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.

 

In the May 2014 issue


ACT Research Spotlight

News

Online Resources

APSAD Conference

Research Findings

New Reports
 

Do NSP staff face particular problems in dealing with people who use performance- and image-enhancing drugs?
 
An Australian study conducted in 2013 involved interviews with thirteen workers in needle and syringe (NSP) programs about their experiences in dealing with people who use steroids and other performance- and image-enhancing drugs (PIED). The findings of the study were that ‘Firstly, NSP workers do not feel well informed about the substances that PIED users are injecting. Secondly, they were unsure what equipment PIED users required. Thirdly, PIED users were perceived to differ from other client groups, and these differences impacted upon the level of rapport staff could build with this group’. The researchers concluded that ‘PIED users pose unique challenges for NSP workers compared with other NSP client groups. The PIEDs used and the way in which they are used are substantially different compared with other NSP clients, and there appears to be a lack of knowledge within the workforce about these substances. This study highlights the need to engage in workforce training, but also the need to more effectively engage with PIED users in relation to effective harm reduction strategies’.
 
Dunn, M, McKay, FH & Iversen, J 2014, ‘Steroid users and the unique challenge they pose to needle and syringe program workers’, Drug and Alcohol Review, vol. 33, no. 1, pp. 71-7.

 
Comment: Australian Crime Commission figures show that the number of arrests, nationally, for steroid offences has tripled over the last five years, with 77% of the arrests in 2012-13 being of steroid consumers. Further attention probably needs to be directed towards people who use these drugs, owing to the significant negative health impacts that they can have on users.


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Are young people who buy alcohol from off-licence outlets more likely to binge drink than those who buy alcohol from on-licence premises?

Australian researchers investigated the extent to which young people purchased alcohol from off-licence outlets, compared with on-licence outlets, on a Saturday night, and whether this was related to binge drinking. They found that ‘Of participants who drank the previous Saturday night…46% bought alcohol only from off-licence outlets (e.g. bottle shops), 19% bought from both off-licence and on-licence outlets (e.g. clubs, bars), and 23% bought only from on-licence outlets. Participants who bought alcohol from off-licence outlets were equally likely to binge-drink as participants who bought only from on-licence outlets...but they drank more cheaply and usually drank at home. Participants who bought alcohol from both off-licence and on-licence outlets were more likely to binge-drink…drank both at home and in public places, were at higher risk of an alcohol use disorder and were more likely to have used stimulants the previous Saturday night. The conclusion of the study was that ‘Off-licence outlets were a major source of alcohol in this sample of young Australian adults, many of whom binge-drank in private homes’.
 
McKetin, R, Livingston, M, Chalmers, J & Bright, D 2014, ‘The role of off-licence outlets in binge drinking: a survey of drinking practices last Saturday night among young adults in Australia’, Drug and Alcohol Review, vol. 33, no. 1, pp. 51-8.

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What effects do restrictions on pub closing times, and lock outs, have on rates of assaults? 
 
A recent study examined assault rates in the Newcastle CBD five years after the introduction of restrictions in pub closing times from 5.00 am to 3.30 am, and compared them with assault rates in the nearby town of Hamilton where pubs are required to lock their doors to new patrons after 1.00 am on Saturdays and Sundays, permitting the service of alcohol to existing patrons until 30 minutes before closing time, which remained unaltered and could be as late as 5.00 am. The researchers found that ‘In the CBD recorded assaults fell from 99/quarter before the restriction to 68/quarter [during the first eighteen months after the introduction of the restricted closing times]… and 71/quarter [over the following 3.5 years]…In the same periods in Hamilton, assault rates were 23, 24, and 22 per quarter respectively’. They concluded ‘The restriction in closing time was associated with a sustained lower assault rate in the Newcastle CBD. We find no evidence that lockouts and other outlet management strategies were effective in Hamilton’.
 
Kypri, K, McElduff, P & Miller, P 2014, ‘Restrictions in pub closing times and lockouts in Newcastle, Australia five years on’, Drug and Alcohol Review, vol. 33, no. 3, pp. 323-6.
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Are fewer Australian teenagers drinking alcohol?

‘Recent evidence suggests that there has been a sharp increase in non-drinking among Australian adolescents.’ An analysis of data from the National Drug Strategy Household Survey series has revealed that ‘Rates of abstention increased overall [among 14-17 year olds] from 32.9%...to 50.2% [between 2001 and 2010]…Increases in abstention have occurred consistently across a wide range of population subgroups defined by demographic, socio-economic and regional factors.’ The author of this study points out that ‘The reductions in drinking among Australian adolescents have not been offset by increases in illicit drug use or smoking, with steady falls in the prevalence of these behaviours over the same period’.
 
