Addiction Journal - Press Release

Tobacco Companies Keep People Smoking Despite UK Cigarette Tax Increases

Tue, 16 Apr 2013 00:00:00 +0100

The tobacco industry keeps the price of its cheapest cigarettes virtually static despite annual increases in tobacco taxes, circumventing the United Kingdom’s public health policy to reduce smoking through higher prices.

Raising tobacco prices is one of the most effective means of reducing tobacco use, particularly among price-sensitive smokers such as young people and people with low incomes. But when the UK government has been raising cigarette taxes to increase prices and deter smoking, tobacco companies have been absorbing the tax increases on their ultra-low-price (ULP) brands to keep their prices low. As a result, real ULP cigarette prices have remained virtually unchanged since 2006 and their market share has doubled, suggesting that as cigarette taxes rise, many smokers downtrade to cheaper cigarettes and carry on smoking.

Transnational tobacco companies categorise cigarette brands into four price segments: premium, mid-price, economy, and ultra-low-price (ULP). A research report published online today in the journal Addiction reveals that while the real weighted average price of premium, mid-price and economy brands has increased gradually between 2001 and 2009, the real price of ULP cigarettes has barely changed since 2006, greatly reducing the effectiveness of cigarette taxes to deter smoking.

Tobacco companies have achieved this by overshifting taxes on their higher priced brands (increasing cigarette prices on top of the tax increases) and undershifting taxes on their ULP brands (absorbing tax increases so they are not passed on to the consumer) to keep the prices of their cheapest brands low. The former enables tobacco companies to increase their profits while the latter helps keep smokers in the market.

Unsurprisingly, the market share held by price-static ULP cigarettes doubled between 2006 and 2009, while the market share of the other three categories has fallen. But the rising prices of the more expensive brands means that, even with a falling market share, revenue from premium and mid-price brands has increased steadily since 2001.

Says lead author Anna Gilmore, Professor of Public Health & Health Foundation Clinician Scientist in the University of Bath’s Department for Health and the UK Centre for Tobacco Control Studies, “Tobacco companies use their price changes to win two ways in the UK: when tobacco taxes increase each year, the tobacco companies hide their price increases on more expensive cigarettes behind the tax increases, making large profits from smokers who aren’t bothered by price increases. Simultaneously, they cut the prices of their cheapest cigarettes so that smokers who would be deterred by price hikes continue to smoke. Tobacco company revenues increase and fewer smokers quit. To increase the effectiveness of cigarette taxes, the UK government must find ways to narrow the price gap between the cheapest and most expensive cigarettes and prevent tobacco companies from discounting their cheapest brands.”

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For editors:

Gilmore A., Tavakoly B., Taylor G., and Reed H. Understanding tobacco industry pricing strategy and whether it undermines tobacco tax policy: The example of the British cigarette market. Addiction, 108: doi: 10.1111/add.12159.

This paper is free to download from the Wiley Online Library for one month from the date of online publication: http://onlinelibrary.wiley.com/doi/10.1111/add.12159/abstract

or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact lead author Professor Anna Gilmore, University of Bath, via telephone (+44 01225 386810) or email (a.gilmore@bath.ac.uk).

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2011 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.

The University of Bath is one of the UK\'s leading universities, ranked in the top ten of all national league tables and third in the Sunday Times University Guide 2013 with only Cambridge and Oxford above us. Our Mission is to deliver world class research and teaching, educating our graduates to become future leaders and innovators, and benefiting the wider population through our research, enterprise and influence. Our courses are innovative and interdisciplinary and we have an outstanding record of graduate employment. View a full list of the University\'s press releases: http ://www .bath .ac .uk /news. Follow the University\'s latest news: www .twitter .com /UniofBath

Study finds minors can successfully buy alcohol on eBay.com

Tue, 16 Apr 2013 00:00:00 +0100

EBay.com, the world’s most visited website that sells alcohol, has allowed minors to successfully purchase alcohol on their website, according to research from the University of North Carolina at Chapel Hill.

A letter published online today in the scientific journal Addiction found that teens were able to successfully buy alcohol from two different eBay alcohol sellers, with neither eBay store verifying the age of the underage buyers. In addition, the eBay sellers shipped the alcohol purchased via the US Postal Service in violation of federal law and shipped an order a second time for free.

EBay is the world’s largest online marketplace and sees sales in excess of $2,000 per second. The website’s policies require sellers to comply with all laws, but do not require age verification at the time of purchase or delivery.

“EBay sellers shipped alcohol to minors in violation of eBay’s policies, and in violation of state and federal laws,” said Rebecca Williams, Ph.D., author of the study and research fellow at the UNC Center for Health Promotion and Disease Prevention, where the study was conducted. “For both wine deliveries, the seller requested FedEx Age Verification at delivery, but FedEx failed to verify the age of the recipient. Both customers received their eBay alcohol orders without ever having to show proof of age.”

According to the study, eBay’s policies established two categories of alcohol sellers: eBay-Approved Wine Sellers, and Alcohol Related Collectibles sellers, and the latter sold common liquors in violation of eBay’s own policies. Neither seller policy required specific age verification procedures.

A 2005 U.S. Supreme Court decision allowed wineries to ship to out-of-state consumers despite states’ concerns over underage sales. In the ruling, the court said that states showed little evidence that youth access to alcohol online was a problem. Williams’ research, funded by the Robert Wood Johnson Foundation Substance Abuse Policy Research Program, is the first peer-reviewed study to find minors can successfully purchase alcohol online and to examine age verification procedures for online alcohol sales. An article published in Archives of Pediatrics and Adolescent Medicine showed that 45% of teens’ purchase attempts from 100 online vendors were successful despite using their real underage IDs. The eBay sellers were the only ones to use the USPS to deliver the purchases, in direct violation of federal law, or to ship an order a second time free of charge.

The producers of ABC television’s 20/20 contacted Dr. Williams after the first article was published to discuss Internet alcohol sales for an episode on underage drinking. After discussing the study’s findings about underage alcohol sales on eBay, the producers successfully documented a teen buying alcohol on eBay for the show. Following this negative national news coverage, eBay revised its policy for Alcohol Related Collectibles sellers to allow sales of empty bottles only; its eBay-Approved Wine Seller and age verification policies remain unchanged.

Dr. Williams sent the letter from Addiction to eBay for comment but received no response.

“EBay could do much more to restrict youth access to alcohol from their website by banning alcohol sales entirely, or at the very least implementing policies requiring strict age verification at the points of order and delivery for all alcohol sales” said Williams. “This study shows that we need to continue to monitor minors’ access to alcohol online as corporate and legislative policies continue to evolve in this dynamic environment.”

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Media Contact:
Sonya Sutton
UNC Center for Health Promotion and Disease Prevention
919-966-4118; ssutton@unc.edu

Williams RS. Underage internet alcohol sales on eBay. Addiction, 108: doi: 10.1111/add.12182

Available to download at http://onlinelibrary.wiley.com/doi/10.1111/add.12182/abstract

Missed Opportunities to Help Smokers with Mental Illness

Thu, 28 Mar 2013 00:00:00 +0000

Researchers from the UK Centre for Tobacco Control Studies say that despite the expansion in smoking cessation services in recent years, GPs are missing opportunities to offer this support to patients with mental health problems.

