People choose healthier food when with outsiders for fear of being negatively judged

As warnings come about cutting sugar consumption, new experiments find food choices differ depending on observers’ social groups

Peer-Reviewed Publication

CITY UNIVERSITY LONDON

People are more likely to choose a healthy food option than an unhealthy food option among people from different social groups because they fear being judged negatively for their choices.

New research, co-authored by Bayes Business School, found that that the presence of individuals from different friendship or social groups played a role in influencing consumers’ food choices.

The study, which explored food choices with those of a different race and from a different university, explains this occurs because individuals anticipate more negative judgement from outsiders. The research, which spoke to around 1,000 individuals in total, shows that people often self-categorise in terms of their race, university affiliation, and work affiliation.

Experiments with several hundred adults in a large US city and university found participants were more likely to choose a healthy snack in the presence of an observer of a different race (as opposed to the same race) or one affiliated with a different university (as opposed to their own university). This was because they anticipated more negative judgment from an outsider group, and they therefore attempted to mitigate these judgments by making healthier food choices.

Four separate experiments supported the authors’ view that the presence of a stranger from a different social group (compared to a stranger from one’s own group – such as their own university) impacted the participants’ food choice.

In one experiment, 180 students were offered the choice between indulgent M&Ms and healthier raisins as a snack. When in the presence of an unknown fellow student from one’s own university, only 12 per cent of students selected the healthier raisins. However, this number more than doubled to 31 per cent when in the presence of an unknown student from another university.

The other experiments showed that the reason for this pattern is that people feel judged to a larger extent by outgroup members, and they strategically use healthy food choices to make a positive impression to counter this negative judgement. For example, 200 consumers were told that others around them were judgemental or were tolerant. In the judgemental environment, consumers were more likely to choose carrots over cookies than in the tolerant environment, which indicates that expected judgement from others explains the findings.

Last month the Action on Sugar and Obesity Health Alliance called on the UK Government to act against the difference in sugar content and portion size of popular snacks. Despite many attempts to help consumers make healthier choices, consumers often struggle to maintain a healthy diet. This research finds that one way to promote a healthy diet could be to advertise the social benefits of healthy choices.

Dr Janina Steinmetz, Associate Professor (Reader) of Marketing at Bayes, said the findings have practical implications for marketers of healthy foods and policy makers hoping to promote healthy eating.

“We know that food plays an important role in social life and consumers often make inferences about others’ traits and characteristics based on their food choices.

“Our research shows that we can use this important role of food for consumer welfare if we highlight that healthy food is not only good for consumers, but also helps them to impress others. These findings could be very significant to those hoping to improve healthy eating practices in the UK because they open a new avenue to promote the benefits of healthy eating: It’s good for you and your health, and it’s also good for making a positive impression.”

Feeling Judged? How the Presence of Outgroup Members Promotes Healthier Food Choices, by Dr Janina Steinmetz, Reader of Marketing at Bayes Business School; Maferima Toure-Tillery, Associate Professor of Marketing at Northwestern University, USA; and Blake Dicosola, PhD student at the University of Oxford is published in Psychology & Marketing.

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JOURNAL

Psychology and Marketing

Study finds realism a key factor in driving engagement with virtual reality videos

Peer-Reviewed Publication

NORTH CAROLINA STATE UNIVERSITY

A recent study finds that realism is a key factor in determining whether viewers engage with virtual reality (VR) videos – and that engagement is itself a key factor in determining whether viewers are interested in watching VR videos in the future.

The researchers focused on VR videos that offer a 360-degree view of a given scene that viewers can navigate on conventional video screens; VR headsets were not required.

For the study, researchers surveyed 1,422 study participants located in the United States, all of whom had previous experience with virtual reality videos. Participants were asked a series of questions designed to explore both which factors drew them to VR videos and what elements of the videos increased viewer engagement.

“We found there were two aspects of virtual reality videos that were the most powerful predictors of whether viewers enjoyed VR videos and engaged with their content,” says Yang Cheng, first author of the study and an associate professor of communication at North Carolina State University. “Specifically, we found that realism and enjoyment were the key variables here. Another variable that contributed to user engagement was whether the VR videos were part of an interactive platform that allowed users to establish a sense of community.

