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Gardner LA, Stockings E, Champion KE, Mather M, Newton NC. Alcohol initiation before age 15 predicts earlier hazardous drinking: A survival analysis of a 7-year prospective longitudinal cohort of Australian adolescents. Addiction 2024; 119:518-529. [PMID: 37926434 DOI: 10.1111/add.16376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND AIMS Early alcohol use may predict later alcohol problems, but the magnitude of this effect and impact of delayed onset remain uncertain. This study measured age-based differences in progression from first full alcoholic drink to hazardous drinking in one of the largest and most recent prospective cohorts of Australian adolescents. DESIGN, SETTINGS, PARTICIPANTS AND MEASUREMENT A 7-year (2012-19) prospective longitudinal cohort of 2082 Australian adolescents was established from the Climate and Preventure (cohort 1) and Climate Schools Combined (cohort 2) studies. Participants completed surveys annually from ages 13 to 20 years. Interval censored survival analyses were conducted with first episode of hazardous drinking [three or more on proxy Alcohol Use Disorders Identification Test (AUDIT-C)] as the survival end-point, controlling for age, sex and mental health symptomatology. Onset of hazardous drinking was expressed as hazard ratios (HRs), and median survival time (years) was used to model first onset of hazardous alcohol use in survival curves. FINDINGS Compared with those aged 15 or older, those who had their first full drink at 12 or younger had significantly elevated risk of hazardous drinking onset during the study period [log (HR): 9.3; 95% confidence interval (CI) = 7.0-12.0, P < 0.001]. Compared with those who had their first full drink at ages 13-14, those who delayed until 15 or older had significantly later onset of hazardous drinking; 1.63 years for males (95% CI = 1.31-1.92, P < 0.001) and 1.50 for females (95% CI = 1.15-1.81, P < 0.001), resulting in a median age of onset of hazardous drinking of > 19 for both sexes (male: 19.05 years, 95% CI = 18.74-19.38; female: 19.47 years, 95% CI = 19.19-19.75). First drink at ages 13-14 was associated with the earliest onset of hazardous drinking (males: 17.43 years; females: 17.98 years). CONCLUSIONS In Australia, alcohol initiation prior to age 15 appears to be associated with an earlier onset of hazardous drinking than initiation after age 15.
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Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Marius Mather
- Sydney Informatics Hub, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Barnes C, Turon H, McCrabb S, Hodder RK, Yoong SL, Stockings E, Hall AE, Bialek C, Morrison JL, Wolfenden L. Interventions to prevent or cease electronic cigarette use in children and adolescents. Cochrane Database Syst Rev 2023; 11:CD015511. [PMID: 37965949 PMCID: PMC10646968 DOI: 10.1002/14651858.cd015511.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND The prevalence of e-cigarette use has increased globally amongst children and adolescents in recent years. In response to the increasing prevalence and emerging evidence about the potential harms of e-cigarettes in children and adolescents, leading public health organisations have called for approaches to address increasing e-cigarette use. Whilst evaluations of approaches to reduce uptake and use regularly appear in the literature, the collective long-term benefit of these is currently unclear. OBJECTIVES The co-primary objectives of the review were to: (1) evaluate the effectiveness of interventions to prevent e-cigarette use in children and adolescents (aged 19 years and younger) with no prior use, relative to no intervention, waitlist control, usual practice, or an alternative intervention; and (2) evaluate the effectiveness of interventions to cease e-cigarette use in children and adolescents (aged 19 years and younger) reporting current use, relative to no intervention, waitlist control, usual practice, or an alternative intervention. Secondary objectives were to: (1) examine the effect of such interventions on child and adolescent use of other tobacco products (e.g. cigarettes, cigars types, and chewing tobacco); and (2) describe the unintended adverse effects of the intervention on individuals (e.g. physical or mental health of individuals), or on organisations (e.g. intervention displacement of key curricula or learning opportunities for school students) where such interventions are being implemented. SEARCH METHODS We searched CENTRAL, Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Clarivate Web of Science Core Collection from inception to 1 May 2023. Additionally, we searched two trial registry platforms (WHO International Clinical Trials Registry Platform; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov), Google Scholar, and the reference lists of relevant systematic reviews. We contacted corresponding authors of articles identified as ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, factorial RCTs, and stepped-wedge RCTs. To be eligible, the primary targets of the interventions must have been children and adolescents aged 19 years or younger. Interventions could have been conducted in any setting, including community, school, health services, or the home, and must have sought to influence children or adolescent (or both) e-cigarette use directly. Studies with a comparator of no intervention (i.e. control), waitlist control, usual practice, or an alternative intervention not targeting e-cigarette use were eligible. We included measures to assess the effectiveness of interventions to: prevent child and adolescent e-cigarette use (including measures of e-cigarette use amongst those who were never-users); and cease e-cigarette use (including measures of e-cigarette use amongst children and adolescents who were e-cigarette current-users). Measures of e-cigarette use included current-use (defined as use in the past 30 days) and ever-use (defined as any lifetime use). DATA COLLECTION AND ANALYSIS Two review authors independently screened the titles and abstracts of references, with any discrepancies resolved through consensus. Pairs of review authors independently assessed the full-text articles for inclusion in the review. We planned for two review authors to independently extract information from the included studies and assess risk of bias using the Cochrane RoB 2 tool. We planned to conduct multiple meta-analyses using a random-effects model to align with the co-primary objectives of the review. First, we planned to pool interventions to prevent child and adolescent e-cigarette use and conduct two analyses using the outcome measures of 'ever-use' and 'current-use'. Second, we planned to pool interventions to cease child and adolescent e-cigarette use and conduct one analysis using the outcome measure of 'current-use'. Where data were unsuitable for pooling in meta-analyses, we planned to conduct a narrative synthesis using vote-counting approaches and to follow the Cochrane Handbook for Systematic Reviews of Interventions and the Synthesis Without Meta-analysis (SWiM) guidelines. MAIN RESULTS The search of electronic databases identified 7141 citations, with a further 287 records identified from the search of trial registries and Google Scholar. Of the 110 studies (116 records) evaluated in full text, we considered 88 to be ineligible for inclusion for the following reasons: inappropriate outcome (27 studies); intervention (12 studies); study design (31 studies); and participants (18 studies). The remaining 22 studies (28 records) were identified as ongoing studies that may be eligible for inclusion in a future review update. We identified no studies with published data that were eligible for inclusion in the review. AUTHORS' CONCLUSIONS We identified no RCTs that met the inclusion criteria for the review, and as such, there is no evidence available from RCTs to assess the potential impact of interventions targeting children and adolescent e-cigarette use, tobacco use, or any unintended adverse effects. Evidence from studies employing other trial designs (e.g. non-randomised) may exist; however, such studies were not eligible for inclusion in the review. Evidence from studies using non-randomised designs should be examined to guide actions to prevent or cease e-cigarette use. This is a living systematic review. We search for new evidence every month and update the review when we identify relevant new evidence. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Heidi Turon
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
- Global Centre for Preventive Health and Nutrition, Institute of Health Technology, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Emily Stockings
- Matilda Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Caitlin Bialek
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Jacob L Morrison
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
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Gardner LA, O'Dean S, Champion KE, Stockings E, Rowe A, Teesson M, Newton NC. Prevalence, patterns of use, and socio-demographic features of e-cigarette use by Australian adolescents: a survey. Med J Aust 2023; 219:332-334. [PMID: 37606587 PMCID: PMC10952690 DOI: 10.5694/mja2.52075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Usethe University of SydneySydneyNSW
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Usethe University of SydneySydneyNSW
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Usethe University of SydneySydneyNSW
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Usethe University of SydneySydneyNSW
| | - Amy‐Leigh Rowe
- The Matilda Centre for Research in Mental Health and Substance Usethe University of SydneySydneyNSW
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Usethe University of SydneySydneyNSW
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Usethe University of SydneySydneyNSW
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Gibbs D, Stockings E, Larney S, Bromberg DJ, Shakeshaft A, Farnbach S. The impact of supported accommodation on health and criminal justice outcomes of people released from prison: a systematic literature review. Harm Reduct J 2023; 20:91. [PMID: 37480060 PMCID: PMC10362610 DOI: 10.1186/s12954-023-00832-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Supported accommodation intends to address challenges arising following release from prison; however, impact of services, and of specific service components, is unclear. We describe key characteristics of supported accommodation, including program components and outcomes/impact; and distil best-evidence components. METHODS We conducted a systematic review, searching relevant databases in November 2022. Data were synthesised via effect direction plots according to the Synthesis Without Meta-analysis guidelines. We assessed study quality using the McGill Mixed Methods Appraisal Tool, and certainty in evidence using the GRADE framework. RESULTS Twenty-eight studies were included; predominantly cross-sectional. Program components which address life skills, vocational training, AOD use, and mental health appear to positively impact criminal justice outcomes. Criminal justice outcomes were the most commonly reported, and while we identified a reduction in parole revocations and reincarceration, outcomes were otherwise mixed. Variable design, often lacking rigour, and inconsistent outcome reporting limited assessment of these outcomes, and subsequently certainty in findings was low. CONCLUSION Post-release supported accommodation may reduce parole revocations and reincarceration. Despite limitations in the literature, the findings presented herein represent current best evidence. Future studies should clearly define program components and measure their impact; use analyses which reflect the high risk of adverse outcomes, such as time-to-event analyses; and consider outcomes which reflect the range of challenges faced by people leaving prison. REGISTRATION PROSPERO registration CRD42020189821.
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Affiliation(s)
- Daisy Gibbs
- National Drug and Alcohol Research Centre, UNSW Sydney, 22-32 King Street, Randwick, NSW, 2031, Australia.
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Jane Foss Russel Building, Camperdown, NSW, 2006, Australia
| | - Sarah Larney
- Department of Family Medicine and Emergency Medicine, Universite de Montreal and Centre de Recherche du CHUM, Montreal, QC, Canada
| | - Daniel J Bromberg
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, 06511, USA
- Center for Interdisciplinary Research On AIDS, Yale University, New Haven, CT, 06511, USA
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, UNSW Sydney, 22-32 King Street, Randwick, NSW, 2031, Australia
- Poche Centre for Indigenous Health, University of Queensland, Toowong, QLD, Australia
| | - Sara Farnbach
- National Drug and Alcohol Research Centre, UNSW Sydney, 22-32 King Street, Randwick, NSW, 2031, Australia
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Barnes C, Yoong SL, Stockings E, Bialek C, Wolfenden L. The need for an evidence surveillance system to inform the public health response to e-cigarette use in youth. Aust N Z J Public Health 2023; 47:100060. [PMID: 37187076 DOI: 10.1016/j.anzjph.2023.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia; Hunter Medical Research Institute, New Lambton, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.
| | - Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia; Hunter Medical Research Institute, New Lambton, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Global Centre for Preventive Nutrition and Health, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Emily Stockings
- Matilda Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Caitlin Bialek
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia; Hunter Medical Research Institute, New Lambton, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
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6
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Gardner LA, Rowe AL, Stockings E, Champion KE, Hides L, McBride N, Allsop S, O'Dean S, Sunderland M, Lee YY, Mihalopoulos C, Freeman B, Leung J, McRobbie H, Stapinski L, Lee N, Thornton L, Debenham J, Teesson M, Newton NC. Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents. BMC Public Health 2023; 23:683. [PMID: 37046211 PMCID: PMC10090743 DOI: 10.1186/s12889-023-15609-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia. METHODS A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12-14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term. DISCUSSION If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control. TRIAL REGISTRATION The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023).
