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GBD 2019 Australia Collaborators. The burden and trend of diseases and their risk factors in Australia, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2023; 8:e585-99. [PMID: 37516475 DOI: 10.1016/S2468-2667(23)00123-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 05/28/2023] [Accepted: 06/05/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019. METHODS In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other high-income countries were made. FINDINGS Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9-77·1) in 1990 to 82·9 years (82·7-83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1-641·3) to 389·2 deaths (381·4-397·6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4-91·9) of total deaths, followed by injuries (5·7%, 5·3-6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9-3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5-28·1). Relative to similar countries, Australia's ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019. INTERPRETATION An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing. FUNDING Bill & Melinda Gates Foundation.
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Puljević C, Feulner L, Hobbs M, Erku D, Bonevski B, Segan C, Baker A, Hefler M, Cho A, Gartner C. Tobacco endgame and priority populations: a scoping review. Tob Control 2023:tc-2022-057715. [PMID: 36720648 DOI: 10.1136/tc-2022-057715] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/11/2023] [Indexed: 02/02/2023]
Abstract
AIM To summarise the research literature on the impacts or perceptions of policies to end tobacco use at a population level (ie, tobacco endgame policies) among people from eight priority population groups (experiencing mental illness, substance use disorders, HIV, homelessness, unemployment or low incomes, who identify as lesbian, gay, bisexual, transgender, queer or intersex (LGBTQI+) or who have experienced incarceration). METHODS Guided by JBI Scoping Review Methodology, we searched six databases for original research examining the impacts or perceptions of 12 tobacco endgame policies among eight priority populations published since 2000. We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. RESULTS Of the 18 included studies, one described perceptions of five endgame policies among people on low incomes in Aotearoa (New Zealand), and 17 focused on the effectiveness or impacts of a very low nicotine content (VLNC) cigarette standard among people experiencing mental illness (n=14), substance use disorders (n=8), low incomes (n=6), unemployment (n=1) or who identify as LGBTQI+ (n=1) in the USA. These studies provide evidence that VLNC cigarettes can reduce tobacco smoking, cigarette cravings, nicotine withdrawal and nicotine dependence among these populations. CONCLUSIONS Most of the tobacco endgame literature related to these priority populations focuses on VLNC cigarettes. Identified research gaps include the effectiveness of endgame policies for reducing smoking, impacts (both expected and unexpected) and policy perceptions among these priority populations.
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Affiliation(s)
- Cheneal Puljević
- The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Leah Feulner
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Maria Hobbs
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Erku
- Menzies Health Institute, Centre for Applied Health Economics, Griffith University, Brisbane, Queensland, Australia
| | - Billie Bonevski
- The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | | | - Amanda Baker
- Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Marita Hefler
- The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Ara Cho
- The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral Gartner
- The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Abstract
INTRODUCTION Understanding the prevalence of cannabis use among tobacco smokers has important implications for research in terms of intervention effectiveness and measurement in smoking cessation trials. The co-use of these substances also has important implications for health service planning, specifically ensuring appropriate and adequate clinical treatment. To date, there have been no synthesis of the literature on the prevalence of tobacco and cannabis co-use in adult clinical populations. Improved understanding of the current prevalence, route of administration and specific subpopulations with the highest rates of tobacco and cannabis co-use will support future intervention development. We aim to provide a pooled estimate of the percentage of smokers who report using cannabis and to examine the prevalence of co-use by sociodemographic characteristics. METHODS AND ANALYSIS We will conduct a systematic review using six scientific databases with published articles from 2000 to 2022 inclusive (CENTRAL, CINAHL, EMBASE, Medline, PsycINFO, Psychology and Behavioural Sciences Collection, Scopus). Peer-reviewed journal articles published in English that report on tobacco and cannabis use will be included. Rates of co-use (simultaneous or sequentially) and routes of administration will be assessed. Use in populations groups will be described. Quality assessments will be conducted for all included studies. Data will be synthesised using a narrative approach. This study will be conducted from June 2022 to the end of August 2022. ETHICS AND DISSEMINATION This review is based on previously published data and, therefore, ethical approval or written informed consent will not be required. It is the intention of the research team to disseminate the results of the systematic review as a peer-reviewed publication and conference presentations. PROSPERO REGISTRATION NUMBER CRD42020194051.
