a dissociative episode lasting 40 minutes that caused anxiety and confusion. The patient was encouraged to listen to music during treatment sessions, which resulted in notable improvement of her symptoms. Listening to music of choice immediately following esketamine nasal spray administration along with reassurance from staff may help manage confusion and anxiety associated with dissociation.
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http://dx.doi.org/10.1097/YIC.0000000000000327DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690636PMC
January 2021

Earlier re-initiation of enteral feeding after necrotizing enterocolitis decreases recurrence or stricture: a systematic review and meta-analysis.

J Perinatol 2020 11 18;40(11):1679-1687. Epub 2020 Jul 18.

Department of Pediatrics (Neonatology), Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.

Objective: To assess the effects of earlier vs. later re-initiation of enteral feeds after necrotizing enterocolitis (NEC).

Study Design: We reviewed the literature to assess timing of enteral feeding after NEC using fixed effects models.

Results: Three studies met inclusion criteria; no randomized trials. After removal of Bell's Stage I infants, the earlier refeeding group (<5-7 or median 4 days) included 79 infants and later refeeding group (≥5-7 or median 10 days) included 119 infants. Pooled analysis revealed earlier re-initiation reduced the incidence in the composite outcome of recurrent NEC and/or post-NEC stricture (OR = 0.27; 95% Cl = 0.10-0.75; p = 0.012). Individually, NEC recurrence (pooled OR = 0.34; 95% Cl = 0.09-1.29; p = 0.112) or stricture (OR = 0.34; 95% Cl = 0.09-1.26; p = 1.06) did not differ between groups.

Conclusions: There was no increase in negative outcomes with earlier refeeding after NEC. Earlier initiation of enteral feeds resulted in a significantly lower risk for the combined outcome of recurrent NEC and/or post-NEC stricture.
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http://dx.doi.org/10.1038/s41372-020-0722-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368613PMC
November 2020

A Systematic Review of the Neurocognitive Effects of Cannabis Use in Older Adults.

Curr Addict Rep 2019 Dec 22;6(4):443-455. Epub 2019 Oct 22.

Medical University of South Carolina, Charleston, South Carolina.

Purpose Of Review: Older adults currently represent the fastest growing demographic of cannabis users, yet few studies have investigated the effects of cannabis use on cognitive functioning in aging. We conducted a systematic review of the recent literature examining cognitive outcomes associated with cannabis use in older adults, with and without neurocognitive disorders, to clarify the potential neuroprotective benefits and risks of cognitive decline in this population.

Recent Findings: We identified 26 studies examining cognitive outcomes associated with medical and recreational use of cannabis in healthy aging, dementia, Parkinson's disease, multiple sclerosis, HIV, and pain populations. Although variability in the cannabis products used, outcomes assessed, and study quality limits the conclusions that can be made, modest reductions in cognitive performance were generally detected with higher doses and heavier lifetime use.

Summary: This review highlights the need for additional high-quality research using standardized, validated assessments of cannabis exposure and cognitive outcomes. Reliable measures and longitudinal data are necessary to better characterize the effects of cannabis use on cognitive aging, as well as differential effects of recreational and medical cannabis.
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http://dx.doi.org/10.1007/s40429-019-00285-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7259587PMC
December 2019

Are anti-smoking social norms associated with tobacco control mass media campaigns, tax and policy changes? Findings from an Australian serial cross-sectional population study of smokers.

Tob Control 2021 Mar 8;30(2):177-184. Epub 2020 Apr 8.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.

Background: Anti-smoking social norms are associated with subsequent quitting behaviours. We examined if exposure to tobacco control advertisements and policy changes predict subjective (perceived disapproval of smoking among close family and friends) and internalised injunctive norms (embarrassed about telling others you are a smoker).

Methods: A serial cross-sectional population survey of Australian adult smokers (n=6649; 2012 to 2015). Logistic regression analyses examined associations of social norms with exposure to different types of tobacco control advertisements, tax increases and other tobacco control policies, adjusting for key demographic, smoking and media exposure covariates. Interaction analyses examined differences by age and socioeconomic status (SES).

