National Representative Survey Research Articles

The effects of exclusive breastfeeding on child health in Chad: evidence from national representative survey data

The effects of exclusive breastfeeding on child health in Chad: evidence from national representative survey data

Microbiological risk assessment of Bacillus cereus in popular hot dishes eaten by plant-based diet consumers in France

There is a current trend towards plant-based diets in Western countries. Since changes in the diet imply possible changes in exposure to foodborne pathogens, there is an increasing need to assess the microbiological risks associated with these diets. This study aims to assess microbiological risks for French adults associated with Bacillus cereus group III and group IV in hot, homemade cereal- and lentil-based dishes. A probabilistic retail-to-fork risk assessment model was developed considering cooking, cooling at ambient temperature, and storage under chilled conditions. Data came from a representative national survey, public database and literature. The model was developed in R, and uncertainty and variability were separated using second-order Monte Carlo simulations. Not all consumers have the same storage and cooling practices, so the results were expressed by probabilistic distributions built by specific storage time. The mean concentration of Bacillus cereus in portions at the time of consumption after 72 h of storage was 1.2 log CFU.g−1 for cereal-based dishes and 3.4 log CFU.g−1 for lentil-based dishes. After 72 h of storage under chilled conditions, the risk per portion, defined as the probability of contamination over 5 log CFU.g−1, was 0 (95 % CI: 0 - 0) for cereal-based dishes and 7.95 × 10−4 (95 % CI: 5.55 × 10−4 - 1.12 × 10−3) for lentils-based dishes. However, if cooling time at room temperature reached 24 h, the risk for cereal- and lentil-based dishes increased to 2.39 × 10−3 (95 % CI: 1.15 × 10−3 - 4.90 × 10−3) and 4.66 × 10−1 (95 % CI: 3.16 × 10−1 - 6.07 × 10−1), respectively. The sensitivity analysis indicated that the initial prevalence and level of contamination were key factors in limiting the risk, ranking before cooling time or refrigeration conditions. Besides, the scenario analysis revealed an influence of consumer behaviour regarding cooling and storage time on the risk per portion. The environmental trend towards plant-forward diets, combined with the emerging no-food waste and batch cooking practices in France, will likely favour new consumption patterns and increase the risk associated with Bacillus cereus. Our model will help quantify this extra burden.

Large and/or single‐parent families: Public attitudes towards pronatalist and anti‐poverty family policies in Hungary

AbstractIn the 2010s, new family benefits were introduced in Hungary, focusing on large families to halt population decline. However, poverty reduction became sidelined, as these schemes benefited higher‐income earners. Based on poverty statistics, the article investigates how two family types associated with a higher risk of poverty—large families and single‐parent families—fare under this new selective pronatalist system. Furthermore, based on new representative national survey data, the article explores public support for the reforms. Although the income poverty rate for large families significantly decreased during the 2010s, it remained persistently high for single‐parent families, especially large single‐parent families. The findings indicate strong public support for state assistance to large, single‐parent and poor families and state pronatalism. However, the public prioritises support for poor, single‐parent families. This underscores a partial mismatch between public attitudes and government policy. Nonetheless, this policy probably secured public legitimacy, chiefly due to the general support for state pronatalism and large families, which were vigorously implemented in family policies, albeit selectively.

Bullying Victimization is Associated with Heightened Rates of Anxiety and Depression Among Autistic and ADHD Youth: National Survey of Children's Health 2016-2020.

Autistic youth and youth with ADHD have heightened rates of bullying victimization, anxiety, and depression. The purpose of this research is to use nationally representative US data to 1) estimate the prevalence of anxiety and depression among bullied neurodivergent youth and 2) investigate whether the association between bullying victimization and anxiety or depression is significantly greater among autistic youth and youth with ADHD. For this research, we used five years of data (2016-2020) from the nationally representative National Survey of Children's Health (NSCH), youth ages 12-17years (n = 71,973). Data were analyzed with R and the R survey package to estimate average marginal percentages, risk differences, and additive interactions as recommended by STROBE guidelines. The study identified heightened anxiety and depression among bullied autistic or ADHD youth. Results also showed that the increase in the rate of anxiety or depression associated with bullying victimization was significantly greater among autistic youth and youth with ADHD relative to non-autistic non-ADHD youth; interactions were significant among both male and female youth. Autistic youth, youth with ADHD, and youth with co-occurring autism and ADHD are particularly vulnerable to bullying victimization and associated depression and anxiety. Future research is needed to understand why the association between bullying victimization and depression/anxiety is significantly greater among autistic and non-autistic ADHD youth. Recommendations include exploring school-wide anti-stigma initiatives to stop the reciprocal bullying-anxiety/depression cycle, routine bullying and mental health screening of autistic and ADHD youth, and clinical management of bullied autistic and ADHD youth with anxiety or depression.

