Objective: To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group. Design: Econometric multiple regression analysis of data on cigarette smoking from the British general household survey. Subjects: Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. Main outcome measures - Changes in cigarette consumption and prevalence of smoking. Results: Price elasticities of demand for cigarettes (percentage change in cigarette consumption for a 1% change in price) were significant at -0.5 (95% confidence interval -0.8 to -0.1) for men and -0.6 (-0.9 to -0.3) for women, were highest in socioeconomic group V (-1.0 for men and -0.9 for women), and lowest (not significantly different from zero) in socioeconomic groups I and II. The gradient in price elasticities by socioeconomic group was significant for men (F=5.6, P=0.02) and for women (F=6.1, P=0.02). Price was a significant factor in cigarette consumption by age for women in every age group and for men aged 25-34. Cigarette consumption by young men aged 16-34 increased with income. There was a significant decrease in smoking over time by women in socioeconomic groups I and II and by men in all age and social groups except socioeconomic group V attributable to health publicity. Price significantly affected smoking prevalence in socioeconomic group V (-0.6 for men and -0.5 for women) and for all women (-0.2). Conclusions: Men and women in lower socioeconomic groups are more responsive than are those in higher socioeconomic groups to changes in the price of cigarettes and less to health publicity. Women of all ages, including teenagers, appear to have been less responsive to health publicity than have men but more responsive to price. Response to health publicity decreased linearly with age. Real price increases in cigarettes could narrow differences between socioeconomic groups in smoking and the related inequalities in health, but specific measures would be necessary to ameliorate effects on the most deprived families that may include members who continue to smoke. The use of a policy to steadily increase cigarette tax is likely to help achieve the government9s targets for smoking and smoking related diseases.

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Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity

Objective: To determine the level of knowledge of emergency contraception among 14 and 15 year olds. Design: Confidential questionnaire survey. Setting: 10 secondary schools in Lothian, south east Scotland. Subjects: 1206 pupils predominantly (98.7%) aged 14 and 15 in the fourth year of secondary school. Main outcome measures: Knowledge of the existence of emergency contraception; of its safety, efficacy, and time limits; and of where to obtain it. Results: 1121 (93.0%) fourth year pupils aged 14-16 had heard of emergency contraception. 194 girls (32.7%) and 168 boys (27.5%) had experienced sexual intercourse. Of girls who had experienced sexual intercourse, 61 (31.4%) had used emergency contraception. Knowledge of correct time limits was poor, sexually active girls being the most knowledgeable. Pupils attending schools ranked lower than the national average for academic attainment were less likely to have heard of emergency contraception and more likely to have been sexually active. 861 (76.8%) pupils knew they could obtain emergency contraception from their doctor. 925 (82.5%) pupils believed emergency contraception to be effective but 398 (35.5%) thought it more dangerous than the oral contraceptive pill. Conclusions: One third of sexually active girls aged under 16 in Lothian have used emergency contraception. This may help explain the fairly constant teenage pregnancy rates despite increasing sexual activity. Scottish teenagers are well informed about the existence of emergency contraception. However, many do not know when and how to access it properly. Health education initiatives should target teenagers from less academic schools as they are more likely to be sexually active at a young age and are less well informed about emergency contraception. Key messages Under 16s have better awareness of the existence of emergency contraception than previously reported Despite good awareness of emergency contraception, teenagers have poor knowledge of specific details—particularly time limits and safety One third of sexually active girls aged under 16 have used emergency contra- ception Health education initiatives should concentrate on the practicalities of emergency contraception and target teenagers at particular risk

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Teenagers' knowledge of emergency contraception: questionnaire survey in south east Scotland