Results: Greater past month exposure to predominantly fear-evoking advertisements was associated with increased odds of perceiving disapproval (per 1000 gross rating points: adjusted OR (AOR) 2.69, 95% CI: 1.34 to 5.39), while exposure to advertisements evoking multiple negative emotions (fear, guilt, sadness) reduced perceived disapproval (AOR 0.61, 95% CI: 0.42 to 0.87). Increased perceived disapproval was also associated with anticipation (AOR 1.38, 95% CI: 1.02 to 1.88), and implementation of a series of annual 12.5% tobacco tax rises (AOR 1.41, 95% CI: 1.03 to 1.94). Associations were consistent across age and SES. There were no associations nor subgroup interactions between advertisement exposure or policy changes and feeling embarrassed about telling others you are a smoker.

Conclusion: Smokers' perceptions of family and friends' disapproval of their smoking was more common after exposure to fear-evoking tobacco control campaigns and after large tobacco tax increases were announced and implemented.
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http://dx.doi.org/10.1136/tobaccocontrol-2019-055325DOI Listing
March 2021

Treatment of Vestibular Migraine: A Systematic Review and Meta-analysis.

Laryngoscope 2021 01 21;131(1):186-194. Epub 2020 Feb 21.

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.

Objective: To assess the efficacy of the various therapies used for the prevention of vestibular migraine (VM).

Methods: Primary studies were identified though PubMed, Scopus, PsycINFO, and Cochrane Library by two independent investigators for articles published through April 2019. The search identified randomized comparison or observational studies pertaining to vestibular migraine treatment. Meta-analysis was performed on pre- and posttreatment Dizziness Handicap Inventory, vertigo frequency, and percentage of perceived improvement.

Results: Literature search identified 13 studies that reported sufficient outcome measures to be included in the analysis. Patients with VM had a mean age of 43.3 years with female-to-male gender ratio of 2.1:1. Classes of therapeutic agents included antiepileptic drugs, calcium channel blockers, tricyclic antidepressants, β-blockers, serotonin and norepinephrine reuptake inhibitors, and vestibular rehabilitation. All treatment options that were analyzed demonstrated improvement in all of the outcome parameters, but due to significant heterogeneity and lack of standardized reporting on outcomes, establishment of preferred treatment modality could not be determined.

Conclusions: Various treatment modalities have been evaluated for preventative treatment of VM. Physician familiarity, patient comorbidities, and the side-effect profiles of various interventions likely influence the selection of intervention. Future randomized controlled trials with restrictive inclusion criteria and generalizable standardized outcome measures will allow for more robust meta-analyses and for more evidence-based treatment of vestibular migraines. Laryngoscope, 131:186-194, 2021.
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http://dx.doi.org/10.1002/lary.28546DOI Listing
January 2021

Public support for introducing cigarette pack inserts in Australia.

Tob Control 2021 Jan 13;30(1):117-118. Epub 2020 Feb 13.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.

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http://dx.doi.org/10.1136/tobaccocontrol-2019-055519DOI Listing
January 2021

Hair Transplantation in Frontal Fibrosing Alopecia and Lichen Planopilaris: A Systematic Review.

Laryngoscope 2021 01 11;131(1):59-66. Epub 2020 Feb 11.

Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.

Objective: Evolving hair transplantation (HT) techniques have offered new possibilities for hair restoration. However, the role of HT in patients with frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP) remains unclear. This study aims to evaluate the outcomes and temporal relationship of HT in this population.

Methods: A literature search of three databases was conducted. We reviewed 1) literature reporting outcomes of patients with LPP or FFA who received HT, and 2) studies reporting the development of LPP or FFA resulting from HT.

Results: Thirteen articles included 42 patients that provided data for evaluation. Fifteen patients had previously been diagnosed with FFA or LPP, and the remaining 27 patients developed disease after undergoing HT. Seven patients with FFA and eight patients with LPP received HT, with a mean sustained disease remission of 2.69 years prior to HT. In total, two of seven (29%) patients with FFA and five of eight (75%) patients with LPP experienced positive HT results over a follow-up period of 8-72 months. Interestingly, 27 patients without evidence of previous disease developed FFA or LPP following HT after a median duration of 16 months.

