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PubMed2006

Bladder cancer risk in sales workers: artefact or cause for concern?

BACKGROUND: A large number of epidemiological studies have reported positive associations between bladder cancer and sales occupations. We investigated whether these findings are likely to be due to chance, confounding or publication bias, or may involve causal associations. METHODS: Studies reporting bladder cancer risk-estimates for sales occupations were reviewed. Using meta-analyses we assessed heterogeneity and publication bias, and derived summary estimates. RESULTS: Eighteen publications were identified, reporting 85 risk-estimates for sales-work. Meta-estimates were elevated for men (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.01-1.21) and women (OR = 1.36, 95% CI = 1.11-1.67). The estimate was heterogeneous for men (p(Q-test) <0.01, women: 0.18) and indicated publication bias for women (p(Egger-test) <0.01, men: 0.40). When including only smoking-adjusted estimates reported irrespective of the strength of the association, the summary estimate for generic groups of sales workers was 0.99 (95% CI 0.90-1.08) for men, and 1.18 (95% CI = 0.99-1.39) for women, without statistically significant heterogeneity or publication bias. For women, risk was positively associated with longer duration of sales-employment in three studies. CONCLUSIONS: Publication bias explained most of the reported increased bladder cancer risk, but sales-work still appeared to be associated with a small risk in women. Possible causal factors include lower frequency of urination and reduced fluid intake.

Bias↗
PubMed2005

Press coverage and sales of Xenical in Sweden, 1998-2000.

OBJECTIVE: The anti-obesity drug Xenical (orlistat, Roche) was launched on the Swedish market in February 1999. The sales peaked in May 1999 and then declined. The purpose of this study was to investigate the press coverage of Xenical during the period 1998-2000 and, if possible, relate press attention to Xenical sales during this period. METHODS: We analysed all articles published in Sweden's four biggest-selling newspapers mentioning Xenical during the period 1998-2000. Promotion activities aimed at healthcare professionals were measured by registering the number of advertisements in the Journal of the Swedish Medical Association. Sales figures for Xenical were obtained from the National Corporation of Swedish Pharmacies. RESULTS: Approximately twice as many positive-effect messages were published than negative or neutral messages. Only six out of 42 positive messages referred to results from scientific studies. The initial high peaks for sales and positive-effect articles coincided with the launch of Xenical on the Swedish market. CONCLUSIONS: It is not possible to discern a causal relationship between press coverage and sales; however, it seems safe to say that the large number of positive articles published before and during the launch greatly increased public awareness of Xenical, thus promoting sales.

Advertising↗
PubMed2006

Impact of the reclassification of omeprazole on the prescribing and sales of ulcer healing drugs.

OBJECTIVES: To investigate if the reclassification of omeprazole from a prescription only medicine to pharmacy sale status had an impact on the prescribing and sales of ulcer-healing drugs and whether deprivation had any influence on this. SETTING: Primary care, Wales, UK. METHOD: Retrospective analysis (March 2002 to February 2005) of prescription data and pharmacy sales data. MAIN OUTCOME MEASURE: Number of items per 1,000 population. RESULTS: The number of prescription items for ulcer-healing drugs across Wales increased in each year of the study. The number of items per 1,000 population for proton pump inhibitors increased by 12.4% (473.3 to 531.8 items) in 2003/04 and 13.8% (531.8 to 605.1 items) in 2004/05, whereas the number of items per 1,000 population for H2 antagonists fell by 6.2% (149.1 to 139.9 items), and 5.7% (139.9 to 131.9 items) during 2003/04 and 2004/05, respectively. The sale of items per 1,000 population of H(2) antagonists increased by 34.3% (19.8 to 26.6 items) in 2003/04, but fell by 8.6% (26.6 to 24.3 items) in 2004/05. In February 2005, 12 months after reclassification, omeprazole accounted for 7.6% (2.0 items per 1,000 population) of the total sales (26.3 items per 1,000 population) of ulcer-healing drugs from pharmacies in Wales. Areas with high multiple deprivation and unemployment were significantly associated with the prescribing of ulcer-healing drugs, H2 antagonists and proton pump inhibitors. Multiple deprivation, unemployment and low income explained 21% of the variation in prescribing of ulcer-healing drugs. The sale of omeprazole through pharmacies was not related to these deprivation characteristics. CONCLUSION: Twelve months after the reclassification of omeprazole the market growth of H2 antagonists sold from pharmacies was halted although there was no apparent impact on the prescription of ulcer-healing drugs. As a consequence there was no saving to the health service drug budget associated with the reclassification of omeprazole.