Public attitudes and emotions toward novel carbon removal methods in alternative sociotechnical scenarios

Abstract Despite high expectations about the role of carbon removal in meeting global climate targets, many of the proposed techniques remain nascent. This is especially so for techniques with potential for large-scale, permanent removal of CO2, such as direct air carbon capture and storage (DACCS) and ocean alkalinity enhancement (OAE). In such a context, understanding public attitudes is crucial but challenging, since we do not have enough information about the sociotechnical configurations which might accompany such proposals over future timescales. Carbon removal at scale will not take place in a vacuum—it will co-evolve within political, social, economic, and legal structures which in turn will have a strong influence on public attitudes. This study used a nationally-representative survey (n = 1978) in the UK to test the impact of alternative sociotechnical systems on public attitudes to DACCS and OAE. Participants were randomly assigned to one of five scenario conditions, representing different forms of governance logic (top–down vs bottom–up) and market logic (planned vs liberal economy), plus one with minimal sociotechnical information. We find that the scenario condition significantly impacted perceptions of OAE, with participants preferring its implementation within a bottom–up, planned economy scenario, and rejecting scenarios which most closely resembled the status quo. There were no significant differences between scenarios for DACCS, suggesting that the technology may be more flexible across alternative sociotechnical arrangements. OAE arouses more negative emotions, particularly worry about impacts on ocean ecosystems, whereas DACCS arouses more hope. We found that climate worry is associated with stronger emotions—both positive and negative—toward both techniques, thus carbon dioxide removal (CDR) could be polarising for the most climate-worried, likely due to tensions between climate urgency and concerns about deterring emissions reductions. The most important criteria for future CDR deployment were deemed to be biodiversity, durability, and cost, with a strong discourse around the current cost-of-living crisis.

Do we accurately measure what we consume?

Understanding how consumption patterns affect the environment and shape well-being hinges on the rationale that the data collected on what is consumed, who consumes it, and where it is consumed are indeed accurate. To identify these consumption patterns and recommend corresponding policies, researchers and policy makers often rely on national surveys. Studies have explored the accuracy of individual surveys and the level of agreement across surveys of the same type (e.g. household expenditures), but no studies have compared representative national surveys measuring consumption in different ways. This study compares household consumption measured as expenditures and as material consumption (i.e. physical units) to assess how well we currently measure what we consume. We use multiple rigorous, national surveys to estimate meat consumption, household energy use, and private automobile use in the United States, with consumption profiles parsed by affluence, race/ethnicity, and education. Our results indicate that commonly used surveys may not accurately track important aspects of household consumption. For meat consumption, which included 30 consumption profiles detailing the consumption patterns across different demographic characteristics and meat types (e.g. kilograms beef consumed/capita for Caucasians), there is considerable disagreement between data sources for 20 profiles. By contrast, national surveys accurately measure household energy and transport (disagreement for four profiles). Our findings indicate that national surveys more accurately measure consistently tracked, standardized consumables like electricity than irregularly tracked, variable goods such as food. These results cast doubt on studies that use national surveys to draw conclusions about the how the environmental impacts of food, and, potentially, other goods (e.g. manufactured goods) vary across demographic groups. Overcoming this challenge will necessitate new surveys, updating legacy databases, and harnessing breakthroughs in data science.

