Smoking termination opportunity for in patients (STOP): Superiority of a course of varenicline tartrate plus counselling over counselling alone for smoking cessation: A 12-month randomised controlled trial for inpatients
Smith B.J.,Queen Elizabeth Hospital |
Carson K.V.,Queen Elizabeth Hospital |
Brinn M.P.,Queen Elizabeth Hospital |
Labiszewski N.A.,Queen Elizabeth Hospital |
And 10 more authors.
Thorax | Year: 2013
Rationale: Smoking cessation interventions in outpatient settings have been demonstrated to be cost effective. Given this evidence, we aimed to evaluate the effectiveness of varenicline tartrate plus Quitline-counselling compared with Quitline-counselling alone when initiated in the inpatient setting. Methods: Adult patients (18-75 years) admitted with a smoking-related illness to three hospitals, were randomised to receive either 12-weeks of varenicline tartrate plus Quitline-counselling, (n=196) or Quitline-counselling alone, (n=196), with 12-months follow-up. Results: For the primary analysis population (intention-to-treat), the proportion of subjects who remained continuously abstinent were significantly greater in the varenicline plus counselling arm (31.1%, n=61) compared with counselling alone (21.4%, n=42; RR 1.45, 95% CI 1.03 to 2.03, p=0.03). Conclusions: The combined use of varenicline plus counselling when initiated in the inpatient setting has produced a sustained smoking cessation benefit at 12-months follow-up, indicating a successful opportunistic treatment for smokers admitted with smoking related illnesses.
Pettigrew S.,University of Western Australia |
Roberts M.,University of Western Australia |
Chapman K.,Cancer Council New South Wales |
Quester P.,University of Adelaide |
Miller C.,Cancer Council South Australia
Appetite | Year: 2012
The ability of food advertising to trigger food consumption and influence social norms relating to food consumption has resulted in increasing attention being given to the prevalence and nature of food advertising. The present study investigated the use of negative themes in food advertisements aired on Australian television to determine the prevalence of depictions of violence/aggression, mocking, nagging, boredom, loneliness, food craving, mood enhancement, and the emotional use of food across 61. days of programming time. The results suggest that advertisers are using negative themes to capture attention and invoke an emotional response in the target audience. Sixteen percent (14,611) of the 93,284 food advertisements contained negative themes, with mood enhancement and food craving being the most commonly depicted negative themes. Advertisements with negative themes were more likely to be for non-core foods and to be aired during children's popular viewing times than at other times. The potential for negative themes in food advertising to promote unhealthy food consumption behaviors among children is likely to be of concern to policy makers. Building on this exploratory study, further research is needed to investigate how nutrition-related decision making is affected by exposure to food advertisements employing negative emotional themes. © 2011 Elsevier Ltd.
Ong Z.Y.,University of Adelaide |
Gibson R.J.,University of Adelaide |
Bowen J.M.,University of Adelaide |
Stringer A.M.,University of Adelaide |
And 4 more authors.
Radiation Oncology | Year: 2010
Background: Mucositis is a toxic side effect of anti-cancer treatments and is a major focus in cancer research. Pro-inflammatory cytokines have previously been implicated in the pathophysiology of chemotherapy-induced gastrointestinal mucositis. However, whether they play a key role in the development of radiotherapy-induced gastrointestinal mucositis is still unknown. Therefore, the aim of the present study was to characterise the expression of pro-inflammatory cytokines in the gastrointestinal tract using a rat model of fractionated radiotherapy-induced toxicity.Methods: Thirty six female Dark Agouti rats were randomly assigned into groups and received 2.5 Gys abdominal radiotherapy three times a week over six weeks. Real time PCR was conducted to determine the relative change in mRNA expression of pro-inflammatory cytokines IL-1β, IL-6 and TNF in the jejunum and colon. Protein expression of IL-1β, IL-6 and TNF in the intestinal epithelium was investigated using qualitative immunohistochemistry.Results: Radiotherapy-induced sub-acute damage was associated with significantly upregulated IL-1β, IL-6 and TNF mRNA levels in the jejunum and colon. The majority of pro-inflammatory cytokine protein expression in the jejunum and colon exhibited minimal change following fractionated radiotherapy.Conclusions: Pro-inflammatory cytokines play a key role in radiotherapy-induced gastrointestinal mucositis in the sub-acute onset setting. © 2010 Ong et al; licensee BioMed Central Ltd.
