Diary of a dependent smoker: The e-cigarette experience

Posted on November 6, 2013November 8, 2013 by oliviamaynard

This blog post reflects the author’s personal experience.

Day 1. Saturday 28^th September 2013, 1.21pm. Inadvertent quit date.

It didn’t cross my mind for a second that this would be my last cigarette. Whilst I’d been away at a (tobacco control) conference, my husband had, out of the blue, decided to invest in an e-cigarette. That was four days ago. He hasn’t had a cigarette since. So, today, I decided to finally invest. I’m a pretty heavy smoker (~25 per day), and have been for about eight years (I appreciate the irony of this, having devoted five years of my life to the study of tobacco dependence). Anyone who has been unfortunate enough to fly long-haul with me will testify just how horrendous I am to be around without tobacco. Ditto my colleagues who’ve experienced my wrath after enlisting me as guinea pig in any experiment involving overnight abstinence. Anyway, I digress. I visited a local store dedicated to the sale of e-cigarettes (‘e-cigs’). Now I’m pretty au fait with the literature on these things. I had lots of questions (mainly relating to vapour composition and actual nicotine delivery), to which I didn’t really receive any satisfactory answers (the general public must not press with such line of questioning – they offered me a job in the store!). But I did learn a lot about the mechanics of these things, and tried out a lot of flavours. Seriously, you have a lot of options! I tried cherry, apple, mango, kiwi, very berry, raspberry, candy floss, blueberry, cherry cola, grape, and barely scratched the surface. There’s also an extensive range of tobacco flavours, dessert flavours (cheesecake anyone?!), rum, beer (?!); the list goes on… I was pretty stunned at the variety. But, in the end, I settled for blueberry and cherry cola. These flavoured nicotine solutions come in several strengths. I was advised, as a 25 cigarette per day smoker, to go for the 18mg mix. So, e-cig ‘starter pack’ in hand [pic], I carried on running my Saturday errands. Three hours later, I suddenly realised I hadn’t had (or wanted) a real cigarette. Now, honestly, it was not my intention to give up smoking. I was just curious (from both a personal and professional perspective) and thought this device might be a useful travel aid. But hey, why not see how long I could run with this? My husband was doing incredibly well so far, so why shouldn’t I try too. So how was I feeling at this point? A little restless. My throat was a little sore. But I wasn’t feeling irritable. I’ve tried giving up before. Nicotine gum, inhalator, bupropion – on all of these, giving up smoking had taken over my ENTIRE LIFE. Cigarettes were always on my mind. Today, that hasn’t been the case. But I have felt like something has been missing. For some reason I’ve been craving the scratch of metal on flint (my trusty clipper, a.k.a. conditioned reinforcer). ‘Smoking’ inside has been a novelty though. I guess I’ve been enjoying the novelty of it all. The cravings kicked in in force after dinner, but a 15 minute ‘vaping’ session helped check them. And yet I didn’t feel totally satisfied… A night in, watching back-to-back episodes of ‘24’, kept me suitably distracted and on track though. Oh, and I downloaded a stop smoking app to keep track of my progress – more on that tomorrow…

Day 2. Sunday 29^th September 2013.

I knew this was going to be hard. The first cigarette of the morning has always been my favourite. For eight years, the first thing I’ve done every morning, without fail, is roll out of bed, head down to the kitchen to roll a cigarette, and sit out in the garden to smoke. That was all I could think about when I woke up. So, this morning, I went out and sat in exactly the same place, and spent 10 minutes vaping. It wasn’t the same, but it helped. I spent almost half of my morning puffing away on that thing (I’m curious to know what my total daily inhalation volume is). I’ve also been really hungry today. We decided to head down to the pub to treat ourselves to a Sunday roast. This was going to be hard – two glasses of wine and a big lunch. We sat out in the garden for half an hour afterwards. That thing was glued to my mouth. But I didn’t crack. When we got home I ended up taking a four hour ‘nap’ (I should add, my sleep has been pretty irregular, and I’ve been having very lucid dreams). I woke up with a dry mouth (again, that’s becoming a pretty regular feature), and a deep sense of incompleteness. More vaping. I’m writing at 11.24pm, and my stop smoking app informs me of the following:

Time since last cigarette: 1 d 10 h 03 mins

Money saved: £7.98

Not smoked: 35.48 cigarettes

Time saved: 0 d 3 h 32 mins

e-cig2

Day 3. Monday 30^th September. Hell hath no fury like a girl without cherry cola flavoured nicotine.

