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Smith AL, Mihrshahi S, Martin-Gall VA, Brkic M, Veitch MG, Freeman B. Towards tobacco-free retailers: feasibility of an intervention encouraging retailers to stop selling tobacco in Tasmania. Tob Control 2024; 33:317-324. [PMID: 36104172 DOI: 10.1136/tc-2022-057374] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 09/02/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite calls for greater emphasis on tobacco supply reduction strategies, limited evidence of interventions (regulatory and non-regulatory) to reduce tobacco retailer numbers exists. This study investigated the feasibility of a real-world, non-regulatory intervention to encourage low volume tobacco retailers to stop selling, in a jurisdiction with a tobacco retailer licensing system. INTERVENTION Between December 2018 and 2019, low volume tobacco retailers (n=164) were exposed to multiple intervention elements (eg, postcard and letter mail-out, onsite visit) focused on the business benefits of stopping selling, in the lead up to their tobacco licence expiry date. The intervention was delivered in Tasmania, Australia in a region characterised by socioeconomic disadvantage, high smoking rates and density of tobacco retailers. METHODS For this mixed-methods study we collected data through implementation records on 164 retailers and postintervention interviews with 21 retailers to explore intervention implementation, awareness, acceptability, usefulness and actions taken. RESULTS Retailers were able to recall the intervention, specifically messages focused on the business-related reasons to stop selling tobacco. Of the 107 retailers that the project officer spoke with onsite or via telephone, the majority (72%) accepted phase I components. The intervention introduced some retailers to the concept of ending tobacco sales, which made them stop and consider this option. Of the 164 retailers exposed to the intervention, 18 (11%) retailers ended tobacco sales. CONCLUSION Our study suggests that a non-regulatory intervention targeting low volume retailers to end tobacco sales may help to reduce the retail availability of tobacco.
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Affiliation(s)
- Abby L Smith
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Quit Tasmania, Cancer Council Tasmania, Hobart, Tasmania, Australia
| | - Seema Mihrshahi
- Department of Health Systems and Populations, Macquarie University, Sydney, New South Wales, Australia
| | - Veronica A Martin-Gall
- Department of Health Tasmania, Public Health Services, Hobart, Tasmania, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Marina Brkic
- Department of Health Tasmania, Public Health Services, Hobart, Tasmania, Australia
| | - Mark G Veitch
- Department of Health Tasmania, Public Health Services, Hobart, Tasmania, Australia
| | - Becky Freeman
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Melody SM, Martin-Gall VA, Veitch MG. Why Tasmanian retailers stop selling tobacco and implications for tobacco control. Tob Control 2021; 30:583-586. [PMID: 32769212 DOI: 10.1136/tobaccocontrol-2019-055588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/23/2019] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The retail availability of tobacco is at odds with the health harms associated with tobacco smoking and undermines tobacco control efforts. Evidence suggests ease of access to tobacco through retail outlets contributes to smoking prevalence. OBJECTIVE This study aimed to understand why retailers stop selling tobacco and explore possible implications for tobacco control. METHODS The Tobacco Licensing Database maintained by the Department of Health Tasmania was used to identify and recruit past retailers who no longer held licences. Semistructured interviews were conducted to explore business demographics and the reasons they stopped selling tobacco. Interview findings were analysed using a thematic framework. RESULTS Twenty former tobacco retailers participated, representing all business types except specialist tobacconists and large supermarkets. Retailers gave multiple reasons for ending tobacco sales, related to business considerations, security, tobacco regulations, ethics and health. Most often, the decision was business-related; health or ethical considerations were rarely a factor. Most retailers felt they played no role in mitigating tobacco-related harm. CONCLUSIONS This study provides insights into factors that make tobacco sales unattractive or unfeasible for low-volume outlets and may inform supply-focused tobacco control policy. A campaign that emphasises the possible business benefits of ending tobacco sales in favour of other higher-margin products may support retailers to transition away from tobacco sales. The regulatory obligations of selling tobacco are disincentives and create a less favourable retail environment.