Anti-Ulcer Agents↗
PubMed2006

Effects of a gun dealer's change in sales practices on the supply of guns to criminals.

Licensed gun dealers are a major conduit for gun trafficking. Prior to May 1999, a single gun store sold more than half of the guns recovered from criminals in Milwaukee, WI, shortly following retail sale. On May 10, 1999, the store stopped selling small, inexpensive handguns popular with criminals, often called "Saturday night specials." The purpose of this study was to estimate the effect of this gun store's changed sales practices on criminals' acquisition of new guns. We used an interrupted time-series design with comparisons to test for changes in the number of guns that police recovered from criminals within a year of retail sale following the gun dealer's new sales policy. The dealer's changed sales policy was associated with a 96% decrease in recently sold, small, inexpensive handguns use in crime in Milwaukee, a 73% decrease in crime guns recently sold by this dealer, and a 44% decrease in the flow of all new, trafficked guns to criminals in Milwaukee. The findings demonstrate the substantial impact that a single gun store's sales practices can have on the supply of new guns to criminals. Proposed anti-gun-trafficking efforts in other cities could benefit from targeting problem retail outlets.

Crime↗
PubMed2004

Short-term associations between air pollution and respiratory drug sales.

STUDY OBJECTIVE: This research was implemented to assess the effect of air pollution on anti-asthmatic, bronchodilator, and cough and cold preparation sales in the city of Rouen (France) based on the Upper Normandy Regional Union of Health Insurance Offices database and the Air Quality Monitoring Network database. DESIGN: An ecological time-series analysis was performed for a period of 2 years (July 1998-June 2000). Generalized additive model yields to relative risks and 95% confidence interval (CI) estimates were also carried out. MAIN RESULTS: The 10-day cumulative effect of a 10-microg/m(3) black smoke increase was significantly associated with a 6.2% (95% CI, 2.4-10.1%) increase in the sales of anti-asthmatics and bronchodilators and to a 9.2% (95% CI, 5.9-12.6%) increase in the sales of cough and cold preparation for children aged under 15 years. The cumulative effect of a 10-microg/m(3) increase in SO(2) was associated with an 11.8% (95% CI, 6.7-17.1%) increase in cough and cold preparation sales for children aged under 15 years. The cumulative effect of 10-microg/m(3) increase in NO(2) was associated with an 13.6% (95% CI, 8-18.3%) increase in cough and cold preparation sales for children under 15 years of age. CONCLUSIONS: The results of this study suggest that an increase in drugs sales was directly related to air pollutant concentration increases in the city of Rouen (France).

Air Pollution↗
PubMed2006

Trends in penicillin and macrolide resistance among pneumococci in the UK and the Republic of Ireland in relation to antibiotic sales to pharmacies and dispensing doctors.