Today has been the hardest day to date. I woke up, after a disturbed night’s sleep, from a particularly violent and lucid dream, with a painfully dry mouth. Reaching for an (empty) glass of water, I noticed the time. ****. I was horribly late for work (read: I have a meeting in 20 minutes and even if I jump straight into the car now I’ll still be late). Thirsty, flustered, and desperate for a cigarette, I flew into a whirlwind, got ready in 25 minutes (a record), and leapt into the car, ready to vape the hell out of that magic stick. However, two deep breaths in, the battery dies on me. Damn. I’m already 40 minutes late at this point. I get to work, park up, and run to the supermarket round the corner. I’ve devoted way too much effort to this cause to give up now. So instead of buying tobacco (the cheaper option by the way), I invested in a disposable e-cigarette. Now this model is very different to the one I’ve been using. It actually looks like a cigarette (see pic). No charging and no refilling needed. So I tear open the packet and start puffing away whilst running into work. It tasted DISGUSTING. I forgot to add, this e-cig was tobacco flavoured, not the fruity concoction I’m starting to grow used to (is cherry cola becoming a new conditioned reinforcer for me?!). I think this was the first time it hit me that my sense of taste had returned in force. Anyway, this hit the spot. Despite the vile taste in my mouth.

e-cig3

A day of data analysis ensues. I have a growing sense of unfulfilment. By 5pm I am in a terrible mood – irritable, hungry, restless. Driving home, my new e-cig, supposedly equivalent to 20 cigarettes, containing an advertised 16mg of nicotine, starts tauntingly flashing at me, before promptly giving up the ghost. At this point I should highlight that I’ve been going through about 2.5ml a day of a solution that contains 18mg nicotine per 10ml bottle. Now, I haven’t been keeping tabs on my circulating nicotine and cotinine levels (I should have been), but a moment of grumpy mental arithmetic en route home tells me something is amiss here. If the advertised nicotine content is correct, then the actual nicotine delivery of these things must wildly fluctuate across models (we know this to be true). So anyway, I get home, disproportionately angry that my husband hasn’t bought baked beans, and spend the next 15 minutes glued to his (cotton candy flavoured) e-cig while mine charges. At the shop (buying beans), I feel a quiet satisfaction in not adding a pouch of tobacco to my basket at the counter. It’s now 7.26pm:

Time since last cigarette: 2 d 6 h 05 mins

Money saved: £12.68

Not smoked: 56.35 cigarettes

Time saved: 0 d 5 h 38 mins

Day 4. Tuesday 1^st October.

Nothing much to report today, other than generally feeling a bit tetchy and low, for no real reason. That’s new I guess. And my throat is still a bit sore. Night.

Day 5. Wednesday 2^nd October.

So today I passed the 100 cigarettes not smoked mark. That feels pretty damn good! This morning also marked the first morning to date that I’ve woken up and haven’t been desperate for a cigarette. I still wanted one, but I didn’t feel like I needed one. And that is a big deal, at least to me. I also managed to resist the urge following a night out with friends, despite a lot of curry and a lot of wine. Jen 1, tobacco 0.

Day 6. Thursday 3^rd October.

I think I’m getting used to this now. I also realised that I’m not so reliant on my e-cigarette anymore. I mean, I’m still using it a lot, and definitely devoting more time to it than I ever did with cigarettes, but it’s not permanently glued to my mouth today. I did have one particularly big craving to smoke today after an argument on the phone – definitely the biggest craving since day one. But that soon passed. I think the increasing brevity of these posts stands testament to the fact that this is getting easier. It’s now 9.25pm:

Time since last cigarette: 5 d 8 h 04 mins

Money saved: £30.02

Not smoked: 133.40 cigarettes

Time saved: 0 d 13 h 20 mins

Day 7. Friday 4^th October.

I encountered my first bar tonight that prohibits e-cigarette use. I asked why this was and was informed that “people get very drunk and we’re worried that people might see other people smoking e-cigarettes and think it’s ok to smoke real cigarettes inside too”. Hmm…

Day 8. Saturday 5^th October.