“Our study is the first to identify that realism in these videos is a key variable in driving viewer engagement,” Cheng says. “And the more engaged viewers were, the more likely they were to want to view additional VR videos in the future.”

The researchers note that their findings can be used by video developers to improve user engagement and encourage continued use of immersive videos.

The paper, “Shared Virtual Reality Experiences during the COVID-19 Pandemic: Exploring the Gratifications and Effects of Engagement with Immersive Videos,” is open access and appears in the International Journal of Environmental Research and Public Health. The paper was co-authored by Yuan Wang of the City University of Hong Kong and by Wen Zhao of Fairfield University.

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JOURNAL

International Journal of Environmental Research and Public Health

DOI

10.3390/ijerph19095056 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Shared Virtual Reality Experiences during the COVID-19 Pan-demic: Exploring the Gratifications and Effects of Engagement with Immersive Videos

Video games can help boost children’s intelligence

Peer-Reviewed Publication

KAROLINSKA INSTITUTET

Researchers at Karolinska Institutet in Sweden have studied how the screen habits of US children correlates with how their cognitive abilities develop over time. They found that the children who spent an above-average time playing video games increased their intelligence more than the average, while TV watching or social media had neither a positive nor a negative effect. The results are published in the journal Scientific Reports.

Children are spending more and more time in front of screens. How this affects their health and whether it has a positive or negative impact on their cognitive abilities are hotly debated. For this present study, researchers at Karolinska Institutet and Vrije Universiteit Amsterdam specifically studied the link between screen habits and intelligence over time.

Over 9,000 boys and girls in the USA participated in the study. At the age of nine or ten, the children performed a battery of psychological tests to gauge their general cognitive abilities (intelligence). The children and their parents were also asked about how much time the children spent watching TV and videos, playing video games and engaging with social media.

Followed up after two years

Just over 5,000 of the children were followed up after two years, at which point they were asked to repeat the psychological tests. This enabled the researchers to study how the children’s performance on the tests varied from the one testing session to the other, and to control for individual differences in the first test. They also controlled for genetic differences that could affect intelligence and differences that could be related to the parents’ educational background and income.

On average, the children spent 2.5 hours a day watching TV, half an hour on social media and 1 hour playing video games. The results showed that those who played more games than the average increased their intelligence between the two measurements by approximately 2.5 IQ points more than the average. No significant effect was observed, positive or negative, of TV-watching or social media.

“We didn’t examine the effects of screen behaviour on physical activity, sleep, wellbeing or school performance, so we can’t say anything about that,” says Torkel Klingberg, professor of cognitive neuroscience at the Department of Neuroscience, Karolinska Institutet. “But our results support the claim that screen time generally doesn’t impair children’s cognitive abilities, and that playing video games can actually help boost intelligence. This is consistent with several experimental studies of video-game playing.”

Intelligence is not constant

The results are also in line with recent research showing that intelligence is not a constant, but a quality that is influenced by environmental factors.

“We’ll now be studying the effects of other environmental factors and how the cognitive effects relate to childhood brain development,” says Torkel Klingberg.

One limitation of the study is that it only covered US children and did not differentiate between different types of video games, which makes the results difficult to transfer to children in other countries with other gaming habits. There was also a risk of reporting error since screen time and habits were self-rated.

The study was financed by the Swedish Research Council and the Strategic Research Area Neuroscience (StratNeuro) at Karolinska Institutet. The researchers report no conflicts of interest.

Publication: “The impact of digital media on children’s intelligence while controlling for genetic differences in cognition and socioeconomic background”. Bruno Sauce, Magnus Liebherr, Nicholas Judd, Torkel Klingberg. Scientific Reports, online 11 May 2022, doi: 10.1038/s41598-022-11341-2.

More reading:
"The problem with screen time" on ki.se
"Video games: our study suggests they boost intelligence inchildren" on theconversation.com

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JOURNAL

Scientific Reports

DOI

10.1038/s41598-022-11341-2 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The impact of digital media on children’s intelligence while controlling for genetic differences in cognition and socioeconomic background

Children with autism exhibit typical joint attention during toy play with a parent

Peer-Reviewed Publication

CELL PRESS

For decades, autism research has relied on data collected during lab tasks or interviews with clinicians that are more constrained than the child’s day-to-day interactions with others. A study published in the journal Current Biology on May 12 challenges the status quo by observing toddlers in more natural play settings. By using a head-mounted camera to track kids’ eye movements as they played with toys, scientists observed that children with autism achieved joint attention—measured by time spent looking at the same toy at the same time as their parent—at typical levels.

