The monthly ACT ATOD Research eBulletin is a concise summary of newly-published research findings and other research activities of particular relevance to ATOD and allied workers in the ACT.
Its contents cover research on demand reduction, harm reduction and supply reduction; prevention, treatment and law enforcement. ATODA's Research eBulletin is a resource for keeping up-to-date with the evidence base underpinning our ATOD policy and practice.
On 1 October Mr Simon Corbell, MLA, ACT Attorney-General, launched the report of the evaluation of the ACT’s drug diversion programs. The evaluation was conducted by the
The ACT drug diversion programs covered by the evaluation were the Simple Cannabis Offence Notice (SCON) Scheme, Police Early Intervention and Diversion (PED), Early Intervention Pilot Program (EIPP), Court Alcohol and Drug Assessment Service (CADAS) and Youth Drug and Alcohol Court (YDAC).
In launching the report, Mr Corbell stated that ‘The territory has been a leader in introducing dedicated drug diversion programs, with five court and police administered programs now operating across the ACT. Diversion programs, which aim to divert offenders away from the criminal justice system, are a pragmatic response to those who commit drug-related crimes. They have the potential to address not only the crime itself, but also the causes of drug use and reoffending. This system also provides offenders with the opportunity to enter into treatment to address illicit drug and alcohol related problems.’
The lead author of the evaluation report, Dr Caitlin Hughes, pointed out that the ACT has been one of the leaders in drug diversion in Australia. She explained that the ACT diversion program has changed over time, becoming increasingly complex and now entailing a number of different components: five diversion programs crossing police, health and courts and targeting alcohol and illicit drugs, along with offenders experiencing substance use disorders. She pointed to the high level of goodwill that exists between the criminal justice and drug treatment agencies and expressed pleasure in the government demonstrating its openness to improve the diversion programs based on the findings of the evaluation.
The Australian Institute of Health and Welfare (AIHW) has undertaken an analysis of the national drug treatment data (the Alcohol and Other Drug Treatment Services National Minimum Data Set) to identify the extent and patterns of treatment services being provided to people diverted from the Australian criminal justice system during the year 2012-13. It has been able to do this owing to the recent introduction of a statistical linkage key (SLK) in the dataset, commencing that year. This makes it possible to count the number of clients receiving treatment, in addition to the number of treatment episodes.
Nationally, during the year, 24,069 treatment clients, 24% of the total, had been diverted into AOD treatment, from the criminal justice system. The corresponding figure for the ACT is 345, 11% of the total, far lower proportion than the national figure.
Among diversion clients nationally, 15% also received non-diversion treatment episodes during the year. The ACT proportion was substantially higher: 23%.
The AIHW report does not provide any further state/territory breakdowns of the data. Nonetheless, other interesting findings, at the national level, include the following:
, cat. no. AUS 186, AIHW, Canberra,
What is the evidence on population-wide effectiveness in preventing HCV transmission by scaling-up sterile injecting equipment and opioid substitution treatment (OST) availability?
Scotland has a history of being a jurisdiction with high levels of drug injection and related harms. In 2008, the Scottish Government launched phase 2 of its Hepatitis C Action Plan for Scotland, and one of its three main aims was to prevent hepatitis C virus (HCV) transmission among people who inject drugs (PWID) through significantly expanding the distribution of sterile injecting equipment and providing opioid substitution therapy. Researchers investigated the extent to which the policy goals have been achieved to date. The researchers used both community level data on service delivery and individual level data, investigating injecting behaviour and related matters. Survey data covered nearly 8,000 PWID. The key outcome measure was recently-acquired HCV infections. The findings were positive: ‘We observed a decline in HCV incidence, per 100 person-years, from 13.6…in 2008-09 to 7.3…in 2011-12; a period during which increases in the coverage of OST and [injecting equipment provision], and decreases in the frequency of injecting and sharing of injecting equipment, were observed. Individual-level evidence demonstrated that combined high coverage of needles/syringes and OST were associated with reduced risk of recent HCV in analyses that were unweighted…and weighted for frequency of injecting... We estimate the combination of harm reduction interventions may have averted 1400 new HCV infections during 2008-2012. This is the first study to demonstrate that impressive reductions in HCV incidence can be achieved among PWID over a relatively short time period through high coverage of a combination of interventions.’
