A birth cohort analysis of smoking by adults in Great Britain 1974-1998

BACKGROUND: The aim of the study was to determine for Great Britain the percentage of current smokers and ever smokers by age in successive birth cohorts and the percentage of ever smokers who continue, by analysis of data from serial cross-sectional surveys of smoking status (General Household Survey). METHOD: A series of 5 year birth cohorts were followed through data from the 13 national surveys conducted at biennial intervals between 1974 and 1998. RESULTS AND CONCLUSION: In all birth cohorts, male and female, after age 25 years the percentage of current smokers falls with age. In the earliest birth cohort for males (1897-1901) about 85 per cent were ever smokers (i.e. had smoked at some time). After the 1922-1926 cohort this started to fall, to reach the level of about 50 per cent in the 1962-1966 cohort. In females only 25 per cent of the earliest cohort ever smoked but this rose, reaching about 65 per cent in the 1922-1926 cohort before falling back to about 50 per cent in the 1962-1966 cohort. The age at which smokers quit appears to be falling in successive cohorts. Once they have started quitting the rate at which smokers do so is very similar in all cohorts, with about 1 per cent of ever smokers quitting each year. If these trends are continued the UK smoking prevalence targets will not be met.     

Temporal trends in orchidopexy,Great Britain, 1992-1998

Concern has been expressed in recent years about worsening male reproductive health, possibly mediated by increasing exposures to environmental endocrine-disrupting agents. Trends suggested large increases in cryptorchidism in Britain and the United States between the 1950s and 1980s, although published data on recent trends have been scarce. We examined numbers of orchidopexy procedures, as a marker for cryptorchidism, using routine hospital admission data for England, Wales, and Scotland for fiscal years 1992-1993 through 1998-1999. Annual trends in orchidopexy rates were analyzed by age, in-patient admission versus day case, and geographical region. Orchidopexy rates were also obtained from the General Practice Research Database (GPRD) for England to cross-validate the hospital admissions data. Orchidopexy rates for boys 0-14 years old fell by 33% (from 23.5 to 15.8 per 10,000 population) between 1992 and 1998, with the steepest decline (50%) in 5-9-year-olds. The decreasing trend for 0-14-year-olds was evident in every region in England, in Wales, and in Scotland. Rates remained stable for men 15 or more years old, at 0.7 per 10,000. There was a marked shift from in-patient to day-case procedures. Rates from the GPRD showed a similar downward trend to the hospital data. Our findings could represent either an underlying decrease in the frequency of undescended testis or a fairly dramatic improvement in the diagnosis of cryptorchidism--resulting in fewer orchidopexies performed for retractile testis--in Great Britain during the 1990s, or both. Either way, our findings do not support the postulate of a recent worsening of male reproductive health of the scale suggested by some recent commentators on the endocrine disruptor hypothesis.     

Patterns and trends of beverage consumption among children and adults in Great Britain, 1986-2009

Many dietary recommendations include reduction of excessive intake of sugar-sweetened beverages (SSB) and other energy-rich beverages such as juices and alcohol. The present study examines surveys of both individual dietary intake data and household food expenditure surveys to provide a picture of patterns and trends in beverage intake and purchases in Great Britain from 1986 to 2009, and estimates the potential for pricing policy to promote more healthful beverage purchase patterns. In 2008-9, beverages accounted for 21, 14 and 18?% of daily energy intake for children aged 1·5-18 and 4-18 years, and adults (19-64 years), respectively. Since the 1990s, the most important shifts have been a reduction in consumption of high-fat dairy products and an increased consumption of fruit juices and reduced-fat milk among preschoolers, children and adolescents. Among adults, consumption of high-fat milk beverages, sweetened tea and coffee and other energy-containing drinks fell, but reduced-fat milk, alcohol (particularly beer) and fruit juice rose. In testing taxation as an option for shifting beverage purchase patterns, we calculate that a 10?% increase in the price of SSB could potentially result in a decrease of 7·5?ml/capita per d. A similar 10?% tax on high-fat milk is associated with a reduction of high-fat milk purchases by 5?ml/capita per d and increased reduced-fat milk purchase by 7?ml/capita per d. This analysis implies that taxation or other methods of shifting relative costs of these beverages could be a way to improve beverage choices in Great Britain.     

Variation in fruit and vegetable consumption among adults in Britain. An analysis from the dietary and nutritional survey of British adults