Conclusions: HT for LPP and FFA is feasible but results may be less favorable compared to HT for other causes. Outcomes may be more favorable for LPP than FFA but this was not statistically significant and evidence is very limited. FFA and LPP can also develop following HT in patients without previous evidence of disease.

Level Of Evidence: NA Laryngoscope, 131:59-66, 2021.
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http://dx.doi.org/10.1002/lary.28551DOI Listing
January 2021

The Effects of Graphic Warning Labels' Vividness on Message Engagement and Intentions to Quit Smoking.

Communic Res 2019 Jul 2;46(5):619-638. Epub 2017 Apr 2.

Annenberg School for Communication, University of Pennsylvania, United States.

The current study examined the effects of manipulating the level of vividness through the presence of various textual and visual components in the context of tobacco warning labels. An online experiment was conducted (N=2165) to examine whether increasing the vividness of warning labels, using narrative and non-narrative components, increased engagement with the messages, and the subsequent effects of vividness and engagement on intentions to quit smoking. Results showed that more vivid warning labels led to increased engagement, which in turn was linked to increased intentions to quit smoking. Specifically, the indirect effect of vividness on intentions to quit smoking was largely driven by the emotional component of engagement. Indirect effects of cognitive engagement were only apparent at higher levels of vividness.
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http://dx.doi.org/10.1177/0093650217700226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675473PMC
July 2019

Validating the Hornik & Woolf approach to choosing media campaign themes: Do promising beliefs predict behavior change in a longitudinal study?

Commun Methods Meas 2019 23;13(1):60-68. Epub 2018 Oct 23.

Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA.

Hornik and Woolf (1999) proposed using cross-sectional survey data to prioritize beliefs to address with communication campaign messages. The empirical component of the approach combines evidence of (1) association of beliefs with intentions and (2) current level of beliefs to calculate a 'percentage to gain' as the potential promise of a belief. However, the method relies on cross-sectional data; its conclusions are open to challenge. Here, a panel study assesses whether the calculated promise of a belief actually predicts future behavior change. A nationally representative sample of 3,204 U.S. youth and young adults were interviewed twice, six months apart. Sixteen beliefs about the benefits and costs of smoking cigarettes are compared with regard to their percentage to gain (calculated from cross-sectional data) and their ability to account for subsequent cigarette use. A belief's cross-sectional percentage to gain is substantially associated with its ability to predict subsequent behavior change (=.53, <.05).
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http://dx.doi.org/10.1080/19312458.2018.1515902DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660171PMC
October 2018

Factors associated with intentions to use e-cigarettes among Australian young adult non-smokers.

Drug Alcohol Rev 2019 07;38(5):579-587

School of Psychology, Curtin University, Perth, Australia.

Introduction And Aims: A growing body of evidence suggests e-cigarette use increases the risk of conventional cigarette use. Assessing the factors associated with intentions to use e-cigarettes can inform programs designed to minimise uptake, potentially assisting in preventing a new population of smokers. This study developed and tested a model assessing the importance of various factors that may be associated with intentions to use e-cigarettes among young adults who have never used e-cigarettes or tobacco cigarettes.

Design And Methods: A web-panel provider recruited 429 Australian 18- to 25-year-olds who had never used e-cigarettes or smoked tobacco cigarettes (56% female, mean age = 21.17 years). Various individual and social factors were assessed as potential direct and indirect predictors of e-cigarette use intentions.

Results: The developed model provided an excellent fit to the data and accounted for 49% of the variance in use intentions. Males had greater intentions to use e-cigarettes compared to females (β = -0.13). Having a greater number of friends who smoke tobacco cigarettes (β = 0.11) and curiosity about e-cigarette use (β = 0.58) were also directly associated with greater use intentions. Positive expectancies about e-cigarettes (β = 0.14), having family members who use e-cigarettes (β = 0.11), and having friends who smoke tobacco cigarettes (β = 0.07) were indirectly associated with intentions via curiosity.