Palmateer, NE, Taylor, A, Goldberg, DJ, Munro, A, Aitken, C, Shepherd, SJ, McAllister, G, Gunson, R & Hutchinson, SJ 2014, ‘Rapid decline in HCV incidence among people who inject drugs associated with national scale-up in coverage of a combination of harm reduction interventions’, PLoS One
, vol. 9, no. 8, p. e10451, open access http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0104515
Comment: For some years we have had good data on the effectiveness, at the individual level, of these interventions, but population-level evidence has been scarce, much of it based on modelling rather than evaluations of real-life interventions. That makes the dramatic improvements attained in just a few years in Scotland, demonstrated here, particularly important. The study provides support for arguments for increased OST treatment and NSP coverage in Australia as key preventive interventions.
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'Cannabis is as addictive as heroin': really?
The 13 October 2014 mass media headlines ‘Cannabis as addictive as heroin’ seriously mis-represented this important article authored by leading Australian scholar Professor Wayne Hall of the University of Queensland. In it he examined changes in the evidence on the adverse health effects of cannabis since 1993; the aim was to see what had been learned over the intervening two decades. The paper’s focus is on ‘...the adverse effects of cannabis smoking, especially the adverse health effects of regular, typically daily, cannabis smoking’ rather than on occasional, light cannabis use. As Hall points out, ‘In epidemiological studies, “heavy” or “regular” cannabis use is usually defined as daily or near-daily use. This pattern, when continued over years and decades, predicts increased risk of many of the adverse health effects attributed to cannabis that are reviewed...
The study found that the evidence base as to the adverse health consequences of heavy cannabis use has grown markedly. ‘Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence. Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs. These associations persist after controlling for plausible confounding variables in longitudinal studies. This suggests that cannabis use is a contributory cause of these outcomes but some researchers still argue that these relationships are explained by shared causes or risk factors. Cannabis smoking probably increases cardiovascular disease risk in middle-aged adults but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco.’
Hall, W 2014, ‘What has research over the past two decades revealed about the adverse health effects of recreational cannabis use?’, Addiction
, online ahead of print, open access http://onlinelibrary.wiley.com/doi/10.1111/add.12703/full
Comment: This is an important paper published in a leading international journal. The media’s mis-representation of its findings has added to mis-information about the health consequences of cannabis. Also note that heavy (daily or near daily) cannabis use is rare: 96% of Australians aged 14 years and older do not consume cannabis weekly, let alone daily.
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How does frequent use of cannabis during adolescence affect educational attainment?
A group of Australian researchers investigated the association between the maximum frequency of cannabis use before age 17 years and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The study’s findings suggest that ‘individuals who were daily users before age 17 years had odds of high-school completion and degree attainment that were 63% and 62% lower, respectively, than those who had never used cannabis; furthermore, daily users had odds of later cannabis dependence that were 18 times higher, odds of use of other illicit drugs that were eight times higher, and odds of suicide attempt that were seven times higher’. The researchers state that ‘Adverse sequelae [i.e. consequences] of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects’.
Silins, E et al.
2014, ‘Young adult sequelae of adolescent cannabis use: an integrative analysis
’, The Lancet Psychiatry
, vol. 1, no. 4, pp. 286-93.
Non-fatal overdoses of long-term heroin users: how frequent and with what predictors?
A study of new data on the natural history of overdose amongst the Australian Treatment Outcome Study (ATOS) cohort, examined overdose at 11 years, approximately 20 years since the initiation of heroin use. The researchers found that, ‘By 11-year follow-up, the proportion who had ever overdosed had risen to over two thirds, with over 2,000 lifetime overdoses reported. While the proportion who had recently overdosed consistently declined across follow-ups, one in 20 had recently overdosed, and one in 10 had done so in the past three years. The correlates of recent overdose, however, remained remarkably stable’. The correlates (also referred to as predictors in the paper) were polydrug use, an overdose history, and more treatment episodes. The authors conclude that ‘While the prevalence had declined, overdoses still occurred. A history of overdose and polydrug use patterns continued to provide strong markers for those at continued risk’.
Darke, S , Marel, C, Mills, KL, Ross, J, Slade, T, Burns, L & Teesson, M 2014, ‘Patterns and correlates of non-fatal heroin overdose at 11 year follow-up: findings from the Australian Treatment Outcome Study
’, Drug and Alcohol Dependence
, online ahead of print.
