Do Flavour Descriptions Influence Subjective Ratings of Flavoured and Unflavoured E-Liquids among Non-Smoking and Non-Vaping UK Adolescents?

INTRODUCTION: Youth use of electronic cigarettes (e-cigarettes) is rising globally and is associated with health harms. Flavour descriptions on e-liquid packaging may contribute to the appeal of e-cigarettes among youth. This study compared subjective ratings of e-liquid packaging flavour descriptions among non-smoking and non-vaping UK adolescents. METHODS: This was an online observational study in a UK sample of non-smoking and non-vaping adolescents aged 11-17 years. The primary analyses compared flavoured versus unflavoured descriptions and the secondary analyses compared candy/sweet flavour versus fruit flavour descriptions. Outcomes were packaging appraisal, packaging receptivity, perceived harm, and perceived audience. RESULTS: The survey was completed by 120 participants (74% female). Packaging appraisal ratings were higher for e-liquids with flavoured descriptions than unflavoured descriptions (mean difference 5.9, 95% CI 4.2 to 7.6, p<.001). Similarly, packaging receptivity ratings were higher for e-liquids with flavoured descriptions than unflavoured descriptions (mean difference 4.2, 95% CI 2.8 to 5.6, p<.001). Participants also perceived e-liquids with flavoured (versus unflavoured) descriptions as less 'grown-up' (mean difference -5.2, 95% CI -7.3 to -3.1, p<.001). However, ratings of perceived harm were similar for flavoured and unflavoured descriptions (mean difference -1.0, 95% CI -2.6 to 0.5, p=.189). CONCLUSIONS: Although this study found differences in subjective ratings of e-liquids with flavoured and unflavoured descriptions, non-smoking and non-vaping UK adolescents generally had low appraisal and receptivity for e-liquids and they perceived them as being 'grown-up' and harmful. IMPLICATIONS: Youth use of electronic cigarettes (e-cigarettes) is increasing globally, leading to concerns about health harms. This study compared adolescents' ratings of e-liquids with flavoured versus unflavoured descriptions and e-liquids with candy/sweet flavour versus fruit flavour descriptions. This study adds to previous studies that have compared adolescents' ratings of e-liquids with tobacco flavour versus non-tobacco flavour descriptions. Although packaging appraisal and receptivity ratings were higher (more positive) for e-liquids with flavoured versus unflavoured descriptions, overall, adolescents who do not smoke or vape had low appraisal and receptivity for e-liquids, and they perceived them as being 'grown-up' and harmful.

Exploring the opinions and potential impact of unflavoured e-liquid on smoking cessation among people who smoke and smoking relapse among people who previously smoked and now use e-cigarettes: findings from a UK-based mixed methods study.

BACKGROUND: Although electronic cigarettes (e-cigarettes) appear to be effective in helping people who smoke to stop smoking, concerns about use of e-cigarettes among young people have led to restrictions on non-tobacco flavoured e-liquids in some countries and some US states. These restrictions could reduce the appeal of these products to non-smoking youth but could have negative consequences for people who smoke or use e-cigarettes. METHODS: In this mixed methods study, we recruited UK adults who smoked or used to smoke and subsequently vaped to explore their opinions of unflavoured e-liquids and their beliefs about how they would be impacted by hypothetical e-liquid flavour restrictions. Participants trialled an unflavoured e-liquid instead of their usual nicotine product for four hours and completed a survey and an online interview. RESULTS: Using Interpretive Phenomenological Analysis and graphically presented data, we found differences in participants' opinions of unflavoured e-liquid. If only unflavoured, tobacco flavoured, and menthol flavoured e-liquids remained on the UK market, some people who smoke or vape may be unaffected, but some may relapse to smoking or continue smoking. Despite most wanting to prevent young people from initiating vaping, participants had varying opinions on whether flavour restrictions would be an effective method. CONCLUSIONS: The findings highlight that people who smoke and vape could be impacted by flavour restrictions in a range of ways, some of which could have a potential adverse impact on harm reduction efforts in the UK (e.g., by making smoking more appealing than vaping).

Associations between self-reported sleep quality, fatigue severity, factors associated with successful cessation, and cessation beliefs among regular smokers.