Bowden J.A.,Cancer Council South Australia |
Bowden J.A.,University of Adelaide |
Miller C.L.,Cancer Council South Australia |
Miller C.L.,University of Adelaide |
Hiller J.E.,University of Adelaide
Australian and New Zealand Journal of Psychiatry | Year: 2011
Objective: To examine smoking prevalence and smoking behaviour among South Australians with a mental illness and compare findings to those with no mental illness. Method: Data were collected in three cross-sectional representative population surveys of South Australians aged ≥15 years from 2005 to 2007. Merged data yielded a total sample size of 8417. The main outcome measures were: smoking prevalence, measures of tobacco dependence, awareness of the health effects of active and passive smoking, smoke-free homes and cars, awareness of health warnings, and use of cessation aids by two measures of mental illness status. Results: Overall 26.4% of the population with a general mental illness and 51.2% of the population with a severe mental illness smoked, compared to 18.7% of the population without a mental illness. People with a mental illness, particularly severe mental illness displayed higher measures of tobacco dependence. Smokers with a severe mental illness were less likely to have smoke-free homes (OR = 0.29, 95%CI 0.16-0.55). Television was an effective medium to present the health effects of smoking to all groups. Those with a general mental illness were more likely than those with no mental illness to have asked a general practitioner for advice to help them quit in the past year (OR = 2.02, 95%CI 1.07-3.84). Conclusions: Whilst smokers with a mental illness are more dependent on their smoking; they are interested in quitting. There are a number of mainstream tobacco control strategies that could be further utilized (e.g. mass media and health professional referrals to the Quitline) to increase cessation among this disadvantaged group. © 2011 The Royal Australian and New Zealand College of Psychiatrists.
Wakefield M.A.,Center for Behavioural Research in Cancer |
Zacher M.,Center for Behavioural Research in Cancer |
Bayly M.,Center for Behavioural Research in Cancer |
Brennan E.,University of Pennsylvania |
And 4 more authors.
Tobacco Control | Year: 2014
Objective We sought to determine the relative frequency and nature of personal display of cigarette packs by smokers in two Australian cities where 30% front-of-pack and 90% back-of-pack health warnings have been used since 2006 and comprehensive tobacco marketing restrictions apply. Methods An observational study counted patrons, active smokers and tobacco packs at cafés, restaurants and bars with outdoor seating. Pack orientation and use of cigarette cases were also noted. Results Overall, 18 954 patrons, 1576 active smokers and 2153 packs were observed, meaning that one out of every 12.0 patrons was actively smoking, and one of every 8.8 patrons displayed a pack. Packs were more frequently observed in lower socio-economic neighbourhoods, reflecting the higher prevalence of smoking in those regions. Packs were displayed less often in venues where children were present, suggesting a greater tendency not to smoke around children. Most packs (81.4%) were oriented face-up, permitting prominent brand display. Only 1.5% of observed packs were cigarette cases, and 4.2% of packs were concealed by another item, such as a phone or wallet. Conclusions Tobacco packs are frequently seen on table-tops in café strips, providing many opportunities for other patrons and passers-by to be incidentally exposed to cigarette brand names and imagery. Use of cigarette cases is rare, suggesting that smokers eventually habituate to pictorial warnings on branded packs and/or find repeated decanting of each newly purchased branded pack into a case to be inconvenient.
Duncan A.,University of Adelaide |
Turnbull D.,University of Adelaide |
Wilson C.,Cancer Council South Australia |
Wilson C.,Flinders University |
And 7 more authors.