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Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
| | - Amy-Leigh Rowe
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug and Research Institute, EnAble Institute, Curtin University, Perth, WA, Australia
| | - Steve Allsop
- National Drug and Research Institute, EnAble Institute, Curtin University, Perth, WA, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Yong Yi Lee
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Cathy Mihalopoulos
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Becky Freeman
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
| | - Hayden McRobbie
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicole Lee
- National Drug and Research Institute, Curtin University, Perth, WA, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
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Barnes C, Yoong SL, Hodder RK, Hall AE, Bialek C, Stockings E, Wolfenden L. Interventions to prevent or cease electronic cigarette use in children and adolescents. Cochrane Database Syst Rev 2022. [PMCID: PMC9706500 DOI: 10.1002/14651858.cd015511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Courtney Barnes
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
- Global Centre for Preventive Health and Nutrition, Institute of Health Technology, School of Health and Social Development; Deakin University; Burwood Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
| | - Alix E Hall
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan Australia
| | - Caitlin Bialek
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
| | - Emily Stockings
- Matilda Centre, Faculty of Medicine and Health; University of Sydney; Sydney Australia
| | - Luke Wolfenden
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
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Gardner LA, Rowe AL, Newton NC, Aitken T, Stockings E, Thornton L, Teesson M, Devine EK, Champion KE. School-based preventive interventions targeting e-cigarette use among adolescents: a systematic review protocol. BMJ Open 2022; 12:e065509. [PMID: 36123088 PMCID: PMC9486280 DOI: 10.1136/bmjopen-2022-065509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Electronic cigarette (e-cigarette) use has drastically increased in recent years, particularly among adolescents. This poses several acute and chronic harms to young people, including poisonings, burns, serious lung injury and-where nicotine e-liquid is used-the potential to impact healthy brain development and precipitate future nicotine addiction. School-based prevention programmes have the potential to address this growing public health concern by reaching large numbers of young people during a critical period for intervention; however, the efficacy of such interventions has not been systematically explored. This systematic review aims to determine the existence and efficacy of school-based preventive interventions targeting e-cigarette use. METHODS AND ANALYSIS A systematic search of MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Database of Systematic Reviews and international clinical trials registries will be conducted from 2000 to April 2022 to identify eligible studies (randomised controlled trials, cluster randomised controlled trials and quasiexperimental studies) evaluating school-based interventions to prevent e-cigarette use among adolescents. Two reviewers will independently screen title, abstract and full text of all studies for eligibility. Both reviewers will independently extract the data and assess the risk of bias. Any discrepancies will be resolved by a third reviewer. Results will be summarised in a narrative synthesis and data will be meta-analysed if appropriate. Heterogeneity in findings will be assessed narratively, and using the I2 statistic (where meta-analysis is feasible), meta-regression will be used to explore potential factors associated with programme efficacy, where data permit. ETHICS AND DISSEMINATION This research is conducted on published work and does not require ethics approval. The findings will be published in a peer-reviewed journal and used to guide the development of new school-based e-cigarette preventive interventions. TRIAL REGISTRATION NUMBER CRD42022323352.
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Affiliation(s)
- Lauren Anne Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Amy-Leigh Rowe
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola Clare Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Tess Aitken
- The University of Sydney Library, The University of Sydney, Sydney, New South Wales, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Emma Krogh Devine
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Katrina Elizabeth Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
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Jin X, Kinner SA, Hopkins R, Stockings E, Courtney RJ, Shakeshaft A, Petrie D, Dobbins T, Puljevic C, Chang S, Dolan K. A randomised controlled trial of motivational interview for relapse prevention after release from smoke-free prisons in Australia. Int J Prison Health 2021. [DOI: 10.1108/ijph-01-2020-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.
Design/methodology/approach
This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.
Findings
From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).
Research limitations/implications
A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.
Originality/value
This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.
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Yoong SL, Hall A, Leonard A, McCrabb S, Wiggers J, Tursan d'Espaignet E, Stockings E, Gouda H, Fayokun R, Commar A, Prasad VM, Paul C, Oldmeadow C, Chai LK, Thompson B, Wolfenden L. Prevalence of electronic nicotine delivery systems and electronic non-nicotine delivery systems in children and adolescents: a systematic review and meta-analysis. Lancet Public Health 2021; 6:e661-e673. [PMID: 34274048 PMCID: PMC8390387 DOI: 10.1016/s2468-2667(21)00106-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND There are concerns that the use of electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS) in children and adolescents could potentially be harmful to health. Understanding the extent of use of these devices is crucial to informing public health policy. We aimed to synthesise the prevalence of ENDS or ENNDS use in children and adolescents younger than 20 years. METHODS In this systematic review and meta-analysis, we undertook an electronic search in five databases (MEDLINE, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, and Wiley Cochrane Library) from Jan 1, 2016, to Aug 31, 2020, and a grey literature search. Included studies reported on the prevalence of ENDS or ENNDS use in nationally representative samples in populations younger than 20 years and collected data between the years 2016 and 2020. Studies were excluded if they were done in those aged 20 years or older, used data from specialist panels that did not apply appropriate weighting, or did not use methods that ensured recruitment of a nationally representative sample. We included the most recent data for each country. We combined multiple national estimates for a country if they were done in the same year. We undertook risk of bias assessment for all surveys included in the review using the Joanna Briggs Institute Critical Appraisal Checklist (by two reviewers in the author list). A random effects meta-analysis was used to pool overall prevalence estimates for ever, current, occasional, and daily use. This study was prospectively registered with PROSPERO, CRD42020199485. FINDINGS The most recent prevalence data from 26 national surveys representing 69 countries and territories, with a median sample size of 3925 (IQR 1=2266, IQR 3=10 593) children and adolescents was included. In children and adolescents aged between 8 years and younger than 20 years, the pooled prevalence for ever (defined as any lifetime use) ENDS or ENNDS use was 17·2% (95% CI 15-20, I2=99·9%), whereas for current use (defined as use in past 30 days) the pooled prevalence estimate was 7·8% (6-9, I2=99·8%). The pooled estimate for occasional use was 0·8% (0·5-1·2, I2=99·4%) for daily use and 7·5% (6·1-9·1, I2=99·4%) for occasional use. Prevalence of ENDS or ENNDS use was highest in high-income geographical regions. In terms of study quality, all surveys scored had a low risk of bias for the sampling frame used, due to the nationally representative nature of the studies. The most poorly conducted methodological feature of the included studies was subjects and setting described in detail. Few surveys reported on the use of flavours or types of ENDS or ENNDS. INTERPRETATION There is significant variability in the prevalence of ENDS and ENNDS use in children and adolescents globally by country income status. These findings are possibly due to differences in regulatory context, market availability, and differences in surveillance systems. FUNDING World Health Organization and the Bill & Melinda Gates Foundation.
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Affiliation(s)
- Sze Lin Yoong
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Alix Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Hunter New England Population Health, Wallsend, NSW, Australia
| | - Alecia Leonard
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Hunter New England Population Health, Wallsend, NSW, Australia
| | - Edouard Tursan d'Espaignet
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter New England Population Health, Wallsend, NSW, Australia; School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Hebe Gouda
- Department of Health Promotion, No Tobacco Unit, World Health Organization, Geneva, Switzerland
| | - Ranti Fayokun
- Department of Health Promotion, No Tobacco Unit, World Health Organization, Geneva, Switzerland
| | - Alison Commar
- Department of Health Promotion, No Tobacco Unit, World Health Organization, Geneva, Switzerland
| | - Vinayak M Prasad
- Department of Health Promotion, No Tobacco Unit, World Health Organization, Geneva, Switzerland
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | | | - Li Kheng Chai
- Health and Wellbeing Queensland, Queensland Government, Milton, QLD, Australia; Centre for Children's Health Research, Institute of Health and Biomedical Innovation Exercise and Nutrition, Queensland University of Technology, South Brisbane, QLD, Australia
| | - Bruce Thompson
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Hunter New England Population Health, Wallsend, NSW, Australia
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11
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Larney S, Peacock A, Tran LT, Stockings E, Santomauro D, Santo T, Degenhardt L. All-Cause and Overdose Mortality Risk Among People Prescribed Opioids: A Systematic Review and Meta-analysis. Pain Med 2021; 21:3700-3711. [PMID: 32951045 DOI: 10.1093/pm/pnaa214] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To estimate all-cause and overdose crude mortality rates and standardized mortality ratios among people prescribed opioids for chronic noncancer pain and risk of overdose death in this population relative to people with similar clinical profiles but not prescribed opioids. DESIGN Systematic review and meta-analysis. METHODS Medline, Embase, and PsycINFO were searched in February 2018 and October 2019 for articles published beginning 2009. Due to limitations in published studies, we revised our inclusion criteria to include cohort studies of people prescribed opioids, excluding those studies where people were explicitly prescribed opioids for the treatment of opioid use disorder or acute cancer or palliative pain. We estimated pooled all-cause and overdose crude mortality rates using random effects meta-analysis models. No studies reported standardized mortality ratios or relative risks. RESULTS We included 13 cohorts with 6,029,810 participants. The pooled all-cause crude mortality rate, based on 10 cohorts, was 28.8 per 1000 person-years (95% CI = 17.9-46.4), with substantial heterogeneity (I2 = 99.9%). The pooled overdose crude mortality rate, based on six cohorts, was 1.1 per 1000 person-years (95% CI = 0.4-3.4), with substantial heterogeneity (I2 = 99.5%), but indications for opioid prescribing and opioid exposure were poorly ascertained. We were unable to estimate mortality in this population relative to clinically similar populations not prescribed opioids. CONCLUSIONS Methodological limitations in the identified literature complicate efforts to determine the overdose mortality risk of people prescribed opioids. There is a need for large-scale clinical trials to assess adverse outcomes in opioid prescribing, especially for chronic noncancer pain.
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Affiliation(s)
- Sarah Larney
- Department of Family Medicine and Emergency Medicine, Université de Montréal and Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montreal, Quebec, Canada.,National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; ‡School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; ‡School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia
| | - Lucy T Tran
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; ‡School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; ‡School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia
| | - Damian Santomauro
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia.,Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Thomas Santo
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; ‡School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; ‡School of Medicine (Psychology), University of Tasmania, Hobart, Tas, Australia
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12
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Peacock A, Tran LT, Larney S, Stockings E, Santo T, Jones H, Santomauro D, Degenhardt L. All-cause and cause-specific mortality among people with regular or problematic cocaine use: a systematic review and meta-analysis. Addiction 2021; 116:725-742. [PMID: 32857457 PMCID: PMC7914269 DOI: 10.1111/add.15239] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/02/2020] [Accepted: 08/24/2020] [Indexed: 12/29/2022]
Abstract
AIMS To estimate pooled all-cause and cause-specific mortality risk for people with regular or problematic cocaine use. METHODS Systematic review and meta-analysis of prospective or retrospective cohort studies or clinical trials (n ≥30) of people with regular or problematic cocaine use with data on all-cause or cause-specific mortality. Of 2808 papers, 28 were eligible and reported on 21 cohorts, with a total 170 019 individuals. Cohorts identified based on acute care for drug poisoning or other severe health presentation were excluded. Title/abstract screening was conducted by one reviewer; a second reviewer independently checked 10% of excluded studies. Two reviewers conducted full-text screening. Data were extracted by one reviewer and checked by a second. A customized review-specific study reporting quality/risk of bias tool was used. Data on crude mortality rates (CMR) and standardized mortality ratios were extracted for both all-cause and cause-specific mortality. Standardized mortality ratios were imputed where not provided by the author using extracted data and information from the Global Burden of Disease Study 2017. Data were pooled using a random-effects model. RESULTS The pooled all-cause crude mortality rate was 1.24 per 100 person-years [95% confidence interval (CI) = 0.86, 1.78; n = 16 cohorts], but with considerable heterogeneity (I2 = 98.8%). The pooled all-cause standardized mortality ratio (SMR) was 6.13 (95% CI = 4.15, 9.05; n = 16 cohorts). Suicide (SMR = 6.26, 95% CI = 2.84, 13.80), accidental injury (SMR = 6.36, 95% CI = 4.18, 9.68), homicide (SMR = 9.38, 95% CI 3.45-25.48) and AIDS-related mortality (SMR = 23.12, 95% CI = 11.30, 47.31) were all elevated compared with age and sex peers in the general population. CONCLUSIONS There are elevated rates of mortality among people with regular or problematic cocaine use for traumatic deaths and deaths attributable to infectious disease.
