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Biomedical subjects

M Wakefield

Publications and source records attributed to M Wakefield.

At least 19 recordsLinked to original sources
PubMed2006

Anti-tobacco television advertising and indicators of smoking cessation in adults: a cohort study.

The objective of this study was to assess the relationship between exposure to state-sponsored anti-tobacco advertising and smoking cessation. Cessation rates in 2001 among a cohort of 2061 smokers who participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed a follow-up survey in 2001 were merged with 2000-01 television advertising exposure data from Nielsen Media Research. The relative risk for quitting was estimated to be 10% higher for every 5000 units of exposure to state anti-tobacco television advertising over the 2-year period, although this did not quite achieve statistical significance. The association was even larger among those who reported that the level of information in the media about the dangers of smoking had increased 'a lot' between 1993 and 2001 (RR = 1.19, 95% CI = 1.03-1.38). These data are consistent with the finding that increased exposure to state anti-tobacco media increases smoking cessation rates.

Adult↗
PubMed2005

Anti-tobacco television advertising and indicators of smoking cessation in adults: a cohort study.

The objective of this study was to assess the relationship between exposure to state-sponsored anti-tobacco advertising and smoking cessation. Cessation rates in 2001 among a cohort of 2061 smokers who participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed a follow-up survey in 2001 were merged with the 2000-01 television advertising exposure data from Nielsen Media Research. The relative risk for quitting was estimated to be 10% higher for every 5000 units of exposure to state anti-tobacco television advertising over the 2-year period, although this did not quite achieve statistical significance. The association was even larger among those who reported that the level of information in the media about the dangers of smoking had increased 'a lot' between 1993 and 2001 (RR = 1.19, 95% CI = 1.03-1.38). These data are consistent with the finding that increased exposure to state anti-tobacco media increases smoking cessation rates.

Adult↗
PubMed2003

Teen penalties for tobacco possession, use, and purchase: evidence and issues.

A handful of empirical studies have related changes in youth smoking to popular laws that penalise tobacco possession, use, and purchase (PUP). In this paper, we review the literature and outline reasons why PUP laws may be unlikely to reduce youth smoking significantly at the population level. In theoretical terms, we argue that PUP laws lack important features required for punishment to be effective in changing behaviour. In practical terms, PUP transgressions seem difficult to detect. Conceptually, there is potential for PUP laws to undermine conventional avenues of discipline, such as the parent-child relationship and the school environment. Strategically, PUP laws may divert policy attention from effective tobacco control strategies, relieve the tobacco industry of responsibility for its marketing practices, and reinforce the tobacco industry's espoused position that smoking is for adults only. To assist further debate and discussion, we identify research issues requiring attention.

Adolescent↗
PubMed2003

Recall and response of smokers and recent quitters to the Australian National Tobacco Campaign.

OBJECTIVE: To track national population indices of recall and response among smokers and recent quitters to an ongoing national televised anti-smoking campaign in Australia. METHOD: National cross sectional population telephone surveys of adults. MAIN OUTCOME MEASURES: Unprompted recall of advertising; recognition of advertising; campaign attributed encouragement to quit or stay quit; unprompted awareness of smoking related health effects; new learning about smoking and health; and agreement with campaign related attitudes. RESULTS: Campaign advertising continued to be highly memorable over the period of study, with 88% having confirmed recognition in 2000. Campaign advertising was consistently thought by half of smokers who had seen it to make them more likely to quit (49% in 2000). Specific changes between surveys in unprompted awareness of smoking related health effects, new learning about smoking and health, and agreement with campaign related attitudes were observed in relation to the main messages of the advertisements, which were time sensitive according to the year of launch of the advert. The "artery" advertisement was associated with the largest and most consistent positive change in all of these parameters. The proportion of respondents who disagreed that the dangers of smoking had been exaggerated increased significantly from 59% in May 1997 to 68% in November 2000. CONCLUSION: A national campaign using graphic advertising to emphasise the health risks of smoking can make significant population wide contributions to improving new learning about smoking damage and positively influence attitudes about smoking risks.