Discussion And Conclusions: Curiosity about e-cigarette use was strongly associated with use intentions. Aspects of the social environment were also important. Further research is needed to identify effective means of challenging positive e-cigarette expectancies given these were found to be strongly associated with intentions via curiosity.
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http://dx.doi.org/10.1111/dar.12963DOI Listing
July 2019

Effectiveness of the IBCLC: Have we Made an Impact on the Care of Breastfeeding Families Over the Past Decade?

J Hum Lact 2019 Aug 17;35(3):441-452. Epub 2019 Jun 17.

3 Medical University of South Carolina, Department of Pediatrics, Charleston, SC, USA.

Background: International Board Certified Lactation Consultants (IBCLCs) have been in existence for over 3 decades, are currently represented in 110 countries, and have the only internationally recognized certification to provide safe and evidenced-based care for breastfeeding women and their infants.

Research Aim: To review the literature about the efficacy of IBCLCs on breastfeeding outcomes as well as studies that have examined the effectiveness of the IBCLC's role.

Methods: The design was a scoping review of the literature and critical analysis using PRISMA guidelines of existing studies published from 2008-2019. Qualitative and quantitative studies were reviewed.

Results: Twelve ( =12) studies met inclusion criteria. Seven themes emerged in the analysis including studies of the role of IBCLCs in resident physician education; IBCLC's role in breastfeeding interventions and the management of breastfeeding problems; the impact of IBCLCs in inpatient and outpatient settings; and the impact of geographic access to IBCLCs on breastfeeding rates. Certification of and ongoing professional development of IBCLCs are also discussed.

Conclusion: In this scoping review of existing literature assessing the effectiveness of IBCLCs in promoting and supporting breastfeeding, it is clear that IBCLCs play a positive role in supporting breastfeeding throughout the world. However, there are certain limitations that must be addressed. Recommendations for future research and clinical practice are discussed in the context of present limitations to breastfeeding expertise and support.
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http://dx.doi.org/10.1177/0890334419851805DOI Listing
August 2019

Hardening or softening? An observational study of changes to the prevalence of hardening indicators in Victoria, Australia, 2001-2016.

Tob Control 2019 May 30. Epub 2019 May 30.

Cancer Council Victoria, Melbourne, Victoria, Australia.

Background: The hardening hypothesis predicts that as smoking prevalence declines, remaining smokers will be more heavily addicted to nicotine and/or less interested in quitting. We tested this hypothesis in a population exposed to a comprehensive tobacco control programme over a 16-year period.

Methods: Annual cross-sectional surveys randomly sampled adults (aged 26+) in the state of Victoria, Australia, between 2001 and 2016. Until 2010, participants were recruited through random digit dialling to landline telephones; from 2011, sampling frames also included mobile phones. Logistic regressions assessed changes over time in the prevalence of smoking and each hardening indicator; additional models examined interactions by sex, age, education and socioeconomic status.

Results: Smoking prevalence declined significantly between 2001 and 2016 (20.1%-13.0%), as did the prevalence of seven hardening indicators: daily smoking, heavy consumption, no quit attempt in the past 5 years or past 12 months, no intention to quit in the next 6 months or next 30 days, and happiness to keep smoking. In addition, the proportion of smokers defined as 'hardcore' decreased from 17.2% to 9.1%. On the whole, hardening indicators decreased to a similar extent among demographic subgroups.

Conclusions: These results are inconsistent with the hardening hypothesis. Rather, they suggest that a comprehensive tobacco control programme that combines provision of cessation support to individual smokers with implementation of population-level interventions to drive all smokers towards quitting, can successfully reduce both smoking prevalence and levels of dependence and desire to keep smoking among the remaining population of smokers.
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http://dx.doi.org/10.1136/tobaccocontrol-2019-054937DOI Listing
May 2019

A Systematic Review of Patient-Reported Outcome Measures Assessing Body Image Disturbance in Patients with Head and Neck Cancer.