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Affiliation(s)
- Amy Peacock
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia,School of Psychology, University of Tasmania, Hobart, Australia
| | - Lucy Thi Tran
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Thomas Santo
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
| | - Hayley Jones
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Damian Santomauro
- Queensland Centre for Mental Health Research and School of Public Health, University of Queensland, Brisbane, Australia,Institute for Health metrics and Evaluation, University of Washington, Washington, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia
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13
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Fehily C, Hodder R, Bartlem K, Wiggers J, Wolfenden L, Dray J, Bailey J, Wilczynska M, Stockings E, Clinton-McHarg T, Regan T, Bowman J. The effectiveness of interventions to increase preventive care provision for chronic disease risk behaviours in mental health settings: A systematic review and meta-analysis. Prev Med Rep 2020; 19:101108. [PMID: 32477852 PMCID: PMC7248238 DOI: 10.1016/j.pmedr.2020.101108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/01/2020] [Accepted: 04/26/2020] [Indexed: 11/25/2022] Open
Abstract
Clinical practice guidelines direct mental health services to provide preventive care to address client chronic disease risk behaviours, however, this care is not routinely provided. The aim of this systematic review was to synthesise evidence regarding the effectiveness of interventions to increase provision of preventive care by mental health services; by care element (ask, assess, advice, assist, arrange) and risk behaviour (tobacco smoking, poor nutrition, harmful alcohol consumption, physical inactivity). Electronic bibliographic databases, Google Scholar, relevant journals, and included study reference lists were searched. Eligible studies were of any design with a comparison group that reported the effectiveness of an intervention to increase the provision of at least one element of preventive care for at least one risk behaviour in a mental health setting. Twenty studies were included, most commonly examining smoking (n = 20) and 'ask' (n = 12). Meta-analysis found interventions involving task shifting were effective in increasing smoking 'advice' (n = 2 RCTs; p = 0.009) and physical activity 'advice' (n = 2 RCTs; p = 0.002). Overall, meta-analysis and narrative synthesis indicated that effective intervention strategies (categorised according to the Effective Practice and Organisation of Care taxonomy) were: task shifting, educational meetings, health information systems, local consensus processes, authority and accountability, and reminders. The most consistent findings across studies were with regard to preventive care for smoking, while conflicting or limited evidence was found regarding other risk behaviours. While further rigorous research examining key risk behaviours is recommended, the findings may inform the selection of strategies for future interventions and service delivery initiatives.
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Affiliation(s)
- Caitlin Fehily
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Rebecca Hodder
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Kate Bartlem
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - John Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Luke Wolfenden
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Julia Dray
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - Jacqueline Bailey
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
| | - Magda Wilczynska
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, Randwick, NSW, Australia
| | - Tara Clinton-McHarg
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Timothy Regan
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Jenny Bowman
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
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14
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Larney S, Tran LT, Leung J, Santo T, Santomauro D, Hickman M, Peacock A, Stockings E, Degenhardt L. All-Cause and Cause-Specific Mortality Among People Using Extramedical Opioids: A Systematic Review and Meta-analysis. JAMA Psychiatry 2020; 77:493-502. [PMID: 31876906 PMCID: PMC6990804 DOI: 10.1001/jamapsychiatry.2019.4170] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Extramedical opioid use has escalated in recent years. A better understanding of cause-specific mortality in this population is needed to inform comprehensive responses. OBJECTIVE To estimate all-cause and cause-specific crude mortality rates (CMRs) and standardized mortality ratios (SMRs) among people using extramedical opioids, including age- and sex-specific estimates when possible. DATA SOURCES For this systematic review and meta-analysis, MEDLINE, PsycINFO, and Embase were searched for studies published from January 1, 2009, to October 3, 2019, and an earlier systematic review on this topic published in 2011. STUDY SELECTION Cohort studies of people using extramedical opioids and reporting mortality outcomes were screened for inclusion independently by 2 team members. DATA EXTRACTION AND SYNTHESIS Data were extracted by a team member and checked by another team member. Study quality was assessed using a custom set of items that examined risk of bias and quality of reporting. Data were pooled using random-effects meta-analysis models. Heterogeneity was assessed using stratified meta-analyses and meta-regression. MAIN OUTCOMES AND MEASURES Outcome measures were all-cause and cause-specific CMRs and SMRs among people using extramedical opioids compared with the general population of the same age and sex. RESULTS Of 8683 identified studies, 124 were included in this analysis (100 primary studies and 24 studies providing additional data for primary studies). The pooled all-cause CMR, based on 99 cohorts of 1 262 592 people, was 1.6 per 100 person-years (95% CI, 1.4-1.8 per 100 person-years), with substantial heterogeneity (I2 = 99.7%). Heterogeneity was associated with the proportion of the study sample that injected opioids or was living with HIV infection or hepatitis C. The pooled all-cause SMR, based on 43 cohorts, was 10.0 (95% CI, 7.6-13.2). Excess mortality was observed across a range of causes, including overdose, injuries, and infectious and noncommunicable diseases. CONCLUSIONS AND RELEVANCE The findings suggest that people using extramedical opioids experience significant excess mortality, much of which is preventable. The range of causes for which excess mortality was observed highlights the multiplicity of risk exposures experienced by this population and the need for comprehensive responses to address these. Better data on cause-specific mortality in this population in several world regions appear to be needed.
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Affiliation(s)
- Sarah Larney
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia,Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Lucy Thi Tran
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Janni Leung
- University of Queensland School of Psychology, St Lucia, Queensland, Australia,Institute of Health Metrics and Evaluation, University of Washington, Seattle
| | - Thomas Santo
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Damian Santomauro
- Institute of Health Metrics and Evaluation, University of Washington, Seattle,University of Queensland School of Public Health, St Lucia, Queensland, Australia,Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
| | - Matt Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
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15
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Borschmann R, Janca E, Carter A, Willoughby M, Hughes N, Snow K, Stockings E, Hill NTM, Hocking J, Love A, Patton GC, Sawyer SM, Fazel S, Puljević C, Robinson J, Kinner SA. The health of adolescents in detention: a global scoping review. Lancet Public Health 2020; 5:e114-e126. [PMID: 31954434 PMCID: PMC7025881 DOI: 10.1016/s2468-2667(19)30217-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022]
Abstract
Adolescents detained within the criminal justice system are affected by complex health problems, health-risk behaviours, and high rates of premature death. We did a global synthesis of the evidence regarding the health of this population. We searched Embase, PsycINFO, Education Resources Information Center, PubMed, Web of Science, CINCH, Global Health, the Cochrane Database of Systematic Reviews, the Campbell Library, the National Criminal Justice Reference System Abstract Database, and Google Scholar for peer-reviewed journal articles, including reviews, that reported the prevalence of at least one health outcome (physical, mental, sexual, infectious, and neurocognitive) in adolescents (aged <20 years) in detention, and were published between Jan 1, 1980, and June 30, 2018. The reference lists of published review articles were scrutinised for additional relevant publications. Two reviewers independently screened titles and abstracts, and three reviewed full texts of relevant articles. The protocol for this Review was registered with PROSPERO (CRD42016041392). 245 articles (204 primary research articles and 41 reviews) were included, with most primary research (183 [90%]) done in high-income countries. A high lifetime prevalence of health problems, risks, and conditions was reported in detained adolescents, including mental disorders (0–95%), substance use disorders (22–96%), self-harm (12–65%), neurodevelopmental disabilities (2–47%), infectious diseases (0–34%), and sexual and reproductive conditions (pregnant by age 19 years 20–37%; abnormal cervical screening test result 16%). Various physical and mental health problems and health-risk behaviours are more common among adolescents in detention than among their peers who have not been detained. As the social and structural drivers of poor health overlap somewhat with factors associated with exposure to the criminal justice system, strategies to address these factors could help to reduce both rates of adolescent detention and adolescent health inequalities. Improving the detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care after release from detention could improve the health outcomes of these vulnerable young people.
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Affiliation(s)
- Rohan Borschmann
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Emilia Janca
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Annie Carter
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Melissa Willoughby
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Nathan Hughes
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Kathryn Snow
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | | | - Jane Hocking
- Sexual Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander Love
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - George C Patton
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Susan M Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Cheneal Puljević
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jo Robinson
- Orygen Youth Health, Melbourne, VIC, Australia
| | - Stuart A Kinner
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, Australia; Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Black N, Stockings E, Campbell G, Tran LT, Zagic D, Hall WD, Farrell M, Degenhardt L. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. Lancet Psychiatry 2019; 6:995-1010. [PMID: 31672337 PMCID: PMC6949116 DOI: 10.1016/s2215-0366(19)30401-8] [Citation(s) in RCA: 223] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/30/2019] [Accepted: 08/30/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Medicinal cannabinoids, including medicinal cannabis and pharmaceutical cannabinoids and their synthetic derivatives, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), have been suggested to have a therapeutic role in certain mental disorders. We analysed the available evidence to ascertain the effectiveness and safety of all types of medicinal cannabinoids in treating symptoms of various mental disorders. METHODS For this systematic review and meta-analysis we searched MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Clinical Trials, and the Cochrane Database of Systematic Reviews for studies published between Jan 1, 1980, and April 30, 2018. We also searched for unpublished or ongoing studies on ClinicalTrials.gov, the EU Clinical Trials Register, and the Australian and New Zealand Clinical Trials Registry. We considered all studies examining any type and formulation of a medicinal cannabinoid in adults (≥18 years) for treating depression, anxiety, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, post-traumatic stress disorder, or psychosis, either as the primary condition or secondary to other medical conditions. We placed no restrictions on language, publication status, or study type (ie, both experimental and observational study designs were included). Primary outcomes were remission from and changes in symptoms of these mental disorders. The safety of medicinal cannabinoids for these mental disorders was also examined. Evidence from randomised controlled trials was synthesised as odds ratios (ORs) for disorder remission, adverse events, and withdrawals and as standardised mean differences (SMDs) for change in symptoms, via random-effects meta-analyses. The quality of the evidence was assessed with the Cochrane risk of bias tool and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. This study is registered with PROSPERO (CRD42017059372, CRD42017059373, CRD42017059376, CRD42017064996, and CRD42018102977). FINDINGS 83 eligible studies (40 randomised controlled trials, n=3067) were included: 42 for depression (23 randomised controlled trials; n=2551), 31 for anxiety (17 randomised controlled trials; n=605), eight for Tourette syndrome (two randomised controlled trials; n=36), three for ADHD (one randomised controlled trial; n=30), 12 for post-traumatic stress disorder (one randomised controlled trial; n=10), and 11 for psychosis (six randomised controlled trials; n=281). Pharmaceutical THC (with or without CBD) improved anxiety symptoms among individuals with other medical conditions (primarily chronic non-cancer pain and multiple sclerosis; SMD -0·25 [95% CI -0·49 to -0·01]; seven studies; n=252), although the evidence GRADE was very low. Pharmaceutical THC (with or without CBD) worsened negative symptoms of psychosis in a single study (SMD 0·36 [95% CI 0·10 to 0·62]; n=24). Pharmaceutical THC (with or without CBD) did not significantly affect any other primary outcomes for the mental disorders examined but did increase the number of people who had adverse events (OR 1·99 [95% CI 1·20 to 3·29]; ten studies; n=1495) and withdrawals due to adverse events (2·78 [1·59 to 4·86]; 11 studies; n=1621) compared with placebo across all mental disorders examined. Few randomised controlled trials examined the role of pharmaceutical CBD or medicinal cannabis. INTERPRETATION There is scarce evidence to suggest that cannabinoids improve depressive disorders and symptoms, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis. There is very low quality evidence that pharmaceutical THC (with or without CBD) leads to a small improvement in symptoms of anxiety among individuals with other medical conditions. There remains insufficient evidence to provide guidance on the use of cannabinoids for treating mental disorders within a regulatory framework. Further high-quality studies directly examining the effect of cannabinoids on treating mental disorders are needed. FUNDING Therapeutic Goods Administration, Australia; Commonwealth Department of Health, Australia; Australian National Health and Medical Research Council; and US National Institutes of Health.