Although smoking prevalence has declined in the United Kingdom over recent decades, it has changed little among people with mental health disorders, remaining substantially higher than the national average. Yet a study published in the journal Addiction, presenting work carried out for a report released today by the Royal College of Physicians and Royal College of Psychiatrists called ‘Smoking and Mental Health’, suggests that general practitioners (GPs) are missing opportunities to help smokers with mental health disorders to quit. Though smokers with mental health problems are more likely than other smokers to receive cessation support from their GP over the course of a year, this reflects the increased frequency of their consultations. Overall, the total proportion of smokers with poor mental health (indicated by a recorded diagnosis or a prescription for a psychoactive medication) who are prescribed a smoking cessation medication in any one year is low: approximately one in ten is prescribed a smoking cessation medication, and only half are advised to quit.

This is bad news for a group that is particularly vulnerable to poor health. People with severe mental illnesses such as schizophrenia have some of the worst physical health of any section of the population. The research published in Addiction, of over 2 million patients, shows that people with mental illness are around twice as likely to smoke as those without and nears 50% in those with more severe illness. Smoking-related illnesses contribute significantly to high sickness and death rates in these groups, with mortality rates up to three times those of the rest of the population.

GPs are particularly well-placed to intervene with patients who have mental health disorders and offer smokers help to quit. The stop-smoking interventions that are known to work in the general population – including nicotine replacement therapy and other medications and referral to a smoking cessation advisor -- are also effective in patients with poor mental health, so primary healthcare professionals should offer such interventions routinely to their patients with mental health disorders.

If GPs were to intervene in an equal proportion of consultations regardless of patients’ mental health status, smokers with indicators of poor mental health would be advised to quit or prescribed a cessation medication more frequently, which would help to reduce the health inequalities in these vulnerable groups of patients.

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For editors:

Szatkowski L. and McNeill A. The delivery of smoking cessation interventions to primary care patients with mental health problems. Addiction, 108: doi: 10.1111/add.12163

This paper is free to download from the Wiley Online Library for one month from the date of online publication: http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291360-0443/earlyview or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact co-authors Ann McNeill, Professor of Tobacco Addiction at King’s College London (telephone: +44 020 7848 0681 or email: ann.mcneill@kcl.ac.uk) or Lisa Szatkowski, Lecturer in Medical Statistics at the University of Nottingham (telephone: +44 0115 823 1391 or email: lisa.szatkowski@nottingham.ac.uk).

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2011 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.

Unhealthy drinking widespread around the world, CAMH study shows

Mon, 04 Mar 2013 00:00:00 +0000

A new study by the Centre for Addiction and Mental Health (CAMH). shows that alcohol is now the third leading cause of the global burden of disease and injury, despite the fact most adults worldwide abstain from drinking.

This research, part of the 2010 Global Burden of Disease study, published in this month’s issue of the journal Addiction, also found that Canadians drink more than 50 per cent above the global average.

“Alcohol consumption has been found to cause more than 200 different diseases and injuries,” said Kevin Shield, the lead author of the study, “These include not only well-known outcomes of drinking such as liver cirrhosis or traffic accidents, but also several types of cancer, such as female breast cancer.”

The study reports the amount and patterns of alcohol consumption by country for 2005, and calculates estimates for these figures for 2010. It reveals vast differences by geographical region in the numbers of people who consume alcohol, the amount they drink, and general patterns of drinking. Some other findings:

Drinkers in Europe and parts of Sub-Saharan Africa are the world’s heaviest consumers of alcohol, on average.
People in Eastern Europe and Southern Sub-Saharan Africa consumed alcohol in the unhealthiest manner, as they frequently consumed large quantities, drank to intoxication, engaged in prolonged binges, and consumed alcohol mainly outside of meals.
People in North Africa, the Middle East and South Asia consumed the least amount of alcohol.
North Americans in general, and Canadians in particular drink more than 50 per cent above the global average, and show a more detrimental drinking pattern than most EU countries, with more bingeing.

The global burden of disease and injury attributable to alcohol is large and growing. In 2010, it was responsible for 5.5 per cent of this overall burden, third after high blood pressure and tobacco smoking, among 67 risk factors overall.

This study summarizes the results from population surveys, sales or production data, and data on alcohol consumption not covered in official records, from all countries, territories and regions.

Researchers also found that almost 30 per cent of alcohol consumed in 2005 was “unrecorded” alcohol – referring to alcohol not intended for consumption, home-brewed alcohol, and illegally produced alcohol. In some regions, unrecorded alcohol constituted more than half of all alcohol consumed.

“The amount of unrecorded alcohol consumed is a particular problem, as its consumption is not impacted by public health alcohol policies, such as taxation, which can moderate consumption,” said Dr. Jürgen Rehm, a study author and director of CAMH’s Social and Epidemiological Research Department.

“Improving alcohol control policies presents one of the greatest opportunities to prevent much of the health burden caused by alcohol consumption,” said Dr. Shield “To improve these policies, information on how much alcohol people are consuming, and how people are consuming alcohol is necessary, and that is exactly the information this article presents.”

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Media contact: Michael Torres; (416) 595-6015; media@camh.ca.

The Centre for Addiction and Mental Health (CAMH) is Canada\'s largest mental health and addiction teaching hospital, as well as one of the world\'s leading research centres in its field.

CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit www.camh.ca.

Shield, K.D., Rylett, M., Gmel, G.sen., Gmel, G.jun., Kehoe-Chan, T., & Rehm J. (2013). Global alcohol exposure estimates by country, territory and region for 2005 – a contribution to the Comparative Risk Assessment for the 2010 Global Burden of Disease Study. Addiction doi: 10.1111/add.12112. [Epub ahead of print Jan 24]

Drop in alcohol-related deaths by nearly a third follows minimum alcohol price increase of 10%

Thu, 07 Feb 2013 00:00:00 +0000

A new study made available online today in ‘Addiction’ shows that, between 2002 and 2009, the percentage of deaths caused by alcohol in British Columbia, Canadadropped more than expected whenminimum alcohol price was increased, while alcohol-related deaths increasedwhen more private alcohol stores were opened. The paper has significant implications for international alcohol policy.

The study was carried out by researchers from British Columbia, the westernmost province in Canada, using three categories of death associated with alcohol – wholly alcohol attributable (AA), acute, and chronic*, analysing death rates across the time period against increases in government set minimum prices of alcohol drinks.

The study was complicated by another provincial policy which allowed partial privatisation of alcohol retail sales, resulting in a substantial expansion of alcohol stores. Previously, alcohol could only be sold directly to the public in government owned stores, unlike in Europe where it is widely available in supermarkets, off-licences and petrol stations. The researchers therefore had to both control for the effects of the wider availability of alcohol, and assess what effect this measure had on mortality rates.

