A rapid literature review of the effect of alcohol marketing on people with, or at increased risk of, an alcohol problem.

AIMS: To explore the effect or potential effect of alcohol marketing in people with an alcohol use disorder, in recovery from an alcohol use disorder, and hazardous and harmful drinkers. METHODS: Relevant literature was identified by searching Medline (OVID), EMBASE (OVID), and PsycINFO (OVID) and relevant websites. Both quantitative and qualitative studies were eligible for inclusion. A narrative approach was used to synthesize the findings. RESULTS: The review included 10 studies. Two quantitative and three qualitative studies focused on participants recovering from an alcohol use disorder and five quantitative studies on those with hazardous or harmful consumption levels of alcohol. The effect of alcohol advertising on alcohol use was only assessed in one study, a small experimental study of young adult heavy drinkers, which found no significant association. Studies looking at other outcomes found that people with or at risk of alcohol problems were likely to notice alcohol advertisements and find them appealing, and that advertisements may have an effect on positive alcohol-related emotions and cognitions. Among people in recovery from an alcohol use disorder, findings suggested that there could be an effect on craving, and that alcohol marketing may be perceived to trigger a desire to drink. CONCLUSIONS: Alcohol marketing is likely to have an effect on alcohol consumption in people with, or at increased risk of, an alcohol problem. Studies have also found that alcohol marketing is perceived to act as a trigger by people in recovery from alcohol problems. SUMMARY: A rapid review explored the effect of alcohol marketing in people with an alcohol use disorder, in recovery from an alcohol use disorder, and hazardous and harmful drinkers. The findings of the 10 included studies suggest that an effect of alcohol marketing in these populations is likely.

Exposure to tobacco, alcohol and 'Junk food' content in reality TV programmes broadcast in the UK between August 2019-2020.

BACKGROUND: Exposure to alcohol, tobacco and foods high in fat, sugar or salt (HFSS) content in media is a risk factor for smoking, alcohol use and HFSS consumption in young people. We report an analysis of tobacco, alcohol and HFSS content in a sample of reality TV programmes broadcast on TV and video-on-demand services throughout a 1-year period. METHODS: We used 1-min interval coding to quantify content in all episodes of 20 different reality TV programmes between August 2019 and August 2020 and estimated population exposure to a sample of these programmes using viewing data and UK population estimates. RESULTS: We coded 13 244 intervals from 264 episodes. Tobacco content appeared in 227 intervals (2%) across 43 episodes (2%), alcohol in 5167 intervals (39%) across 258 episodes (98%) and HFSS in 1752 intervals (13%) across 234 episodes (88%). A sample of 15 series delivered ~157.4 million tobacco, 3.5 billion alcohol and 1.9 billion HFSS gross impressions to the UK population, including 24 000, 12.6 million and 21.4 million, to children, respectively. CONCLUSION: Tobacco, alcohol and HFSS content are common in reality TV programmes. These programmes deliver exposure to tobacco, alcohol and HFSS imagery, which are a potential driver of tobacco use, alcohol use and HFSS consumption in young people.

Motor neuron disease mimics in practice: a case series.

In the majority of cases of motor neuron disease (MND), diagnosis is clinical and unambiguous. However, given the gravity of the diagnosis, it is crucial that treatable mimics are differentiated accurately. We present three cases referred to our clinic with possible MND with unusual features that led to an alternative diagnosis. (1) A middle-aged man with swallowing, then speech problems and foot drop. Tongue movements were slow and electromyography (EMG) showed fibrillations/positive sharp waves. Following investigation, a tonsillar tumour involving the tongue root was identified, and the foot drop improved, suggesting unrelated common peroneal nerve palsy (related to weight loss) or lumbar radiculopathy. (2) An elderly man presenting with progressive unilateral leg weakness and localised fasciculations on EMG. Following investigation, a high-grade brain glioma was diagnosed. (3) An elderly woman presenting with progressive quadriparesis over 18 months with fibrillations and chronic denervation on EMG. Symmetrical weakness and short duration response to immunotherapy led to further serological investigation and a diagnosis of anti-GD1a motor neuropathy. She was treated successfully with intravenous immunoglobulin, cyclophosphamide and rituximab and is now in remission.

A content analysis of 'junk food' content in children's TV programmes: a comparison of UK broadcast TV and video-on-demand services.