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Affiliation(s)
- Nicola Black
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW, Australia
| | - Gabrielle Campbell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW, Australia
| | - Lucy T Tran
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW, Australia
| | - Dino Zagic
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW, Australia
| | - Wayne D Hall
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane QLD, Australia; National Addiction Centre, Kings College London, London, UK
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW, Australia.
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17
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Caldwell DM, Davies SR, Hetrick SE, Palmer JC, Caro P, López-López JA, Gunnell D, Kidger J, Thomas J, French C, Stockings E, Campbell R, Welton NJ. School-based interventions to prevent anxiety and depression in children and young people: a systematic review and network meta-analysis. Lancet Psychiatry 2019; 6:1011-1020. [PMID: 31734106 PMCID: PMC7029281 DOI: 10.1016/s2215-0366(19)30403-1] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Rates of anxiety and depression are increasing among children and young people. Recent policies have focused on primary prevention of mental disorders in children and young people, with schools at the forefront of implementation. There is limited information for the comparative effectiveness of the multiple interventions available. METHODS We did a systematic review and network meta-analysis, searching MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled trials for published and unpublished, passive and active-controlled randomised and quasi-randomised trials. We included educational setting-based, universal, or targeted interventions in which the primary aim was the prevention of anxiety and depression in children and young people aged 4-18 years. Primary outcomes were post-intervention self-report anxiety and depression, wellbeing, suicidal ideation, or self-harm. We assessed risk of bias following the Cochrane Handbook for Systematic Reviews of Interventions. We estimated standardised mean differences (SMD) using random effects network meta-analysis in a Bayesian framework. The study is registered with PROPSERO, number CRD42016048184. FINDINGS 1512 full-text articles were independently screened for inclusion by two reviewers, from which 137 studies of 56 620 participants were included. 20 studies were assessed as being at low risk of bias for both random sequence generation and allocation concealment. There was weak evidence to suggest that cognitive behavioural interventions might reduce anxiety in primary and secondary settings. In universal secondary settings, mindfulness and relaxation-based interventions showed a reduction in anxiety symptoms relative to usual curriculum (SMD -0·65, 95% credible interval -1·14 to -0·19). There was a lack of evidence to support any one type of intervention being effective to prevent depression in universal or targeted primary or secondary settings. Comparison-adjusted funnel plots suggest the presence of small-study effects for the universal secondary anxiety analysis. Network meta-analysis was not feasible for wellbeing or suicidal ideation or self-harm outcomes, and results are reported narratively. INTERPRETATION Considering unclear risk of bias and probable small study effects for anxiety, we conclude there is little evidence that educational setting-based interventions focused solely on the prevention of depression or anxiety are effective. Future research could consider multilevel, systems-based interventions as an alternative to the downstream interventions considered here. FUNDING UK National Institute for Health Research.
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Affiliation(s)
- Deborah M Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Sarah R Davies
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Sarah E Hetrick
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jennifer C Palmer
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paola Caro
- School for Policy Studies, University of Bristol, Bristol, UK
| | - José A López-López
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Spain
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Judi Kidger
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Clare French
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Snowdon N, Allan J, Shakeshaft A, Rickwood D, Stockings E, Boland VC, Courtney RJ. Outpatient psychosocial substance use treatments for young people: An overview of reviews. Drug Alcohol Depend 2019; 205:107582. [PMID: 31778903 DOI: 10.1016/j.drugalcdep.2019.107582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/12/2019] [Accepted: 08/16/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Systematic reviews and meta-analyses (reviews) conflict regarding the efficacy and feasibility of substance disorder treatments for young people (YP). This overview of reviews, synthesizes, and methodologically assesses reviews examining substance disorder interventions for YP in outpatient settings. METHODS Reviews published between 1990 and March 2018 were searched using EBM Reviews, PsycINFO, Embase, Ovid Medline, and Campbell Collaboration. Reviews investigating efficacy and/or feasibility of YP substance disorder treatments in outpatient settings were included. FORTY-THREE REVIEWS MET ALL INCLUSION CRITERIA To appraise methodological biases, 40 reviews were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and 3 were narratively assessed. One reviewer (NS) extracted study data and evaluated all 43 reviews. For inter-rater reliability, 13 (30%) reviews were extracted and appraised in duplicate by a second reviewer (JA, RC or ES). Agreement on AMSTAR2 ratings reached 100%. Agreement was moderate; κ = .52 (p < .05), 95% CI (.20, .84). RESULTS All high quality methodological reviews (n = 6) focused on intervention efficacy and none on treatment feasibility. One (n = 1) high quality review reported evidence for an intervention. Multidimensional Family Therapy (MDFT) has possible efficacy in reducing YP substance use when compared to treatment as usual, Cognitive Behavior Therapy, Adolescent Community Reinforcement Approach and Multifamily Educational Therapy. CONCLUSIONS Methodological and reporting quality of reviews require improvement. High quality reviews focused on intervention efficacy but treatments commonly lacked evidence. One high quality review found MDFT demonstrated promising outcomes. Reviews examining feasibility of interventions were of low methodological quality.
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Affiliation(s)
- Nicole Snowdon
- Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia; National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia.
| | - Julaine Allan
- Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia
| | - Debra Rickwood
- Research and Evaluation, headspace, The National Youth Mental Health Foundation, South Tower, Level 2, 485 La Trobe St, Melbourne VIC 3000, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
| | - Veronica C Boland
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
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Farrell M, Martin NK, Stockings E, Bórquez A, Cepeda JA, Degenhardt L, Ali R, Tran LT, Rehm J, Torrens M, Shoptaw S, McKetin R. Responding to global stimulant use: challenges and opportunities. Lancet 2019; 394:1652-1667. [PMID: 31668409 PMCID: PMC6924572 DOI: 10.1016/s0140-6736(19)32230-5] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 07/31/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
We did a global review to synthesise data on the prevalence, harms, and interventions for stimulant use, focusing specifically on the use of cocaine and amphetamines. Modelling estimated the effect of cocaine and amphetamine use on mortality, suicidality, and blood borne virus incidence. The estimated global prevalence of cocaine use was 0·4% and amphetamine use was 0·7%, with dependence affecting 16% of people who used cocaine and 11% of those who used amphetamine. Stimulant use was associated with elevated mortality, increased incidence of HIV and hepatitis C infection, poor mental health (suicidality, psychosis, depression, and violence), and increased risk of cardiovascular events. No effective pharmacotherapies are available that reduce stimulant use, and the available psychosocial interventions (except for contingency management) had a weak overall effect. Generic approaches can address mental health and blood borne virus infection risk if better tailored to mitigate the harms associated with stimulant use. Substantial and sustained investment is needed to develop more effective interventions to reduce stimulant use.
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Affiliation(s)
- Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia.
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Population Health Sciences, University of Bristol, Bristol, UK
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Annick Bórquez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Javier A Cepeda
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Robert Ali
- Discipline of Pharmacology, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Lucy Thi Tran
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Jürgen Rehm
- Institute Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, IM Sechenov First Moscow State Medical University, Moscow, Russia
| | - Marta Torrens
- Addiction Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Neuropsiquiatria i Addiccions, Barcelona, Spain
| | - Steve Shoptaw
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
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20
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McKetin R, Leung J, Stockings E, Huo Y, Foulds J, Lappin JM, Cumming C, Arunogiri S, Young JT, Sara G, Farrell M, Degenhardt L. Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis. EClinicalMedicine 2019; 16:81-97. [PMID: 31832623 PMCID: PMC6890973 DOI: 10.1016/j.eclinm.2019.09.014] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. METHODS A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. FINDINGS 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3-3.3), violence (OR = 2.2, 95%CI 1.2-4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8-2.4), suicidality OR = 4.4, 95%CI 2.4-8.2; AOR = 1.7, 95%CI 1.0-2.9) and depression (OR = 1.6, 95%CI 1.1-2.2; AOR = 1.3, 95%CI 1.2-1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9-4.8; AOR = 2.4, 95%CI 1.6-3.5), violence (OR = 6.2, 95%CI 3.1-12.3), and suicidality (OR = 2.3, 95%CI 1.8-2.9; AOR = 1.5, 95%CI 1.3-1.8). INTERPRETATION Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Corresponding author.
| | - Janni Leung
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Yan Huo
- Faculty of Health and Behavioural Sciences, The University of Queensland, Australia
| | - James Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Julia M. Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- School of Psychiatry, University of NSW, Sydney, Australia
| | - Craig Cumming
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Jesse T. Young
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Grant Sara
- Northern Clinical School, Sydney Medical School, University of Sydney, Australia
- InforMH, System Information and Analytics Branch, NSW Ministry of Health, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Stockings E, Tran LT, Santo T, Peacock A, Larney S, Santomauro D, Farrell M, Degenhardt L. Mortality among people with regular or problematic use of amphetamines: a systematic review and meta-analysis. Addiction 2019; 114:1738-1750. [PMID: 31180607 PMCID: PMC6732053 DOI: 10.1111/add.14706] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/14/2019] [Accepted: 05/31/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Amphetamines are the second most commonly used class of illicit drugs. We aimed to produce pooled estimates of mortality risks among people with regular or dependent use of amphetamines, with a focus upon all-cause mortality as well as specific causes of death. DESIGN Systematic review and meta-analysis of cohorts of people with problematic use or dependence on amphetamines with data on all-cause or cause-specific mortality. SETTING AND PARTICIPANTS Of 4240 papers, 30 were eligible, reporting on 25 cohorts that measured all-cause mortality, drug poisoning, suicide, accidental injuries, homicide and cardiovascular mortality. Cohorts (n = 35-74 139) were in North America, several Nordic countries and Asia Pacific. MEASUREMENT Titles/abstracts were independently screened by one reviewer and excluded those reviewed by a second reviewer. Full-text screening was by two reviewers with discrepancies resolved via a third reviewer. We extracted data on crude mortality rates (CMR) per 100 person-years (py), standardized mortality ratios (SMRs). We imputed SMRs where possible if not reported by study authors. We also calculated mortality relative risks. Data were pooled using random-effects models; potential reasons for heterogeneity were explored using subgroup analyses and meta-regressions. FINDINGS Twenty-three cohorts contributed data for the pooled all-cause CMR: 1.14 per 100 py [95% confidence interval (CI) = 0.92-1.42]. Pooled cause-specific mortality rates were: drug poisoning, 0.14 per 100 py (95% CI = 0.06-0.34); cardiovascular disease, 0.13 per 100 py (95% CI = 0.06-0.29); suicide, 0.20 per 100 py (95% CI = 0.07-0.55); accidental injury, 0.20 per 100 py (95% CI = 0.08-0.47) and homicide, 0.03 per 100 py (95% CI = 0.02-0.06). There was substantial heterogeneity for all pooled CMR estimates except homicide. The pooled all-cause SMR was 6.83 (95% CI = 5.27-8.84). Pooled cause-specific SMRS were: poisoning, 24.70 (95% CI = 16.67, 36.58); homicide, 11.90 (95% CI = 7.82-18.12); suicide, 12.20 (95% CI = 4.89-30.47); cardiovascular disease, 5.12 (95% CI = 3.74-7.00) and accidental injury, 5.12 (95% CI = 2.88-9.08). CONCLUSIONS People with regular or dependent amphetamine use are at elevated risk of a range of causes of mortality compared with people without regular or dependent amphetamine use.