It is widely believed that reducing antimicrobial usage should reduce resistance, although observational evidence is mixed. Pneumococci make ideal subjects to test this belief as they are widely surveyed and lack an animal reservoir. Accordingly, susceptibility data for pneumococci in the UK and Ireland were retrieved from the Health Protection Agency's LabBase/CoSurv system and from the European Antimicrobial Resistance Surveillance System (EARSS) and British Society for Antimicrobial Chemotherapy (BSAC) databases. The BSAC surveillance examines respiratory pneumococci; the other systems focus upon invasive organisms only, with the LabBase/CoSurv system being the most comprehensive, capturing data on most bacteraemias in England and Wales. National pharmacy sales data were obtained from the IMS Health MIDAS database and were modelled to the resistance data by logistic and linear regression analysis. All systems except for the BSAC respiratory surveillance data indicated that penicillin resistance has fallen significantly since 1999 in the UK, whereas macrolide resistance has been essentially stable, or has risen slightly. The data for Ireland were based on smaller sample sizes but suggested a fall in penicillin non-susceptibility from 1999 to 2004, with conflicting evidence for macrolide resistance. The recent decreasing trend in penicillin resistance is in contrast to a rising trend in England and Wales until (at least) 1997 and strongly rising macrolide resistance from 1989 to 1993. UK pharmacy sales of macrolides and oral beta-lactams fell by ca. 30% in the late 1990s following increased concern about resistance, before stabilising or rising weakly; sales in Ireland were stable or rose slightly in the study period. We conclude that falling penicillin resistance in pneumococci followed reduced sales of oral beta-lactams to pharmacies in the UK, but a similar fall in macrolide sales was not associated with any fall in resistance. Stabilisation or decline in penicillin resistance has occurred in Ireland despite stable or increasing oral beta-lactam sales.

Anti-Bacterial Agents↗
PubMed1998

Reducing cigarette sales to minors in an urban setting: issues and opportunities for merchant intervention.

INTRODUCTION: Intervention studies to reduce cigarette sales to minors have been conducted primarily in suburban settings. Little is known about sociocultural factors influencing cigarette sales to minors in urban settings. This study sought to determine sociodemographic and cultural factors that may play a role in cigarette sales and in efforts to reduce sales to minors in urban areas. METHODS: Merchant education and follow-up surveys were conducted in small local stores in predominantly African-American urban census tracts in Baltimore. The stores had prior evidence of cigarette sales to minors. RESULTS: Merchants reported hostility (66%) and foul language (64%) when they requested youth identification. Youthful-oriented advertising of cigarettes was highly prevalent in all stores and moreso in stores owned and staffed by Asian merchants. Advertising with specific youthful content was predictive (OR = 3.97; 95% CI = 1.70, 9.23; P = .0014) of higher requests for cigarettes from minors. CONCLUSIONS: Youth-oriented cigarette advertising is a prevalent environmental risk for urban youth. Differences between Asian and African-American merchants suggest socioethnic factors may be an influential component of illegal sales and educational campaigns to reduce smoking among minors.

Adolescent↗
PubMed2000

The relationship of perceived age and sales of tobacco and alcohol to underage customers.

The ability of store clerks to estimate the age of their customers is critical in preventing illegal sales of tobacco and alcohol to underage individuals. To avoid illegal sales of tobacco products to minors, the Food and Drug Administration created a policy in 1997 requiring store clerks to request identification of anyone perceived to be underage 27. A similar age standard has not been implemented for alcohol. The purpose of this article is to assess whether age 27 is adequate for minimizing tobacco sales to those under age 18 and whether this age is also a useful standard for minimizing illegal alcohol sales to those under age 21. The analysis is based on age estimates from 49 gas station and convenience store clerks. Each clerk estimated ages of 45 people filmed on video whose actual ages ranged from 15 to 29. T-tests, analysis of variance, contingency tables and logistic regression were used to analyze the data. Store clerks found it more difficult to estimate ages of female customers than male customers. In addition, the store clerks significantly underestimated age of male customers under 18 and of female customers under 21. In contrast, the clerks significantly overestimated age of customers 21 years and older. Among underage customers, the store clerks' age, gender, work experience, education, and training in requesting identification had no influence on ability to judge age, nor did it have a strong influence on whether an underage customer was considered 18 or older or 21 or older. The results suggest that age 27 is adequate for minimizing illegal tobacco sales. Adoption of a similar or slightly older age may be appropriate for minimizing illegal alcohol sales.

Adolescent↗
PubMed1999

The relationship between alcohol sales and assault in New South Wales, Australia.