OBJECTIVES: Exposure to high in fat, sugar or salt (HFSS) food imagery is associated with unhealthy consumption, and subsequently obesity, among young people. We report and compare the results of two content analyses, one of popular children's television channels in the UK and the other of a selection of children's programmes available on video-on-demand (VOD) services. METHODS: Content analysis of 3 days' worth of programmes on two popular children's television channels broadcast on UK television (CBeebies and Milkshake as well as a sample of children's programmes available on the VOD platforms (Netflix and Amazon Prime) using 1-min interval coding. RESULTS: In children's television channels, HFSS content was seen in 181 episodes (36%) and in 417 intervals (13%) on terrestrial television, 'Milkshake' had a significantly higher proportion of broadcasts, which contained HFSS content than 'CBeebies'. In VOD platforms, HFSS content was seen in 82 episodes (72% of the total number of episodes), across 459 intervals (19% of the total number of intervals), with no significant difference in the proportion of programmes containing HFSS content between Netflix and Amazon Prime. CONCLUSIONS: HFSS content is common in both popular UK children's television channels and children programmes on VOD services and is likely having an effect on HFSS consumption in children. Legislative opportunities to prevent this exposure are being missed.

Population exposure to alcohol and junk food advertising during the 2018 FIFA world cup: implications for public health.

BACKGROUND: Advertising alcoholic drinks and food high in fat, sugar, and salt (HFSS) is a driver of alcohol use and HFSS consumption, among children and young people. Whilst advertising legislation and broadcasting regulation protect children from alcohol and HFSS imagery, the 2018 FIFA World Cup, which attracted a global audience, was sponsored and partnered by alcohol and HFSS brands. This study investigated the exposure of viewers to HFSS and alcohol imagery in a selection of group matches, and the final match, of the FIFA 2018 World Cup. METHODS: The frequency and duration of appearances (to the nearest second) of branding from two sponsors (McDonald's and Budweiser), one official partner (Coca-Cola) and the official sports drink (Powerade) were recorded during all active play in live coverage of a sample of 13 matches (Six in Group A, which included the host nation, Russia, which has stringent alcohol promotion regulations in place; six in Group G, which featured England; and the final) broadcast in the UK. We used census and viewing data to calculate gross and per capita impressions generated by this imagery in the UK population. RESULTS: The 13 matches included 1262 min of active play and a total of 1806 appearances of alcohol and HFSS food advertisements, delivering approximately 7.5 billion branded HFSS impressions, including 759 million to children (age < 16 years), and 3.3 billion alcohol impressions, including 385 million to children, in the UK. Appearances of HFSS and alcohol brands were not statistically different between the games in either group. CONCLUSION: UK advertising legislation and broadcasting regulations intended to prevent exposure to alcohol and HFSS imagery and advertising in UK television was circumvented completely by sponsorship arrangements in the 2018 FIFA World Cup. Preventing this exposure therefore requires revision of existing advertising and broadcasting controls to include sponsorship.

Impact of Smoking and Vaping in Films on Smoking and Vaping Uptake in Adolescents: Systematic Review and Meta-Analysis.

Prevention of smoking uptake in young people is an essential public health target. We have previously reported a systematic review and meta-analysis of the effect of exposure to smoking imagery in films on the risk of smoking uptake in young people. This study updates that review, and includes studies of the effects of exposure to media vaping imagery on vaping uptake. Four electronic databases (MEDLINE, EMBASE, PsycINFO, and IBSS) were searched to August 2020 for studies reporting the association between exposure to smoking/vaping in films and smoking/vaping uptake in adolescents. Two authors independently screened papers, extracted data, and assessed quality. This review included 26 studies. Exposure to high levels of smoking imagery in films was associated with an increased likelihood of having ever smoked in nine cross-sectional studies and of smoking uptake in 11 longitudinal studies. Vaping imagery in films was associated with increased likelihood of ever vaping in two cross-sectional studies and vaping uptake in five longitudinal studies. This review concluded that exposure to smoking imagery in films increases the risk of smoking among young people. It is likely that a similar association exists between exposure to vaping imagery and vaping uptake. Therefore, this review recommends introduction of new policies to minimize the impact of this in films which contain smoking or vaping and are likely to be viewed by children and adolescents.

Content analysis of Netflix and Amazon Prime Instant Video original films in the UK for alcohol, tobacco and junk food imagery.