Adolescent↗
PubMed2003

Do adult focused anti-smoking campaigns have an impact on adolescents? The case of the Australian National Tobacco Campaign.

OBJECTIVES: To examine adolescents' awareness of and response to an adult focused anti-smoking advertising campaign. DESIGN AND SETTING: Data were obtained from two cross sectional surveys of adolescents. The first study, a national evaluation study, involved a telephone survey of a randomly selected sample of 400 14-17 year olds across Australia in 1998. The second study involved a survey of 3714 students aged 12-17 years, randomly selected from a probability sample of secondary schools in the Australian State of Victoria. MAIN OUTCOME MEASURES: In both surveys, adolescents answered questions on their awareness of the advertising campaign and actions taken in response to the campaign. Adolescents in the national evaluation study also answered questions assessing knowledge of health effects of smoking, impact of the campaign on adolescents, and relevance of the campaign for adolescents and other groups. Responses for smokers and nonsmokers were examined. RESULTS: Among the national evaluation sample, 85% of adolescent smokers thought the campaign was relevant to them. Fifty three per cent indicated that the campaign had led some teenagers to at least try to quit and 85% thought it made smoking seem less cool and desirable. Among students who were established smokers the campaign generated quitting activity, with 27% cutting down the number of cigarettes they smoked and 26% having thought about quitting. CONCLUSION: Results indicate that adolescents were very aware of this adult focused anti-smoking campaign and thought it relevant to them. The findings suggest that a graphic health effects cessation focused campaign may have been successful in promoting anti-smoking attitudes among adolescents.

Adolescent↗
PubMed2003

Uptake and effectiveness of the Australian telephone Quitline service in the context of a mass media campaign.

OBJECTIVES: Since June 1997, Australia has run its first nationally coordinated mass media anti-smoking campaign, with all States collaborating to offer a standard Quitline service. An overview of the Australian national Quitline service is presented as well as two studies describing (a) the relationship between television advertising and call volume and type, and (b) the quit rates of callers over time. DESIGN: Data on extent of advertising, as measured by weekly television target audience rating points (TARPs), is compared with weekly call volume and disposition. A randomly selected sample of callers was followed up at 3 weeks, 6 months and 12 months to assess caller appraisal and quit rates. SETTING: The Australian Quitline service, in the context of a nationally coordinated, major anti tobacco campaign. RESULTS: In a one year period from June 1997, 3.6% of adult Australian smokers called the Quitline. Weekly call volume was strongly related to TARPs and increased further when an advertisement specifically promoting the Quitline was broadcast. Calls involving requests for counselling, as opposed to brief calls to request quit materials, were more likely with lower TARPs. Of the cohort who were smoking at baseline, 28% reported they had quit smoking at a one year follow up and 5% had been quit for an entire year. CONCLUSIONS: In the context of a national mass media campaign, this study illustrates that it is possible to bring together differing State based services to provide an accessible, acceptable, and effective quit smoking service.

Adolescent↗
PubMed2003

Impact of tobacco tax reforms on tobacco prices and tobacco use in Australia.

OBJECTIVE: To document the impact of changes to tobacco taxes on the range and price of tobacco sold during the period when the National Tobacco Campaign (NTC) was run. DATA SOURCES: Information about brand availability, pack size, and price was extracted from Australian Retail Tobacconist. A retail observational survey was undertaken to monitor actual retail prices. Data on cigarette prices, brands, packet configurations, and outlets from which they were purchased were obtained from the benchmark and three follow up population telephone surveys conducted to evaluate the NTC. METHOD: Data from the three sources were compared to see the extent to which the impact of tax changes had been offset by greater retail discounting and a more concerted effort by consumers to purchase cheaper products. RESULTS: Smokers were unable to cushion themselves from the sharp price increases that occurred during the third phase of the NTC. Both average recommended retail prices of manufactured cigarettes and average actual cigarette prices paid by smokers increased by 25% in real prices. CONCLUSION: The fall in smoking prevalence over the first two phases of the NTC was substantially greater than would be expected due to tax changes alone. The fall in smoking consumption over the first two phases was slightly less than would be expected and in the third considerably higher than would be expected.

