Prevalence of smoking restrictions and child exposure to secondhand smoke in cars and homes: a repeated cross-sectional survey of children aged 10-11 years in Wales.

OBJECTIVE: Small increases in smoking restrictions in cars and homes were reported after legislation prohibiting smoking in public places. Few studies examine whether these changes continued in the longer term. This study examines changes in restrictions on smoking in cars and homes, and child exposure to secondhand smoke (SHS) in these locations, since 2008 postlegislation surveys in Wales. SETTING: State-maintained primary schools in Wales (n=75). PARTICIPANTS: Children aged 10-11 years (year 6) completed CHETS (CHild exposure to Environmental Tobacco Smoke) Wales surveys in 2007 (n=1612) and 2008 (n=1605). A replication survey (CHETS Wales 2) was conducted in 2014, including 1601 children. PRIMARY OUTCOME VARIABLE: Children's reports of whether smoking was allowed in their car or home and exposure to SHS in a car or home the previous day. RESULTS: The percentage of children who reported that smoking was allowed in their family vehicle fell from 18% to 9% in 2014 (OR=0.42; 95% CI 0.33 to 0.54). The percentage living in homes where smoking was allowed decreased from 37% to 26% (OR=0.30; 95% CI 0.20 to 0.43). Among children with a parent who smoked, one in five and one in two continued to report that smoking was allowed in their car and home. The percentage reporting SHS exposure in a car (OR=0.52; 95% CI 0.38 to 0.72) or home (OR=0.44; 95% CI 0.36 to 0.53) the previous day also fell. Children from poorer families remained less likely to report smoking restrictions. CONCLUSIONS: Smoking in cars and homes has continued to decline. Substantial numbers of children continue to report that smoking is allowed in cars and homes, particularly children from poorer families. A growing number of countries have legislated, or plan to legislate, banning smoking in cars carrying children. Attention is needed to the impact of legislation on child health and health inequalities, and reducing smoking in homes.

Language issues in the community pharmacy: a perspective from Wales.

OBJECTIVES: This study aimed to obtain the views of Welsh speakers to explore the role of the Welsh language in community pharmacies in bilingual communities in Wales. METHODS: Two communities with a high proportion of Welsh speakers were purposively identified for the research: one in North Wales and one in West Wales. Stage 1: semi-structured interviews with a purposive sample of Welsh speakers to identify key themes. Data collection continued until no new themes emerged. Interviews were tape-recorded, transcribed verbatim, coded manually and analysed thematically. Stage 2: self-complete questionnaire developed based on the interview results. The anonymous, bilingual questionnaire and covering letter, with a postage-paid envelope, were delivered to 500 homes (250 in each community) for completion by the person in the household who visited a pharmacy most often. There was no follow-up mailing due to anonymity. Data were analysed using SPSS version 12. KEY FINDINGS: Results from both interviews (n = 36) and questionnaires (response rate was 52%, 82% of whom were Welsh speakers) found that the majority of Welsh speakers in the study were able to understand English but preferred to use Welsh in the pharmacy. They would find it easier to explain symptoms and would ask more about their medication if they could speak Welsh with the pharmacist. In addition, the study participants would generally feel more at ease with a Welsh-speaking pharmacist and would feel they were getting a better service if they could use their first language. CONCLUSIONS: This study of Welsh speakers indicates that language choice is important for bilingual people who may prefer to use their native, minority language for consultation with health professionals. Further, it is clear that a concordant partnership between patient and pharmacist is less likely where one party is using a language with which they are not confident or comfortable. Pharmacists need to be aware of the linguistic needs and preferences of bilingual clients.

Effects of dietary amines on the gut and its vasculature.

Trace amines, including tyramine and beta-phenylethylamine (beta-PEA), are constituents of many foods including chocolate, cheeses and wines and are generated by so-called 'friendly' bacteria such as Lactobacillus, Lactococcus and Enterococcus species, which are found in probiotics. We therefore examined whether these dietary amines could exert pharmacological effects on the gut and its vasculature. In the present study we examined the effects of tyramine and beta-PEA on the contractile activity of guinea-pig and rat ileum and upon the isolated mesenteric vasculature and other blood vessels. Traditionally, these amines are regarded as sympathomimetic amines, exerting effects through the release of noradrenaline from sympathetic nerve endings, which should relax the gut. A secondary aim was therefore to confirm this mechanism of action. However, contractile effects were observed in the gut and these were independent of noradrenaline, acetylcholine, histamine and serotonin receptors. They were therefore probably due to the recently described trace amine-associated receptors. These amines relaxed the mesenteric vasculature. In contrast, the aorta and coronary arteries were constricted, a response that was also independent of a sympathomimetic action. From these results, we propose that after ingestion, trace amines could stimulate the gut and improve intestinal blood flow. Restriction of blood flow elsewhere diverts blood to the gut to aid digestion. Thus, trace amines in the diet may promote the digestive process through stimulation of the gut and improved gastrointestinal circulation.