Otolaryngol Head Neck Surg 2019 06 12;160(6):941-954. Epub 2019 Feb 12.

1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Objective: To synthesize published literature describing the severity of body image disturbance (BID) in patients with head and neck cancer (HNC) over time, its psychosocial and functional associations, and treatment strategies as assessed by patient-reported outcome measures (PROMs).

Data Source: PubMed/MEDLINE, Scopus, PsycINFO, Web of Science, and Google Scholar.

Review Methods: A systematic review of the English-language literature was performed to identify studies of BID in patients with HNC using psychometrically validated PROMs to assess (1) severity of BID over time, (2) psychosocial and functional associations, and (3) management strategies.

Results: A total of 17 studies met inclusion criteria. BID was assessed via 10 different PROMs, none of which were HNC-specific measures of BID. Two of 2 longitudinal studies (100%) reported that BID improved from pretreatment to posttreatment, and 2 of 3 longitudinal studies (67%) showed that the severity of BID decreased over time as survivors got further out from treatment. Seven of 17 studies (41%) described negative functional and psychosocial associations with BID, although study methodology limited conclusions about cause and effect. None of the studies assessing interventions to manage BID (0/2, 0%) demonstrated an improvement in BID relative to control.

Conclusion: BID in patients with HNC has negative functional and psychosocial associations and lacks evidence-based treatment. Research is limited by the lack of an HNC-specific BID PROM. Further research should address knowledge gaps related to the lack of an HNC-specific BID PROM, longitudinal course of BID in patients with HNC, confusion with regards to risk factors and outcomes, and lack of prevention and treatment strategies.
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http://dx.doi.org/10.1177/0194599819829018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546516PMC
June 2019

Anti-smoking social norms are associated with increased cessation behaviours among lower and higher socioeconomic status smokers: A population-based cohort study.

PLoS One 2018 12;13(12):e0208950. Epub 2018 Dec 12.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.

Background: Social denormalisation of smoking can provide an environment that helps smokers to quit. This study examined which of three measures of anti-smoking social norms have the greatest influence on quitting-related cognitions and behaviours, and if this influence differs according to socioeconomic status (SES).

Methods: The Victorian Tracking Survey measured social norms among 1,348 (n(weighted) = 1,373) Australian adult smokers (aged 18-59) between 2012 and 2014, who were followed-up one week later. Weighted logistic regression analyses examined prospective associations of baseline subjective (family and friends' disapproval of smoking), injunctive (feeling embarrassed about being a smoker) and descriptive norms (living with someone who tried to quit in the past 12 months), with quitting-related cognitions and behaviours at follow-up. Data were weighted to account for telephony status (landline or mobile phone), sex and age. Analyses were adjusted for demographic characteristics, addiction level, tobacco control policies and quitting-related outcomes measured at baseline. Differences in associations between lower and higher SES smokers (based on educational attainment and area-based disadvantage) were examined through interaction terms and stratified analyses.

Results: Sixty-four percent of participants (n(weighted) = 872) perceived disapproval from family and friends, 31% (n(weighted) = 419) felt embarrassed to be a smoker, and 11% (n(weighted) = 155) lived with a recent quitter. All three norms were associated with having set a firm date to quit in the next month and with engaging in smoking limiting behaviours. Embarrassment was also associated with an increased likelihood of talking about quitting and with making a quit attempt. Associations were mostly comparable for lower and higher SES smokers, with no significant negative rebound effects overall or among subgroups.

Conclusions: These findings indicate close others' disapproval and feelings of embarrassment most strongly motivate smokers to try to quit. If tobacco control policies or media campaigns further denormalise smoking, there should be no reason for concern that such denormalisation undermines cessation behaviours.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208950PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291149PMC
May 2019

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer: A Systematic Review.

JAMA Otolaryngol Head Neck Surg 2019 02;145(2):166-177

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.

Importance: Delays in the delivery of care for head and neck cancer (HNC) are a key driver of poor oncologic outcomes and thus represent an important therapeutic target.

