Public health interventions and legislation

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  • Public health interventions and legislation for addictions
    • Doctors advice
      • doctors are seen as authoritative and credible sources of information
        • about 70% of smokers in the UK consult their GP each year
      • a study carried out accross 5 London GP's compared results where patients were given varying degrees of assistance
        • given a FOLLOW-UP only: 0.3% had given up smoking at 12 months
        • those who filled in a QUESTIONNAIRE on their smoking habits and was given a FOLLOW-UP also: 1.6% gave up smoking at 12 months
        • ADVISED by the doctor to give up smoking, given QUESTIONNAIRE and FOLLOW-UP: 3.3% had given up smoking at 12 months
        • ADVISED by the doctor to give up smoking, given a LEAFLET with tips for giving up smoking and given a FOLLOW-UP: 5.1%  had given up smoking at 12 months
          • this appears small but if all GP's advised their patients to stop smoking and offered them tips on how to do so, there would be half a million ex-smokers within a year (Ogden)
      • doctors can also offer early treatment for alcohol addiction: they are likely to know the patient and their family well so they can give advice and info at an early stage when there are safer drinking levels
        • Room et al- this is effective for those with mild alcohol problems but not those who have developed complete alcohol independence
    • workplace intervention
      • over the years more and more workplaces have adopted strategies to discourage smoking; these attempts have been enforced by government legislation
    • legislation
      • there are various forms of government legislation to discourage excessive alcohol or smoking intake
        • restrictions or a ban on advertising
        • increasing the cost
        • controls on sales
        • reducing the harmful components in cigarettes or drinks
        • ban on public smoking or drinking
        • complete smoking and drinking ban
    • Restricting advertising
      • advertising aims to present smoking/ drinking as sophisticated or ****
        • SLT states that this leads to us associating such characteristics with smoking/drinking so removing such advertising would remove this type of learning
          • a ban was made in 2003 to advertise smoking, however alcohol advertising is still legal
      • in the UK annual alcohol advertising expenditure rose from £million to £million between 1989-2000
        • during this time there appears to be a strong correlation between alcohol consumption children aged 11-15 and alcohol expenditure (academy of medical science)
          • similar was found by SNYDER- strong correlation of number of adverts for alcohol watched by young people aged between 15-26 and the amount of alcohol they consumed
          • however there are often other confounding variables
      • studies comparing cigarette consumption before and after total bans on advertising suggest that there is a significant reduction that cannot be attributed to other measures
        • Smart- restrictions on alcohol advertising appear to have less of an effect on consumption
          • this may be because drinking alcohol is still seen as socially aceptable
      • there has been a ban on advertising appealing to those under the age of 18 or displaying role models that wold appeal specifically to youth culture- although these types of adverts are available on online sites like utube
    • Increasing the cost
      • there does appear to be a relationship between the cost of cigarettes and alcohol and consumption- it can encourage people to stop and deter children from starting in the first place
        • e.g. in cognition this would be a powerful factor when weighing up the perceived costs and benefits of the behaviour
        • however increasing the cost through taxes is not as straight forward as it seems
    • Controls on sales
      • there are already restrictions in place in terms of age when purchasing alcohol/cigarettes/lottery cards
        • but some people feel alcohol is too widely available, it is so lenient that alcohol can be purchased round the clock 7 days a week
    • Reducing harmful componants
      • it was proposed that a gradual reduction in nicotine content in cigarettes would gradually wean smokers off the addictive substance and find it easier to give up smoking
        • however to compensate smokers may smoke more cigarettes more viciousley
        • Benowitz et al offered some support for this approach: 25% of the smokers in the experiment gave up smoking spontaneously by the end of the trial and found no increase in smoking overall
        • Tengs et al- performed a computer simulation of the effects of compulsory nicotine reduction policy: it predicted that a progressive decrease in nicotine content over 6 years would result in a decline of smoking prevalence from 23% to only 5% in the US population
          • they concluded that in spite of any mortality rates due to compensatory smoking , the proposal of reducing nicotine content would overall prevent the addiction of new smokers and improve the nations health
    • Ban on public smoking
      • smoking has gradually become less acceptable in the UK and as of 2007 it is now illegal to smoke in enclosed places in the UK
        • this should reduce the likelihood of current cues becoming associated with smoking (e.g. pubs, alcohol)
          • however people may just compensate by drinking and smoking more at home and the risk of a sense of community from those who huddle outside and smoke and make it appear attractive and sociable
    • Total ban on smoking and alcohol
      • it is already illegal to take some drugs however this still does not stop people becoming addicted
        • some have lobbied for the legislation of these drugs as a way to make them more manageable


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