Risk perception, efficacies and disaster preparedness: A comparison between people with and without disability

AbstractPersons with disabilities (PwDs) face a disproportionately high risk due to their physical or mental limitations and socioeconomic barriers during emergencies. To better understand and empower PwDs for disaster preparedness, this study used an updated national representative survey (2021 Federal Emergency Management Agency National Household Survey) from the United States to examine the differences between PwDs and their counterparts concerning disaster preparedness with the guidance of the protection motivation theory. The results of the Tobit regression models indicated that being disabled was negatively correlated with the level of preparedness. Furthermore, disability status significantly and negatively modified the relationship between risk perception and disaster preparedness. Likewise, self‐efficacy was less strongly correlated with preparedness activities if people self‐reported themselves as having a disability. Moreover, for people with disabilities, their beliefs about the effectiveness of preventive behaviours (response efficacy) predicted decreased adoption of preparedness measures. Promoting disaster risk reduction education, strengthening self‐efficacy and developing more inclusive and targeted intervention strategies for PwDs can be used to improve their preparedness degree and capacity for disaster prevention.

Impact of Long Working Hours on Mental Health Status in Japan: Evidence from a National Representative Survey.

Using the 2010-2019 Comprehensive Survey of Living Conditions (CSLC) conducted in Japan, we examined the impact of long working hours on mental health in Japan while addressing the endogeneity issue arising from non-random selection bias. We assessed the variations in the effects of long working hours on mental health across different groups. The results show that first, individuals working longer hours (55 h or more per week) exhibited a higher likelihood of developing mental illness than those working regular hours or fewer hours. Second, the negative effect of long working hours on mental health is more pronounced among non-regular workers than among regular workers. Third, the effect of long working hours on mental health varies among different demographic groups, with a greater impact observed among women, managers, non-regular workers, employees in small- or large-sized firms, and those in smaller cities compared to their counterparts. Thus, to enhance worker productivity, the Japanese government should address the issue of long working hours to improve employees' mental well-being. Initiatives aimed at promoting work-life balance, family-friendly policies, and measures to ameliorate working conditions are expected to help mitigate the challenges associated with long working hours and mental health issues, especially among non-regular workers.

A decompositional analysis of social group inequality in India

ABSTRACT Using the national representative Indian household surveys collected by the National Sample Survey Organization, we examine the welfare gaps across social groups for the entire distribution in 1983, 1993–94, 2004–05 and 2011–12. We use spatially adjusted per capita consumption expenditure as the measure of welfare and show that there exists significant welfare gap between Scheduled Tribes/Scheduled Castes (ST/SC) and General Category (GC) households at higher quantiles of the distribution, but the magnitude of the gap has declined over the years for the SC households. Using unconditional quantile regression decomposition, we find that the coefficient effect (unexplained effect) dominates the endowment effect (explained effect) in explaining the gap in all four years. Further decomposition shows that the difference in educational distribution between the SC/ST and GC households drives most of the explained differences between the social groups.

National burden of gambling in Japan: an estimation from an online-based cross-sectional investigation and national epidemiological survey

BackgroundGambling is a popular leisure activity in many countries, often expected to boost regional economies. Nevertheless, its negative impacts remain a significant concern. Gambling disorder is recognized as the most severe consequence; however, even non- or low-risk gamblers may also face negative impacts. This study aimed to estimate the number of Japanese gamblers experiencing gambling-related harm (GRH) and its distribution across six life domains, financial, relational, emotional, health, social and other aspects, based on the severity of their problem gambling risk.MethodsThis cross-sectional study relied on an online survey conducted between August 5 and 11, 2020. Participants aged 20 years and above, who engaged in gambling during 2019 were recruited via a market research company. The survey assessed the prevalence of GRH 72 items among four gambler risk groups (non-problem, low-, moderate-, and high-risk), as categorized by the Problem Gambling Severity Index. The data was adjusted for population weighting using representative national survey data: the 2017 Comprehensive Survey of Living Conditions and the 2017 Epidemiological Survey on Gambling Addictions.ResultsOut of the 28,016 individuals invited to the survey, 6,124 participated in the screening, 3,113 in the main survey, and 3,063 provided valid responses. After adjusting the survey data, it was estimated that 39.0 million (30.8%) of Japan’s 126.8 million citizens gambled in 2019. Among them, 4.44 million (11.4%) experienced financial harm, 2.70 million (6.9%) health harm, 2.54 million (6.5%) emotional harm, 1.31 million (3.4%) work/study harm, 1.28 million (3.3%) relationship harm, and 0.46 million (1.2%) other harm. Although high-risk gamblers experienced severe harm at the individual level, over 60% of gamblers who experienced GRHs were non- and low-risk gamblers, with the exception of other harm, at the population level.ConclusionsThe study highlighted the prevention paradox of gambling in Japan. While national gambling policies primarily focus on the prevention and intervention for high-risk gamblers, a more effective approach would involve minimizing GRH across the entire population.