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To what extent do different types of opioid treatment result in different benefits for participants?
The British Randomised Injectable Opioid Treatment Trial (RIOTT) ‘compared supervised injectable heroin (SIH), and supervised injectable methadone (SIM) with optimised oral methadone (OOM)... Heroin [dependent people] (previously unresponsive to treatment) made significant reductions in “street-heroin” use at six months when treated with SIH’. A further randomised control trial compared SIH vs. OOM and SIM vs. OOM in three supervised injectable opiate clinics in England. The researchers found that ‘all treatments achieved benefits at six months. SIH, SIM and OOM led to significant reductions in crime and money spent on illicit drugs, treatment with SIH and SIM led to significant improvements in physical health and OOM treatment led to significant improvements in mental health. No significant improvements were found in social functioning, or significant reductions in crack/cocaine or illicit benzodiazepines use and alcohol use remained high’. The authors concluded that ‘Supervised injection of heroin and supervised injection of methadone showed no clearly identified benefit over optimised oral methadone in terms of wider drug use, crime, physical and mental health within a 6 month period despite reducing street heroin use to a greater extent. All interventions were associated with improvements in these outcomes’.
Metrebian, N et al.
2014, ‘Drug use, health and social outcomes of hard-to-treat heroin addicts receiving Supervised Injectable Opiate Treatment: secondary outcomes from the Randomised Injectable Opioid Treatment Trial (RIOTT)
, online ahead of print.
Comment: This study adds to the now-significant body of research evidence supporting the expansion of treatment options for opioid-dependent people who are not doing well on oral methadone.
How do the outcomes of buprenorphine pharmacotherapy and behavioural treatment differ among people who use heroin, prescription opioids and combination of these drugs?
A recent paper in the Journal of Substance Abuse Treatment
compares outcomes of buprenorphine pharmacotherapy and behavioural treatment among people who use heroin, people who use prescription opioids (PO) and those who use a combination of these drugs. A summary of the paper in Drug and Alcohol Connections http://www.connections.edu.au/publicationhighlight/non-heroin-using-prescription-opioid-users-respond-well-opioid-substitution
states that ‘The authors analysed data from a randomised controlled trial of behavioural treatment provided for 16 weeks on a platform of buprenorphine pharmacotherapy and medication management. They compared 54 heroin users, 54 PO users and 71 combination heroin and PO users to test the hypothesis that PO users will have better treatment outcomes compared with heroin users. The PO group provided more opioid-negative urine drug screens over the combined treatment period and at the end of the combined treatment period. Retention was lowest in the heroin group. There was no significant difference in buprenorphine dose between the groups. PO users appear to have better outcomes in buprenorphine pharmacotherapy compared to those reporting any heroin use, confirming that buprenorphine pharmacotherapy is effective in PO users.
‘Consistent with findings from previous research, it appears that PO users who do not also use heroin have favourable treatment outcomes with both buprenorphine and methadone treatment. These combined findings suggest that treatment protocols that were developed based on evidence from studies with heroin users may also be appropriate for PO users. Further research may be needed to identify if there are groups of PO users who do not do well in treatment. Also, given the promising treatment outcomes, future efforts to make treatment more accessible to all PO users appears to be a critical strategy for reducing the currently high mortality rates in young people from PO overdose’.
Nielsen, S, Hillhouse, M, Mooney, L, Ang, A & Ling, W 2014, ‘Buprenorphine pharmacotherapy and behavioral treatment: comparison of outcomes among prescription opioid users, heroin users and combination users
’, Journal of Substance Abuse Treatment
, online ahead of print.
To what extent can involvement with the criminal justice system be used as an opportunity to engage Indigenous people in opioid substitution therapy?
A study in NSW compared the nature and types of charges, time in custody and opioid substitution therapy (OST) treatment utilisation between opioid-dependent Indigenous and non-Indigenous Australians in contact with the criminal justice system. The findings were ‘Of the 34,962 people in the cohort, 6,830 (19.5%) were Indigenous and 28,132 (80.5%) non-Indigenous…The median number of charges per person against Indigenous people…was significantly greater than non-Indigenous people…Overall, Indigenous people were charged with 33.2% of the total number of charges against the cohort and 44.0% of all violent offences. The median percentage of follow-up time that Indigenous males and females spent in custody was twice that of non-Indigenous males…and females…The percentage of Indigenous people who first commenced OST in prison (30.2%) was three times that of non-Indigenous people (11.2%)…Indigenous males spent less time in OST compared to non-Indigenous males’. The researchers concluded ‘contact with the criminal justice system provides an important opportunity to engage Indigenous people in OST’.