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Affiliation(s)
- Eliza Skelton
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Jane Rich
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tonelle Handley
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Billie Bonevski
- College of Health and Medicine, Flinders University, Bedford Park, South Australia, Australia
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Puljević C, Morphett K, Hefler M, Edwards R, Walker N, Thomas DP, Khan MA, Perusco A, Le Grande M, Cullerton K, Ait Ouakrim D, Carstensen G, Sellars D, Hoek J, Borland R, Bonevski B, Blakely T, Brolan C, Gartner CE. Closing the gaps in tobacco endgame evidence: a scoping review. Tob Control 2022; 31:365-375. [PMID: 35241614 DOI: 10.1136/tobaccocontrol-2021-056579] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Tobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities. DATA SOURCES Guided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) for evidence syntheses published in English since 1990 on 12 policies, and Google for publications from key national and international organisations. Reference lists of included publications were hand searched. STUDY SELECTION Two reviewers independently screened titles and abstracts. Inclusion criteria were broad to capture policy impacts (including unintended), feasibility, public and stakeholder acceptability and other aspects of policy implementation. DATA EXTRACTION We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SYNTHESIS Eight policies have progressed to evidence synthesis stage (49 publications): mandatory very low nicotine content (VLNC) standard (n=26); product standards to substantially reduce consumer appeal or remove the most toxic products from the market (n=1); moving consumers to reduced risk products (n=8); tobacco-free generation (n=4); ending sales (n=2); sinking lid (n=2); tax increases (n=7); and restrictions on tobacco retailers (n=10). Based on published evidence syntheses, the evidence base was most developed for a VLNC standard, with a wide range of evidence synthesised. CONCLUSIONS VLNC cigarettes have attracted the most attention, in terms of synthesised evidence. Additional focus on policies that reduce the availability of tobacco is warranted given these measures are being implemented in some jurisdictions.
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Affiliation(s)
- Cheneal Puljević
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Kylie Morphett
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Marita Hefler
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Richard Edwards
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Natalie Walker
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Addiction Research, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - David P Thomas
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Md Arifuzzaman Khan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Perusco
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Michael Le Grande
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine Cullerton
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Driss Ait Ouakrim
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Georgia Carstensen
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - David Sellars
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Janet Hoek
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ron Borland
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Billie Bonevski
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- College for Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Tony Blakely
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Claire Brolan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Lodge S, Bartlem K, Gibson L, Fehily C, Bradley T, McKeon E, Reakes K, Rickards S, Hastings P, Bowman J. Characteristics and service use of NSW Quitline callers with and without mental health conditions. Front Psychiatry 2022; 13:868084. [PMID: 36545036 PMCID: PMC9760947 DOI: 10.3389/fpsyt.2022.868084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Smoking rates remain higher for people with a mental health condition compared to the general population and contribute to greater chronic disease burden and premature mortality. Quitline services offer telephone-based smoking cessation support to the public and have been shown to be effective. There is limited research exploring the characteristics of smokers with a mental health condition who use the Quitline or the impacts of using the service on their smoking behaviors. METHODS This observational study aimed to compare demographic and smoking related characteristics, service use and quit attempts of callers to the New South Wales Quitline (2016-2018) with and without a mental health condition (N = 4,219). RESULTS At baseline, 40% of callers reported a current mental health condition. Desire to quit smoking was similar for both groups, however participants with a mental health condition had higher nicotine dependency and had made more quit attempts prior to engaging with the service. During program enrolment, quit attempts and 24 hours smoke free periods were similar, however participants with a mental health condition engaged in a greater number of calls and over a longer period with Quitline compared to those without. DISCUSSION The findings suggest Quitline efficacy for people with a mental health condition in making a quit attempt for at least 24 h. Increasing the use of Quitline services and understanding service use for this critical group of smokers will increase the likelihood that their quit attempts are transformed into sustained periods of smoking abstinence. Future research should explore whether tailoring of Quitline service provision for people with mental health conditions may increase the likelihood of quit success.
