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Biomedical subjects

Simon Chapman

Publications and source records attributed to Simon Chapman.

At least 19 recordsLinked to original sources
PubMed2006

Political dynamics promoting the incremental regulation of secondhand smoke: a case study of New South Wales, Australia.

BACKGROUND: The history of governmental responses to the accumulation of scientific evidence about the harms of secondhand smoke (SHS) presents an intriguing case study of incremental public health policy development. Australia has long been considered a world-leader in progressive tobacco control policies, but in the last decade has fallen behind other jurisdictions in introducing SHS legislation that protects all workers. Bars, clubs and pubs remain the only public indoor spaces where smoking is legally permitted, despite SHS exposure in the hospitality industry being higher and affecting more people than in any other setting after domestic exposure. This paper examines the political dynamics that have shaped this incremental approach to SHS. METHODS: In-depth interviews with 21 key stakeholders in the state of New South Wales (NSW), including politicians, their advisors, health officials and tobacco control advocates, were conducted and subjected to thematic content analysis. Interviewees' comments provided insights into the dynamics surrounding the debates and outcomes of SHS legislative attempts and the current political environment, and about how to progress SHS legislation. RESULTS: SHS restrictions have been delayed by several broad factors: the influence of industry groups successfully opposing regulation; issue wear-out; and political perceptions that there is not a salient constituency demanding that smoking be banned in bars and clubs. Interviewees also provided suggestions of strategies that advocates might utilise to best overcome the current political inertia of incremental compromises and achieve timely comprehensive smoking bans. CONCLUSION: Advocates concerned to shorten the duration of incremental endgames must continue to insist that governments address SHS fundamentally as a health issue rather than making political concessions to industry groups, and should broaden and amplify community voices calling on governments to finish the job. Publicity to the growing number of state and national governments that have successfully implemented total bans over the past decade is likely to make incrementalism an increasingly unattractive political option.

Air Pollution, Indoor↗
PubMed2006

What maintains parental support for vaccination when challenged by anti-vaccination messages? A qualitative study.

This study sought to explore how parents respond to competing media messages about vaccine safety. Six focus groups with mothers of infants were shown television vignettes of typical pro- and anti-vaccination claims. Thematic analysis of transcripts was undertaken. Mothers expressed surprise and concern about alleged vaccine risks but quickly reinstated their support for vaccination by deference to authority figures; type-casting immunisation opponents; and notions of anticipatory regret, good parenting and social responsibility. We conclude that personal experiences, value systems and level of trust in health professionals are fundamental to parental decision making about vaccination. Vaccination advocacy should increase the focus on matters of process such as maintaining trust and public confidence, particularly in health professionals. Stories about people affected by vaccine-preventable diseases need to re-enter the public discourse.

Adult↗
PubMed2006

Structural elements in achieving legislative tobacco control in NSW, 1955-95: political reflections and implications.

OBJECTIVE: To analyse structural factors revealed by politicians that shaped legislation on tobacco control in New South Wales, 1955-95. METHODS: Parliamentary debates and other records were collected. Open-ended interviews were conducted with 17 Members of Parliament (MPs) who were significantly involved, and then analysed for structural elements. RESULTS: Tobacco industry lobbying had a significant but limited influence on policy making, being exerted largely through social interactions with executives and based on concerns about the economic impact on third parties. MPs saw health advocates' chief functions as (1) generating community concern about the issue and support for control measures, and (2) bringing any new information to political attention, providing pro-control arguments and data through the media. Factors that delayed tobacco control policies included: the conservative stance of Premiers and major parties, commitments to unanimous federal action, and rivalry between parties. Factors that facilitated control policies included: reforms that gave the Legislative Council increased power, the use of parliamentary committees, and backbencher and grass roots support. CONCLUSIONS: Tobacco control policy and legislation has been the product of political structures that gave power to those MPs in the least powerful positions--minor parties, Members of the Legislative Council (MLCs), backbenchers, women and party rank and file--rather than to major parties and their executives. IMPLICATIONS: Advocates should make the most of their access points to the political process, providing information, arguments and support and demonstrating public opinion in favour of further control.

Humans↗
PubMed2006

Health treaty dilution: a case study of Japan's influence on the language of the WHO Framework Convention on Tobacco Control.

BACKGROUND: The Japanese government is an important shareholder in the Japanese tobacco industry. Negotiations to develop the WHO's historic Framework Convention on Tobacco Control (FCTC) were based on consensus, resulting in countries needing to agree to the lowest acceptable common denominator in clause development. OBJECTIVE: To illustrate Japan's role in negotiating key optional language in the FCTC text. METHODS: Summary reports, text proposals, conference papers, and speeches related to the six FCTC negotiation sessions were reviewed for repeated words, concepts and emerging themes. Key stakeholders were interviewed. Key words such as "sovereignty", "appropriate", "latitude", "individual", "flexibility", and "may" representing optional language were examined. RESULTS: The Japanese government's proposals for "appropriate" and optional measures are reflected in the final FCTC text that accommodates flexibility on interpretation and implementation on key tobacco controls. While Japan was not alone in proposing optional language, consensus accommodated their proposals. CONCLUSION: Japan's success in arguing for extensive optional language seriously weakened the FCTC. Accordingly, international tobacco control can be expected to be less successful in reducing the burden of disease caused by tobacco use.