LOCAL WELLBEING INDEX: THEORETIC MODEL AND RESEARCH METHODOLOGY VALIDATION

The article contains a description of the development process of Local Wellbeing Index (LWBI) by the Rating Lab research laboratory for urban and rural settlements. The first part of the text is dedicated to building a theoretical model based on publications from sociological and psychological fields, which studied one’s wellbeing in settlements The models and studies of urban research, psychological and emotional parameters of wellbeing of residents of settlements, sustainability of well-being, provision of basic needs in the settlement and cities as zoned spaces were used a basis for the study. The following part depicts the results of constructing an empirical model for LWBI measurements built based on conducting of two waves of testing surveys on small-scale samples. The final model consists of 22 indicators which are distributed across five dimensions – emotional perception of a settlement, the level of economic opportunities, the level of orderliness of a settlement, the level of education and medicine, and the level of civil security in a settlement. The third stage of our study covered the measurement of LWBI in Ukrainian settlements based on the results of a national representative survey (n=8572). The retrieved data was used to validate the methodology we developed according to the parameters of the model’s reliability, criterion, and construct validity. Such methods as correlation analysis, confirmatory factor analysis (CFA) and the checks of data’s applicability to the data were applied to achieve the results. Overall, we have managed to confirm the validity of our measurement tool and its suitability for research projects aimed at measuring the levels of local wellbeing in urban and rural settlements.

LGBTQ+ Christians in Australia

This article argues that the focus on the harm and stigma experienced by LGBTQ+ Christians misrepresents the complexity of the experience of many LGBTQ+ Christians, many of whom report affirmation and self-acceptance. A national representative survey indicates 5.5% of all Australians, 2.9% of Christians, and 8.4% of those with no religion identify their sexuality as lesbian, gay, bisexual, or ‘other’. LGB+ Christians appear to be distributed through all large Christian denominations. A second non-random national online survey indicates that many LGBTQ+ Christians report both self-acceptance and acceptance in their Christian community. While many LGBTQ+ Christians experience significant discrimination in Christian contexts, the often reported incompatibility of Christianity with LGBTQ+ sexual and gender identities is only one part of the story. There are significant sectors of Australian Christianity that are welcoming of LGBTQ+ people. Furthermore, LGBTQ+ people who remain Christians are often deeply committed to their faith.

Association Between Egalitarian Gender Attitudes and Attitudes Toward Same-Sex Marriage: Findings from a National Representative Survey

ABSTRACT Egalitarian gender attitudes are linked to increased support for same-sex marriage, with previous studies mainly focusing on Western countries. Limited existing research from Asian countries often relied on non-representative, convenient samples. Taiwan, the first Asian country to legalize same-sex marriage in 2019, offers a valuable context. Since surveys before 2020 lacked questions on attitudes toward same-sex marriage, we utilized the 2020 PSFD data for a cross-sectional analysis. Logistic regression analyses were conducted to explore the relationship between gender attitudes (assessed through six questions) and attitudes toward same-sex marriage, along with examining the moderation effects of socio-demographic variables. The results revealed significant associations between embracing egalitarian gender attitudes and increased support for same-sex marriage (adjusted odds ratio [aOR] ranged from 1.34 to 2.08, 95% CI = [1.15, 2.45]). Moderation analysis indicated that this connection appeared to be more pronounced among younger individuals, those who were not currently married, and those with higher educational attainment. Individuals who are older, less educated, or married and hold negative views on gender equality should be targeted for efforts to enhance their support for same-sex marriage. Advocating for gender equality aligns with principles of equality, nondiscrimination, and recognizing fundamental rights for all, irrespective of sexual orientation.

