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Introduction. While the scientific consensus on the benefits of vaccination is unambiguous, there is a growing proportion of the population that is skeptical about vaccination. The idea that vaccination programs are losing their momentum concerns public health agencies throughout the world. Many studies assessing determinants of vaccine acceptance have been published in the last decade. Areas covered. In this article, we review the existing qualitative literature on parents’ attitudes toward childhood vaccination. Studies were included if they: (1) focused on the views, decision-making, or experiences of caregivers (hereafter, referred to as ‘parents’) regarding vaccinations for young children; (2) used qualitative methods for both data and data analysis; (3) were conducted in countries that ranked ‘very high’ on the 2016 United Nations Human Development Index; and (4) had been peer-reviewed. Twenty-two (22) studies met our inclusion criteria and were reviewed, using the socio-ecological model as a conceptual framework. Expert commentary. Parental vaccination decisions are complex and multi-dimensional. Experiences, emotions, routine ways of thinking, information sources, peers/family, risk perceptions, and trust, among other factors, inform parents’ attitudes and decision-making processes. Further research is needed in order to design evidence-informed responses to vaccine hesitancy appropriate to the setting, context, and hesitant subgroups. [ABSTRACT FROM AUTHOR]

Introduction: The reasons for vaccine hesitancy and its relation to individual socioeconomic status (SES) must be better understood. Areas covered: This review focused on developed countries with programs addressing major financial barriers to vaccination access. We systematically reviewed differences by SES in uptake of publicly funded childhood vaccines and in cognitive determinants (beliefs, attitudes) of parental decisions about vaccinating their children. Using the PRISMA statement to guide this review, we searched three electronic databases from January 2000 through April 2016. We retained 43 articles; 34 analyzed SES differences in childhood vaccine uptake, 7 examined differences in its cognitive determinants, and 2 both outcomes. Expert commentary: Results suggest that barriers to vaccination access persist among low-SES children in several settings. Vaccination programs could be improved to provide all mandatory and recommended vaccines 100% free of charge, in both public organizations and private practices, and to reimburse vaccine administration. Multicomponent interventions adapted to the context could also be effective in reducing these inequalities. For specific vaccines (notably for measles, mumps, and rubella), in UK and Germany, uptake was lowest among the most affluent. Interventions carefully tailored to respond to specific concerns of vaccine-hesitant parents, without reinforcing hesitancy, are needed. [ABSTRACT FROM PUBLISHER]

Human papillomavirus (HPV) vaccination coverage in France has fallen substantially since 2010 and the onset of a media controversy on the subject of its safety and efficacy. In this article we examine how and why mothers agree or do not agree to HPV vaccination for their daughters. We draw on data from a survey of French mothers of girls within the HPV vaccination target population (11–14 years old). We used semi-structured interviews to examine their perceptions of this relatively new vaccine and how such perceptions were shaped by their past experiences of vaccines and health in general. We also talked to them about their sources of information, their level of trust in these sources, and how their perception of risk changed as they accessed different and often contradictory information. We found that mothers’ fears of side effects and of ‘new’ vaccines was one of the main reason why they either refused to get their daughters vaccinated or hesitated. Mothers told us that they consulted several different sources, tended to trust their doctors most, but still questioned their recommendations. Although they presented the media and the Internet as untrustworthy, the information from those sources, whether gathered proactively or in passing, significantly influenced their decisions by introducing doubt or by prompting more information-seeking. In this article we show the dynamic nature of this decision-making process and we found that a substantial number of the mothers in our study said that they had been advised by at least one of their doctors not to have their daughter vaccinated. [ABSTRACT FROM AUTHOR]

Background: In recent years, vaccine hesitancy among health professionals has emerged as an important issue on public health agendas. However, we do not yet know very much about whether, and if so how, trust in institutions affects their practices. Methods: A path analysis model explaining the influence of trust on GPs’ vaccine hesitancy was applied to a cross-sectional survey of 1,582 French GPs performed in 2014. We hypothesized that distrust in public health institutions influences GPs’ concerns about the safety of various vaccines, their perceptions about the importance of vaccination, their self-efficacy in the doctor-patient relationship, and ultimately their vaccination recommendations to patients. Results: GPs’ trust in institutions was found to be significantly associated with lower vaccine hesitancy, an association mediated to a large extent by the vaccine’s perceived safety (β = 0.09,P < 0.01) and the importance of vaccination (β = 0.46,P < 0.001). Conclusion: These results suggest that restoration of high vaccination coverage may require the re-establishment of a significant degree of trust in the public health system among health professionals. [ABSTRACT FROM PUBLISHER]