To understand how children interact with social partners in more comfortable and natural settings, Julia Yurkovic-Harding, an autism researcher at Indiana University, was among the first to use a dual head-mounted eye-tracking method with children with autism to study social interactions between the children and their parents. “The head-mounted eye tracking allows us to get precision in measuring their visual attention and manual action but allows us to let the children play more naturally,” says Yurkovic-Harding (@YurkovicHarding), the co-first author on the study.  

Children who fall on the autism spectrum often have difficulty following a social partner’s eyes. This behavior, called gaze following, is a key part of how autism researchers tend to define joint attention. However, researchers who use head-mounted eye tracking to study the development of typically developing children recently found that children don’t look at their parents’ faces very often when they’re playing with toys together. This means that gaze following might not be an available cue for achieving joint attention in some more natural settings. Instead, typically developing children follow their parent’s hands, which are often touching or holding toys, as a way to know what their parent is looking at.

An assessment of data gathered during play sessions with a group of 50 kids aged 2 to 4 found that autistic children maintained joint attention at levels consistent with their neurotypical peers. These results were exciting to Yurkovic-Harding. “Every time that you find something that's typical and intact in children with autism, there's this opportunity to explore,” she says. Additionally, the children with autism also used hand-following rather than gaze-following cues to follow their parent’s attention into joint attention.

Experiences where a child focuses on an activity, like playing with a toy truck or building with blocks, together with a parent are thought to support language development. The current study found that parents of children with autism spectrum disorder named toys more frequently when they were in joint attention together compared to when they weren’t looking at the same toy. Yurkovic-Harding and her team hope that by identifying times when kids with autism are able to play in more typical ways, adults can encourage autistic children to do more of these activities and allow for more chances for learning.

“We need to push to understand the everyday lives of individuals with autism, the social pressures that they face day to day, and the social context that they interact in so we can help them exist in the social world that's all around us in a way that is comfortable and confident for them,” she says.

###

This work was supported by funding from the Cincinnati Children’s Hospital Research Foundation and National Institutes of Health.

Current Biology, Yurkovic-Harding et al. “Children with ASD Establish Joint Attention during Free-Flowing Toy Play without Face Looks,” https://www.cell.com/current-biology/fulltext/S0960-9822(22)00662-5   

Current Biology (@CurrentBiology), published by Cell Press, is a bimonthly journal that features papers across all areas of biology. Current Biology strives to foster communication across fields of biology, both by publishing important findings of general interest and through highly accessible front matter for non-specialists. Visit: http://www.cell.com/current-biology. To receive Cell Press media alerts, contact press@cell.com.

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JOURNAL

Current Biology

DOI

10.1016/j.cub.2022.04.044 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Children with ASD Establish Joint Attention during Free-Flowing Toy Play without Face Looks

Perspectives on racism in health care among Black veterans with chronic kidney disease

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this qualitative study of 36 Black veterans with chronic kidney disease, participants described feeling angry and resentful and experiencing stress as a result of encounters with racism. Some veterans also expressed a strong sense of distrust in the health care system coupled with a need to be hypervigilant during clinical encounters.

Authors: Shimrit Keddem, Ph.D., of the Corporal Michael J. Crescenz Veterans Affairs Medical Center in Philadelphia, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2022.11900)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2022.11900?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=051222

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

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JOURNAL

JAMA Network Open

Poll shows impact of menopause and other health issues on older women’s sex lives

Less than half of those experiencing menopause-related symptoms have talked to their health care provider about treatment, National Poll on Healthy Aging shows

Reports and Proceedings

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

 

IMAGE: KEY FINDINGS ABOUT SEXUAL HEALTH AND MENOPAUSE IN WOMEN AGES 50 TO 80, FROM THE NATIONAL POLL ON HEALTHY AGING view more 

CREDIT: UNIVERSITY OF MICHIGAN

Despite stereotypes to the contrary, many older women have active sex lives into their 70s, a new poll shows. But health concerns, including menopause symptoms, often get in the way of intimacy, according to the new results from the University of Michigan National Poll on Healthy Aging.