Adolescent↗
PubMed2003

Tobacco in the news: an analysis of newspaper coverage of tobacco issues in Australia, 2001.

OBJECTIVE: To assess the extent and nature of newspaper coverage of tobacco related issues in Australia in 2001. DESIGN: Content analysis of newspaper articles. SUBJECTS: All articles (n=1188) at least seven lines long and containing at least one paragraph focused on tobacco in all major Australian national and State capital city newspapers (n=12) in 2001. MAIN OUTCOME MEASURES: Number of articles, month of publication, State in which newspaper published, prominence of article, type of article, article theme, and slant of article relative to tobacco control objectives. RESULTS: The number of tobacco articles varied considerably in different months over the course of the year, from a low of 51 in December to a peak of 180 in May. The most frequent theme was secondhand smoke issues (30% of articles), with the second most dominant theme related to education, prevention, and cessation programmes and services (20%). Events that were covered were predominantly positive for tobacco control: 62% of articles were related to events that were positive, compared with 21% that were negative for tobacco control objectives. Excluding news articles, the opinions expressed by the authors of articles were also mainly positive (61%) rather than negative (22%) for tobacco control objectives. The amount of coverage of and population exposure to tobacco focused articles showed considerable variation across different Australian States, with Victoria having the highest frequency and rate of articles and the most media impressions per capita throughout 2001. CONCLUSIONS: : Coverage of events and opinions related to tobacco in Australian newspapers in 2001 was generally positive for tobacco control objectives. Given that over 2 million individuals (out of a population of 19 million) were potentially exposed to tobacco related newspaper articles per day in Australia, this represents good news for tobacco control advocates. The variation in news coverage in different States and at different times in the year, however, illustrates how a combination of local events and advocacy efforts may at times combine to make tobacco more newsworthy. Understanding which tobacco issues are most likely to be covered and the nature of the coverage about them provides valuable feedback for tobacco control advocates and is a useful gauge of actual events as well as the tobacco related agendas promoted by the press.

Attitude to Health↗
PubMed2003

Appraisal of anti-smoking advertising by youth at risk for regular smoking: a comparative study in the United States, Australia, and Britain.

OBJECTIVE: To compare the similarity in how youth in the United States, Australia, and Britain appraise anti-smoking advertisements with different characteristics. DESIGN: Each participant viewed and evaluated a set of 10 anti-smoking adverts (from an overall total of 50 adverts) in a controlled experimental context using an audience response methodology. A structured telephone interview was completed one week after viewing the adverts, in which recall and engagement with the adverts by participants was evaluated. SUBJECTS: 615 youths who were experimenting with smoking or were susceptible nonsmokers. MAIN OUTCOME MEASURES: Measures of advert appraisal and engagement. RESULTS: Youth in the United States, Australia, and Britain responded in very similar ways to the same anti-smoking advertisements. In full multivariate models, the target audience of the advert and the advert theme were not related to the main outcome measures employed in this study. However, adverts with visceral negative or personal testimonial executional characteristics were appraised more positively by youths and were more likely to be recalled, thought about, and discussed at follow up one week later. CONCLUSIONS: Youths in three different countries responded to anti-smoking advertisements in very similar ways, suggesting that such adverts might be more actively shared among nations. The appraisal of, and engagement with, the anti-smoking adverts, however, varied substantially depending on executional characteristics. In the design of effective anti-smoking adverts, due attention needs to be paid to those characteristics that appear to most engage youth across different social and cultural environments.

Adolescent↗
PubMed2002

My pack is cuter than your pack.

Faced with bans on advertising, the tobacco companies are looking to new, more subtle ways of maintaining their brands' profile in the public eye.

Advertising↗
PubMed2002

Socially cued smoking in bars, nightclubs, and gaming venues: a case for introducing smoke-free policies.