Livingston, M 2014, ‘Trends in non-drinking among Australian adolescents’, Addiction, vol.109, no.6, pp. 922-99
 
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Are Indigenous children now less likely to be exposed to second-hand smoke? 
 
Analysis of data from the 2004 National Aboriginal and Torres Strait Islander Health Survey, the 2008 National Aboriginal and Torres Strait Islander Social Survey, and the National Health Surveys in 2004 and 2007, demonstrated that ‘The proportion of Indigenous children living with at least one daily smoker who smokes inside declined significantly from 28.4% in 2004 to 20.8% in 2008, with significant improvements only detected among the most disadvantaged categories of Indigenous children. The proportion of Indigenous daily smokers who lived in multi-person households where no daily smoker householder usually smoked inside increased significantly from 45.0% in 2004 to 56.3% in 2008. The absolute size of these changes was greater among Indigenous children and smokers than among all Australians. More disadvantaged Indigenous children were more likely to be exposed to second-hand smoke at home, and more disadvantaged Indigenous smokers were more likely to live in households where smokers usually smoked inside. Indigenous smokers in smoke-free homes smoke significantly less cigarettes’. The researchers concluded that ‘The increases in Indigenous smoke-free homes are encouraging, especially as they are from the period before recent increased attention to Indigenous tobacco control, which should accelerate these trends and their resultant health benefits for Aboriginal and Torres Strait Islander children and families’.
 
Thomas, DP & Stevens, M 2014, ‘Aboriginal and Torres Strait Islander smoke-free homes, 2002 to 2008’, Australian and New Zealand Journal of Public Health, vol. 38, no. 2, pp. 147-53.
 

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Which major public health phenomenon has been neglected for 50 years? 

In this Viewpoint, Andrea Smith and Simon Chapman from the School of Public Health at the University of Sydney discuss the tensions in the public health community between promoting pharmacological smoking cessation aids, on the one hand, and investing in social marketing campaigns that aim to promote quit attempts, on the other. They point out that the Commonwealth Government spends far more on the former than the latter, despite clear evidence that the vast majority of people who quit smoking do so without pharmacological aids.
Part of the responsibility for this lies, they argue, with the research community: ‘Smoking cessation research today is dominated by the development and evaluation of interventions to improve the odds of quitting successfully. Yet little attention has been paid to the large majority of ex-smokers who quit without recourse to any formal assistance. To many, these unassisted quitters are of little interest other than as a comparator population against which to test the efficacy or effectiveness of pharmaceutical or behavioral interventions. The effect of this neglect is compounded by the preference for reporting intervention success as rates rather than as the numbers of ex-smokers generated across populations through such interventions. In so doing, researchers have insulated those in policy and practice from the importance of unassisted smoking cessation and the unparalleled contribution it has made and will continue to make to reducing smoking prevalence...Far more is known about the “tail” of people who quit smoking via pharmacological and professionally mediated interventions than about the mass “dog” of ex-smokers who continue to quit unassisted.’
As guidance to policy workers they point out that, ‘For many smokers, having a reason to quit (a why) was more important than having a method to quit (a how). The key may therefore be to focus on motivating more smokers to try to quit and to try to quit more frequently, regardless of whether these quit attempts are assisted or unassisted’.
 
Smith, AL & Chapman, S 2014, ‘Quitting smoking unassisted: the 50-year research neglect of a major public health phenomenon’, JAMA, vol. 311, no. 2, pp. 137-8.
 
Comment: As ATODA has argued in the past, the best approach is to have a mix of interventions available to keep pushing down smoking prevalence, and to reduce the socio-economic disparities in smoking rates. Policy workers are urged to attend more closely to the relative benefits, at the population level, of promoting assisted, compared with unassisted, quit attempts.

 
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Are people who were mistreated as children at greater risk of alcohol and nicotine dependence as adults? 

A study conducted in the United States investigated whether physical, sexual and emotional abuse, and physical and emotional neglect, were predictors of persistent alcohol and nicotine dependence. The researchers concluded that ‘A history of childhood maltreatment predicts persistent adult alcohol and nicotine dependence. This association, robust to control for other childhood adversities, suggests that maltreatment (rather than a generally difficult childhood) affects the course of dependence’.
 