My throat is KILLING me. I was genuinely in agony when I woke up this morning. My teeth have been hurting a lot too. They’ve been pretty sensitive since I had them bleached a couple of years ago, but the pain has flared up in style recently. Coincidence perhaps? Obviously association does not imply causation, but, the vapour is very sweet tasting – need to check which sweeteners are used in that nicotine solution… By the way, today marks one entire week tobacco free! It’s 12.21pm.

Time since last cigarette: 6 d 23 h 01 mins

Money saved: £39.15

Not smoked: 173.99 cigarettes

Time saved: 0 d 17 h 23 mins

Day 10. Monday 7^th October.

So my teeth feel fine again now. But for the last couple of days I’ve really had a sore throat – so sore that I’ve been putting off using my e-cig until I’m literally desperate for nicotine. And my nose has been running, constantly. I’m not sure if this is just my airways clearing themselves, a side effect of the e-cig, or just a cold. Whichever it is, I decided to try and remedy it by really heavily cutting back on my vaping today, and to patch up the withdrawal with nicotine lozenges. That actually seems to be working pretty well. Let’s see how the throat fares tomorrow… It’s 8.55pm:

Time since last cigarette: 9 d 07 h 34 mins

Money saved: £52.40

Not smoked: 232.89 cigarettes

Time saved: 0 d 23 h 17 mins

Day 12. Wednesday 9^th October

My throat feels fine. However, my e-cig is a long way from fine. In fact, it tastes like burnt metal. I’m no expert on these things, but from what I can tell the heating element has burnt out. I was told this would only need to be replaced every two months, but I guess I’ve been using it a lot, particularly during week one. Anyway, this means I ended up stuck at work without any withdrawal soothing vapour. But I did have a pack of nicotine lozenges on hand as back up, and you know what? I actually did pretty well on those today. And I have a back up mouthpiece at home, so life is good.

Day 13. Thursday 10^th October

Absolutely nothing to report today, other than passing the ‘1 day of my life saved’ milestone (Fun fact: Adults between the ages of 25 and 34 years who quit smoking gain around 10 years of life compared to those who continue to smoke! More info here). Oh, and I’ve just read back through this blog for the first time. It feels pretty good to have come this far! It’s now 11.11pm.

Time since last cigarette: 12 d 09 h 50 mins

Money saved: £69.81

Not smoked: 310.26 cigarettes

Time saved: 1 d 07 h 01 mins

Day 16. Sunday 13^th October.

I feel like I’ve spent a lot of this blog complaining about my teeth. But I have to mention it again, because I’ve started to notice a trend – they only seem to start hurting when I’m using the Cherry Cola flavour solution. No problems with Blueberry. There’s no information as to exactly what ‘flavourings’ consist of in these solutions on the company website. I’m going to dig deeper on this. Also, another observation: I seem to be much more sensitive to the effects of alcohol since quitting smoking. Two glasses of wine really have been knocking me for six. Anecdotal evidence, of course, although my husband has independently also made the same connection. Is there any research into this?! A five minute literature search does indeed suggest that nicotine decreases blood alcohol concentration! Surely this information needs to be publicised more widely for clear safety reasons… It’s 10.19pm:

Time since last cigarette: 15 d 08 h 58 mins

Money saved: £86.48

Not smoked: 384.35 cigarettes

Time saved: 1 d 14 h 26 mins

Day 19. Wednesday 16^th October.

Why do I always leave it to the last minute to pack for holiday?! Super quick update today. It’s 12.29am:

Time since last cigarette: 18 d 11 h 21 mins

Money saved: £103.86

Not smoked: 461.62 cigarettes

Time saved: 1 d 22 h 09 mins

Day 20. Thursday 17^th October.

HOLIDAY! Operation mini-break is go. I’m currently sitting at the airport. For some reason, I am DESPERATE for a cigarette right now – more so than I have been all week. I’m pinning this to one of two reasons: 1) I actually can’t have a cigarette right now (rather than just choosing not to); or 2) Whenever I’m at an airport I’m always in some growing state of nicotine withdrawal, and now my surroundings are basically acting as cues to provoke the deep state of unrest with which they’ve become associated. Possibly both. Plus I’m drinking coffee, which always makes me want to smoke.

