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Edinburgh, United Kingdom

McNeill G.,University of Aberdeen | Masson L.F.,University of Aberdeen | Craig L.C.A.,University of Aberdeen | MacDiarmid J.I.,University of Aberdeen | And 3 more authors.
Public Health Nutrition

Objective: To assess the intake and sources of non-milk extrinsic sugars (NMES) and fat among children in Scotland in relation to socio-economic status, and to estimate the changes in diet required to achieve recommended levels of intake. Design: Cross-sectional survey with diet assessed by semi-quantitative FFQ.Setting Eighty postcode sectors across Scotland.Subjects Children (n 1398) aged 3-17 years recruited from the Child Benefit register (76 % of those contacted). Results: The mean intake of NMES of 17.4 (95 % CI 17.0, 17.8) % food energy was considerably higher than the UK recommended population average of 11 % food energy. The mean intake of total fat of 32.9 (95 % CI 32.7, 33.2) % food energy met the recommended population average of no more than 35 % food energy, while the mean intake of SFA of 13.8 (95 % CI 13.7, 14.0) % food energy was above the recommended population average of no more than 11 % food energy. Despite clear socio-economic gradients in the mean daily consumption of many healthy and unhealthy food groups, socio-economic differences in NMES as a percentage of food energy were limited and there was no significant variation in the intake of total fat or SFA as a percentage of food energy with socio-economic status. Modelling of the data showed that removing sugar-sweetened soft drinks and increasing fruit and vegetable intake by 50 % would not restore the intake of NMES and SFA to recommended levels. Conclusions: Major changes in the intake of many food groups will be required to bring the NMES and saturated fat intake in line with current dietary recommendations. Copyright © 2010 The Authors. Source

Masson L.F.,University of Aberdeen | Blackburn A.,University of Aberdeen | Sheehy C.,Scottish Center for Social Research | Craig L.C.A.,University of Aberdeen | And 3 more authors.
British Journal of Nutrition

The aim of this analysis was to investigate the strength of the association between sugar intake and treatment for dental decay in children in Scotland, and the impact of tooth brushing frequency on this association. The Survey of Sugar Intake among Children in Scotland was carried out in 2006 in those aged 3-17 years. Diet was assessed using the Scottish Collaborative Group FFQ, and interviews were carried out by trained fieldworkers who asked about dental health. A total of 1700 interviews were carried out, and 1512 FFQ were returned. Of the children, 56% had received treatment for decay (fillings or teeth removed due to decay). Intake of non-milk extrinsic sugars (NMES), but not total sugar, increased the risk of having had treatment for decay: adjusted OR 184 (95% CI 128, 264) for the highest (≥200% food energy) v. lowest (≤148% food energy) tertile of NMES intake. This raised risk remained in children who reported brushing their teeth at least twice a day. Compared with children who reported brushing their teeth at least twice a day and were in the lowest tertile of NMES intake, children who reported brushing their teeth once a day or less and were in the highest tertile of NMES intake were over three times more likely to have received treatment for decay (adjusted OR 339, 95% CI 197, 582). In order to improve dental health in children in Scotland, dental health strategies must continue to stress the importance of both reduced NMES intake and good oral hygiene. Copyright © The Authors 2010. Source

Highet G.,University of Edinburgh | Ritchie D.,University of Edinburgh | Platt S.,University of Edinburgh | Amos A.,University of Edinburgh | And 3 more authors.
Ethnicity and Health

Objective. To explore how male Bangladeshi smokers adapted to the English smoke-free legislation. Design. We draw on data derived from the Evaluation of Smoke-free England (ESME), a qualitative, longitudinal study conducted between 2007 and 2008 in two English metropolitan areas. Repeat interviews (n=34) were conducted before and after the legislation with 15 male Bangladeshi panel informants and from two focus groups: one with Bangladeshi men and the other with Bangladeshi women. Results. Bangladeshi smokers who participated in this study had largely accommodated to the smoke-free legislation and most had reduced their consumption of cigarettes, albeit to a modest degree. However, at the same time some Bangladeshi smokers appeared to have increased their use of shisha, a popular alternative method of smoking tobacco in this community. Smoke-free legislation also had an impact on the social and cultural forces that shape smoking behaviour in this group. In particular, family homes continued to be a key space where tobacco is consumed, although the legislation may have helped to shift the balance in favour of forces that oppose smoking and against enduring cultural pro-smoking norms. Smoking in public was also less socially acceptable, especially in the vicinity of local mosques and at community events. In some older groups, however, smoking remains a deeply embedded social habit which can undermine smokers' efforts to quit. Conclusion. For maximum impact, tobacco control interventions aimed at whole populations may need to be supplemented by culturally sensitive measures in local areas where there is a high concentration of Bangladeshi people. Similar considerations may apply to other minority communities with a high prevalence of smoking. © 2011 Taylor & Francis. Source

Ritchie D.,Center for Tobacco Control Studies | Amos A.,Center for Tobacco Control Studies | Martin C.,Scottish Center for Social Research
Health and Place

The social context of smoking behaviours is explored after the introduction of Scottish smoke-free legislation. A longitudinal qualitative study was conducted in four contrasting localities. Whilst post-legislation changes in smoking behaviour were evident in all four localities, they were most apparent in the disadvantaged localities. Changes in the patterns of smoking were linked to the ways in which people interacted in social contexts and how people re-negotiated habitual smoking behaviours in public spaces. Pre-legislation differences in the communities appeared to influence the extent of these changes. Cultural and social contexts are important in shaping smoking behaviours and locating change within public places. © 2009 Elsevier Ltd. All rights reserved. Source

Ritchie D.,University of Edinburgh | Amos A.,University of Edinburgh | Martin C.,Scottish Center for Social Research
Nicotine and Tobacco Research

Introduction: The Scottish smoke-free legislation has had considerable success, with high compliance resulting in significant health benefits and the increased denormalization of smoking. International literature on the impact of smoke-free legislation has mostly focused on the success of such policies. Relatively little consideration has been given to the potentially negative, albeit unintended, consequences of smoke-free policies within different social and cultural contexts, in particular the increased stigmatization of smokers. Methods: A 3-wave longitudinal qualitative study in 4 localities in Scotland using repeat in-depth interviews. Participants comprised a panel of 40 current and recent ex-smokers, interviewed before and after implementation of the legislation in 2 socioeconomically advantaged and 2 disadvantaged localities in Scotland. Results: Smokers perceived the smoke-free legislation to have increased the stigmatization of smoking. By separating, albeit temporarily, those who were smoking from those who were not had led to increased felt stigma. This had led to a social milieu that fostered self-labeling and self-stigmatization by smokers of their own smoking behavior, even when they were not smoking. While there was little reported direct discrimination, there was a loss of social status in public places. Smokers attempted to ameliorate stigmatization by not smoking outside, reducing going out socially, joining in the stigmatization of other smokers, and/or acknowledging the benefits of smoke-free environments. Discussion: The unintended negative consequences of smoke-free legislation for some suggest that tobacco control strategies need to consider how smokers who experience increased stigma are supported by public health to address their smoking while continuing to create smoke-free environments. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. Source

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