OBJECTIVE: To assess smokers' perceived effects of smoking bans in bars, nightclubs, and gaming venues on their smoking behaviour. DESIGN: Cross sectional structured interview telephone survey of a random sample of smokers. SETTING: Population survey in Victoria, Australia. PARTICIPANTS: The sample comprised 597 smokers and analyses were conducted on 409 smokers who reported patronising bars, nightclubs or gaming venues at least monthly. OUTCOME MEASURES: Two outcomes studied were socially cued smoking and readiness to quit as a result of restrictions on smoking in social venues. Respondents were identified as socially cued smokers if they reported attending bars, nightclubs or gaming venues at least monthly and said that they smoke more in these venues. The potential influence of bans in social venues on readiness to quit was measured by asking respondents if they would be more or less likely to quit smoking if smoking were banned in hotels, licensed bars, gaming venues, and nightclubs. RESULTS: Of all adult smokers, 69% attended bars, nightclubs or gaming venues at least monthly. Of these smokers, 70% reported smoking more in these settings (socially cued smokers) and 25% indicated they would be likely to quit if smoking were banned in social venues. Compared to smokers not likely to quit if there were bans, smokers likely to quit were more likely to be socially cued (odds ratio (OR) 2.64), to be contemplating or preparing to quit (OR 2.22), to approve of bans in social venues (OR 2.44), and to be aged under 30 years (OR 1.73). Compared with smokers not socially cued, socially cued smokers were more likely to be under the age of 30 years (OR 6.15), more likely to believe that there is a safe level of cigarette consumption (OR 2.25), and more likely to have previously made a quit attempt (OR 2.60). CONCLUSIONS: These findings suggest that bans on smoking in bars, nightclubs, and gaming venues could reduce cigarette consumption and increase quitting among smokers who frequently patronise these settings. These beneficial effects are likely to be strongest among younger smokers.

Adult↗
PubMed2002

The cigarette pack as image: new evidence from tobacco industry documents.

OBJECTIVES: To gain an understanding of the role of pack design in tobacco marketing. METHODS: A search of tobacco company document sites using a list of specified search terms was undertaken during November 2000 to July 2001. RESULTS: Documents show that, especially in the context of tighter restrictions on conventional avenues for tobacco marketing, tobacco companies view cigarette packaging as an integral component of marketing strategy and a vehicle for (a) creating significant in-store presence at the point of purchase, and (b) communicating brand image. Market testing results indicate that such imagery is so strong as to influence smoker's taste ratings of the same cigarettes when packaged differently. Documents also reveal the careful balancing act that companies have employed in using pack design and colour to communicate the impression of lower tar or milder cigarettes, while preserving perceived taste and "satisfaction". Systematic and extensive research is carried out by tobacco companies to ensure that cigarette packaging appeals to selected target groups, including young adults and women. CONCLUSIONS: Cigarette pack design is an important communication device for cigarette brands and acts as an advertising medium. Many smokers are misled by pack design into thinking that cigarettes may be "safer". There is a need to consider regulation of cigarette packaging.

Adolescent↗
PubMed2001

Comparison of two oxytocin regimens to prevent uterine atony at cesarean delivery: a randomized controlled trial.

OBJECTIVE: To determine if high-dose oxytocin reduces the need for additional uterotonic agents at cesarean. METHODS: A randomized, double-masked trial of two oxytocin regimens was performed to prevent postpartum uterine atony in laboring women. The pharmacy prepared sequentially numbered oxytocin solutions containing either 10 U/500 mL or 80 U/500 mL of lactated Ringer's solution infused over 30 minutes after cord clamping. The need for additional uterotonic agents was determined by the surgical team. Hypotension was diagnosed and treated with crystalloid or a pressor agent. To detect a 50% decrease in the need for additional uterotonic agents and considering a beta error of 0.2, 220 patients would be required in each group (alpha = 0.05, two-tailed chi(2) test). RESULTS: The low-dose group (n = 163) received 333 mU/min, and the high-dose group (n = 158) received 2667 mU/min of oxytocin. The groups were similar with respect to risk factors for atony. Women in the low-dose group received additional uterotonic medication significantly more often than those in the high-dose group (39% compared with 19%, P <.001, relative risk 2.1, 95% confidence interval 1.4, 3.0). Moreover, more women in the low-dose group received methylergonovine, 15-methyl prostaglandin F(2alpha) or both (9% compared with 2%, relative risk 4.8, 95% confidence interval 1.4, 16) after additional oxytocin (median 20 U) had been added to the study solution. The incidence of hypotension was similar in both groups. CONCLUSION: Compared with an infusion rate of 333 mU/min, oxytocin infused at 2667 mU/min for the first 30 minutes postpartum reduces the need for additional uterotonic agents at cesarean delivery.

