Brennen W Mills

The effect of retail cigarette pack displays on unplanned purchases: results from immediate postpurchase interviews

Objective: To assess the influence of point-of-sale (POS) cigarette displays on unplanned purchases. Methods: Intercept interviews were conducted with customers observed purchasing cigarettes from retail outlets featuring POS cigarette displays. Measures included intention to purchase cigarettes prior to entering the store, unprompted and prompted salience of POS tobacco displays, urge to buy cigarettes as a result of seeing the POS display, brand switching and support for a ban on POS cigarette displays. Results: In total, 206 daily smokers aged 18–76 years (90 male, 116 female) were interviewed. Unplanned cigarette purchases were made by 22% of participants. POS displays influenced nearly four times as many unplanned purchases as planned purchases (47% vs 12%, p<0.01). Brand switching was reported among 5% of participants, half of whom were influenced by POS displays. Four times as many smokers were supportive of a ban on POS tobacco displays than unsupportive (49% vs 12%), and 28% agreed that such a ban would make it easier to quit. Conclusions: POS tobacco displays act as a form of advertising even in the absence of advertising materials. They stimulate unplanned cigarette purchases, play an important role in brand selection and tempt smokers trying to quit. This justifies removing POS tobacco displays from line of sight—something that very few smokers in our sample would object to.

Impact of a point-of-sale tobacco display ban on smokers’ spontaneous purchases: comparisons from postpurchase interviews before and after the ban in Western Australia

Objective To assess the impact of the Western Australian tobacco point-of-sale display ban on spontaneous purchase behaviours. Methods Daily adult smokers (n=402) observed purchasing cigarettes were recruited via exit interviews either 2 months before or after the implementation of the display ban. Smokers were asked if they had intended to purchase cigarettes before entering the store to assess spontaneous purchase behaviours. Whether smokers had noticed the displays before their purchase and the extent to which this influenced their purchase decision was also assessed via non-prompting questions. Results When compared with before the ban, fewer smokers after the ban noticed the displays (27.1% vs 1.1%, p<0.001), fewer reported making spontaneous purchases (28.2% vs 19.8%, p<0.05) and fewer claimed the displays influenced their purchase decisions (free recall 5.0% vs 1.1%, p<0.05; cued recall 22.1% vs 3.8%, p<0.001). Before the ban, spontaneous purchasers were more likely than planned purchasers to suggest the displays influenced their purchase decisions (free recall 9.7% vs 3.2%, p<0.05; cued recall 40.0% vs 17.9%, p<0.01). After the ban, spontaneous purchasers nominating the influence of displays fell substantially (free recall 9.7% vs 5.6%, p=NS; cued recall 40.0% vs 11.1%, p<0.01) as it did for planned purchasers (free recall 3.2% vs 0.0%, p<0.05; cued recall 17.9% vs 2.1%, p<0.01). Conclusions We observed a 30% reduction in smokers making spontaneous tobacco purchases after implementation of the Western Australian tobacco display ban and between a fivefold and sixfold reduction in the proportion suggesting displays influenced their decision to purchase cigarettes. These data are consistent with previous research suggesting tobacco displays encourage spontaneous purchases and their removal corresponds to reductions in the same.

An independent audit of the Australian food industry’s voluntary front-of-pack nutrition labelling scheme for energy-dense nutrition-poor foods

Background/Objective:Since 2006, the Australian food industry has promoted its front-of-pack (FOP) food labelling system—the Daily Intake Guide (DIG)—as a success story of industry self-regulation. With over 4000 products already voluntary featuring the DIG, the industry argues that government regulation of FOP nutrition labelling is simply unnecessary. However, no independent audit of the industry’s self-regulation has ever been undertaken and we present the first such Australian data.Subjects/Methods:Energy-dense nutrient-poor (EDNP) snacks were audited at nine Australian supermarkets, including biscuits, candy, ice creams, chocolates, crisps, sports drinks, energy drinks, flavoured milks, sweetened juices and soft drinks. In these categories nutrition labels were recorded for 728 EDNP products in various packaging sizes.Results:The DIG was displayed on 66% of audited EDNP products but most of these (75%) did not report saturated fat and sugar content. Only generic supermarket EDNP products were likely to display saturated fat and sugar content, compared with very few branded products (48% vs 4%, P<0.001). Branded products not displaying fat and sugar content contained on average 10-times more saturated fat than those displaying such (10% vs 1% DI, P<0.001) and nearly twice as much sugar (21 vs 13% DI, P<0.05).Conclusions:Most Australian manufacturers of EDNP products have adopted the DIG; consistent with industry claims of widespread adoption, but almost all still avoid displaying the high saturated fat and sugar content of their products by opting for the ‘energy alone’ option, violating the industry’s own voluntarily guidelines and highlighting serious weaknesses with the industry’s self-regulation.

Measuring the effect of cigarette plain packaging on transaction times and selection errors in a simulation experiment

Introduction Australia has introduced legislation to force all cigarette packaging to be generic from 2012 onwards. The tobacco retail industry estimates this will result in transaction times increasing by 15–45 s per pack and is spending at least

Effects of Low- Versus High-Fidelity Simulations on the Cognitive Burden and Performance of Entry-Level Paramedicine Students: A Mixed-Methods Comparison Trial Using Eye-Tracking, Continuous Heart Rate, Difficulty Rating Scales, Video Observation and Interviews.

