scholarly journals Influence of the SARS-CoV-2 Outbreak on the Uptake of a Popular Smoking Cessation App in UK Smokers: Interrupted Time Series Analysis (Preprint)

2020 ◽  
Author(s):  
Olga Perski ◽  
Aleksandra Herbeć ◽  
Lion Shahab ◽  
Jamie Brown

BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak may motivate smokers to attempt to stop in greater numbers. However, given the temporary closure of UK stop smoking services and vape shops, smokers attempting to quit may instead seek out mobile health support, such as smartphone apps. OBJECTIVE We examined, using an interrupted time series approach, whether the SARS-CoV-2 outbreak has been associated with a step change or increasing trend in UK downloads of an otherwise popular smoking cessation app, Smoke Free. METHODS Data were from daily and nondaily adult smokers in the United Kingdom who had downloaded the Smoke Free app between January 1, 2020, and March 31, 2020 (primary analysis), and January 1, 2019, and March 31, 2020 (secondary analysis). The outcome variable was the number of downloads aggregated at the 12-hourly (primary analysis) or daily level (secondary analysis). The explanatory variable was the start of the SARS-CoV-2 outbreak, operationalized as March 1, 2020 (primary analysis), and January 15, 2020 (secondary analysis). Generalized additive mixed models adjusted for relevant covariates were fitted. RESULTS Data were collected on 45,105 (primary analysis) and 119,881 (secondary analysis) users. In both analyses, there was no evidence for a step change or increasing trend in downloads attributable to the start of the SARS-CoV-2 outbreak. Calculation of Bayes factors (BFs) indicated that the data for the primary analysis favored the null hypothesis compared with large associations (for level, BF=0.25; for slope, BF=0.26) but were insensitive to the detection of small associations (for level, BF=0.78; for slope, BF=1.35). CONCLUSIONS In the United Kingdom, between January 1, 2020, and March 31, 2020, and between January 1, 2019, and March 31, 2020, there was no evidence that the SARS-CoV-2 outbreak has been associated with a large step change or increasing trend in downloads of a popular smoking cessation app. Findings on the association of the SARS-CoV-2 outbreak with a small step change or increasing trend were inconclusive.

10.2196/19494 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e19494 ◽  
Author(s):  
Olga Perski ◽  
Aleksandra Herbeć ◽  
Lion Shahab ◽  
Jamie Brown

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak may motivate smokers to attempt to stop in greater numbers. However, given the temporary closure of UK stop smoking services and vape shops, smokers attempting to quit may instead seek out mobile health support, such as smartphone apps. Objective We examined, using an interrupted time series approach, whether the SARS-CoV-2 outbreak has been associated with a step change or increasing trend in UK downloads of an otherwise popular smoking cessation app, Smoke Free. Methods Data were from daily and nondaily adult smokers in the United Kingdom who had downloaded the Smoke Free app between January 1, 2020, and March 31, 2020 (primary analysis), and January 1, 2019, and March 31, 2020 (secondary analysis). The outcome variable was the number of downloads aggregated at the 12-hourly (primary analysis) or daily level (secondary analysis). The explanatory variable was the start of the SARS-CoV-2 outbreak, operationalized as March 1, 2020 (primary analysis), and January 15, 2020 (secondary analysis). Generalized additive mixed models adjusted for relevant covariates were fitted. Results Data were collected on 45,105 (primary analysis) and 119,881 (secondary analysis) users. In both analyses, there was no evidence for a step change or increasing trend in downloads attributable to the start of the SARS-CoV-2 outbreak. Calculation of Bayes factors (BFs) indicated that the data for the primary analysis favored the null hypothesis compared with large associations (for level, BF=0.25; for slope, BF=0.26) but were insensitive to the detection of small associations (for level, BF=0.78; for slope, BF=1.35). Conclusions In the United Kingdom, between January 1, 2020, and March 31, 2020, and between January 1, 2019, and March 31, 2020, there was no evidence that the SARS-CoV-2 outbreak has been associated with a large step change or increasing trend in downloads of a popular smoking cessation app. Findings on the association of the SARS-CoV-2 outbreak with a small step change or increasing trend were inconclusive.


