Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item A mixed-methods evaluation of an intervention for enhancing alcohol screening in adults aged 50+ attending primary health care(CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners, 2025-01-02) Towers A; Newcombe D; White G; McMenamin J; Sheridan J; Rahman J; Moore A; Stokes TIntroduction Adults aged 50 years and over are drinking more than ever but primary health care (PHC) professionals find it challenging to screen them for alcohol-related harm, despite being at greater risk for harm than younger drinkers. Aim This intervention aimed to enhance alcohol screening for this cohort by (a) introducing an algorithm in the patient management system to automate detection of alcohol risk in patients and (b) providing training to support health professionals' practice of, knowledge about, and comfort with alcohol screening in this cohort. Methods Eleven PHC practices in Aotearoa New Zealand took part in this intervention, including 41 PHC health professionals. Development and integration of the automated alcohol screening process within PHC patient management systems was undertaken in parallel with health professional training approaches. Results Screening rates increased substantially at intervention initiation but fell immediately with the onset of the New Zealand COVID-19 national lockdown. Two-thirds of health professionals identified the system screening prompts, over 40% felt this changed their screening practice, and 33% increased their awareness of - and felt more comfortable screening for - alcohol-related risk in those aged 50+. Discussion We illustrated an initial increase in alcohol screening rates in those aged 50+ as a result of this intervention, but this increase could not be sustained in part due to COVID-19 disruption. However, health professionals indicated that this intervention helped many change their practice and enhanced their awareness of such risk and comfort in screening for alcohol-related risk in those aged 50+.Item Assessing alcohol industry penetration and government safeguards: the International Alcohol Control Study(BMJ Publishing Group, 2024-11-24) Leung JYY; Casswell S; Randerson S; Athauda L; Banavaram A; Callinan S; Campbell O; Chaiyasong S; Dearak S; Dumbili EW; Romero-García L; Gururaj G; Kalapat R; Karki K; Karlsson T; Kong M; Liu S; Maldonado Vargas ND; Gonzalez-Mejía JF; Naimi T; Nthomang K; Oladunni O; Owino K; Herrera Palacio JC; Phatchana P; Pradhan PMS; Rossow I; Shorter G; Sibounheuang V; Štelemėkas M; Son DT; Vallance K; van Dalen W; Wettlaufer A; Zamora A; Jankhotkaew J; Veitch EBACKGROUND: The alcohol industry uses many of the tobacco industry's strategies to influence policy-making, yet unlike the Framework Convention on Tobacco Control, there is no intergovernmental guidance on protecting policies from alcohol industry influence. Systematic assessment of alcohol industry penetration and government safeguards is also lacking. Here, we aimed to identify the nature and extent of industry penetration in a cross-section of jurisdictions. Using these data, we suggested ways to protect alcohol policies and policy-makers from undue industry influence. METHODS: As part of the International Alcohol Control Study, researchers from 24 jurisdictions documented whether 22 indicators of alcohol industry penetration and government safeguards were present or absent in their location. Several sources of publicly available information were used, such as government or alcohol industry reports, websites, media releases, news articles and research articles. We summarised the responses quantitatively by indicator and jurisdiction. We also extracted examples provided of industry penetration and government safeguards. RESULTS: There were high levels of alcohol industry penetration overall. Notably, all jurisdictions reported the presence of transnational alcohol corporations, and most (63%) reported government officials or politicians having held industry roles. There were multiple examples of government partnerships or agreements with the alcohol industry as corporate social responsibility activities, and government incentives for the industry in the early COVID-19 pandemic. In contrast, government safeguards against alcohol industry influence were limited, with only the Philippines reporting a policy to restrict government interactions with the alcohol industry. It was challenging to obtain publicly available information on multiple indicators of alcohol industry penetration. CONCLUSION: Governments need to put in place stronger measures to protect policies from alcohol industry influence, including restricting interactions and partnerships with the alcohol industry, limiting political contributions and enhancing transparency. Data collection can be improved by measuring these government safeguards in future studies.Item Exploring the substitution of cannabis for alcohol and other drugs among a large convenience sample of people who use cannabis.