BACKGROUND: Smokers report poorer sleep than non-smokers and sleep quality deteriorates further during cessation, increasing risk of smoking relapse. Better understanding of the relationship between sleep and relapse-related outcomes could inform novel approaches to smoking cessation support. The aim of this study was to investigate same day associations of self-reported sleep quality and fatigue severity with factors associated with successful cessation and cessation beliefs, among regular smokers. METHODS: This cross-sectional observational study (n=412) collected self-reported sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs among regular smokers via an online survey (60% male). RESULTS: There was evidence of an association between sleep quality (SQ) and reduced 24hr (ß = -0.12, p = 0.05) and lifetime (ß = -0.09, p = 0.04) abstinence self-efficacy. In addition, poorer SQ and higher fatigue severity (FS) were associated with increased smoking urges (SQ: ß = 0.27, p < .001; FS: ß = 0.32, p < .001), increased barriers to cessation (SQ: ß = 0.19, p < .001; FS: ß = 0.32, p < .001), and increased perceived risks to cessation (SQ: ß = 0.18, p < .001; FS: ß = 0.26, p < .001). Fatigue severity was weakly associated with increased perceived benefits to cessation (ß = 0.12, p = .017). CONCLUSIONS: Self-reported sleep quality and fatigue severity were associated with multiple factors associated with successful cessation and cessation beliefs. Further research is needed to extend these findings by using different methods to identify the temporal direction of associations and causality. IMPLICATIONS: This study is the first to examine associations between sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs. Findings show that both sleep quality and fatigue severity are associated with multiple factors associated with successful cessation and could be modifiable targets for future smoking cessation interventions. Furthermore, our data suggest that fatigue severity has an independent effect on multiple factors associated with successful cessation when accounting for sleep quality. This indicates that fatigue, independent of sleep quality, could be an important factor in a quit attempt.

Effects of electronic cigarette e-liquid flavouring on cigarette craving.

BACKGROUND: E-liquid flavour restrictions may discourage electronic cigarette (e-cigarette) uptake among youth. However, possible unintended consequences may include reduced appeal and effectiveness of e-cigarettes for smoking cessation. Non-tobacco flavours appear to be important for smoking cessation, but how and why are currently unclear. METHODS: We conducted an experimental study in a UK sample of adult daily smokers using an independent groups design (N=84). Participants were randomised to use an e-cigarette with nicotine-containing fruit/sweet-flavoured e-liquid (blackcurrant, strawberry, vanilla, caramel) or unflavoured e-liquid for 1 week. The primary outcomes were average, peak and cue-elicited cigarette craving (the latter was assessed using a cue exposure task). The secondary outcomes were smoking lapse occurrence, enjoyment of the e-cigarette, ease of transitioning from smoking to using an e-cigarette, intentions to continue using an e-cigarette, intentions and motivation to quit smoking, return to smoking, and continuation of e-cigarette use. RESULTS: E-liquid flavouring did not appear to have an effect on average cigarette craving (b 0.18, 95% CI -0.44 to 0.79, p=0.57), peak cigarette craving (b -0.12, 95% CI -0.59 to 0.35, p=0.62) or cue-elicited cigarette craving (b -0.21, 95% CI -3.86 to 3.43, p=0.91). We did not find evidence of a difference in secondary outcomes. CONCLUSIONS: We did not find evidence to suggest that nicotine-containing fruit/sweet-flavoured and unflavoured e-liquids have different effects on cigarette cravings after 1 week of use. Further research is needed to establish if differences emerge over longer periods of exposure and extend to smoking cessation outcomes.

Nucleation increases the visual appeal of lager but does not alter overall likeability or drinking rate.