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Affiliation(s)
- Emily Stockings
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, 2052, Australia
| | - Lucy Thi Tran
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, 2052, Australia
| | - Thomas Santo
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, 2052, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, 2052, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, 2052, Australia
| | - Damian Santomauro
- Queensland Centre for Mental Health Research and School of Public Health, University of Queensland, Locked Bag 500, Archerfield, 4108, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, 2052, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, 2052, Australia
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Metse AP, Stockings E, Bailey J, Regan T, Bartlem K, Wolfenden L, Taylor G, Wiggers J, Bowman J. Rates of retention of persons with a mental health disorder in outpatient smoking cessation and reduction trials, and associated factors: protocol for a systematic review and meta-analysis. BMJ Open 2019; 9:e030646. [PMID: 31488491 PMCID: PMC6731776 DOI: 10.1136/bmjopen-2019-030646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/20/2019] [Accepted: 07/31/2019] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Smoking among persons with a mental health disorder is associated with inequitable health, social and economic burden. Randomised controlled trials (RCTs) are considered the gold standard design for the assessment of healthcare intervention efficacy/effectiveness. However, many RCTs of smoking interventions for persons with a mental health disorder lack rigour due to low participant retention. No systematic review has pooled retention rates in randomised trials of smoking interventions for persons with a mental health disorder or explored associated factors. The aims of the systematic review will therefore be to: (1) summarise overall rates of participant retention in smoking cessation and reduction trials involving persons with a mental health disorder (including for experimental and control groups separately) and (2) determine if retention rates vary according to participant, environmental, researcher and study factors. METHODS AND ANALYSIS PsycINFO, EMBASE, MEDLINE, CENTRAL and The Cochrane Tobacco Addiction Review Group Specialised Register will be searched for reports of RCTs of outpatient smoking cessation or reduction interventions for adults with a mental health disorder. The search terms will include MeSH terms and free text words, and there will be no language or date restrictions. All databases will be searched from inception to present. Data will be analysed using the Mantel-Haenszel fixed-effect model, and where substantial heterogeneity (I2 >50%) is detected, DerSimonian & Laird inverse-variance random effects model. Pooled estimates and 95% CIs will be calculated for overall participant retention rates and for intervention and control trial arms separately. Associations between participant retention and participant, environmental, researcher and study factors will be assessed via subgroup analyses and, where sufficient data are obtained, meta-regression. ETHICS AND DISSEMINATION This study does not require ethical approval. The findings of this review will be disseminated via publication in a peer-reviewed open access medical journal and presentations at international scientific meetings.
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Affiliation(s)
- Alexandra Patricia Metse
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
- Discipline of Psychology, Murdoch University, Murdoch, Western Australia, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Bailey
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Timothy Regan
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kate Bartlem
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Gemma Taylor
- Department of Psychology, University of Bath, Bath, BA2 7AY, United Kingdom
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Jenny Bowman
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
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Gilligan C, Wolfenden L, Foxcroft DR, Williams AJ, Kingsland M, Hodder RK, Stockings E, McFadyen T, Tindall J, Sherker S, Rae J, Wiggers J. Family-based prevention programmes for alcohol use in young people. Cochrane Database Syst Rev 2019; 3:CD012287. [PMID: 30888061 PMCID: PMC6423557 DOI: 10.1002/14651858.cd012287.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alcohol use in young people is a risk factor for a range of short- and long-term harms and is a cause of concern for health services, policy-makers, youth workers, teachers, and parents. OBJECTIVES To assess the effectiveness of universal, selective, and indicated family-based prevention programmes in preventing alcohol use or problem drinking in school-aged children (up to 18 years of age).Specifically, on these outcomes, the review aimed:• to assess the effectiveness of universal family-based prevention programmes for all children up to 18 years ('universal interventions');• to assess the effectiveness of selective family-based prevention programmes for children up to 18 years at elevated risk of alcohol use or problem drinking ('selective interventions'); and• to assess the effectiveness of indicated family-based prevention programmes for children up to 18 years who are currently consuming alcohol, or who have initiated use or regular use ('indicated interventions'). SEARCH METHODS We identified relevant evidence from the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library, MEDLINE (Ovid 1966 to June 2018), Embase (1988 to June 2018), Education Resource Information Center (ERIC; EBSCOhost; 1966 to June 2018), PsycINFO (Ovid 1806 to June 2018), and Google Scholar. We also searched clinical trial registers and handsearched references of topic-related systematic reviews and the included studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster RCTs (C-RCTs) involving the parents of school-aged children who were part of the general population with no known risk factors (universal interventions), were at elevated risk of alcohol use or problem drinking (selective interventions), or were already consuming alcohol (indicated interventions). Psychosocial or educational interventions involving parents with or without involvement of children were compared with no intervention, or with alternate (e.g. child only) interventions, allowing experimental isolation of parent components. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 46 studies (39,822 participants), with 27 classified as universal, 12 as selective, and seven as indicated. We performed meta-analyses according to outcome, including studies reporting on the prevalence, frequency, or volume of alcohol use. The overall quality of evidence was low or very low, and there was high, unexplained heterogeneity.Upon comparing any family intervention to no intervention/standard care, we found no intervention effect on the prevalence (standardised mean difference (SMD) 0.00, 95% confidence interval (CI) -0.08 to 0.08; studies = 12; participants = 7490; I² = 57%; low-quality evidence) or frequency (SMD -0.31, 95% CI -0.83 to 0.21; studies = 8; participants = 1835; I² = 96%; very low-quality evidence) of alcohol use in comparison with no intervention/standard care. The effect of any parent/family interventions on alcohol consumption volume compared with no intervention/standard care was very small (SMD -0.14, 95% CI -0.27 to 0.00; studies = 5; participants = 1825; I² = 42%; low-quality evidence).When comparing parent/family and adolescent interventions versus interventions with young people alone, we found no difference in alcohol use prevalence (SMD -0.39, 95% CI -0.91 to 0.14; studies = 4; participants = 5640; I² = 99%; very low-quality evidence) or frequency (SMD -0.16, 95% CI -0.42 to 0.09; studies = 4; participants = 915; I² = 73%; very low-quality evidence). For this comparison, no trials reporting on the volume of alcohol use could be pooled in meta-analysis.In general, the results remained consistent in separate subgroup analyses of universal, selective, and indicated interventions. No adverse effects were reported. AUTHORS' CONCLUSIONS The results of this review indicate that there are no clear benefits of family-based programmes for alcohol use among young people. Patterns differ slightly across outcomes, but overall, the variation, heterogeneity, and number of analyses performed preclude any conclusions about intervention effects. Additional independent studies are required to strengthen the evidence and clarify the marginal effects observed.
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Affiliation(s)
- Conor Gilligan
- University of Newcastle, Hunter Medical Research InstituteSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - David R Foxcroft
- Oxford Brookes UniversityDepartment of Psychology, Social Work and Public HealthMarston Road, Jack Straws LaneMarstonOxfordEnglandUKOX3 0FL
| | - Amanda J Williams
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Rebecca K Hodder
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Emily Stockings
- University of New South WalesNational Drug and Alcohol Research Centre (NDARC)SydneyAustralia
| | - Tameka‐Rae McFadyen
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Jenny Tindall
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
| | - Shauna Sherker
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Alcohol and Drug FoundationProgram Development and EvaluationLevel 12, 607 Bourke StreetMelbourneVictoriaAustralia3000
| | - Julie Rae
- Alcohol and Drug FoundationProgram Development and EvaluationLevel 12, 607 Bourke StreetMelbourneVictoriaAustralia3000
| | - John Wiggers
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendNSWAustralia2287
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Stockings E, Black N, Bartlem KM, Metse AP, Regan T, Bailey JM, Wolfenden L, Wiggers J, Bowman JA. Outpatient interventions for smoking cessation and reduction for adults with a mental disorder. Hippokratia 2019. [DOI: 10.1002/14651858.cd013286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Emily Stockings
- University of New South Wales; National Drug and Alcohol Research Centre (NDARC); Sydney Australia
| | - Nicola Black
- University of New South Wales; National Drug and Alcohol Research Centre (NDARC); Sydney Australia
| | - Kate M Bartlem
- University of Newcastle; School of Psychology; University Drive Callaghan New South Wales Australia 2308
| | - Alexandra P Metse
- University of Newcastle; School of Psychology; University Drive Callaghan New South Wales Australia 2308
| | - Tim Regan
- Hunter New England Local Health District; Hunter New England Population Health; Locked Bag 10 Wallsend NSW Australia 2287
| | - Jacqueline M Bailey
- University of Newcastle; School of Psychology; University Drive Callaghan New South Wales Australia 2308
| | - Luke Wolfenden
- University of Newcastle; School of Medicine and Public Health; Callaghan NSW Australia 2308
| | - John Wiggers
- Hunter New England Local Health District; Hunter New England Population Health; Locked Bag 10 Wallsend NSW Australia 2287
| | - Jennifer A Bowman
- University of Newcastle; School of Psychology; University Drive Callaghan New South Wales Australia 2308
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Campbell G, Stockings E, Nielsen S. Understanding the evidence for medical cannabis and cannabis-based medicines for the treatment of chronic non-cancer pain. Eur Arch Psychiatry Clin Neurosci 2019; 269:135-144. [PMID: 30635715 DOI: 10.1007/s00406-018-0960-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/21/2018] [Indexed: 12/18/2022]
Abstract
The use of medical cannabis and cannabis-based medicines has received increasing interest in recent years; with a corresponding surge in the number of studies and reviews conducted in the field. Despite this growth in evidence, the findings and conclusions of these studies have been inconsistent. In this paper, we outline the current evidence for medical cannabis and cannabis-based medicines in the treatment and management of chronic non-cancer pain. We discuss limitations of the current evidence, including limitations of randomised control trials in the field, limits on generalisability of previous findings and common issues such as problems with measurements of dose and type of cannabinoids. We discuss future directions for medicinal cannabinoid research, including addressing limitations in trial design; developing frameworks to monitor for use disorder and other unintended outcomes; and considering endpoints other than 30% or 50% reductions in pain severity.
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Affiliation(s)
- Gabrielle Campbell
- National Drug and Alcohol Research Centre (NDARC), Faculty of Medicine, UNSW Sydney, 22-32 King Street, Randwick, NSW, 2031, Australia.
| | - Emily Stockings
- National Drug and Alcohol Research Centre (NDARC), Faculty of Medicine, UNSW Sydney, 22-32 King Street, Randwick, NSW, 2031, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Level 2, 5 Arnold Street, Box Hill, VIC, 3128, Australia
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Brakoulias V, Stockings E. A systematic review of the use of risperidone, paliperidone and aripiprazole as augmenting agents for obsessive-compulsive disorder. Expert Opin Pharmacother 2018; 20:47-53. [PMID: 30360669 DOI: 10.1080/14656566.2018.1540590] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is often viewed as a difficult to treat disorder. In some patients, antipsychotics are used to augment the action of serotonin reuptake inhibitors (SRIs), particularly when there is only a partial response to treatment. AREAS COVERED This comprehensive literature review aims to assess the effectiveness and tolerability of three commonly used atypical antipsychotic agents: risperidone, paliperidone and aripiprazole, as augmentation agents in the treatment of OCD. EXPERT OPINION Antipsychotic augmentation should only be trialed once treatment with selective SRIs at high dose and exposure and response prevention therapy have failed. Currently, there is evidence to support the use of risperidone, paliperidone and aripiprazole as augmentation agents for OCD in adult samples but more studies with larger samples are needed to assess predictors of response to antipsychotic augmentation and to detect any differential effects between the three agents. At this point in time, the choice of antipsychotic is best determined by the side effect profile of the drug and a patient's medication history.
