Martine Stead

“It's as if you’re locked in”: qualitative explanations for area effects on smoking in disadvantaged communities

Evidence suggests that place of residence may be associated with smoking independently of individual poverty and socio-economic status. Qualitative research undertaken in disadvantaged communities in Glasgow explored possible pathways which might explain this area effect. A poorly resourced and stressful environment, strong community norms, isolation from wider social norms, and limited opportunities for respite and recreation appear to combine not only to foster smoking but also to discourage or undermine cessation. Even the more positive aspects of life, such as support networks and identity, seem to encourage rather than challenge smoking. Policy and intervention responses need to tackle not only individual but also environmental disadvantage.

Preventing adolescent smoking: a review of options

in Europe’-2. The Health for All in Wales targets&dquo; call for regular smoking among 15-year-olds to be reduced. This review was commissioned by Health Promotion Wales to inform and guide a new programme of work aimed at rcducing adolescent smoking prevalence, particularly among females. A review was conducted of recent published research data and recommendations on adolescent smoking from the UK, North America, Australasia and

Confident, fearful and hopeless cooks: Findings from the development of a food‐skills initiative

One of the many barriers to a healthier diet in low‐income communities is a presumed lack of practical food skills. This article reports findings from exploratory qualitative research conducted with potential participants in a cooking skills intervention, in low income communities in Scotland. The research found widely varying levels of skill and confidence regarding cooking, supported the need for a community‐based intervention approach, and demonstrated the importance of consumer research to inform the content of interventions. Challenges the view that low income communities lack skills, suggesting that food skills should be defined more broadly than “cooking from scratch”. Other barriers to healthy eating, such as poverty, food access and taste preferences, remain important.

A qualitative study of older people's perceptions of ageing and exercise: the implications for health promotion

Older peoples perceptions of ageing and exercise were explored in this qualitative research project. Fifteen focus group discussions were con ducted in Scotland with older (55-75+) and younger (18-49) people, with the aim of investigating how ageing, health and exercise were conceptual ised and of exploring the factors which influence participation in physical activity. Differences between age groups were also examined. The findings demonstrate that many older people are unlikely to participate in exercise for its own sake, nor for health reasons; attempts to promote activity should stress instead the social rewards, and should use different strategies for those currently active and for those who take little or no exercise.

Rethinking drugs prevention: Radical thoughts from social marketing

NE Choices was a major drugs prevention programme which targeted 13 to 16-year-olds in the north-east of England between 1996 and 1999. It had explicit drug use prevention, prevalence reduction and harm minimisation behaviour change objectives. The intervention had everything going for it: strong theoretical underpinnings; a multi-component design, combining a schools intervention with community, media and stakeholder activity; extensive, long term resources (the programme lasted three years plus a one-year pilot and an additional year of follow-up); a comprehensive bank of formative, process and impact evaluations to inform its development and implementation; and a quasi-experimental design to measure its effect on behaviour. But it did not work. Despite consistently and markedly positive formative, process and impact results, it did not change behaviour. This paper examines the lessons that emerge from NE Choices. It begins with a conventional analysis, which suggests a need for relatively straightforward alterations to the intervention, starting at an earlier age, for example, or making the evaluation more rigorous. The paper then looks at some of the interventions strengths, before taking a more radical perspective, and using learning from social marketing to call for a fundamental rethink of the intervention mentality.