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Affiliation(s)
- Simone Lodge
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Kate Bartlem
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia.,Hunter New England Population Health, Wallsend, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Lauren Gibson
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Caitlin Fehily
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tegan Bradley
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Emma McKeon
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Kate Reakes
- Screening and Prevention, Cancer Institute, St Leonards, NSW, Australia
| | - Sandra Rickards
- Screening and Prevention, Cancer Institute, St Leonards, NSW, Australia
| | - Phillipa Hastings
- Screening and Prevention, Cancer Institute, St Leonards, NSW, Australia
| | - Jenny Bowman
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Thomas DP, McMahon E, Wang Z, Scollo MM, Durkin SJ. Impact of three annual tobacco tax rises on tobacco sales in remote Australian Aboriginal community stores. Tob Control 2021; 30:e122-e127. [PMID: 32967983 DOI: 10.1136/tobaccocontrol-2020-055865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/06/2020] [Accepted: 08/19/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is strong evidence from many settings that tobacco tax rises which increase prices reduce tobacco consumption, but only limited evidence from Indigenous settings. METHODS We analysed 3 years (2016-2018) of weekly sales data from 32 stores in remote Aboriginal communities. We used interrupted time series analysis to estimate the immediate impact of the price rice following annual 12.5% tobacco tax rises on sales on (A) stick equivalents of tobacco and (B) fruit and vegetables (kg) per $A1000 of grocery sales, and on the trend in sales between price rises. RESULTS We detected 5.8% and 8.2% immediate declines in tobacco sales following the price rises associated with annual 12.5% tax rises in 2016 and 2018, and a non-significant decline (1.6%) following the 2017 tax rise. Decreased sales were mainly driven by declines in mainstream and premium factory-made cigarettes. Fruit and vegetable sales did not change at the time of tobacco price rises. CONCLUSION For the first time, we demonstrated evidence of price-sensitivity and the immediate impact of price rises from tobacco tax rises on tobacco sales in remote Aboriginal communities. We acknowledge that Australia already has very high tobacco taxation and prices, but recommend further increases to the taxation of roll-your-own (RYO) tobacco to prevent smokers and industry using cheaper RYO cigarettes to undermine this impact of high tobacco taxes and prices.
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Affiliation(s)
- David P Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Emma McMahon
- Menzies School of Health Research, Charles Darwin University, Brisbane, Queensland, Australia
| | - Zhiqiang Wang
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Michelle M Scollo
- Centre for Behavioural Research, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research, Cancer Council Victoria, Melbourne, Victoria, Australia
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Puljević C, Snoswell A, Rivas L, Ali MM, de Greef W, Ferris J, Gartner C. 'Money up in smoke': The financial benefits of smoking cessation may be more motivating to people who are homeless than potential health gains. Drug Alcohol Rev 2021; 40:1308-1314. [PMID: 33829571 DOI: 10.1111/dar.13293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION High rates of tobacco smoking among people who are homeless or living in temporary accommodation exacerbate poor health outcomes and financial disadvantage. There is limited research on this population's perceptions of smoking cessation benefits or support strategies. METHODS We conducted a cross-sectional survey of 68 male smokers living in a temporary accommodation hostel in Brisbane, Australia. The survey measured smoking and quit attempt history, perceptions of cessation aids and benefits of cessation, and awareness of the Intensive Quit Support program-a free Queensland government-funded program comprising 12 weeks of nicotine replacement therapy supplemented with weekly calls from Quitline. RESULTS Participants (56% aged ≤40 years) spent a high proportion of their income on smoking (median $80/week). Although the most commonly reported perceived benefit of smoking cessation was improved health, more participants were interested in a campaign promoting the financial savings of quitting rather than the health benefits. Twice as many participants reported the high cost of smoking-provoked thoughts of quitting than graphic health warning labels on cigarette packs (70.6% vs. 30.9%). Participants reported a high level of interest in e-cigarettes as a cessation aid. There was a low level of awareness but moderate level of interest in the Intensive Quit Support program. DISCUSSION AND CONCLUSIONS Smoking cessation campaigns promoting the financial savings of cessation may be more salient than health-focused campaigns among relatively young men who smoke and experience homelessness. There is a clear need for innovative, targeted strategies promoting smoking cessation among this population.