Elliott, JC, Stohl, M, Wall, MM, Keyes, KM, Goodwin, RD, Skodol, AE, Krueger, RF, Grant, BF & Hasin, DS 2014, ‘The risk for persistent adult alcohol and nicotine dependence: the role of childhood maltreatment’, Addiction, vol. 109, no. 5, pp. 842-50.

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What economic impacts do smoking bans have on restaurants and bars?

A systematic review of the literature and meta-analysis of the economic impact of smoking bans in restaurants and bars in the United States, Australia, South America and Europe ‘…showed no associations between smoking bans and changes in absolute sales or employment. An increase in the share of bar and restaurant sector sales in total retail sales was associated with smoking bans’. A reduction in bar sales was associated with smoking bans, but no such changes occurred in restaurant sales. No changes in employment occurred in bars, but employment increased in restaurants. The researchers concluded that ‘Meta-analysis of the economic impact of smoking bans in hospitality sector showed overall no substantial economic gains or losses. Differential impacts were observed across individual business types and outcome variable, but at aggregate level these appear to balance out’.
 
Cornelsen, L, McGowan, Y, Currie-Murphy, LM & Normand, C 2014, ‘Systematic review and meta-analysis of the economic impact of smoking bans in restaurants and bars’, Addiction, vol. 109, no. 5, pp. 720-7.

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What happens when the price of tobacco retailer licences increases?

A natural experiment occurred in 2007 in South Australia when a regulatory change increased tobacco retailers’ licence fees from just $12.90 to $200 per annum. Tobacco licence records were studied covering the year prior to, and two years after, the increase using an interrupted time series analysis, to assess the impacts of the increase. The researchers found that ‘The total number of tobacco licences decreased by 23.7% from December 2007 to December 2009. The increased tobacco licence fee implemented on 1 January 2007, was associated with a significant reduction in the number of tobacco licences purchased or renewed in subsequent years. Of the 1144 entertainment licensees holding valid licences in December 2007, 30.9% no longer held a licence by December 2009, and 19.9% had reduced the number of points of sale within the same venue...Our data add to the growing body of evidence supporting further regulation of retail sale of tobacco. The results demonstrate that a tobacco licence price increase off a low base is a potentially effective method of reducing tobacco points of sale when consumer demand for cigarette products is low. However, further research is needed to identify additional measures that may be necessary to reduce the availability of tobacco products in areas where consumer demand for cigarettes is high.’
Importantly, the fall in the numbers of licences was greatest for entertainment outlets, coinciding with strengthened restrictions in tobacco sales and use in these premises. ‘The tobacco licence fee increase had minimal impact on reducing licences in other retail outlet types, which may reflect the importance of tobacco sales in these outlets. For instance, a 2005 industry report showed that tobacco products accounted for 95% of sales for tobacconists, over 30% of sales for convenience stores, but only 1% of sales for hotels and clubs. In supermarkets, only 7% of sales were attributable to tobacco products, but the gross revenue exceeded that of other retail types due to the high volume of sales. Thus, it appears that the tobacco licence fee increase was not sufficient to impact on retailers that have a high volume of sales from tobacco products’.
 
Bowden, JA, Dono, J, John, DL & Miller, CL 2014, ‘What happens when the price of a tobacco retailer licence increases?’, Tobacco Control, vol. 23, no. 2, pp. 178-80.
 
Comment: With regard to its alcohol control policies, the ACT Government is making strong efforts to apply what is known from research about what works, for whom, in what circumstances, and why. It is now seeking to apply this approach to restricting the availability of tobacco products. Unfortunately, hardly any research exists on the impacts on the availability and use of tobacco products of changing tobacco licence fees. Indeed, this study appears to be the only one of its kind. Tobacco licence fees for ACT retailers are currently just $200 per annum. ATODA believes that it is bad policy to permit people to legally sell a product which, if used as intended, will kill a high proportion of its users, and pay just $200 a year to do so.

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What are the relative degrees of harm associated with various nicotine delivery products?