On manipulation by emotional AI: UK adults' views and governance implications.

With growing commercial, regulatory and scholarly interest in use of Artificial Intelligence (AI) to profile and interact with human emotion ("emotional AI"), attention is turning to its capacity for manipulating people, relating to factors impacting on a person's decisions and behavior. Given prior social disquiet about AI and profiling technologies, surprisingly little is known on people's views on the benefits and harms of emotional AI technologies, especially their capacity for manipulation. This matters because regulators of AI (such as in the European Union and the UK) wish to stimulate AI innovation, minimize harms and build public trust in these systems, but to do so they should understand the public's expectations. Addressing this, we ascertain UK adults' perspectives on the potential of emotional AI technologies for manipulating people through a two-stage study. Stage One (the qualitative phase) uses design fiction principles to generate adequate understanding and informed discussion in 10 focus groups with diverse participants (n = 46) on how emotional AI technologies may be used in a range of mundane, everyday settings. The focus groups primarily flagged concerns about manipulation in two settings: emotion profiling in social media (involving deepfakes, false information and conspiracy theories), and emotion profiling in child oriented "emotoys" (where the toy responds to the child's facial and verbal expressions). In both these settings, participants express concerns that emotion profiling covertly exploits users' cognitive or affective weaknesses and vulnerabilities; additionally, in the social media setting, participants express concerns that emotion profiling damages people's capacity for rational thought and action. To explore these insights at a larger scale, Stage Two (the quantitative phase), conducts a UK-wide, demographically representative national survey (n = 2,068) on attitudes toward emotional AI. Taking care to avoid leading and dystopian framings of emotional AI, we find that large majorities express concern about the potential for being manipulated through social media and emotoys. In addition to signaling need for civic protections and practical means of ensuring trust in emerging technologies, the research also leads us to provide a policy-friendly subdivision of what is meant by manipulation through emotional AI and related technologies.

Sex differences in tobacco use, attempts to quit smoking, and cessation among dual users of cigarettes and e-cigarettes: Longitudinal findings from the US Population Assessment of Tobacco and Health Study

SignificanceA growing number of adults use more than one tobacco product, with dual use of cigarettes and e-cigarettes being the most common combination. Monitoring sex disparities in tobacco use is a public health priority. However, little is known regarding whether dual users differ by sex. MethodsData came from Waves 4–6 (12/2016–11/2021) of the Population Assessment of Tobacco and Health Study, a US nationally-representative longitudinal survey. This analysis included current adult dual users of cigarettes and e-cigarettes. We used weighted generalized estimating equations to assess the association between sex and (1) making a cigarette quit attempt (n = 1882 observations from n = 1526 individuals) and (2) smoking cessation (n = 2081 observations from n = 1688 individuals) across two wave pairs, adjusting for age, education, ethnicity, time-to-first cigarette after waking, and e-cigarette use frequency. ResultsAmong US dual users, 14.1% (95% Confidence Intervals [Cl] = 11.9–16.4) of females and 23.4% (20.0–26.9) of males were young adults (aged 18–24), 11.7% (9.2–14.2) of females and 14.4% (11.6–17.2) of males had <high school education, and 82.2% (79.4–84.5) of females and 78.7% (75.1–82.4) of males were white. Overall, 44.9% (41.6–48.1) of females compared with 37.4% (33.5–41.3) of males made an attempt to quit smoking between a baseline and follow-up wave (Adjusted Risk Ratio [ARR] = 1.23, 1.05–1.45). In contrast, there were no apparent differences between females (22.1%, 19.0–25.2) and males (24.3%, 21.5–27.1) in smoking cessation (ARR = 1.06, 0.84–1.35). ConclusionUS females who dual use e-cigarettes and cigarettes were more likely to attempt to quit smoking, but not more likely to succeed at quitting, than males.