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Affiliation(s)
- Vlasios Brakoulias
- a Department of Psychiatry , The University of Sydney and Nepean Hospital, Sydney Medical School - Nepean, Discipline of Psychiatry , Sydney/Penrith , NSW , Australia.,b UNSW/Usyd Co-Chair for Research Collaboration for Early and Mid-Career Researchers , Sydney , NSW , Australia
| | - Emily Stockings
- b UNSW/Usyd Co-Chair for Research Collaboration for Early and Mid-Career Researchers , Sydney , NSW , Australia.,c National Drug and Alcohol Research Centre , UNSW , Sydney , NSW , Australia
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Stockings E, Bartlem K, Hall A, Hodder R, Gilligan C, Wiggers J, Sherker S, Wolfenden L. Whole-of-community interventions to reduce population-level harms arising from alcohol and other drug use: a systematic review and meta-analysis. Addiction 2018; 113:1984-2018. [PMID: 29806876 DOI: 10.1111/add.14277] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/08/2018] [Accepted: 05/23/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Whole-of-community interventions aim to reduce alcohol and other drug (AOD) use and harms by mobilizing community leaders, organizations and policy-makers to respond effectively to AOD use. The aim of this review is to estimate the effectiveness of whole-of-community interventions in reducing population-level harms arising from AOD use. DESIGN A systematic review of electronic databases CENTRAL, Embase, Medline, Medline in Process and PsycINFO was conducted from database inception to August 2017. Eligible trials had a parallel comparison group, implemented interventions in two or more community settings, and reported data on AOD use or harms. SETTING Intervention settings included schools, sporting clubs, police and law enforcement agencies, community centres, local media and retail premises. PARTICIPANTS Twenty-four trials from 63 publications were included (n = 249 125 participants). MEASUREMENTS Outcomes from AOD consumption (quantity and frequency), AOD-related crime and AOD-related accidents, injuries and hospital admissions. Data were pooled using random-effects inverse variance meta-analysis in Review Manager version 5.3. FINDINGS Risk of bias was mostly high, due to lack of random allocation, selective reporting and significant attrition. Meta-analyses indicated significant reductions in risky drinking [Alcohol Use Disorders Identification Scale (AUDIT) > 8; three trials (7 data points), relative risk (RR) = 0.78, 95% confidence interval (CI) = 0.62-0.99)], but found no impact on past-month alcohol use (five trials, RR = 0.95, 95% CI = 0.89-1.02), binge drinking (five trials, RR = 0.97, 95% CI = 0.89-1.06) or 12-month marijuana use (two trials, RR = 0.98, 95% CI = 0.86-1.11). Narrative synthesis indicated some reductions in AOD-related assault rates and arrests, but were equivocal for quantity of alcohol consumed, 12-month illicit drug use, assault or abuse, motor vehicle accidents and hospital admissions. CONCLUSIONS Interventions to reduce alcohol and other drug use and harms applied to whole communities have resulted so far in small reductions in risky alcohol consumption, but have had little impact upon past month alcohol use, binge drinking or 12-month marijuana use and the studies have been subject to high risk of bias.
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Affiliation(s)
- Emily Stockings
- National Drug and Alcohol Research Centre, UNSW Sydney, Randwick, NSW, Australia
| | - Kate Bartlem
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Psychology, University of Newcastle, Callaghan, NSW, Australia
| | - Alix Hall
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - Rebecca Hodder
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - Conor Gilligan
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - John Wiggers
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
| | - Shauna Sherker
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Alcohol and Drug Foundation, North Melbourne, Victoria, Australia
| | - Luke Wolfenden
- Hunter New England Population Health (HNEPH), Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, Australia
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Jin X, Kinner SA, Hopkins R, Stockings E, Courtney RJ, Shakeshaft A, Petrie D, Dobbins T, Dolan K. Brief intervention on Smoking, Nutrition, Alcohol and Physical (SNAP) inactivity for smoking relapse prevention after release from smoke-free prisons: a study protocol for a multicentre, investigator-blinded, randomised controlled trial. BMJ Open 2018; 8:e021326. [PMID: 30341114 PMCID: PMC6196819 DOI: 10.1136/bmjopen-2017-021326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 05/17/2018] [Accepted: 07/19/2018] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Smoking remains the leading risk factor for disease burden and mortality worldwide. Heavy Smoking is often associated with poor Nutrition, Alcohol abuse and Physical inactivity (known as 'SNAP'). Australia's first prison smoking ban was introduced in the Northern Territory in July 2013. However, relapse to smoking after release from prison is normative. Holistic and cost-effective interventions are needed to maintain post-release abstinence to realise the potential public health impact of smoke-free prison policies. Rigorous, large-scale trials of innovative and scalable interventions are crucial to inform tobacco control policies in correctional settings. METHODS AND ANALYSIS This multicentre, investigator-blinded, randomised parallel superiority trial will evaluate the effectiveness of a brief intervention on SNAP versus usual care in preventing smoking relapse among people released from smoke-free prisons in the Northern Territory, Australia. A maximum of 824 participants will be enrolled and randomly assigned to either SNAP intervention or usual care at a 1:1 ratio at baseline. The primary endpoint is self-reported continuous smoking abstinence three months after release from prison, verified by breath carbon monoxide test. Secondary endpoints include seven-day point prevalence abstinence, time to first cigarette, number of cigarettes smoked post release, Health Eating Index for Australian Adults, Alcohol Use Disorder Identification Test-Consumption and International Physical Activity Questionnaire scores. The primary endpoint will be analysed on an intention-to-treat basis using a simple log binomial regression model with multiple imputation for missing outcome data. A cost-effectiveness analysis of the brief intervention will be conducted subsequently. ETHICS AND DISSEMINATION This study was approved by the University of New South Wales Human Research Ethics Committee (HREC), Menzies HREC and Central Australia HREC. Primary results of the trial and each of the secondary endpoints will be submitted for publication in a peer-review journal. TRIAL REGISTRATION NUMBER ACTRN12617000217303; Pre-results.
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Affiliation(s)
- Xingzhong Jin
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn Hopkins
- Northern Territory Correctional Services, Darwin, Northern Territory, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Dennis Petrie
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Kate Dolan
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
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Charlson FJ, Ferrari AJ, Santomauro DF, Diminic S, Stockings E, Scott JG, McGrath JJ, Whiteford HA. Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophr Bull 2018; 44:1195-1203. [PMID: 29762765 PMCID: PMC6192504 DOI: 10.1093/schbul/sby058] [Citation(s) in RCA: 757] [Impact Index Per Article: 126.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction The global burden of disease (GBD) studies have derived detailed and comparable epidemiological and burden of disease estimates for schizophrenia. We report GBD 2016 estimates of schizophrenia prevalence and burden of disease with disaggregation by age, sex, year, and for all countries. Method We conducted a systematic review to identify studies reporting the prevalence, incidence, remission, and/or excess mortality associated with schizophrenia. Reported estimates which met our inclusion criteria were entered into a Bayesian meta-regression tool used in GBD 2016 to derive prevalence for 20 age groups, 7 super-regions, 21 regions, and 195 countries and territories. Burden of disease estimates were derived for acute and residual states of schizophrenia by multiplying the age-, sex-, year-, and location-specific prevalence by 2 disability weights representative of the disability experienced during these states. Findings The systematic review found a total of 129 individual data sources. The global age-standardized point prevalence of schizophrenia in 2016 was estimated to be 0.28% (95% uncertainty interval [UI]: 0.24-0.31). No sex differences were observed in prevalence. Age-standardized point prevalence rates did not vary widely across countries or regions. Globally, prevalent cases rose from 13.1 (95% UI: 11.6-14.8) million in 1990 to 20.9 (95% UI: 18.5-23.4) million cases in 2016. Schizophrenia contributes 13.4 (95% UI: 9.9-16.7) million years of life lived with disability to burden of disease globally. Conclusion Although schizophrenia is a low prevalence disorder, the burden of disease is substantial. Our modeling suggests that significant population growth and aging has led to a large and increasing disease burden attributable to schizophrenia, particularly for middle income countries.
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Affiliation(s)
- Fiona J Charlson
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Alize J Ferrari
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Damian F Santomauro
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, Wacol, Australia
- Centre for Clinical Research, The University of Queensland, Herston, Australia
- Metro North Mental Health, Royal Brisbane and Women’s Hospital, Herston, Australia
| | - John J McGrath
- Queensland Centre for Mental Health Research, Wacol, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Australia
- National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Harvey A Whiteford
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
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Stockings E, Zagic D, Campbell G, Weier M, Hall WD, Nielsen S, Herkes GK, Farrell M, Degenhardt L. Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence. J Neurol Neurosurg Psychiatry 2018; 89:741-753. [PMID: 29511052 DOI: 10.1136/jnnp-2017-317168] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/12/2017] [Accepted: 12/16/2017] [Indexed: 01/08/2023]
Abstract
UNLABELLED Review evidence for cannabinoids as adjunctive treatments for treatment-resistant epilepsy. Systematic search of Medline, Embase and PsycINFO was conducted in October 2017. Outcomes were: 50%+ seizure reduction, complete seizure freedom; improved quality of life (QoL). Tolerability/safety were assessed by study withdrawals, adverse events (AEs) and serious adverse events (SAEs). Analyses were conducted in Stata V.15.0. 36 studies were identified: 6 randomised controlled trials (RCTs), 30 observational studies. Mean age of participants was 16.1 years (range 0.5-55 years). Cannabidiol (CBD) 20 mg/kg/day was more effective than placebo at reducing seizure frequency by 50%+(relative risk (RR) 1.74, 95% CI 1.24 to 2.43, 2 RCTs, 291 patients, low Grades of Recommendation, Assessment, Development and Evaluation (GRADE) rating). The number needed to treat for one person using CBD to experience 50%+ seizure reduction was 8 (95% CI 6 to 17). CBD was more effective than placebo at achieving complete seizure freedom (RR 6.17, 95% CI 1.50 to 25.32, 3 RCTs, 306 patients, low GRADE rating), and improving QoL (RR 1.73, 95% CI 1.33 to 2.26), however increased risk of AEs (RR 1.24, 95% CI 1.13 to 1.36) and SAEs (RR 2.55, 95% CI 1.48 to 4.38). Pooled across 17 observational studies, 48.5% (95% CI 39.0% to 58.1%) of patients reported 50%+ reductions in seizures; in 14 observational studies 8.5% (95% CI 3.8% to 14.5%) were seizure-free. Twelve observational studies reported improved QoL (55.8%, 95% CI 40.5 to 70.6); 50.6% (95% CI 31.7 to 69.4) AEs and 2.2% (95% CI 0 to 7.9) SAEs. Pharmaceutical-grade CBD as adjuvant treatment in paediatric-onset drug-resistant epilepsy may reduce seizure frequency. Existing RCT evidence is mostly in paediatric samples with rare and severe epilepsy syndromes; RCTs examining other syndromes and cannabinoids are needed. PROSPERO REGISTRATION NUMBER CRD42017055412.