An international expert panel convened by the Independent Scientific Committee on Drugs, and led by Professor David Nutt, developed a multi-criteria decision analysis model of the relative importance of different types of harm related to the use of various nicotine-containing products.  Multi-criteria decision analysis is a strategy within operations research that aids decision-making in areas where many different assessment criteria operate. In this case, a group of experts pooled their knowledge of 12 nicotine-containing products and 14 criteria of harm that results from the use of those products. Seven criteria covered harms to the users and seven covered harms to others. ‘The group scored all the products on each criterion for their average harm worldwide using a scale with 100 defined as the most harmful product on a given criterion, and a score of zero defined as no harm. The group also assessed relative weights for all the criteria to indicate their relative importance.’
They found that ‘Cigarettes (overall weighted score of 100) emerged as the most harmful product, with small cigars in second place (overall weighted score of 64). After a substantial gap to the third-place product, pipes (scoring 21), all remaining products scored 15 points or less’. Electronic nicotine delivery systems including nicotine-containing electronic cigarettes and other vapourisers scored below 5 on the 100-point scale. The authors concluded that ‘Cigarettes are the nicotine product causing by far the most harm to users and others in the world today. Attempts to switch to non-combusted sources of nicotine should be encouraged as the harms from these products are much lower.’
 
Nutt, DJ, Phillips, LD, Balfour, D, Curran, HV, Dockrell, M, Foulds, J, Fagerstrom, K, Letlape, K, Milton, A, Polosa, R, Ramsey, J & Sweanor, D 2014, ‘Estimating the harms of nicotine-containing products using the MCDA approach’, European Addiction Research, vol. 20, no. 5, pp. 218-25.

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What are Australians’ views on drug policy? 

ABSTRACT
BACKGROUND: Policy choices for illicit drugs such as cannabis entail consideration of competing factors such as individual health, societal views about pleasure, and criminal justice impacts. Society must weigh up these factors in determining the preferred cannabis policy; although often cast as a contest between legalisation of cannabis or full prohibition the actual policy choices are not so black and white. This study assessed societal preferences for different cannabis policies and multiple consequences.
METHOD: A discrete choice experiment (DCE) quantified value-based preferences for alternative cannabis policies described by the five key attributes legal status, health harms, criminal justice service costs, rates of cannabis use and purchase location. An online survey was conducted on a population sample of 1020 Australians. The analytical model was based on stated choices for Policy A, B or Current Policy.
RESULTS: The results revealed a strong general preference for either civil penalties or legalisation compared to cannabis cautioning (Current Policy) and a strong dislike of criminalising possession and use of cannabis. Results also demonstrate difference in preferences among those with different demographics and beliefs. Understanding these nuances help to quantify the range of preferences held within the population and can be used to inform policy.
CONCLUSION: This is the first known DCE survey applied to the area of illicit drugs policy. It demonstrates the public hold disparate views on the most appropriate status for cannabis offences and they are able to make trade-offs between policy choices and outcomes in complex areas of social policy.
 
Shanahan, M, Gerard, K & Ritter, A 2014, ‘Preferences for policy options for cannabis in an Australian general population: a discrete choice experiment’, International Journal of Drug Policy, online ahead of print.

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Do people who use drugs have different opinions about legalisation and treatment according to the types of drugs they use?

An Australian study investigated whether there is heterogeneity of opinion about drug policies amongst people with different experiences of drug use, with a view to stimulating discussion about how the diverse perspectives of people who use drugs can be meaningfully included in policy deliberation. The study involved a comparison of the views of people who inject drugs with the views of people who regularly use MDMA, using data obtained from the Ecstasy and Related Drugs Reporting System (EDRS) and the Illicit Drug Reporting System (IDRS). Support for drug-related policies (including treatment, harm reduction and drug legalisation was examined using questions from the National Drug Strategy Household Survey. The extent to which demographic variables and/or drug use experience accounted for differences of opinion amongst the two samples was also explored.
The researchers found that ‘There were significant differences between the views of IDRS and EDRS participants, about legalisation, and a range of harm reduction and treatment interventions. The heterogeneity in support for the legalisation of different drugs could be accounted for by recent experience of use, over and above demographic differences between people who inject drugs and people who regularly use MDMA’. They concluded that ‘These findings speak to the diversity of attitudes and experiences amongst people who use drugs, and reinforce the need to better represent a diversity of opinion in drug policy deliberation and challenge stereotypical perceptions which stigmatise people who use drugs’.
 
Lancaster, K, Sutherland, R & Ritter, A 2014, ‘Examining the opinions of people who use drugs towards drug policy in Australia’, Drugs: Education, Prevention, and Policy, vol. 21, no. 2, pp. 93-101.

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Which is the more cost effective option for cannabis policy: continuation of the status quo or the adoption of a legalised/regulated policy?