 

Even so, only 44% of women with menopause symptoms have discussed treatment with their health care provider. Among those who did receive treatment, 88% felt their symptoms were managed somewhat or very well.

 

Meanwhile, women over 50 who have other health issues, or who say their mental or physical health are fair or poor self-reported , were more likely to report less satisfaction with their sex lives. And 1 in 4 women over 50 said their partner’s health interfered with their own ability to be sexually active.

 

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, the University of Michigan’s academic medical center.

 

Daniel Morgan, M.D., a professor of obstetrics and gynecology at Michigan Medicine who studies and works to improve the quality of OB/Gyn care, worked with the poll team on the report.

 

“Women over 50 who experience menopause symptoms or other health concerns that interfere with sexual activity should absolutely speak up to their health care providers and find out what their options might be,” said Morgan. “Often women and their partners overlook the intertwined nature of physical and mental health, and sexual health and the ways menopause-related symptoms can have an impact on sexual activity. It’s important to understand what your treatment options are, and which ones might be appropriate for your needs and goals.”

 

Menopause symptoms affected 84% of the women in the past year, with 35% saying that they’d experienced four or more symptoms from a list of 8 symptoms. Sleep problems (56%) and weight gain or slow metabolism (55%) were the most common, followed closely by reduced sexual drive (48%).  Hot flashes and night sweats affected 41%, mood swings and irritability were reported by 38%, urinary tract infections by 16%, and smaller percentages reported other symptoms.

As expected, women between the ages of 50 and 64 were more likely to report menopause symptoms than those age 65 to 80, but 78% of the older group said they still experienced at least one symptom.

 

The effect of menopause symptoms on sexual health and other aspects of life isn’t often discussed, said poll director Preeti Malani, M.D., a Michigan Medicine infectious disease physician also trained in geriatrics.

 

“In all, 28% of women over 50 told us that their menopause symptoms interfere with their ability to be sexually active, and there was not a major difference between the two age groups,” she said. “Meanwhile, other types of health problems interfered with the sex lives of 17% of these women. Women reporting menopause symptoms or health problems were  less likely than other women to say their satisfied with their level of sexual activity.”

 

Sexual activity and satisfaction

 

The poll finds that 43% of women over 50 say they’ve been sexually active in the past year, using the poll’s definition of caressing, foreplay, masturbation, or intercourse. The percentages were higher among those aged 50 to 64 compared with those aged 65 to 80 (53% vs. 30%) and those who are married or have a partner compared with those who do not (58% vs. 26%).

 

The poll also shows that 52% of older women who are not sexually active said they’re satisfied with their sexual activity, compared with 74% of those who are sexually active. Among those who aren’t sexually active despite having a partner, 50% said they were satisfied with the level of intimacy in their relationship.

 

Just over a third (35%) of women who said their mental health was fair or poor said they were satisfied with their sexual activity, compared with 65% of those reporting better mental health.

 

“We’ve found in previous AARP research that women don’t know as much as they should about the conditions leading up to menopause and healthcare providers are not proactive in initiating the conversation about this life transition,” said Teresa A. Keenan, Ph.D., Director of Health Security Research, AARP Research.  “As this new report notes, it’s important for women to feel empowered to take control of their own health and to initiate discussions with their health care provider, including discussions around sex and intimacy, to contemplate potential treatment options. With many years of post-menopausal life ahead, their concerns are too important to ignore.”

 

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI, and administered online and via phone in January and February 2022 among 1,206 women age 50–80. The sample was subsequently weighted to reflect the U.S. population. Read past National Poll on Healthy Aging reports and about the poll methodology. 

 

Women’s Health: Sex, Intimacy, and Menopause. University of Michigan National Poll on Healthy Aging. May/June 2022. Available at: https://dx.doi.org/10.7302/4451

 

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DOI

10.7302/4451 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

Uneven distribution of emergency physician residency programs can impact workforce challenges, new analysis finds

Peer-Reviewed Publication

AMERICAN COLLEGE OF EMERGENCY PHYSICIANS

WASHINGTON, D.C.—A new analysis of the emergency physician resident workforce in Annals of Emergency Medicine finds that while the number of residency programs is increasing, new residency programs are disproportionately located in urban areas in states with existing programs, rather than rural communities with limited access to emergency care.