Adult↗
PubMed2001

Chromosomal painting detects non-random chromosome arrangement in dasyurid marsupial sperm.

Chromosome arrangements have been studied in metaphase and interphase somatic cells and in sperm of many animal species, but there are conflicting data and it is still not clear whether chromosomes are arranged randomly or non-randomly. We used chromosome painting to reveal the positions of chromosomes in marsupial sperm. Marsupials are ideally suited for these studies because they have only a few large chromosomes. Here, we show that chromosomes occupy fixed positions in the immature and mature sperm of Sminthopsis crassicaudata. We suggest that the non-random arrangement of chromosomes in marsupial sperm may be important in establishing chromosome arrangement and patterns of gene activity within the developing embryo.

Animals↗
PubMed2001

Quality of life in asthma: a comparison of community and hospital asthma patients.

This study compares the quality of life of a community sample of people with asthma in South Australia, using population norms, people suffering from other chronic diseases, and a sample of asthma patients from two hospital clinics. A representative population survey was performed by trained interviewers in spring 1995 of 3001 respondents aged > or = 15 years. A physician's diagnosis of current asthma was reported by 299 (9.9%). The hospital clinic sample had a physician's diagnosis and lung function evidence of asthma (n = 293). All completed the SF-36 health survey. Standardized SF-36 scores, adjusted for age, sex, and social class, were significantly lower for respondents with asthma, compared with population norms, across all subscales of the SF-36 (p < 0.05). Physical component summary (PCS) and mental component summary (MCS) scores were not significantly different in people in the community sample with asthma from scores in people with diabetes and arthritis. PCS and MCS scores did not differ for those with similar symptom frequency in the community and hospital asthma samples, except that hospital patients with frequent symptoms had significantly lower MCS scores (p < 0.01). Asthma has a major impact on the health-related quality of life in the community, comparable to other chronic diseases. The SF-36 performs uniformly in asthma in different situations.

Adolescent↗
PubMed2001

State variation in retail promotions and advertising for Marlboro cigarettes.

BACKGROUND: There is some evidence that tobacco companies marketing efforts undermine the effects of comprehensive tobacco control programmes. OBJECTIVE: To determine whether point-of-purchase advertising and promotions are more pervasive in states where comprehensive tobacco control programmes are underway. DESIGN: Cross sectional survey using 1996 data, with merged records of the existence of local tobacco advertising restrictions. PARTICIPANTS AND SETTING: 581 tobacco retail stores located in close proximity to high schools in mainland USA. MAIN OUTCOME MEASURES: Existence of gift-with-purchase, number of interior advertisements, and exterior store advertisements for Marlboro cigarettes. RESULTS: After controlling for store type and existence of advertising restrictions, offer of a gift-with-purchase for Marlboro cigarettes was significantly more likely in states with comprehensive tobacco control programmes than those without programmes (odds ratio 2.59, 95% confidence interval 1.57 to 4.26). Although not significant, results show an increase in the number of interior and exterior store advertisements for stores located in states with a comprehensive tobacco control programme than those in other states. CONCLUSION: Results suggest some point-of-purchase tobacco promotions and advertising are more pervasive in states with comprehensive tobacco control programmes. These efforts are likely to act against the objectives of programmes and need to be accounted for in programme evaluations.

Advertising↗