Everyone has their own unique version of the visual world and there has been growing interest in understanding the way that personality shapes one's perception. Here, we investigated meaningful ...visual experiences in relation to the personality dimension of schizotypy. In a novel approach to this issue, a non-clinical sample of subjects (total n = 197) were presented with calibrated images of scenes, cartoons and faces of varying visibility embedded in noise; the spatial properties of the images were constructed to mimic the natural statistics of the environment. In two experiments, subjects were required to indicate what they saw in a large number of unique images, both with and without actual meaningful structure. The first experiment employed an open-ended response paradigm and used a variety of different images in noise; the second experiment only presented a series of faces embedded in noise, and required a forced-choice response from the subjects. The results in all conditions indicated that a high positive schizotypy score was associated with an increased tendency to perceive complex meaning in images comprised purely of random visual noise. Individuals high in positive schizotypy seemed to be employing a looser criterion (response bias) to determine what constituted a 'meaningful' image, while also being significantly less sensitive at the task than those low in positive schizotypy. Our results suggest that differences in perceptual performance for individuals high in positive schizotypy are not related to increased suggestibility or susceptibility to instruction, as had previously been suggested. Instead, the observed reductions in sensitivity along with increased response bias toward seeing something that is not there, indirectly implicated subtle neurophysiological differences associated with the personality dimension of schizotypy, that are theoretically pertinent to the continuum of schizophrenia and hallucination-proneness.
ABSTRACT
Aims To document accurately the amount of quitting, length of quit attempts and prevalence of plans and serious thought about quitting among smokers.
Design We used longitudinal data from ...7 waves of the International Tobacco Control Policy Evaluation Four Country Survey (ITC‐4). We considered point‐prevalence data and cumulative prevalence over the 7 years of the study. We also derived annual estimates of quit activity from reports of quit attempts starting only within more recent time‐frames, to control for biased recall.
Setting Australia, Canada, the United Kingdom and the United States.
Participants A total of 21 613 smokers recruited across seven waves.
Measurements Reported life‐time quit attempts, annual quit attempts, length of attempts, time since last attempt started, frequency of aborted attempts, plans to quit and serious thought about quitting.
Findings Around 40.1% (95% CI: 39.6–40.6) of smokers report attempts to quit in a given year and report an average of 2.1 attempts. Based on free recall, this translates to an average annual quit attempt rate of 0.82 attempts per smoker. Estimates derived only from the preceding month to adjust for recall bias indicate an annual rate of approximately one attempt per smoker. There is a high prevalence of quit‐related activity, with more than a third of smokers reporting thoughts or actions related to quitting in a given month. More than half the surveyed smokers eventually succeeded in quitting for at least 1 month, and a majority of these for over 6 months.
Conclusions Smokers think a great deal about stopping and make many unsuccessful quit attempts. Many have been able to last for extended periods and yet they still relapsed. More attention needs to be focused on translating quit‐related activity into long‐term abstinence.
ObjectiveTaxation equitably reduces smoking, the leading cause of health inequalities. The tobacco industry (TI) can, however, undermine the public health gains realised from tobacco taxation through ...its pricing strategies. This study aims to examine contemporary TI pricing strategies in the UK and implications for tobacco tax policy.DesignReview of commercial literature and longitudinal analysis of tobacco sales and price data.SettingA high-income country with comprehensive tobacco control policies and high tobacco taxes (UK).Participants2009 to 2015 Nielsen Scantrak electronic point of sale systems data.Main outcome measuresTobacco segmentation; monthly prices, sales volumes of and net revenue from roll-your-own (RYO) and factory-made (FM) cigarettes by segment; use of price-marking and pack sizes.ResultsThe literature review and sales data concurred that both RYO and FM cigarettes were segmented by price. Despite regular tax increases, average real prices for the cheapest FM and RYO segments remained steady from 2013 while volumes grew. Low prices were maintained through reductions in the size of packs and price-marking. Each year, at the point the budget is implemented, the TI drops its revenue by up to 18 pence per pack, absorbing the tax increases (undershifting). Undershifting is most marked for the cheapest segments.ConclusionsThe TI currently uses a variety of strategies to keep tobacco cheap. The implementation of standardised packaging will prevent small pack sizes and price-marking but further changes in tax policy are needed to minimise the TI’s attempts to prevent sudden price increases.