Author(s):  
Olga Perski ◽  
Aleksandra Herbec ◽  
Lion Shahab ◽  
Jamie Brown

BACKGROUND The SARS-CoV-2 outbreak may motivate smokers to attempt to stop in greater numbers. However, given the temporary closure of UK stop smoking services and vape shops, smokers attempting to quit may instead seek out digital support, such as websites and smartphone apps. OBJECTIVE We examined, using an interrupted time series approach, whether the SARS-CoV-2 outbreak has been associated with a step change or increasing trend in UK downloads of an otherwise popular smoking cessation app, Smoke Free. METHODS Data were from daily and non-daily adult smokers in the UK who had downloaded the Smoke Free app between 1 January 2020 and 31 March 2020 (primary analysis) and 1 January 2019 and 31 March 2020 (secondary analysis). The outcome variable was the number of downloads aggregated at the 12-hourly (primary analysis) or daily level (secondary analysis). The explanatory variable was the start of the SARS-CoV-2 outbreak, operationalised as 1 March 2020 (primary analysis) and 15 January 2020 (secondary analysis). Generalised Additive Mixed Models adjusted for relevant covariates were fitted. RESULTS Data were collected on 45,105 (primary analysis) and 119,881 (secondary analysis) users. In both analyses, there was no evidence for a step change or increasing trend in downloads attributable to the start of the SARS-CoV-2 outbreak. CONCLUSIONS In the UK, between 1 January 2020 and 31 March 2020, and between 1 January 2019 and 31 March 2020, there was no evidence that the SARS-CoV-2 outbreak has been associated with a surge in downloads of a popular smoking cessation app. CLINICALTRIAL osf.io/zan2s


2017 ◽  
Vol 67 (658) ◽  
pp. e352-e360 ◽  
Author(s):  
Sean MacBride-Stewart ◽  
Charis Marwick ◽  
Neil Houston ◽  
Iain Watt ◽  
Andrea Patton ◽  
...  

BackgroundIt is uncertain whether improvements in primary care high-risk prescribing seen in research trials can be realised in the real-world setting.AimTo evaluate the impact of a 1-year system-wide phase IV prescribing safety improvement initiative, which included education, feedback, support to identify patients to review, and small financial incentives.Design and settingAn interrupted time series analysis of targeted high-risk prescribing in all 56 general practices in NHS Forth Valley, Scotland, was performed. In 2013–2014, this focused on high-risk non-steroidal anti-inflammatory drugs (NSAIDs) in older people and NSAIDs with oral anticoagulants; in 2014–2015, it focused on antipsychotics in older people.MethodThe primary analysis used segmented regression analysis to estimate impact at the end of the intervention, and 12 months later. The secondary analysis used difference-in-difference methods to compare Forth Valley changes with those in NHS Greater Glasgow and Clyde (GGC).ResultsIn the primary analysis, downward trends for all three NSAID measures that were existent before the intervention statistically significantly steepened following implementation of the intervention. At the end of the intervention period, 1221 fewer patients than expected were prescribed a high-risk NSAID. In contrast, antipsychotic prescribing in older people increased slowly over time, with no intervention-associated change. In the secondary analysis, reductions at the end of the intervention period in all three NSAID measures were statistically significantly greater in NHS Forth Valley than in NHS GGC, but only significantly greater for two of these measures 12 months after the intervention finished.ConclusionThere were substantial and sustained reductions in the high-risk prescribing of NSAIDs, although with some waning of effect 12 months after the intervention ceased. The same intervention had no effect on antipsychotic prescribing in older people.


2021 ◽  
Author(s):  
Christopher A Martin ◽  
Daniel Pan ◽  
Joshua Nazareth ◽  
Avinash Aujayeb ◽  
Luke Bryant ◽  
...  

Abstract Objectives: To determine the prevalence and predictors of self-reported access to appropriate personal protective equipment (aPPE) for healthcare workers (HCWs) in the United Kingdom (UK) during the first UK national COVID-19 lockdown (March 2020) and at the time of questionnaire response (December 2020 - February 2021). Design: Two cross sectional analyses using data from a questionnaire-based cohort study. Setting: Nationwide questionnaire from 4th December 2020 to 28th February 2021. Participants: A representative sample of HCWs or ancillary workers in a UK healthcare setting aged 16 or over, registered with one of seven main UK healthcare regulatory bodies. Main outcome measure: Binary measure of self-reported aPPE (access all of the time vs access most of the time or less frequently) at two timepoints: the first national lockdown in the UK (primary analysis) and at the time of questionnaire response (secondary analysis). Results: 10,508 HCWs were included in the primary analysis, and 12,252 in the secondary analysis. 3702 (35.2%) of HCWs reported aPPE at all times in the primary analysis; 6806 (83.9%) reported aPPE at all times in the secondary analysis. After adjustment (for age, sex, ethnicity, migration status, occupation, aerosol generating procedure exposure, work sector, work region, working hours, night shift frequency and trust in employing organisation), older HCWs (per decade increase in age: aOR 1.2, 95% CI 1.16 - 1.26, p<0.001) and those working in Intensive Care Units (1.61, 1.38 - 1.89, p<0.001) were more likely to report aPPE at all times. Those from Asian ethnic groups compared to White (0.77, 0.67 - 0.89, p<0.001), those in allied health professional (AHPs) and dental roles (vs those in medical roles; AHPs: 0.77, 0.68 - 0.87, p<0.001; dental: 0.63, 0.49 - 0.81, p<0.001), and those who saw a higher number of COVID-19 patients compared to those who saw none (≥21 patients 0.74, 0.61 - 0.90, p=0.003) were less likely to report aPPE at all times in the primary analysis. aPPE at all times was also not uniform across UK regions (reported access being better in South West and North East England than London). Those who trusted their employing organisation to deal with concerns about unsafe clinical practice, compared to those who did not, were twice as likely to report aPPE at all times (2.18, 1.97 - 2.40, p<0.001). With the exception of occupation, these factors were also significantly associated with aPPE at all times in the secondary analysis. Conclusions: We found that only a third of HCWs in the UK reported aPPE at all times during the period of the first lockdown and that aPPE had improved later in the pandemic. We also identified key sociodemographic and occupational determinants of aPPE during the first UK lockdown, the majority of which have persisted since lockdown was eased. These findings have important public health implications for HCWs, particularly as cases of infection and long-COVID continue to rise in the UK.