Moderation of the real-world effectiveness of smoking cessation aids by mental health conditions: A population study

Objective To examine whether the real-world effectiveness of popular smoking cessation aids differs between users with and without a history of mental health conditions. Design Nationally-representative cross-sectional survey conducted monthly between 2016–17 and 2020–23. Setting England. Participants 5,593 adults (2,524 with a history of ≥1 mental health conditions and 3,069 without) who had smoked regularly within the past year and had attempted to quit at least once in the past year. Main outcome measures The outcome was self-reported abstinence from quit date up to the survey. Independent variables were use of the following cessation aids during the most recent quit attempt: prescription nicotine replacement therapy (NRT), NRT over-the-counter, varenicline, bupropion, vaping products, face-to-face behavioural support, telephone support, written self-help materials, websites, hypnotherapy, Allen Carr’s Easyway, heated tobacco products, and nicotine pouches. The moderator was history of diagnosed mental health conditions (yes/no). Covariates included sociodemographic characteristics, level of cigarette addiction, and characteristics of the quit attempt. Results Relative to those without, participants with a history of mental health conditions were significantly more likely to report using vaping products (38.8% [95%CI 36.7–40.8] vs. 30.7% [28.9–32.5]), prescription NRT (4.8% [3.9–5.7] vs. 2.7% [2.1–3.3]), and websites (4.0% [3.2–4.8] vs. 2.2% [1.6–2.7]). Groups did not differ significantly in their use of other aids. After adjusting for covariates and use of other cessation aids, those who used vaping products (OR = 1.92, 95%CI 1.61–2.30), varenicline (OR = 1.88, 95%CI 1.19–2.98), or heated tobacco products (OR = 2.33, 95%CI 1.01–5.35) had significantly higher odds of quitting successfully than those who did not report using these aids. There was little evidence that using other cessation aids increased the odds of successful cessation, or that the user’s history of mental health conditions moderated the effectiveness of any aid. Conclusions Use of vaping products, varenicline, or heated tobacco products in a quit attempt was associated with significantly greater odds of successful cessation, after adjustment for use of other cessation aids and potential confounders. There was no evidence to suggest the effectiveness of any popular cessation aid differed according to the user’s history of mental health conditions.

High-resolution mapping of essential maternal and child health service coverage in Nigeria: a machine learning approach

BackgroundNational-level coverage estimates of maternal and child health (MCH) services mask district-level and community-level geographical inequities. The purpose of this study is to estimate grid-level coverage of essential MCH services...

A large and feasible national survey representative of population exposure to outdoor gamma radiation in urban areas.

Although data on outdoor gamma radiation are available for many countries, they have generally been obtained with measurements performed in undisturbed environments instead of in urban areas where most of the population lives. Only one large national survey, with on-site measurements in urban areas, has been identified worldwide, probably due to high costs (e.g., personnel and instrumentation) and difficulties in selecting measuring points. A campaign of outdoor gamma radiation measurements has been carried out in the entire Italian territory. All measurement points were selected at the infrastructures of an Italian telecommunications company as representatives of all the possible situations of outdoor exposure to gamma radiation for population in urban areas. Ten replicates of portable gamma (X) detectors carried out all the measurements. Approximately 4,000 measurements have been performed. They are distributed across 2,901 Italian municipalities, accounting for 75% of the Italian population. The national population-weighted mean of the gamma ambient dose equivalent rate (ADER) is 117 nSv h-1, and it ranges from 62 to 208 nSv h-1 and from 40 to 227 nSv h-1 for 21 regions and 107 provinces, respectively. The average variability at the municipal level, in terms of the coefficient of variation (CV) is 21%, ranging from 3 to 84%. The impact of land coverage and the distance from a building on the outdoor gamma radiation level was assessed with complementary measurements, leading to differences ranging from -40 to 50% and to 50%, respectively. A representative campaign of outdoor gamma dose rate measurements has been performed in Italy, only in urban areas, to assess the exposure effect due to outdoor gamma radiation on the population. It is the largest national campaign in urban areas worldwide, with a total of 3,876 on-site measurements. The land coverage and the distance from surrounding buildings were recognized to strongly affect outdoor gamma radiation levels, leading to high variability within small areas. The collaboration with a company that owns a network of facilities on a national territory as dense as the residing population made this survey feasible and affordable. Other countries might adopt this methodology to conduct national surveys in urban environments.