Objective: To synthesize information about the association between delays in the delivery of care for HNC and oncologic outcomes.

Evidence Review: A systematic review of the English-language literature in PubMed/MEDLINE and Scopus published between January 1, 2007, and February 28, 2018, was performed to identify articles addressing the association between treatment delays and oncologic outcomes for patients with HNC. Articles that were included (1) addressed cancer of the oral cavity, oropharynx, hypopharynx, or larynx; (2) discussed patients treated in 2004 or later; (3) analyzed time of diagnosis to treatment initiation (DTI), time from surgery to the initiation of postoperative radiotherapy, and/or treatment package time (TPT; the time from surgery through the completion of postoperative radiotherapy); (4) included a clear definition of treatment delay; and (5) analyzed the association between the treatment time interval and an oncologic outcome measure. Quality assessment was performed using the Institute of Health Economics Quality Appraisal Checklist for Case Series Studies.

Findings: A total of 18 studies met inclusion criteria and formed the basis of the systematic review. Nine studies used the National Cancer Database and 6 studies were single-institution retrospective reviews. Of the 13 studies assessing DTI, 9 found an association between longer DTI and poorer overall survival; proposed DTI delay thresholds ranged from more than 20 days to 120 days or more. Four of the 5 studies assessing time from surgery to the initiation of postoperative radiotherapy (and all 4 studies assessing guideline-adherent time to postoperative radiotherapy) found an association between a timely progression from surgery to the initiation of postoperative radiotherapy and improved overall or recurrence-free survival. Of the 5 studies examining TPT, 4 found that prolonged TPT correlated with poorer overall survival; proposed thresholds for prolonged TPT ranged from 77 days or more to more than 100 days.

Conclusions And Relevance: Timely care regarding initiation of treatment, postoperative radiotherapy, and TPT is associated with survival for patients with HNC, although significant heterogeneity exists for defining delayed DTI and TPT. Further research is required to standardize optimal time goals, identify barriers to timely care for each interval, and design interventions to minimize delays.
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http://dx.doi.org/10.1001/jamaoto.2018.2716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494704PMC
February 2019

E-cigarette product preferences among Australian young adult e-cigarette users.

Aust N Z J Public Health 2018 Dec 24;42(6):572-574. Epub 2018 Sep 24.

School of Psychology, Curtin University, Western Australia.

Objective: To assess preferences for e-cigarettes containing nicotine and flavourings among Australian young adult e-cigarette users.

Methods: An online survey was administered to 1,116 young adults (18-25 years), 104 of whom had used an e-cigarette in the last 30 days and were the focus of this study. Among users, 53% also smoked tobacco cigarettes, 27% were non-smokers and 20% had never smoked.

Results: Nearly two-thirds (64%) of e-cigarette users preferred nicotine-containing e-cigarettes (71% of smokers, 56% of non-smokers, 55% of never smokers). The vast majority (89%) preferred flavoured e-cigarettes (92% of smokers, 82% of non-smokers, 95% of never smokers), with fruit flavours the most popular.

Conclusions: E-cigarettes containing nicotine and flavourings were popular among users of these devices in this sample of young adults. Implications for public health: Previous research has documented potential harms associated with e-liquid additives, flavourings, and nicotine. The present results showing strong preferences for nicotine and flavourings among the sampled e-cigarette users suggest that: i) flavourings in e-liquids should be regulated; and ii) existing prohibitions on the unauthorised supply of liquid nicotine should be better enforced. Population-wide monitoring of the use of e-cigarettes with different product characteristics is also warranted.
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http://dx.doi.org/10.1111/1753-6405.12842DOI Listing
December 2018

Differences in use of electronic nicotine delivery systems by smoking status and demographic characteristics among Australian young adults.

Health Promot J Austr 2019 Apr 24;30(2):207-211. Epub 2018 Sep 24.

School of Psychology, Curtin University, Bentley, WA, Australia.