AIMS: This paper explores the relationship between alcohol sales and assault in New South Wales (NSW), Australia. DESIGN: The design was a cross-sectional analysis of the relationship between alcohol sales and assault, taking into account spatial autocorrelation. SETTING: The analyses were carried out separately on data from metropolitan Sydney and country NSW. PARTICIPANTS: The unit of analysis was local government areas (178 in NSW). MEASUREMENTS: The dependent variable was assault rates. The independent variables were overall alcohol sales and sales disaggregated by alcohol and outlet type and relevant demographic and socio-economic factors. FINDINGS: Multiple regression analyses revealed a significant relationship between overall alcohol sales in an area and its incidence of assault for both Sydney and country NSW. There were few effects of outlet or alcohol type for Sydney, but the effect of alcohol sales from hotels and off-licences accounted for most of the alcohol-assault relationship for country NSW. CONCLUSIONS: Although the current research cannot exclude an opportunity account of the role of alcohol in assault, the results are entirely consistent with alcohol consumption as a causal agent.

Alcohol Drinking↗
PubMed1997

The effect of enforcing tobacco-sales laws on adolescents' access to tobacco and smoking behavior.

BACKGROUND: Enforcing laws banning tobacco sales to minors is widely advocated as a way to reduce young people's access to tobacco and tobacco use. Whether this approach is successful is not known. METHODS: In a two-year controlled study, we assessed sales of tobacco to minors and young people's access to and use of tobacco in six Massachusetts communities. Three communities (the intervention group) enforced tobacco-sales laws, whereas three matched communities (the control group) did not. To assess compliance with the law, minors working for the study investigators attempted to purchase tobacco from all retail vendors in each community every six months. Three annual anonymous surveys of a total of 22,021 students in grades 9 through 12 (response rate, 84 percent) measured access to tobacco and smoking behavior. RESULTS: At base line, 68 percent of 487 vendors sold tobacco to minors. Compliance with the law improved significantly faster in the intervention communities than in the controls (P<0.001). By the study's end, 82 percent of the merchants in the intervention communities complied with the law, as compared with 45 percent in the control communities (P<0.001). However, adolescents under 18 years old reported only a small drop in their ability to purchase tobacco and no decline in its use. Communities with and those without enforcement programs did not differ with respect to these outcomes. CONCLUSIONS: Enforcing tobacco-sales laws improved merchants' compliance and reduced illegal sales to minors but did not alter adolescents' perceived access to tobacco or their smoking. Test purchases of tobacco do not accurately reflect adolescents' self-reported access to tobacco, and reducing illegal sales to less than 20 percent of attempts -- the goal of a new federal law-- may not decrease young people's access to or use of tobacco.

Adolescent↗
PubMed1999

The impact of over-the-counter availability of nasal sprays on sales, prescribing, and physician visits.

OBJECTIVE: The aim was to study changes in sales and prescribing of nasal decongestants containing oxymetazoline or xylometazoline, changes in number of physician visits for rhinitis and sinusitis, and changes in public expenditures for physician visits due to the switch of these drugs from prescription to over-the-counter status in Sweden in 1989. DESIGN: Retrospective registry study using the local sales statistics on medicines in the municipality of Tierp from The National Corporation of Swedish Pharmacies and the individual-based computerised registry in Tierp based on health care utilisation and drug use from the Centre for Primary Care. Analyses were carried out during the time period 1988-1995. SETTING: The Swedish community of Tierp with about 20,000 inhabitants. SUBJECTS: The population of Tierp. MAIN OUTCOME MEASURE: Sales of nasal decongestants and dispensed prescriptions of nasal decongestants, physician visits for rhinitis and sinusitis, and public expenditures for these. RESULTS: Sales of nasal sprays increased, while sales of nasal drops decreased. The number of dispensed prescriptions as well as physician visits decreased. The public expenditures estimated for physician visits decreased as well. CONCLUSION: This study shows an increase in sales of nasal decongestants and a significant decrease in prescribing of nasal decongestants and the number of physician visits for rhinitis and sinusitis as well as the public expenditures estimated for these, after the switch from prescription to over-the counter status of nasal sprays in 1989.

Adolescent↗
PubMed1995

Regional differences in consumption of 103 fat products in Belgium: a supermarket-chain sales approach.

