The unchecked rise of shisha tobacco cafes, and making breastfeeding stick

·34 min·3 clips

A public health professor says she wouldn't fund an intensive breastfeeding support intervention because it hasn't been effective.

The episode opens with host Rebecca Coombs introducing two main segments: breastfeeding support research and the rise of shisha tobacco cafes. The first segment focuses on a trial published in The BMJ, led by public health professor Kate Jolly, which tested an intensive peer support intervention called ABBA Feed to improve breastfeeding rates in the UK. Jolly explains that despite the UK's low breastfeeding rates and evidence from systematic reviews suggesting support could help, previous large trials of peer support have shown no difference. The ABBA Feed intervention included antenatal contact, proactive daily support via text and WhatsApp for two weeks post-birth, and aimed to support all infant feeding choices, not just breastfeeding. The trial recruited over 80% of women who planned to breastfeed, many highly educated, during the COVID-19 pandemic, leading to remote delivery methods. Results showed no statistically significant difference in breastfeeding rates at six to eight weeks between the intervention and usual care groups, though there were hints of reduced anxiety and increased social support temporarily. Jolly notes disappointment but emphasizes lessons for policymakers, suggesting targeting support to disadvantaged groups and reconsidering funding for intensive interventions. The second segment shifts to shisha tobacco, with Zainab Hussain discussing her BMJ feature on its rising popularity in the UK. She cites data showing nearly a thousand shisha cafes, a 33% increase in five years, with London having more than McDonald's branches. Hussain explains that shisha cafes operate in a regulatory gray area, lacking licensing requirements, making it hard for councils to track numbers. She highlights health risks similar to cigarettes, but notes perceptions of safety due to flavors and water filtration, especially among young people from Middle Eastern, North African, and South Asian backgrounds. The upcoming Tobacco and Vapes Bill is mentioned as potentially addressing this by applying consistent regulations to all tobacco products, including shisha, but concerns about stigmatizing communities are raised. Experts call for culturally sensitive campaigns and community-led research to address health equity. The episode concludes with a summary and call to subscribe.

As heard by us

A negative breastfeeding trial and loose shisha regulation reveal two public-health blind spots.

Public health is often most telling when a sensible intervention disappoints, or when a familiar product slips past the rules designed to manage risk.

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Why you'd press play

You want to know what a negative breastfeeding trial can still teach you, and why shisha cafes slip through UK smoking policy.

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