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Affiliation(s)
- Shannon M Melody
- Department of Health Tasmania, Hobart, Tasmania, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Mark G Veitch
- Department of Health Tasmania, Hobart, Tasmania, Australia
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Williamson DA, Lane CR, Easton M, Valcanis M, Strachan J, Veitch MG, Kirk MD, Howden BP. Increasing Antimicrobial Resistance in Nontyphoidal Salmonella Isolates in Australia from 1979 to 2015. Antimicrob Agents Chemother 2018; 62:e02012-17. [PMID: 29180525 PMCID: PMC5786757 DOI: 10.1128/aac.02012-17] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/13/2017] [Indexed: 12/28/2022] Open
Abstract
Australia has high and increasing rates of salmonellosis. To date, the serovar distribution and associated antimicrobial resistance (AMR) patterns of nontyphoidal Salmonella enterica (NTS) in Australia have not been assessed. Such information provides critical knowledge about AMR in the food chain and informs decisions about public health. We reviewed longitudinal data on NTS in two Australian states over a 37-year period, between 1979 and 2015, and antimicrobial resistance since 1984. Overall, 17% of isolates were nonsusceptible to at least one antimicrobial, 4.9% were nonsusceptible to ciprofloxacin, and 0.6% were nonsusceptible to cefotaxime. In total, 2.5% of isolates were from invasive infections, with no significant difference in AMR profiles between invasive and noninvasive isolates. Most isolates with clinically relevant AMR profiles were associated with travel, particularly to Southeast Asia, with multiple "incursions" of virulent and resistant clones into Australia. Our findings represent the largest longitudinal surveillance system for NTS in Australia and provide valuable public health knowledge on the trends and distribution of AMR in NTS. Ongoing surveillance is critical to identify local emergence of resistant isolates.
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Affiliation(s)
- Deborah A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Courtney R Lane
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Marion Easton
- Department of Health and Human Services, Victoria, Australia
| | - Mary Valcanis
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Janet Strachan
- Department of Health and Human Services, Victoria, Australia
| | - Mark G Veitch
- Department of Health and Human Services, Tasmania, Australia
| | | | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Australia
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Kirk MD, Fullerton KE, Hall GV, Gregory J, Stafford R, Veitch MG, Becker N. Surveillance for outbreaks of gastroenteritis in long-term care facilities, Australia, 2002-2008. Clin Infect Dis 2011; 51:907-14. [PMID: 20825308 DOI: 10.1086/656406] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Each year in Australia, health departments investigate hundreds of gastroenteritis outbreaks. Long-term care facilities (LTCFs) for elderly persons are a common setting for these outbreaks and can result in potentially serious outcomes. METHODS We established surveillance for gastroenteritis outbreaks in 2001, and analyzed data on outbreaks occurring from 1 July 2002 through 30 June 2008 to estimate the incidence in Australian LTCFs and residents. We summarized outbreaks by mode of transmission and etiological agent. We used negative binomial regression to examine variation in the number of fecal specimens collected in outbreaks-a marker of investigation intensity. RESULTS During surveillance, 3257 (52%) of 6295 outbreaks of gastroenteritis and foodborne disease in Australia were reported in LTCFs. These outbreaks affected 84,769 people, with 1577 people hospitalized and 209 deaths. There were 0.19 (95% confidence interval, 0.14-0.26) residents affected per 1000 bed days and 16.8 (95% confidence interval, 12.4-22.7) outbreaks per 100 LTCFs annually. LTCF outbreaks were most commonly transmitted from person to person. Only 43 (1.3% ) of 3257 outbreaks were foodborne, although 47 (6.4%) of 733 residents were hospitalized and 20 (2.7%) of 733 died. Norovirus was responsible for 1136 (35%) of all 3257 outbreaks. Higher numbers of fecal specimens per outbreak were collected in 4 Australian States, in later years of surveillance, and where the etiology was identified. CONCLUSIONS Norovirus outbreaks spread from person to person are common in LTCFs, although clinicians should be alert for foodborne outbreaks with more serious consequences. There is a need to identify effective infection control measures to assist facilities in managing outbreaks of gastroenteritis.
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Affiliation(s)
- Martyn D Kirk
- Australian Government Department of Health and Ageing, National Centre for Epidemiology and Population Health, The Australian National University, OzFoodNet, Canberra, Australia.
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Abstract
Elderly people in long-term care facilities (LTCFs) may be more vulnerable to infectious gastroenteritis and food-borne disease and more likely to experience serious outcomes. We review the epidemiology of gastroenteritis and food-borne diseases in elderly residents of LTCFs to inform measures aimed at preventing sporadic disease and outbreaks. Gastroenteritis in elderly people is primarily acquired from other infected persons and contaminated foods, although infections may also be acquired when residents have poor personal hygiene, have contaminated living environments or water, or have contact with infected pets. Early recognition of outbreaks and implementation of control measures is critical to reduce the effects on LTCF residents and staff members. Although outbreaks among LTCF residents are common, they are challenging to investigate, and there are still major gaps in our knowledge, particularly in regards to controlling noroviruses, the incidence and causes of specific infections, and sources of food-borne disease.