BACKGROUND: Exposure to alcohol, tobacco and high fat, sugar and salt (HFSS) food imagery is a significant risk factor for the uptake and regular use of these products in young people, and imagery are more frequently portrayed in video-on-demand (VOD) than in terrestrial television programmes. This study compared alcohol, tobacco and HFSS imagery in original films on Amazon Prime Instant Video and Netflix. METHODS: Content analysis of 11 original films released by Amazon Prime and Netflix in 2017 using 5-minute interval coding of alcohol, tobacco and HFSS content. Proportions of intervals containing alcohol, tobacco and HFSS imagery were compared between services using the chi-square test. RESULTS: Alcohol content appeared in 200 (41.7%) out of the total of 479 intervals coded, whereas tobacco and HFSS appeared in 129 (26.9%) and 169 (35.24%), respectively. Proportions were similar between Amazon Prime Instant Video and Netflix original films and were unrelated to film age classification. CONCLUSIONS: Alcohol, tobacco and HFSS content likely to promote consumption among young people occurs frequently in original films shown by VOD services in the UK. Further studies are needed to investigate effective regulatory frameworks for VOD services to protect viewers from harmful or unwanted contents.

Excited states engineering enables efficient near-infrared lasing in nanographenes.

The spectral overlap between stimulated emission (SE) and absorption from dark states (i.e. charges and triplets) especially in the near-infrared (NIR), represents one of the most effective gain loss channels in organic semiconductors. Recently, bottom-up synthesis of atomically precise graphene nanostructures, or nanographenes (NGs), has opened a new route for the development of environmentally and chemically stable materials with optical gain properties. However, also in this case, the interplay between gain and absorption losses has hindered the attainment of efficient lasing action in the NIR. Here, we demonstrate that the introduction of two fluoranthene imide groups to the NG core leads to a more red-shifted emission than the precursor NG molecule (685 vs. 615 nm) and also with a larger Stokes shift (45 nm vs. 2 nm, 1026 cm-1vs. 53 cm-1, respectively). Photophysical results indicate that, besides the minimisation of ground state absorption losses, such substitution permits to suppress the detrimental excited state absorption in the NIR, which likely arises from a dark state with charge-transfer character and triplets. This has enabled NIR lasing (720 nm) from all-solution processed distributed feedback devices with one order of magnitude lower thresholds than those of previously reported NIR-emitting NGs. This study represents an advance in the field of NGs and, in general, organic semiconductor photonics, towards the development of cheap and stable NIR lasers.

A Content Analysis and Population Exposure Estimate Of Guinness Branded Alcohol Marketing During the 2019 Guinness Six Nations.

AIMS: To quantify Guinness-related branding in the 2019 Guinness Six Nations Championship. METHODS: Content analysis of Guinness-related branding ('Guinness' and the alibi brand 'Greatness') was shown during active play throughout all 15 games of the 2019 Guinness Six Nations Championship. The duration of each appearance was timed to the nearest second to provide information on the amount of time that Guinness-related branding was shown on screen. Census data and viewing figures were used to estimate gross and per capita alcohol impressions. RESULTS: Our coding identified a total of 3719 appearances of two logos of which 3415 (92%) were for 'Guinness' and 304 (8%) were for 'Greatness'. 'Guinness' imagery was present for 13,640 s (227.3 min or 3.8 h, 16% of total active play time), 'Greatness' was present for 944 s (15.7 min, 1% of total active play time), with a combined total of 14,584 s across all games (243 min or 4.05 h, 17% of active play time). The 15 games delivered an estimated 122.4 billion Guinness-related branded impressions to the UK population, including 758 million to children aged under 16. CONCLUSIONS: Alcohol marketing was highly prevalent during the 2019 Guinness Six Nations Championship and was a significant source of exposure to alcohol marketing and advertising for children, likely influencing youth alcohol experimentation and uptake.

Tobacco and alcohol content in soap operas broadcast on UK television: a content analysis and population exposure.

