Prevalence and characteristics associated with concurrent smoking and alcohol misuse within Australian general practice patients

2020 ◽  
Vol 44 (1) ◽  
pp. 125
Author(s):  
Breanne Hobden ◽  
Jamie Bryant ◽  
Kristy Forshaw ◽  
Christopher Oldmeadow ◽  
Tiffany-Jane Evans ◽  
...  
Keyword(s):  
General Practice ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
General Practitioners ◽  
Alcohol Misuse ◽  
Smoking Status ◽  
Demographic Characteristics ◽  
International Studies ◽  
Australian General Practice ◽  
Different Levels

Objectives This study sought to determine, among a large sample of Australian general practice patients: (1) the prevalence of smoking among different levels of alcohol misuse; and (2) whether the associations between demographic characteristics and alcohol use differ according to smoking status. Methods A cross-sectional survey was administered from 2010 to 2011 to 3559 patients from 12 Australian urban general practices. Patients reported their demographic details, smoking status and their alcohol intake. Results The overall prevalence of reported concurrent smoking and alcohol misuse was 7.8%. Smokers were 3.81-fold more likely to have a higher level of alcohol consumption than non-smokers (95% confidence interval 3.13–4.63; P<0.0001). There was evidence that smoking was an effect modifier of the relationship between alcohol misuse and chronic illness. Conclusions There was an increasing prevalence of smoking with increasing level of alcohol consumption. In addition, those with chronic conditions who smoked had greater odds of higher levels of alcohol consumption. Preventative interventions for these substances are needed to reduce the burden associated with concurrent smoking and alcohol misuse. What is known about the topic? Tobacco and alcohol are the most commonly used substances and contribute to over 10million deaths annually. The risk of disease is high when using either of these substances, however, concurrent use is associated with a greatly compounded risk. Australian data is limited regarding the prevalence of concurrent tobacco and alcohol misuse, however, international studies suggest variation in prevalence rates between different clinical settings. What does this paper add? This study examined the prevalence of concurrent smoking and alcohol misuse among different levels of alcohol misuse severity within an Australian general practice setting. Additionally it explored whether the associations between demographic characteristics and alcohol use differ according to smoking status. What are the implications for practitioners? This study has important implications for disease prevention and the delivery of preventive health services by general practitioners. Considering one in 100 clinical treatments provided in general practice relate to preventative smoking or alcohol counselling, it is critical that efforts are made to ascertain risk factors such as smoking and alcohol misuse to increase treatment rates. General practitioners should consider screening for smoking and alcohol misuse opportunistically during routine clinical encounters, as well as screening for smoking or alcohol misuse if one or the other is present.

scholarly journals Do rates of depression vary by level of alcohol misuse in Australian general practice?

2017 ◽  
Vol 23 (3) ◽  
pp. 263 ◽  
Author(s):  
Breanne Hobden ◽  
Jamie Bryant ◽  
Rob Sanson-Fisher ◽  
Christopher Oldmeadow ◽  
Mariko Carey
Keyword(s):  
General Practice ◽  
Alcohol Use ◽  
Alcohol Misuse ◽  
Sociodemographic Factors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Patient Health ◽  
Australian General Practice ◽  
Disorder Identification

Limited data exist regarding co-occurring alcohol misuse and depression among general practice patients. This study examined the prevalence of depression by level of alcohol misuse, and the sociodemographic factors associated with depression and increased alcohol misuse severity. A cross-sectional survey was administered to 3559 Australian general practice patients. Patients completed their demographic details, the Patient Health Questionnaire (9-item) and the Alcohol Use Disorder Identification Test (Consumption items). The prevalence of alcohol misuse and depression was 6.7%, and depression prevalence varied significantly according to level of alcohol misuse (P<0.001). Age, gender, Aboriginality and number of chronic diseases were associated with depression and higher levels of alcohol misuse. These findings may assist General Practitioners in identifying those at risk of experiencing co-morbid depression and alcohol use, and aid in effective treatment and referral.