Gisev, N et al.
2014, ‘Offending, custody and opioid substitution therapy treatment utilisation among opioid-dependent people in contact with the criminal justice system: comparison of Indigenous and non-Indigenous Australians
’, BMC Public Health
, vol. 14:920 (6 September 2014).
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How likely is it that patrons of late-night entertainment districts become drunker as the night proceeds?
A study conducted in the night-time entertainment districts of Sydney, Melbourne, Perth, Wollongong and Geelong involved data collection approximately fortnightly in each city on a Friday or Saturday night between 8 pm and 5 am. Brief structured interviews (3–10 min) and breathalyser tests were undertaken in busy thoroughfares over six months. ‘Of the 7037 individuals approached to participate in the study, 6998…agreed to be interviewed. There was a linear increase in blood alcohol concentration (BAC) levels throughout the night. Post hoc testing revealed significantly more highly intoxicated participants (i.e. BAC above 0.10 mg of alcohol per 100 mL of blood) after midnight…The overall mean BAC was 0.06 mg/100 mL. Men were more intoxicated than women earlier in the night, but gender differences disappeared by 3 am. There was no age differences in intoxication earlier in the night, but after midnight, patrons over the age of 21 showed increasing BAC levels.’ The researchers concluded that ‘There is a consistent trend across the cities of high to very high levels of intoxication later in the night, with trends after midnight being significantly different to those before’.
Miller, P et al
. 2014, ‘A comparative study of blood alcohol concentrations in Australian night-time entertainment districts
’, Drug and Alcohol Review
, vol. 33, no. 4, pp. 338-45.
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What is the association between alcohol intoxication and stimulant use in the night-time economy?
A second study which utilised the data described in the item above tested whether participants in the night-economy who had consumed stimulants (either energy drinks or illicit stimulants), as well as alcohol, had higher blood alcohol concentration (BAC) levels than patrons who had consumed alcohol only. The researchers found that ‘Six percent of alcohol consumers interviewed in the Australian night-time economy reported consuming at least one type of illicit simulant on the current night out. Those who consumed illicit stimulants were significantly more likely to be male, engage in pre-drinking, to have spent time at a nightclub and to have consumed full strength beer, spirits and cannabis. More than one in five participants reported consumption of alcohol and energy drinks on the current night out and energy drink consumers were significantly more likely to be younger, to be interviewed after midnight, to engage in pre-drinking, to have spent time at nightclub, and to have consumed spirits or “shots”…Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours.’ They concluded ‘While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session’.
Pennay, A, Miller, P, Busija, L, Jenkinson, R, Droste, N, Quinn, B, Jones, SC & Lubman, DI 2014, ‘”Wide Awake Drunkenness”? Investigating the association between alcohol intoxication and stimulant use in the night-time economy
, online ahead of print.
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What do we know about the barriers to and enablers of providing alcohol treatment among Aboriginal Australians?
Australian researchers reviewed the results of five research projects that had been commissioned with the goal of improving alcohol treatment among Aboriginal Australians. They sought to identify overarching things that could be learned from that group of studies. They do this by work shopping drafts of the papers and reviewing the papers once finalised. The studies revealed how ‘…a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised.’ Importantly, the review led to the conclusion that ‘There is no simple way to reduce alcohol-related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research.’
Gray, D, Wilson, M, Allsop, S, Saggers, S, Wilkes, E & Ober, C 2014, ‘Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: a thematic review of five research projects
’, Drug and Alcohol Review
, vol. 33, no. 5, pp. 482-90.
Comment: The authors have made a valuable contribution, particularly in highlighting that ‘…with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved’. This finding can serve as evaluation criteria for initiatives related to improving alcohol treatment for Aboriginal Australians.
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What do Australian police want from liquor licensing legislation?