BMC Public Health | Year: 2014
Background: Social cognitive variables are often examined for their association with initial participation in colorectal cancer screening. Few studies have examined the association of these variables with adherence to multiple screening offers i.e., rescreening. This study aimed to describe patterns of participatory behaviour after three rounds of screening using faecal immunochemical tests (FIT) and to determine social cognitive, demographic and background variables predictive of variations in adherence. Methods. Participants were 1,540 men and women aged 50 to 75 living in South Australia who completed a behavioural survey measuring demographic (for example, age, gender) and social cognitive variables relevant to FIT screening (for example, perceived barriers, benefits, self-efficacy). The survey was followed by three, free FIT screening offers mailed on an annual basis from 2008 to 2010. Patterns of participation after three screening rounds were described as one of five screening behaviours; 1) consistent re-participation (adherent with all screening rounds), 2) consistent refusal (adherent with no screening rounds), 3) drop out (adherent with earlier but not later rounds), 4) intermittent re-participation (adherent with alternate rounds) and 5) delayed entry (adherent with later but not initial round(s)). Univariate (Chi Square and Analysis of Variance) and multivariate (Generalised Estimating Equations) analyses were conducted to determine variables predictive of each category of non-adherence (those that did not participate in every screening offer, groups 2, 3, 4 and 5) relative to consistent re-participation. Results: Significant social cognitive predictors of non-adherence were; less self-efficacy (drop out and consistent refusal), greater perceived barriers (drop out) and lower levels of response efficacy (consistent refusal). Demographic predictors of non-adherence included; male gender (delayed entry), younger age (intermittent, delayed and consistent refusal), less frequent GP visits (intermittent re-participation) and 'ancillary only' private health insurance (drop out). Less satisfaction with screening at baseline predicted drop out, consistent refusal and delayed entry. Conclusions: Different combinations of demographic and behavioural variables predicted different patterns of rescreening adherence. Rescreening interventions may benefit from a targeted approach that considers the different needs of the population subgroups. Satisfaction with past FOBT screening measured prior to the study screening offers was an important predictor of adherence. © 2014 Duncan et al.; licensee BioMed Central Ltd.
Sharplin G.R.,Cancer Council South Australia |
Jones S.B.W.,Cancer Council South Australia |
Hancock B.,Cancer Council South Australia |
Knott V.E.,University of Adelaide |
And 2 more authors.
Medical Journal of Australia | Year: 2010
Objective: To assess the impact of an 8-week structured mindfulness-based cognitive therapy (MBCT) program on individuals experiencing distress as a consequence of cancer. Design, setting and participants: Prospective study of 16 participants with a history of cancer and five carers of people with cancer recruited from August 2008 to February 2009 through calls to the Cancer Council South Australia Helpline. Participants were assessed for anxiety and depression before and after undergoing a course in MBCT between 30 September and18 November 2008 and 20 February and 10 April 2009. Main outcome measures: Depression, anxiety and mindfulness as measured by the Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), and Freiburg Mindfulness Inventory (FMI), respectively, and a consumer-centred evaluation. Results: There were significant reductions in depression (F [1,24] = 6.37; P = 0.012; partial-η 2 = 0.27) and anxiety (F [2,34] = 9.43; P = 0.001, partial-η 2 = 0.36) and mindfulness (F [2,32] = 8.36; P= 0.001; partial-η 2 = 0.34) following the intervention, and these effects were sustained at the 3-month follow-up. Reliable change indices further support these findings. Participants' scores on measures of depression and anxiety decreased as a function of increased mindfulness, as reflected by significant (P< 0.05) negative correlations between FMI scores and BDI-II scores (ranging from r= -0.46 to r= -0.79) and STAI scores (ranging from r = - 0.46 to r= -0.50) scores at all time points. Conclusion: The MBCT program appears to be an efficacious intervention for use among people affected by cancer who also experience symptoms of depression and anxiety.
Beckmann K.R.,Cancer Council South Australia |
Buckingham J.,Australian National University |
Craft P.,Australian National University |
Dahlstrom J.E.,Australian National University |
And 3 more authors.
