The latest medical research on Addiction Psychiatry

Overall, products advertised as higher strength were found to have higher nicotine content than products advertised as lower strength. The measured total nicotine content was either equal to or less than the level stated on the label, except for one product. Although TFN products may not contain tobacco lamina and may lack many harmful chemicals and carcinogens found in conventional smokeless products, freebase nicotine levels in the pouch products are elevated and could contribute to higher levels of addiction and other negative health effects.

Moisture, total nicotine and pH content were analysed in 70 commercially available TFN products, covering five different types (lozenges, chewing gum, loose leaf, toothpicks and pouches). The freebase nicotine was calculated using the measured pH values.

Total nicotine levels ranged from 0.822 to 31.5 mg/g. Nicotine levels were highest in nicotine pouches (1.41-8.11 mg/product) and lowest in toothpicks (1.19-1.57 mg/product). Nicotine levels in TFN loose leaf (1.26-9.16 mg/g) were comparable to conventional moist snuff. The pH ranged from pH 4.68 to 9.49 and per cent freebase nicotine ranged from 0.0453% to 96.7%. The freebase nicotine content was highest in nicotine pouches (2.15-16.8 mg/g) and lowest in lozenges (0.0004-0.349 mg/g). The majority of TFN products (91.4%) analysed were advertised to contain flavour components.

NCT03573973; Pre-results.

The study adopted a convergent mixed-methods design. Quantitative data extracted from study store planograms (visual representation of stores and product placement) before and after intervention implementation were used to assess the positioning of fresh fruit and vegetables in the first aisle from the front entrance (intervention dose). The availability of fresh fruit and vegetables in each study store was examined from stock-keeping unit (SKU) figures before and after intervention implementation. An intervention implementation survey (IIS) completed with store managers and senior supervisors before and 1- and 6-months post-intervention implementation enabled examination of the context across study stores. Semi-structured interviews with store managers and senior supervisors provided qualitative data about store staff experiences and perceptions of the intervention between 6-months post-intervention implementation.

The placement intervention was implemented with close adherence to the study protocol. There were marked differences, post-intervention implementation, in the positioning of fresh fruit and vegetables in intervention stores compared with control stores: median distance in intervention stores was 8.0 m (IQR 5.0 to 10.0) compared with 23.8 m (IQR 21.0 to 30.0) in control stores (P < 0.0001). The availability of varieties of fresh fruit and vegetables increased in intervention stores post-intervention compared with control stores: median (IQR) among intervention stores was 72 (51, 84) compared with 56.5 (50, 62) in control stores (P = 0.03). The mean change from baseline to post-implementation in number of different fruit and vegetables available in intervention stores was 15.3 (SD 16.7) (P = 0.01). IIS and interview data demonstrated little difference between intervention and store contexts over time. Reinforcing factors for intervention implementation included: head-office leadership, store staff views and attitudes and increased awareness of the importance of offering healthy food in prominent locations within stores.

This study demonstrated that placement interventions which promote fresh fruit and vegetables to customers in discount supermarkets can be implemented effectively. These findings are encouraging for the implementation of national food policies which modify retail environments to improve population purchasing and dietary patterns.

Licensing of tobacco retailers, including high retail licence fees, is one tobacco control measure that may reduce tobacco retail availability. Between 2015 and 2018, the tobacco licence fee in Tasmania, Australia, tripled to $A1132/year. We sought to explore small retailer perspectives on selling tobacco following the tripling of the licence fee.

In-depth semistructured telephone interviews (n=21) were conducted with business owners and managers between March and July 2020. Participants were asked broad questions about their business, attitudes and intentions towards selling tobacco and the perceived importance of tobacco to their business.

Participants' perspectives and decision-making about selling tobacco were influenced by an interplay of factors, including tobacco's perceived core business value and its waning importance in small retail due to declining demand. Although participants frequently reported tobacco as unprofitable, with many describing it as their least profitable product, most continued selling it. The high tobacco licence fee created a tipping point that challenged the cost-benefit balance previously weighted towards selling tobacco. While the fee, alongside the increasing cost of tobacco itself, pushed some retailers towards a critical decision point to stop selling tobacco, others continued to sell tobacco but appear to be headed in the same direction.

A high annual tobacco licence fee serves as a potential mechanism for phasing out the sale of commercial tobacco in small retailers in a jurisdiction with other strong tobacco control measures.

Mortality from physical inactivity-related non-communicable diseases (NCDs) is projected to surpass deaths from communicable diseases by 2030 in Africa. Monitoring physical activity (PA) is important for planning public health interventions addressing NCDS and planetary health, but there is a dearth of evidence on PA trends in Africa. This study explored the secular trends in overall and domains of PA (leisure, occupation, and transport), and examined the gender, age, and education disparities in PA trends across African countries.

We utilized data from the STEPwise approach to NCDs risk factor surveillance in eleven African countries (Algeria, Benin, Botswana, Cabo Verde, Eritrea, Eswatini, Malawi, Mali, Central Africa Republic, Sao Tome and Principe, and Zambia) with at least two surveys conducted between 2003/2010 (first-wave) and 2010/2020 (second-waves). A total of 29,282 and 40,147 adults (18-69 years) in the first and second waves, respectively, completed PA interviews using the Global Physical Activity Questionnaire. Gender, age, and education status were self-reported. Weighted individual-country PA prevalence and 95% confidence interval (95%CI) were obtained. Random-effect meta-analysis was conducted to assess pooled estimates of PA trends across countries. Gender, age, and education disparities in PA trends were also investigated.

Country-specific results showed significant upward trends in total PA in eight countries. Seven countries showed significant increasing trends in some leisure-time PA (2.0% - 13.9% increase) and ≥ 150 min/week transport PA (4.0% - 24.5% increase), while five countries recorded significant increasing trends in occupational PA (6.6% - 56.9% increase). Gender, age and education disparities in meeting the WHO PA guidelines remained relatively stable over time, but disparities in leisure, transport and occupational PA increased in most countries.

The prevalence of overall PA among African adults has marginally increased over 17 years. There are still many adults, especially women and people with lower education, not doing well in domain specific PA. Policy and environmental interventions are needed to improve PA and to reduce gender, age, and education disparities in leisure, transport, and occupational PA in African countries.