Australian researchers interviewed ‘53 Australian police officers with specialist expertise in liquor law enforcement to ascertain their perspectives concerning the liquor licensing legislation in Australia’s eight states and territories. Respondents generally indicated that current arrangements favoured the interests of the alcohol industry and did not sufficiently empower them to reduce alcohol-related harms. Other key themes included: ambiguity surrounding the police role in liquor licensing; difficulties in enforcing drunkenness-related offences; partnerships; strategies to enhance enforcement; data/intelligence gathering; and the separation of Ministerial responsibilities for liquor licensing and policing. Overall, police in Australia are not currently being given the tools they require to effectively reduce alcohol-related harms.’
Trifonoff, A, Nicholas, R, Roche, AM, Steenson, T & Andrew, R 2014, ‘What police want from liquor licensing legislation: the Australian perspective’
, Police Practice and Research
, vol. 15, no. 4, pp. 293-306.
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Are people who are in remission from a substance use disorder (SUD) more or less likely to develop a second SUD compared to people not in remission?
A study in the United States aimed to determine whether ‘remission from a substance use disorder (SUD) increases the risk of onset of a new SUD after a 3-year follow-up compared with lack of remission from an SUD and whether sociodemographic characteristics and psychiatric disorders, including personality disorders, independently predict a new-onset SUD’. The researchers found that, ‘In a large nationally representative sample of adults with SUDs, approximately 1 in 5 had developed a new-onset SUD during the course at the 3-year follow-up. Contrary to our first hypothesis, individuals who remitted from 1 SUD at wave 2 were significantly less likely than those who did not remit to develop a new SUD…Individuals who remitted from an SUD had less than half the risk of developing a new SUD than those who did not remit from any SUD’. They concluded ‘: As compared with those who do not remit from an SUD, remitters have less than half the risk of developing a new SUD. Contrary to clinical lore, achieving remission does not typically lead to drug substitution but rather is associated with a lower risk of new SUD onsets’.
Blanco, C, Okuda, M, Wang, S, Liu, S-M & Olfson, M 2014, ‘Testing the drug substitution switching-addictions hypothesis: a prospective study in a nationally representative sample
’, JAMA Psychiatry
, online ahead of print.
Comment: Most studies of drug substitution have occurred in clinical samples; apparently this is the first to use population-level survey data. It acknowledges the widespread assumption that the substance use disorder is a single condition with multiple expressions, i.e. expressed through dependent or otherwise harmful use of a range of psychoactive substances. Discovering that people in remission from a substance use disorder (in other words, people no longer experiencing problematic drug use including those who would be considered to be treatment successes) have markedly lower risks of developing a new substance use disorder after three years, should provide encouragement to people in the drug treatment sector. This is because it challenges earlier views that the successful treatment of problematic use of one drug is likely to be followed by the person having problems with another drug, i.e. drug substitution.
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Why have methamphetamine-related harms increased in Victoria recently, even though use is stable or declining?
A study conducted in Victoria over the period January 2009 to June 2013 aimed to determine how changes in price and purity of methamphetamine, compared with other drugs such as heroin, may explain the recent increase in methamphetamine-related harms in Victoria, in the context of stable or declining levels of use of the drug. They found that ‘While the average purity of heroin seizures remained consistent and low, the average purity of powder and of crystal methamphetamine seizures increased from 12%...to 37%...and 21%...to 64%...respectively. Crystal methamphetamine purity was bimodal, with observations generally less than 20% or greater than 70%. The average unadjusted price per gram for heroin decreased from $374…to $294…powder methamphetamine didn’t change significantly from $252…and crystal methamphetamine increased substantially from $464…in 2009 to $795…in 2011. This increase was offset by an even greater increase in purity, meaning the average purity-adjusted price per gram declined. Furthermore, pure prices of both methamphetamine forms were similar, whereas their unadjusted prices were not. The pure price of heroin fluctuated with no ongoing trends’. The researchers concluded ‘Decreases in methamphetamine purity-adjusted price along with the bimodality of crystal methamphetamine purity may account for some of the recent increase in methamphetamine related harm. For a given amount spent, methamphetamine purchase power has increased and the presence of extreme purity variations may challenge individuals’ control of consumption’.
Scott, N, Caulkins, JP, Ritter, A, Quinn, C & Dietze, P 2014, ‘High-frequency drug purity and price series as tools for explaining drug trends and harms in Victoria, Australia
, online ahead of print.
Comment: This study helps to explain the apparent anomaly of the levels of methamphetamine use being stable whereas harms related to its use appear to be increasing. Note the use of purity-adjusted price as the key measure: research has demonstrated that it is particularly useful for monitoring changes in drug markets.
