The Royal Society Pairing Scheme: My Week in Westminster

I was delighted to be selected to take part in the Royal Society Pairing Scheme. The scheme offers the opportunity for research scientists and UK parliamentarians and civil servants to learn about each other’s’ world.  Additionally, as part of the scheme the Royal Society hosts a week of events that offer a unique insight into how science is used in Westminster. I took part in the scheme along with two other scientists from the University of Bath; Professor Jonathan Davies from Mathematics and Dr Vimal Dhokia from Mechanical Engineering.

As a scientist and Health Psychologist I am interested in how scientific evidence is used by policy makers to inform strategy and policy development related to health. In particular, my research examines the cognitive and behavioural effects of alcohol and tobacco use and I am therefore interested in how this research is used by parliamentarians and civil servants to make policy decisions related to alcohol and tobacco. For example, how is evidence used in policy making surrounding plain packaging of cigarettes and minimum unit pricing of alcohol? To this end, I was thrilled to be paired with the Head of the Drugs and Alcohol Team at the Drug and Alcohol Unit in the Home Office.

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Ready for a week of science policy at the Palace of Westminster, Houses of Parliament

 

Science Policy            

In the sessions and events hosted by the Royal Society I had the opportunity to tour the Palace of Westminster and attend a reception, with talks from science minister Jo Johnson MP, President of the Royal Society; Sir Venki Ramakrishnan, Professor of Public Engagement at the Royal Society; Professor Brian Cox and Stephen Metcalfe MP; Chair of the Commons Science and Technology. It was incredibly inspiring to hear such influential individuals from the worlds of science and politics speak with such passion on the role of science in policy making.

 

 

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Meeting Professor Brian Cox, Professor of Public Engagement, The Royal Society

 

The Royal Society also organised extremely insightful sessions including talks from the House of Parliament Outreach Service, who described how parliament works in terms of passing of bills, lobbying etc. I also spent a morning at the Government Office for Science, learning how the office works, uses foresight projects and how science is used to responds to emergencies. A particularly informative event was a mock select committee on science and technology. During this session I had the chance to observe the parliamentary process of a select committee, which has helped improve my understanding of how specialist witnesses are selected, the benefits and weaknesses of select committees and how the evidence gathered at these committees informs policy making.

 

Drug and Alcohol Policy

During my time at the Home Office the Drug and Alcohol Unit prepared a full and very interesting programme of meetings with individuals involved in various aspects of drug and alcohol policy making.  I was exceptionally impressed by the use of evidence in the unit as a central lens in shaping policy alongside delivery and politics. Prior to the scheme I had been quite naïve in assuming that science was the only force or most important force driving policy decisions, however my time at the unit really helped my understanding and appreciation of the different stakeholders involved in policy making.

During my pairing I had individual meetings with key players within the Drug and Alcohol Unit and further afield in the Home Office, including the Head of Drug and Alcohol Team, the Head of the Drug Strategy Team and the Home Office Chief Scientific Advisor. These meetings were a great opportunity to find out how the Drug and Alcohol Unit and the Advisory Council on the Misuse of Drugs use research evidence to make policy-related decisions. It was particularly interesting to hear about the role of science in policy making in relation to topical issues in the field of drugs and alcohol e.g. the Psychoactive Substances Act 2016, minimum unit pricing of alcohol, alcohol availability and licensing. I was also attended very interesting meetings at Public Health England and the Department of Health that enabled me to understand how the Home Office works with other departments to consult on factors influencing policy making; including research evidence.

Conclusions

I could not have asked for a better or richer insight into policy making. The combination of the events hosted by the Royal Society and the experience of being placed at the Drug and Alcohol Unit at the Home Office provided me with an invaluable opportunity and a new found appreciation of how science is used by policy makers in general and in my specific research field. I am looking forward to the reciprocal visit from the civil servant I was paired with at the Home Office. I am hope that I can offer insight into how scientific research is designed, conducted and disseminated. The scheme has undoubtedly improved my knowledge of the “wider political stage” on which my research is considered in policy making. Taking part in the scheme has also helped me understand how I as a scientist can produce evidence in a way that is optimal and accessible to policy makers. I would have no hesitation in recommending the Royal Society Pairing Scheme to any scientists with a desire to learn more about how science and their research is used by parliamentarians and civil servants.

