BackgroundWe assessed whether the Australian plain packs with larger graphic health warnings (GHWs) achieved three specific objectives of reducing the appeal of tobacco, increasing health warning effectiveness and reducing the ability of packaging to mislead about smoking harms.MethodsWe compared responses from continuous cross-sectional telephone surveys of n=2176 cigarette smokers during pre-plain packaging (April–September 2012, pre-PP) with n=759 surveyed in the transition period (October–November 2012) and n=4240 during the first year of implementation (December 2012–November 2013, PP year 1), using multivariate logistic regression analyses.ResultsFrom pre-PP to PP year 1, more smokers disliked their pack (p<0.001), perceived lower pack appeal (p<0.001), lower cigarette quality (p<0.001), lower satisfaction (p<0.001) and lower value (p<0.001) and disagreed brands differed in prestige (p=0.003). There was no change in perceived differences in taste of different brands. More smokers noticed GHWs (p<0.001), attributed much motivation to quit to GHWs (p<0.001), avoided specific GHWs when purchasing (p<0.001), and covered packs (p<0.001), with no change in perceived exaggeration of harms. PP year 1 saw an increased proportion believing that brands do not differ in harmfulness (p=0.004), but no change in the belief that variants do not differ in strength or the perceived harmfulness of cigarettes compared with a year ago. Interactions signified greater change for four outcomes assessing aspects of appeal among young adults and two appeal outcomes among mid-aged adults.ConclusionsThe specific objectives of plain packaging were achieved and generally sustained among adult smokers up to 12 months after implementation.

There is emerging research examining alcohol consumption and alcohol-related harms within regional and rural Australia. All studies show that these populations experience disproportionate harm because of alcohol consumption. The causes and mechanism for this have not been investigated, and a program of research is required to understand how and why rural populations experience disproportionate levels of alcohol-related harm and ultimately, what interventions will be most effective in reducing alcohol-related harms.

The data suggest that mandatory interventions based on trading hours restrictions were associated with reduced emergency department injury presentations in high-alcohol hours than voluntary interventions.

Purpose-There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco and illicit drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the United States and Victoria (VIC) in Australia. Participants-TheInternational Youth Development Study (IYDS) recruited representative samples of students from Grade 7 (aged 12 to 13 years) and Grade 9 (aged 14 to 15) in both states. A total of 3,729 students responded to questions about alcohol, tobacco, cannabis, and other illicit substance use (n VIC = 1,852; n WA = 1,877). In each state, males and females were equally represented and ages ranged from 12-15-years.Methods-Data were analyzed to compare lifetime and current (past 30 days) substance use for students located in census areas classified as urban, large or small town, and rural. Findings were adjusted for school clustering and weighted to compare prevalence at median age 14 years.Findings-Rates of lifetime and current alcohol, tobacco and cannabis use were significantly higher in rural compared to urban students in both states (odds ratio for current substance use = 1.31). Conclusions-In both WashingtonState and Victoria, early adolescent rural students use substances more frequently than their urban counterparts. Future studies should examine factors that place rural adolescents at risk for alcohol, tobacco and illicit drug use.

There is no discernible long-term impact on alcohol-related ED attendances of the lockout intervention in Ballarat. As such, other interventions may be more appropriate to reduce alcohol-related ED attendances.