Physical Activity, Sleeping Problems, Weight, Feelings of Social Isolation, and Quality of Life of Older Adults After Coronavirus Infection: A Longitudinal Cohort Study.

BACKGROUND: There is debate as to whether a coronavirus infection (SARS-CoV-2) affects older adults' physical activity, sleeping problems, weight, feelings of social isolation, and quality of life (QoL). We investigated differences in these outcomes between older adults with and without coronavirus infection over 180 days following infection. METHODS: We included 6789 older adults (65+) from the Lifelines COVID-19 cohort study who provided data between April 2020 and June 2021. Older adults (65+) with and without coronavirus infection were matched on sex, age, education, living situation, body mass index, smoking status, vulnerable health, time of infection, and precoronavirus health outcome. Weighted linear mixed models, adjusted for strictness of governmental policy measures, were used to compare health outcomes after infection between groups. RESULTS: In total, 309 participants were tested positive for coronavirus. Eight days after infection, older adults with a coronavirus infection engaged in less physical activity, had more sleeping problems, weighed less, felt more socially isolated, and had a lower QoL than those without an infection. Differences in weight, feelings of social isolation, and QoL were absent after 90 days. However, differences in physical activity were still present at 90 days following infection and sleeping problems were present at 180 days. CONCLUSION: Our findings found negative associations of coronavirus infection with all the examined outcomes, which for physical activity persisted for 90 days and sleeping problems for 180 days. Magnitudes of estimated effects on physical activity and sleeping problems remain uncertain.

Lesson-drawing in tobacco control: A qualitative study of stakeholder perceptions in five North-Western European countries.

INTRODUCTION: The theory of 'family of nations' posits that countries draw policy lessons predominantly from similar countries. Lesson-drawing in tobacco control has, however, been primarily studied in the 'English-speaking' family. We examined in five diverse North-Western European countries whether the government engages in lesson-drawing regarding best practices in tobacco control, which countries they look at for guidance, and why these were chosen as a reference. METHODS: Perceptions of 29 policy participants from civil society and government were assessed by means of interviews conducted in Belgium, Finland, Germany, Ireland, and the Netherlands. Relevant excerpts were grouped according to country and a bottom-up thematic analysis was performed. RESULTS: The tobacco control instruments described by the policy participants were tobacco marketing bans (display ban and plain packaging) and smoke-free policies. German interviewees stated that the German federal government is not inclined to engage in foreign lesson-drawing. All other governments were perceived to look at Australia for lessons because of its global leadership in tobacco control. At the same time however, lessons from Australia were easily dismissed because it is an 'island' and far away. Irish interviewees observed their government to primarily look at other English-speaking countries. Governments in Belgium, Finland and the Netherlands were observed to primarily look at nearby European countries for lessons. CONCLUSIONS: Countries in North-Western Europe seem to draw policy lessons based on proximity and similarity to other countries concerning marketing bans and smoke-free policies. Proponents of tobacco control may use these findings to facilitate effective lesson-drawing in their countries.

Tobacco control partnership capacity: An overview and comparison of 18 European partnerships.

INTRODUCTION: In most countries, public health partnerships exist to advance national tobacco control. We assessed characteristics related to tobacco control partnership capacity across Europe. METHODS: We developed a tool to assess partnership characteristics related to their theoretical capacity to influence policy. The tool was based on an existing framework in the literature, which we adapted for the tobacco control field, through an expert panel, insights from the literature and pilot tests. The tool consists of three dimensions: resources (8 items), member characteristics (2 items), and organizational characteristics (8 items) and was administered to 18 European partnerships across 17 European countries in 2019. RESULTS: Whereas several characteristics likely related to tobacco control partnership capacity were highly prevalent across European partnerships, some were not. Of all 18 partnerships, 5 did not include professional lobbyists, 7 did not have access to national information on tobacco industry presence and lobbying, 9 had no influence on national research agendas, and 7 did not maintain working relationships with the relevant Minister or Secretary of State. Furthermore, 5 of 18 partnerships had no agreement on roles and responsibilities of member organizations, and 6 had no agreement on how credits are divided across member organizations. A leadership figure was absent in 6 of 18 partnerships. CONCLUSIONS: This study confirms that tobacco control partnerships vary greatly in the extent to which they possess characteristics associated with their ability to advance tobacco control. There is much room for improvement of European tobacco control partnerships.

Who calls the shots in tobacco control policy? Policy monopolies of pro and anti-tobacco interest groups across six European countries.

