AOD in the News: The Australian, the Guardian and the Age

$20m bid to butt out smoking

The Australian, Journalist Olivia Caisley

The Morrison government will aim to cut Australia’s smoking rate to under 10 per cent by 2025 as part of a new $20 million strategy to reduce daily smoking among Australians.

Speaking at the National Press Club in Canberra yesterday, Health Minister Greg Hunt said the push would focus on bringing down the rates of daily smoking among indigenous Australians

“In many cases, some of the worst smoking rates in the country are in indigenous Australia, up to 40 per cent,” he said.

“We want to work very closely in targeted programs with indigenous communities to dramatically reduce the rate of youth uptake, and provide for those in the middle of life to support them to stop or bring down their smoking.

“The government wants to bring the rate of those who smoke down from 13.8 per cent to below 10 per cent by 2025, which would see just one in 10 Australians that smoke.

“This is the moment where we have to push further — and the combination of that direct education campaign and work in indigenous Australia … will be a very important campaign, but there’ll be more work to do.”

High on Mr Hunt’s agenda are efforts to boost mental health care.

The broader 10-year health plan will include a dedicated strategy for improving the mental health of Australian children.

Under the push, conditions such as depression, anxiety, bipolar disorder and psychosis will be given greater attention.

“We know that half of all symptoms of mental illness begin before the age of 14, and that neuropsychiatric conditions are the leading cause of disability in young people.

“If untreated, these conditions severely influence how children develop, and how they do at school and in life,” he said.

Mr Hunt also wants to work with the states on creating a more integrated mental health system over the next two years, encouraging each of them to have a dedicated youth mental health unit.

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Greg Hunt says alcohol strategy wasn’t watered down due to industry meddling

The Guardian, journalist Christopher Knaus

The health minister, Greg Hunt, has rejected suggestions Australia’s key strategy to reduce alcohol-related harm was watered down due to industry influence.

The latest version of the national alcohol strategy made several significant changes to a 2017 draft, including deleting a passage prohibiting industry involvement in strategy governance and softening passages on the negative consequences of Australia’s drinking culture.

The changes were made after consultations with industry, among others, and angered the Australian Capital Territory and West Australian governments, who pulled their support for the strategy. Guardian Australia understands the ACT is still refusing to endorse the document.

Earlier this month, the Foundation for Alcohol Research and Education (Fare), a health industry group, alleged industry meddling and influence had prompted the changes.

That allegation has been strongly denied by alcohol industry peak group Alcohol Beverages Australia, which said it was supportive of evidence-based policies to tackle problem drinking.

Hunt also rejected any suggestion of industry meddling on Wednesday, during an address to the National Press Club. He said industry would be inevitably disappointed with some aspects of the strategy and pleased with others.

“No, I wouldn’t accept that proposition at all,” Hunt said. “[Industry are] in agreement with some things. They’re in significant disagreement with other things.

“I think all of the states and territories held a roundtable with those who wanted complete action in some areas. Industry was part of that. That was a public exercise, as it should have been.”

Last week, Alcohol Beverages Australia said it had simply participated in an “open and transparent consultation process” to provide input on the policy.

The group said most Australians consumed alcohol responsibly and that alcohol consumption rates were at 50-year lows.

“ABA’s members support targeted education, awareness and prevention measures, as evidenced by individual member programmes, the support of Drinkwise and other targeted government-led programs.”

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Are all drinkers in a pickle?

The Age, journalist Caroline Zielinksi, August 15th


The occasional tipple may do more damage than you think, writes Caroline Zielinski.

A cheeky red, a buttery chardonnay, an organic G&T … whichever way you drink it, alcohol remains the recreational drug of choice for many Australians.

We’re drinking less than we used to – the lowest levels in more than 50 years, according to the most recent Australian Institute of Health and Welfare National Drug Strategy Household Survey.

In fact, only 6 per cent of nearly 2000 Australians polled by the Foundation for Alcohol Research and Education in 2018 reported that they drank every day. Most said they were ‘‘moderate drinkers’’ (having nine or fewer standard drinks per week); half said they drank one or two drinks in a single session; and one-third said they drank between three and five.

And yet … we do hear a lot about the harm alcohol continues to cause. More harm, overall in Australia, than 22 illicit drugs including heroin and ice, according to another recent study.

So, really, how concerned should we be? Do merely moderate drinkers have any reason to worry about booze? What difference does a pinot or two at the end of the day really make? Come to think of it, isn’t a tipple of red good for you?

How much is too much?

Many countries have guidelines around ‘‘safe-enough’’ drinking levels.

In Australia, the National Health and Medical Research Council recommends that healthy men and women should drink no more than two standard drinks on any day.

What they mean is that two drinks – that’s 20 grams or 25 millilitres of pure ethyl alcohol – will put you at low risk, but not no risk, of developing an alcoholrelated disease and/or being injured over your lifetime.

The guidelines, released in 2009, are being revised and will be released to the public for feedback this year.

What will two drinks a day put you at low risk of, exactly?