OBJECTIVE: In Belgium, important regional differences in mortality exist which have been linked to differences in dietary consumption patterns. METHODS: To study regional food consumption in Belgium, sales data of 103 spreading and cooking fat products in 110 branch stores of a major supermarket chain (Colruyt) for 12 months (1991-92) were analyzed. RESULTS: Sale of more ordinary and polyunsaturated spreading margarine and of more polyunsaturated low-fat spread in the north in combination with a greater sale of butter and dairy low-fat spread in the south resulted in a P/S-ratio of 0.99 in the north vs. 0.40 in the south (p < 0.001) and a U/S-ratio of 1.93 vs. 1.10 (p < 0.001) for spreading fats. The P/S- and U/S-ratios of cooking fats were lower in the north (ns). Mortality data correlated positively with the sale of butter and dairy low-fat spread and negatively with sales data of spreading margarine, polyunsaturated spreading margarine, and polyunsaturated low-fat spread (all p < 0.001). CONCLUSION: Sales data from supermarket chains provide useful information on regional fat consumption and offer interesting perspectives of trends over time.

Belgium↗
PubMed1997

Discrepancies in cigarette brand sales and adult market share: are new teen smokers filling the gap?

OBJECTIVE: To examine the extent and type of cigarette brand switching by adult smokers. To evaluate discrepancies between actual and projected cigarette brand sales based on changes in adult smoking patterns. DESIGN: Data analysed come from a cohort tracking survey of 11966 cigarette smokers aged 25-64 years from 20 communities in the United States who were followed between 1988 and 1993 as part of the National Cancer Institute's Community Intervention Trial for Smoking Cessation. OUTCOME MEASURES: Respondents were asked about their current cigarette brand in 1988 and 1993. Brand switching was inferred when a smoker reported a different cigarette brand in 1988 and 1993. Company switching was defined as brand switching for whom a different parent company was identified for the 1993 brand compared with the brand used in 1988. A ratio measure was computed to reflect gains in market share from brand switching and losses from brand switching, quitting, and death, for specific cigarette brands, between 1988 and 1993. This ratio measure was used to estimate the projected unit sales for top-selling premium brands in 1993 and was compared with actual unit sales for the same year. RESULTS: We estimate that an average of 9.5% of smokers switched cigarettes brands and 7.6% switched companies each year. Most of those who did switch cigarette brands changed from a premium brand to a discount or generic brand. Between 1988 and 1993, top-selling premium brands such as Marlboro, Camel, and Newport, lost about four times as many adult smokers as they gained. Whereas premium brand cigarettes lost some smokers to discount and generic cigarettes, over 50% of losses were due to smokers quitting or dying. Actual unit sales were substantially higher than projected sales (based on adult market share) for Marlboro and Camel, but not for other brands. CONCLUSIONS: Most smokers are brand loyal. Price seems to be an important factor motivating brand switching among adult smokers. It appears that recruitment of new customers among the ranks of non-smokers is necessary for premium cigarette brands such as Marlboro and Camel to maintain sales comparable to previous years.

Adolescent↗
PubMed2004

Subsidized sales of insecticide-treated nets in Afghan refugee camps demonstrate the feasibility of a transition from humanitarian aid towards sustainability.

BACKGROUND: Introducing sustainability and self-reliance is essential in chronic humanitarian emergencies before financial assistance is phased out. In Pakistan-based Afghan refugee camps, this was attempted through shifting from indoor residual spraying (IRS) to the subsidized sale of insecticide-treated nets (ITNs) for prevention of malaria and anthroponotic cutaneous leishmaniasis (ACL). Here we outline the strategy and document the progress to provide guidance for replication of similar approaches in other chronic refugee situations. METHODS: The operational monitoring data presented were collected through: (i) two surveys of knowledge, attitude and practice (KAP); (ii) routine sales reporting of health-care providers; (iii) records completed during field visits; and (iv) registers used during annual re-treatment campaigns. RESULTS: From 2000 until 2003, subsidized ITN sales expanded from 17 to 44 camps. Based on 2003 sales records, maximum coverage from subsidized sales exceeded 50% in 13 camps and 20% in an additional 14 camps. Free annual treatment campaigns showed that many refugees were in possession of non-programme nets, which were either locally-made or had leaked from an ITN programme in Afghanistan. Estimated re-treatment coverage of sold and existing nets through annual campaigns exceeded 43% in all camps and was above 70% in the majority. CONCLUSION: Subsidized sales of ITNs have effectively introduced the components of sustainability and self-reliance to the prevention of malaria and ACL in Afghan refugee camps. Similar approaches should be investigated in other chronic refugee situations to discourage expectations of continuing humanitarian donations that cannot be fulfilled.