Day 34. Thursday 31^st October.

Woah. It’s been a REALLY long time since my last entry. I’ve been meaning to squeeze in an update for ages but a back-to-back holiday, business trip, and unexpected stint in hospital have all gotten in the way (incidentally, not having to drag a drip outside every hour for a smoke has definitely been an unexpected bonus to quitting). So…update. And this is going to be my final entry, as I only planned to keep this diary going until the 1 month mark.

Today marks my 34^th day smoke-free. I am genuinely feeling pretty proud of myself, given that the longest I’ve gone without tobacco in the last eight years is a little under 24 hours. It hasn’t been easy. There have definitely been times when I’ve been desperate for a cigarette. And I have begged friends for a drag whilst out (they refused, for which I was grateful, at least the next morning). However, I have not (yet) slipped at all, which is pretty great considering I never even intended on quitting in the first place.

I also wanted to sum up on my experiences of quitting using an e-cigarette. Firstly, I should make it clear that I almost certainly wouldn’t have been able to quit without these. As I said in one of my first entries, I have tried a LOT of different cessation methods before, and failed royally with each every time. However, I also have some concerns. Before starting this experiment, I felt quite strongly that these products shouldn’t come under MHRA regulation. Why should products which seem to be proving to be so helpful in getting people off cigarettes be regulated more tightly than cigarettes themselves? However, over the course of the last month it has become very clear that some regulation of e-cigarettes is certainly warranted. There is a huge degree of variability between brands and models, for example, in terms of actual nicotine delivery. I have also experienced a number of negative symptoms which have coincided with the use of these products. These have ranged from the relatively minor (e.g., dry mouth, sore throat, and tooth ache, as discussed), to the more serious (e.g., coughing up bloody phlegm, as I rather worryingly experienced last night). All in all, however, I really am in favour of these devices. But for now, I think I’ll be switching to nicotine lozenges. It’s 3pm. My final stats are:

Time since last cigarette: 33 d 02 h 39 mins

Money saved: £186.25

Not smoked: 827.78 cigarettes

Time saved: 3 d 10 h 47 mins

P.s. If you’re interested in learning more about e-cigarettes, you might want to check out this briefing, recently released by Action on Smoking and Health.

This article is posted by Jen Ware

Conferencing in South America: A tale of cocaine, capuchins, cachaça and chupacabra

Posted on September 24, 2013September 24, 2013 by oliviamaynard

I have to admit, I’d been a little apprehensive about this trip. This was the first time I’d visited South America, let alone solo, and since that initial invitation to present arrived in my inbox a little over a month ago, my head had been filled with cautionary tales from everyone with whom I’d shared my travel plans.

Now, on the penultimate day of my visit to Belo Horizonte, I can honestly say I am devastated to be leaving. Despite my eleventh hour travel and lodging arrangements and sparse audience (problems exacerbated, or indeed caused, by my woefully inadequate grasp of Portuguese), I can honestly say that I’ve never before had such a rich and eye-opening conference experience.

This has been nothing like the traditional, slick, and sanitised Western conference experience to which I’ve grown accustomed. The programme was no more than a loose hint at timings (Brazilians, I have learned, are very relaxed about punctuality), posters were strung wildly with (what appeared to be) repurposed wire coat-hangers, and there were no lavish spreads of patisseries and exotic teas during symposium breaks (that is not to say, of course, that Brazilian cuisine is lacking – more on that later).

What there was, however, was a gathering of incredibly hospitable and astute neuroscientists, all with a keen interest in a shared cause – drug abuse. A carefully selected programme of speakers, hailing from multiple continents and disciplines, presenting cutting-edge science, was matched by an equally impressive daily schedule of cultural events. These included a moving performance from Orquestra Jovem de Contagem. This is an orchestra of children hailing from the very poorest areas of the city (the favelas), tutored and directed by a Professor of Music at our host institution, the Universidade Federal de Minas Gerais. Their forthcoming US tour stands testament to their talent.