BACKGROUND: Glassware can be an effective vehicle to recruit customers, revive brands, build profits and increase alcohol consumption by capitalising on the immediacy of glassware to the point of consumption. The design of glassware can also contribute to harm reduction by slowing and reducing consumption. Nucleated bases have been added to lager glasses in recent years which allow carbon dioxide (CO2) to be more rapidly released and ascend through the solution. The aim of these studies was to investigate the effect of nucleated glasses on the likeability and drinking rate of lager in alcohol drinkers. METHODS: In Study 1, participants (n = 116) were asked to taste two glasses of lager (280 millilitres (ml) each) in separate 5-min taste tests and fill out a likeability questionnaire after each glass in a within-subjects design with one factor of glass (nucleated, non-nucleated). The primary outcome was the likeability of lager and the secondary outcome was volume consumption during taste tests. In Study 2, participants (n = 160) were asked to consume a pint of lager (568 ml) and fill out a likeability questionnaire in a between-subjects design with one factor of glass (nucleated, non-nucleated). The primary outcome was time taken to consume a pint of lager and secondary outcomes were the likeability of lager, mood and alcohol craving. RESULTS: There was no clear evidence that likeability of lager differed between nucleated and non-nucleated glasses in either study. In Study 1, a paired-samples t test found strong evidence that lager in nucleated glasses was more visually appealing (single item from likeability measure) than lager in non-nucleated glasses (mean difference (MD) = 10.2, 95% confidence interval (CI) 6.1, 14.2, p < 0.001). In Study 2, a linear regression found no clear evidence that lager was consumed at different rates from nucleated and non-nucleated glasses (nucleated: 16.9 min, non-nucleated: 16.3 min, MD: 0.6 min, 95% CI - 1.5, 2.7, p = 0.57). CONCLUSIONS: Nucleated lager glasses do not appear to alter the likeability or consumption (volume consumed in Study 1 or drinking rate in Study 2) of lager, although they do seem to increase the visual appeal and refreshment of lager. This may increase the number of drinking episodes by making the drinking experience more enjoyable which may lead to increased alcohol related harm.

Examining the bidirectional association between emotion recognition and social autistic traits using observational and genetic analyses.

BACKGROUND: There is mixed evidence for an association between autism spectrum disorder (ASD) and emotion recognition deficits. We sought to assess the bidirectionality of this association using phenotypic and genetic data in a large community sample. METHODS: Analyses were conducted in three stages. First, we examined the bidirectional association between social autistic traits at age 8 years and emotion recognition task (ERT) responses at age 24 years (Study 1; N = 3,562); and between Diagnostic Analysis of Non-Verbal Accuracy (DANVA) emotion recognition responses at age 8 years and social autistic traits at age 10 years (Study 2; N = 9,071). Next, we used genetic analyses (Study 3) to examine the association between polygenic risk scores for ASD and outcomes for the ERT and DANVA. The genetic correlation between ASD and ERT responses at age 24 was also estimated. Analyses were conducted in the Avon Longitudinal Study of Parents and Children. RESULTS: Social autistic traits at age 8 years were negatively associated with later total correct responses on ERT in Study 1 (b = -0.18; 95% CI: -0.27 to -0.09). We also found evidence of an association in Study 2 (b = -0.04; 95% CI: -0.05 to -0.03). We found the opposite association, that is positive, between the ASD polygenic risk score and ERT (b = 0.40; 95% CI: 0.10 to 0.70); however, this association varied across different p-value thresholds and would not survive multiple testing, so should be interpreted with caution. We did not find evidence of a genetic correlation between ASD and ERT. CONCLUSION: We found an observational association between poorer emotion recognition and increased social autistic traits. Our genetic analyses may suggest a shared genetic aetiology between these or a potential causal pathway; however, future research would benefit from using better powered GWAS to examine this further. Our results may inform interventions targeting emotion recognition.

Effects of state anxiety on gait: a 7.5% carbon dioxide challenge study.

We used the 7.5% carbon dioxide (CO2) model of anxiety induction to investigate the effects of state anxiety on normal gait and gait when navigating an obstacle. Healthy volunteers (n = 22) completed a walking task during inhalations of 7.5% CO2 and medical air (placebo) in a within-subjects design. The order of inhalation was counterbalanced across participants and the gas was administered double-blind. Over a series of trials, participants walked the length of the laboratory, with each trial requiring participants to navigate through an aperture (width adjusted to participant size), with gait parameters measured via a motion capture system. The main findings were that walking speed was slower, but the adjustment in body orientation was greater, during 7.5% CO2 inhalation compared to air. These findings indicate changes in locomotor behaviour during heightened state anxiety that may reflect greater caution when moving in an agitated state. Advances in sensing technology offer the opportunity to monitor locomotor behaviour, and these findings suggest that in doing so, we may be able to infer emotional states from movement in naturalistic settings.

No Impact of Calorie or Unit Information on Ad Libitum Alcohol Consumption.