“Predictions of an oversupply of emergency physicians in the next decade may not apply to every part of the country,” said Christopher L. Bennett, MD, MA, assistant professor of emergency medicine at Stanford University School of Medicine and lead study author. “Regional differences over time need to be considered in any discussions of workforce challenges—these findings underscore the likelihood that rural emergency physician shortages will persist.”

A small number of states with an already high number of residency programs gained the most programs between 2013 and 2020, according to the study. At the same time, there is an emergency physician “desert” in the rural United States characterized by a lack of residents and residency training programs.

The six states with the largest increase in residency programs were Florida (increased from five to 19), Michigan (increased from 11 to 25), New York (21 to 31), Ohio (nine to 18), Pennsylvania (12 to 21), and California (14 to 22). Twenty states did not gain a program and some states do not have any emergency medicine residency programs, including Idaho, Montana, North Dakota, South Dakota, and Wyoming.

The number of emergency medicine residencies expanded from 160 to 265 between 2013 and 2020, according to Accreditation Council for Graduate Medical Education (ACGME) data analyzed. The study also notes that of 6,993 emergency medicine residents in the 2020 American Medical Association data set, 98% were in urban areas.

This analysis of residencies is consistent with a 2020 study by the same authors that found most emergency physicians (92%) were in urban areas and that clinically active emergency physicians in rural communities skewed older and closer to retirement than their urban area peers.

Urban residency programs that can expand opportunities for rural training rotations may be able to help solve aspects of the projected workforce challenges, the authors note.

“Emergency physicians tend to practice where they train,” said Dr. Bennett. “As newer physicians seek footing in a challenging job market, exposing residents to rural emergency medicine can open doors to rewarding career paths while addressing the critical need to improve access to emergency services in these communities.”

### 

Annals of Emergency Medicine is one of the peer-reviewed scientific journals for the American College of Emergency Physicians (ACEP), the national medical society representing emergency medicine. Annals of Emergency Medicine is the largest and most frequently cited circulation peer-reviewed journal in emergency medicine and publishes original research, clinical reports, opinion, and educational information related to the practice, teaching, and research of emergency medicine.

Contact: Steve Arnoff | sarnoff@acep.org | Twitter: @emergencydocs 

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JOURNAL

Annals of Emergency Medicine

DOI

10.1016/j.annemergmed.2022.03.007 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

United States 2020 Emergency Medicine Resident Workforce Analysis

New study finds global adolescent vaping is low

Peer-Reviewed Publication

SOCIETY FOR THE STUDY OF ADDICTION

A new study published today in the scientific journal Addiction has found that approximately 8.6% of adolescents reported using e-cigarettes (vaping) in the past 30 days, but only 1.7% engaged in frequent vaping. This suggests most adolescents who vape are experimenting but not making it a habit.

Researchers from the University of Queensland (Australia) wanted to estimate as far as possible the global prevalence of adolescent vaping.  The researchers analysed data from 151,960 adolescents in 47 countries who participated in the World Health Organization’s (WHO’s) Global Youth Tobacco Survey between 2015 and 2018.  The overall weighted prevalence of adolescent vaping and frequent vaping in the past 30 days was 8.6% and 1.7% respectively.

Lead author Dr. Gary Chan says “There are two likely explanations for the low levels of frequent vaping among young people.  First, e-cigarettes are relatively new and are often sold in colourful packages with highly palatable flavours that could appeal to adolescents, thus leading to experimentation but not continued use. Second, while some e-cigarettes contain high levels of nicotine, adolescents can also vape non-nicotine or low nicotine e-cigarettes and avoid becoming addicted. Future WHO surveys should ask participants to disclose whether nicotine is in the vaping liquids they use.”

The researchers also wanted to test the association between the implementation of World Health Organization (WHO) tobacco control policies and adolescent vaping.  In 2008, WHO introduced the MPOWER policy package, with six policies to reduce tobacco use: monitoring, smoke-free environments, cessation programs, health warnings, advertising bans, and taxation.  Implementation of these policies has reduced tobacco use; however, it is unclear if these policies have had any impact on youth uptake of e-cigarettes.

Using data from the 44 countries where implementation data were available, the researchers found inconclusive evidence that implementation of five of the MPOWER policies was associated with lower adolescent vaping.  Implementation of the sixth policy – higher taxes on tobacco products – was curiously associated with more adolescent vaping. This suggests that some adolescents in countries with a higher tobacco tax may be substituting cigarettes with e-cigarettes.