Issue Addressed: Electronic nicotine delivery systems (ENDS) continue to grow in popularity, particularly among young adults. Understanding by whom various ENDS are being used and why within this population segment can assist the development of appropriate interventions targeting those most vulnerable to use and inform policy decisions in this area. Accordingly, this study assessed the demographic characteristics associated with ENDS use among Australian young adults, and reasons for current e-cigarette use.

Methods: An online survey was administered to 1116 Australians aged 18-25 years (59% female).

Results: Smokers were more likely than non-smokers to report (a) ever use of ENDS (67% vs 28%), (b) ever use of an e-cigarette (64% vs 24%), e-cigar (17% vs 8%) or e-hookah (15% vs 8%) and (c) current use of e-cigarettes (19% vs 6%). Male smokers were more likely than female smokers to be current e-cigarette users. The most common reason for current e-cigarette use was enjoyment.

Conclusions: Young male adults appear to be particularly vulnerable to becoming regular e-cigarette users. This demographic group may need to be a primary focus of prevention and intervention efforts. Contrary to popular belief, smoking cessation was not a primary reason for e-cigarette use. SO WHAT?: Greater efforts are needed to educate young adults on the harms associated with ENDS use, especially if use is being driven by the perception that they are a harmless means of amusement. Maintaining existing regulations limiting the accessibility of these products is crucial to ensuring widespread use is minimised.
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http://dx.doi.org/10.1002/hpja.202DOI Listing
April 2019

Designing Effective Testimonial Pictorial Warning Labels for Tobacco Products.

Health Commun 2019 11 9;34(12):1383-1394. Epub 2018 Jul 9.

Penn Tobacco Center of Regulatory Science, Annenberg School for Communication, University of Pennsylvania.

Warning labels on tobacco products sometimes feature images and stories of real people whose health has been affected by smoking. We examined effects of some of the design elements that may contribute to the effectiveness of these testimonial pictorial warning labels (PWLs). Beginning with a testimonial PWL that contained an image of a person and a basic warning statement (e.g., "Smoking can kill you"), we examined the impact of adding: (a) text detailing the person's name, age and health status (identifiers); and (b) explanatory statements that elaborated on the basic warning using a testimonial or non-testimonial message. In an online experiment, 1255 adult smokers in the United States were randomly assigned to one of six experimental conditions (2 [identifier: none/identifier] × 3 [explanatory statement: none/non-testimonial/testimonial]), or a control condition (text only warning labels that currently appear on packs in the United States). In each condition, participants were exposed to multiple labels each focused on a different health effect. Effectiveness was assessed using emotional responses, engagement and behavioral intentions measured immediately post-exposure, and quit attempts measured at five-week follow up. Testimonial PWLs were more effective than the text only labels. However, there was little evidence that adding identifiers or the explanatory statements enhanced effectiveness; rather, there was some evidence that testimonial explanatory statements reduced effectiveness. These findings suggest that the most effective design for testimonial PWLs may be to combine a basic warning statement with an image of a real person, without any additional textual components.
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http://dx.doi.org/10.1080/10410236.2018.1493417DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326893PMC
November 2019

Population awareness of tobacco-related harms: implications for refreshing graphic health warnings in Australia.

Med J Aust 2018 08 9;209(4):173-174. Epub 2018 Jul 9.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC.

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http://dx.doi.org/10.5694/mja17.01207DOI Listing
August 2018

Fear, Sadness and Hope: Which Emotions Maximize Impact of Anti-Tobacco Mass Media Advertisements among Lower and Higher SES Groups?

J Health Commun 2018 27;23(5):445-461. Epub 2018 Apr 27.

a Centre for Behavioural Research in Cancer, Cancer Council Victoria , Melbourne , Victoria , Australia.