BACKGROUND: Exposure to tobacco and alcohol content in media is a risk factor for smoking and alcohol use in young people. Our previous research suggested that tobacco and alcohol imagery is common in soap operas. We now report an analysis of tobacco and alcohol content in a sample of soap operas broadcast in the UK. METHODS: We used 1-minute interval coding to quantify tobacco and alcohol content in all episodes (including advertisement breaks) of six soap operas broadcast on UK television during three separate weeks in November and December 2018 and January 2019. RESULTS: We coded 2222 intervals from 87 episodes and 360 intervals from 77 advertisement breaks. Tobacco content was rare, occurring in 4% of all intervals across 30% of episodes, the only tobacco appearances in adverts appeared in anti-smoking advertising. Alcohol occurred in 24% of intervals across 95% of episodes and in 13% of advertisement intervals. The programmes delivered ~381.28 million tobacco and 2.1 billion alcohol gross impressions to the UK population, including 18.91 million tobacco and 113 million alcohol gross impressions to children. CONCLUSION: Whilst tobacco was rare, alcohol content was common, resulting in billions of viewer impressions. Soap operas represent a potential driver of alcohol consumption in young people.

Tobacco and tobacco branding in films most popular in the UK from 2009 to 2017.

BACKGROUND: Exposure to tobacco content in films is a cause of smoking uptake in young people. In an earlier study, we reported that tobacco content occurred in 70% of UK box office films popular between 1989 and 2008. We now report an analysis of tobacco content in a sample of the top grossing UK box office films between 2009 and 2017, and of population exposure resulting from audience exposure to the 2017 films. METHODS: Occurrence of tobacco intervals (actual tobacco use, implied use, appearance of smoking paraphernalia or branding) was measured by 5 min interval coding in the 15 most commercially successful films in the UK in each year from 2009 to 2017. A nationally representative survey was used to estimate population exposure to the top 15 films from 2017. RESULTS: We coded 3248 intervals from the 135 films. Tobacco content appeared in 245 intervals (8%, 95% CI 7% to 9%) across 56 (41%, 95% CI 33% to 49%) films. Tobacco content occurred in films in all BBFC age ratings, and 36 (64%, 95% CI 51% to 77%) of films containing tobacco imagery were classified as suitable for viewing by people aged under 15 years. Although less prevalent than in our earlier study, there was no evidence of a secular decline in tobacco content during this study period. The top 15 films from 2017 delivered approximately 21.6 (95% CI 21.06-22.14) million tobacco impressions to young people aged 10-18 years in the UK. CONCLUSIONS: Tobacco content continues to appear in UK Box Office films and is widely seen by young people, representing a major driver of smoking uptake.

Quantifying alcohol audio-visual content in UK broadcasts of the 2018 Formula 1 Championship: a content analysis and population exposure.

OBJECTIVES: Exposure to alcohol imagery is associated with subsequent alcohol use among young people, and UK broadcasting regulations protect young people from advertising alcohol content in UK television. However, alcohol promotion during sporting events, a significant potential medium of advertising to children, is exempt. We report an analysis and estimate the UK population exposure to, alcohol content, including branding, in UK broadcasts of the 2018 Formula 1 (F1) Championship. SETTING: UK. PARTICIPANTS: None. Content analysis of broadcast footage of 21 2018 F1 Championship races on Channel 4, using 1-minute interval coding of any alcohol content, actual or implied use, other related content or branding. Census data and viewing figures were used to estimate gross and per capita alcohol impressions. RESULTS: Alcohol content occurred in all races, in 1613 (56%) 1-minute intervals of race footage and 44 (9%) of intervals across 28% of advertisement breaks. The most prominent content was branding, occurring in 51% of race intervals and 7% of advertisement break intervals, appearing predominantly on billboard advertisements around the track, with the Heineken and Johnnie Walker brands being particularly prominent. The 21 races delivered an estimated 3.9 billion alcohol gross impressions (95% CI 3.6 to 4.3) to the UK population, including 154 million (95% CI 124 to 184) to children, and 3.6 billion alcohol gross impressions of alcohol branding, including 141 million impressions to children. Branding was also shown in race footage from countries where alcohol promotion is prohibited. CONCLUSIONS: Alcohol content was highly prevalent in the 2018 F1 Championship broadcasts, delivering millions of alcohol impressions to young viewers. This exposure is likely to represent a significant driver of alcohol consumption among young people.

A content analysis of tobacco and alcohol audio-visual content in a sample of UK reality TV programmes.