How accurately do general practitioners detect concurrent tobacco use and risky alcohol consumption? A cross-sectional study in Australian general practice

2018 ◽  
Vol 24 (5) ◽  
pp. 378
Author(s):  
Jamie Bryant ◽  
Breanne Hobden ◽  
Kristy Forshaw ◽  
Christopher Oldmeadow ◽  
Justin Walsh ◽  
...  
Keyword(s):  
General Practice ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
General Practitioners ◽  
Tobacco Use ◽  
Self Report ◽  
Evidence Based ◽  
Preventative Health ◽  
Risky Alcohol ◽  
Risky Alcohol Consumption

The negative health consequences of tobacco and risky alcohol consumption are compounded when used concurrently. Australian preventative health guidelines recommend that general practitioners (GPs) assess and provide evidence-based intervention. No studies, however, have examined the accuracy of GP detection of concurrent tobacco use and risky alcohol consumption or the factors associated with accurate detection. This study aimed to examine the: (i) accuracy of GP detection of concurrent tobacco and risky alcohol use compared to patient self-report; and (ii) GP and patient characteristics associated with accurate detection following a single clinical encounter. Patients attending 12 Australian general practices completed a survey assessing smoking and alcohol consumption. For each participating patient, GPs completed a checklist to indicate the presence of these risk factors. GP judgements were compared to patient self-report. Fifty-one GPs completed a health risk checklist for 1332 patients. Only 23% of patients who self-reported concurrent tobacco and risky alcohol use identified by their GP. Patients who visited their GP four to six times in the last year were most likely to have concurrent tobacco and risky alcohol use were identified. It is imperative to establish systems to increase detection of preventative health risks in general practice to enable the provision of evidence-based treatments.

scholarly journals Alcohol Consumption by Older New York City Residents: The Need for New Policies to Address Misuse

2020 ◽  
Vol 55 (4) ◽  
pp. 448-454
Author(s):  
Daniel Weisz ◽  
Michael Kelley Gusmano
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
York City ◽  
Alcohol Misuse ◽  
Cross Sectional ◽  
Local Public Health ◽  
New Public Health

Abstract Aims The aim of this study is to assess risk factors for alcohol misuse among older New York City residents and examine the effect of local public health efforts to address alcohol misuse. Methods The Community Health Survey, a cross-sectional telephone survey of 8500 randomly selected adult New Yorkers, records the frequency of alcohol use. We examine these results among 65 and older subjects by sociodemographic status using logistic regression modeling and compare trends in smoking and alcohol consumption between 2002 and 2016. Results Those with unhealthy drinking habits, combining binge drinking and excessive consumption, constituted 5.7% of 65 plus population and were more likely to be White, US born, healthy, better educated and wealthier. The percentage of older smokers in New York City has decreased while unhealthy drinking is nearly flat since 2002. Conclusions Our findings reinforce the importance of screening geriatric populations for alcohol use disorders and support the development of new public health efforts to address alcohol misuse if the city is to achieve results similar to those obtained in decreasing tobacco consumption.

Alcohol Consumption in the Australian Mining Industry: The Role of Workplace, Social, and Individual Factors

2021 ◽  
pp. 216507992110057
Author(s):  
Carole L. James ◽  
Ross J. Tynan ◽  
Aaron T. Bezzina ◽  
Md Mijanur Rahman ◽  
Brian J. Kelly
Keyword(s):  
Psychological Distress ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Misuse ◽  
Site Response ◽  
Convenience Sample ◽  
Harmful Drinking ◽  
Factors Associated ◽  
Harmful Alcohol ◽  
Metalliferous Mining

Background: Coal miners have been reported to have higher rates of risky/harmful alcohol misuse; however, it is not known if metalliferous mining employees whose working conditions differ in workplace practices, also have increased rates of risky/harmful alcohol misuse. This study aimed to examine alcohol consumption in a sample of Australian metalliferous mining workers and to examine the demographic and workplace factors associated with risky/harmful alcohol use. Methods: All employees from a convenience sample of four Australian mine sites were invited to complete a paper-based cross-sectional survey between June 2015 and May 2017. The survey contained questions relating to social networks, health behaviors, psychological distress, demographic characteristics, and risky/harmful drinking. Current alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated measure of risky and/or harmful drinking. Factors associated with risky/harmful drinking were investigated using univariate and multivariable logistic regression. Findings: A total of 1,799 participants completed the survey (average site response rate 95%). Overall, 94.8% of males and 92.1% of females reported using alcohol in the preceding 12 months. The odds of risky/harmful alcohol use were significantly higher in those who were male, younger, and reported higher psychological distress. Conclusions/Application to Practice: This study identified that metalliferous mining employees engage in at-risk levels of alcohol consumption significantly higher than the national average despite workplace policies and practices that restrict alcohol use. Personal and workplace risk factors that may help target specific employee groups and inform the development of tailored, integrated multicomponent intervention strategies for the industry were identified.