OBJECTIVES: Using a national representative sample to examine variation in fruit and vegetable consumption among adults in the UK, with particular reference to consumers with high and low reported intakes. DESIGN: National representative dietary survey using 7-d weighed diet records of men and women aged 16-64 y living in private households in the UK in 1986-1987. SETTING: The UK. SUBJECTS: 1087 men and 1110 women. The sample was selected by a multi-stage random probability design. The response was 70%. Subjects with low energy intake were subsequently excluded. MAIN OUTCOME MEASURES: Food group, nutrient intake, physiological measures socio-economic, demographic and behavioural characteristics. RESULTS: Consumption of fruit and vegetables was estimated. The sample was divided by sex into four quarter groups according to fruit and vegetable consumption. There were significant similarities between quarter groups in fruit and vegetable and other food intake, nutrient intake, physiological measures, and socioeconomic, demographic and behavioural variable. The lowest consumers of fruit and vegetables had a mean intake of 738 g/week (men) and 630 g/week (women), equivalent to 1.3 and 1.1 portion/d, respectively. Conversely, the mean intake of both men women with the highest consumption was 3137 g/week (5.6 portions day). There were more than twice as many adults in the age group 16-24 located in Q1 than in Q4. The Manual social class and those in receipt of benefits were negatively associated with fruit and vegetable consumption. Smokers were significantly associated with low fruit and vegetable intake. Being married was associated with increased fruit and vegetable intake and being single or divorced/separated was associated with low fruit and vegetable intake. Eating home grown produce was associated with high intake. Consumers who lived in London or the South-East were associated with higher fruit and vegetable intake. CONCLUSIONS: The analysis draws attention to the wide variation in reported fruit and vegetable consumption among British adults. High consumers merit further investigation to elucidate practical strategies for increasing fruit and vegetable consumption. Strategies to increase consumption should be targeted at groups most likely to include low consumers of fruits and vegetables. SPONSORSHIP: London School of Hygiene and Tropical Medicine.     

Tobacco consumption in Switzerland 1950-1978

This article discusses the statistical bases for the estimation of tobacco consumption in Switzerland. Estimates for cigarettes, cigars and pipe tobacco are given from 1950 to 1978.     

Social and regional differences in food and alcohol consumption and their measurement in a national birth cohort.

The problem of collecting detailed dietary information on a large population scattered throughout England, Wales and Scotland was resolved by use of a 7 day dietary diary, introduced at home interviews. Information on food types and quantities was coded to provide data on a wide range of nutrients. Reported levels of iron and fibre intake were found to be particularly low in relation to current recommended daily intakes, which were more often achieved by men than by women. Best dietary habits were associated with good educational attainment, whatever the social class of origin, but in women this was in some circumstances associated also with relatively high intakes of alcohol, protein and fats. Worst dietary habits were associated with low social class of family of origin and low educational attainment. Mean intakes of some nutrients varied significantly by region, in most cases independently of class and education. The implications of these findings are discussed.     

Mesothelioma in Great Britain in 1968-1983

The British mesothelioma register records deaths in Great Britain when the word "mesothelioma" is on the death certificate. In 1968-1983 the mesothelioma deaths among men increased from 114 to 467, while those among women increased from 38 to 90. In 1983 the crude mesothelioma death rates were 17.5 per million and 3.2 per million for the men and women, respectively. The Northern region had the highest crude rates. At the county level, the highest crude deaths rates in 1976-1983 were recorded for the men in Devon and for the women in Lancashire. Marked differences occurred in the ratio of deaths among men to deaths among women for mesothelioma of the pleura (4.6:1) and for mesothelioma of the peritoneum (2:1). The age-specific death rates for men and women diverged markedly for pleural mesothelioma but not for peritoneal mesothelioma. Trends in the use of asbestos and in age- and sex-specific death rates suggest that the annual number of mesothelioma deaths will continue to increase, possibly until the turn of the century. This increase will be concentrated among the men as the main asbestos exposure of women occurred during the war and the annual deaths due to this exposure may have already peaked.     

The density of alcohol outlets and adolescent alcohol consumption: An Australian longitudinal analysis

Higher density of alcohol outlets has been linked to increased levels of adolescent alcohol-related behaviour. Research to date has been cross-sectional. A longitudinal design using two waves of annual survey data from the Australian arm of the International Youth Development Study was used. The sample comprised 2835 individuals with average age at wave 2 of 14 years (SD=1.67; range=11–17 years). GSEM was used to examine how absolute levels of alcohol outlet density was associated with student-reported alcohol use one year later, while controlling for prior alcohol use, risk factors at wave one and changes in density over the 2 years. Adolescents' perception of alcohol availability and friends' alcohol use were tested as potential mediators of the association between alcohol outlet density and adolescent alcohol use. Elasticity modelling identified a 10% increase in overall density at wave one was associated with an approximately 17% increase in odds of adolescent alcohol consumption at wave two. Living in areas with a higher density of outlets was associated with a statistically significant increase in the likelihood of adolescents developing early age alcohol consumption.     

Improving information on the role of alcohol in interpersonal violence in Great Britain

In Great Britain, at present, no valid or reliable estimate can be made of the proportion of interpersonal violence caused by alcohol, nor can an assessment be made of the levels of alcohol consumption associated with an increased risk of involvement in interpersonal violence. A critical review of existing British studies and surveillance systems has been undertaken, which indicates that the role of alcohol in interpersonal violence could be defined more precisely, if new and better analytical studies were conducted, if ongoing logitudinal studies and existing surveillance systems were improved or better exploited, and if new surveillance systems were implemented.     