 

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Analysis: “Pushed to the Edge” -Derren Brown

Last week saw new Derren Brown Project “Pushed to the Edge” aired on Channel 4. I am asked by the Sunday Times to offer my thoughts on the show. In particular the ethical implications and the contribution of the show to our understanding of social compliance. Below is a summary of my take on the show as an experimental psychologist.

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Psychologists study compliance as a form of social influence, to understand why we conform or “comply” with requests, when asked. Derren Brown’s “Pushed to the Edge” is based on classic experiments in social psychology where aspects of an individual’s environment are manipulated and compliance is measured, albeit an extreme form of this. As a psychologist I was very interested in the techniques of social influence used such as “foot in the door technique” to manipulate compliance. I was equally shocked at the extremity of the requests made to participants, especially the overarching demand to push a man to his death.

Psychologists have been studying compliance for over 50 years. The experiment carried out is very similar to previous studies of social compliance, showing that individuals can be manipulated to comply with very extreme requests. The ecological validity or real-life value of this experiment is limited as the programme manipulated many aspects of the situation. For example participants were chosen for their ability to readily conform and every aspect of the experiment was highly controlled.

Ethical Implications

For me the experiment was reminiscent of the infamous Milgram (1963) experiment, where participants were asked to administer electric shocks to another person, believing they were causing pain, distress or even death. Participants were instructed “the experiment requires you to continue” as a method of inducing compliance. This experiment is historically regarded as a classic example of compliance. However, the experiment is more readily thought of as a cautionary tale of deception and unethical treatment of participants.

In the “Pushed to the Edge” experiment deception played a huge role in getting participants to believe that they were dragging and hiding a dead body and in the case of three participants kicking an unconscious man and pushing him to his death. Whilst deception is used in psychological experiments to get at “hidden truths”, levels of deception are evaluated, usually by an ethics committee to ensure that participants are not exposed to distress or harm. It is likely participants in “Pushed to the Edge” were debriefed about the true nature of the study, however it is not clear if consent was given by participants to be exposed to such a potentially distressing scenario that could cause psychological harm. If “Pushed to the Edge” had been proposed to an ethics committee, it is highly unlikely it would have been approved due to the level of deception and potential for harm to participants.

Contribution of the Experiment

The show used many known psychological techniques for inducing compliance, as I mentioned before the “foot in the door” technique, where by agreeing to a small request increases the chance of later agreeing to a larger demand. This technique works by establishing consistency in agreeing to the multiple requests. Derren also used celebrities and the lead actor as authority figures to endorse compliance, particularly in the video with the repetition of the phrase “whatever it takes…push”. This is line with research showing that compliance is more likely, when requested by an authority figure.

The results were perhaps not surprising to me as a psychologist. Out of the four participants, 3 out of 4 complied with the final overarching request “to push”. This is consistent with laboratory experiments of compliance, especially the Milgram study where around two thirds of participants provided electric shocks to another person to a threshold at which they believed caused extreme pain or death.

 

What has blogging ever done for me? : The benefits of writing for a non-academic audience

The short answer to this question is lots! As for the slightly longer answer, I have been blogging for just under 3 years and the impact has been far greater than I ever anticipated. Blogging has influenced my own research design and funding applications, helped foster new collaborations and has increased my engagement with stakeholders and policy makers. Additionally, blogging has improved my confidence in writing for non-scientific audiences, which is important for clearly communicating research with the main beneficiaries of my work (for me this means writing for a general audience of smokers and drinkers.). Below I share some of the most satisfying and beneficial experiences I have had blogging.

 
Impact on Research
I have previously blogged and written about research within my own area of interest and expertise -the cognitive and behavioural effects of alcohol use. However, one of the best experiences I have had blogging is writing about research topics that I am less familiar with. I wrote two pieces for the Guardian blog “Sifting the Evidence” on the science of hangovers and the genetic basis of hangover. I really enjoyed writing these blogs and investigating a new body of research. Writing the blogs also made me aware that alcohol hangover was an important, but poorly understood and under-investigated research area. These blogs were the starting point of a new stream of research for me, including; the development of a new collaboration and the submission of funding applications. To date I have submitted a large grant application (unfortunately unsuccessful) and a PhD studentship (Successful!). I am delighted that in September this year I will have a PhD student working on a fully funded studentship examining the cognitive effects of hangover. As a results of the hangover blogs I have also developed an international collaboration. I will be attending the annual meeting of the Alcohol Hangover Research Group in New Orleans to meet my research collaborator and other individuals working on alcohol hangover.