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Affiliation(s)
- Emily Stockings
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Dino Zagic
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Gabrielle Campbell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Megan Weier
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Wayne D Hall
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Queensland, Australia.,National Addiction Centre, Kings College London, London, England
| | - Suzanne Nielsen
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Geoffrey K Herkes
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
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Yoong SL, Stockings E, Wolfenden L. Regulating e‐cigarettes in Australia: implications for tobacco use by young people. Med J Aust 2018. [DOI: 10.5694/mja17.01280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sze Lin Yoong
- University of Newcastle, Newcastle, NSW
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
| | - Luke Wolfenden
- University of Newcastle, Newcastle, NSW
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW
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Yoong SL, Stockings E, Chai LK, Tzelepis F, Wiggers J, Oldmeadow C, Paul C, Peruga A, Kingsland M, Attia J, Wolfenden L. Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta-analysis of country level data. Aust N Z J Public Health 2018. [PMID: 29528527 DOI: 10.1111/1753-6405.12777] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To describe the prevalence and change in prevalence of electronic nicotine delivery systems (ENDS) use in youth by country and combustible smoking status. METHODS Databases and the grey literature were systematically searched to December 2015. Studies describing the prevalence of ENDS use in the general population aged ≤20 years in a defined geographical region were included. Where multiple estimates were available within countries, prevalence estimates of ENDS use were pooled for each country separately. RESULTS Data from 27 publications (36 surveys) from 13 countries were included. The prevalence of ENDS ever use in 2013-2015 among youth were highest in Poland (62.1%; 95%CI: 59.9-64.2%), and lowest in Italy (5.9%; 95%CI: 3.3-9.2%). Among non-smoking youth, the prevalence of ENDS ever use in 2013-2015 varied, ranging from 4.2% (95%CI: 3.8-4.6%) in the US to 14.0% in New Zealand (95%CI: 12.7-15.4%). The prevalence of ENDS ever use among current tobacco smoking youth was the highest in Canada (71.9%, 95%CI: 70.9-72.8%) and lowest in Italy (29.9%, 95%CI: 18.5-42.5%). Between 2008 and 2015, ENDS ever use among youth increased in Poland, Korea, New Zealand and the US; decreased in Italy and Canada; and remained stable in the UK. CONCLUSIONS There is considerable heterogeneity in ENDS use among youth globally across countries and also between current smokers and non-smokers. Implications for public health: Population-level survey data on ENDS use is needed to inform public health policy and messaging globally.
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Affiliation(s)
- Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales
| | - Emily Stockings
- National Drug and Alcohol Research Centre, UNSW Australia, New South Wales
| | - Li Kheng Chai
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Christopher Oldmeadow
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Armando Peruga
- Centro de Epidemiología y Políticas de Salud (Center for Epidemiology and Health Policies), Facultad de Medicina/CAS, Universidad del Desarrollo, Región Metropolitana, Chile
| | - Melanie Kingsland
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - John Attia
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
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Wolfenden L, Stockings E, Yoong SL. Regulating e‐cigarettes in Australia: implications for tobacco use by young people. Med J Aust 2017; 208:89. [DOI: 10.5694/mja17.00787] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 01/11/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Luke Wolfenden
- University of Newcastle, Newcastle, NSW
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
| | - Sze Lin Yoong
- University of Newcastle, Newcastle, NSW
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW
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Whiteford H, Buckingham B, Harris M, Diminic S, Stockings E, Degenhardt L. Estimating the number of adults with severe and persistent mental illness who have complex, multi-agency needs. Aust N Z J Psychiatry 2017; 51:799-809. [PMID: 28718716 DOI: 10.1177/0004867416683814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. METHODS We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. RESULTS Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. CONCLUSION Agreed indicators of complex, multi-agency needs are required to refine these estimates. Closer alignment of information collected about possible service needs across epidemiological surveys is needed.
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Affiliation(s)
- Harvey Whiteford
- 1 School of Public Health, The University of Queensland, Herston, QLD, Australia.,2 Queensland Centre for Mental Health Research, Wacol, QLD, Australia.,3 Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Meredith Harris
- 1 School of Public Health, The University of Queensland, Herston, QLD, Australia.,2 Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Sandra Diminic
- 1 School of Public Health, The University of Queensland, Herston, QLD, Australia.,2 Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Emily Stockings
- 5 National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia
| | - Louisa Degenhardt
- 3 Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.,5 National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia.,6 Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.,7 Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, VIC, Australia
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Chatterton ML, Stockings E, Berk M, Barendregt JJ, Carter R, Mihalopoulos C. Psychosocial therapies for the adjunctive treatment of bipolar disorder in adults: network meta-analysis. Br J Psychiatry 2017; 210:333-341. [PMID: 28209591 DOI: 10.1192/bjp.bp.116.195321] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/30/2016] [Accepted: 11/06/2016] [Indexed: 12/17/2022]
Abstract
BackgroundFew trials have compared psychosocial therapies for people with bipolar affective disorder, and conventional meta-analyses provided limited comparisons between therapies.AimsTo combine evidence for the efficacy of psychosocial interventions used as adjunctive treatment of bipolar disorder in adults, using network meta-analysis (NMA).MethodSystematic review identified studies and NMA was used to pool data on relapse to mania or depression, medication adherence, and symptom scales for mania, depression and Global Assessment of Functioning (GAF).ResultsCarer-focused interventions significantly reduced the risk of depressive or manic relapse. Psychoeducation alone and in combination with cognitive-behavioural therapy (CBT) significantly reduced medication non-adherence. Psychoeducation plus CBT significantly reduced manic symptoms and increased GAF. No intervention was associated with a significant reduction in depression symptom scale scores.ConclusionsOnly interventions for family members affected relapse rates. Psychoeducation plus CBT reduced medication non-adherence, improved mania symptoms and GAF. Novel methods for addressing depressive symptoms are required.
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Affiliation(s)
- Mary Lou Chatterton
- Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Emily Stockings
- Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Michael Berk
- Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Jan J Barendregt
- Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Rob Carter
- Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Cathrine Mihalopoulos
- Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
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Metse AP, Wiggers J, Wye P, Wolfenden L, Freund M, Clancy R, Stockings E, Terry M, Allan J, Colyvas K, Prochaska JJ, Bowman JA. Efficacy of a universal smoking cessation intervention initiated in inpatient psychiatry and continued post-discharge: A randomised controlled trial. Aust N Z J Psychiatry 2017; 51:366-381. [PMID: 28195010 DOI: 10.1177/0004867417692424] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Interventions are required to redress the disproportionate tobacco-related health burden experienced by persons with a mental illness. This study aimed to assess the efficacy of a universal smoking cessation intervention initiated within an acute psychiatric inpatient setting and continued post-discharge in reducing smoking prevalence and increasing quitting behaviours. METHOD A randomised controlled trial was undertaken across four psychiatric inpatient facilities in Australia. Participants ( N = 754) were randomised to receive either usual care ( n = 375) or an intervention comprising a brief motivational interview and self-help material while in hospital, followed by a 4-month pharmacological and psychosocial intervention ( n = 379) upon discharge. Primary outcomes assessed at 6 and 12 months post-discharge were 7-day point prevalence and 1-month prolonged smoking abstinence. A number of secondary smoking-related outcomes were also assessed. Subgroup analyses were conducted based on psychiatric diagnosis, baseline readiness to quit and nicotine dependence. RESULTS Seven-day point prevalence abstinence was higher for intervention participants (15.8%) than controls (9.3%) at 6 months post-discharge (odds ratio = 1.07, p = 0.04), but not at 12 months (13.4% and 10.0%, respectively; odds ratio = 1.03, p = 0.25). Significant intervention effects were not found on measures of prolonged abstinence at either 6 or 12 months post-discharge. Differential intervention effects for the primary outcomes were not detected for any subgroups. At both 6 and 12 months post-discharge, intervention group participants were significantly more likely to smoke fewer cigarettes per day, have reduced cigarette consumption by ⩾50% and to have made at least one quit attempt, relative to controls. CONCLUSIONS Universal smoking cessation treatment initiated in inpatient psychiatry and continued post-discharge was efficacious in increasing 7-day point prevalence smoking cessation rates and related quitting behaviours at 6 months post-discharge, with sustained effects on quitting behaviour at 12 months. Further research is required to identify strategies for achieving longer term smoking cessation.
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Affiliation(s)
- Alexandra P Metse
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia.,2 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - John Wiggers
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia.,2 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,3 Hunter New England Population Health, Wallsend, NSW, Australia
| | - Paula Wye
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia.,2 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,3 Hunter New England Population Health, Wallsend, NSW, Australia
| | - Luke Wolfenden
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia.,2 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,3 Hunter New England Population Health, Wallsend, NSW, Australia
| | - Megan Freund
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia.,2 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Richard Clancy
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia.,2 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,4 Centre for Translational Neuroscience and Mental Health, Calvary Mater Hospital, Waratah, NSW, Australia
| | - Emily Stockings
- 5 National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Margarett Terry
- 6 Mental Health and Substance Use Service, Calvary Mater Hospital, Waratah, NSW, Australia
| | - John Allan
- 7 Mental Health Alcohol and Other Drugs Branch, Queensland Health, Fortitude Valley, QLD, Australia
| | - Kim Colyvas
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia
| | - Judith J Prochaska
- 8 Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA
| | - Jenny A Bowman
- 1 The University of Newcastle, Australia, Callaghan, NSW, Australia.,2 Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Metse AP, Wiggers J, Wye P, Wolfenden L, Freund M, Clancy R, Stockings E, Terry M, Allan J, Colyvas K, Prochaska JJ, Bowman JA. An integrated smoking intervention for mental health patients: a randomised controlled trial. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Metse AP, Wiggers J, Wye P, Wolfenden L, Prochaska JJ, Stockings E, Williams JM, Ansell K, Fehily C, Bowman JA. Smoking and mental illness: a bibliometric analysis of research output over time. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw165.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bailey J, Bartlem K, Wye P, Wiggers J, Stockings E, Metse A, Bowman J. Chronic disease risk behaviour care for people with a mental illness: family carer expectations. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw164.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gilligan C, Wolfenden L, Foxcroft DR, Kingsland M, Williams AJ, Hodder RK, Small T, Sherker S, Rae J, Tindall J, Stockings E, Wiggers J. Family-based prevention programs for alcohol use in young people. Hippokratia 2016. [DOI: 10.1002/14651858.cd012287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Conor Gilligan
- University of Newcastle; School of Medicine and Public Health; Callaghan NSW Australia 2308
| | - Luke Wolfenden
- University of Newcastle; School of Medicine and Public Health; Callaghan NSW Australia 2308
| | - David R Foxcroft
- Oxford Brookes University; Department of Psychology, Social Work and Public Health; Marston Road, Jack Straws Lane Marston Oxford England UK OX3 0FL
| | - Melanie Kingsland
- University of Newcastle; School of Medicine and Public Health; Callaghan NSW Australia 2308
| | - Amanda J Williams
- Hunter New England Local Health District; Hunter New England Population Health; Wallsend NSW Australia 2287
| | - Rebecca K Hodder
- Hunter New England Local Health District; Hunter New England Population Health; Wallsend NSW Australia 2287
| | - Tameka Small
- University of Newcastle; School of Medicine and Public Health; Callaghan NSW Australia 2308
| | - Shauna Sherker
- Alcohol and Drug Foundation; Program Development and Evaluation; Level 12, 607 Bourke Street Melbourne Victoria Australia 3000
| | - Julie Rae
- Alcohol and Drug Foundation; Program Development and Evaluation; Level 12, 607 Bourke Street Melbourne Victoria Australia 3000
| | - Jenny Tindall
- Hunter New England Local Health District; Hunter New England Population Health; Wallsend NSW Australia 2287
| | - Emily Stockings
- UNSW, Australia; National Drug and Alcohol Research Centre (NDARC); 22-32 King Street, Randwick NSW Australia 2031
| | - John Wiggers
- Hunter New England Local Health District; Hunter New England Population Health; Wallsend NSW Australia 2287
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Ferrari AJ, Stockings E, Khoo JP, Erskine HE, Degenhardt L, Vos T, Whiteford HA. The prevalence and burden of bipolar disorder: findings from the Global Burden of Disease Study 2013. Bipolar Disord 2016; 18:440-50. [PMID: 27566286 DOI: 10.1111/bdi.12423] [Citation(s) in RCA: 332] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/06/2016] [Accepted: 07/18/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We present the global burden of bipolar disorder based on findings from the Global Burden of Disease Study 2013 (GBD 2013). METHODS Data on the epidemiology of bipolar disorder were obtained from a systematic literature review and assembled using Bayesian meta-regression modelling to produce prevalence by country, age, sex and year. Years lived with disability (YLDs) were estimated by multiplying prevalence by disability weights quantifying the severity of the health loss associated with bipolar disorder. As there were no years of life lost (YLLs) attributed to bipolar disorder, YLDs equated to disability-adjusted life years (DALYs) as a measure of total burden. RESULTS There were 32.7 million cases of bipolar disorder globally in 1990 and 48.8 million in 2013; equivalent to a 49.1% increase in prevalent cases, all accounted for by population increase and ageing. Bipolar disorder accounted for 9.9 million DALYs in 2013, explaining 0.4% of total DALYs and 1.3% of total YLDs. There were 5.5 million DALYs recorded for female individuals and 4.4 million for male individuals. DALYs were evident from age 10 years, peaked in the 20s, and decreased thereafter. DALYs were relatively constant geographically. CONCLUSIONS Despite being relatively rare, bipolar disorder is a disabling illness due to its early onset, severity and chronicity. Population growth and aging are leading to an increase in the burden of bipolar disorder over time. It is important that resources be directed towards improving the coverage of evidence-based intervention strategies for bipolar disorder and establishing strategies to prevent new cases of the disorder.