Education,alcohol use and abuse among young adults in Britain

In this article we explore the relationship between education and alcohol consumption. We examine whether the probability of abusing alcohol differs across educational groups. We use data from the British Cohort Study, a longitudinal study of one week’s birth in Britain in 1970. We analysed data collected at age 34 (in 2004) and complement it with information gathered at previous sweeps. Measures of alcohol abuse include alcohol consumption above NHS guidelines, daily alcohol consumption and problem drinking. We found that higher educational attainment is associated with increased odds of daily alcohol consumption and problem drinking. The relationship is stronger for females than males. Individuals who achieved high educational test scores in childhood are at a significantly higher risk of abusing alcohol across all dimensions. Our results also suggest that educational qualifications and academic performance are associated with the probability of belonging to different typologies of alcohol consumers among women while this association is not present in the case of educational qualifications and is very weak in the case of academic performance among males.     

Epidemiological analysis of data for scrapie in Great Britain

In recent years, the control or eradication of scrapie and any other transmissible spongiform encephalopathies (TSEs) possibly circulating in the sheep population has become a priority in Britain and elsewhere in Europe. A better understanding of the epidemiology of scrapie would greatly aid the development and evaluation of control and eradication strategies. Here we bound the range of key epidemiological parameters using a combination of relatively detailed pathogenesis and demography data, more limited data on susceptibility and incubation times, and recent survey data on scrapie incidence in Great Britain. These data are simultaneously analysed using mathematical models describing scrapie transmission between sheep and between flocks. Our analysis suggests that occurrence of scrapie in a flock typically provokes changes in flock management that promote termination of the outbreak, such as the adoption of selective breeding, and that a large fraction of cases (possibly over 80%) goes undetected. We show that the data analysed are consistent with the within-flock reproduction number of scrapie lying in the range 1.5-6, consistent with previous epidemiological studies.     

Alcohol consumption and lipodystrophy in HIV-infected adults with alcohol problems

Lipodystrophy is a common long-term complication of HIV infection that may lead to decreased quality of life and less adherence to antiretroviral therapy (ART). A complete understanding of the etiology of HIV-associated lipodystrophy has not yet been achieved, although factors related to the virus, per se, and use of ART appear to be related. Alcohol use is common among HIV-infected patients and has biological effects on fat distribution, yet alcohol's relationship to HIV-associated lipodystrophy has not been examined. The goal of this clinical study was to assess the effect of alcohol consumption on lipodystrophy in HIV-infected adults with alcohol problems. This was a prospective study (2001-2006) of 289 HIV-infected persons with alcohol problems. The primary outcome was self-reported lipodystrophy, which was assessed at one time point (median 29 months after enrollment). Alcohol use was assessed every 6 months and classified as: abstinent at all interviews; ≥1 report of moderate drinking but no heavy drinking; 1 or 2 reports of heavy drinking; or ≥3 reports of heavy drinking. Multivariable logistic regression models were fit to the data. Fifty-two percent (150/289) of subjects reported lipodystrophy. Alcohol consumption was: 34% abstinent at all interviews; 12% ≥1 report of moderate drinking, but no heavy drinking; 34% 1-2 reports of heavy drinking; and 20% ≥3 reports of heavy drinking. Although not statistically significant, subjects with alcohol use had a higher odds of lipodystrophy (adjusted odds ratios and 95% confidence interval: ≥1 report of moderate drinking, 2.36 [0.89, 6.24]; 1-2 reports of heavy drinking, 1.34 [0.69, 2.60]; ≥3 reports of heavy drinking, 2.07 [0.90, 4.73]). Alcohol use may increase the odds of developing HIV-associated lipodystrophy among subjects with alcohol problems. However, larger studies are needed to fully elucidate the role and impact of alcohol consumption on the development of this common long-term complication of HIV infection and its treatment.     

上海市男性饮酒与死亡关系的前瞻性研究

目的　探讨饮酒与上海市市区中老年男性死亡的关系。方法　自 1986年 1月～ 1989年 9月调查上海市区 4 5～ 6 4岁男性居民 182 4 4人 ,每年上门随访一次 ;用COX比例风险模型计算相对危险度。结果　至 2 0 0 2年度随访结束 ,全队列共随访 2 35 76 2人年 ,人均随访 12 .9年。在此期间共死亡 336 5人 ,其中恶性肿瘤死亡 1381人。在调整年龄、吸烟情况及教育程度后 ,相对于不饮酒者每天饮酒酒精量 <15 g和 15～ 2 9g者总死亡相对危险度 (RR)分别为 0 .80 (95 %CI:0 .72～ 0 .89)和 0 .87(95 %CI :0 .78～ 0 .97) ,每天饮酒酒精量 90 g及以上者RR为 1.2 5 (95 %CI:1.0 4～ 1.5 1)。少量饮酒者缺血性心脏病和慢性阻塞性肺部疾病死亡危险性显著降低。每天饮酒酒精量 70 g及以上者食管癌、结直肠癌、脑血管病死亡危险性显著升高 ,RR分别为 5 .0 8,2 .5 7和 1.5 7,肝硬化死亡危险性在每天饮酒酒精量 30 g及以上者中也显著上升 ,RR为 1.89。 结论　少量饮酒会降低中老年男性总死亡危险性 ,大量饮酒则会增加中老年男性食管癌、结直肠癌、脑血管病及肝硬化的死亡危险性。