The major finding was that increased minimum alcohol prices were associated with immediate, substantial and significant reductions in wholly AA deaths:

A 10% increase in the average minimum price for all alcoholic beverages was associated with a 32% reduction in wholly AA deaths
Some of the effect was also detected up to a year after minimum price increases
Significant reductions in chronic and total AA deaths were detected between two and three years after minimum price increases
A 10% increase in private liquor stores was associated with a 2% increase in acute, chronic, and total AA mortality rates

This overall drop in deaths was more than expected, and disproportionate to the size of the minimum price increase – a minimum price increase of 1% was associated with a mortality decline of more than 3%.

The authors suggest that the reason for the reduction in mortality is that increasing the price of cheaper drinks reduces the consumption of heavier drinkers who prefer these drinks. They note that other research has also suggested that impacts on some types of mortality may be delayed by one or two years after price increases.

Dr Tim Stockwell, director of the University of Victoria’s Centre for Addictions Research of British Columbia and a lead author, said “This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase. It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia.”

Notes to Editors

For further information and interviews with the study team, please contact Emma Carter (Centre for Addictions Research, University of Victoria) on +1 250 472 5445 or the principal investigator Dr Tim Stockwell at the University of Victoria, British Colombia, Canada (email timstock@uvic.ca or phone +1 250 415 7376) or co-author Dr Bill Ponicki, Scientist, Prevention Research Center, Pacific Institute for Research and Evaluation, California, USA (email bponicki@PREV.org, phone +1 510 883-5713).

For a full text copy of this article, please contact Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853 or Gill Rangel, Journal Manager, Addiction, gill@addictionjournal.org, tel +44 (0)20 7848 0452.

Zhao J, Stockwell T, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, and Buxton J. (2013) The relationship between changes to minimum alcohol prices, outlet densities and alcohol attributable deaths in British Columbia in 2002-2009. Addiction, 108: doi: 10.1111/add.12139

* Wholly alcohol attributable deaths included the following: poisonings due to alcohol, alcoholic psychoses, alcohol dependence, alcohol abuse, alcoholic cardiomyopathy, alcoholic gastritis, chronic pancreatitis (alcohol induced), fetal alcohol syndrome and excess alcohol blood level; acute alcohol attributable deaths comprised mainly injuries whether caused intentionally or unintentionally while chronic alcohol attributable deaths were those caused by alcohol-related illnesses such as liver cirrhosis and various cancers (e.g. cancers of the mouth, oesophagus, stomach, colon and breast). These types of diagnosis were determined from the underlying cause of death identified on the death certificates.

Weakness in working memory predicts progression of alcohol use in early adolescents

Wed, 28 Nov 2012 00:00:00 +0000

Weakness in a cognitive skill called “working memory” predicts both the initiation and the escalation of alcohol use in adolescents ages 10 to 15, according to a longitudinal study by researchers at the Annenberg Public Policy Center of the University of Pennsylvania and the Children’s Hospital of Philadelphia.

Working memory is the cognitive function that allows us to deliberate before acting, a process that is critical for making decisions and planning behavior. It depends heavily on parts of the brain that control impulses and allow one to consider the consequences of behavior. Past research has suggested that alcohol use during adolescence causes a reduction in this ability by adversely affecting the development of the adolescent brain.

“By repeating assessments on the same children over four years during early adolescence, this project is the first to show that individual differences in working memory precede and predict early alcohol onset and progressive drinking behaviors in adolescents,” noted Atika Khurana, lead author of the study. Khurana conducted this study while she was a post-doctoral fellow at the University of Pennsylvania; she is now an Assistant Professor in the Dept. of Counseling Psychology & Human Services at the University of Oregon. “It is still quite likely that heavy alcohol use during adolescence is responsible for decrements in this ability, however our research shows that at least some of these weaknesses are already present before adolescents even begin using alcohol.”

Recently published in the journal Addiction, the study followed a community cohort of 358 adolescents from the Philadelphia area over a period of four years. The researchers conducted extensive neuropsychological testing of the children beginning at ages 10 to 12, prior to their initiation of any alcohol use, and at each annual follow-up. Assessments of impulsivity, sensation seeking, and alcohol use were also conducted at all four time points.

Youth who had weak working memory exhibited greater levels of impulsivity as assessed by tendencies that reflect lack of self-control, such as acting without thinking and inability to delay gratification. Adolescents with higher levels of impulsivity were more likely to have lower working memory ability, and also more likely to report early initiation and progression of alcohol use.

In contrast, adolescents who reported attraction to exciting activities, a personality trait known as sensation seeking, were not more likely to use alcohol once the effect of impulsivity was controlled for. This is consistent with the finding that unlike youth that are impulsive, sensation seekers tend to have stronger (and not weaker) working memory. Research with animals also suggests that although sensation seekers are likely to experiment with drugs, it is impulsivity that more strongly predicts adverse effects of drug use.

Early use of alcohol is a strong predictor of later alcohol abuse. According to the CDC, excessive use of alcohol accounts for nearly half of traffic accidents in persons ages 20 to 44 and half of all homicides in the U.S.

“Because early alcohol use is a predictor of later alcohol abuse, our findings suggest that children with weak working memory ability and associated forms of impulsivity could be targeted for early intervention to prevent later problems,” said Dan Romer, co-author of the study and director of the Adolescent Communication Institute at the Annenberg Public Policy Center of the University of Pennsylvania. “The findings also suggest that adolescents high in sensation-seeking, often thought to be at risk, may actually be somewhat protected by their better working memory ability.”

“Recent research suggests that working memory ability can be improved with training. This suggests a promising avenue to intervene to reduce impulsive tendencies associated with weak working memory, and consequently to prevent alcohol abuse as teens mature,” Khurana added. “This is a possibility that should be studied in future research.”

“While working memory abilities continue to develop during adolescence, these skills depend on early experience and learning, so interventions should be applied as early as possible to maximize their effect,” says Laura Betancourt, the senior clinical researcher on the team from Children’s Hospital of Philadelphia.

The research was supported by the National Institute of Drug Abuse; however, the conclusions are solely those of the authors.

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For editors:

Khurana A, D Romer, LM Betancourt, NL Brodsky, JM Giannetta and H Hurt (2012) Working memory ability predicts trajectories of early alcohol use in adolescents: the mediational role of impulsivity. Addiction, 108: doi: 10.1111/add.12001.

Adolescents with low status among peers are more likely to become adult smokers

Tue, 20 Nov 2012 00:00:00 +0000

A new study from Sweden reveals that having low peer status in adolescence is a strong risk factor for regular and heavy smoking in adulthood.

Researchers from Stockholm University in Sweden used a large database that followed the lives of more than 15,000 Swedes, mainly from the Stockholm area, from birth to middle age. The researchers isolated 2,329 people who were interviewed once at age 13 about peer status at school and again at age 32 about their smoking habits. The results indicate that the lower a young person’s status is among his or her school peers, the more likely that person is to become a regular (less than 20 cigarettes per day) or heavy (20+ cigarettes) smoker in adulthood.

Unlike some previous studies of peer status and health-related behaviours, this study benefited from an objective measure of peer status, in that the students were not asked to assess their own status but instead nominated the three classmates they ‘best liked to work with at school’. By checking the responses of all classmates from each school, the researchers identified individuals nominated 0 times by their classmates (marginalised students), 1 time (peripheral), 2-3 times (accepted), 4-6 times (popular), and 7+ times (class favourites). Students with few nominations were assumed to be less accepted and respected within the group and to have fewer friends.