Drug Policy Modelling Program researchers conducted a cost benefit analysis of two cannabis policy options: the status quo (where cannabis is illegal) compared with a legalised–regulated option. The analysis classified the costs and benefits into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill-over events). The results were expressed as a net social benefit (NSB). The researchers found that ‘The mean NSB per annum…for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised–regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised–regulated is higher than for status quo’.
The researchers concluded that ‘Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case’.
 
Shanahan, M & Ritter, A 2014, ‘Cost benefit analysis of two policy options for cannabis: status quo and legalisation’, PLoS One, vol. 9, no. 4, p. e95569, free full text.
 
Comment: This economic evaluation provides valuable information for people contemplating making cannabis policy more rational.

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How are legal thresholds for drug trafficking derived?

ABSTRACT
Legal thresholds are used in many parts of the world to define the quantity of illicit drugs over which possession is deemed “trafficking” as opposed to “possession for personal use”. There is limited knowledge about why or how such laws were developed. In this study we analyse the policy processes underpinning the introduction and expansion of the drug trafficking legal threshold system in New South Wales (NSW), Australia. A critical legal and historical analysis was undertaken sourcing data from legislation, Parliamentary Hansard debates, government inquiries, police reports and research. A timeline of policy developments was constructed from 1970 until 2013 outlining key steps including threshold introduction (1970), expansion (1985), and wholesale revision (1988). We then critically analysed the drivers of each step and the roles played by formal policy actors, public opinion, research/data and the drug trafficking problem. We find evidence that while justified as a necessary tool for effective law enforcement of drug trafficking, their introduction largely preceded overt police calls for reform or actual increases in drug trafficking. Moreover, while the expansion from one to four thresholds had the intent of differentiating small from large scale traffickers, the quantities employed were based on government assumptions which led to “manifest problems” and the revision in 1988 of over 100 different quantities. Despite the revisions, there has remained no further formal review and new quantities for “legal highs” continue to be added based on assumption and an uncertain evidence-base. The development of legal thresholds for drug trafficking in NSW has been arbitrary and messy. That the arbitrariness persists from 1970 until the present day makes it hard to conclude the thresholds have been well designed. Our narrative provides a platform for future policy reform.
 
Hughes, CE, Ritter, A & Cowdery, N 2014, ‘Legislating thresholds for drug trafficking: a policy development case study from New South Wales, Australia’, The International Journal of Drug Policy, online ahead of print.

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How common is it for opioid dependent people to spend time in prison?
 
A group of Australian researchers calculated the prevalence and duration of incarceration in a large cohort of opioid-dependent people in Australia using data linkage methods, and estimated the costs associated with their incarceration, by means of a retrospective linkage study of all entrants to opioid substitution therapy (OST) for the treatment of opioid dependence in NSW, 1985–2010, with data on incarceration, 2000–2012. They found that ‘Among 47,196 opioid-dependent people, 37% (43% of men and 24% of women) had at least one episode of incarceration lasting one or more days. Men had a median of three (ranging between 1–47) incarcerations, and women, two (1–35). Indigenous men spent 23% of follow-up time incarcerated, compared with 8% for non-Indigenous men; similarly, Indigenous women spent a substantially greater proportion of time incarcerated than non-Indigenous women (8% vs. 2%). Costs of incarceration of this cohort between 2000 and 2012 totalled nearly AUD$3 billion.’ They concluded that ‘…a substantial minority of opioid-dependent people experience incarceration, usually on multiple occasions and at significant cost. Treatment for opioid dependence, inside and outside prisons, may help reduce incarceration of this cohort’.
 
Degenhardt, L, Larney, S, Gisev, N, Trevena, J, Burns, L, Kimber, J, Shanahan, M, Butler, T, Mattick, RP & Weatherburn, D 2014, ‘Imprisonment of opioid-dependent people in New South Wales, Australia, 2000–2012: a retrospective linkage study’, Australian and New Zealand Journal of Public Health, vol. 38, no. 2, pp. 165-70.

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New Reports

ACIL Allen Consulting 2014, Two year review of ACT liquor laws and licensing fees, report to the ACT Justice and Community Safety Directorate, ACIL Allen Consulting, Canberra, http://www.justice.act.gov.au/review/view/27/title/review-of-liquor-act-reforms.
 
Australian National Council on Drugs 2014, ANCD Position Statement: mandatory treatment, ANCD, Canberra, http://ancd.org.au/images/PDF/Positionpapers/Mandatory_Treatment.pdf.
 
Australian National Council on Drugs 2014, Statement of funding principles for non-government organisations providing alcohol and other drug treatments, April 2014, ANCD, Canberra, http://ancd.org.au/images/PDF/Generalreports/Funding_Principles.pdf.
 