A10 million of tobacco industry funds on an advertising campaigns claiming that the increased time and errors associated with plain packaging will ultimately cost small businesses

Plain packaging for cigarettes improves retail transaction times

A461 million per annum and endanger 15 000 jobs. We undertook an objective experiment to test these claims. Methodology Participants (n=52) were randomly assigned to stand in front of a display of either 50 plain or coloured cigarette packets and then were read a randomly ordered list of cigarette brands. The time participants took to locate each packet was recorded and all selection errors were noted. After 50 ‘transactions’, participants repeated the entire experiment with the alternative plain/coloured packs. Afterwards, participants were asked in an open-ended manner whether plain or coloured packaging was easier to locate and why. Results The average transaction was significantly quicker for plain compared with coloured packs (2.92 vs 3.17 s; p=0.040). One or more mistakes were made by 40.4% of participants when selecting coloured packaging compared with only 17.3% for plain packaging (p=0.011). Qualitative results suggested that the colours and inconsistent location of brand names often served to distract when participants scanned for brands. Conclusion Rather than plain packaging requiring an additional 45 s per transaction, our results suggest that it will, if anything, modestly decrease transaction times and selection errors.

Clinical Placement Before or After Simulated Learning Environments?: A Naturalistic Study of Clinical Skills Acquisition Among Early-Stage Paramedicine Students

Introduction High-fidelity simulation-based training is often avoided for early-stage students because of the assumption that while practicing newly learned skills, they are ill suited to processing multiple demands, which can lead to “cognitive overload” and poorer learning outcomes. We tested this assumption using a mixed-methods experimental design manipulating psychological immersion. Methods Thirty-nine randomly assigned first-year paramedicine students completed low- or high-environmental fidelity simulations [low–environmental fidelity simulations (LFenS) vs. high–environmental fidelity simulation (HFenS)] involving a manikin with obstructed airway (SimMan3G). Psychological immersion and cognitive burden were determined via continuous heart rate, eye tracking, self-report questionnaire (National Aeronautics and Space Administration Task Load Index), independent observation, and postsimulation interviews. Performance was assessed by successful location of obstruction and time-to-termination. Results Eye tracking confirmed that students attended to multiple, concurrent stimuli in HFenS and interviews consistently suggested that they experienced greater psychological immersion and cognitive burden than their LFenS counterparts. This was confirmed by significantly higher mean heart rate (P < 0.001) and National Aeronautics and Space Administration Task Load Index mental demand (P < 0.05). Although group allocation did not influence the proportion of students who ultimately revived the patient (58% vs. 30%, P < 0.10), the HFenS students did so significantly more quickly (P < 0.01). The LFenS students had low immersion resulting in greater assessment anxiety. Conclusions High–environmental fidelity simulation engendered immersion and a sense of urgency in students, whereas LFenS created assessment anxiety and slower performance. We conclude that once early-stage students have learned the basics of a clinical skill, throwing them in the “deep end” of high-fidelity simulation creates significant additional cognitive burden but this has considerable educational merit.

Working with children with autism: an interprofessional simulation-based tutorial for speech pathology and occupational therapy students

Australia implemented generic packaging laws on 1 December 2012.1 Similar legislation under consideration in the UK is vigorously opposed by national retail groups. Dubious tobacco industry funded studies predict tobacco transaction times will increase by 15-45 s and selection errors by 5-25%,2 3 costing retailers nationwide £37m (€43m;

Testing children’s ability to correctly use the “Shadow Rule” for sun protection

57.5m) a year.4 Conversely, independent peer reviewed …

Quantification of opportunities for early-stage paramedicine students to practice clinical skills during clinical placements compared with an equal dose of simulation-based workshops

Background There is conflicting evidence surrounding the merit of clinical placements (CPs) for early-stage health-profession students. Some contend that early-stage CPs facilitate contextualization of a subsequently learned theory. Others argue that training in simulated-learning experiences (SLEs) should occur before CP to ensure that students possess at least basic competency. We sought to investigate both claims. Methods First-year paramedicine students (n = 85) undertook 3 days of CP and SLEs as part of course requirements. Students undertook CP either before or after participation in SLEs creating 2 groups (Clin→Sim/Sim→Clin). Clinical skills acquisition was measured via direct scenario-based clinical assessments with expert observers conducted at 4 intervals during the semester. Perceptions of difficulty of CP and SLE were measured via the National Aeronautics and Space Administration Task Load Index. Results Students’ clinical assessment scores in both groups improved significantly from beginning to end of semester (P < 0.001). However, at semester’s end, clinical assessment scores for the Sim→Clin group were statistically significantly greater than those of the Clin→Sim group (P = 0.021). Both groups found SLEs more demanding than CP (P < 0.001). However, compared with the Sim→Clin group, the Clin→Sim group rated SLE as substantially more time-demanding than CP (P = 0.003). Conclusions Differences in temporal demand suggest that the Clin→Sim students had fewer opportunities to practice clinical skills during CP than the Sim→Clin students due to a more limited scope of practice. The Sim→Clin students contextualized SLE within subsequent CP resulting in greater improvement in clinical competency by semester’s end in comparison with the Clin→Sim students who were forced to contextualize skills retrospectively.