Releases Saturday 15 December 2001
No 7326 Volume 323
Please remember to credit the BMJ as source when publicising
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(1) SEEING SMOKING IN FILMS
ENCOURAGES TEENAGERS TO TRY
SMOKING
(2) TIME TO REASSESS THE VALUE OF HRT
(3) TEENAGE
PREGNANCY IS NOT A PUBLIC
HEALTH PROBLEM
(4) PEOPLE
IN LOW SOCIAL CLASSES
DELAY SEEKING
TREATMENT FOR
SCHIZOPHRENIA
(1) SEEING SMOKING
IN FILMS
ENCOURAGES TEENAGERS TO TRY
SMOKING
(Effect of seeing tobacco use in
films on trying
smoking among adolescents: cross
sectional
study)
http://bmj.com/cgi/content/full/323/7326/1394
(Editorial: Smoking in teenagers
and watching
films showing smoking)
http://bmj.com/cgi/content/full/323/7326/1378
The more smoking teenagers see in films
the
more likely they are to smoke, finds a
study in
this week's BMJ, providing powerful new
evidence that depictions of smoking in
films
influence adolescents to smoke.
James Sargent and colleagues surveyed 4,919
schoolchildren in the United States (aged
9-15
years) about the amount of smoking they
had
seen in films and whether they had ever
tried
smoking. They found that the likelihood
of ever
trying cigarettes increased with higher
exposure
to smoking in films, even when other factors
linked with adolescent smoking were taken
into
account.
For instance, among students who had watched
films with 50 or fewer occurences of smoking,
only 4.9% had ever tried smoking. Of those
who
had watched films with more than 150
occurences of smoking, 31.5% had tried
smoking.
The results indicate that exposure to tobacco
in
films is pervasive, say the authors. More
importantly, such exposure is associated
with
trying smoking, which supports the hypothesis
that films have a role in the initiation
of smoking,
they conclude.
It is time for the entertainment industry
to accept
responsibility for its actions and stop
serving the
interests of tobacco companies, writes
Professor
Stanton Glantz in an accompanying editorial.
His
campaign called "Smoke Free Movies" challenges
Hollywood to take effective steps to make
their
films smoke free, such as running strong
anti-tobacco ads before films containing
smoking
scenes and increasing the age rating for
any film
with smoking.
"None of these measures will choke creativity
or
restrict content. Each will make American
films
much less complicit in the global tobacco
epidemic," he concludes.
Contacts:
[Paper]: James Sargent, Associate Professor,
Dartmouth Medical School, Lebanon, USA
Email: James.D.Sargent{at}Hitchcock.org
[Editorial]: Stanton Glantz, Professor
of Medicine,
University of California, San Francisco,
USA
Email: glantz{at}medicine.ucsf.edu
(2) TIME TO REASSESS THE VALUE OF HRT
(Editorial: Hormone replacement therapy
and the
breast)
http://bmj.com/cgi/content/full/323/7326/1381
It may be time to reassess the value of
hormone
replacement therapy, following evidence
that it
reduces the effectiveness of breast screening
and
causes breast cancer in women over the
age of
50, says a leading breast surgeon in this
week's
BMJ.
Increasing numbers of women in their 50s
and
60s are using hormone replacement therapy
to
alleviate menopausal symptoms, yet the
effect of
long term use of these agents in women
aged
over 50 on the breast is only now becoming
apparent.
In many women, hormone replacement therapy
increases breast density. This affects
both the
sensitivity and specificity of breast
screening
because the effectiveness of breast screening
depends on the decreasing breast density
normally seen with age.
In countries where hormone replacement
therapy
is widely used, this reduction in the
sensitivity of
breast screening could undermine the capacity
of
national breast screening programmes to
reduce
deaths due to breast cancer, explains
the author.