BACKGROUND: Exposure to tobacco and alcohol content in audio-visual media is a risk factor for smoking and alcohol use in young people. We report an analysis of tobacco and alcohol content, and estimates of population exposure to this content, in a sample of reality television programmes broadcast in the UK. METHODS: We used 1-minute interval coding to quantify tobacco and alcohol content in all episodes of five reality TV programmes aired between January and August 2018 (Celebrity Big Brother; Made in Chelsea; The Only Way is Essex; Geordie Shore and Love Island), and estimated population exposure using viewing data and UK population estimates. RESULTS: We coded 5219 intervals from 112 episodes. Tobacco content appeared in 110 (2%) intervals in 20 (18%) episodes, and alcohol in 2212 (42%) intervals and in all episodes. The programmes delivered approximately 214 million tobacco gross impressions to the UK population, including 47.37 million to children; and for alcohol, 4.9 billion and 580 million respectively. CONCLUSION: Tobacco, and especially alcohol, content is common in reality TV. The popularity of these programmes with young people, and consequent exposure to tobacco and alcohol imagery, represents a potentially major driver of smoking and alcohol consumption.

Experience of Identity Change in People Who Reported a Diagnosis of Multiple Sclerosis: A Qualitative Inquiry.

BACKGROUND: A diagnosis of multiple sclerosis (MS) can lead to changes to a person's sense of self. The aim of this study was to investigate the subjective experience of identity change and subsequent adjustment to MS. METHODS: Semistructured interviews were conducted with 16 people who reported having MS. Interviews were analyzed using thematic analysis. RESULTS: In the early stages of disease progression, participants wanted to compartmentalize the disease. Over time, through reflected self-appraisals, brought about by increasing symptoms and changed relationships with others, the disease became a part of participants' self-identity. CONCLUSIONS: For people with MS, incorporating and accepting the disease as part of their self-identity can have positive implications for seeking and receiving support.

Quantifying tobacco and alcohol imagery in Netflix and Amazon Prime instant video original programming accessed from the UK: a content analysis.

OBJECTIVES: Exposure to tobacco and alcohol content in audio-visual media is a risk factor for smoking and alcohol use in young people. Previous UK research has quantified tobacco and alcohol content in films and broadcast television but not that of video-on-demand (VOD) services such as Netflix and Amazon Prime. Furthermore, it is not clear whether regulation by Dutch (Netflix) or UK (Amazon Prime) authorities results in differences in content. We report an analysis of tobacco and alcohol content in a sample of episodes from the most popular programmes from these two VOD providers, and compare findings with earlier studies of UK prime-time television content. SETTING: UK. PARTICIPANTS: None. Content analysis of a sample of 50 episodes from the five highest rated series released on Netflix and Amazon Prime in 2016, using 1 min interval coding of any tobacco or alcohol content, actual or implied use, paraphernalia and branding. RESULTS: Of 2704 intervals coded, any tobacco content appeared in 353 (13%) from 37 (74%) episodes. Any alcohol content appeared in 363 (13%) intervals in 47 (94%) episodes. There were no significant differences between the two services, however the proportion of episodes containing tobacco and alcohol was significantly higher in VOD original programmes than those recorded in an earlier study of prime-time UK television. CONCLUSIONS: Audio-visual tobacco and alcohol content is common in VOD original programmes and represents a further source of exposure to imagery causing smoking uptake and alcohol use in young people. This appears to be equally true of services regulated in the UK and The Netherlands. Given that VOD services are consumed by a global audience, it appears likely that VOD content is an important global driver of tobacco and alcohol consumption.

Content analysis of tobacco content in UK television.

AIMS: Exposure to audiovisual tobacco content in media is a risk factor for smoking in young people. While tobacco content in films has been extensively documented, content in mainstream television has received relatively little attention. We report an analysis of tobacco content in a sample of UK free-to-air prime-time television broadcasts in 2015, and compare this with a similar analysis from 2010. DESIGN: Content analysis of all programmes and advertisements or trailers broadcast on the five national UK free-to-air channels in the UK between 18:00 and 22:00 during three separate weeks in September, October and November 2015. SETTING: Great Britain. PARTICIPANTS: None (media analysis only). MEASUREMENTS: Occurrence of any tobacco, tobacco use, implied use, other tobacco reference/related objects and branding in every 1 min coding interval. FINDINGS: Tobacco content occurred in 33% of all programmes and 8% of all adverts or programme trailer breaks. Actual tobacco use occurred in 12% of all programmes broadcast. Tobacco-related objects, primarily no smoking signs, occurred in 2% of broadcasts; implied tobacco use and tobacco branding were also rare. The majority of tobacco content occurred after the 21:00 watershed. CONCLUSIONS: These findings are virtually unchanged from our earlier analysis of programme content from 2010. Audiovisual tobacco content remains common in UK television programmes.