Breast | Year: 2011
Purpose: Uncertainty remains about the impact of bilateral breast cancer. Characteristics and outcomes of unilateral and bilateral breast cancer were compared within an Australian multi-institutional cohort. Methods: Demographic, tumour and treatment characteristics were compared among unilateral (n = 2336) and bilateral cases (52 synchronous, 35 metachronous) using descriptive analyses. Disease-specific outcomes were investigated using Cox regression modelling to adjust for prognostic and treatment factors. Results: Factors associated with increased risk of bilateral breast cancer included lobular histology (p = 0.046), family history (p = 0.025) and metropolitan residence (p = 0.006). Mastectomy was more common for bilateral cases (p = 0.001) while radiotherapy was less common (p = 0.015). Index metachronous cases were less likely to receive hormonal therapy (p = 0.001). Five-year survivals for metachronous, synchronous and unilateral cases were 79%, 88% and 94%, respectively. Poorer outcomes remained after adjusting for prognostic factors [HR = 2.26, 1.21-4.21]. Conclusion: Our results confirm international findings indicating worse outcomes from bilateral compared with unilateral breast cancer. © 2010 Elsevier Ltd.
Chong A.,Aboriginal Health Council SA Inc |
Roder D.,Cancer Council South Australia
Asian Pacific Journal of Cancer Prevention | Year: 2010
The aim of this study is to compare cancer survivals of Indigenous and non-Indigenous Australians and consider health-service and research implications Cancer registry data from South Australia were used to calculate disease-specific survivals for Indigenous (n=671) and sampled non-Indigenous (n=15,799) patients diagnosed during 1977-2007, using Kaplan-Meier estimates and Cox proportional hazards regression. Indigenous and non-Indigenous five-year survivals were respectively: 40% and 57% for all cancer sites combined; 61% and 80% for female breast; 34% and 56% for colon/rectum; and 63% and 73% for cervix; whereas one-year survivals for cancers of unknown primary site were 5% and 22% respectively. Conversely, although not statistically significant (p=0.262), lung cancer survival tended to be higher in Indigenous than non-Indigenous patients. For all sites combined, Indigenous patients had lower survivals up to 70-79 years. The relative risk of death in Indigenous compared with non-Indigenous patients was 2.0 after adjusting for socio-demographic factors and diagnostic period, reducing to 1.4 when also adjusting for prognosis by primary site. Relative risks were 3.7 and 2.7 respectively for Indigenous compared with non-Indigenous patients from Far North remote communities. We conclude that relative risks for Indigenous compared with non-Indigenous patients for all cancers combined are elevated, as seen in the Northern Territory and Queensland. Despite uncertain accuracy of recording of Indigenous status, independent studies show risk elevations and point to the need to prevent cancers, particularly those of high lethal potential, to detect cancers earlier, and to complete planned treatment. A concerted health-service response is needed to address contributing geographic, socio-economic and cultural factors.
Luke C.,Queen Elizabeth Hospital |
Price T.,Queen Elizabeth Hospital |
Roder D.,Cancer Council South Australia
Asian Pacific Journal of Cancer Prevention | Year: 2010
The incidence of liver and intrahepatic bile duct cancer in Australia is low at about one third the world average but increases are evident. South Australian registry data have been used to describe: age-standardized incidence and mortality trends; and disease-specific survivals, using Kaplan-Meier estimates and Cox proportional hazards regression. The study included 1,220 incident cancers (901 hepatocellular carcinomas; 201 cholangiocarcinomas; 118 other types) and 983 deaths. Incidence and mortality rates increased by 2-3 fold during 1977-2007. Incidence increases affected males, females and all ages. There was a strong: male predominance (3 to 1); and age gradient (70+ year old incidence >30 times under 50 year old incidence). Compared with hepatocellular carcinomas, cholangiocarcinomas and other histology types more often affected females and older ages and less often the Asian born. All histology types showed similar incidence increases. Apart from recognized risk factors (e.g., hepatitis B/C infection and aflatoxins for hepatocellular carcinoma; liver-fluke infection for cholangiocarcinomas, etc.), common risk factors may include excess alcohol consumption and possibly obesity and diabetes mellitus. Five-year disease-specific survival in 1998-2007 was 16%, with higher fatalities applying for earlier periods, older patients, males, lower socio-economic groups, and cholangiocarcinomas. Aboriginal patients tended to have higher case fatalities (p=0.054). Survival increases may be due to earlier diagnosis from alpha feta protein testing and diagnostic imaging, plus more aggressive treatment of localized disease. Mortality increases require a preventive response, including hepatitis B vaccination, prevention of viral infection though contaminated blood and other body fluids, early detection initiatives for high-risk patients, aggressive surgery for localized disease, and experimentation with new systemic therapies.