Alcohol use among older adults

2010 ◽  
Vol 20 (1) ◽  
pp. 56-68 ◽  
Author(s):  
Philip D St John ◽  
Wanda M Snow ◽  
Suzanne L Tyas
Keyword(s):  
Older Adults ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Intake ◽  
Alcohol Misuse ◽  
Heavy Episodic Drinking ◽  
Policy Makers ◽  
Alcohol Interventions ◽  
Screening Questionnaires ◽  
Moderate Alcohol Intake

SummaryAlcohol use is common in older adults and is associated with numerous health and social problems. Recent evidence suggests that in addition to level of alcohol consumption, drinking pattern may also be important. Moderate alcohol intake may confer some cardiac benefits, while heavy episodic drinking seems particularly problematic. Detecting alcohol misuse in older adults is difficult since clinical acumen is often poor, screening questionnaires have serious limitations and laboratory tests are not diagnostic. Brief alcohol interventions to reduce alcohol consumption appear useful in younger populations, but are less studied in older adults. While there is increasing research into the issue of alcohol use among older adults, clinicians and policy-makers must rely on limited evidence when making clinical decisions.

scholarly journals Stopping smoking advice given by practice assistants after routine cervical screening in general practice: a qualitative exploration of potential barriers and enablers.

2019 ◽  
Author(s):  
Marthe B.L. Mansour ◽  
Matty R. Crone ◽  
Henk C. van Weert ◽  
Niels H. Chavannes ◽  
Kristel M. van Asselt
Keyword(s):  
General Practice ◽  
Smoking Cessation ◽  
General Practitioners ◽  
Smoking Status ◽  
Cervical Screening ◽  
Behavioural Change ◽  
Young Female ◽  
Influential Factors ◽  
Individual Level ◽  
Potential Barriers

Abstract Background Cervical screening could be an appropriate moment to provide female smokers with stopping smoking advice and support. In Dutch general practice cervical smears are performed by practice assistants. The aim of this study was to identify potential barriers or enablers for a stopping smoking strategy performed by trained practice assistants after routine cervical screening. The strategy consists of brief stopping smoking advice and is based on the Ask-Advise-Connect approach.Methods Three focus group meetings were held with 10 practice assistants, 3 nurses, and 6 general practitioners. We analysed data using thematic analysis. Identified factors are presented within the framework of the Social Ecological Model.Results Potential influential factors were identified at individual, interpersonal, and workplace levels. At the individual level: practice assistants did not see themselves as having a professional role in a smoking cessation program. While they could register smoking status, they were reluctant to provide advice. However, practice assistants valued having advice at hand in order to make relatively young female smokers aware of the health risks At the interpersonal level: practice assistants thought that their relationship with the women would change if they gave stopping smoking advice. Moreover, the assistant’s own attitude to smokers and her beliefs about the smoker’s willingness to change behaviour could influence the relationship. At the workplace level: the availability and motivation of nurses might hamper referral. The general practitioners’ opinion about primary prevention and smoking cessation could influence the amount of support given to practice assistants when it comes to providing stopping smoking advice.Conclusions At individual, interpersonal, and workplace levels, several factors could influence the provision of a stop smoking strategy by a practice assistant. These factors could be used to design a behavioural change intervention to be provided by practice assistants after cervical cancer screening.

scholarly journals General practitioners, pregnancy and addictions in France in 2015

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Andler ◽  
C Cogordan ◽  
A Pasquereau ◽  
J-F Buyck ◽  
V Nguyen-Thanh
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Pregnant Women ◽  
General Practitioners ◽  
Tobacco Smoking ◽  
Alcohol Drinking ◽  
Health Hazard ◽  
Active Role ◽  
Antenatal Visit ◽  
Smoking During Pregnancy

Abstract Background Tobacco smoking and alcohol drinking during pregnancy result in serious health hazard for both the baby and the mother. In France, about 17% of pregnant women smoke and 20% consume alcohol. General practitioners (GPs) can have an active role in preventing those behaviors as they often interact with pregnant patients: one quarter of French pregnant women have had at least one antenatal visit with a GP. The aim of our study is to describe French GPs’ practices (screening and counseling) toward pregnant patients regarding tobacco smoking and alcohol drinking. Methods In 2015, a telephone survey was set based on a stratified random sampling of metropolitan France GPs. A representative sample of 1,414 French GPs completed the study. Results Screening for alcohol consumption at least once for every patient was done by 61% of GPs and for smoking by 82% of GPs. Counselling to quit alcohol consumption was done by 77% of GPs while counselling to quit smoking was done by about 90% of them. GPs’ practices were significantly better among those who had more recent ongoing training. Regular drinkers GPs were less likely to systematically screen for alcohol use and GPs’ alcohol use frequency was adversely related to recommending quitting. Current and former smokers GPs were less likely to recommend quitting to pregnant patients smoking over 5 cigarettes per day. Conclusions Screening for alcohol use and smoking during pregnancy is not yet systematic among GPs in France. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation. Besides, as regular alcohol use and smoking are related to unwanted practices, prevention for the benefit of GPs could be even more fruitful. Key messages Screening for alcohol use and smoking during pregnancy is not systematically done by French GPs. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation.