-- Ends –

For editors:

This paper is free to read for one month after the embargo lifts from the Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1111/add.15892 or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org.

To speak with lead author Dr Gary Chan, please contact him at the The University of Queensland by telephone (+61 7 344 32533) or email (c.chan4@uq.edu.au).

Full citation for article: Chan GCK, Gartner C, Lim C, Sun T, Hall W, Connor J, Stjepanović D, and Leung J (2022) Association between the implementation of tobacco control policies and adolescent vaping in 44 lower-middle, upper-middle, and high-income countries. Addiction: doi: 10.1111/add.15892

Funding: GCKC was funded by a National Health and Medical Research Council (NHMRC) Investigator Grant (GNT1176137). CG was funded by NHMRC Centre of Research Excellence Grant. CL was funded by National Health and Medical Research Council Postgraduate Scholarship (GNT2005317). TS, WH and JC were funded by Department of Health, Australia. The funders have no role in any stage of this study.

Declaration of interests:  The authors declare no competing interest.

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, 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.

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JOURNAL

Addiction

DOI

10.1111/add.15892 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Association between the implementation of tobacco control policies and adolescent vaping in 44 lower-middle, upper-middle, and high-income countries

ARTICLE PUBLICATION DATE

12-May-2022

COI STATEMENT

The authors declare no competing interest.

Smokers who switch to e-cigarettes may adopt other healthy routines

Peer-Reviewed Publication

UNIVERSITY OF WASHINGTON

Adult smokers who shift to using to e-cigarettes may have more chances to improve health and well-being, according to new research from the University of Washington.

The study monitored changes in health and social functioning among smokers at two stages in adulthood, age 30 and again at 39. Approximately one-third of smokers shifted to vaping some or all the time by age 39. This group reported better physical health, exercised more and had more active social engagement, the study found.

“Despite the obvious risks to nonsmokers, e-cigarettes have the potential to play a health-promoting role in the lives of smokers,” said study co-author Marina Epstein, a research scientist with the Social Development Research Group in the UW School of Social Work.

The study, which recently published in Drug and Alcohol Dependence, drew from a larger longitudinal study, the Seattle Social Development Project, which in 1985 began following some 800 children as fifth-graders in Seattle elementary schools. The sample for the current study focused on 156 of those participants who reported smoking at age 30 and smoking or vaping at age 39.

E-cigarettes first appeared in the United States in the mid-2000s, right around the time the participants in the study sample turned 30. By 2018, 10% of adult smokers nationally also used e-cigarettes. Vaping is especially popular among teens and young adults; the Centers for Disease Control and Prevention identifies e-cigarettes as the most popular tobacco product among young people in the U.S., estimating that nearly 21% of youth use e-cigarettes. Previous research, from the UW and others, found that adolescent and young adult vaping can lead to later cigarette use. "In this way, e-cigarettes have been a public health disaster," said study lead author Rick Kosterman, a research scientist with the Social Development Research Group.

At the same time, while vaping carries certain risks — the aerosol contains nicotine, small amounts of heavy metals and other ultrafine and cancer-causing particles that can enter the lungs — the CDC considers them safer than traditional, or combustible, cigarettes.

Given the common perception of e-cigarettes as a “healthier” alternative, the researchers wanted to examine behavior among smokers who switch to e-cigarettes some or all the time as they approach midlife. The research team collected a series of accepted measures of healthy aging and well-being, such as overall physical and mental health, engaging in healthy behaviors and social activities, and education and income levels. They then surveyed participants, at ages 30 and 39, about this information and how often they engaged in certain activities.

Of the 156 study participants, 64% smoked only combustible cigarettes at age 39; 28% smoked and vaped; and 8% only vaped. Results from the surveys showed that more frequent vaping — relative to smoking — was associated with better physical health, more exercise, more active social engagement and higher socioeconomic status.

“Although the study cannot show a causal relationship, we think that because e-cigarettes have less stigma, less odor and are less physically harmful, they may increase health-promoting opportunities among smokers. E-cigarette users may be more likely to be in settings that promote physical activity and have more opportunities to interact with nonsmokers,” said Kosterman.