BACKGROUND: One of the factors influencing variation in tobacco control policies across European countries is the relative policy dominance of pro and anti-tobacco control interest groups. Scholars investigating this power balance have predominantly conducted single country case studies. This study aims to explore and describe the relative dominance of pro and anti-tobacco control interest groups across six European countries by using a tobacco display ban as a case study. We examined whether there are patterns and similarities with regards to two components of policy monopolies: framing of tobacco and institutional arrangements. METHODS: Thirty-two semi-structured interviews with 36 key stakeholders were conducted in Belgium, Finland, Germany, Ireland, Italy, and the Netherlands. These interviews were coded using the Framework Method. RESULTS: In countries where health Non-Governmental Organizations (NGOs) have a relative policy dominance, tobacco consumption was predominantly framed as a health issue, NGO communities were well developed, the industry was largely absent in terms of production and manufacture, the health ministries played central roles in the policymaking process, and FCTC article 5.3 was strictly interpreted. In countries where the tobacco industry has a relative policy dominance, tobacco was framed as a private problem, NGO communities were absent or weak, the industry was well represented, the health ministries played subordinate roles in the policymaking process, and FCTC article 5.3. was only interpreted in terms of transparency. CONCLUSION: The ways in which tobacco consumption is framed in a country and the ways in which institutions are arranged correspond to the policy monopoly in place, with strong similarities across countries with the same policy monopoly.

Policies that limit youth access and exposure to tobacco: a scientific neglect of the first stages of the policy process.

BACKGROUND: Policymakers can adopt and implement various supply-side policies to limit youth access and exposure to tobacco, such as increasing the minimum age of sale, limiting the number or type of tobacco outlets, or banning the display of tobacco products. Many studies have assessed the impact of these policies, while less is known about the preceding policy process. The aim of our review was to assess the available evidence on the preceding process of agenda setting, policy formulation, and policy legitimation. METHODS: A systematic literature search was conducted using the PubMed and the Social Sciences Citation Index databases. After selection, 200 international peer-reviewed articles were identified and analyzed. Through a process of close reading, evidence based on scientific enquiry and anecdotal evidence on agenda setting, policy formulation and policy legitimation was abstracted from each article. RESULTS: Scientific evidence on the policy process is scarce for these policies, as most of the evidence found was anecdotal. Only one study provided evidence based on a scientific analysis of data on the agenda setting and legitimation phases of policy processes that led to the adoption of display bans in two Australian jurisdictions. CONCLUSION: The processes influencing the adoption of youth access and exposure policies have been grossly understudied. A better understanding of the policy process is essential to understand country variations in tobacco control policy.

How can a ban on tobacco sales to minors be effective in changing smoking behaviour among youth? - A realist review.

The aim of the study was to understand, from the perspective of youth, how and under which circumstances a ban on tobacco sales to minors can be effective in influencing youth smoking behaviour. We searched Medline, Embase, and PsychINFO in February 2016. A systematic search for studies about a ban on sales to minors and smoking behaviour was performed. Only studies that addressed potential mechanisms were included, resulting in thirty-three studies. We extracted evidence from 26 quantitative, 5 qualitative, and 2 mixed-methods studies, explaining how the ban may be effective in reducing smoking behaviour, and contextual factors that may influence these mechanisms. We identified two mechanisms and three contra-mechanisms. First, when direct access to commercial sources is limited, cigarette consumption may be reduced because minors have restricted access to commercial cigarettes. Minors' access to social sources and the various ways in which they continue to buy cigarettes by circumventing the ban, are two contra-mechanisms that undermine this effect. Second, when the ban is strongly enforced, an anti-smoking norm may be created and adolescents may smoke less as a result. One contra-mechanism may possibly undermine this effect: the 'forbidden fruit' effect. Whether these (contra-)mechanisms occur depends on contextual and individual factors such as level of enforcement, the minors' social network, and their dependence on smoking. The ban can be effective if well enforced. However, minors' access to social sources and their ways to circumvent the ban should be addressed to achieve its full potential.

Public support for tobacco control policies: The role of the protection of children against tobacco.

INTRODUCTION: In many countries, health advocates aim to increase public support for tobacco control policies by framing these policies in terms of child protection. We examined whether support for the protection of children is indeed associated with support for tobacco control policies, even among smokers, opponents of state intervention and opponents of a governmental role in tobacco control. METHODS: We used a survey on a representative sample of Dutch adults of 18 years and older (n = 1631). The survey measured respondents' support for banning tobacco displays, raising the age of sale for tobacco to 21 years and limiting tobacco sales to specialized shops. Regression analyses were done to assess the association with respondents' support for the protection of children against tobacco. In further analyses, subgroup interactions were added. RESULTS: Respondents' support for the protection of children against tobacco with legislation was positively related to support for all three policies. Associations were weaker for smokers (except for raising the age of sale) but similar for opponents of state intervention and opponents of a governmental role in tobacco control. CONCLUSION: This is the first paper to empirically support the idea that emphasizing the need to protect children against tobacco enhances support for tobacco control policies. This 'child effect' is effective in all segments of the population, albeit somewhat weaker among smokers.