Health Policy↗
PubMed2006

Smokers and non-smokers talk about regulatory options in tobacco control.

OBJECTIVE: Community members are occasionally polled about tobacco control policies, but are rarely given opportunities to elaborate on their views. We examined laypeople's conversations to understand how 11 regulatory options were supported or opposed in interactions. DESIGN: Qualitative design; purposive quota sampling; data collection via focus groups. SETTING: Three locations in Sydney, Australia. PARTICIPANTS: 63 smokers and 75 non-smokers, men and women, from three age groups (18-24, 35-44, 55-64 years), recruited primarily via telephone. MEASUREMENTS: Semi-structured question route; data managed in NVivo; responses compared between groups. RESULTS: Laypeople rejected some regulatory proposals and certain arguments about taxation and the cost of cessation treatments. Protecting children and hypothecating tobacco excise for health education and care were highly acceptable. Plain packaging, banning retail displays and youth smoking prevention received qualified support. Bans on political donations from tobacco corporations were popular in principle but considered logistically fraught. Smokers asked for better cessation assistance and were curious about cigarette ingredients. Justice was an important evaluative principle. Support was often conditional and unresolved arguments frequent. We present both sides of these conflicts and the ways in which policies were legitimised or de-legitimised in conversation. CONCLUSIONS: Simple measures of agreement used in polls may obscure the complexity of community responses to tobacco policy. Support was frequently present but contested; some arguments that seem self-evident to advocates were not so to participants. The detailed understanding of laypeople's responses provided through qualitative methods may help frame proposals and arguments to meet concerns about justice, effectiveness and feasibility.

Adolescent↗
PubMed2005

Impact of news of celebrity illness on breast cancer screening: Kylie Minogue's breast cancer diagnosis.

OBJECTIVES: To describe the main media narratives in the reportage of singer Kylie Minogue's illness with breast cancer; and to assess the impact of this coverage on bookings for screening for breast cancer by mammography in four Australian states. SETTING: Government sponsored BreastScreen programs in Queensland, Victoria, Tasmania and Western Australia. MAIN OUTCOME MEASURES: Narratives on breast cancer in television news programs 17-27 May 2005; initial and re-screening bookings for mammograms. PARTICIPANTS: Women aged > or = 40 years who booked for mammograms in BreastScreen programs in the 19 weeks before, the 2 weeks during, and the 6 weeks after the publicity. RESULTS: There was a 20-fold increase in news coverage of breast cancer, which emphasised that young women do get breast cancer and that early detection was critical. Overall screening bookings rose 40% in the 2 weeks of the publicity, with a 101% increase in non-screened women in the eligible age-group 40-69 years. Six weeks after the publicity, bookings remained more than a third higher in non-screened women. CONCLUSIONS: News coverage of Kylie Minogue's breast cancer diagnosis caused an unprecedented increase in bookings for mammography. Health advocates should develop anticipatory strategies for responding to news coverage of celebrity illness.

Australia↗
PubMed2005

Nicotine analogues: a review of tobacco industry research interests.

AIMS: To explore the tobacco industry's interest and intentions driving its nicotine analogue research. METHODS: Review of internal tobacco industry documents regarding nicotine analogues released as part of the Master Settlement Agreement between the tobacco industry and US state governments in 1998. FINDINGS: The tobacco industry investigated nicotine analogues extensively. Four principal areas of interest are evident. First, research on tobacco products was directed towards greater understanding of nicotine pharmacology, how to screen for potential analogues and how to separate the central and peripheral effects of nicotine. Secondly, interest lay in the potential for analogues to replace nicotine in order to create more 'desirable' products and to circumvent anticipated nicotine regulation. Thirdly, interest lay in potential pharmaceutical applications for analogues such as treatments for neurological disorders. Finally, there was interest in the public relations potential of the therapeutic potential of analogues to reduce the demonization of nicotine, by allowing the industry to point to its beneficial uses. CONCLUSIONS: With tobacco product and nicotine regulation being increasingly advocated in tobacco control it is important to understand the industry's interests in the potential role of nicotine analogues. Initial interest included using analogues as a means to circumvent regulation, but evidence suggests these plans were discarded due to fear that this may have instigated regulation of tobacco products. Nicotine analogue research has led to potential therapeutic uses for Alzheimer's and Parkinson's diseases and alarmingly for the industry, to a potential vaccine to prevent nicotine addiction. RECOMMENDATIONS: Tobacco manufacturers should be obliged to declare all additives being used in tobacco products. Regulatory bodies should be aware that that there is a distinct possibility that the industry has discovered ways to circumvent future regulation of nicotine through the utilization of nicotine analogues. Any regulatory drafting should broaden the definition of nicotine in order to incorporate analogues into the scope of pharmacologically active substances being regulated.

Food Additives↗
PubMed2005

Framing pub smoking bans: an analysis of Australian print news media coverage, March 1996-March 2003.

