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Nash J, Leong T, Dawkins P, Stone E, Marshall H, Brims F. The TSANZ and Lung Foundation Australia 2023 landscape survey of lung cancer care across Australia and Aotearoa New Zealand. Respirology 2024; 29:405-412. [PMID: 38431910 DOI: 10.1111/resp.14693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND AND OBJECTIVE Unwarranted variations in lung cancer care have been well described in both Australia and Aotearoa New Zealand, with shortfalls in hospital-based workforce and infrastructure previously demonstrated. A survey of lung cancer clinicians was performed to gain an updated understanding of current workforce and infrastructure. METHODS An online Qualtrics survey included questions on institutional demographics, estimated lung cancer case load, multidisciplinary team (MDT) characteristics including workforce and local infrastructure. We sought to obtain one response from every institution treating lung cancer in Australia and Aotearoa New Zealand. RESULTS Responses were received from 89 institutions, estimated to include 85% centres treating lung cancer in Australia and 100% of public hospitals in Aotearoa New Zealand. Lung cancer nurse specialist and Nuclear Medicine are poorly represented in multidisciplinary teams (MDTs) with just 34/88 (38%) institutions fulfilling recommended core workforce for MDT meetings. Case presentation is low with 32/88 (36%) regularly discussing all lung cancer patients at MDT. Metropolitan institutions appear to have a more comprehensive range of services on site, compared to non-metropolitan institutions. Few (4/88) institutions have embedded smoking cessation services. Compared to the previous 2021 Landscape Survey, thoracic surgery representation and core MDT workforce have improved, with modest change in specialist nurse numbers. CONCLUSION This wide-reaching survey has identified persistent deficiencies and variations in lung cancer workforce and gaps in infrastructure. Multidisciplinary collaboration and care coordination are needed to ensure all patients can access timely and equitable lung cancer care.
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Affiliation(s)
- Jessica Nash
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Tracy Leong
- Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Paul Dawkins
- Middlemore Hospital, Auckland, New Zealand
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Emily Stone
- Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital, Sydney, New South Wales, Australia
- School of Clinical Medicine, UNSW, Sydney, New South Wales, Australia
| | - Henry Marshall
- Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
- The University of Queensland Thoracic Research Centre, Brisbane, Queensland, Australia
| | - Fraser Brims
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- Institute for Respiratory Health, Perth, Western Australia, Australia
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Chaffee BW, Donaldson CD, Couch ET, Andersen-Rodgers E, Guerra C, Cheng NF, Ameli N, Stupplebeen D, Farooq O, Wilkinson M, Gansky S, Zhang X, Hoeft K. "I think we can do without [tobacco]": support for policies to end the tobacco epidemic among California adolescents. Tob Control 2023:tc-2023-058288. [PMID: 38148144 DOI: 10.1136/tc-2023-058288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/20/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION The tobacco endgame, policies aiming to end the commercial tobacco epidemic, requires sustained public support, including among youth. We assessed endgame support among California (USA) adolescents, including their reasons and associated participant and policy-specific factors. METHODS Teens, Nicotine and Tobacco Project online surveys (n=4827) and focus groups were conducted in 2021 and 2022 among California residents aged 12-17 years. Cross-sectional survey participants were asked their agreement level with eight policy statements related to tobacco and/or cannabis sales restrictions, use in public places and use in multiunit housing. Ordered logistic regression modelled level of agreement according to respondent characteristics, behaviours and statement content. Qualitative data were collected through focus groups (n=51 participants), which were analysed to provide insight into support for different policies. RESULTS Most survey participants agreed or strongly agreed with tobacco product sales restrictions (72%-75%, depending on the policy), bans on use in public spaces (76%-82%) and smoke-free (79%) and vape-free (74%) apartment buildings. Support was stronger among younger, female, Asian and tobacco non-using participants and for policies directed at 'tobacco' (vs 'vapes' or cannabis), at flavoured tobacco (compared with all tobacco), and when statements featured 'should end' (vs 'not allowed'). Focus group participants who were supportive viewed policies as protecting children from harmful products, while those less supportive cited concerns about limiting adults' freedoms and unintended consequences. CONCLUSIONS Most participants supported strong tobacco control policies. Public communication that promotes broader endgame benefits besides protecting youth and accelerates industry denormalisation may counter youth concerns and further bolster their support.
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Affiliation(s)
- Benjamin W Chaffee
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
| | - Candice D Donaldson
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, California, USA
| | - Elizabeth T Couch
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth Andersen-Rodgers
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, California, USA
| | - Claudia Guerra
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
| | - Nancy F Cheng
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
| | - Niloufar Ameli
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
| | - David Stupplebeen
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, California, USA
| | - Omara Farooq
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, California, USA
| | - Monica Wilkinson
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, California, USA
| | - Stuart Gansky
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
| | - Xueying Zhang
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, California, USA
| | - Kristin Hoeft
- Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California, USA
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Stephens EKH, Marshall HM, Chin V, Fong KM. Air pollution and lung cancer-A new era. Respirology 2023; 28:313-315. [PMID: 36750226 DOI: 10.1111/resp.14464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 01/24/2023] [Indexed: 02/09/2023]
Affiliation(s)
- Edward K H Stephens
- The Prince Charles Hospital and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Henry M Marshall
- The Prince Charles Hospital and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Venessa Chin
- The Garvan Institute of Medical Research, Sydney, New South Wales, Australia.,The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, New South Wales, Australia.,University of NSW, Sydney, New South Wales, Australia
| | - Kwun M Fong
- The Prince Charles Hospital and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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