A randomized controlled trial of an appearance-related smoking intervention.

OBJECTIVES: To investigate whether exposure to a smoking-related facial age-progression technique impacts on quit smoking cognitions, nicotine dependence, and self-reported and objectively assessed smoking in young women in a randomized controlled trial. METHODS: eighteen- to 34-year-old women smokers (n = 70) were allocated at random to either an appearance-related intervention (plus usual care) or control (usual care) group. Women completed questionnaires assessing attitudes, subjective norms, perceived behavioral control and intention to quit smoking immediately before, immediately after, and four weeks after receiving the intervention or usual care. At the first and last time points they also completed measures of nicotine dependence and self-reported and objectively assessed smoking (breath carbon monoxide levels). RESULTS: The two groups were well matched at baseline. Using intention to treat analyses and baseline as a covariate, women in the appearance-related intervention group compared to the control group had significantly more positive attitudes, subjective norms, perceived behavioral control, and intentions to quit smoking immediately after exposure. Only the effects on quit smoking attitudes remained significant at four weeks postintervention. Nicotine dependence and self-reported smoking (total cigarettes in last seven days), but not objective smoking, were significantly lower in the intervention compared with control group at four weeks. CONCLUSIONS: This study suggests that an appearance-related smoking intervention may be a useful adjunct to traditional cessation programs with young women smokers.

Women smokers' experiences of an age-appearance anti-smoking intervention: a qualitative study.

OBJECTIVES: This study was designed to investigate women's experiences of engaging in an age-appearance anti-smoking intervention. METHODS: Ten 18- to 34-year-old women gave accounts of their experiences after engaging in an age-appearance facial morphing anti-smoking intervention in interviews (n= 7) and a focus group (n= 3), and 37 women gave their accounts while they were engaged in the intervention. Transcripts were analysed using a thematic analysis broadly informed by the procedures of Grounded Theory. RESULTS: Women were very concerned about the impact of ageing on their faces in general, and in particular the additional impact of smoking on their skin. Women were concerned about other people's reactions to them as older smokers with wrinkled skin, and many experienced a physical shock reaction (including reports of nausea) to seeing how they would age if they continued to smoke. They reported that seeing their own face aged on the computer screen increased their perceived risk of skin wrinkling. Women reported being highly motivated to quit smoking as a result of the intervention, and many reported that they would take active steps to quit having seen how they would look if they continued to smoke. This was linked with increased perceived personal responsibility for quitting. CONCLUSIONS: Results are discussed in relation to suggestions for anti-smoking interventions aimed at women in the 18- to 34-year-old age group. It is concluded that interventions incorporating age-appearance morphing techniques are likely to be effective in helping women to take active steps to quit smoking.

Randomised controlled trial of additional lifestyle support for the reduction of cardiovascular disease risk through primary care in Stoke-on-Trent, UK.

The purpose of this trial is to evaluate the effectiveness of providing additional support in modifying lifestyles and in reducing population cardiovascular disease risk compared with usual primary prevention care. A prospective, individually randomised controlled trial design is used, within which groups of patients are clustered by general practice. Multi-level modelling is proposed to account for clustering effects by practice and a two-stage least squares regression approach to account for expected contamination at the analysis stage. The research is set in Stoke-on-Trent, a mid-sized urban city in central England with a generally poor health profile. Patients included will be those aged between 35 and 74 years who have been identified as being at increased risk of developing cardiovascular disease. Approximately 920 patients will be recruited in each arm of the trial (20 control, 20 treatment in each of 46 practices). Usual primary prevention care (control) will be compared with usual primary prevention care plus bespoke lifestyle support (treatment). The primary outcome measure is the Framingham 10-year cardiovascular disease risk at one year. Intermediate outcomes: weight, physical activity and health-related quality of life, will be determined at six months to monitor progress with treatment. Change in individual risk factors: blood pressure, lipid profile, weight, body mass index, waist circumference, smoking, diabetes and cardiovascular disease status and medications will also be measured at one year to help understand the specific mechanisms by which the primary endpoint was achieved.

Use of community pharmacies: a population-based survey.

BACKGROUND: Community pharmacies are widely used in the UK, but the services they provide are changing, with pharmacists expected to take on wider roles and responsibilities. The impact of such changes will partly depend on who uses pharmacies and their illnesses. METHODS: This was a cross-sectional survey of a stratified random sample of 10,000 adults aged 35 years plus. RESULTS: In the previous month, 59 per cent of respondents had collected a prescription medicine and 40 per cent had purchased an over-the-counter (OTC) medicine from a pharmacy, whereas only 12 per cent had asked for advice. Women were more likely to have obtained medicine or asked for advice (76 per cent), but nearly two-thirds of men had done so (63 per cent). Poor self-rated health was the key factor in obtaining medicine, both on prescription and OTC. Purchasers of OTC medicine were more likely to be younger and from higher socio-economic classes, whereas those who collected prescription medicine were more likely to be older, feel at risk of vascular health problems and non-smokers. Medicines to treat cold and flu symptoms were the most frequently reported purchase type. Only a small number of respondents who asked for advice had not also obtained medicine. Respondents who asked for advice were more likely to have asked about a specific medicine or illness than to have asked for general health advice. CONCLUSION: Whilst those with poorer health are more likely to visit, a wide range of ages and social classes visit pharmacies each month. This provides an opportunity for public health initiatives to be delivered in pharmacies.