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Affiliation(s)
- Cheneal Puljević
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia.,Centre for Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Aaron Snoswell
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Lorena Rivas
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia.,Griffith Criminology Institute, Brisbane, Australia
| | - Mohammed M Ali
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia.,Griffith Criminology Institute, Brisbane, Australia.,Centre for Investigative Interviewing, Griffith University, Brisbane, Australia
| | - Wouter de Greef
- Security Unit, Princess Alexandra Hospital, Brisbane, Australia
| | - Jason Ferris
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Coral Gartner
- Centre for Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Australia
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Erku D, Gartner CE, Morphett K, Snoswell CL, Steadman KJ. Nicotine vaping products as a harm reduction tool among smokers: Review of evidence and implications for pharmacy practice. Res Social Adm Pharm 2020; 16:1272-1278. [PMID: 32061550 DOI: 10.1016/j.sapharm.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 12/26/2022]
Abstract
With the growing popularity and use of nicotine vaping products (NVPs, also known as e-cigarettes) as a way to quit smoking, pharmacy staff are frequently asked by smokers for advice about NVPs. In Australia, there are currently no clear guidelines or policy statements provided by any of the professional organisations for pharmacists on how they should handle customer enquiries about NVPs, or on extemporaneous compounding of prescriptions for nicotine solution for use in NVPs as a smoking cessation aid. This commentary summarises the current evidence surrounding the safety and efficacy of NVPs, the Australian regulatory landscape, and provides a guide for pharmacy staff to use in discussions with customers regarding NVPs. Evidence strongly points to NVPs being considerably less harmful than smoking tobacco cigarettes and that they can be effective for smoking cessation. The maximum benefit from using NVPs as a harm reduction tool, however, will only be realised if smokers completely stop smoking rather than using NVPs as a partial substitute, because even low level smoking still confers substantial health risk. Vaping products containing nicotine are illegal to sell in Australia but users can still legally access nicotine e-liquid through some limited pathways if they hold a valid prescription from a registered medical practitioner. It is important that pharmacy staff keep abreast of the current evidence surrounding these products and provide evidence-based advice to customers.
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Affiliation(s)
- Daniel Erku
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, 4102, Queensland, Australia.
| | - Coral E Gartner
- School of Public Health, The University of Queensland, Herston Road, Herston, 4006, Queensland, Australia; Queensland Alliance for Environmental Health Sciences, The University of Queensland, 20 Cornwall Street, Woolloongabba, 4102, Queensland, Australia.
| | - Kylie Morphett
- School of Public Health, The University of Queensland, Herston Road, Herston, 4006, Queensland, Australia.
| | - Centaine L Snoswell
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, 4102, Queensland, Australia; Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Brisbane, Qld, 4102, Australia.
| | - Kathryn J Steadman
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, 4102, Queensland, Australia.
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McCrabb S, Twyman L, Palazzi K, Guillaumier A, Paul C, Bonevski B. A cross sectional survey of internet use among a highly socially disadvantaged population of tobacco smokers. Addict Sci Clin Pract 2019; 14:38. [PMID: 31610808 PMCID: PMC6792182 DOI: 10.1186/s13722-019-0168-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 10/02/2019] [Indexed: 11/28/2022] Open
Abstract
Background Tobacco smoking is highest among population groups which are the most socially disadvantaged. Internet-based smoking cessation programs have been found to be effective, though rates of internet access are not well known in these groups. This study describes the rates of internet use and types of technology used to access the internet by a population of socially disadvantaged smokers. The study also examined relationships between sociodemographic and smoking behaviours with amount of internet use and type of device used. Methods A cross-sectional survey of 369 clients (response rate 77%) from two non-government community service organisations in metropolitan New South Wales, Australia was conducted using touchscreen computers. Descriptive statistics and logistic regressions were used to examine results. Results Eligible participants ranged from 19 to 88 years old current tobacco users. Over half (58%) of the participants reported weekly or more frequent use of the internet with less than a third (28%) not having any access. The odds of using the internet at least weekly decreased with age and as heaviness of smoking increased (OR = 0.94, p < 0.001; OR = 0.81, p = 0.022, respectively). Odds of internet use were higher as income increased (OR = 2.74, p < 0.001 for individuals earning $201–$400 per week; OR = 2.83, p = 0.006 for individuals earning > $400 per week). Device use differed for age and income. Conclusions Internet-based interventions appear to reach the majority of socially disadvantaged populations. It is expected that this reach will continue to grow, making internet-based interventions a potential platform for providing care to low socioeconomic individuals who smoke, however inequalities may be exacerbated for those individual without internet access. Implications Internet use among socially disadvantaged tobacco users is moderate (58%). An internet-based smoking cessation intervention for socially disadvantaged tobacco users may be an effective intervention however, older, heavier tobacco users may not benefit as easily due to limited internet access and therefore acknowledging these limitations when developing an intervention can help to acknowledge limitation of intervention reach.