Australian National Preventive Health Agency (ANPHA) 2014, Exploring the public interest case for a minimum (floor) price for alcohol, final report May 2014, Report to the Australian Government Minister for Health, ANPHA, Canberra, http://www.anpha.gov.au/internet/anpha/publishing.nsf/Content/minimum-price-final-report Large file warning: 3.1 MB.
 
Children’s Policy Centre, Crawford School of Public Policy, The Australian National University 2014, Children feel unsafe around alcohol, Children’s Policy Centre, Crawford School of Public Policy, https://crawford.anu.edu.au/news/3664/children-feel-unsafe-around-alcohol
http://issuu.com/anuasiapacific/docs/advance_autumn_2014_final-for_pdf_u.
 
Farsalinos & Polosa 2014, Cigarette électronique: toutes les études scientifiques en un clic! All ecigarette studies!, Absolut-Vapor, http://www.absolut-vapor.com/addiction-tabac/cigarette-electronique-dernieres-etudes-scientifiques/.

• This is a new website established by an e-cigarette company. It states ‘In order to ensure that each consumer, professional, journalist and politician have an accurate and updated overview of the state of knowledge about the electronic cigarette, a database containing all references to the existing scientific studies related to ecig has been compiled…To ensure that this database is as objective as possible, no study will be excluded regardless of: (i) its negative or positive findings on electronic cigarette, (ii) the disputes that might be raised by other scientists regarding the methodology’.

 
Hughes, C 2014, The Australian (illicit) Drug Policy Timeline 1985-2014, Drug Policy Modelling Program, University of NSW, Sydney, http://www.dpmp.unsw.edu.au/resource/drug-policy-timeline.
 
Lac, A 2014, ‘A primer for using meta-analysis to consolidate research’, Substance Use and Misuse, vol. 49, no. 8, pp. 1064-8.

• In selecting articles for inclusion in the Research eBulletin, ATODA gives some preference to review articles, including those that use meta-analyses. This is because, in many cases, far more can be learned from pooling the data and information from multiple studies than can be learned from single studies. This paper has been written to assist the readers of articles based on meta-analyses to understand the methods applied.

 
Loring, B 2014, Tobacco and inequities. Guidance for addressing inequities in tobacco-related harm, World Health Organization Regional Office for Europe, http://www.euro.who.int/en/health-topics/disease-prevention/tobacco/publications/2014/tobacco-and-inequities.-guidance-for-addressing-inequities-in-tobacco-related-harm.
 
Munro, G & Wilkins, C 2014, New psychoactive drugs: no easy answer, Australian Drug Foundation, Melbourne, http://www.adf.org.au/images/stories/Policy__Advocacy/FINAL_PolicyTalk_NewPsychoactiveDrugs_April2014_final.pdf.
 
Noller, G 2014, Synthetic cannabinoid use in New Zealand: assessing the harms. A report to The STAR Trust, Report #01, The STAR Trust (Social Tonics Advocacy & Research), Auckland, http://www.thestartrust.org/images/pdf/Synthetic%20cannab%20harms%20NZ%20final%20draft-3.pdf.

• This detailed report has been produced for, and disseminated by, the New Zealand STAR Trust (Social Tonics Advocacy & Research), an industry group for new psychoactive substances (NPSs). Despite this provenance, it contains much useful information about NPSs and New Zealand’s pioneering approach to their regulation.

 
Ritter, A, Hull, P, Berends, L & Chalmers, J 2014, Planning processes for alcohol and other drug treatment in Australia, Working Paper no. 9 - Review of AOD prevention and treatment services, Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, http://dpmp.unsw.edu.au/sites/default/files/dpmp/page/WP9.pdf.
 
Ritter, A, Hull, P, Berends, L & Chalmers, J 2014, Approaches to purchasing alcohol and other drug treatment in Australia, Working Paper no. 10 -  Review of AOD prevention and treatment services, Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, http://www.dpmp.unsw.edu.au/content/WP10.
 
Roth, L 2014, Liquor licensing restrictions to address alcohol-related violence in NSW: 2008 to 2014, e-brief 4/2014, NSW Parliamentary Research Service, Parliament of NSW, Sydney, http://www.parliament.nsw.gov.au/Prod/parlment/publications.nsf/0/9F047211E0A382E6CA257C9E0082EB01/$File/Liquor+licensing+reforms.pdf.
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