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What prompts smokers to phone a Quitline?
An analysis of the characteristics of new callers to the NSW Quitline over the period 2008 to 2011 examined whether the demographic profile, level of nicotine dependance, living circumstances (with/without smokers), motivations and quitting status at first call showed change over time. The researchers found that, ‘Between 2008 and 2011 the profile of callers to the NSW Quitline appeared to be undergoing small but consistent changes. The proportion of male callers showed a small increase over time an encouraging trend given evidence suggesting that men are less likely to seek help but are more likely to smoke. The age distribution showed some fluctuations but lacked an interpretable trend. Although the distribution of area-level socioeconomic disadvantage was constant between 2008 and 2011, the proportion of callers who were not working…increased substantially…Analysis of motivations to quit among callers showed a consistently high proportion nominating “future health”, perhaps reflecting a developing culture of taking a proactive approach to health rather than waiting for incident disease to trigger cessation. Continuing investment by both the Federal and State governments in mass media campaigns highlighting health impacts of smoking may in part be responsible for this sustained effect. Money as a motivation showed a dramatic increase, perhaps deriving some impetus from a nationwide 25% tax increase on cigarettes implemented in April 2010’.
The conclusion of the research was ‘Clear effects of tobacco policy were shown, as money as a motivator increased dramatically in conjunction with increased tobacco taxation, highlighting the importance of promoting cessation services concurrent with policy change to capitalise on increased motivation to quit’.
Grunseit, AC, Ding, D, Anderson, C, Crosbie, D, Dunlop, S & Bauman, A 2014, ‘A profile of callers to the New South Wales Quitline, Australia, 2008 to 2011’
, Nicotine & Tobacco Research
, online ahead of print.
Comment: As the NSW Quitline also serves ACT residents it is likely that ACT callers to it share the characteristics set out above.
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How effective is banning point-of-sale tobacco pack displays in reducing young people's inclination to smoke?
An evaluation of the medium-term impact on young people of the bans on tobacco pack displays at point-of-sale (PoS) in NSW and Queensland used data from the Tobacco Promotion Impact Study, a repeated cross-sectional survey of youth (12–24 years). The researchers found that ‘Recall of PoS tobacco displays was significantly less likely for youth interviewed after the bans versus before…They were also less likely to report tobacco brand awareness…to over-estimate peer smoking…or be current smokers…Stratified analyses showed that these differences were primarily apparent in the group of youth most likely to be affected by tobacco PoS displays: those who visit tobacco retailers most frequently. After the bans, smokers were less likely to report that they think about smoking as a result of seeing PoS tobacco displays’. The researchers concluded ‘Our findings suggest an immediate impact of display bans on youth’s exposure to tobacco pack displays, and likely impacts on smoking-related outcomes. These results suggest that removing tobacco displays from retail environments can positively contribute to the denormalization of smoking among youth’.
Dunlop, S, Kite, J, Grunseit, AC, Rissel, C, Perez, DA, Dessaix, A, Cotter, T, Bauman, A, Young, J & Currow, D 2014, ‘Out of sight and out of mind? Evaluating the impact of point-of-sale tobacco display bans on smoking-related beliefs and behaviors in a sample of Australian adolescents and young adults’, Nicotine & Tobacco Research, online ahead of print.
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How and to what extent do increasing taxes on cigarettes and strengthening smoke-free policies affect alcohol consumption?
Researchers in the United States examined whether increases in cigarette taxes and strengthening of smoke-free air laws were associated with reductions in per capita alcohol consumption, and whether any reductions were specific to certain beverage types. They found that ‘Increases in state cigarette prices and restrictions on indoor smoking (SFA [smoke free areas] policies) were significantly associated with decreases in state per capita alcohol consumption during1980 to 2009. The joint effects of the policies were significantly associated with reductions in consumption of total alcohol and of beer and spirits, but not wine. A 10% increase in cigarette price was associated with a 0.83% decrease in per capita total alcohol consumption and a 1.06% decrease in beer consumption. A 1-point increase in SFA policy score was associated with a 1.1% decrease in per capita total alcohol consumption, a 0.7% decrease in beer consumption, and a 1.9% reduction in per capita spirits consumption’. The researchers concluded that ‘The public health benefits of increasing cigarette taxes and smoke-free policies may go beyond the reduction of smoking and extend to alcohol consumption, specifically beer and spirits’.