 
Links to Further Public Engagement Activities
Several of the blogs I have written have also led to further opportunities for public engagement and science communication. For example the blogs on hangover led to several local and national radio interviews. In general blogging has increased my profile as an academic who is engaged in science communication. I now have a good relationship with the press office at my university and I am regularly contacted to speak about alcohol-related stories in the media. For me, public engagement is one of the most rewarding and enjoyable activities I do as an academic. Blogging has improved my confidence in public speaking and increased my appetite for further public engagement. Since blogging I have become actively involved with the public engagement unit of my university; receiving funding to engage smokers and drinkers in my research, presenting to other academics on the benefit of engagement and starting my own health-related blog.

 

Engaging with Policy Makers                                                                                    A blog that I wrote on the availability of alcohol at motorway service stations led to an invite to a consultation meeting of alcohol sales at the Home Office. This was a fantastic opportunity to present research at a meeting of stakeholders and policy makers. This invite was directly related to the blog and demonstrates the potential that blogging has to reach not only the general public but policy makers too.

 
Conclusions
For academics and students I can’t think of a better recommendation for a New Year’s Resolution than to start blogging. For me blogging not only represents an opportunity to engage a wider audience with research, it is an enriching and informative activity for personal and research development. Happy New Year and Happy Blogging!

“Sober for October”: Reactions to going sober for 31 days

I have previous undertaken periods of sobriety e.g. “Dry January”, times when I’ve tried to be healthier etc. To me these were decisions I had made to not drink and I have been fine with it. OK, there have been times when “everyone” else was drinking and I did feel the urge to join in! However, the main problem I have encountered is other people’s reactions to me not drinking. It somehow makes people feel uncomfortable, or makes me appear boring or righteous. When going sober I also have to be ready to deal with the “Are you pregnant?” and “Go on have one…you’ll enjoy it” rebukes. Determined to have a booze free month (I’ve just got married and could do with a break from drinking!) I thought it would be interesting to write about my encounters with others (i.e. how often I am asked why I’m not drinking and how often someone encourages me to drink). Also, given my research interests I am also interested to see how many times during the month I am exposed to alcohol-related cues. My research centres on the theory that with regular drinking, repeated exposure to drink-related cues (e.g. seeing someone else drink, seeing a bar display) can trigger alcohol craving and seeking, even when sober. So here goes…

October 1st: Day 1.

First day, first test! I am attending a welcome back reception for my fourth year students at university. From last year’s event I know there will be wine. Despite there being a huge ice bucket of wine, this was actually a breeze. My colleague Charlotte is also giving the sober thing a go and we both have soft drinks. No one remarks on us not drinking and another colleague even notes that I am as “loud and gregarious” without the booze. Good times!

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October 3rd-4th: First weekend

This was to be my first “Sober for October” weekend. Typically I do enjoy a glass of wine at the weekend, after a week at work. I am spending this weekend with my family. As a family alcohol is quite a big part of our socialising; wine and nibbles, dinner and wine, drinks with friends etc. Therefore I thought it was necessary to explain that I wouldn’t be drinking before I arrived.

My family were concerned that I was depriving myself of a “treat” or something to help me relax after a long week at work. I did feel that I needed to explain my sobriety, as I normally enjoy a drink at the weekend. In general I have felt like needed to explain my sobriety, more than I thought I would. A study of adolescents found that it was difficult for young people to express their desire not to drink alcohol. Another study reported that young adults often develop strategies and responses to help them manage explaining their not drinking. I was unable to find any studies of attitudes towards sobriety in adults, except for those towards individuals recovering from alcohol dependency. It appears that research is required to examine whether non-drinking adults feel the need to defend or explain their non-drinking behaviour.