Social smoker identity and associations with smoking and quitting behaviour: A cross-sectional study in England

Background'Social smoking' typically occurs predominantly or exclusively in the presence of others who are smoking. Relatively little is known about changes in the prevalence of 'social smoking identity' over time and its association with other smoking-related correlates. MethodsData were from the Smoking Toolkit Study, a nationally-representative cross-sectional survey in England. Participants were 26,774 adults who currently smoked or had quit in the past year, surveyed between February-2014 and April-2021. We estimated the proportion identifying as having a social smoking identity, changes over time, and associations with smoking in social situations, cigarette dependence, motivation to stop, quit attempts and success. ResultsOf adults who currently smoked or had quit in the past year, 34.0% (95% Confidence Interval (CI)=33.5–34.6) identified as having a social smoking identity. There was a near linear increase in this proportion from 31.9% (95%CI=29.7–34.2) in February-2014 to 36.5% (95%CI=34.1–38.9) in April-2021. Adults who currenty smoked identifying as having a social smoking identity were less cigarette dependent (adjusted B=0.34, 95%CI=0.31–0.37) and more motivated to stop (aOR=1.20, 95%CI=1.15–1.26) than those who did not. Adults who currently smoked or had quit in the past year identifying as having a social smoking identity reported more smoking in social situations (aOR=6.45, 95%CI=6.13–6.80) and past-year quit attempts (aOR=1.22, 95%CI=1.14–1.30) than those who did not. Quit success was not associated with having a social smoking identity among adults who currently smoked or had quit in the past year and who had attempted to quit (aOR=0.90, 95%CI=0.79–1.02). ConclusionsAn increasing proportion, over a third, of adults who currently smoked or had quit in the past year in England identify as having a social smoking identity. Despite being associated with lower dependence, greater motivation to quit and more quit attempts, social smoking identity is not associated with greater quit success, suggesting a complex interplay between identity and smoking-related behaviours.

Trends in vaping and smoking following the rise of disposable e-cigarettes: a repeat cross-sectional study in England between 2016 and 2023

There has been a rapid rise in disposable (single-use) e-cigarette vaping among young adults in England since June 2021 (leading to a planned ban on these products). We examined how this has affected population trends in current (i) vaping, (ii) tobacco smoking, and (iii) inhaled nicotine use. We used data from a nationally-representative monthly repeat cross-sectional survey of adults (≥18) in England (n=132,252; July-2016-May-2023). Using interrupted time-series analyses (segmented logistic regression), we estimated yearly trends in current tobacco smoking, vaping, and inhaled nicotine use (smoking and/or vaping) before ('pre-disposables') and after June-2021 ('post-disposables'), stratified by age group (18 to 24, 25 to 44, 45 and over). We also examined trends in daily use and in vaping among never-smokers. Pre-disposables, vaping and smoking prevalence had been stable or declining across all age groups. However, post-disposables, the odds of current vaping increased by 99% per year among 18 to 24-year-olds (odds ratio [OR]=1.99; 95% confidence interval [CI]=1.71 to 2.31), compared with 39% (OR=1.39; 95% CI=1.26 to 1.52) in 25 to 44-year-olds and 23% (OR=1.23; 95% CI=1.12 to 1.35) in those aged 45 or older. Smoking rates continued to decline - albeit modestly - in 18 to 24-year-olds (OR=0.88, 95% CI=0.77 to 1.00) and 25 to 44-year-olds (OR=0.93, 95% CI=0.86 to 1.00), but increased among those aged 45 or older (OR=1.12, 95% CI=1.05 to 1.20). As a result, post-disposables, the overall prevalence of inhaled nicotine use increased across all age groups. Trends were similar for daily use, but post-disposables increases in vaping were greatest among people who had never regularly smoked (e.g., 18 to 24-year-olds: OR=2.50, 95% CI=1.82 to 3.43). Since disposable vapes started becoming popular in England, historic declines in nicotine use have reversed. Now, nicotine use appears to be rising, driven primarily by sharp increases in vaping among young people. Smoking declines have been most pronounced in age groups with the largest increases in vaping. Cancer Research UK.