AIMS: To investigate the impact of unit and calorie information on drinking behaviour in an ad libitum taste test paradigm. METHODS: In this experimental human laboratory study, participants were randomized to one of four conditions, balanced by gender, using a 2 (unit information: present vs. absent) × 2 (calorie information: present vs. absent) between-subjects design. The percentage of beer consumed during the taste test was the primary outcome measure. RESULTS: Among this largely undergraduate student population, we found no evidence that either unit or calorie information impacted alcohol consumption in an ad libitum taste test. A manipulation check indicated that few of the participants receiving either unit and/or calorie information could accurately recall the number of units and/or calories in the beverages provided to them, indicating low levels of engagement with this information. Analysis of qualitative reactions to calorie and unit labelling indicated possible negative unintended consequences of calorie and unit information, including using unit information to facilitate consumption of higher strength beverages, and calorie information to reduce food consumption prior to a drinking episode. CONCLUSION: We find no evidence to support an effect of unit or calorie information, a public-health initiative supported by the alcohol industry, on drinking behaviour. It is possible that compulsory unit and calorie labelling, at least in the numeric format used here, would have no effect on alcohol intake and may even have some negative unintended consequences among certain populations.

Alcohol pictorial health warning labels: the impact of self-affirmation and health warning severity.

BACKGROUND: We examined whether enhancing self-affirmation among a population of drinkers, prior to viewing threatening alcohol pictorial health warning labels, would reduce defensive reactions and promote reactions related to behaviour change. We also examined how health warning severity influences these reactions and whether there is an interaction between self-affirmation and severity. METHODS: In this experimental human laboratory study, participants (n = 128) were randomised to a self-affirmation or control group. After the self-affirmation manipulation was administered, we tracked participants' eye movements while they viewed images of six moderately-severe and six highly-severe pictorial health warning labels presented on large beer cans. Self-reported responses to the pictorial health warning labels were then measured, including avoidance, reactance, effectiveness, susceptibility and motivation to drink less. Finally, participants reported their self-efficacy to drink less and their alcohol use. RESULTS: There was no clear evidence that enhancing self-affirmation influenced any outcome. In comparison to moderately-severe health warnings, highly-severe health warnings increased avoidance and reactance and were perceived as more effective and increased motivation to drink less. CONCLUSIONS: These findings call into question the validity of the self-affirmation manipulation, which is purported to reduce defensive reactions to threatening warnings. We discuss possible explanations for this null effect, including the impact of participants' low perceived susceptibility to the risks shown on these pictorial health warning labels. Our finding that highly-severe health warnings increase avoidance and reactance but are also perceived as being more effective and more likely to motivate people to drink less will inform future health warning design and have implications for health warning label theory.

Drinking status but not acute alcohol consumption influences delay discounting.

OBJECTIVE: The aim of this study was to investigate the following: (a) the effects of acute alcohol on delay discounting; (b) the effects of drinking status on delayed discounting; and (c) whether these effects differ according to reward type (alcohol vs. money). METHODS: Heavy and light social alcohol users (n = 96) were randomized to receive either an acute dose of alcohol at 0.4 or 0.6 g/kg or placebo in a between-subjects, double-blind design. Delay discounting of alcohol and monetary rewards was measured using a hyperbolic model, with higher scores indicative of greater delay discounting. RESULTS: ANOVA of discount scores indicated a main effect of reward type, where all participants had higher discount scores for alcohol versus money rewards. A main effect of drinking status was also observed, where heavier drinkers had higher discount scores compared with lighter drinkers. We did not observe a main effect of acute alcohol use on delay discounting or the hypothesized interactions between acute alcohol use and drinking status with reward type. CONCLUSIONS: Our data suggest that heavier drinkers discount the value of delayed rewards more steeply than lighter drinkers. Delay discounting may therefore be a promising marker of heavy alcohol consumption in social drinkers.

Effect of glass markings on drinking rate in social alcohol drinkers.

