Tobacco Control Unit

Sydney, Australia

Tobacco Control Unit

Sydney, Australia
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Young D.,Tobacco Control Unit | Borland R.,Tobacco Control Unit
Translational Behavioral Medicine | Year: 2011

This paper identifies key barriers to the translation of science into practice and policy and makes recommendations for addressing them. It focuses on the challenges of translation within the field of tobacco control, but we argue that the insights are widely generalisable. Actor-Network Theory is used to frame an analysis, supplemented by focussed discussions with international tobacco control practitioners (service delivery and advocacy) and researchers. The central challenge to translation is that researchers and practitioners have different "practical ontologies". Researchers use findings from specific contexts to generalise to universal principles, while practitioners try to use these generalisations to inform their work in what are typically a somewhat different set of specific contexts. Neglecting the need to translate back from the general to the particular means research syntheses are not framed to meet practitioners' needs. Traditional knowledge broking roles need to be extended to better align the needs of researchers and practitioners. This may be facilitated by more creative use of "social computing" to enable real-time input into research syntheses from all interested parties, including input to the questions that research addresses. To do this systematically requires that we construct "generalisation gradients" to help practitioners apply general research conclusions to their particular situation and researchers to identify the relevance of their work. Disadvantaged communities in particular need help, since there is typically less research directly applicable to their contexts; thus, they need to generalise more. © 2011 Society of Behavioral Medicine.


Gruer L.,NHS Health Scotland | Tursan d'Espaignet E.,Tobacco free Initiative | Haw S.,University of Stirling | Fernandez E.,Tobacco Control Unit | Mackay J.,World Lung Foundation
Public Health | Year: 2012

Article 8 of the World Health Organization Framework Convention on Tobacco Control (2005) requires all signatory countries to adopt measures to protect people from tobacco smoke in indoor workplaces, indoor public places, public transport and other public places as appropriate. The aims of this symposium were to review progress across the world, to assess the evidence for the impact of legislation on health, and to identify the continuing challenges in making universal protection a reality. There was agreement that even in countries where strict legislation is enforced, many children continue to be dangerously exposed to parental second-hand smoke in the womb, the home and private cars. The importance of using accurate estimates of the burden of disease caused by second-hand smoke was agreed, in order to present an unassailable case for legislation and enforcement. © 2012 The Royal Society for Public Health.


PubMed | University of Newcastle, University of New South Wales, Tobacco Control Unit, Alcohol and 4 more.
Type: Journal Article | Journal: Trials | Year: 2016

The provision of smoking cessation support in Australian drug and alcohol treatment services is sub-optimal. This study examines the cost-effectiveness of an organisational change intervention to reduce smoking amongst clients attending drug and alcohol treatment services.A cluster-randomised controlled trial will be conducted with drug and alcohol treatment centres as the unit of randomisation. Biochemically verified (carbon monoxide by breath analysis) client 7-day-point prevalence of smoking cessation at 6weeks will be the primary outcome measure. The study will be conducted in 33 drug and alcohol treatment services in four mainland states and territories of Australia: New South Wales, Australian Capital Territory, Queensland, and South Australia. Eligible services are those with ongoing client contact and that include pharmacotherapy services, withdrawal management services, residential rehabilitation, counselling services, and case management services. Eligible clients are those aged over 16years who are attending their first of a number of expected visits, are self-reported current smokers, proficient in the English language, and do not have severe untreated mental illness as identified by the service staff. Control services will continue to provide usual care to the clients. Intervention group services will receive an organisational change intervention, including assistance in developing smoke-free policies, nomination of champions, staff training and educational client and service resources, and free nicotine replacement therapy in order to integrate smoking cessation support as part of usual client care.If effective, the organisational change intervention has clear potential for implementation as part of the standard care in drug and alcohol treatment centres.Australian and New Zealand Clinical Trials Registry, ACTRN12615000204549 . Registered on 3 March 2015.


Young D.,Tobacco Control Unit | Yong H.-H.,Tobacco Control Unit | Borland R.,Tobacco Control Unit | Shahab L.,University College London | And 3 more authors.
Journal of Environmental and Public Health | Year: 2012

Objective. To establish the trends in prevalence, and correlates, of roll-your-own (RYO) use in Canada, USA, UK and Australia, 2002-2008. Methods. Participants were 19,456 cigarette smokers interviewed during the longitudinal International Tobacco Control (ITC) Four-Country Survey in Canada, USA, UK, and Australia. Results. Predominant RYO use (i.e., 50 of cigarettes smoked) increased significantly in the UK and USA as a proportion of all cigarette use (both P <.001) and in all countries as a proportion of any RYO use (all P <.010). Younger, financially stressed smokers are disproportionately contributing to some use (i.e., 50 of cigarettes smoked). Relative cost was the major reason given for using RYO, and predominant RYO use is consistently and significantly associated with low income. Conclusions. RYO market trends reflect the price advantages accruing to RYO (a product of favourable taxation regimes in some jurisdictions reinforced by the enhanced control over the amount of tobacco used), especially following the impact of the Global Financial Crisis; the availability of competing low-cost alternatives to RYO; accessibility of duty-free RYO tobacco; and tobacco industry niche marketing strategies. If policy makers want to ensure that the RYO option does not inhibit the fight to end the tobacco epidemic, especially amongst the disadvantaged, they need to reduce the price advantage, target additional health messages at (young) RYO users, and challenge niche marketing of RYO by the industry. Copyright © 2012 David Young et al.


