If poor food retail access in deprived areas of British cities is linked, as suggested in many of the policy debates of the late 1990s, via compromised diets/undernutrition to poor health and widening health inequalities, what is the impact of a sudden and significant improvement in food retail access likely to be on the food consumption patterns of residents? In this paper, we describe and provide preliminary results from the first-ever UK study of a major retail provision on diet in a 'food desert'—a 'before/after' study of food consumption patterns in the highly deprived, previously poor food retail access area of Seacroft, Leeds, experiencing a sudden and significant change in its food retail access as a result of the opening of a large superstore by the UK's leading food retailer. We suggest that this study has the potential to provide some of the missing links between poor food retail access, compromised diets/undernutrition, poor health and compound social exclusion that characterised statements on the topic of 'food deserts' in the health inequalities and social exclusion debates of the late 1990s, and that its findings may have significant implications for policy debate.

This paper forms part of the 'Food Deserts in British Cities' project. It reports on the findings of a series of focus groups conducted with residents in the Seacroft 'food desert' (in Leeds) in the period prior to a major improvement in their food retail accessibility. The paper explores individual food shopping behaviour, consumption patterns and attitudes towards a healthy diet and, in so doing, begins to develop an understanding of how different demographic groups adapt to living within a 'food desert'. The focus is on the perceived economic and physical constraints of residents in the area, but interwoven with this are other considerations such as motivation to consider health, family responsibilities and individual smoking status.

Objectives To evaluate the effectiveness of a self help approach to smoking cessation in pregnancy. Design Pragmatic cluster randomised controlled trial with community midwife as the unit of randomisation. Setting Three NHS hospital trusts in England. Participants 1527 women who smoked at the start of pregnancy. Intervention A series of five self help booklets comprising a step by step programme to increase motivation for quitting smoking and to teach strategies for cessation and relapse prevention. The first booklet was given to the women by a midwife at the earliest opportunity in antenatal care, together with a booklet for partners, family members, and friends. The remaining four booklets were mailed directly to the women. Main outcome measures The primary outcome was smoking cessation validated by cotinine measurement at the end of the second trimester of pregnancy. Other outcomes were self reported smoking status and cigarette consumption among daily smokers. Qualitative data exploring the acceptability of the intervention and the way that smoking cessation advice was delivered in both trial arms were also collected. Results Smoking cessation rates were low: the cotinine validated rates were 18.8% (113/600) in the intervention group and 20.7% (144/695) in the normal care group (difference 1.9%, 95% confidence intervals − 3.5% to 7.3%). Self reported quit rates were higher. In the intervention group, 156 (25.6%) women reported not smoking for at least seven days, compared with 207 (29.1%) in the normal care group. In both groups, median self reported daily cigarette consumption among daily smokers was 10 cigarettes per day. Pregnant women and midwives approved of the intervention, but the way in which it was delivered varied considerably. For the primary smoking outcome, the degree of clustering at the midwife level was non-trivial (intracluster correlation coefficient 0.031). Conclusion The self help intervention was acceptable but ineffective when implemented during routine antenatal care. More intensive and complex interventions, appropriately targeted and tailored, need to be developed and evaluated. Validated smoking cessation rates among pregnant women are substantially lower than the self reported rates on which current smoking policy is based.

Objective The unknown aetiology of Serrated Polyposis Syndrome (SPS) impedes risk prediction and prevention. We investigated risk factors for SPS, overall and stratified by World Health Organization (WHO)2010 clinical criteria and by colorectal cancer (CRC). Method A retrospective case-control study involving a cross-sectional analysis from 350 unrelated individuals with SPS from the Genetics of Colonic Polyposis Study and 714 controls from the Australasian Colorectal Cancer Family Registry. Univariate and multivariate logistic regression modelling was used to determine the association between risk factors and SPS and risk factors associated with CRC in SPS. Results Female biological sex (odds ratio (OR) = 4.54; 95%Confidence interval (CI) = 2.77–7.45), increasing body mass index (BMI) at age 20 years (OR = 1.09; 95%CI = 1.04–1.13), hormone replacement therapy (OR = 0.44; 95%CI = 0.20.98), and increasing weekly folate intake (OR = 0.82; 95%CI = 0.75–0.90) were associated with SPS by multivariate analysis. Increasing weekly calcium intake (OR = 0.79; 95%CI = 0.64–0.97) and smoking > 10 cigarettes daily (OR = 0.45; 95%CI = 0.23–0.86) were associated with WHO criterion I only. The consumption of 1-100 g of alcohol per week (OR = 0.39; 95%CI = 0.18–0.83) was associated with WHO criterion III only. Smoking 1–5 cigarettes daily (OR = 2.35; 95%CI = 1.09–5.05), weekly non-steroidal anti-inflammatory drug (NSAIDs) intake (OR = 0.88; 95%CI = 0.78–0.99), and increased height (OR = 1.09; 95% = 1.05–1.13), were associated with SPS fulfilling both WHO criteria I and III. Moreover, weekly NSAIDs intake (OR = 0.81; 95%CI = 0.67–0.98) was associated with a reduced likelihood of CRC in SPS. Conclusion We identified novel risk and potential protective factors associated with SPS, some specific for certain WHO2010 criteria. Weekly use of NSAIDs may reduce the risk of CRC in people with SPS.

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