Background: The main aim of these studies was to explore the influence of volume information on glassware on the time taken to consume an alcoholic beverage. Methods: In Study 1, male and female social alcohol consumers ( n = 159) were randomised to drink 12 fl oz of either low or standard strength lager, from either a curved glass marked with yellow tape at the midpoint or an unmarked curved glass, in a between-subjects design. In Study 2, male and female social alcohol consumers ( n = 160) were randomised to drink 12 fl oz of standard strength lager from either a curved glass marked with », ½ and ¾ volume points or an unmarked curved glass, in a between-subjects design. The primary outcome measure for both studies was total drinking time of an alcoholic beverage. Results: In Study 1, after removing outliers, total drinking time was slower from the glass with midpoint volume marking [mean drinking times (min): 9.98 (marked) vs. 9.55 (unmarked), mean difference = 0.42, 95% CI: -0.90, 1.44]. In Study 2, after removing outliers, total drinking time was slower from the glass with multiple volume marks [mean drinking times: 10.34 (marked) vs. 9.11 (unmarked), mean difference = 1.24, 95% CI: -0.11, 2.59]. However, in both studies confidence intervals were wide and also consistent with faster consumption from marked glasses. Conclusion: Consumption of an alcoholic beverage may be slower when served in glasses with volume information. Replication in larger studies is warranted.

Association of Alcohol Consumption with Perception of Attractiveness in a Naturalistic Environment.

AIMS: To investigate the relationship between objectively-assessed alcohol consumption and perception of attractiveness in naturalistic drinking environments, and to determine the feasibility and acceptability of conducting a large-scale study in these environments. METHODS: Observational study conducted simultaneously across three public houses in Bristol, UK. Participants were required to rate the attractiveness of male and female face stimuli and landscape stimuli administered via an Android tablet computer application, after which their expired breath alcohol concentration (BrAC) was measured. RESULTS: Linear regression revealed no clear evidence for relationships between alcohol consumption and either overall perception of attractiveness for stimuli, for faces specifically, or for opposite-sex faces. The naturalistic research methodology was feasible, with high levels of participant engagement and enjoyment. CONCLUSIONS: We found no evidence for a relationship between alcohol consumption and perception of attractiveness in our large-scale naturalistic study. Our study is important given the large sample size, the successful translation of an experimental, laboratory-based paradigm to a naturalistic drinking environment and the high level of public engagement with the study. Future studies should use similarly ecologically-valid methodologies to further explore the conditions under which this effect may be observed and identify the mechanisms underlying any relationships.

Effects of nicotine and nicotine expectancy on attentional bias for emotional stimuli.

INTRODUCTION: Nicotine's effects on mood are thought to enhance its addictive potential. However, the mechanisms underlying the effects of nicotine on affect regulation have not been reliably demonstrated in human laboratory studies. We investigated the effects of nicotine abstinence (Experiment 1), and nicotine challenge and expectancy (Experiment 2) on attentional bias towards facial emotional stimuli differing in emotional valence. METHODS: In Experiment 1, 46 nicotine-deprived smokers were randomized to either continue to abstain from smoking or to smoke immediately before testing. In Experiment 2, 96 nicotine-deprived smokers were randomized to smoke a nicotinized or denicotinized cigarette and to be told that the cigarette did or did not contain nicotine. In both experiments participants completed a visual probe task, where positively valenced (happy) and negatively valenced (sad) facial expressions were presented, together with neutral facial expressions. RESULTS: In Experiment 1, there was evidence of an interaction between probe location and abstinence on reaction time, indicating that abstinent smokers showed an attentional bias for neutral stimuli. In Experiment 2, there was evidence of an interaction between probe location, nicotine challenge and expectation on reaction time, indicating that smokers receiving nicotine, but told that they did not receive nicotine, showed an attentional bias for emotional stimuli. CONCLUSIONS: Our data suggest that nicotine abstinence appears to disrupt attentional bias towards emotional facial stimuli. These data provide support for nicotine's modulation of attentional bias as a central mechanism for maintaining affect regulation in cigarette smoking.

Increased facial attractiveness following moderate, but not high, alcohol consumption.

AIMS: Alcohol consumption is known to be associated with risky sexual behaviours, but this relationship may be complex and bidirectional. We explored whether alcohol consumption leads to the consumer being rated as more attractive than sober individuals. METHODS: Heterosexual social alcohol consumers completed an attractiveness-rating task, in which they were presented with pairs of photographs depicting the same individual, photographed while sober and after having consumed alcohol (either 0.4 or 0.8 g/kg), and required to decide which image was more attractive. RESULTS: Photographs of individuals who had consumed a low dose of alcohol (equivalent to 250 ml of wine at 14% alcohol by volume for a 70 kg individual) were rated as more attractive than photographs of sober individuals. This was not observed for photographs of individuals who had consumed a high dose of alcohol. CONCLUSION: In addition to perceiving others as more attractive, a mildly intoxicated alcohol consumer may also be perceived as more attractive by others. This in turn may play a role in the relationship between alcohol consumption and risky sexual behaviour.