Most smokers attempting to quit relapse. There is little evidence whether the use of e-cigarettes ('vaping') increases or decreases relapse. This study aimed to assess 1) whether vaping predicted ...relapse among ex-smokers, and 2) among ex-smokers who vaped, whether vaping characteristics predicted relapse.
Longitudinal web-based survey of smokers, recent ex-smokers and vapers in the UK, baseline in May/June 2016 (n = 3334), follow-up in September 2017 (n = 1720). Those abstinent from smoking ≥ 2 months at baseline and followed up were included. Aim 1: Relapse during follow-up was regressed onto baseline vaping status, age, gender, income, nicotine replacement therapy use and time quit smoking (n = 374). Aim 2: Relapse was regressed onto baseline vaping frequency, device type, nicotine strength and time quit smoking (n = 159).
Overall, 39.6% relapsed. Compared with never use (35.9%), past/ever (45.9%;
OR = 1.13; 95% CI, 0.61-2.07) and daily vaping (34.5%;
OR = 0.61; 95% CI, 0.61-1.89) had similar odds of relapse, for non-daily vaping evidence of increased relapse was inconclusive (65.0%;
OR = 2.45; 95% CI, 0.85-7.08). Among vapers, non-daily vaping was associated with higher relapse than daily vaping (
OR = 3.88; 95% CI, 1.10-13.62). Compared with modular devices (18.9% relapse), tank models (45.6%;
OR = 3.63; 95% CI, 1.33-9.95) were associated with increased relapse; evidence was unclear for disposable/cartridge refillable devices (41.9%;
OR = 2.83; 95% CI, 0.90-8.95). Nicotine strength had no clear association with relapse.
Relapse to smoking is likely to be more common among ex-smokers vaping infrequently or using less advanced devices. Research into the effects of vaping on relapse needs to consider vaping characteristics.
Background and aims
Evidence on the effectiveness of electronic cigarettes (ECs) to facilitate abstinence from smoking is limited. The current study aimed to estimate the relative effectiveness of ...ECs and smoking cessation medication compared with using no help, accounting for frequency of use of ECs.
Design
Four consecutive wave‐to‐wave transitions (waves 1–2, 2–3, 3–4 or 4–5) of a longitudinal online survey collected between 2012 and 2017 were analysed. Time between waves ranged between 12 and 17 months. Cigarette smokers at the baseline wave who attempted to quit smoking between waves were included.
Setting
United Kingdom
Participants
A total of 1155 respondents (aged 18–81, 56.1% male, 64.6% in social grade C2DE, 93.8% white) provided 1580 pairs of observations for the primary analysis.
Measurements
Primary outcome: abstinence from smoking for at least 1 month at follow‐up; secondary outcome: at least 1 month's abstinence from smoking between baseline and follow‐up. The main predictor was stop smoking aid used (No help, nicotine replacement therapy only, smoking cessation medication only, disposable/cartridge EC, refill/modular EC, combination), adjusted for demographics.
Findings
Primary Compared with using no help, the odds of abstinence were increased by daily use of disposable/cartridge ECs (OR = 3.31 (1.32, 8.26), P = .010) and daily use of refill/modular ECs (OR = 5.47 (2.70, 11.11), P < .001). Odds were reduced by non‐daily use of disposable/cartridge ECs (OR = 0.23 (0.08–0.63), P = .005), and by use of disposable/cartridge ECs to quit and no longer using at follow‐up (OR = 0.10 (0.16–0.62), P < .013). Secondary Results were similar to the primary outcome; however, odds of abstinence were also increased by use of smoking cessation medication (OR = 4.15 (1.79, 9.62), P = .001).
Conclusions
When used daily, electronic cigarettes appear to facilitate abstinence from smoking when compared with using no help.