But enough of the conference. I learnt more outside of the classroom. I spent one evening with my hosts at a beautiful local restaurant discussing Brazilian drug culture and political corruption, being treated to traditional Brazilian cuisine. I sampled my first (and second and third) caipirinha(s). I stayed up until the early hours with six wonderful Professors kind enough to tolerate my naive (but enthusiastic) ramblings, ensconced in an impassioned discussion of science and policy. I was driven to the beautiful Inhotim Institute, a botanical garden and contemporary art gallery, and to Ouro Preto (“Black Gold”), an 18^th century mining town famous for its exquisite Baroque architecture, by three American Professors sweet enough to take me under their wing for the week.

I was struck by the immediate contrast between first and third world, painfully apparent on even the shortest journey through this city. I watched wild capuchins play in the rafters of a local restaurant, drank freshly pressed sugarcane juice (delicious) and coconut milk (less enjoyable –see picture) by the roadside, and cycled up russet-red dirt tracks into the mountains encircling the city to greet a sunset never to be paralleled. And there may or may not have been a sighting of a chupacabra. Oh, wait, a capybara.

If you’ve persevered through my confused ramblings this far, thank you. If you’ve skipped ahead to what appears to be the concluding paragraph, nice work. It is. So here I sum up: This trip has taught me two things, which I hope to share. Firstly, don’t limit your travel to the ‘Western’ world – you’ll be missing out, you just don’t know it yet (I didn’t). Secondly, embrace opportunities to travel to conferences alone – you’ll make so much more of the experience, and meet so many more people, when pushed outside of the comfortable and familiar. Frederico, David, Colin, Bob, Monica, Sarah, Yael, Analice, Ricardo, Reinaldo – if you happen to stumble upon this, thank you for making my time in Brazil such an incredible and memorable experience. I can’t wait to see you all again. Finally, I want to thank our TARG Prof, Marcus, for very generously letting me travel in his place. This was an incredible opportunity. I hope you enjoyed the cachaça!

Obrigado por ler!

This article is posted by Jen Ware

One for the road? The hidden risks of roadside alcohol availability

Posted on July 2, 2013 by oliviamaynard

As JD Wetherspoon looks set to open its first motorway service station pub, it may be time to ask where to draw the line in the sale of alcohol, says Sally Adams

In the UK, you can purchase and drink alcohol in bars, restaurants, cafes, at the cinema, at the theatre and on planes and trains. However, how often have you had the urge for a pint while driving along the M40 and not had the opportunity?

Well fear not, this week sees popular pub chain JD Wetherspoon take to the motorways of Great Britain. In explaining the move, the company draws focus towards the franchise’s successful soft drink and food sales. However, what appears to be unspoken is the fact that this move will see alcohol served roadside. The successful application to a Buckinghamshire local council is alleged to include a licence to serve alcohol between 8am and 1am. The application is timely, given that the government is currently reviewing its alcohol strategy, including the sale of alcohol at motorway services.

One of the key aims of the government’s strategy is to regard “health as a new alcohol licensing objective … so that licensing authorities can consider alcohol-related health harms when managing the problems relating to the number of premises in their area”. In a UK where 17% of females and 26% of males drink above the weekly government recommendation for alcohol, increasing its availability at motorway service stations seems counterintuitive to this goal.

Firstly, let’s consider the proposed location of the first roadside JD Wetherspoon pub. This is a location that is only accessible by road. Therefore, for every group of customers there will be at least one designated driver. While it’s legal to drive after a drink, evidence has clearly demonstrated that even a small amount of alcohol is detrimental to driving performance.

One review concludes that there is no known threshold of blood alcohol concentration (BAC) at which impairment does not occur and no sufficient evidence that a certain category of driver will not be affected by alcohol. Alcohol-related impairments in driving are not consequence free. In 2010 it was estimated that 14% of road fatalities involved drink-driving. Figures from the same Department for Transport report indicated that almost 10,000 road traffic casualties occurred when the driver was over the legal alcohol limit.

These figures have the potential to be sobering if drivers are aware of their alcohol intake and the drink-driving limit. However, it is well documented that knowledge of alcohol units is weak. Moreover, awareness of the legal limit and penalties for drink driving are poorly understood.

Regardless of whether drivers are armed with this knowledge, the decision to drink alcohol, or of how much to consume, may be impaired as soon as you see that bar sign from the motorway. Cue reactivity is the principle that mere exposure to cues associated with alcohol use (eg a bar setting, or seeing others drinking) can trigger physiological and psychological responses indicative of arousal such as increased heart rate, sweating and alcohol craving. Importantly, these responses are often automatic, occurring without any conscious thought.