2021 ◽  
Author(s):  
Matthew John Fell ◽  
Craig Russell ◽  
Jibby Medina ◽  
Toby Gillgrass ◽  
Shaheel Chummun ◽  
...  

Objectives: To analyse the association between active and passive cigarette smoking and the incidence of children born with a cleft lip and/or palate within the United Kingdom. Design: First, a longitudinal time-series study was conducted with routinely collected smoking prevalence data for females over 16 years of age. Second, an interrupted time-series design was used as a natural experiment to assess the impact of smoke-free legislation using segmented Poisson regression. Setting: United Kingdom. Population: All children born between 2000 and 2018 and their mothers. Main outcome measures: Orofacial cleft incidence, reported annually for England, Wales and Northern Ireland and separately for Scotland. Results: Over the study period, the annual incidence of orofacial cleft per 10,000 live births ranged from 14.2-16.2 in England, Wales and Northern Ireland and 13.4-18.8 in Scotland. The proportion of active smokers amongst females in the United Kingdom declined by 37% during the study period. Adjusted regression analysis did not show a correlation between the proportion of active smokers and orofacial cleft incidence in either dataset, although we were unable to exclude a modest effect of the magnitude seen in individual-level observational studies. The data in England, Wales and Northern Ireland suggested an 8% reduction in orofacial cleft incidence (95%CI 1% to 14%; P=0.026) following the implementation of smoke-free legislation. In Scotland, there was weak evidence for an increase in orofacial cleft incidence following smoke-free legislation. Conclusion: These two ecological studies offer a novel insight into the influence of smoking in orofacial cleft aetiology, adding to the evidence base from individual-level studies. Our results suggest that smoke-free legislation may have reduced orofacial cleft incidence in England, Wales and Northern Ireland.


BMJ ◽  
2011 ◽  
Vol 342 (jan25 3) ◽  
pp. d108-d108 ◽  
Author(s):  
B. Serumaga ◽  
D. Ross-Degnan ◽  
A. J. Avery ◽  
R. A. Elliott ◽  
S. R. Majumdar ◽  
...  

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Nigel Fox ◽  
Anna Maria Jönsson

Abstract Background A warmer climate has consequences for the timing of phenological events, as temperature is a key factor controlling plant development and flowering. In this study, we analyse the effects of the long-term climate change and an extreme weather event on the first flowering day (FFD) of five spring-flowering wild plant species in the United Kingdom. Citizen science data from the UK Woodland Trust were obtained for five species: Tussilago farfara (coltsfoot), Anemone nemorosa (wood anemone), Hyacinthoides non-scripta (bluebell), Cardamine pratensis (cuckooflower) and Alliaria petiolate (garlic mustard). Results Out of the 351 site-specific time series (≥ 15-years of FFD records), 74.6% showed significant negative response rates, i.e. earlier flowering in warmer years, ranging from − 5.6 to − 7.7 days °C−1. 23.7% of the series had non-significant negative response rates, and 1.7% had non-significant positive response rates. For cuckooflower, the response rate was increasingly more negative with decreasing latitudes. The winter of 2007 reflects an extreme weather event, about 2 °C warmer compared to 2006, where the 2006 winter temperatures were similar to the 1961–1990 baseline average. The FFD of each species was compared between 2006 and 2007. The results showed that the mean FFD of all species significantly advanced between 13 and 18 days during the extreme warmer winter of 2007, confirming that FFD is affected by temperature. Conclusion Given that all species in the study significantly respond to ambient near-surface temperatures, they are suitable as climate-change indicators. However, the responses to a + 2 °C warmer winter were both more and less pronounced than expected from an analysis of ≥ 15-year time series. This may reflect non-linear responses, species-specific thresholds and cumulative temperature effects. It also indicates that knowledge on extreme weather events is needed for detailed projections of potential climate change effects.


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