There are several possible reasons why low status children grow up to become smokers. Marginalized adolescents may come to believe in their low status, which may then affect future prospects and ambitions and influence their choices (e.g. smoking) over the course of a lifetime. Marginalized people may be more likely to adopt controversial behaviours, such as smoking, while ‘favourites’ conform to social expectations of good behaviour. Unaccepted youngsters may take up smoking in school as a bid for attention or popularity, with the smoking habit – via nicotine addiction -- continuing into adulthood.

What is clear, however, is that anti-smoking programs in schools are likely to be more effective if they increase integration and foster acceptance among students as well as transmitting negative attitudes towards smoking. Not only would adolescent smoking rates be reduced, but the benefits gained from integrating marginalised students could have wide-ranging positive influences on health and health behaviours into adulthood.

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For editors:

Almquist YB and Östberg V. Special relationships and subsequent health-related behaviours: Linkages between adolescent peer status and levels of adult smoking in a Stockholm cohort. Addiction, 108: doi:10.1111/j.1360-0443.2012.04097.x

This paper is free to download from the Wiley Online Library for one month from the date of online publication: http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291360-0443 or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact Viveca Östberg at the Centre for Health Equity Studies (CHESS), Stockholm University by email (viveca.ostberg@chess.su.se) or telephone (+46 8 162650).

Treatment for alcoholism dramatically reduces the financial burden of addiction on families

Tue, 25 Sep 2012 00:00:00 +0100

The financial effects of alcoholism on the family members of addicts can be massive, but little is known about whether treatment for alcoholism reduces that financial burden. A study of 48 German families published online today in the journal Addiction reveals that after twelve months of treatment, family costs directly related to a family member’s alcoholism decreased from an average of €676.44 (£529.91, US$832.26) per month to an average of €145.40 (£113.90, $178.89) per month. Put another way, average costs attributable to alcoholism decreased from 20.2% to 4.3% of the total pre-tax family income.

Among those 48 families, two of the largest family expenditures directly related to alcoholism were for alcoholic beverages (averaging €252.13/£197.51/$310.29 per month) and cigarettes (averaging €92.98/£72.83/$114.43 per month). Twelve months into treatment, those costs had reduced to €70.63 (£55.32, $86.92) and €64.21 (£50.29, $79.04) per month.

Also, after twelve months of treatment, the average amount of time spent caring for the affected family member dropped from 32.2 hours per month to 8.2 hours per month. Using the minimum wage in Germany for employees in the nursing industry (€8.50 per hour), informal care provided by family members initially piled on an additional financial burden of €274.30 (£214.87, $337.66) per month, which reduced to €69.79 (£54.67, $85.88) per month after one year of treatment.

Even in cases of relapse, treatment for alcoholism still reduced the financial burden on families, but only by €65.22 (£51.09, $80.26) per month on average.

Lead author Dr. Salize (Central Institute of Mental Health, Mannheim, Germany) says, “We’re opening up an area of addiction research that doesn’t receive much attention. When they look at effects on families, addiction studies mainly focus on problems such as domestic violence and depression, not on the financial burden of caring for an alcoholic. But when health services and policymakers study the costs and benefits of treating alcoholism, they need to know that treatment has an immense financial effect not just on the alcoholic but also on his or her spouse, partner, children, and parents. The benefits of treatment reach well beyond the individual patient.”

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For editors:

Salize H.J, Jacke C., Kief S., Franz M., and Mann K. Treating alcoholism reduces financial burden on caregivers and increases quality-adjusted life years. Addiction, 107: doi:10.1111/j.1360-0443.2012.04002.x.

This paper is free to download from the Wiley Online Library for one month from the date of online publication: http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291360-0443 or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact Dr. Hans Joachim Salize, Central Institute of Mental Health, Mannheim, Germany by telephone (+49 (0)621 1703 6401) or email (hans-joachim.salize@zi-mannheim.de).

Smokers who value the future are more likely to quit

Wed, 05 Sep 2012 00:00:00 +0100

Addiction researchers have known for many years that smokers are less likely than non-smokers to look to the future in planning their lives. New research has now shown that among smokers, those who have more of a future orientation are more likely to stop smoking.

Drs. Heather Brown and Jean Adams of Newcastle University (UK) tapped into eight years of data from a large Australian database to make this discovery. The Household Income and Labour Dynamics of Australia (HILDA) survey collects data on economic and subjective well-being, work, and family dynamics every year from over 7,000 Australian households. Brown and Adams identified 1,817 participants who were smokers at the start of the survey (2001) and analysed their planning regarding their saving and spending to measure their future orientation. People whose spending and saving plans looked ahead by more than three months were categorized as having a longer time horizon, while those whose financial plans looked no more than a week ahead had a shorter time horizon. The researchers then looked at how many of those 2001 smokers had quit or tried to quit by 2008. Seventy-six percent of quitters were long-time-horizon planners, compared with 66% of those who continued to smoke.

Researchers in other fields have found similar associations: newly diagnosed diabetics who are future-focused are more likely to make healthy changes to their diet and exercise habits, and cocaine users who discount the future are less likely subsequently to stop using the drug.

Says co-author Jean Adams, \"It is possible that helping smokers to think about the future a bit more might be a useful way to help them quit.\"

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For editors:

Brown H and Adams J. The role of time preference in smoking cessation: A longitudinal analysis of data from the Household Income and Labour Dynamics of Australia survey, 2001-08. Addiction, 107, doi:10.1111/j.1360-0443.2012.03997.x

This paper is free to download from the Wiley Online Library (http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291360-0443) for one month from the date of online publication, or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact lead author Dr. Heather Brown by telephone (+44 (0) 191 222 6281) or by email (heather.brown@ncl.ac.uk).

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2011 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.

Study finds medications greatly improve smokers chances of quitting

Tue, 14 Aug 2012 00:00:00 +0100

BUFFALO — Smokers who try to quit have a better chance of succeeding when they use FDA-approved stop-smoking medications rather than going it alone, according to a new study by researchers at Roswell Park Cancer Institute (RPCI) published online today in the British journal Addiction.

Stop-smoking medications such as nicotine replacement therapy (NRT), bupropion and varenicline have been shown to be effective in clinical trials, but population-based studies have produced mixed results on effectiveness when medications are used outside the confines of a research study. This latest study, conducted through the International Tobacco Control (ITC) research collaboration, is one of the largest real-world evaluations of medication effectiveness conducted to date, and the first to comprehensively control for biases in participants’ recall of quit attempts.

The study tracked the smoking behaviors of more than 2,500 adult smokers in the United Kingdom, Canada, Australia and the United States who reported making a quit attempt between 2006 and 2009. Study participants were asked how recently they had attempted to quit and whether they used any type of stop-smoking medication. Six-month continuous abstinence among those who recalled making a very recent quit attempt was assessed at the next follow-up interview. The results showed that those who used varenicline, bupropion or the nicotine patch had much higher quit success at six months compared to those who tried to quit without using medication.