First, the bad news. Alcohol is classed as a known human carcinogen by the United Nations International Agency for Research on Cancer; it’s on a long, A-Z list that starts with acetaldehyde, which your liver produces when it breaks down alcohol, and ends with X- and gamma radiation. Drinking alcohol, says the international agency, increases your risk of developing mouth, pharyngeal, laryngeal, oesophageal, colorectal, liver and, for women, breast cancers.

This is backed by an analysis of 527 studies published between 1956 and 2012 and documenting a total of nearly 500,000 cancer cases. The analysis, in the British Journal of Cancer, adds more sad news: there is accumulating evidence that booze is associated with pancreatic and prostate cancers and melanoma.

Drinking alcohol has also been found to contribute to dementia and to escalate learning and cognitive difficulties in people who already have them.

‘‘Alcohol is closely related to around 60 different diagnoses,’’ says the World Health Organisation, ‘‘and for almost all there is a close dose-response relationship, so the more you drink, the higher your risk of disease. Less is better.’’

The analysis of 500,000 cancer cases found that heavy drinkers were five times more likely to develop mouth, throat and oesophagus cancers than non- or occasional drinkers, and twice as likely to develop liver cancer.

But – brace yourself – moderate and even light drinkers were not exempt. Light drinking was associated with cancer of the oral cavity and pharynx, oesophagus and, in women, breast. Colorectal and laryngeal (voice box) cancer came into the picture with moderate drinking, defined as between 12.5 grams and 50 grams a day – so including two-glass-a-day drinkers.

A study of the burden created by alcohol use in 195 countries between 1990 and 2016 reiterates that moderate drinking carries risks. The lead author of the study, Dr Max Griswold, says: ‘‘Based off our study, two standard drinks [as a guideline] is too high. At most, our study would recommend zero to one standard drinks a day, so the same as the Netherlands – with an emphasis on zero.’’

Should women drink less than men?

Yes. ‘‘The current guidelines don’t distinguish between men and women, but my understanding is that women are more sensitive to the long-term effects of alcohol,’’ says Turning Point’s clinical director Dr Matthew Frei.

Studies show women produce smaller quantities of an enzyme called alcohol dehydrogenase, which is released in the liver and breaks down alcohol in the body.

Women also tend to have higher levels of body fat and lower levels of body water than men, which also influences alcohol absorption rates and amount, as fat retains alcohol.

So the rule of thumb that it takes the body about an hour to break down a drink may apply differently to women just as it varies depending on a man’s build and metabolism.

The Australian guidelines say that with heavier drinking, the risk of disease ramps up more quickly for women, while the risk of injury ramps up more quickly for men.

But ‘‘at low levels of alcohol consumption, there is little difference between the risk of alcohol-related harm for men and women, both over a lifetime and on a single drinking occasion’’.

Where’s the good news? Isn’t alcohol good for you in small doses?

Not really. Well, there is evidence small amounts of alcohol can be good for the heart and circulatory system (and even protect against Type 2 diabetes and gallstones).

Some studies show moderate consumption can reduce the risk of heart attack, ischemic (clotcaused) stroke, peripheral vascular disease, sudden cardiac death and death from all cardiovascular causes by 25 to 40 per cent. But even if you could target alcohol to specific organs of the body for specific purposes, the harms to other parts of the body remain clear.

‘‘What many people don’t realise is that alcohol affects virtually every organ system in the body,’’ says Associate Professor Yvonne Bonomo, an addiction medicine specialist and lead researcher for the St Vincent’s Hospital national study. ‘‘It can affect liver function, eventually leading to cirrhosis [scarring of the liver], affect the actual heart muscle and cause heart arrhythmia [irregular heartbeat], increase blood pressure and even increase the chance of brain injury.’’

Seriously, how can an occasional bottle of chardonnay hurt?

It may not, but there are a host of less-talked-about unforseen consequences that come with even occasional drinking.

Most people are not alcoholics – most of the alcohol in Australia is consumed by one-fifth of our population, according to a 2016 report by FARE.

But Sam Biondo, executive officer of the Victorian Alcohol and Drug Association, can count off alcohol-related scenarios involving ‘‘moderate’’ drinkers that end up being life-changing, whether because they are corrosive over time or sudden and traumatic.

‘‘Take women who are pregnant. If they don’t know they’re pregnant, people can find themselves consuming more alcohol than they should, which could lead to complications for the unborn child,’’ Mr Biondo says.

‘‘Then there’s people who are normally quite peaceful and lawabiding who get themselves into king-hit scenarios after bingeing.

‘‘Personal relationships get put under pressure, and then there’s the family violence that occurs.’’

In its pre-budget 2017-18 submission to Treasury, FARE said while 15 Australians die of alcohol-related causes every day, a further 430 are hospitalised because of booze. That’s 430 people who end up in A&E after having a drink. Mr Biondo says it’s not enough to just blame the consumer, and points to ‘‘direct marketing of alcohol across a whole range of mediums to target consumers and make a profit’’.

Recent revelations that the alcohol industry is helping the government form its new national alcohol strategy could be seen as a case in point.

‘At most [we] would recommend zero to one standard drinks a day – with an emphasis on zero.’

Researcher Dr Max Griswold

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