In a survey of 167 physicians with expertise in adolescent health 84% said they prescribe contraception to adolescents but only 80% of these prescribe emergency contraception generally a few times a year at most. Some 12% of respondents said they believe that providing emergency contraception to adolescents would encourage contraceptive risk-taking 25% said they think it would discourage correct use of other methods and 29% said they think repeated use of the method could pose health risks. Physicians who were more likely than their colleagues to prescribe emergency contraception included obstetrician-gynecologists (92%) those who graduated from medical school after 1970 (77%) and those who describe their practice as being in an "academic" setting (76%). Physicians may restrict use of the method by limiting treatment to adolescents who seek it within 48 hours after unprotected intercourse (29%) by requiring a pregnancy test (64%) or an office visit (68%) or by using the timing of menses as a criterion for providing the method (46%). While 41% of physicians who provide emergency contraception counsel adolescents about the method during family planning visits only 28% do so during visits for routine health care; 16% counsel women who are not yet sexually active about the method. (authors)

Emergency contraception: a national survey of adolescent health experts.

Emergency contraception: a review of the programmatic and social science literature.

Adolescents' views of helping professionals: a review of the literature.

Despite interest in preventing pregnancy among teenagers little is known about the most effective strategies.1 An effective way of preventing pregnancy is to use emergency contraception after unprotected intercourse. We report a descriptive study of pregnant teenagers in Devon that examined awareness and use of emergency contraception and its potential for preventing unwanted teenage pregnancy.

With approval of the ethics committee pregnant teenagers were recruited consecutively after local start dates. All those approached agreed to interview, though hospital staff refused access to five patients having a termination. The interviews were conducted between August 1992 and January 1994.

A total of 167 pregnant teenagers (aged 13-19 years) were interviewed. Ninety five (57%) were attending for an NHS termination (8-12 weeks pregnant) and 72 (43%) were attending booking appointments at hospital antenatal clinics (16-17 weeks pregnant). Twenty (12%) pregnancies were planned, 122 (73%) were definitely unplanned (86 …

Pregnant teenagers' knowledge and use of emergency contraception

167 pregnant teenagers were interviewed in England to determine if those opting for abortion had different characteristics and patterns of use of local family planning (FP) services from those continuing their pregnancies. The teenagers were interviewed in 1 of 4 health districts during the period of August 1992 to January 1994. 95 of the teenagers had an abortion and 72 were receiving prenatal care. It was found that the teenagers who chose abortion were significantly younger than the other group were more likely to describe themselves as having tried to avoid pregnancy were more likely to have relied on condoms for contraception and were less likely to be involved in a stable relationship with a young man. Six of the teenagers receiving prenatal care had planned their pregnancies and those planning to keep their babies were more likely to have used oral contraceptives. The teenagers choosing abortion were more likely to have received contraceptive information from a school teacher than from a clinic. These teenagers also found visiting a general practitioner to be embarrassing. With this confirmation of the studys broad hypothesis that differences exist between these two groups more research is indicated to point out the relative importance of each difference as a factor in preventing unplanned and unwanted pregnancies.

Teenage pregnancy: a comparative study of teenagers choosing termination of pregnancy or antenatal care.

Family planning services in Devon, UK: Awareness, experience and attitudes of pregnant teenagers

General practitioners provide about three quarters of the family planning services in the United Kingdom, so potential users should be aware of the services offered by their practice. All general practices are now required to produce leaflets to describe the contraceptive services provided.1 As leaflets are generally well received by patients2 and influence patient behaviour,3 they could be a useful information source for many aspects of family planning. We analysed the information about family planning in practice leaflets.

The leaflets are held by the Devon Family Health Services Authority and were assessed by one of us (MNM). We used criteria representing quality indicators for assessment (table), allocating one equally weighted point for each of the criteria mentioned and adding them together to give a score for each practice. These scores were related to the number of …

M. R. Owen

Papers

Pregnant teenagers' knowledge and use of emergency contraception

Teenage pregnancy: a comparative study of teenagers choosing termination of pregnancy or antenatal care.

Family planning services in Devon, UK: Awareness, experience and attitudes of pregnant teenagers

Promotion of family planning services in practice leaflets.