(BioMed Central Ltd, 2024-11-05) Wilkins C; Romeo J; Rychert M; Graydon-Guy TBackground The substitution of cannabis for alcohol and other drugs has been conceptualised in a harm reduction framework as where cannabis is used to reduce the negative side-effects, addiction potential, and social stigma of other drugs. There is currently mixed evidence with recent reviews suggesting cannabis co-use patterns may vary by age and ethnicity. Yet few studies have had large enough samples to examine this demographic variation in detail. Aims To explore the co-use of cannabis with alcohol and other drugs within demographic subgroups of a large sample of people who use cannabis. Specifically: (1) whether cannabis is being substituted for other drugs, and (2), whether cannabis use leads to more, less or the same level of other drug use. Method Online convenience survey promoted via Facebook™ completed by 23,500 New Zealand respondents. Those who had used cannabis and any of eight other substances in the same six-month period were asked if their use of cannabis had any impact on their use of each other substance (“a lot more”, “little more”, “no impact/same”, “little less”, “a lot less”). Frequency and quantity used of each other drug was compared by co-use group. Generalised logistic regression models were developed to predict co-use categories. Results Significant proportions reported cannabis use led to “less” alcohol (60%), synthetic cannabinoid (60%), morphine (44%) and methamphetamine (40%) use. Those who reported using “less” had lower frequency and amount used of other drugs. Approximately seven-out-ten reported cannabis use had “no impact” on LSD, MDMA, and cocaine use. One-in-five reported using cannabis led to “more” tobacco use. Young adults (21–35-years) were more likely to report cannabis use led to “less” drinking and methamphetamine use. Adolescent co-users (16–20 years) reported mixed impacts. Māori were more likely to report cannabis use resulted in “less” alcohol, tobacco, methamphetamine, and LSD use. Students and those living in cities were less likely to report cannabis use lowering use of other substances. Conclusion Cannabis and other drug co-use patterns are moderated by life stages, lifestyles, cultural perspectives, and urbanicity. Harm reduction initiatives and policy reforms should take account of these moderating factors.Item The impact of alcohol pricing policies on public health in Hong Kong, China: A modelling study.(Elsevier B.V., 2022-06-24) Ng CS; Au M; Ma R; Leung JYY; Quan JBackground Contrary to most developed economies, Hong Kong has reduced and eliminated taxes on beer and wine over the last 15 years and observed increasing alcohol consumption. Methods We applied econometric epidemiological modelling to assess the impact of reverting ad valorem taxation to pre-2008 levels (20% on wine and 40% on beer) on consumption and health outcomes. We used 15 years of industry sales and pricing data (2004-2018) to derive 25 own-price and cross-price elasticity estimates. We applied risk functions from the World Health Organization 2018 Global Status Report to assess the impact on 25 alcohol-attributable conditions. Findings An estimated 616 deaths (91.3% in men) were attributable to alcohol in 2018. Raising taxes to pre-2008 levels is estimated to reduce consumption of pure alcohol consumption by 8.0%, 15.9%, and 31.1%; and reduce alcohol-attributable deaths by 11.6%, 21.8%, and 40.2% assuming 25%, 50% and 100% pass through rates of taxes to consumers. The largest projected decreases in alcohol-attributable mortality in absolute numbers are alcohol abuse, alcohol dependence, and alcoholic psychoses (wholly alcohol-attributable disorders). The largest absolute number of new alcohol-attributable cases in 2018 were hypertension, alcohol dependence and alcohol abuse; which are estimated to be reduced by 31.3%, 34.2%, and 34.3% respectively by raising taxes to pre-2008 levels. The alcohol-attributable health burden and absolute reductions in health harms are far greater in men. Interpretation Reversing the 2008 alcohol tax reductions is potentially effective in averting the alcohol-attributable health burden and thus mitigate against the avoidable harms of alcohol-related disease. Funding Health and Medical Research Fund, Food and Health Bureau of the Hong Kong SAR, China [03170067].Item Youth identity formation and contemporary alcohol marketing(Taylor & Francis, 2005) McCreanor TN; Greenaway A; Moewaka Barnes HE; Borell SS; Gregory MJThis paper considers linkages between contemporary marketing theory and practice, and emerging conceptualizations of identity, to discuss implications for public health concerns over alcohol use among young people. Particular attention is paid to the theorizing of consumption as a component of youth identities and the ways in which developments of marketing praxis orients to such schemata. The authors' analyses of exemplars of marketing materials in use in Aotearoa New Zealand, drawn from their research archive, emphasize the sophistication and power of such forms of marketing. They argue that public health policy and practice must respond to the interweaving of marketing and the self-making practices of young people to counter this complex threat to the health and well-being of young people. © 2005 Taylor & Francis.