“By restricting our analyses to those who made very recent quit attempts, we reduced the extent to which differences in quit-attempt recall could bias the estimates of medication effectiveness. Consistent with the strong evidence from clinical trials, our findings show that medications are indeed effective in increasing smokers’ chances of quitting when used in the real world,” said Karin Kasza, MA, statistician in the Division of Cancer Prevention & Population Sciences at RPCI and lead author of the study.

Ron Borland, PhD, Nigel Gray Distinguished Fellow in Cancer Prevention at the Cancer Council Victoria in Melbourne, Australia and co-author of the study, added, “The major advance of this study is that we have been able to show that greater forgetting of unassisted failed attempts is the most likely reason other studies have not found a benefit for medication in population-based settings. This finding should reassure clinicians and public health workers to continue to encourage the widespread use of medications.”

“Despite the benefit of using medications, many smokers still try to quit without help. And even when medications are used, quitting smoking is hard, and relapses are common. Continued efforts are needed to develop and deliver more effective treatments to help smokers who want to quit,” said Andrew Hyland, PhD, Chair of the Department of Health Behavior at RPCI.

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For editors:

Kasza KA, Hyland AJ, Borland R, McNeill AD, Bansal-Travers M, Fix BV, Hammond D, Fong GT, and Cummings KM. Effectiveness of Stop-Smoking Medications: Findings from the International Tobacco Control (ITC) Four Country Survey. Addiction, 107: doi:10.1111/j.1360-0443.2012.04009.x

Media seeking interviews may contact Annie Deck-Miller, Senior Media Relations Manager, on +1 716-845-8593; annie.deck-miller@roswellpark.org

The ITC Policy Evaluation Project (www.itcproject.org) is a collaborative effort with international health organizations and policymakers in more than 20 countries, inhabited by more than 50% of the world\'s population, 60% of the world\'s smokers, and 70% of the world\'s tobacco users. In each country, the ITC Project is conducting prospective cohort surveys to assess the impact and identify the determinants of effective tobacco control policies.

The mission of Roswell Park Cancer Institute (RPCI) is to understand, prevent and cure cancer. RPCI, founded in 1898, was one of the first cancer centers in the country to be named a National Cancer Institute-designated comprehensive cancer center and remains the only facility with this designation in Upstate New York. The Institute is a member of the prestigious National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers; maintains affiliate sites; and is a partner in national and international collaborative programs. For more information, visit RPCI’s website at http://www.roswellpark.org, call 1-877-ASK-RPCI (1-877-275-7724) or email askrpci@roswellpark.org.

Plain packaging of cigarettes encourages young smokers to heed health warnings

Thu, 09 Aug 2012 00:00:00 +0100

New research published online in the scientific journal Addiction shows that plain packaging (requiring cigarettes to be packaged in standard packages without attractive designs and imagery) may help to draw the attention of some adolescent smokers to the health warnings on the package. If so, this may in turn deter young smokers from continuing to smoke.

Researchers asked eighty-seven teenage secondary school (high school) students from the city of Bristol, UK, to look at twenty images of cigarette packs on a computer screen for ten seconds each while a device tracked their eye movements. Some packs were plain, carrying only the name of the brand in a plain font and a standard pictorial health warning. The rest were the conventional and colourful packs of ten popular cigarette brands, which included the same health warnings.

Students who had never smoked paid attention to the health warnings on both plain and branded cigarette packets, while daily smokers tended to avoid looking at any health warnings at all. But students who were occasional (non-daily) smokers, or had tried smoking at least once, paid more attention to the health warnings on the plain packs than to those on the branded packs.

Compared with adults, adolescents are highly vulnerable to taking up smoking. Research has established that pictorial health warnings can discourage young smokers and that adolescents who forego a cigarette because of a health warning have a lower intention to smoke.

As a result of its plain-packaging legislation, the Australian government is facing an international trade dispute involving several tobacco companies and tobacco-producing nations. The results of this study will give the Australian government another piece of evidence in its favour, and something for other governments to consider as they contemplate plain-packaging legislation of their own.

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For editors:

Maynard O., Munafo M., and Leonards, U. Visual attention to health warnings on plain tobacco packaging in adolescent smokers and non-smokers. Addiction 107, doi: 10.1111/j.1360-0443.2012.04028.x

This paper is currently available online as an unproofed, accepted article. It will be free to download from the Wiley Online Library for one month from the date of online publication: http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291360-0443 or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact lead author Olivia Maynard by telephone (via University of Bristol Press Office, +44 (0)117 928 8896) or email (olivia.maynard@bristol.ac.uk).

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2011 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.

Addiction launches new website

Tue, 31 Jul 2012 00:00:00 +0100

The world’s leading addiction research journal, simply titled Addiction, has been published continuously since 1884. It is the oldest addiction specialty journal in print, and is published each month in paper and online. This week, it launches a completely revamped website (www.addictionjournal.org) that makes the journal useful to a much wider readership than the cadre of academics and clinicians who are its regular subscribers. The website offers features designed to help close the gap between pure research and its practical application.

Of greatest interest to new and established readers is the Key Findings service, which encapsulates the most significant scientific discoveries published in each issue of Addiction. Every time a new issue is published, this service provides a one or two sentence summary of each paper, written in everyday language, explaining what is new and important about the research. Readers can sort key findings by month or search them by topic. Full abstracts are accessible in one click, and regular subscribers can download complete papers. We encourage journalists and policy makers to subscribe to our key findings RSS feed to ensure that they are kept up-to-date each month.

Other new features of the website:

News and Meetings: A blog-style feature that summarises the latest international news in addiction, updated monthly, coupled with a continuously updated list of addiction-related academic meetings and conferences.
New Books: A comprehensive list of new publications in addiction science, compiled by the Executive Director of SALIS (Substance Abuse Librarians & Information Specialists) and updated five times per year.
Links to other sources of addiction information: Three new categories on our homepage direct readers to ‘Addiction Blogs’ written by researchers, journalists, students, and recovering addicts; ‘Addiction Links’ to addiction-related publications, societies, services, and reliable sources of information; and ‘Help with Addiction Problems’.
Social Networking: Links to our Twitter and Facebook accounts.

And we’ve continued these popular services:

Press Releases: The full story on the most noteworthy papers published in Addiction.
How to contribute: Find out how to submit your research to the journal.
Browse the journal: Click through to our publisher’s website to browse newly-accepted papers, fully proofed papers, full issues, and themed ‘virtual issues’. Some content is available to all readers, and some only to subscribers (though non-subscribers can buy individual papers, issues, and even full volumes of the journal).

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For editors:

For more information, please contact Jean O’Reilly, Editorial Manager, Addiction, by email (jean@addictionjournal.org) or telephone (+44 (0)20 7848 0853).

A $1 cigarette tax increase would decrease consumption by 20 percent and almost triple revenues

Mon, 30 Jul 2012 00:00:00 +0100

Georgia sold 544 million packs of cigarettes in 2010, earning $201 million in state tax revenue. New research from the University of Georgia suggests a $1 tax increase would decrease consumption by 20 percent and almost triple revenues, with similar effects in nine other states.

A recent study by UGA associate professor of psychology James MacKillop, published in the journal Addiction, estimates a $1 per pack tax increase would generate a 197% increase in tax revenue, yielding almost $600 million in state tax revenues.