Effects of first exposure to plain cigarette packaging on smoking behaviour and attitudes: a randomised controlled study.

BACKGROUND: Plain packaging requires tobacco products to be sold in packs with a standard shape, method of opening and colour, leaving the brand name in a standard font and location. We ran a randomised controlled trial to investigate the impact of plain packaging on smoking behaviour and attitudes. METHODS: In a parallel group randomised trial design, 128 daily smokers smoked cigarettes from their usual UK brand, or a plain Australian brand that was closely matched to their usual UK brand for 24 hours. Primary outcomes were number of cigarettes smoked and volume of smoke inhaled per cigarette. Secondary outcomes were self-reported ratings of motivation to quit, cigarette taste, experience of using the pack, experience of smoking, attributes of the pack, perceptions of the health warning, changes in smoking behaviour, and views on plain packaging. RESULTS: There was no evidence that pack type had an effect on either of the primary measures (ps > 0.279). However, smokers using plain cigarette packs rated the experience of using the pack more negatively (-0.52, 95% CI -0.82 to -0.22, p = 0.001), rated the pack attributes more negatively (-1.59, 95% CI -1.80 to -1.39, p < 0.001), and rated the health warning as more impactful (+0.51, 95% CI 0.24 to 0.78, p < 0.001). CONCLUSIONS: Plain cigarette packs reduce ratings of the experience of using the cigarette pack, and ratings of the pack attributes, and increase the self-perceived impact of the health warning, but do not change smoking behaviour, at least in the short term. TRIAL REGISTRATION: Current Controlled Trials ISRCTN52982308. Registered 27 June 2013.

"The worst thing is lying in bed thinking 'I want a cigarette'" a qualitative exploration of smoker's and ex-smoker's perceptions of sleep during a quit attempt and the use of cognitive behavioural therapy for insomnia to aid cessation.

Smokers report poorer sleep quality than non-smokers and sleep quality deteriorates further during cessation, increasing risk of smoking relapse. Despite the use of cognitive behavioural therapy for insomnia (CBT-I) to aid quit attempts emerging in the area, little is known about smokers and ex smoker's experiences of sleep during a quit attempt or their perceptions of CBT-I. This study addresses this gap by exploring smoker's and ex-smoker's experiences of the link between smoking and sleep and how this may change as a function of smoking/smoking abstinence. It also explores views of traditional CBT-I components (i.e., perceived feasibility, effectiveness, barriers of use). We conducted semi-structured interviews with current and recently quit smokers (n = 17) between January and September 2022. The framework method was used for analysis. Four themes addressing research questions were described. These included: 1) A viscous cycle; poor sleep quality and negative psychological state during cessation; 2) Perceived engagement and effectiveness; the importance of feasibility, experience, value, identity and psychological state in assessing CBT-I as a cessation tool; 3) Striking a balance; tailoring CBT-I to reduce psychological overload in a time of lifestyle transition; and 4) Personalisation and digital delivery helping overcome psychological barriers during cessation. The analysis suggested during quit attempts smokers experienced a range of sleep problems that could increase risk of relapse due to a negative impact on psychological state. It also revealed participants thought that CBT-I is something they would use during a quit attempt but suggested changes and additions that would improve engagement and be better tailored to quitting smokers. Key additions included the integration of smoking-based cognitive restructuring, starting the intervention prior to a quit attempt, and the need for personalisation and tailoring.

The impact of introducing alcohol-free beer options in bars and public houses on alcohol sales and revenue: A randomised crossover field trial.

