Amanda Marie Atkinson

Reducing harm in drinking environments: a systematic review of effective approaches.

Drinking environments, including bars, nightclubs and their surrounds are associated with high levels of acute alcohol-related harms. This systematic review examined the effectiveness of interventions implemented in drinking environments to reduce alcohol use and associated harms. The findings of the review were limited by the methodological shortcomings of the included studies. However, three studies indicated that multicomponent programmes combining community mobilisation, RBS training, house policies and stricter enforcement of licensing laws may be effective in reducing assaults, traffic crashes, and underage sales depending on the focus of the intervention. The effectiveness of other intervention approaches was limited. Future studies of interventions in drinking environments should focus on using appropriate and robust study designs.

Effects of alcohol preload on attentional bias towards cocaine-related cues

BackgroundDrug and alcohol users have an ‘attentional bias’ for substance-related cues, which is likely to reflect the incentive-motivational properties of those cues. Furthermore, administration of an alcohol preload increases attentional bias for alcohol and tobacco-related cues in heavy drinkers and tobacco smokers, respectively. The present study investigated attentional bias for cocaine cues in cocaine users and non-users following administration of either alcohol or placebo.MethodThirty-two regular cocaine users and 40 non-users took part. Participants were administered alcohol or placebo, and administration was double blind. After drink administration, a Visual Probe task and Modified Stroop task were used to assess attentional bias. Subjective craving and alcohol outcome expectancies were also measured.ResultsThere was a significant interaction between group and drink type on the visual probe task indicating that cocaine users who had received alcohol had increased attentional bias for cocaine pictures compared to non-users and cocaine users who received placebo. The cocaine Stroop revealed no differences between cocaine users and non-users, and no effects of alcohol in either group.ConclusionsAlcohol preload in regular cocaine users increases attentional bias for cocaine cues. However, cocaine users who received placebo did not show attentional bias for cocaine stimuli. Future research should investigate the effects of alcohol preload on attentional bias in cocaine-dependent individuals.

Smoking behaviours, access to cigarettes and relationships with alcohol in 15- and 16-year-old schoolchildren

BACKGROUND Adolescent smoking is a significant public health concern in the UK and across Europe. This study examines smoking behaviours, methods of accessing cigarettes and use of non-commercial (fake, foreign and single) cigarettes across a sample of schoolchildren. Relationships with alcohol consumption, deprivation, personal income and extra-curricular activities are also explored. METHODS A cross-sectional survey of 9833 15- and 16-year-old schoolchildren in the North West of England. RESULTS Cigarettes were most commonly accessed from off-licences and newsagents, but pupils also reported non-commercial access through friends, family and street sellers/neighbours. A high percentage of smokers had bought foreign (57%), fake (28%) and single (54%) cigarettes. Frequent binge drinking, not participating in extra-curricular activities, receiving greater personal income, and having parents that smoked were significantly associated with being a regular and heavier smoker. Frequent binge drinking was also significantly associated with buying foreign/fake or single cigarettes. A higher percentage of those living in deprived areas were current smokers, although deprivation was not an independent predictor of cigarette use. CONCLUSION Strategies that restrict commercial access to cigarettes among adolescents may increase their reliance on social methods of access, and use of fake, foreign and single cigarettes. Interventions to reduce adolescent smoking must recognize the critical role of parents and communities in discouraging smoking and preventing social access to cigarettes in children. A joint approach to prevention is required that targets children at risk of smoking, heavy alcohol use and associated health-damaging behaviours.

Young peoples' perspective on the portrayal of alcohol and drinking on television: Findings of a focus group study

This article presents findings of focus groups (n = 15) with young people (n = 114) which aimed to explore their views, experiences and interpretations of the ways in which alcohol and drinking are portrayed on television. Young people showed a sophisticated level of awareness of alcohol and its use on television and were adept at deconstructing the alcohol-related messages presented. Participants were undecided as to whether they believed television represented alcohol use in a realistic manner and acknowledged a contradiction between realistic accounts and exaggeration for the creation of ‘entertaining’ content. Overall, participants felt that television should provide a balanced view of alcohol use, showing both the positive side of drinking and the possible negative effects without an overemphasis on the latter. Young people did perceive television to exert an influence upon audiences. However, a ‘third person effect’ was found, with participants speaking in the third person and suggesting that television may influence others, but not themselves. The implications of the findings are discussed in relation to the potential influence of these representations on the development of alcohol-related beliefs and behaviour and the use of television in alcohol-related health promotion.

