Alcohol packaging as a promotional tool: A focus group study with young adult drinkers in Scotland

Background

Given the dearth of research on consumer perceptions of alcohol packaging as a marketing tool, with existing studies focused on children and adolescents, our aim was to explore how young adults view and engage with alcohol packaging.

Methods

Eight focus groups were conducted in Glasgow (Scotland) in September 2019 with young adult drinkers (n = 50), segmented by age (18-24, 25-35), gender (female, male) and social grade (ABC1, C2DE). Participants were shown, allowed to handle, and asked about, a range of alcoholic products. Data were analysed thematically using an inductive approach.

Results

Five main themes emerged from the data. The first was the ubiquity of alcohol packaging, with frequent exposure reported in different settings, such as shops and drinking venues, and via marketing. The second was appeal, with pack graphics (e.g. colour), structure (e.g. shape, size) and promotions (e.g. gifts, limited-editions) allowing alcohol packs to capture attention, enable products to stand out on shelves, and help create product and brand liking, interest and choice. Third, alcohol packaging was frequently associated with specific occasions and activities. Fourth, alcohol packaging informed perceptions of product-consumer targeting, suitability, and intended drinker profiles. Fifth, alcohol packaging also engaged non-visual senses, guiding expectations of product taste and palatability.

Conclusions

For young adult drinkers in Scotland, alcohol packaging can capture attention, create appeal, and help shape perceptions of the product, drinker and drinking experience.

Key messages

Alcohol packaging is a key marketing communications vehicle, which can attract attention, create product and brand liking, interest and choice, guide expectations, and influence purchasing decisions. Alcohol packaging conveys messages of consumer-product suitability and acceptability, helping to reinforce perceptions that alcohol is a desirable product via pack structure, graphics, and promotions.

Visibility of age restriction warnings, harm reduction messages and terms and conditions: a content analysis of paid-for gambling advertising in the United Kingdom

OBJECTIVE

The inclusion and design of age restriction warnings, harm reduction messages and terms and conditions (T&Cs) in gambling advertising is self-regulated in the United Kingdom. Our study examines the visibility and nature of this information in a sample of paid-for gambling adverts.

STUDY DESIGN

A content analysis of a stratified random sample of gambling adverts (n = 300) in the United Kingdom from eight paid-for advertising channels (March 2018).

METHODS

For each advert, we assessed whether any age restriction warnings, harm reduction messages and T&Cs were present. If so, visibility was scored on a five-point scale ranging from very poor (≤10% of advert space) to very good (≥26% of advert), which had high inter-rater reliability. Descriptive information on position, design and tone of language was recorded.

RESULTS

One in seven adverts (14%) did not feature an age restriction warning or harm reduction message. In adverts that did, 84% of age restriction warnings and 54% of harm reduction messages had very poor visibility. At least one in ten adverts did not contain T&Cs. In adverts that did, 73% had very poor visibility. For age restriction warnings, harm reduction messages and T&Cs, most appeared in small fonts and outside the main advert frame. Most harm reduction messages did not actually reference gambling-related harms.

CONCLUSION

Age restriction warnings, harm reduction messages and T&Cs do not always appear in paid-for gambling advertising. When they do, visibility is often very poor and the messaging not clear. The findings do not support a self-regulatory approach to managing this information in gambling adverts.

Credentialing for robotic lobectomy: what is the learning curve? A retrospective analysis of 272 consecutive cases by a single surgeon

Credentialing processes for surgeons seeking robotic thoracic surgical privileges are not evidence-based, and the learning curve has not been reported. The goal of this study is to review our experience with robotic lobectomies and provide evidence for the development of a more uniform credentialing process. We performed a retrospective review of the first 272 consecutive robotic lobectomies performed between 2011 and 2017 by a single surgeon with prior video-assisted thoracoscopic (VATS) experience. Primary outcomes were operative duration, blood loss, chest tube duration, length of hospital stay, intraoperative complication, and conversion to thoracotomy. The patients were subdivided by surgical date into two cohorts of 120 consecutive patients to compare differences in outcomes, thereby illustrating the learning curve. Between 2011 and 2017, 272 patients (median age 67.5 years) underwent a robotic lobectomy by a single surgeon. The majority of patients (157/272) had early stage (T1N0) adenocarcinoma. For the entire cohort, median operative time was 160 min (83-317 min). The median blood loss was 75 mL (10-4000 mL). Median chest tube duration was 2 days (1-23 days) and median hospital stay was 3 days (1-25 days). Intraoperative complications occurred in seven patients. Only six patients required conversion to thoracotomy. Using multivariable logistic regression, it was found that the age, gender, and stage do not factor into conversion to thoracotomy, but BMI was found to be a significant covariate (p 0.043). As the surgeon performs more surgeries, there is a significantly shorter operative time (p < 0.001), decreased blood loss (p < 0.001), and shorter hospital stay (p < 0.014). When the first 120 and last 120 surgeries were compared, there was significantly less blood loss (234.6 vs 78.69 cc, p < 0.001), shorter operative time (181.9 vs 147.4 min, p < 0.001), shorter tube duration (3.49 vs 3.11 days, p 0.007), and shorter length of stay (4.03 vs 3.48 days, p < 0.001), respectively. More intraoperative complications were observed during the first 120 surgeries (6/120) compared to the last 120 surgeries (0/120; Fischer exact p = 0.029). Regression model plots did not show any apparent and significant change points, but rather a steady improvement. The more cases the surgeon does, the better is the outcome in terms of operative duration, blood loss, post-operative length of stay and intraoperative complications. The learning curve for robotic surgery for a surgeon with prior VATS experience is that of a continuous improvement with experience instead of a particular change point. Since most thoracic surgeons who perform robotic-assisted surgery have already gotten past their VATS learning curves, they no longer have a definable learning curve for robotic surgery. Hence, if a surgeon is already proficient and credentialed to perform VATS lung resections, he or she is no longer faced with a significant learning curve for robotic lung resections, and should be credentialed to do so once he or she has undergone the appropriate training with the equipment and technology.

P3b versus P3a: an event-related potential investigation of the glucose facilitation effect

The ingestion of a glucose containing drink has been shown to improve performance on a variety of cognitive tasks. There is debate, however, as to whether glucose especially benefits hippocampal memory functioning or whether it has a more global effect on attentional systems. The present study used event related potential methodology (ERPs) to investigate further glucose-mediated cognitive processes. Each participant acted as his/her own control in a repeated measures design, receiving one of two possible treatments (25 g glucose vs. placebo) in a counterbalanced order. After a two hour fasting period participants completed a visual three-stimulus oddball task. This paradigm involves an individual detecting an infrequent target stimulus randomly embedded in a train of repetitive background or standard stimuli. Detection of the target results in a large P3b ERP component (memory updating effect). The infrequent presentation of a novel and irrelevant stimulus, randomly interspersed with the target and standard stimuli, generates a P3a response (orientation of attention effect). These components were used as markers to establish whether the glucose enhancement effect was restricted to the neuro-cognitive processes related to memory. Consistent with behavioural work, glucose moderated the magnitude and latency of the P3b ERP component. However, glucose also interacted with attentional systems (P3a and an earlier P2), although this effect was non-significant. This work converges with recent fMRI findings indicating the sensitivity of the medial-temporal lobes and the pre-frontal cortex to glucose administration.