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Affiliation(s)
- Martyn D Kirk
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory 0200, Australia.
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Veitch MG, Johnson PD, Flood PE, Leslie DE, Street AC, Hayman JA. A large localized outbreak of Mycobacterium ulcerans infection on a temperate southern Australian island. Epidemiol Infect 1997; 119:313-8. [PMID: 9440434 PMCID: PMC2809003 DOI: 10.1017/s0950268897008273] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Mycobacterium ulcerans, the organism which causes Buruli or Bairnsdale ulcer, has never been isolated in culture from an environmental sample. Most foci of infection are in tropical regions. The authors describe the first 29 cases of M. ulcerans infection from a new focus on an island in temperate southern Australia, 1992-5. Cases were mostly elderly, had predominantly distal limb lesions and were clustered in a small region in the eastern half of the main town on the island. The authors suspected that an irrigation system which lay in the midst of the cluster was a source of infection. Limitation of irrigation was associated with a dramatic reduction in the number of new cases. These findings support the hypothesis that M. ulcerans has an aquatic reservoir and that persons may be infected directly or indirectly by mycobacteria disseminated locally by spray irrigation.
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Affiliation(s)
- M G Veitch
- National Centre for Epidemiology and Population Health, Australian National University, Canberra
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Veitch MG, Hogg GG. Is it food poisoning? Aust Fam Physician 1997; 26:1281-7. [PMID: 9386310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Food borne infections and intoxications, typically manifesting as gastroenteritis, are a common community acquired illness in Australia. For infants, immunocompromised people, pregnant women and the elderly, food borne illness can be fatal. Food borne illness can be difficult to distinguish from illness transmitted by other routes, but specific pathogens, clinical syndromes, and epidemiological clues suggest possible 'food poisoning'. Management is usually supportive, but investigations provide information of public health value. Persons with gastroenteritis should be given simple advice to reduce the risk of transmitting infection to others, and educated about how enteric infections may be spread from infected persons and animals, and from food.
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Affiliation(s)
- M G Veitch
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria
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Ross BC, Johnson PD, Oppedisano F, Marino L, Sievers A, Stinear T, Hayman JA, Veitch MG, Robins-Browne RM. Detection of Mycobacterium ulcerans in environmental samples during an outbreak of ulcerative disease. Appl Environ Microbiol 1997; 63:4135-8. [PMID: 9327583 PMCID: PMC168730 DOI: 10.1128/aem.63.10.4135-4138.1997] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Mycobacterium ulcerans is an environmental bacterium which causes chronic skin ulcers. Despite significant epidemiological evidence to suggest that water is the source of infection, the organism has never been identified in the environment. Environmental water samples were collected from a small town in which an outbreak of 29 cases had occurred in a 3-year period. These were examined by mycobacterial culture and PCR amplification. Similar to previous studies, M. ulcerans was not cultured from the water samples. However, five samples were positive for M. ulcerans by PCR. These samples were collected from a swamp and a golf course irrigation system within the outbreak area. This is the first time that M. ulcerans has been demonstrated to be present in the environment and supports the postulated epidemiology of disease due to this organism.
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Affiliation(s)
- B C Ross
- Department of Microbiology and Infectious Disease, Royal Children's Hospital, Melbourne, Victoria, Australia.
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Abstract
OBJECTIVE To document the emergence of new foci of Mycobacterium ulcerans infection (Bairnsdale ulcer) in Victoria. METHODS From data kept by one of us (JAH) and records from the Mycobacterium Reference Laboratory, Fairfield Hospital, we reviewed cases of M. ulcerans infection in Victoria between 1980 and 1995, and identified those apparently acquired outside the east Gippsland endemic region. A case was defined as a person with a lesion suggestive of M. ulcerans infection, from which the organism had been cultured or, in the absence of culture information, from which a histological specimen characteristic of M. ulcerans infection had been obtained. RESULTS We identified 45 people who appeared to have acquired their infections in Victoria but outside the east Gippsland region. A new focus appeared on the northern shores of Western Port, near Melbourne, in 1982, and there was a dramatic increase in cases between 1991 and 1994 associated with foci on Phillip Island, and in the Frankston-Langwarrin area of outer suburban Melbourne. Single cases came from Crib Point, Narre Warren and Bendigo. CONCLUSIONS There have been at least three new foci of M. ulcerans infection within 80 km of Melbourne since 1982. Victorian clinicians should consider the possibility of Bairnsdale ulcer when dealing with unusual skin lesions.
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Affiliation(s)
- P D Johnson
- Department of Microbiology and Infectious Diseases, Royal Children's Hospital, Melbourne, VIC.
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