Krauss, MJ, Cavazos-Rehg, PA, Plunk, AD, Bierut, LJ & Grucza, RA 2014, ‘Effects of state cigarette excise taxes and smoke-free air policies on state per capita alcohol consumption in the United States, 1980 to 2009’, Alcoholism: Clinical and Experimental Research, online ahead of print.
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How cost-effective are call-back counselling services for smoking cessation?
An analysis of the cost-effectiveness of the introduction of call-back counselling for smoking cessation in Quitlines in Queensland, Western Australia and the Northern Territory indicated that it is ‘…an intervention that both improves health with additional quitters, and achieves net cost savings due to the cost offsets being greater than the cost of the intervention… These results suggest that expansion of the call-back counselling service should achieve substantial cost offsets when compared with the cost of the intervention at $A289 000. Call-back counselling should result in approximately 375 additional quitters, save 980 DALYs, and yield total cost offsets of $A773 000’. The researchers concluded that ‘Call-back counselling is a cost-effective intervention for smoking cessation that can be provided by a centralised service for a large population, and to reach people in isolated communities’.
Lal, A, Mihalopoulos, C, Wallace, A & Vos, T 2014, 'The cost–effectiveness of call-back counselling for smoking cessation’, Tobacco Control, vol. 23, no. 5, pp. 437-42.
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Copeland, J & Clement, N 2014, The use of cannabis for medical purposes, NCPIC Bulletin Series no. 18, National Cannabis Prevention and Information Centre, Sydney, http://ncpic.org.au/ncpic/publications/bulletins.
De Wit, J, Mao, L, Adam, P & Treloar, C (eds) 2014, HIV/AIDS, hepatitis and sexually transmissible infections in Australia: annual report of trends in behaviour 2014, monograph 6/2014, Centre for Social Research in Health, UNSW, Sydney, https://csrh.arts.unsw.edu.au/media/CSRHFile/Annual_Report_of_Trends_in_Behaviour_2014.pdf.
Dunn, M, McKay, F, Murphy, B, Munro, G & Hausdorf, K 2014, Preventing alcohol and drug problems in your community, Prevention Research, Australian Drug Foundation, Melbourne, http://www.druginfo.adf.org.au/reports/pr-communities.
Lord, S, Kelsall, J, Kirwan, A & King, T 2014, Opioid pharmacotherapy fees: a long-standing barrier to treatment entry and retention, Policy Brief no. 8, Centre for Research Excellence into Injecting Drug Use, Melbourne, http://creidu.edu.au/policy_briefs_and_submissions/10-opioid-pharmacotherapy-fees-a-long-standing-barrier-to-treatment-entry-and-retention.
Public Health Association of Australia 2014, Position statement: medicinal cannabis in Australia, Public Health Association of Australia, Canberra, http://www.phaa.net.au/documents/140922PHAA%20Position%20Statement-Medicinal%20cannabis%20in%20Australia%20FINAL.pdf.
Quinn, B 2014, ‘Don’t panic, we need a clear head to respond to crystal meth’, The Conversation, https://theconversation.com/dont-panic-we-need-a-clear-head-to-respond-to-crystal-meth-30258.
Roxburgh, A & Burns, L 2013, Drug-related hospital stays in Australia 1993–2012, National Drug and Alcohol Research Centre, Sydney, http://ndarc.med.unsw.edu.au/resource/drug-related-hospital-stays-australia-1993%E2%80%932012.
Shane Rattenbury MLA, ACT Greens Member for Molonglo 2014, Medical cannabis discussion paper, ACT Greens, Canberra, http://www.actgreens.org.au/medical_cannabis.
The Kirby Institute 2014, HIV, viral hepatitis and sexually transmissible infections in Australia: Annual Surveillance Report 2014, The Kirby Institute, The University of New South Wales, Sydney, http://kirby.unsw.edu.au/surveillance/2014-annual-surveillance-report-hiv-viral-hepatitis-stis.
Wan, W-Y, Poynton, S, Doorn, Gv & Weatherburn, D 2014, Parole supervision and reoffending, Trends & Issues in Crime and Criminal Justice, no. 485, Australian Institute of Criminology,, Canberra, http://aic.gov.au/publications/current%20series/tandi/481-500/tandi485.html.
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