Views and experiences of hepatitis C testing and diagnosis among people who inject drugs: Systematic review of qualitative research

BACKGROUND Many developed countries are facing a major challenge to improve identification of individuals acutely and chronically infected with hepatitis C virus (HCV) infection. We explored the views and experiences of people who inject drugs (PWID) in relation to HCV testing, and diagnosis through a review and synthesis of qualitative research. METHODS Based on the thematic synthesis of qualitative research. Searches were conducted in 14 databases and supplemented by reference checking, hand searching of selected journals, and searches of relevant websites. Studies of any qualitative design that examined the views and experiences of, and attitudes towards, HCV testing and diagnosis among PWID or practitioners involved in their care were included. Key themes and sub-themes were systematically coded according to the meaning and content of the findings of each study which proceeded to the preparation of a narrative account of the synthesis. RESULTS 28 qualitative studies were identified. We identified a number of overarching descriptive themes in the literature, finding overall that PWID hold complex and differing views and experiences of testing and diagnosis. Three major themes emerged: missed opportunities for the provision of information and knowledge; shifting priorities between HCV testing and other needs; and testing as unexpected and routine. Evidence of missed opportunities for the provision of knowledge and information about HCV were clear, contributing to delays in seeking testing and providing a context to poor experiences of diagnosis. Influenced by the nature of their personal circumstances, perceptions of the risk associated with HCV and the prioritisation of other needs acted both to encourage and discourage the uptake of HCV testing. Undergoing HCV testing as part of routine health assessment, and an unawareness of being testing was common. An unexpected positive diagnosis exacerbated anxiety and confusion. CONCLUSION This review has identified that there are modifiable factors that affect the uptake of HCV testing and experiences of HCV diagnosis among PWID. Intervention development should focus on addressing these factors. There is a need for further research that engages PWID from a diverse range of populations to identify interventions, strategies and approaches that they consider valuable.

An exploration of alcohol advertising on social networking sites: an analysis of content, interactions and young people’s perspectives

Abstract Young people increasingly communicate and interact via social digital media such as Social Network Sites (SNS), where they discuss and display alcohol-related content. SNS have also become an important aspect of the alcohol industry’s multi-platform marketing strategies, which may contribute to the creation of intoxigenic digital spaces in which young people learn about alcohol. This paper presents findings of a content analysis of the extent, nature, and user interaction with SNS-based alcohol marketing for brands popular among young people in the UK. It provides a systematic analysis of both official and user generated marketing content on brand Facebook and Twitter profiles, and user interaction with such content. Findings from peer group interviews (N = 14) also present young people’s (N = 70) perspectives and experiences regarding alcohol marketing on SNS. New SNS engagement marketing strategies extended existing multi-platform brand marketing. Young people interacted with such strategies as part of their identity-making practices, yet through a discourse of immaturity distanced themselves from certain brands, online marketing practices and the idea that their own actions were influenced by marketing. Local night life economy marketing appeared more meaningful and relevant to young people and led to further interaction with brand marketing. Implications of the findings are discussed in relation to the influence of alcohol marketing on young people, and the implications for current regulatory frameworks.

Depictions of Alcohol Use in a UK Government Partnered Online Social Marketing Campaign: "Hollyoaks" "The Morning after the Night before".

Aims: This study analysed the depiction of alcohol in an online government partnered social marketing campaign: Hollyoaks ‘The Morning After the Night Before’. This was a new initiative, providing Internet-delivered episodes of a popular terrestrial drama targeted at young people. Methods: All the 12 episodes were coded for visual representations of alcohol, drinking acts and alcohol effect references. The drinking setting, point in time, type of alcoholic beverage consumed, drinkers demographics, effects/consequences of drinking, and official and unofficial responses to alcohol consumption and related harms were also coded. Audience comments were then categorized according to their content in order to gain an insight into viewers’ thoughts regarding the campaign. Findings: A wide variety of data is reported. Most representations of alcohol were positively framed, and were depicted without immediate consequence. No explicit sensible drinking messages were included in the episodes. Analysis of viewer feedback indicated a lack of awareness of the intentions of the campaign and little discussion of alcohol-related issues was generated. In contrast, viewers seemed to reject the depictions of alcohol portrayed, and identified with, or admired, the central characters. Further analysis indicated little coherence between alcohol framing in the online campaign and representations in the terrestrial TV series. Conclusions: This article uses the example of KYL/Hollyoaks to draw attention to the emergent use of the internet and other new media in health promotion. New media provides creative new opportunities to engage young people with health-promoting messages. However, although new ways of delivery are important they should be part of a co-ordinated and internally consistent campaign, present realistic depictions of alcohol use, and be based upon clear evidence-based principles.