OBJECTIVE: To investigate framing strategies used by the Australian Hotels Association (AHA) and tobacco control groups to (respectively) resist or advocate laws providing smoke free bars. METHODS: Online archives of Australian print media were searched 1996 to 2003. A thematic analysis of all statements made by AHA spokespeople and tobacco control advocates was conducted. Direct quotes or journalistic summaries of statements attributed to named people were coded into four broad themes and the slant of articles coded. RESULTS: More than three times as many articles reported issues that were positive (n = 171) than negative (n = 48) for tobacco control objectives. The AHA emphasised negative economic issues and cultural/ideological frames about cultural identity, while tobacco control interests emphasised health concerns as well as cultural/ideological frames about threats to inequitable workplace policies. CONCLUSIONS: Smoke free bars have now been secured, suggesting that health advocates' position prevailed. The inability of the AHA to avoid the core health arguments, its wildly exaggerated economic predictions, and its frequent recourse to claiming smoke bans threatened nostalgic but outmoded vistas of Australian day to day life were decidedly backward looking and comparatively easily dismissed as being out of touch with views held by many in contemporary Australia. Health groups' emphasis on the unfairness in denying the most occupationally exposed group the same protection that all other workers enjoyed under law was powerfully and consistently argued. Australia's recent success in securing dates for the implementation of smoke free pubs is likely to have owed much to the enduring media advocacy by health groups.

Alcohol Drinking↗
PubMed2005

Sex and drugs in popular movies: an analysis of the top 200 films.

We analyse the portrayal of sex and drug use in the most popular movies of the last 20 years using the Internet Movie Database list of the top 200 movies of all time. Films released or set prior to the HIV era (pre 1983), animated, not about humans or G/PG rated, were excluded. Films were reviewed by one of two teams of two observers using a data extraction sheet tested for inter-rater reliability. Sexual activity, sexually transmitted disease (STD) prevention, birth control measures, drug use and any consequences discussed or depicted were recorded. There were 53 sex episodes in 28 (32%) of the 87 movies reviewed. There was only one suggestion of condom use, which was the only reference to any form of birth control. There were no depictions of important consequences of unprotected sex such as unwanted pregnancies, HIV or other STDs. Movies with cannabis (8%) and other non-injected illicit drugs (7%) were less common than those with alcohol intoxication (32%) and tobacco use (68%) but tended to portray their use positively and without negative consequences. There were no episodes of injected drug use. Sex depictions in popular movies of the last two decades lacked safe sex messages. Drug use, though infrequent, tended to be depicted positively. The social norm being presented is concerning given the HIV and illicit drug pandemics.

Adolescent↗
PubMed2004

Media coverage of anthrax vaccination refusal by Australian Defence Force personnel.

BACKGROUND: During February 2003 a number of Australian sailors were returned home from their deployment to the Persian Gulf after refusing anthrax vaccination. This paper examines the media coverage of this episode as a case study in how controversies about vaccine safety escalate. METHODS: Frame analysis of articles from major Australian newspapers (n=83) and transcripts of radio and television news and current affairs programs (n=22) to identify the main supportive and oppositional themes used in reportage and media debate. FINDINGS: Initially, the major news frames were supportive of the vaccine refusing soldiers, and conveyed a sense of distrust of the government's actions. These initial themes were rapidly re-framed and new dominant discourses appeared. First, sailors went from brave whistleblowers to being portrayed as deserters and cowards. Second, proponents shifted from their portrayal as faceless regulators to personal risk takers embodied in a well-respected Major General having the vaccine. Third, the voluntary nature of the vaccine was emphasised, thus dousing the flames of implied coercion. CONCLUSION: Marked shifts in the representation of vaccine opponents and proponents possibly contributed to the rapid diminishment of media interest in the story.

Anthrax↗
PubMed2004

"Bulletproof skeptics in life's jungle": which self-exempting beliefs about smoking most predict lack of progression towards quitting?

OBJECTIVE: To determine the prevalence, correlates, and predictive value for intention to quit of 18 commonly expressed self-exempting beliefs about smoking among smokers and recent quitters, some 20 years after intensive tobacco control commenced in Australia. METHOD: National telephone survey of randomly selected 802 adults (685 smokers; 117 recent quitters). Main outcome measures. Level of agreement or disagreement with 18 self-exempting beliefs about smoking and intention to quit. RESULTS: Four coherent categories of self-exempting beliefs are widely held by smokers ("bulletproof", "skeptic", "jungle", and "worth it"). Smokers who hold self-exempting beliefs are more likely to be aged over 50, smoke more than 15 cigarettes per day, have less than 12 years of schooling, and be in the precontemplation stage of change. All scales had some relationship with progress towards quitting. In particular, "worth it" beliefs are powerful independent predictors of smokers not planning to quit. CONCLUSIONS: Some self-exempting beliefs seem to act as a shield for smokers, giving them false reassurance and allowing them to avoid thinking deeply about the importance of quitting. This is particularly true of "worth it" beliefs. The prevalence of such beliefs may suggest confusion about smoking being a risk rather than a probable cause of illness. Creative approaches to increasing the saliency of the costs of smoking may be fruitful.

Adult↗