Abstract
Introduction
Raising tobacco prices is the most effective population-level intervention for reducing smoking, but this is undermined by the availability of cheap tobacco. This study monitors ...trends in cheap tobacco use among adult smokers in the United Kingdom between 2002 and 2014 via changes in product type, purchase source, and prices paid.
Methods
Weighted data from 10 waves of the International Tobacco Control policy evaluation study were used. This is a longitudinal cohort study of adult smokers with replenishment; 6169 participants provided 15812 responses. Analyses contrasted (1) product type: roll-your-own (RYO) tobacco, factory-made packs (FM-P), and factory-made cartons (FM-C); (2) purchase source: UK store-based sources (e.g., supermarkets and convenience stores) with non-UK/nonstore sources representing tax avoidance/evasion (e.g., outside the UK, duty free, and informal sellers); and (3) prices paid (inflation-adjusted to 2014 values). Generalized estimating equations tested linear changes over time.
Results
(1) RYO use increased significantly over time as FM decreased. (2) UK store-based sources constituted approximately 80% of purchases over time, with no significant increases in tax avoidance/evasion. (3) Median RYO prices were less than half that of FM, with FM-C cheaper than FM-P. Non-UK/nonstore sources were cheapest. Price increases of all three product types from UK store-based sources from 2002 to 2014 were statistically significant but not substantial. Wide (and increasing for FM-P) price ranges meant each product type could be purchased in 2014 at prices below their 2002 medians from UK store-based sources.
Conclusions
Options exist driving UK smokers to minimize their tobacco expenditure; smokers do so largely by purchasing cheap tobacco products from UK stores.
Implications
The effectiveness of price increases as a deterrent to smoking is being undermined by the availability of cheap tobacco such as roll-your-own tobacco and cartons of packs of factory-made cigarettes. Wide price ranges allowed smokers in 2014 to easily obtain cigarettes at prices comparable to 12 years prior, without resorting to tax avoidance or evasion. UK store-based sources accounted for 80% or more of all tobacco purchases between 2002 and 2014, suggesting little change in tax avoidance or evasion over time. There was a widening price range between the cheapest and most expensive factory-made cigarettes.
•Smokers likely adjust the way they use Roll Your Own tobacco to keep it affordable.•Lower mean weight of RYO cigarettes was found in high tobacco price countries.•2% yearly reduction in mean weight ...of RYO cigarettes in Australia and the UK.•RYO use was lower in countries that equivalize RYO and factory-made cigarette taxes.•RYO cigarettes significantly undertaxed relative to factory made in Australia/UK.
Roll-Your-Own tobacco (RYO) use is increasingly popular in many countries: it is generally cheaper than factory-made cigarettes (FM), and smokers can further reduce costs by adjusting the amount of tobacco in each cigarette. However, the level of risk of RYO compared with FM cigarettes is similar and does not meaningfully change with cigarette weight. We assessed the weight of tobacco in RYO cigarettes across jurisdictions with differing tobacco taxes/prices and over time.
Six waves of the International Tobacco Control 4 Country longitudinal study of smokers and recent ex-smokers, providing 3176 observations from exclusive RYO users covering 2006–15, are used to calculate the weight of tobacco used in RYO cigarettes in the US, Canada, Australia, and the UK. Multilevel regression analyses were used to compare weights across countries, socio-demographic factors, and over time.
Smokers in the UK and Australia, where tobacco is relatively expensive, show higher levels of exclusive RYO use (25.8% and 13.8% respectively) and lower mean weights of tobacco per RYO cigarette (0.51 g(sd 0.32 g) and 0.53 g(0.28 g)), compared with both Canada and especially the US (6.0% and 3.5%, and 0.76 g(0.45 g) and 1.07 g(0.51 g)). Smokers in the UK and Australia also exhibited a statistically significant year-on-year decrease in the mean weight of each RYO cigarette.
Taxation of RYO should increase considerably in the UK and Australia so that RYO and FM cigarettes are taxed equivalently to reduce RYO attractiveness and inequalities. Other measures to reduce the price differentials, including taxing RYO solely on weight, are also discussed.