October 6th: A Mid-Lecture Snack

I decided I needed some reinforcements in a break between teaching. Whilst grabbing a quick diet coke I noticed a rather extensive alcohol display in the campus supermarket.

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All of the alcohol-related cues!

Last year a student of mine completed a mapping exercise as part of her MSc health psychology dissertation to explore where and when alcohol was sold on campus. This type of research is important for understanding how alcohol availability may contribute to drinking behaviours. Evidence has indicated that availability of alcohol may influence alcohol consumption, however this relationship is very complicated and is affected by many factors. My own research has focused on the capability of alcohol-related cues (e.g. bar and supermarket displays) to increase alcohol craving and actual alcohol use. Bearing in mind the power of drinking-related cues, it is potentially problematic that availability of alcohol is growing. I cannot think of many places you can go as an adult and not be exposed to alcohol-related cues e.g. the cinema, train and air travel, restaurants and cafés etc.

Sunday 1st November-Reflections on my sober month

So Saturday was my final day of “Sober for October” and I’ve got plenty to reflect on. One thing I noticed was that, once people were aware that I was not drinking, they stopped asking me about it and also stopped encouraging me to “just have one”. This made things much easier, however other environmental factors did impact my month of sobriety.

In some bars and restaurants the price difference between alcoholic and soft drinks was small or virtually non-existent. In one particular bar, a pint of cider was £4.00 versus £2.80 for a pint of cola. If this had been a normal drinking week for me, I may have decided that I would rather have an alcoholic drink for £1.20 more. I can imagine many others would feel this way too. There has been plenty of robust, well-conducted research on the potential benefit of introducing a minimum unit price for alcohol. However, as a researcher I am not aware of any studies on the likely impact of reducing the costs of alcohol alternatives such as mineral water, soft drinks and juices on alcohol drinking behaviours. This could be a potential method for encouraging individuals to have “a night off” drinking or to limit the amount of alcoholic beverages drunk in one night.

During my sober month I was also very aware of the availability and advertising of alcohol. It may have been a reflection of my abstinent state, but alcohol-related images and the sale of alcohol sale seemed to be everywhere. There is mixed evidence on how individuals process alcohol-related cues (e.g. seeing others drink) during periods of abstinence and what effect this may have on the ability to resist drinking. Research in alcohol-dependent individuals has indicated that exposure to alcohol-related cues during abstinence leads to increased desire to drink. However, a more recent study has suggested that an increased response to alcohol cues was not predictive of relapse to drinking in abstinent alcohol dependent individuals. Together these studies suggest that there is a need for further research to determine whether alcohol cue exposure influences drinking behaviours in non-dependent individuals who are looking to cut down or remain abstinent for a period of time.

I get the train to work everyday and I often notice the announcement of alcohol sales and a promotion to buy 3 alcoholic drinks for £10. I have often wondered if I could buy alcohol at anytime of the day. It turns out you can, at least from the start of the train at 6am in Leeds. In terms of opportunity to drink alcohol in the past month, I had the potential to booze at the hairdressers, the train to work, a student award ceremony, cafes at work and more conventionally at several dinners and birthday celebrations, Research has shown that greater alcohol availability (i.e. number of outlets that sell alcohol) is associated with an increased positive attitude towards drinking and an increased likelihood of drinking alcohol. However, it remains unknown how the increase in alcohol availability in different setting e.g. cinema, transport etc. may influence drinking behaviours.

My “Sober for October” journey was an interesting one. I realised that whilst I can make a conscious decision to not to drink alcohol, there are many social and environmental factors that play a role in temptation and coercion to drink. Maybe for “Dry January” I should hibernate, or be prepared to face the alcohol cues and questions again.

Measure for Measure: What evidence is there for UK drinking guidelines?

Dr Sally Adams, Lecturer in Health Psychology

As an alcohol researcher, a couple of questions I often get asked are “How much alcohol can I drink?” and “How much is too much?” I attempt to answer by describing the UK government weekly guidelines of no more that 21 units for males and no more than 14 units for females and the daily guidelines that state males should not regularly exceed 3-4 units per day and 1-2 units for females. I might also throw in the recommended 2-3 alcohol-free days per week. However I have recently stopped to think about the answers I give, wondering where the evidence for these guidelines came from. Inevitably this led to several other questions: Who suggested these guidelines? Are they still relevant?