Afghanistan↗
PubMed2004

Managerial implications of medical sales representative perceptions of job duties, job qualifications, and other performance-related issues.

This study examined the perceptions of medical sales representatives of job related duties, job qualifications needed, and motivating factors and tested for differences based on gender, age, years of experience and education using prior research as a base. This study also explored issues that may arise between sales people and physicians. The authors surveyed 132 medical sales representatives from pharmaceutical firms located in Ankara, Turkey. The authors' findings highlight the need in Turkey for developing in-service training programs for medical sales representatives, especially in the areas related to technical aspects of the product, effective marketing and personal selling strategies, and consumer relations. Training in these areas will help salespeople to better manage the problems typically encountered in physician-sales representative relations. While the study was conducted in Turkey, the results are similar to findings in prior research conducted in other countries and therefore may be of interest to all sales managers.

Administrative Personnel↗
PubMed2006

Sales management coaching: a model for improved insurance company performance.

Of all the things sales managers do to develop salespeople, many people believe the most important one is coaching. Coaching is defined as using skills, experience, and direction to help someone improve their performance. Coaching consists primarily of giving people feedback to reinforce what they do well while suggesting ways and means to improve. Coaching implies that everybody can improve and hopefully everybody wants to get better at what they do. Many sales managers erroneously believe that they have to be better than the person they are coaching at the skill set they are discussing in order to be a useful coaching resource to that person. To be a good coach requires an understanding of the skills being discussed and a desire to help someone improve in the performance of their job. The sales manager who knows how to provide that feedback will have more productive, effective, satisfied, and motivated salespeople. This paper provides an overview of the coaching sequence and the skills required to make it work with some comment on how this was successfully applied to a major national insurance company. Sales Management styles vary, and what works for one person may not work for another. Effective Sales Management Coaching can provide sales managers with the skills to help salespeople grow and develop professionally.

Commerce↗
PubMed1997

Ear dominance and telephone sales.

In a field study, three equally sized sales teams used on of three head-sets--left, right, both ears--for a day's selling of insurance by telephone. This had no effect on sales. In a retrospective study of records, daily sales performance including the percentage conversion rate for sales divided by the number of calls and the number and duration of calls was related to preference for type of head-set. Sales were markedly influenced by the choice of head-set. People who chose to wear the left earpiece significantly out sold the others wearing right and stereohead-sets. Neither the number of incoming calls nor the time spent on the telephone were influenced by the choice of head-set. When sales are analysed in terms of individual differences in personal preference for type of head-set, those who chose the left ear had an advantage. Forced use of the left, versus right ear or both ears for one day had no effect.

Commerce↗
PubMed1990

Sales force development in health services organizations; a boundary spanning perspective.

Sales force development is of growing importance to HSOs in their increasingly competitive and heterogenous health care markets. There is always some danger that, under such circumstances, strategies new to HSOs will be adopted without sufficient attention to how they function and how they might best be integrated into the organization's overall mission. The sales force is becoming an important part of administration in the modern HSO. Ensuring that sales personnel effectively meet the needs of clients and of all relevant units of their HSO calls for attention to a number of concerns raised in organization-environment theory. Concepts from the literature on organizational boundaries and boundary spanning used here organize and illuminate major issues in sales force development. The approach taken is one which underscores the importance of these issues, illustrates some possible responses, and encourages HSO administrators to reflect on organizational implications of sales force development. The perspective offered provides a base for more detailed design considerations in planning and implementing a sales force.

Data Collection↗