Health Behaviors of Cancer Survivors: Examining Opportunities for Cancer Control Intervention

2005 ◽  
Vol 23 (34) ◽  
pp. 8884-8893 ◽  
Author(s):  
Keith M. Bellizzi ◽  
Julia H. Rowland ◽  
Diana D. Jeffery ◽  
Timothy McNeel
Keyword(s):  
Physical Activity ◽  
Cancer Screening ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Health Behaviors ◽  
Cancer Survivors ◽  
Smoking Status ◽  
Specific Antigen ◽  
Cancer Site ◽  
Time Since Diagnosis

PurposeA population-based investigation was conducted to examine the prevalence of health behaviors (smoking, alcohol use, physical activity, and cancer screening) of cancer survivors by age, time since diagnosis, and cancer site. Understanding health behaviors of survivors is imperative, as many survivors are living longer and are at risk for cancer recurrence, second cancers, and complications from treatment.MethodsUsing the National Health Interview Survey, this study examined the prevalence of smoking and alcohol use as well as whether cancer survivors (n = 7,384) are meeting current recommendations for physical activity and cancer screening compared with noncancer controls (n = 121,347).ResultsCancer survivors are similar to controls with respect to smoking status and alcohol consumption after adjusting for group differences. However, younger survivors (18 to 40 years) are at greater risk for continued smoking than controls. Survivors are 9% more likely to meet physical activity recommendations compared with controls. χ2tests indicate no significant differences in smoking, alcohol consumption, and physical activity by time since diagnosis, but differences by cancer site exist. Female cancer survivors are 34% and 36% more likely to meet mammogram and Papanicolaou smear screening recommendations, respectively, compared with controls. Similar screening patterns were found for prostate-specific antigen screening in men.ConclusionThis study provides benchmark approximations of the prevalence of risky health behaviors of survivors by time since diagnosis and cancer site. As part of the collective effort to reduce late effects of cancer treatment, oncologists may be in the best position to offer initial guidance for promoting healthy lifestyle behaviors among cancer survivors.

scholarly journals Primary care management of chronic insomnia: a qualitative analysis of the attitudes and experiences of Australian general practitioners

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jenny Haycock ◽  
Nicole Grivell ◽  
Anne Redman ◽  
Bandana Saini ◽  
Andrew Vakulin ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Best Practice ◽  
Geographic Location ◽  
Behavioural Therapy ◽  
Chronic Insomnia ◽  
Structured Interviews ◽  
Treatment Pathways ◽  
Falling Asleep ◽  
Australian General Practice

Abstract Background Chronic insomnia is a highly prevalent disorder, with ten to thirty percent of Australian adults reporting chronic difficulties falling asleep and/or staying asleep such that it causes significant daytime impairment. Current Australian general practice guidelines recommend cognitive behavioural therapy for insomnia (CBTi) as first line treatment for insomnia, however research suggests that most general practice consultations for insomnia result in a prescription for hypnotic or sedative medicines. Although the first point of contact for patients experiencing symptoms of insomnia is often general practice, little is known about the current role, experiences and capacity of Australian general practitioners to manage insomnia. This study aimed to address that gap by exploring the attitudes and opinions of general practitioners regarding insomnia management, to inform the development and implementation of new models of best practice insomnia care within general practice. Methods A descriptive, pragmatic qualitative study. Purposive sampling was used to recruit practising Australian general practitioners, varying in age, years of experience and geographic location. Semi-structured interviews were conducted, and data analysed using thematic analysis.  Results Twenty-eight general practitioners participated in the study. Three major themes were identified: 1) Responsibility for insomnia care; 2) Complexities in managing insomnia; and 3) Navigating treatment pathways. Whilst general practitioners readily accepted responsibility for the management of insomnia, provision of care was often demanding and difficult within the funding and time constraints of general practice. Patients presenting with comorbid mental health conditions and insomnia, and decision-making regarding long-term use of benzodiazepines presented challenges for general practitioners. Whilst general practitioners confidently provided sleep hygiene education to patients, their knowledge and experience of CBTi, and access and understanding of specialised referral pathways for insomnia was limited.  Conclusions General practitioners report that whilst assessing and managing insomnia can be demanding, it is an integral part of general practice. Insomnia presents complexities for general practitioners. Greater clarity about funding options, targeted education about effective insomnia treatments, and referral pathways to specialist services, such as benzodiazepine withdrawal support and psychologists, would benefit insomnia management within general practice.

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