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Affiliation(s)
- Alize J Ferrari
- The University of Queensland, School of Public Health, Herston, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, Australia.,University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Emily Stockings
- University of New South Wales, National Drug and Alcohol Research Centre, Sydney, NSW, Australia
| | - Jon-Paul Khoo
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Holly E Erskine
- The University of Queensland, School of Public Health, Herston, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, Australia.,University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Louisa Degenhardt
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA.,University of New South Wales, National Drug and Alcohol Research Centre, Sydney, NSW, Australia.,University of Melbourne, Melbourne School of Population and Global Health, Melbourne, VIC, Australia
| | - Theo Vos
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Harvey A Whiteford
- The University of Queensland, School of Public Health, Herston, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, Australia.,University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
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Metse AP, Wiggers J, Wye P, Moore L, Clancy R, Wolfenden L, Freund M, Van Zeist T, Stockings E, Bowman JA. Smoking and environmental characteristics of smokers with a mental illness, and associations with quitting behaviour and motivation; a cross sectional study. BMC Public Health 2016; 16:332. [PMID: 27080019 PMCID: PMC4832515 DOI: 10.1186/s12889-016-2969-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/18/2016] [Indexed: 11/11/2022] Open
Abstract
Background Persons with a mental illness are less likely to be successful in attempts to quit smoking. A number of smoking and environmental characteristics have been shown to be related to quitting behaviour and motivation of smokers generally, however have been less studied among smokers with a mental illness. This study aimed to report the prevalence of smoking characteristics and a variety of physical and social environmental characteristics of smokers with a mental illness, and explore their association with quitting behaviour and motivation. Methods A cross-sectional descriptive study was undertaken of 754 smokers admitted to four psychiatric inpatient facilities in Australia. Multivariable logistic regression analyses were undertaken to explore the association between smoking and environmental characteristics and recent quitting behaviour and motivation. Results Participants were primarily daily smokers (93 %), consumed >10 cigarettes per day (74 %), and highly nicotine dependent (51 %). A third (32 %) lived in a house in which smoking was permitted, and 44 % lived with other smokers. The majority of participants believed that significant others (68–82 %) and health care providers (80–91 %) would be supportive of their quitting smoking. Reflecting previous research, the smoking characteristics examined were variously associated with quitting behaviour and motivation. Additionally, participants not living with other smokers were more likely to have quit for a longer duration (OR 2.02), and those perceiving their psychiatrist to be supportive of a quit attempt were more likely to have had more quit attempts in the past six months (OR 2.83). Conclusions Modifiable characteristics of the physical and social environment, and of smoking, should be considered in smoking cessation interventions for persons with a mental illness.
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Affiliation(s)
- Alexandra P Metse
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
| | - John Wiggers
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Hunter New England Population Health, Longworth Ave, Wallsend, NSW, 2287, Australia
| | - Paula Wye
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Hunter New England Population Health, Longworth Ave, Wallsend, NSW, 2287, Australia
| | - Lyndell Moore
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Richard Clancy
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Centre for Translational Neuroscience and Mental Health, Corner Edith and Platt Streets, Waratah, NSW, 2298, Australia
| | - Luke Wolfenden
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Hunter New England Population Health, Longworth Ave, Wallsend, NSW, 2287, Australia
| | - Megan Freund
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Tara Van Zeist
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street, Randwick, NSW, 2031, Australia
| | - Jenny A Bowman
- University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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Stockings E, Hall WD, Lynskey M, Morley KI, Reavley N, Strang J, Patton G, Degenhardt L. Prevention, early intervention, harm reduction, and treatment of substance use in young people. Lancet Psychiatry 2016; 3:280-96. [PMID: 26905481 DOI: 10.1016/s2215-0366(16)00002-x] [Citation(s) in RCA: 213] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/22/2015] [Accepted: 12/22/2015] [Indexed: 01/19/2023]
Abstract
We did a systematic review of reviews with evidence on the effectiveness of prevention, early intervention, harm reduction, and treatment of problem use in young people for tobacco, alcohol, and illicit drugs (eg, cannabis, opioids, amphetamines, or cocaine). Taxation, public consumption bans, advertising restrictions, and minimum legal age are effective measures to reduce alcohol and tobacco use, but are not available to target illicit drugs. Interpretation of the available evidence for school-based prevention is affected by methodological issues; interventions that incorporate skills training are more likely to be effective than information provision-which is ineffective. Social norms and brief interventions to reduce substance use in young people do not have strong evidence of effectiveness. Roadside drug testing and interventions to reduce injection-related harms have a moderate-to-large effect, but additional research with young people is needed. Scarce availability of research on interventions for problematic substance use in young people indicates the need to test interventions that are effective with adults in young people. Existing evidence is from high-income countries, with uncertain applicability in other countries and cultures and in subpopulations differing in sex, age, and risk status. Concerted efforts are needed to increase the evidence base on interventions that aim to reduce the high burden of substance use in young people.
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Affiliation(s)
- Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales Australia (UNSW), Sydney, NSW, Australia.
| | - Wayne D Hall
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia; National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michael Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katherine I Morley
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - George Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales Australia (UNSW), Sydney, NSW, Australia
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Harris M, Diminic S, Marshall C, Stockings E, Degenhardt L. Estimating service demand for respite care among informal carers of people with psychological disabilities in Australia. Aust N Z J Public Health 2015; 39:284-92. [PMID: 25715812 DOI: 10.1111/1753-6405.12337] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 05/01/2014] [Accepted: 10/01/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To estimate service demand (willingness to seek or use services) for respite care among informal, primary carers of people with a psychological disability and to describe their characteristics. METHODS Analysis of data from the household component of the 2009 Survey of Disability Ageing and Carers (n=64,213 persons). RESULTS In Australia in 2009, 1.0% of people aged 15 years or over (177,900 persons) provided informal, primary care to a co-resident with a psychological disability. One-quarter (27.2%) of these carers reported service demand for respite care, of whom one-third had used respite services in the past three months and four-fifths had an unmet need for any or more respite care. A significantly greater percentages of carers with service demand for respite care spent 40 or more hours per week on caregiving, provided care to a person with profound activity restrictions and reported unmet support needs, compared to carers without service demand. Lack of suitable, available respite care models was a barrier to utilisation. CONCLUSIONS Findings confirm significant service demand for, and under-utilisation of, respite care among mental health carers. IMPLICATIONS Increased coverage of respite services, more flexible service delivery models matched to carers' needs and better integration with other support services are indicated.
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Affiliation(s)
- Meredith Harris
- School of Public Health, The University of Queensland.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Queensland Health
| | - Sandra Diminic
- School of Public Health, The University of Queensland.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Queensland Health
| | - Caroline Marshall
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Queensland Health
| | - Emily Stockings
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales.,School of Population and Global Health, University of Melbourne, Victoria.,Murdoch Children's Research Institute, Victoria.,Department of Global Health, School of Public Health, University of Washington, US
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Metse AP, Bowman JA, Wye P, Stockings E, Adams M, Clancy R, Terry M, Wolfenden L, Freund M, Allan J, Prochaska JJ, Wiggers J. Evaluating the efficacy of an integrated smoking cessation intervention for mental health patients: study protocol for a randomised controlled trial. Trials 2014; 15:266. [PMID: 24996596 PMCID: PMC4091653 DOI: 10.1186/1745-6215-15-266] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 06/17/2014] [Indexed: 12/17/2022] Open
Abstract
Background Smoking rates, and associated negative health outcomes, are disproportionately high among people with mental illness compared to the general population. Smoke-free policies within mental health hospitals can positively impact on patients’ motivation and self-efficacy to address their smoking. However, without post-discharge support, preadmission smoking behaviours typically resume. This protocol describes a randomised controlled trial that aims to assess the efficacy of linking mental health inpatients to community-based smoking cessation supports upon discharge as a means of reducing smoking prevalence. Methods/Design Eight hundred participants with acute mental illness will be recruited into the randomised controlled trial whilst inpatients at one of four psychiatric inpatient facilities in the state of New South Wales, Australia. After completing a baseline interview, participants will be randomly allocated to receive either: ‘Supported Care’, a multimodal smoking cessation intervention; or ‘Normal Care’, consisting of existing hospital care only. The ‘Supported Care’ intervention will consist of a brief motivational interview and a package of self-help material for abstaining from smoking whilst in hospital, and, following discharge, 16 weeks of motivational telephone-based counselling, 12 weeks of free nicotine replacement therapy, and a referral to the Quitline. Data will be collected at 1, 6 and 12 months post-discharge via computer-assisted telephone interview. The primary outcomes are abstinence from smoking (7-day point prevalence and prolonged cessation), and secondary outcomes comprise daily cigarette consumption, nicotine dependence, quit attempts, and readiness to change smoking behaviour. Discussion If shown to be effective, the study will provide evidence in support of systemic changes in the provision of smoking cessation care to patients following discharge from psychiatric inpatient facilities. Trial registration Australian New Zealand Clinical Trials Registry ANZTCN:
ACTRN12612001042831. Date registered: 28 September 2012.
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Affiliation(s)
- Alexandra P Metse
- University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
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Stockings E, Bowman J, McElwaine K, Baker A, Terry M, Clancy R, Bartlem K, Wye P, Bridge P, Knight J, Wiggers J. Readiness to quit smoking and quit attempts among Australian mental health inpatients. Nicotine Tob Res 2012; 15:942-9. [PMID: 23089486 PMCID: PMC3621580 DOI: 10.1093/ntr/nts206] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Mental health inpatients smoke at higher rates than general population smokers. However, provision of nicotine-dependence treatment in inpatient settings is low, with barriers to the provision of such care including staff views that patients do not want to quit. This paper reports the findings of a survey of mental health inpatients at a psychiatric hospital in New South Wales, Australia, assessing smoking and quitting motivations and behaviors. METHODS Smokers (n = 97) were surveyed within the inpatient setting using a structured survey tool, incorporating the Fagerström Test for Nicotine Dependence, Reasons for Quitting Scale, Readiness and Motivation to Quit Smoking Questionnaire, and other measures of smoking and quitting behavior. RESULTS Approximately 47% of smokers reported having made at least one quit attempt within the past 12 months, despite nearly three quarters (71.2%) being classified as in a "precontemplative" stage of change. Multinomial logistic regressions revealed that self-reporting "not enjoying being a smoker" and having made a quit attempt in the last 12 months predicted having advanced beyond a precontemplative stage of change. A high self-reported desire to quit predicted a quit attempt having been made in the last 12 months. CONCLUSIONS The majority of smokers had made several quit attempts, with a large percentage occurring recently, suggesting that the actual quitting behavior should be considered as an important indication of the "desire to quit." This paper provides further data supporting the assertion that multimodal smoking cessation interventions combining psychosocial and pharmacological support should be provided to psychiatric inpatients who smoke.
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Bonevski B, Bowman J, Richmond R, Bryant J, Wye P, Stockings E, Wilhelm K, Butler T, Indig D, Wodak A. Turning of the tide: changing systems to address smoking for people with a mental illness. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/17523281.2011.555073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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