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Affiliation(s)
- Sam McCrabb
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.
| | - Laura Twyman
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia.,Cancer Council New South Wales, Woolloomooloo, NSW, 2011, Australia
| | - Kerrin Palazzi
- Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, 2305, Australia
| | - Ashleigh Guillaumier
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia
| | - Christine Paul
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW, 2308, Australia
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10
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Luxton NA, Mackenzie R, Shih P. Smoking Cessation Care in Cardiothoracic Surgery: A Qualitative Study Exploring the Views of Australian Clinicians. Heart Lung Circ 2019; 28:1246-52. [DOI: 10.1016/j.hlc.2018.04.293] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 04/02/2018] [Accepted: 04/18/2018] [Indexed: 12/26/2022]
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11
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Marck CH, das Nair R, Grech LB, Borland R, Constantinescu CS. Modifiable risk factors for poor health outcomes in multiple sclerosis: The urgent need for research to maximise smoking cessation success. Mult Scler 2019; 26:266-271. [PMID: 31219393 PMCID: PMC7065446 DOI: 10.1177/1352458519858730] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tobacco smoking is a well-established risk factor for multiple sclerosis (MS) onset, progression and poor health outcomes in people with MS. Despite smoking being a modifiable risk factor, no research has been undertaken to understand how, or who is best placed, to assess or understand smoking behaviour in people with MS, or how healthcare professionals can best assist people with MS to quit. People with MS may have unique motivators to continue smoking, or unique barriers to smoking cessation, that are not addressed by existing cessation tools. Research is urgently needed in this area if the aim is to maximise health outcomes for all people with MS.
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Affiliation(s)
- Claudia H Marck
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK/Institute of Mental Health, Nottingham, UK
| | - Lisa B Grech
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia/Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia/Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia/Cancer Council Victoria, Melbourne, VIC, Australia/Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Cris S Constantinescu
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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12
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Young JT, Puljević C, Love AD, Janca EK, Segan CJ, Baird D, Whiffen R, Pappos S, Bell E, Kinner SA. Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia. BMJ Open 2019; 9:e027307. [PMID: 31167867 PMCID: PMC6561422 DOI: 10.1136/bmjopen-2018-027307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Smoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia. METHODS AND ANALYSIS The multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population. TRIAL REGISTRATION NUMBER ACTRN12618000072213; Pre-results.