Online test purchased new psychoactive substances in 5 different European countries: A snapshot study of chemical composition and price

BACKGROUND New psychoactive substances (NPS) are on offer worldwide online, in order to shed light on the purity and price of these substances in the European Union, a research collaboration was set up involving France, United Kingdom (UK), the Netherlands, Czech Republic and Poland. METHODS Per country, around 10 different NPS were test purchased from different webshops. Then, chemical analysis of NPS was done with according reference standards to identify and quantify the contents. RESULTS In contrast to what is generally advertised on the webshops (>99%), purity varied considerably per test purchased NPS. Several NPS were mislabelled, some containing chemical analogues (e.g. 25B/C-NBOMe instead of 25I-NBOMe, pentedrone instead of 3,4-DMMC). But in some cases NPS differed substantially from what was advertised (e.g. pentedrone instead of AMT or 3-FMC instead of 5-MeO-DALT). Per gram, purity-adjusted prices of cathinones differed substantially between three countries of test purchase, with Poland being the least expensive. Synthetic cannabinoids were relatively the most expensive in the Czech Republic and least expensive in the UK. CONCLUSION The current findings provides a snapshot of the price and chemical contents of NPS products purchased by different countries and in different webshops. There is a potential danger of mislabelling of NPS. The great variety in price and purity of the delivered products might be the result of the market dynamics of supply and demand and the role of law enforcement in different European countries.

‘Isn’t it mostly girls that do pre-drinks really?’ Young men and women’s accounts of pre-loading in the UK

Abstract Aims: Pre-loading, the consumption of off-sale alcohol within private settings before socialising in licenced premises, is common among young people. The research explored young people’s accounts of pre-loading within their experience of wider peer group drinking occasions in the UK. Methods: Fourteen semi-structured focus group interviews were conducted with peer groups of young people (N = 70, 16–21 years) and analysed using thematic analysis. Results: Pre-loading with friends prior to a ‘night out’ drinking in public spaces was a common sequential practice within their collective drinking experiences. Although traditionally conceptualised within policy, academic and media discourse as drinking in the domestic sphere before entering licenced premises, young people also considered drinking within the home prior to attending private parties (e.g. house parties) as pre-loading. Price was represented as a key, yet not sole, motivating factor and pre-drinking alcohol held importance in reaching a desired state of intoxication that enhanced shared fun and pleasure among both young men and women. However, the social (e.g. chatting with friends, taking photographs) and preparatory activities (e.g. ‘getting ready’) at play during pre-loading appeared to hold more importance to young women, in promoting group bonding and in the creation and management of heterosexual feminine identities both on- and off-line. Conclusions: Although price is important, there is a wider social and cultural significance of pre-loading as a gendered phenomenon. Young people apply a wider definition of pre-loading that incorporated the consumption of off-sale alcohol prior to parties within private settings.

Neo-liberal discourse of substance use in the UK reality TV show, The Jeremy Kyle Show

Abstract This article presents findings of a content and thematic analysis of representations of substance use and users in the UK Reality Television programme, The Jeremy Kyle Show. It provides evidence that substance use and users were problematised through the process of ‘othering’ which contributed to a reductionist drugs discourse. We argue that such discourse can be understood within the wider socio-economic political context of neoliberalism. Four intertwined themes revealed underlying neo-liberal notions that reduced substance use and users to a number of characteristics and associated issues, and provided a narrow and skewed representation of use and users. Through framing substance use as a rational choice, users were held fully responsible and blamed for their substance use, resulting problems, and failure of treatment. Substance use was associated with unemployment and dependency on state welfare, with those claiming welfare being deemed accountable for their lack of employment and shamed for their failure to meet the neoliberal notion of the productive citizen. Structural causes of substance use and inequality were silenced, and an emphasis on individual responsibility prioritised, which may lead to the reinforcement of stigma, and societal and institutional interventions being overlooked. Users were also encouraged to repair a ‘lost’ sense of self through abstinence within private inpatient treatment, endorsing the neo-liberal notion of private health care and prioritising abstinence-based responses and individual responsibility in treatment success. Implications for public perceptions of substance use, users and suitable responses, and substance users’ perceptions of themselves, are considered.