Smoking and mental health - NCSCT

More documents

Recommendations

Info

Smoking and mental health Smoke-free legislation has, throughout the UK, proved to be popular, to achieve high levels of compliance, to improve air quality and reduce passive smoke exposure, and to have a positive impact on health outcomes. 2–7 The legislation also stimulated quit attempts, 8 although the longer-term impact on wider smoking prevalence, if any, appears to have been modest. 9 The legislation also appears to have changed smoking behaviour, resulting in reductions in passive exposure in the home, 6 although tackling passive smoke exposure, particularly of children, in these settings remains a pressing challenge for policy makers. The Royal College of Physicians has previously called for more effective policies to promote smoke-free homes, vehicles and a more extensive range of public places. 6 6.2.2 Mass media campaigns International evidence suggests that mass media campaigns are an effective means of increasing smoking cessation and reducing smoking prevalence, 10–15 although evidence specific to the UK is limited to older studies. 16–19 In recent years the UK government has invested in anti-smoking mass media campaigns highlighting the health risks of smoking, the hazards of passive smoking, the addictive nature of smoking and a range of other health topics, promoting National Health Service (NHS) stop smoking services, and in 2012 the Stoptober mass quit campaign. Media campaigns have also been used by pharmaceutical companies to promote use of nicotine replacement therapy (NRT) to quit smoking, and there is some international evidence that such advertising can have a positive effect on NRT sales. 13,20,21 Data from the UK data indicate, however, that pharmaceutical company advertising has less impact on quit attempts than government-funded campaigns. 22 6.2.3 Health warnings Evidence from the UK and elsewhere demonstrates that health warnings on tobacco products raise awareness of the risks of smoking and support quit attempts. 23,24 Health warnings have been displayed on cigarette packs in the UK since 1971, but the implementation of the EU Tobacco Products Directive in 2002 has required all tobacco products to display a written health warning covering at least 30% of the front of the pack, and an additional warning covering at least 40% of the back of the pack. 25 Graphic pictorial health warnings are more effective than text warnings, however, and these were introduced in the UK in 2008. 26,27 The 2002 Tobacco Products Directive sets out other regulations for labelling cigarette packs and other tobacco products, including the provision of tar, nicotine and carbon monoxide yields, although the validity of the last measures, and their effectiveness in communication with consumers, has been 112 © Royal College of Physicians 2013
Population strategies to prevent smoking in mental disorders 6 widely questioned. These and other labelling regulations are likely to change as a result of a new Tobacco Products Directive now expected in early 2013. 6.2.4 Ending tobacco advertising, promotion and sponsorship Tobacco industry advertising and sponsorship encourages non-smokers, particularly young people, to take up smoking, discourages current smokers from quitting and hence increases tobacco consumption. 28,29 Cigarette advertising on television was prohibited in the UK in 1965, and an EU Directive has prohibited all other UK television tobacco advertising since 1991. 30–33 The Tobacco Advertising and Promotion Act 2002 prohibited most remaining UK tobacco advertising 34 in stages, beginning with press, billboard and direct marketing in 2003, point-of-sale advertising in 2004 and tobacco company sponsorship from 2005, in accordance with the most recent EU Tobacco Advertising Directive (2003/33/EC). 35 Remaining media for tobacco advertising include point-of-sale displays, which have been prohibited in large shops in England from April 2012 and in all other shops from 2015, with similar legislation likely to follow in Wales, Northern Ireland and Scotland. Tobacco imagery continues to be common in the media, however, particularly in films watched by children and young people, 36 and is a strong determinant of smoking uptake, 37,38 which remains unchecked. Tobacco packaging is also a means of promoting tobacco brands and related imagery, and in 2012 the UK government launched a consultation on mandatory standardised packaging for all tobacco products. 6.2.5 Price increases Raising the price of tobacco through tax is probably the most effective means of reducing short-term tobacco consumption, 39 and probably also of reducing smoking-related inequalities in health. 40 Globally, on average, a 10% increase in tobacco price reduces consumption by 4%; 41 in the UK the figure may be as high as 5%. 42 People on low incomes who smoke, and young people who smoke, are particularly responsive to these effects. 41 As a result of successive tax increases, to the extent that tax currently constitutes almost 80% of the sale price of cigarettes, UK cigarette prices are now among the highest in Europe. 39,43 However, these increases have not kept pace with increases in income, and cigarette affordability is now around 50% greater in the UK than in the 1960s. 44 The impact of price rises as a disincentive to smoking is further undermined by the fact that cigarettes are in fact available in many different brands with a range of prices, providing the opportunity to trade down to lower cost brands, the availability of 10 packs of cigarettes, the lower cost of handrolling tobacco and the availability of illicit tobacco. © Royal College of Physicians 2013 113
Page 1 and 2:
PDF not for circulation Smoking and
Page 3 and 4:
Contents Members of the Tobacco Adv
Page 5 and 6:
Contents 4.4.3 Attention deficit hy
Page 7 and 8:
Contents 6.4.3 Staff knowledge 122
Page 9 and 10:
Contents 10.5 Tobacco policy and me
Page 11 and 12:
Contributors Anthony Aclet - Specia
Page 13 and 14:
Contributors Jill Williams - Associ
Page 15 and 16:
1 Mental disorders 1.1 What is a me
Page 17 and 18:
Mental disorders 1 1.3 Common menta
Page 19 and 20:
Mental disorders 1 1.4.4 Somatisati
Page 21 and 22:
Mental disorders 1 In addition to s
Page 23 and 24:
Mental disorders 1 not diagnosed un
Page 25 and 26:
Mental disorders 1 Similar to many
Page 27 and 28:
Mental disorders 1 12 Chang CK, Hay
Page 29 and 30:
Mental disorders 1 52 Young S, Toon
Page 31 and 32:
Smoking among people with mental di
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Neurobiological and behavioural mec
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76: Neurobiological and behavioural mec
Page 77 and 78: Epidemiology of the association bet
Page 99 and 100: Smoking cessation interventions for
Page 125: 6 Population strategies to prevent
Page 129 and 130: Population strategies to prevent sm
Page 145 and 146: Smoking and mental disorders: speci
Page 177 and 178:
Smoking and mental disorders: speci
Page 179 and 180:
The economic cost of smoking in peo
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Ethical and legal aspects 9 pose co
Page 199 and 200:
Ethical and legal aspects 9 less an
Page 201 and 202:
Ethical and legal aspects 9 patient
Page 203 and 204:
10 Summary and conclusions 10.1 Smo
Page 205 and 206:
Summary and conclusions 10 10.4 Smo
Page 207 and 208:
Summary and conclusions 10 although
Page 209 and 210:
11 Key conclusions and recommendati
Page 211 and 212:
Key conclusions and recommendations
Page 213 and 214:
Page 215:
show all

Smoking and mental health - NCSCT

Create successful ePaper yourself

Delete template?

Save as template?