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Affiliation(s)
- Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Cheneal Puljević
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
| | - Alexander D Love
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Emilia K Janca
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine J Segan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Donita Baird
- Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | | | - Stan Pappos
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Emma Bell
- Australian Community Support Organisation, Richmond, Victoria, Australia
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Mater Research Institute-UQ, The University of Queensland, Brisbane, Queensland, Australia
- Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, The Netherlands
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13
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Mussulman LM, Scheuermann TS, Faseru B, Nazir N, Richter KP. Rapid relapse to smoking following hospital discharge. Prev Med Rep 2019; 15:100891. [PMID: 31193919 DOI: 10.1016/j.pmedr.2019.100891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/30/2019] [Accepted: 05/12/2019] [Indexed: 11/20/2022] Open
Abstract
Many of nearly 7 million smokers who are hospitalized each year plan to stay quit after they leave the hospital. Most, however, relapse after discharge. This is a secondary analysis of a large Midwestern hospital-based smoking cessation trial that occurred between July 2011 and May 2013 to better understand how quickly smokers relapse and the predictors of rapid relapse. Of 942 participants who completed follow up, 25% returned to smoking within a day after hospital discharge. Among these rapid relapses, 36.6% relapsed within one-hour of leaving the hospital, 35.3% between one and 24 h, and 28.1% relapsed one-day post-discharge. Predictors with the highest odds for rapid relapse (within a day of hospital discharge) included tobacco use during hospitalization (OR, 7.37, [95% CI, 3.85–14.13], P < 0.01); low confidence for quitting (OR, 2.07, [95% CI, 1.49–2.88], P < 0.01); and not setting a quit date (OR, 1.76, [95% CI, 1.25–2.48], P < 0.01). Other significant predictors included higher nicotine dependence, shorter length of stay, and depression. Patients who are vulnerable to rapid relapse may benefit from policies that discourage leaving the hospital to smoke. In addition, hospital interventions that target smokers' confidence in quitting, encourage setting a quit date, and addressing nicotine dependence and depression may also be effective at supporting smoker's intentions to make their pre-admission cigarette their last. Clinical Trials Registration NCT01305928
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14
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Bonevski B. Considerations for High-Risk Populations: Response to Zeller's The Future of Nicotine Regulation: Key Questions and Challenges. Nicotine Tob Res 2019; 21:342-343. [PMID: 30312458 DOI: 10.1093/ntr/nty201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute (HMRI), Newcastle, New South Wales, Australia
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15
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Twyman L, Cowles C, Walsberger SC, Baker AL, Bonevski B. 'They're Going to Smoke Anyway': A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation. Front Psychiatry 2019; 10:503. [PMID: 31379622 PMCID: PMC6652148 DOI: 10.3389/fpsyt.2019.00503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 06/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Addressing the high prevalence of tobacco use experienced by people with severe mental illness (SMI) requires consideration of the influence of wider cultural, socioeconomic and environmental factors. This qualitative study aimed to examine the impact of social and living environments on tobacco use and cessation by people with SMI accessing community managed mental health services. The perspectives of both staff and consumers with SMI were explored. Methods: Semi-structured focus groups were undertaken with a purposive sample of community mental health staff and consumers from three sites in three major cities in NSW, Australia. Two sites provided outreach support, and one site provided residential support. Data were collected (2017-2018) until saturation was reached. Focus groups were audio-recorded and transcribed, and thematic analysis was conducted. Results: Thirty-one staff and 17 consumers participated separately in six focus groups. Themes identified by staff included a degree of fatalism, conceptualising tobacco use as choice rather than addiction and tensions between cessation support and broader models of care. Staff viewed smoke-free home and mental health service policies as effective at promoting quitting but contradictory to recovery-oriented models of care. Consumers identified smoking as an integral part of life and social networks, as a way of maintaining control and lack of social support to quit as key themes. While many consumers reported smoking inside the home, others described enforcing smoke-free rules. Conclusion: Social and living environments played an integral role in tobacco use and cessation for both staff and consumers. The role of community managed mental health organisations in addressing tobacco use within social and living environments was not strongly supported by staff and sometimes seen as antithetical to recovery-oriented models of care. Potential ways to address this include education and training for prospective and current community mental health organisation staff highlighting the synergy between the recovery-oriented model and provision of preventive health support.