Aims: We present the results of a cross-sectional survey that investigates young smokers’ reactions to an increase in cigarette prices in France, and the factors associated with these reactions. Methods: This survey was carried out in 2005–2006, in South-Eastern France, among first-year university students (response rate: 71%, N = 1723). Findings: Among the 427 current daily smokers, 32% did not react to the increase, 33% reduced the cost of smoking (they purchased cigarettes in foreign countries or smuggled cigarettes, turned to a cheaper brand or to hand-rolled cigarettes) and 35% reduced their consumption or tried to quit. Daily smokers with low-educated parents were less likely to react to the price increase, as well as those with psychological distress. Students with financial difficulties were more prone to diminish the cost of smoking, while students who suffered from being apart from family were less likely to reduce their consumption. Conclusions: Further research is needed to better understand the diversity and heterogeneity of young smokers’ reaction to cigarette price increase, in relation to their socio-economic background and their motivations for smoking. [ABSTRACT FROM AUTHOR]

This paper aims to illustrate the relevance of Howard S. Becker's sociological model of deviance for a better understanding of contemporary adult smoking. From this perspective, one crucial aspect of smoking is smokers' ability to develop and entertain convincing rationalizations that help them to deny smoking hazards and challenge anti-tobacco messages. Several hypotheses are derived from this model and most of them are successfully tested with quantitative data from a cross-sectional survey conducted in the Paris Ile-de-France Region. As expected, most smokers agreed that smoking damages health and considered being well-informed about smoking hazards, even those who denied these hazards for themselves. Moreover, smokers' rationalizations were closely correlated to cigarette consumption and duration since smoking initiation. Paradoxically, risk denial was also stronger among smokers who have some characteristics usually considered as protective factors against smoking (especially future-orientation and importance attached to one's health). More generally, our sociological perspective leads to consider smokers' risk denial as the result of acquired cognitive skills instead of the consequences of lack of information or psychological bias. We believe it provides a promising avenue for further research. [ABSTRACT FROM AUTHOR]

This study examines attitudes to smoking among adolescents. Data for the study is derived from a large quantitative French cross-sectional survey of school students. Attitudes toward smoking were found to be associated with regularity and quantity of consumption, and the type of school attended. These associations are explained according to Becker's concept of a 'moral career', for attitudes differ among occasional, regular and heavy smokers. The association with school type indicates advanced formal schooling enables students to offer sophisticated rationalisations for smoking, combining an acknowledgement of health-related risks of smoking, emphasis on personal benefits derived from smoking, and claims that smoking is a private matter. [ABSTRACT FROM AUTHOR]

This study investigated attitudes toward buprenorphine maintenance treatment (BMT) among general practitioners (GPs) and their maintained patients' propensity to turn to several prescribers (doctor shopping), among a sample of 345 GPs prescribing BMT in South-East-em France. Survey data were anonymously matched to administrative data that provided information about GPs' patients. A simultaneous equation model suggests that GPs' attitude influenced doctor shopping, not the reverse. Doctor shopping was lower among GPs who reported inducting BMT with 8 mg of buprenorphine per day or more, and was higher for GPs endorsing a stringent attitude toward patients. Thus doctor shopping should not be understood exclusively as a deviant behaviour. It is partially physician-driven, and further research is needed to assess whether it reflects patients' dissatisfaction toward inappropriate care supply and the difficulty to establish a good therapeutic relationship between an opiate-dependent patient and a general practitioner. [ABSTRACT FROM AUTHOR]

This article aims to investigate the effect of French mass media national prevention campaigns on attitudes and behaviours of people living with HIV/AIDS (PLWHAs), with a special emphasis on HIV-related sexual risk behaviours. In 2001, a face-to-face survey was conducted in 32 hospital departments delivering HIV care randomly selected in two French regions (Paris metropolitan area and South-Eastern France). Eligible respondents were HIV-infected outpatients aged 18 or older, and diagnosed for at least 1 year. Overall, 1386 patients were asked to participate and 900 agreed to answer the questionnaire (response rate: 64.9%). Most respondents supported national AIDS information media campaigns; some have found support from these campaigns to talk to relatives or friends about AIDS (19.7%), or to manage their sexual life (24.5%). In multivariate analysis, PLWHAs who declared that these media campaigns have helped them to manage their sexual life were more likely to report condom use in the prior 6 months (“sometimes” vs. “never”: OR?=?2.77 [95% CI?=?1.15?–?6.71]; “always” vs. “never”: 2.46 [1.14?–?5.29]). So mass media general information campaigns can play an efficient role for secondary prevention among PLWHAs and may need to be redesigned to include this goal more explicitly. [ABSTRACT FROM AUTHOR]

This article aims to assess the hypothesis of Charlton & Bates about a negative correlation between cigarette smoking and mobile phone ownership among adolescents. This hypothesis is discussed and tested by using data from a national survey conducted in France in 2000 (n = 8414; age 17). The results show that, in France, owning a mobile phone is positively correlated with smoking, and this relationship remains significant once confounding factors are controlled. Thus, cigarette smoking and mobile phone ownership could turn out to be complementary rather than substitutable goods or could be considered as two characteristics of the same lifestyle. [ABSTRACT FROM AUTHOR]