So imagine the scene: you stop at the services after a stint of driving and have to decide where to eat/drink. You are a regular drinker and recognise a familiar chain-pub brand, alcohol-related cue #1. You decide to go and refuel at this well-known chain and walk into a bar alcohol-related cue #2, with multiple drinks on display alcohol-related cue #3 and numerous other customers drinking alcohol alcohol-related cue #4. Before you have even made the decision whether to consume alcohol or not, you have been confronted with several alcohol-related cues.

Studies of alcohol cue exposure suggest that cues previously and repeatedly presented with drinking can become powerful cues in their own right, leading to cognitive and physical responses that can trigger alcohol seeking and consumption. Interestingly, the association between alcohol-related cues and reward can be especially powerful for heavier, more regular drinkers, meaning these drinkers are more vulnerable to environmental alcohol cues.

For social drinkers, cues can range from environmental context (being in a bar) and time of day (after work), to the external properties of alcohol (sight/smell of wine). These cues alone can be so strongly associated with alcohol-related reward that they promote alcohol use. A potential problem of roadside alcohol cue exposure is therefore the risk of drinking alcohol without any real intention to drink. This is particularly potent when you think of the potential damage alcohol consumption may cause in this context – namely, getting back in a vehicle and driving at high speeds.

Considering that the dawn of the new government alcohol strategy is upon us, increasing the presence of alcohol-related cues and availability of alcohol in a roadside location does not signal a step in the right direction. Is it time to call time on the availability of alcohol in seemingly hazardous and unnecessary places?

Sally Adams is a postdoctoral researcher in Experimental Psychology at the University of Bristol

This article first appeared on the Guardian science blog website on 5th June 2013 and is posted by Sally Adams

Shifting the Evidence

Posted on May 28, 2013 by oliviamaynard

An excellent paper published a few years ago, Sifting the Evidence, highlighted many of the problems inherent in significance testing, and the use of P-values. One particular problem highlighted was the use of arbitrary thresholds (typically P < 0.05) to divide results into “significant” and “non-significant”. More recently, there has been a lot of coverage of the problems of reproducibility in science, and in particular distinguishing true effects from false positives. Confusion about what P-values actually tell us may contribute to this.

It is often not made clear whether research is exploratory or confirmatory. This distinction is now commonly made in genetic epidemiology, where individual studies routinely report “discovery” and “replication” samples. That in itself is helpful – it’s all too common for post-hoc analyses (e.g., of sub-groups within a sample) to be described as having been based on a priori hypotheses. This is sometimes called HARKing (Hypothesising After the Results are Known), which can make it seem like results were expected (and therefore more likely to be true), when in fact they were unexpected (and therefore less likely to be true). In other words, a P-value alone is often not very informative in telling us whether an observed effect is likely to be true – we also need to take into account whether it conforms with our prior expectations.

One way we can do this is by taking into account the pre-study probability that the effect or association being investigated is real. This is difficult of course, because we can’t know this with certainty. However, what we perhaps can estimate is the extent to which a study is exploratory (the first to address a particular question, or use a newly-developed methodology) or confirmatory (the latest in a long series of studies addressing the same basic question). Broer et al (2013) describe a simple way to take this into account and increase the likelihood that a reported finding is actually true. Their basic point is that the likelihood that a claimed finding is actually true (which they call the positive predictive value, or PPV) is related to three things: the prior probability (i.e., whether the study is exploratory or confirmatory), the statistical power (i.e., the probability of finding an effect if it really exists), and the Type I error rate (i.e., the P-value or significance threshold used). We have recently described the problems associated with low statistical power in neuroscience (Button et al., 2013).

What Broer and colleagues show is that if we adjust the P-value threshold we use, depending on whether a study is exploratory or confirmatory, we can dramatically increase the likelihood that a claimed finding is true. For highly exploratory research, with a very low prior probability, they suggest a P-value of 1 × 10^-7. Where the prior probability is uncertain or difficult to estimate, they suggest a value of 1 × 10^-5. Only for highly confirmatory research, where the prior probability is high, do they suggest that a “conventional” value of 0.05 is appropriate.