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Affiliation(s)
- Laura Twyman
- Tabacco Control Unit, Cancer Council NSW, Woolloomooloo, NSW, Australia.,School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Carla Cowles
- Human Capital Alliance, Potts Point, NSW, Australia
| | | | - Amanda L Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
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16
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Lawn S, Zabeen S, Rowlands N, Picot S. Hidden care: Revelations of a case-note audit of physical health care in a community mental health service. Int J Ment Health Nurs 2018; 27:1742-1755. [PMID: 29797643 DOI: 10.1111/inm.12479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2018] [Indexed: 12/30/2022]
Abstract
People with severe mental illness (SMI) are widely reported to be at an increased risk of morbidity and premature death due to physical health conditions. Mental health nurses are ideally placed to address physical and mental health comorbidity as part of their day-to-day practice. This study involved an audit of hardcopy and electronic clinical case-notes of a random sample of 100 people with SMI case managed by community mental health service in metropolitan South Australia, to determine how well physical health conditions and risk factors, screening, and follow-up are recorded within their service records. Every contact between 1 July 2015 and 30 June 2016 was read. One-way ANOVA, Scheffe's test, and Fisher's exact test determined any significant associations across audit variables, which included gender, age, income, living arrangement, diagnosis, lifestyle factors, recording of physical health measures, and carer status. A focus on physical health care was evident from everyday case-note records; however, because this information was 'buried' within the plethora of entries and not brought to the fore with other key information about the person's psychiatric needs, it remained difficult to gain a full picture of potential gaps in physical health care for this population. Under-reporting, gaps and inconsistencies in the systematic recording of physical health information for this population are likely to undermine the quality of care they receive from mental health services, the ability of mental health service providers to respond in a timely way to their physical healthcare needs, and their communication with other healthcare providers.
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Affiliation(s)
- Sharon Lawn
- Flinders Human Behaviour and Health Research Unit, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Sara Zabeen
- Flinders Human Behaviour and Health Research Unit, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Nikki Rowlands
- Flinders Human Behaviour and Health Research Unit, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Southern Mental Health, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Sharon Picot
- Southern Mental Health, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
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17
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MacKenzie R, LeGresley E, Daube M. Legal does not mean unaccountable: suing tobacco companies to recover health care costs. Med J Aust 2018; 207:419-421. [PMID: 29129167 DOI: 10.5694/mja17.00310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/01/2017] [Indexed: 11/17/2022]
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18
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Peters MJ, Bourke JE. Lung health in a changing world. Med J Aust 2018; 207:426-428. [PMID: 29129172 PMCID: PMC7168401 DOI: 10.5694/mja17.00853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/13/2017] [Indexed: 11/21/2022]
Affiliation(s)
| | - Jane E Bourke
- Biomedicine Discovery Institute, Monash University, Melbourne, VIC
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19
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Jin X, Kinner SA, Hopkins R, Stockings E, Courtney RJ, Shakeshaft A, Petrie D, Dobbins T, Dolan K. Brief intervention on Smoking, Nutrition, Alcohol and Physical (SNAP) inactivity for smoking relapse prevention after release from smoke-free prisons: a study protocol for a multicentre, investigator-blinded, randomised controlled trial. BMJ Open 2018; 8:e021326. [PMID: 30341114 PMCID: PMC6196819 DOI: 10.1136/bmjopen-2017-021326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 05/17/2018] [Accepted: 07/19/2018] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Smoking remains the leading risk factor for disease burden and mortality worldwide. Heavy Smoking is often associated with poor Nutrition, Alcohol abuse and Physical inactivity (known as 'SNAP'). Australia's first prison smoking ban was introduced in the Northern Territory in July 2013. However, relapse to smoking after release from prison is normative. Holistic and cost-effective interventions are needed to maintain post-release abstinence to realise the potential public health impact of smoke-free prison policies. Rigorous, large-scale trials of innovative and scalable interventions are crucial to inform tobacco control policies in correctional settings. METHODS AND ANALYSIS This multicentre, investigator-blinded, randomised parallel superiority trial will evaluate the effectiveness of a brief intervention on SNAP versus usual care in preventing smoking relapse among people released from smoke-free prisons in the Northern Territory, Australia. A maximum of 824 participants will be enrolled and randomly assigned to either SNAP intervention or usual care at a 1:1 ratio at baseline. The primary endpoint is self-reported continuous smoking abstinence three months after release from prison, verified by breath carbon monoxide test. Secondary endpoints include seven-day point prevalence abstinence, time to first cigarette, number of cigarettes smoked post release, Health Eating Index for Australian Adults, Alcohol Use Disorder Identification Test-Consumption and International Physical Activity Questionnaire scores. The primary endpoint will be analysed on an intention-to-treat basis using a simple log binomial regression model with multiple imputation for missing outcome data. A cost-effectiveness analysis of the brief intervention will be conducted subsequently. ETHICS AND DISSEMINATION This study was approved by the University of New South Wales Human Research Ethics Committee (HREC), Menzies HREC and Central Australia HREC. Primary results of the trial and each of the secondary endpoints will be submitted for publication in a peer-review journal. TRIAL REGISTRATION NUMBER ACTRN12617000217303; Pre-results.