The study assessed 1,056 smokers in Georgia, Rhode Island and South Carolina to evaluate how estimated purchasing decisions were affected by price increases, with prices varying from free to $20 per pack.

“As price goes up, consumption goes down, which reflects how much the product is valued,” MacKillop said, who is also the director of the Behavioral Economics and Neuroeconomics Workgroup at the UGA Institute for Behavioral Research. “We looked at small intervals of price changes to better understand the relationship between cost and consumption, and so we could make specific predictions about changes in prices to inform policy makers.”

MacKillop’s research highlights the effects of price on cigarette consumption and how price changes impact tax revenues. Georgia’s current tobacco tax is .37 cents per pack, nearly the lowest in the country, and a pack of cigarettes costs on average $4.37, which is 48^th nationally. Meanwhile, the Centers for Disease Control estimates the state tobacco burden from healthcare costs and lost productivity to be $9.02 for every pack sold.

The study also looked at the effects of a $1 tax increase would have on tobacco burden, estimating a savings of $976 million in Georgia. Together with additional revenue, the net effect of the tax increase was estimated to be 1.37 billion dollars.

According to MacKillop, “these findings suggest a $1 tax increase is a win-win situation.” “The price increase generates more in tax revenue and saves money in healthcare costs and lost productivity. Plus, a tax increase may ultimately create an environment where fewer people start smoking and more people try to quit smoking.”

The study looked at how tax increases would impact Alabama, Georgia, Idaho, Kentucky, Louisiana, North Carolina, North Dakota, South Carolina, Virginia and West Virginia. A $1 tax increase in North Carolina was predicted to increase revenues by $410.7 million and save $824.9 million in tobacco burden, a net effect of 1.23 billion dollars. Virginia, which sells 543 million packs per year, was predicted to generate $402.7 million dollars in additional revenue and save $677.9 million dollars in tobacco burden with a $1 tax increase, a net effect of 1.08 billion dollars.

Further, the study suggests that this is partially because of the potent effects of “left-digit” effects, in which consumers are disproportionately affected by the first digit in a product’s price.

“The areas where we saw the biggest changes were those with left-digit transitions, or prices where the whole dollar price went up,” MacKillop said. Compared to the effect of a pack price increase from $5.60 to $5.80, the decrease in cigarette consumption from $5.80 to $6 was four times larger.

“People are disproportionately affected by those prices because we tend to think of numbers in whole terms,” he said. “This has important implications for policy makers because it suggests certain price changes will have a particularly large impact.”

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For editors:

The study was funded by the Robert Wood Johnson Foundation.

Writer: April Sorrow, +1 706 542 7991, aprilr@uga.edu

Contact: James MacKillop, +1 706 542 3033, jmackill@uga.edu

MacKillop J, Few LR, Murphy JG, Wier LM, Acker J, Murphy C, Stojek M, Carrigan M, and Chaloupka F. High-resolution behavioural economic analysis of cigarette demand to inform tax policy. Addiction, 107: doi: 10.1111/j.1360-0443.2012.03991.x

The debate over ecstasy continues

Thu, 26 Jul 2012 00:00:00 +0100

New study finds evidence of memory impairments with one year of recreational use.

There has been significant debate in policy circles about whether governments have over-reacted to ecstasy by issuing warnings against its use and making it illegal. In the UK, David Nutt said ecstasy was less dangerous than horseback riding, which led to him being fired as the government’s chief drug advisor. Others have argued that ecstasy is dangerous if you use it a lot, but brief use is safe.

New research published online today by the scientific journal Addiction, gives some of the first information available on the actual risk of using ecstasy. It shows that even in recreational amounts over a relatively short time period, ecstasy users risk specific memory impairments. Further, as the nature of the impairments may not be immediately obvious to the user, it is possible people wouldn\'t get the signs that they are being damaged by drug use until it is too late.

According to the study, new ecstasy users who took ten or more ecstasy pills over their first year of use showed decreased function of their immediate and short-term memory compared with their pre-ecstasy performance. These findings are associated with damage of the hippocampus, the area of the brain that oversees memory function and navigation. Interestingly, hippocampal damage is one of the first signs of Alzheimer’s disease, resulting in memory loss and disorientation.

The study participants took an average of 32 pills each over the course of the year, or about two and a half pills per month. Some participants took as few as ten pills over the year and still showed signs of memory impairments.

Lead author Dr. Daniel Wagner says: “This study was designed to minimize the methodological limitations of earlier research, in which it was not possible to say whether cognitive impairments seen among ecstasy users were in place before drug use began. By measuring the cognitive function of people with no history of ecstasy use and, one year later, identifying those who had used ecstasy at least ten times and remeasuring their performance, we have been able to start isolating the precise cognitive effects of this drug.”

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For editors:

Wagner D., Becker B., Koester P., Gouzoulis-Mayfrank E., and Daumann J. A prospective study of learning, memory, and executive function in new MDMA users. Addiction, 107: doi: 10.1111/j.1360-0443.2012.03977.x

This paper is free to download from the Wiley Online Library for one month from the date of online publication (http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291360-0443) or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact lead author Dr. Daniel Wagner at the Uniklinik Köln in Germany by email (daniel.wagner@uk-koeln.de) or telephone (+49 221 478 87114).

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2010 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.

A better way to help high-risk pregnant smokers

Thu, 21 Jun 2012 00:00:00 +0100

Cigarette smoking among drug dependent pregnant women is alarmingly high, estimated at 77 to 99%. Programs that treat pregnant patients for substance use disorders often fail to address cigarette smoking despite the clear risks to both mother and child, including ectopic pregnancy, spontaneous abortion, preterm delivery, low birth weight, and Sudden Infant Death Syndrome. However, programs to help people quit smoking do not seem to interfere with drug abuse treatment, and may actually improve drug abstinence rates.

One of the most effective methods of helping people to quit smoking is contingency management, which gives smokers monetary incentives for meeting target goals. Researchers at Johns Hopkins University’s Center for Addiction and Pregnancy recently used contingency management to shape smoking reduction and abstinence in drug-dependent pregnant women, with promising results.

One hundred and three pregnant smokers who were prescribed methadone maintenance for heroin dependence were enrolled in a study comparing three conditions. A third of the women were enrolled in a contingency management shaping program and received escalating monetary incentives for reducing their level of cigarette smoking or by being abstinent as measured by breath carbon monoxide levels. The smoking reduction targets required for monetary incentives increased over time from minimal reduction in the early phases of treatment to the requirement of total abstinence by week 12. A relapse meant no monetary incentive was earned and the participant returned to the lowest level of payment. A third of the women could earn incentives for reduced smoking according to a schedule of payments not connected to the woman’s own smoking behaviour (non-contingent incentives). The final group of women received information about the risks of smoking during pregnancy but received no money for reduced smoking.

All of the groups showed some reduction in smoking levels during the experiment, but the women in the contingency management group greatly outperformed the two other groups. Nearly half of the contingency management women met the target of 75% reduction at least once, and a third of them met criteria for smoking abstinence (100% reduction) at least once by week 12. In contrast, none of the other condition participants met the abstinence criteria and only 2% of participants met the 75% reduction target during the study period.