Psychologists are notorious for having an unhealthy fixation on P-values, and particularly the 0.05 threshold. This is unhelpful for lots of reasons, and many journals now discourage or even ban the use of the word “significant”. The genetics literature that Broer and colleagues draw on has learned these lessons from bitter experience. However, if we are going to use thresholds, it makes sense that these reflect the exploratory or confirmatory nature of our research question. Fewer findings might pass these new thresholds, but those that do will be much more likely to be true.

References:

Broer L, Lill CM, Schuur M, Amin N, Roehr JT, Bertram L, Ioannidis JP, van Duijn CM. (2013). Distinguishing true from false positives in genomic studies: p values. Eur J Epidemiol; 28(2): 131-8.

Button KS, Ioannidis JP, Mokrysz C, Nosek BA, Flint J, Robinson ES, Munafò MR. (2013). Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci; 14(5): 365-76.

Posted by Marcus Munafo and thanks to Mark Stokes at Oxford University for the ‘Statistical power is truth power’ image.

Why I applied for an internship at the Behavioural Insights Team

Posted on May 15, 2013May 23, 2013 by oliviamaynard

Hi, and welcome to TARG’s shiny new blog! I’m Olivia Maynard and I’m a final year PhD student. I’ve recently found out that for three months over the summer, I will be working as a Research Fellow in the Behavioural Insights Team, part of the UK government Cabinet Office . I thought that I would use my first blog post to tell you a bit about the team I’ll be working in and why I applied for the job.

The Behavioural Insights Team’s aim is to ‘find innovative ways of encouraging, enabling and supporting people to make better choices for themselves’. Since its creation in 2010, the team has claimed among its many successes: encouraging more people to pay their income tax, saving energy by promoting loft insulation, helping more people into work and making government savings of 22 times the team’s cost.

The secret behind the team’s success is its reliance on ‘nudges’, which are anything that ‘alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives’. It is therefore known as the ‘Nudge Unit’, and uses these nudges to help inform and design effective policy interventions. To use the example of the loft insulation scheme, the team realised that one of the greatest barriers to people insulating their lofts was the amount of junk they had stored up there. In a trial where residents of two London Boroughs were offered loft insulation with or without a subsidised loft clearance scheme, those offered the loft clearance were four times more likely to get their lofts insulated. In this case, removing the ‘hassle factor’ nudged people in the direction of saving both energy and money in the long-run.

The team also hope to make inroads into the nation’s health problems, with plans to encourage organ donation by changing the current opt-in scheme to an opt-out scheme, promoting healthy eating by placing signs at supermarket checkouts detailing the amount of fruit and vegetables the average shopper buys, and helping people to quit smoking through schemes offering rewards to those who sign a contract stating their commitment to quit. In addition to using these novel techniques to encourage behaviour change, the team have pioneered the use of rigorous randomised controlled trial methodology to assess these interventions.

My main motivation for wanting to work in this team stems from my strong interest in public health and the important interplay I see between research and policy. Now in the third and final year of my PhD, I’ve been using objective experimental techniques, such as eye-tracking and brain imaging to directly assess, for the first time, the likely impact of standardised tobacco packaging on behaviour. As an academic researcher, it’s all too easy to lock yourself in your windowless lab and ignore the outside world. However, I have learnt the value and importance of engaging with policy makers throughout my PhD, and as a result, my research has been used by a number of governments and by the European Union to inform their tobacco control policies. I hope that by working within the Behavioural Insights Team, I will gain a greater understanding of how evidence is actually used by governments to inform policy and I hope to be able to come back to research with a fresh perspective on how to engage and collaborate with policy makers.

Another motivation is that I want to try something new. Although I’ve enjoyed working in such an exciting field over the course of my PhD, the very nature of a PhD means that you spend three or four years focussing all of your attention on one particular idea or project. Now I’m approaching the home-stretch, I’m looking to expand my research interests and develop myself as an independent researcher. The three month internship will involve working collaboratively across government and local authorities, writing briefings for members of government on how behavioural science can inform policy and also designing, managing and analysing the data from a variety of policy intervention trials. I hope that this experience will provide me with new ideas for research when I return to my PhD in October.