No association was found between switching to vaping and better mental health, less-frequent use of other substances such as alcohol, or whether one's partner or closest peers smoke (though vapers' broader social environment may be healthier).

Overall, the researchers stress that e-cigarettes still have substantial public health downsides, but this study shows that smokers who turn to vaping, whether occasionally or instead of cigarettes, may have more opportunities for healthier lifestyle choices. That doesn’t mean vaping is healthy, they say, but that for people who already smoke — and are unable to quit — it can be associated with other healthy routines.

The study was funded by the National Cancer Institute, the National Institute on Aging and the National Institute on Drug Abuse.

Co-authors were Jennifer Bailey and J. David Hawkins of the Social Development Research Group.

 

For more information, contact Kosterman at rickk@uw.edu or Epstein at marinae@uw.edu.

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JOURNAL

Drug and Alcohol Dependence

DOI

10.1016/j.drugalcdep.2022.109395 

Hundreds of patient data breaches are left unpunished, reveals The BMJ

Private companies and universities among those that may be failing to protect patient confidentiality. A major policy shift and investment is needed, say experts

Peer-Reviewed Publication

BMJ

Hundreds of organisations including drug companies, NHS commissioners, and universities have breached patient data sharing agreements in the past seven years, reveals an investigation by The BMJ today.

GlaxoSmithKline (GSK) and Imperial College London are among those that have carried out “high risk” breaches according to NHS Digital audits examined by investigative reporter Esther Oxford. This means that they are handling information outside of agreed data contracts and may be failing to protect confidentiality.

In one instance of a high risk breach, clinical care commissioners allowed sensitive, identifiable patient data to be released to Virgin Care without permission from NHS Digital. When NHS Digital’s audit team tried to get access to Virgin Care to check their compliance, it was denied access for several weeks and the company refused to delete the patient data.

“It is outrageous that private companies and university research teams are failing to comply,” says Kingsley Manning, former chair of NHS Digital. “How is it that these organisations can be so lax with data?”

Yet Oxford explains that none of the organisations have had their access to NHS Digital’s data curtailed in light of the breaches. Instead, NHS Digital said it works with the organisations to rectify problems.

NHS Digital has the power to suspend the provision of data but any decision to curtail access to data would “need to be balanced against any negative impact to patient care”, a spokesperson said. Clinical Commissioning Groups (CCGs) would be unable to commission services if they had to return data, and ceasing access to data for clinical trials would mean their benefits would not be achieved, they added.

Phil Booth, coordinator of campaigning group medConfidential, says there needs to be real consequences if companies, commissioners, and research teams breach their agreements, otherwise data sharing contracts are meaningless. “These contractual requirements aren’t just for fun: a single data breach could include sensitive information about millions of patients,” he said. 

Natalie Banner, former lead for the Understanding Patient Data initiative hosted by Wellcome agrees that the current system “is failing to protect data adequately and a major policy shift and investment is needed.”

Oxford explains that NHS Digital also has the power to report an organisation to the Information Commissioner’s Office (ICO) if there has been a personal data breach.

But the ICO said it could not tell The BMJ if NHS Digital had ever reported a pharmaceutical company, university, or organisation for breaching a data sharing agreement, and there are no examples of enforcement action against these entities published on the ICO website.

NHS Digital has plans to provide a more secure system - known as a trusted research environment (TRE) - for organisations wanting to access health and social care data, notes Oxford. But there are fears about how TREs will work if taken up by the NHS, including how they will be made accountable and transparent.

Many are also worried about the government’s plan to abolish NHS Digital and allow NHS England to take on its powers and responsibilities.

“The move is alarming,” says Philip Hunt, member of the House of Lords. “NHS England has so many roles and motivations it is never going to be able to protect patient information in the way an independent body with specific responsibilities to do so would.”

A spokesperson from the Department of Health and Social Care said, “The obligations that NHS Digital currently has to safeguard patient data will become those of NHS England. This will include the same level of transparency as to how data are disseminated and used.”

It will take time to decide on the correct policy and to arrange the new data infrastructure, says Banner. “What’s being done about NHS Digital’s audits and those failures in the meantime?”

[Ends]

 

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JOURNAL

The BMJ

DOI

10.1136/bmj.o1126 

METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Investigation: Hundreds of patient data breaches are left unpunished

ARTICLE PUBLICATION DATE

11-May-2022