Preventing Adolescent Drug Use: the development, design and implementation of the first year of 'NE Choices'

Illicit drug use by adolescents in the UK is of major concern. Recent surveys suggest that increasing proportions of young people are using drugs, that the number of different drugs used has increased, and that young people are experimenting at a younger age (Roberts et al ., 1995). As part of its response to these problems, the UK Government established the Home Office Drugs Prevention Initiative (DPI), a nationwide programme of interventions combining central guidance and local initiatives, and designed to establish best practice in the field (Home Office, 1996). NE Choices was one of the largest interventions in the programme, a 3-year multi-component social influences intervention targeting 13-16-year-old school children in the north-east of England. Following a 3-year development and pilot phase, the intervention began its full implementation in January 1997 and ran until April 1999. A longitudinal quasi-experimental study measured drug use behaviour before, during and after the programme, while process and impact evaluation studies examined delivery and immediate response. This paper describes the development, design and delivery of the programmes first year, the Year Nine intervention.Illicit drug use by adolescents in the UK is of major concern. Recent surveys suggest that increasing proportions of young people are using drugs, that the number of different drugs used has increased, and that young people are experimenting at a younger age (Roberts et al ., 1995). As part of its response to these problems, the UK Government established the Home Office Drugs Prevention Initiative (DPI), a nationwide programme of interventions combining central guidance and local initiatives, and designed to establish best practice in the field (Home Office, 1996). NE Choices was one of the largest interventions in the programme, a 3-year multi-component social influences intervention targeting 13-16-year-old school children in the north-east of England. Following a 3-year development and pilot phase, the intervention began its full implementation in January 1997 and ran until April 1999. A longitudinal quasi-experimental study measured drug use behaviour before, during and after the programme, while pr...

Tobacco marketing: shackling the pied piper.

These are encouraging times for tobacco control. Both the British and the American governments are trying to curb the activities of the tobacco industry, and the European Union will probably now move against tobacco advertising across Europe. This is a good moment, therefore, to emphasise that our key concern should be not with advertising, or sponsorship, or indeed any individual element of the industrys promotional activity, but with the whole process of tobacco marketing.nnAs with the successful marketing of other consumer goods, tobacco marketing is based on careful research to provide a detailed understanding of customers, and this guides linked strategies in the four marketing areas of product development, distribution, pricing, and promotion. These strategies aim to build successful brands and thereby maximise the appeal of the industrys offerings.nnTobacco has two sorts of customer: starters, who are just trying out the habit and deciding whether to take it up, and committed users, who have been smoking for some time. Committed users are easier to please: they simply need access to their regular fix of nicotine.nnStarters …

Local AIDS prevention and the use of television advertising

AbstractTelevision advertising as a medium for health education is often dismissed as a blunt tool which can only be used effectively by the big players and at prohibitive costs. But in 1991 East Cumbria, with the support of Northern Regional Health Authority, ran the first ever TV campaign by a district health authority, promoting condom use humorously and positively to 16–24 year olds. Awareness impact was high, and the advert attracted much local media coverage. The key to the success was, firstly, the fact that the target group influenced all stages of the campaign, and, secondly, that the campaign was perceived to be by and for local people. Consumer research pre- and post-campaign by the Advertising Research Unit played a vital role.

Smoking in disadvantaged communities: Assessing motivation and ability to quit

For several years, tobacco control organizations have advocated price manipulation by raising taxes on tobacco products as a strategy for promoting smoking cessation.Data from several countries have shown a direct correlation between price and consumption (e.g. European Bureau for action on Smoking Prevention, 1992; Townsend et al. 1994): when price rises, consumption decreases, and vice versa. Recent evidence suggests, however, that price rises may be ineffective among the poorest smokers (Marsh & McKay, 1994). The decreases in prevalence that have occurred in all other sections of the population have not occurred in the poorest groups, who continue to smoke at the same rate as 20 years ago (Figure 1).

No Smoking Day: How Can National Media Campaigns Stimulate Local Action?

This paper uses recent research conducted into the No Smoking Day (NSD) campaign to examine how individuals working in smoking cessation at a local and community level can best be supported in their work. It does not seek to examine the ultimateeffectivenessof NSD, but to draw lessons for other similar campaigns from the process by which NSD is organised and supported. The study is part of a five-phase rolling programme of research commissioned by the Health Education Board for Scotland (HEBS), the national agency with responsibility for health promotion in Scotland.