AIMS: The study aimed to estimate the impact of introducing a draught alcohol-free beer, thereby increasing the relative availability of these products, on alcohol sales and monetary takings in bars and pubs in England. DESIGN: Randomised crossover field trial. SETTING: England. PARTICIPANTS: Fourteen venues that did not previously sell draught alcohol-free beer. INTERVENTION AND COMPARATOR: Venues completed two intervention periods and two control periods in a randomised order over 8 weeks. Intervention periods involved replacing one draught alcoholic beer with an alcohol-free beer. Control periods operated business as usual. MEASUREMENTS: The primary outcome was mean weekly volume (in litres) of draught alcoholic beer sold. The secondary outcome was mean weekly revenue [in GBP (£)] from all drinks. Analyses adjusted for randomised order, special events, season and busyness. FINDINGS: The adjusted mean difference in weekly sales of draught alcoholic beer was -20 L [95% confidence interval (CI) = -41 to +0.4], equivalent to a 4% reduction (95% CI = 8% reduction to 0.1% increase) in the volume of alcoholic draught beer sold when draught alcohol-free beer was available. Excluding venues that failed at least one fidelity check resulted in an adjusted mean difference of -29 L per week (95% CI = -53 to -5), equivalent to a 5% reduction (95% CI = 8% reduction to 0.8% reduction). The adjusted mean difference in weekly revenue was +61 GBP per week (95% CI = -328 to +450), equivalent to a 1% increase (95% CI = 5% decrease to 7% increase) when draught alcohol-free beer was available. CONCLUSIONS: Introducing a draught alcohol-free beer in bars and pubs in England reduced the volume of draught alcoholic beer sold by 4% to 5%, with no evidence of the intervention impacting net revenue.

Acute anxiety impairs accuracy in identifying photographed faces.

We investigated whether acutely induced anxiety modifies the ability to match photographed faces. Establishing the extent to which anxiety affects face-matching accuracy is important because of the relevance of face-matching performance to critical security-related applications. Participants (N = 28) completed the Glasgow Face Matching Test twice, once during a 20-min inhalation of medical air and once during a similar inhalation of air enriched with 7.5% CO2, which is a validated method for inducing acute anxiety. Anxiety degraded performance, but only with respect to hits, not false alarms. This finding provides further support for the dissociation between the ability to accurately identify a genuine match between faces and the ability to identify the lack of a match. Problems with the accuracy of facial identification are not resolved even when viewers are presented with a good photographic image of a face, and identification inaccuracy may be heightened when viewers are experiencing acute anxiety.

Acutely induced anxiety increases negative interpretations of events in a closed-circuit television monitoring task.

In two experiments we measured the effects of 7.5% CO2 inhalation on the interpretation of video footage recorded on closed circuit television (CCTV). As predicted, inhalation of 7.5% CO2 was associated with increases in physiological and subjective correlates of anxiety compared with inhalation of medical air (placebo). Importantly, when in the 7.5% CO2 condition, participants reported the increased presence of suspicious activity compared with placebo (Experiment 1), a finding that was replicated and extended (Experiment 2) with no concomitant increase in the reporting of the presence of positive activity. These findings support previous work on interpretative bias in anxiety but are novel in terms of how the anxiety was elicited, the nature of the interpretative bias, and the ecological validity of the task.

Assessing the effectiveness of online emotion recognition training in healthy volunteers.

Facial emotion recognition (ER) difficulties are associated with mental health and neurodevelopmental conditions, including autism and poorer social functioning. ER interventions may therefore have clinical potential. We investigated the efficacy of ER training (ERT). We conducted three online studies with healthy volunteers completing one ERT session. Studies 1 and 2 included active and control/sham training groups and tested the efficacy of (i) four-emotion ERT (angry, happy, sad and scared) (n = 101), and (ii) six-emotion ERT (adding disgusted and surprised) (n = 109). Study 3 tested generalizability of ERT to non-trained stimuli with groups trained and tested on the same stimuli, or different stimuli (n = 120). Training effects on total correct hits were estimated using linear mixed effects models. We did not observe clear evidence of improvement in study 1 but note the effect was in the direction of improvement (b = 0.02, 95% confidence interval (CI) = -0.02 to 0.07). Study 2 indicated greater total hits following training (b = 0.07, 95% CI = 0.03-0.12). Study 3 demonstrated similar improvement across groups (b = -0.01, 95% CI = -0.05 to 0.02). Our results indicate improved ER (as measured by our task), which generalizes to different facial stimulus sets. Future studies should further explore generalizability, longer-term effects and ERT in populations with known ER difficulties.