Wilson N.,University of Otago | Weerasekera D.,University of Otago | Borland R.,Tobacco Control Unit | Edwards R.,University of Otago | And 2 more authors.
Nicotine and Tobacco Research | Year: 2010

Introduction: We aimed to describe use of a national quitline service and the variation in its use by smoker characteristics (particularly ethnicity and deprivation). The setting was New Zealand (NZ), which takes proactive measures to attract disadvantaged smokers to this service. Methods: The NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) utilizes the New Zealand Health Survey (a national sample) from which we surveyed adult smokers in two waves (N = 1,376 and N = 923) 1 year apart. Results: Quitline use in the last 12 months rose from 8.1% (95% CI = 6.3%-9.8%) in Wave 1 to 11.2% (95% CI = 8.4%-14.0%) at Wave 2. Māori (the indigenous people of NZ) were significantly more likely to call the Quitline than were European/other smokers. Relatively higher call rates also occurred among those reporting higher deprivation, financial stress, a past mental health disorder, a past drug-related disorder, and higher psychological distress (Kessler 10-item index). Independent associations in the multivariate analyses of Quitline use were being Māori, reporting financial stress, and ever having been diagnosed with a mental health disorder. Discussion: This national Quitline service is successfully stimulating disproportionately more calls by Māori smokers and those with some measures of disadvantage. It may therefore be contributing to reducing health inequalities. It appears possible to target quitlines to reach those smokers in greatest need. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


Young D.,Tobacco Control Unit | Wilson N.,University of Otago | Borland R.,Tobacco Control Unit | Edwards R.,University of Otago | Weerasekera D.,University of Otago
Nicotine and Tobacco Research | Year: 2010

Aim: To describe the prevalence, correlates of, and reasons for use of roll-your-own (RYO) tobacco in a high RYO use and ethnically diverse country: New Zealand (NZ). Methods: The NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) is sampled from the New Zealand Health Survey, with boosted sampling of Māori, Pacific peoples, and Asian New Zealanders. We surveyed 1,376 current adult smokers using standard ITC project procedures in 2007-2008. Results: Prevalence of regularly smoking RYOs was 53% (with 38% of all smokers being exclusive RYO smokers). RYO use was higher among disadvantaged smokers, heavier smokers, those with a relatively low intention of quitting, and those with more friends who smoke. RYO use increased more in the youngest age groups as disadvantage increased. "Lower price" dominated the reasons smokers' cited for smoking RYOs (at 83%). About one fifth cited "less health concerns" as a reason. Conclusions: RYO smoking is particularly associated with individual deprivation and high levels of dependence. Its capacity to blunt price signals provided by tobacco taxes is accompanied by misperceptions that it is less hazardous to health and it is particularly prevalent among vulnerable disadvantaged populations (including Māori, young people, and those with mental health problems). Governments should reconsider removing any tax advantages given to RYO tobacco, ensure RYO smokers are properly informed of health risks, and supported to quit as strongly as other smokers. However, governments should also examine a broader range of options including a higher differential tax on RYO tobacco, removing flavors, and controlling all tobacco marketing. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


Gartner C.,University of Queensland | Scollo M.,Tobacco Control Unit | Marquart L.,Queensland Institute of Medical Research | Mathews R.,University of Queensland | Hall W.,University of Queensland
Australian and New Zealand Journal of Public Health | Year: 2012

Objective: According to the 'hardening hypothesis', the proportion of smokers that are 'low-probability quitters' will increase as societal disapproval of smoking increases. This paper examines whether there has been increased hardening in Australian smokers over the past decade as reflected in an increased prevalence of psychological distress and social disadvantage among current smokers. Methods: The relationship between psychological distress, living in a disadvantaged area and level of education was determined using logistic regression at two time points 7 to 10 years apart in three cross-sectional household survey series: National Drug Strategy Household Survey (NDSHS), National Health Survey (NHS) and National Survey of Mental Health and Well-being (NSMHW). Results: The relationships between smoking and living in the most disadvantaged areas and having completed less than 12 years of schooling strengthened between 2001 and 2010 in the NDSHS, but there were no significant changes between survey years in the NHS and NSMHW. There was no significant change in the relationship between smoking and psychological distress between survey years in any of the survey series. Conclusion: Social disadvantage may be increasing among current smokers, but the results were inconsistent between survey series, presenting weak evidence that the population of Australian smokers hardened as smoking prevalence declined by approximately 4% over the last decade. Implications: A greater focus on intensive individual-level tobacco cessation interventions does not appear warranted at this time. © 2012 The Authors.