The benefits of contingency management carried on after the experiment. The women in the contingent group had fewer pre-term births (17%, compared with 25% and 29% in the other two groups) and fewer babies with low birth weight (20%, compared with 38% and 43%), and they reported less smoking in the weeks after birth.

The results of the study indicate that contingency management programs are an effective way to reduce smoking in the hard-to-treat population of drug-dependent pregnant women.

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For editors:

Tuten M., Fitzsimons H., Chisolm M.S., Nuzzo P.A., and Jones H.E. Contingent incentives reduce cigarette smoking among pregnant, methadone maintained women: Results of an initial feasibility and efficacy randomized clinical trial. Addiction, 107. doi: 10.1111/j.1360-0443.2012.03923.x

This paper is free to download from the Wiley Online Library for one month from the date of online publication or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact Stephanie Desmon, Senior Media Relations Representative, Johns Hopkins Medicine via telephone (+44 1-410-955-8665) or email (sdesmon1@jhmi.edu).

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2010 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.

Substance Abuse Librarians Raise the Alarm as Libraries Continue to Close

Tue, 12 Jun 2012 00:00:00 +0100

Berkeley, California, 12 June 2012 -- Members of the Substance Abuse Librarians and Information Specialists (SALIS) are calling for urgent action to halt the closure of specialist libraries and databases, before valuable resources and expertise are lost forever.

Since SALIS started actively campaigning against the closure of alcohol, tobacco and other drug (ATOD) libraries and databases eight years ago, more than twenty-five libraries and databases worldwide have been downsized or closed, their resources dispersed or destroyed.

In 2004 SALIS waged a campaign to persuade the U.S. National Institute on Alcohol Abuse and Alcoholism to reverse its decision to cut funding for ETOH, the most comprehensive alcohol science database in the world. Then in 2006, when the U.S. National Institute on Drug Abuse closed its library, a collection of great value dating back to the mid 1930s, SALIS brought the issue to the forefront of the ATOD media.

To raise awareness, SALIS members have published an editorial in the journal Addiction calling for collaboration among librarians, the research community and other stakeholders to maintain ATOD library services and preserve core collections; fund digitization; and create digital repositories.

If action is not taken, important documents could be lost forever, especially the grey literature, i.e. unpublished reports and working papers, government documents, and programmatic materials, which tend to disappear when libraries are closed.

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For editors:

Andrea Mitchell, Sheila Lacroix, Barbara Weiner, Clare Imholtz, Christine Goodair. Collective Amnesia: Reversing the Global Epidemic of Addiction Library Closures. Addiction, 107: doi:10.1111/j.1360-0443.2012.03813.x

Media seeking interviews may contact SALIS Executive Director Andrea Mitchell, amitchell@salis.org

For a full text copy of this article, please contact Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

SALIS (Substance Abuse Librarians & Information Specialists) is an international association of individuals and organizations with special interests in the exchange and dissemination of alcohol, tobacco, and other drug (ATOD) information. Formed as an association in 1978 and incorporated in California since 1988, SALIS is recognized by the U.S. Internal Revenue Service under the Internal Revenue Code Section 501 (c)(3) as a non-profit corporation. http://salis.org

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2010 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.

Treatment of addictive disorders: (Not) an issue for medical education?

Thu, 03 May 2012 00:00:00 +0100

A survey among German medical students investigated whether future physicians in Germany received adequate training to treat various diseases during undergraduate education. The main conclusion was that German medical students did learn how to treat hypertension and diabetes; however, treatment of alcohol use disorders and smoking was hardly covered during undergraduate study. The survey was co-ordinated at Göttingen University (Germany); various researchers from Charité – University Medical Centre, Hamburg Medical School as well as the University of Birmingham and University College London contributed to the paper published online in Addiction today.

A total of almost 20,000 medical students were surveyed regarding their preparation for clinical practice. Thus, the sample comprised half of all medical students enrolled at 27 medical schools participating in the study. Only one in five fifth-year students thought they knew how to treat alcohol use disorders and smoking, and only 7% of students felt they were able to counsel a smoker willing to quit. Over half of fifth-year students wished to learn more about these addictive disorders during undergraduate medical education.

The health consequences of problem drinking and smoking are at least as devastating as the consequences of general medical disorders with similar prevalence such as hypertension and diabetes. In Germany, one in ten hospital admissions is accounted for by alcohol use or smoking. Problem drinking affects 5% of the population and shortens life-expectancy by approximately 23 years. At least one in two smokers dies from smoking-related disease, totalling 140,000 preventable deaths in Germany each year. The economic cost to society caused by problem drinking and smoking is estimated to exceed 40 billion Euros annually.

Study coordinator Dr Tobias Raupach (University Medical Centre Göttingen and University College London) said, “Physicians tend to focus on prescribing medication and carrying out diagnostic and therapeutic procedures. As a consequence, the identification and in-depth discussion of risk factors receives less attention. Yet, communication is at the heart of treating addictive disorders. Thus, the acquisition of communication skills required to help problem drinkers and smokers should be promoted during undergraduate medical education.”

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For editors:

Strobel L., Schneider N.K., Krampe H., Beißbarth T., Pukrops T., Anders S., West R., Aveyard P., and Raupach T. German medical students lack knowledge of how to treat smoking and problem drinking. Addiction, 107: doi:10.1111/j.1360-0443.2012.03907.x

For a full text copy of this article, please contact Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact Tobias Raupach, Health Behaviour Research Centre, University College London. E-mail: t.raupach@ucl.ac.uk

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing more than 2000 pages every year. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the top journal in the field of substance abuse and is number one in the 2010 ISI Journal Citation Reports © Ranking in the Substance Abuse Category. Addiction publishes peer-reviewed research reports on alcohol, illicit drugs and tobacco, bringing together research conducted within many different disciplines, as well as editorials and other debate pieces.

GPs should advise drinkers to keep a daily record of their drinking

Wed, 28 Mar 2012 00:00:00 +0100

The new UK alcohol strategy includes a plan to ensure that General Practitioners (GPs) advise heavy drinkers to cut down (The Government’s Alcohol Strategy, 23 March 2012, downloadable from http://www.homeoffice.gov.uk/publications/). There is good evidence that this can reduce how much people drink. The big question is, what should GPs say to their patients?

A new study published online by the scientific journal Addiction analysed the advice given by GPs in all the major clinical trials evaluating this kind of advice, looking for common components linked to the largest reductions in drinking across the different studies.

Among the many different components of the advice, such as providing information on the harms of excessive drinking, trying to boost motivation and self-confidence, and advising on avoidance of social cues for drinking, they found that the most effective piece of advice was to encourage the patient to monitor his or her alcohol consumption, typically by keeping a daily record.

Lead author Susan Michie, Professor of Health Psychology at University College London, explains why self-monitoring is such helpful advice: “In brief interventions, it’s important to advise people how to reduce their drinking rather than just saying they ought to drink less. Getting patients to record how much alcohol they drink each day provides a concrete, easy task that raises their awareness of their behaviour and how well they are doing in staying within limits that they set themselves. This may seem like common sense but common sense needs to be supported by hard evidence for it to be acted upon in official policies.”