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Affiliation(s)
- Xingzhong Jin
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn Hopkins
- Northern Territory Correctional Services, Darwin, Northern Territory, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Dennis Petrie
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Kate Dolan
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
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20
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Thomas DP, Lusis N, Van der Sterren AE, Borland R. Electronic Cigarette Use and Understanding Among a National Sample of Australian Aboriginal and Torres Strait Islander Smokers. Nicotine Tob Res 2018; 21:1434-1440. [DOI: 10.1093/ntr/nty154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 07/18/2018] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Adult daily smoking prevalence in the Aboriginal and Torres Strait Islander population is 2.8 times that of other Australians. There is little data on prevalence of electronic cigarette (e-cigarette) use among Aboriginal and Torres Strait Islander peoples. We measured e-cigarette use and beliefs about their harmfulness in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers.
Methods
The Talking About the Smokes project interviewed a nationally representative quota sample of 1301 Aboriginal and Torres Strait Islander smokers between August 2013 and August 2014. The Australian Wave 9 survey of the long-running International Tobacco Control Project interviewed 1093 smokers between February and May 2013. Estimates for all Australian smokers were standardized to the age and sex distribution of Aboriginal and Torres Strait Islander smokers.
Results
Fewer Aboriginal and Torres Strait Islander than all Australian smokers had tried an e-cigarette (21% vs. 30%). This was in part because of more Aboriginal and Torres Strait Islander smokers having not heard of e-cigarettes. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers agreed that e-cigarettes are less harmful than conventional cigarettes (22% vs. 50%).
Conclusions
Many Aboriginal and Torres Strait Islander smokers have used e-cigarettes. However, there is considerable misunderstanding about the relative harm of e-cigarettes compared with conventional cigarettes, in part because of the tight regulatory environment in Australia.
Implications
The study describes e-cigarette use and understanding in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers. Only small studies have reported on e-cigarette use in this high smoking prevalence population. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers had tried an e-cigarette and fewer agreed that e-cigarettes are less harmful than conventional cigarettes. Australian governments, health authorities, health professionals, and e-cigarette regulations should provide clearer messages that e-cigarettes are less harmful.
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Affiliation(s)
- David P Thomas
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Nadia Lusis
- Victorian Aboriginal Community Controlled Health Organisation Inc., Collingwood, Victoria, Australia
| | - Anke E Van der Sterren
- Alcohol Tobacco and Other Drugs Association of ACT, Watson, Australian Capital Territory, Australia
| | - Ron Borland
- Cancer Council Victoria, Melbourne, Victoria, Australia
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21
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Affiliation(s)
- David P Thomas
- Menzies School of Health Research, Northern Territory.,Editorial Board, ANZJPH
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22
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Cockburn N, Gartner C, Ford PJ. Smoking behaviour and preferences for cessation support among clients of an Indigenous community-controlled health service. Drug Alcohol Rev 2018; 37:676-682. [DOI: 10.1111/dar.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 12/21/2017] [Accepted: 02/11/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Nicole Cockburn
- School of Dentistry; The University of Queensland; Brisbane Australia
| | - Coral Gartner
- Faculty of Medicine, School of Public Health; The University of Queensland; Brisbane Australia
| | - Pauline J. Ford
- School of Dentistry; The University of Queensland; Brisbane Australia
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23
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Bonevski B, Thomas DP, Richmond RL. No smoker left behind: it's time to tackle tobacco in Australian priority populations. Med J Aust 2018; 208:52. [PMID: 29384613 DOI: 10.5694/mja17.00948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 10/06/2017] [Indexed: 11/17/2022]
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24
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Puljević C, Kinner SA. No smoker left behind: it's time to tackle tobacco in Australian priority populations. Med J Aust 2018; 208:52. [PMID: 29320674 DOI: 10.5694/mja17.00847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 10/06/2017] [Indexed: 12/17/2023]
Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, QLD
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, QLD
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