Wakefield M.A.,Center for Behavioural Research in Cancer | Spittal M.J.,University of Melbourne | Yong H.-H.,Tobacco Control Unit | Durkin S.J.,Center for Behavioural Research in Cancer | Borland R.,Tobacco Control Unit
Health Education Research | Year: 2011

Objective: To assess the extent to which intensity and timing of televised anti-smoking advertising emphasizing the serious harms of smoking influences quit attempts.Methods: Using advertising gross rating points (GRPs), we estimated exposure to tobacco control and nicotine replacement therapy (NRT) advertising in the 3, 4-6, 7-9 and 10-12 months prior to follow-up of a replenished cohort of 3037 Australian smokers during 2002-08. Using generalized estimating equations, we related the intensity and timing of advertising exposure from each source to the likelihood of making a quit attempt in the 3 months prior to follow-up.Results: Tobacco control advertising in the 3-month period prior to follow-up, but not in more distant past periods, was related to a higher likelihood of making a quit attempt. Each 1000 GRP increase per quarter was associated with an 11% increase in making a quit attempt [odds ratio (OR) = 1.11, 95% confidence interval (CI) 1.03-1.19, P = 0.009)]. NRT advertising was unrelated to quit attempts.Conclusions: Tobacco control advertising emphasizing the serious harms of smoking is associated with short-term increases in the likelihood of smokers making a quit attempt. Repeated cycles of higher intensity tobacco control media campaigns are needed to sustain high levels of quit attempts. © The Author 2011. Published by Oxford University Press. All rights reserved.


O'Brien J.,Tobacco Control Unit | Salmon A.M.,Tobacco Control Unit | Penman A.,Tobacco Control Unit
Drug and Alcohol Review | Year: 2012

Issue. While population wide smoking rates are falling steadily the rates remain high among the disadvantaged. The future we face is one where the differentials in smoking rates will continue to widen and will flow through to increased health inequalities. Approach. How best to reduce smoking rates among the disadvantaged? Alongside existing population level initiatives and social policy initiatives is an urgent need for a targeted, comprehensive approach that acknowledges the serious impact of smoking on the disadvantaged. In 2006 Cancer Council NSW embarked on a statewide, multi-component Tackling Tobacco Program to encourage and support non-government social and community services to address smoking among their clients. Key Findings. Tackling Tobacco Program results have shown that the 1600 staff from 400 organisations trained to provide smoking care can attain the knowledge and confidence to address tobacco and that clients are very receptive to receiving quit support from them. Improvements in quality of life for clients who do quit have been encouraging and the Tackling Tobacco Program has challenged assumptions and attitudes that disadvantaged people are uninterested and unable to quit. Implications. Alongside population and social policy approaches must be a serious investment in tackling smoking among the disadvantaged. Conclusions. Tackling Tobacco Program is an innovative example of how to engage disadvantaged smokers, de-normalise smoking and encourage and support quitting using familiar settings. Engaging Australia's large network of social and community services as allies in this work should be vigorously pursued.[O'Brien J, Salmon AM, Penman A. What has fairness got to do with it? Tackling tobacco among Australia's disadvantaged. Drug Alcohol Rev 2012;31:723-726] © 2012 Australasian Professional Society on Alcohol and other Drugs.


O'Brien J.,Tobacco Control Unit | Bonevski B.,University of Newcastle | Salmon A.,Tobacco Control Unit | Goodger B.,NSW Ministry of Health | Soewido D.,NSW Ministry of Health
Drug and Alcohol Review | Year: 2012

Introduction and Aims. New strategies are required to reach subpopulations with high smoking rates. This study reports on an evaluation of the Smoking Care intervention-a 2-year organisational capacity building strategy-for social and community service organisations (SCSOs) to provide smoking care to clients. Design and Methods. The Smoking Care intervention consisted of: awareness raising seminars (half-day); smoking cessation training (1day) and; nicotine replacement therapy grants (3months). Baseline and 3-month follow-up data were collected within participating SCSOs and the primary outcomes measured were: changes in staff attitudes, confidence and practice of smoking cessation care. Changes in client self-reported smoking behaviours, quit attempts and interest in quitting were also measured. Results. Of 600 staff who attended training, 306 (51%) returned pre- and post-intervention surveys. At 3-month follow-up staff reported statistically significant increases in positive attitudes to providing smoking cessation care, increased confidence in providing such care and increases in cessation practice. Of 400 client surveys distributed, 367 (92%) were returned at pre-intervention and 255 (64%) at post-intervention. Fewer clients reported daily smoking at post-intervention, while use of nicotine replacement therapy and group counselling increased significantly. Client interest in quitting and receiving quit support from case workers was high at both pre- and post-intervention. Discussion and Conclusions. The intervention had an impact on SCSO staff attitudes, confidence and provision of smoking care. Results show clients were receptive to this support. More rigorous testing of similar interventions in SCSOs is warranted.[O'Brien J, Bonevski B, Salmon A, Oakes W, Goodger B, Soewido D. An evaluation of a pilot capacity building initiative for smoking cessation in social and community services: The Smoking Care project. Drug Alcohol Rev 2012;31:685-692]. © 2012 Australasian Professional Society on Alcohol and other Drugs.

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