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For editors:

Michie S., Whittington C., Hamoudi Z., Zarnani F., Tober G., and West R. Identification of behaviour change techniques to reduce excessive alcohol consumption. Addiction, 107: doi: 10.1111/j.1360-0443.2012.03845.xs

For a full text copy of this article, please contact Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact lead author Susan Michie by email: s.michie@ucl.ac.uk

Trans-Pacific Partnership Agreement Threatens Public Health

Mon, 12 Mar 2012 00:00:00 +0000

An editorial to be published by the scientific journal Addiction has been made available online, revealing that negotiations are underway behind closed doors for a far-reaching new trade and investment agreement that could tie the hands of governments’ future alcohol and tobacco control policies in perpetuity.

According to editorial author Jane Kelsey, Professor of Law at the University of Auckland, the nine-country Trans-Pacific Partnership Agreement (TPPA) currently being negotiated between Australia, Brunei, Chile, Malaysia, New Zealand, Peru, Singapore, United States and Vietnam, with Canada, Japan and Mexico in the wings, aims to set a ‘gold standard’ for removing barriers to the global alcohol and tobacco industries and give them greater leverage over domestic policy decisions. The goal is to produce a state-of-the-art agreement that other states in the Asia Pacific Economic Cooperation (APEC) grouping will adopt, culminating in a Free Trade Area of the Asia Pacific.

The draft TPPA text is secret, aside from chapters and background documents that have been leaked. Despite the secrecy, Kelsey says it is clear that the cumulative effect of its substantive rules and procedural requirements would shift the balance of policy-making power firmly in favour of transnational corporate interests. By ensuring that domestic alcohol and tobacco policy and regulation pose minimal impediments to global strategies, and that industry has a role in writing them, the draft TPPA threatens progressive public health policies. At its core, the TPPA threatens sovereignty and democratic governance. The problem is with the agreement itself.

TPPA negotiations are not going forward unopposed. The American Medical Association has already called for the exclusion of measures affecting the supply, distribution, sale, advertising, promotion or investment in tobacco products and alcoholic beverages from trade agreements. Tobacco control advocates are well advanced in their campaign, bringing pressure at the national level and at the stakeholder programmes held on the margins of the formal TPPA negotiating rounds.

In Australia, The Public Health Association of Australia (PHAA) is working with other health, medical and fair trade organisations to lobby the Australian government to ensure that it refuses investor-state dispute settlement provisions applying to Australia and that it insists that public health and access to medicines are not compromised in the developing country parties to the agreement. The PHAA has also organised discussions between public health experts and Australia\'s trade negotiators, written to politicians, issued press releases, and organised several public events to raise awareness in the public health community about the risks to health associated with the TPPA, including during the negotiations in Melbourne.

But Kelsey asserts that there is danger in focusing on issue silos. Beyond alcohol and tobacco are other public health concerns, such as Pharmaceutical Benefits Schemes, and beyond public health is a multitude of other negative impacts, from mining and sustainable livelihoods to indigenous rights and culture. These trade agreements represent a major public health challenge which requires action from people interested in reducing the harm from addiction and substance use around the world.

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For editors:

More information is available from the following editorial: Kelsey J. Implications of the Proposed Trans-Pacific Partnership Agreement for alcohol and tobacco policies. Addiction, 107: doi: 10.1111/j.1360-0443.2012.03874.x

For a full text copy of this editorial, please contact Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact the author of this editorial, Professor Jane Kelsey, by email: j.kelsey@auckland.ac.nz

Recovery Housing and Treatment Programs Reduce Relapse among Recovering Opioid Addicts

Tue, 28 Feb 2012 00:00:00 +0000

Opioid-dependent individuals who want to kick the habit typically begin the road to recovery with detoxification. But detox is ineffective as a stand-alone treatment, with relapse rates ranging from 65% to 80% just one month after discharge. New research published online today in the journal Addiction reveals that individuals with substance use disorders may be as much as ten times more likely to stay abstinent when they have access to drug-free recovery housing and day-treatment programs following detox.

Opioid abuse, which includes the use of illegal substances such as heroin and the nonmedical use of prescription painkillers like OxyContin, Percocet, and Vicodin, has reached epidemic levels in the United States. According to a November 2011 press release from the Centers for Disease Control and Prevention (CDC), the death toll in the US from overdoses of prescription painkillers has more than tripled in the past decade, with more than 40 people dying each day. In 2010, 12 million people in the US reported using prescription painkillers for nonmedical use, according to the CDC’s National Survey on Drug Use and Health.

To find out if opioid-dependent individuals achieve higher abstinence rates given access to recovery housing and day treatment, researchers from Johns Hopkins University School of Medicine followed 243 patients -- primarily heroin users -- after their release from detox. Eighty-three patients received 12 weeks of rent-free recovery housing and were required to remain drug-free during their residency. Eighty more patients received 12 weeks of recovery housing plus 26 weeks of outpatient treatment, including cognitive behavioral group therapy, recreational activities, vocational assistance, and individual counseling. The final eighty patients received referrals for aftercare treatment at other community programs. The researchers assessed all participants at one, three, and six months after detox to see how many had remained abstinent.

The overall abstinence rate for participants given no housing or treatment was a disappointing 13%, but patients who received housing showed a 37% abstinence rate, and among the group that received housing plus day treatment, 50% were abstinent. At each of the three assessment points, participants receiving housing plus treatment were twice as likely to remain abstinent than those receiving housing only, and ten times more likely to remain abstinent than those receiving no housing or treatment at all.

In general, the best outcomes came from participants who stayed in recovery housing the longest, and access to day treatment tended to promote longer residencies: an average of 49.5 days versus 32.2 days for housing residents who received no day treatment.

Says lead researcher Michelle Tuten: “It’s no surprise that opioid-dependent individuals stay off drugs longer when they live in a structured, drug-free environment after finishing detox. Drug-dependent individuals frequently report housing as their most pressing need. If we want to help people stay off heroin and stop abusing prescription painkillers, we need to do more than help them initiate abstinence; we need to help them maintain abstinence and build a drug-free life style as well. Improved access to drug-free recovery housing and day-treatment programs would clearly move us closer to that goal.”

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For editors:

Tuten M., DeFulio A., Jones H.E., and Stitzer M. Abstinence-contingent recovery housing and reinforcement-based treatment following opioid detoxification. Addiction, 107: doi:10.1111/j.1360-0443.2011.03750.x

For a full text copy of this article, please contact Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0853.

Media seeking interviews may contact Stephanie Desmon, Senior Media Relations Representative, Johns Hopkins Medicine via telephone (+44 1-410-955-8665) or email (sdesmon1@jhmi.edu).

The CDC press release referred to in paragraph two, “Prescription painkiller overdoses at epidemic levels kill more Americans than heroin and cocaine combined,” can be found at http://www.cdc.gov/media/releases/2011/p1101_flu_pain_killer_overdose.html (accessed 5 January 2012).

Addiction (www.addictionjournal.org) is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2010 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition). Membership to the Society for the Study of Addiction (http://www.addiction-ssa.org/) is £85 and includes an annual subscription to Addiction.