Studies of early hormone replacement therapy
reported an increased risk of breast cancer
for
each year of use. More recent studies
have
reported significantly higher levels of
risk in
women taking combined hormone preparations
compared with women taking oestrogen alone.
The evidence that hormone replacement therapy
reduces the effectiveness of breast screening
and
causes breast cancer in women over the
age of
50 is clear, says the author. The challenge
for
clinicians is to control menopausal symptoms
while limiting these unwanted effects,
he
concludes.
Contact:
Mike Dixon, Consultant Surgeon and Senior
Lecturer, Edinburgh Breast Unit, Western
General Hospital, Edinburgh, Scotland
Email: jmd{at}wght.demon.co.uk
(3) TEENAGE PREGNANCY
IS NOT A PUBLIC
HEALTH PROBLEM
(Letter: Teenage pregnancy is not
in fact a public
health problem)
http://bmj.com/cgi/content/full/323/7326/1428
Teenage pregnancy is not a public health
problem, but is really a reflection of
what is
considered to be socially, culturally,
and
economically acceptable in the United
Kingdom,
argue researchers in this week's BMJ.
Women having babies in their 30s and 40s
are not
labelled a public health problem, and
neither are
women who have problems conceiving, even
though their babies have an increased
risk of
prenatal death, write Debbie Lawlor and
colleagues from the University of Bristol.
There
is no biological reason to suggest that
having a
baby before the age of 20 is associated
with ill
health, they add.
Current policy in the United Kingdom aims,
firstly
to halve the conception rate of the under
18s and
set a downward trend in the rate for under
16s by
2010 and, secondly, to achieve a reduction
in the
risk of long term social exclusion of
teenage
parents and their children. "We would
argue that
the second of these goals is the appropriate
public
health aim, and yet most action is likely
to be
geared towards the first."
"Teenage pregnancy is not a public health
problem; the cumulative effect of social
and
economic exclusion on the health of mothers
and
their babies, whatever their age, is,"
they
conclude.
Contact:
Debbie Lawlor, Lecturer in Epidemiology
and
Public Health Medicine, University of
Bristol,
Bristol, UK
Email: D.A.Lawlor{at}bristol.ac.uk
(4) PEOPLE IN
LOW SOCIAL CLASSES
DELAY SEEKING TREATMENT FOR
SCHIZOPHRENIA
(Effect of social class at birth
on risk and
presentation of schizophrenia: case-control
study)
http://bmj.com/cgi/content/full/323/7326/1398
People born into low social classes are
not at
increased risk of developing schizophrenia,
but
they appear to seek treatment at a later
age than
those in higher social classes, concludes
a study
in this week's BMJ.
Fiona Mulvany and colleagues used the records
of 352 patients referred to psychiatric
services in
Dublin to determine whether social class
of origin
influenced the risk of schizophrenia and
the age
at which patients first made contact with
psychiatric services.
They found no link between social class
at birth
and risk of schizophrenia, but found more
than an
eight year difference in age at presentation
to
psychiatric services between the lowest
and
highest social classes.
People from lower social classes may find
it
more difficult to access services, suggest
the
authors. Alternatively, people from the
higher
social classes may be better informed
about
schizophrenia or find it easier to identify
deviations from normal daily functioning.
This delay in treatment may, at least partly,
explain why people in low social classes
have a
poor outcome, add the authors. Efforts
to reduce
the duration of untreated psychosis through
earlier detection should be particularly
focused on
people in lower social classes, they conclude.
Contact:
Eadbhard O'Callaghan, Professor, Department
of
Psychiatry, University College Dublin,
Ireland
Email: eadbhard{at}indigo.ie
or
Fiona Mulvany, Researcher, Department of
Adult
Psychiatry, Hospitaller Order of St John
of God,
Cluain Mhuire Family Centre, Dublin, Ireland
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
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BMA House
Tavistock Square
London WC1H 9JR
(contact: pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American
Association for the
Advancement of Science
(http://www.eurekalert.org)
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