Emotive anti-tobacco advertisements can increase quitting. Discrete emotion theories suggest evoking fear may be more effective than sadness; less research has focused on hope. A weekly cross-sectional survey of smokers and recent quitters (N = 7683) measured past-month quit attempts. The main predictor was level of exposure to four different types of anti-tobacco advertisements broadcast in the two months prior to quit attempts: advertisements predominantly evoking fear, sadness, hope, or evoking multiple negative emotions (i.e., fear, guilt, and/or sadness). Greater exposure to fear-evoking advertisements (OR = 2.16, p < .01) increased odds of making a quit attempt and showed similar effectiveness among those in lower and higher SES areas. Greater exposure to advertisements evoking multiple negative emotions increased quit attempts (OR = 1.70, p < .01), but interactions indicated this was driven by those in lower SES, but not higher SES areas. Greater exposure to hope-evoking advertisements enhanced effects of fear-evoking advertisements among those in higher SES, but not lower SES areas. Findings suggest to be maximally effective across the whole population avoid messages evoking sadness and use messages eliciting fear. If the aim is to specifically motivate those living in lower SES areas where smoking rates are higher, multiple negative emotion messages, but not hope-evoking messages, may also be effective.
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http://dx.doi.org/10.1080/10810730.2018.1463320DOI Listing
December 2019

Observed smoking and tobacco pack display in Australian outdoor cafés 2 years after implementation of plain packaging.

Eur J Public Health 2018 08;28(4):702-707

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC 3004, Australia.

Background: Implementation of tobacco plain packaging (PP) in Australia in December 2012 was associated with significant reductions in the percentage of patrons at outdoor cafés observed to be displaying tobacco packs and actively smoking, immediately post-implementation and 1 year later. This study examines whether these positive effects were sustained through to 2 years post-PP.

Methods: An observational study conducted at cafés, restaurants and bars with outdoor seating in Melbourne, Australia documented the number of: patrons; patrons actively smoking; tobacco packs on display; orientation and type of displayed packs and whether or not children were present. Data were collected pre-PP (2012), early post-PP (2013), 1 year post-PP (2014) and 2 years post-PP (2015). Multilevel Poisson regressions analyzed changes in each outcome, adjusting for important covariates.

Results: Overall, positive effects of PP implementation on tobacco pack display and active smoking were not fully sustained through to 2 years post-PP for the total sample. Interactions between phase and the presence of children indicated that pack display and active smoking were lower in all post-implementation phases (compared with pre-PP) at venues where children were present but not at venues where children were not present.

Conclusions: Children at outdoor cafés were still being exposed to less tobacco packaging and active smoking, 2 years after implementation of the packaging changes. More regular refreshment of graphic health warnings is likely to be required to sustain these effects, and to reduce pack display behaviour at venues with no children.
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http://dx.doi.org/10.1093/eurpub/cky051DOI Listing
August 2018

Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study.

Addiction 2018 06 27;113(6):1019-1029. Epub 2018 Feb 27.

School of Communication Ohio State University, Columbus, OH, USA.

Aims: To compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines.

Design: Between-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G).

Setting: Australia, 2016.

Participants: A total of 3718 drinkers aged 18-64 years (48.5% male).

Measurements: Post-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption.

Findings: After exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P < 0.001) and LTH advertisements without guidelines, respectively (P = 0.019) and ALC control (STH+G, P < 0.001; LTH+G, P < 0.001) and NON-ALC control conditions (STH+G, P < 0.001; LTH+G, P = 0.011). Drinkers exposed to STH conditions were more likely to intend to reduce next-week alcohol consumption than those exposed to ALC control (both P < 0.001) and NON-ALC control conditions (STH, P = 0.001; STH+G, P < 0.001); a similar pattern was observed for intentions to avoid alcohol. Drinkers exposed to LTH conditions were also more likely than drinkers exposed to ALC or NON-ALC controls to intend to avoid and reduce alcohol in the next week. Additionally, drinkers exposed to LTH+G were more likely to intend to reduce drinking than those exposed to LTH advertisements without guidelines (P = 0.022). Response patterns for low- and high-risk drinkers by condition were similar.

Conclusions: Alcohol harm television advertisements increase intentions to reduce alcohol consumption among both low- and high-risk drinkers. The addition of low-risk drinking guidelines can enhance these effects for advertisements featuring long-term harms and improve estimates of both short- and long-term harmful drinking levels.
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http://dx.doi.org/10.1111/add.14147DOI Listing
June 2018