Looking at the guidelines set by The Department of Health and adopted by the National Institute for Health and Care Excellence (NICE) the first question I have is; What is all this units business? Units were intended as a simple measure of the amount of alcohol in a drink and a method for comparing the alcohol content of different drinks. A unit represents 8 grams of pure alcohol and takes approximately 1 hour for the average adult to break down (i.e. for the alcohol to leave the blood).

Whilst this may be a useful measure for standardising drinks, it does not appear to improve a drinker’s knowledge about alcohol. The Office for National Statistics suggests that the general public’s understanding of what constitutes a unit has improved in recent years. Even so, only just over half of the men asked (who drank beer) were able to identify the correct number of units in half a pint. One of the problems may be that different strengths of alcohol can change the number of units in a drink. For example whilst a pint of Carlsberg (3.8%) contains just over 2 units, a pint of Stella Artois (4.8 %) has almost 3 units. Although this difference may seem small it could affect whether you’d be over the drink-drive limit.

11037565_10153750029680663_44632274546704025_nWhat is a standard pint? and how many units does it have?

Secondly, where did the notion of units and the recommended drinking guidelines come from? And what evidence is there to support the suggested amounts? Historically, weekly recommended drinking guidelines were based on evidence presented by the Royal College of Physicians (RCP) in 1987. The report offered recommendations for “sensible” drinking limits based on input from leading doctors and the evidence available at the time. However, the report does acknowledge that the research used to make these recommendations was insufficient for making confident statements about how much alcohol is safe. The resulting report and guidelines therefore represent the best judgement possible about relative risk of alcohol use at the time.

Reports that alcohol in small amounts may be protective against coronary heart disease (CHD) led to the re-examination of these guidelines. This in itself is interesting, given that evidence has shown an association between moderate drinking and lower risk of CHD, but there remains no clear evidence that alcohol causes a reduction in risk (but that’s another story). The review of drinking guidelines, based on advice from the RCP and the British Medical Association suggested the 1987 guidelines were still the most suitable for communicating risk to the public. At this review daily benchmarks for sensible drinking were also set to address concern with episodes of heavy drinking i.e. binge drinking. Guidelines recommend no more 1-2 units per day for females and no more than 3-4 unit for males. Advice to not drink for 48 hours following a binge (to allow the body to recover) was also put forward. A problem with these new recommendation is that they appear to approve daily drinking, which is potentially a risk factor for alcohol abuse and dependency. If the daily limit of 4 units for a man was drunk this would increase the weekly alcohol limit to 28 units per week, which marks over a 30 % increase on the 1987 guidelines. Perhaps most concerning is the fact these changes were not supported by a review of the evidence on drinking limits by the RCP.

Aside from minor tweaks, no real revisions of these 20-year old recommendations have been made (and this is a really long time in science and research!). However, in 2011, an inquiry into drinking guidelines was ordered by the House of Commons. This consultation included public health experts, but sadly also included members of the alcohol industry (who have a vested interest in the sale of alcohol). The inquiry led to the setting up of a working group to review the evidence for drinking recommendations, however to date the guidelines remain unchanged. Most recently the coalition government recognised the need to address poor knowledge of drinking limits and evidence that many drinkers drink above the recommended guidelines. The Chief Medical Officer has been tasked with overseeing a review of drinking guidelines that will;

…” take account of available science on how we can best communicate the risks from alcohol, improving the public’s understanding of both personal risks and societal harms”

The concerns I report at the beginning of this piece are reflected in the RCP’s call for clear, evaluated methods for communicating drinking guidelines. The RCP also recommend that guidelines should be improved to reflect the evidence based for “levels of safe drinking”, the effects of drinking frequency and the impact of ageing on drinking limits.

As an alcohol researcher and a drinker, I hope these recommendations are followed to allow drinkers to make informed choices about the amount and frequency of their alcohol use. Is there truly a “safe amount of alcohol?” and at what levels does alcohol consumption increases the risk of alcohol-related diseases? Finally is it too much to expect that these guidelines will be delivered in the near future and will be purely evidence based?