IntroductionE-cigarette regulations are the topic of extensive debate. Approaches vary worldwide, and limited evidence is available on public support for specific policies or what influences support. ...The present study aimed to assess smokers' and ex-smokers' support for 3 e-cigarette policies: (1) equal or higher availability relative to cigarettes, (2) advertising, (3) use in smoke-free places, and to assess changes in support over time and associations with respondent characteristics.MethodsSmokers and ex-smokers (n=1848) provided 3279 observations over 2 waves (2013 and 2014) of a longitudinal web-based survey in Great Britain. Multivariable logistic regressions fitted using generalised estimating equations assessed change in policy support over time, and associations between support and demographics (age, gender and income), smoking and e-cigarette use status, nicotine knowledge and perceived relative harm.ResultsEqual or higher relative availability was supported by 79% in 2013 and 76% in 2014; advertising by 66% and 56%, respectively; neither change was significant in adjusted analyses. Support for use in smoke-free places decreased significantly from 55% to 45%. Compared with ex-smokers, smokers were more likely to support advertising and use in smoke-free places. Respondents using e-cigarettes, those who perceived e-cigarettes as less harmful than cigarettes, and those with more accurate knowledge about nicotine were more likely to support all 3 policies.ConclusionsLess restrictive e-cigarette policies were more likely to be supported by e-cigarette users, and respondents who perceived e-cigarettes to be less harmful than cigarettes, or knew that nicotine was not a main cause of harm to health.
Randomized, controlled trials typically indicate stop-smoking medications (SSMs: e.g., Varenicline, Bupropion, and over-the-counter nicotine replacement therapies) to be effective, whereas ...cross-sectional community-based studies have found them to be less effective, ineffective, or even associated with higher risk of relapse. Consequently, some critics have suggested SSMs have no useful applications in "real-world" settings. This discrepancy may, however, be due to systematic biases affecting cross-sectional survey outcomes. Namely, failed quit attempts where SSMs were used may be better recalled than failed unassisted attempts. Moreover, smokers who choose to quit using SSMs may be more addicted and thus less likely to succeed. Either of these factors would lead to an over-representation of failed quit attempts among SSM users in cross-sectional surveys even if there were real benefits.
We report on data from the International Tobacco Control 4-country cohort study to examine the relationship between SSM use, level of nicotine addiction, and the reported date since the start of participants' (N = 1,101) most recent quit attempt.
The last quit attempt was reported to have begun longer ago among participants who used SSMs than those who did not. Scores on the Heaviness of Smoking Index, measuring addiction severity, were also higher among SSM users, with no interactions.
Better recall of quit attempts and stronger addiction to nicotine are two characteristics found more often among smokers using SSMs compared with self-quitters, which could potentially bias the assessed effects of SSMs on cessation outcomes in cross-sectional surveys.
BackgroundTobacco companies claim that higher taxes will force smokers into buying illicit tobacco, but if they were truly concerned about increasing illicit sales with higher prices they would only ...increase retail prices in line with changes in taxation. In this paper, we explore UK pricing of both factory-made cigarettes (FM) and roll-your-own tobacco (RYO) to explore the extent to which price increases were due to government tax rises or industry strategies to increase profit per pack.MethodNielsen commercial data on UK tobacco sales data (2010–2015) were combined with official UK data on inflation and tax rates, to identify the source of real price increases.ResultsBetween 2010 and 2012, when there were unexpected large tax increases, industry driven price changes were small (16% of the price rise in FM and 20% in RYO), and changes were similar between market segments. Between 2013 and 2015, when tax increases were smaller and expected, industry behaviour generally accounted for a larger share of price rises (33% FM, 48% RYO), but changes varied considerably by segment.ConclusionThe industry has increased its prices beyond that required by tax changes, even when tax rises were larger and unexpected, although were notably smaller in such conditions. This suggests (1) that the industry is not actually concerned by the threat of illicit, especially since RYO had the highest levels of industry driven price increases despite higher levels of illicit, and (2) there remains scope for further tax increases, which should be relatively large and unexpected.
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