Predictors of successful smoking cessation were examined in a randomized controlled trial of 450 smokers who received an intervention by their general practitioner (GP). Pretreatment characteristics predicting outcome at 3, 6 and 12 months and for continuous abstinence to 12 months were determined using logistic regression analyses. Results showed the variables that significantly predicted abstention at 3 months were age and motivation, whereas the predictors at 6 months were socio-economic status, motivation, level of dependence and time spent with smokers. No single predictor emerged at 12 months. Predictors for continuous abstinence to 12 months were age, time spent with smokers and motivation. A model was developed which best describes the likelihood of patients achieving continuous long-term abstinence. The results show that five factors (high motivation level, older age, less time spent with smokers, low dependence level, and higher socio-economic status) together have a 76% accuracy of predicting continuous abstinence to 12 months.

The police work-force offers an opportunity to screen for a large number of healthy, young and high risk individuals (particularly men) who are hard to reach in other settings and who rarely visit their general practitioner. A sizeable majority (83%) of NSW police had at least one unhealthy life-style behaviour with 19% reporting 3-5 unhealthy factors. The high prevalence of excessive alcohol consumption among police is of particular concern. More active health promotion and provision of brief interventions among police may reduce morbidity and mortality associated with unhealthy life-styles.

No abstract

The over-use of antibiotics, in particular, inappropriate use to treat upper respiratory tract infections (URTIs), is a global public health concern. In an attempt to reduce inappropriate use of antibiotics for URTIs, and, in particular, to modify patient misconceptions about the effectiveness of antibiotics for URTIs, Australia's National Prescribing Service Ltd (NPS) has undertaken a comprehensive, multistrategic programme for health professionals and the community. Targeted strategies for the community, via the NPS common colds community campaign, commenced in 2000 and have been repeated annually during the winter months. Community strategies were closely integrated, using the same tagline, key messages and visual images, and were delivered in numerous settings including general practice, community pharmacy, child-care centres and community groups. Strategies included written information via newsletters and brochures, mass media activity using billboards, television, radio and magazines and small grants to promote local community education. The evaluation used multiple methods and data sources to measure process, impact and outcomes. Consistent with intervention messages, the integrated nationwide prescriber and consumer programme is associated with modest but consistent positive changes in consumer awareness, beliefs, attitudes and behaviour to the appropriate use of antibiotics for URTIs. These positive changes among the community are corroborated by a national decline in total antibiotic prescriptions dispensed in the community (from 23.08 million prescriptions in 1998-99 to 21.44 million in 2001-02) and, specifically, by a decline among the nine antibiotics commonly used for URTI such that by 2003 nationally 216,000 fewer prescriptions for URTI are written each year by general practitioners.

The level of recognition and treatment of osteoporosis is not well characterized in primary care. In data from a large sample of postmenopausal women attending 927 primary care physicians, 29% of women reported one or more fractures after menopause. The great majority (72%) were not on any osteoporosisspecific therapy.Introduction: Osteoporosis is often first recognized at the time of a low-trauma fracture. However, by this stage, the risk of subsequent fractures has already risen substantially. Moreover, in many countries, only a small proportion of women, who have already sustained fractures, receive a treatment shown to reduce this increased risk of further fractures. Materials and Methods:This project was initiated to examine the prevalence of osteoporotic fractures, risk factors for osteoporosis, and use of antifracture therapy among postmenopausal Australian women. More than 88,000 women from 927 primary care physicians returned over 69,358 surveys. Of these, 57,088 reported the presence of a postmenopausal fracture or risk factors. Results: Among these randomly selected postmenopausal women, 29% reported having had one or more low-trauma fractures after menopause (44% substantiated in current records). One-third of these women reported multiple fractures. The prevalence of all types of fractures, except rib and ankle, increased with age and low body weight. Those who reported fractures were also more likely to report early menopause, corticosteroid use, and a family history of osteoporosis. Moreover, those with vertebral fractures were more likely to record height loss, kyphosis, and back pain. Physical inactivity, low calcium intake, and smoking had no consistent relationship with any fracture outcome. Of the women who reported a fracture after menopause, only 28% were on any specific therapy for osteoporosis, and 7% were on calcium alone. Of those who had been told they had osteoporosis by a doctor, 40% were receiving specific osteoporosis therapy. Conclusions:In this large study of postmenopausal Australian women attending primary care physicians, 29% reported at least one low-trauma fracture after menopause. Less than one-third of these women were on specific treatment for osteoporosis, and only 40% were ever told they had osteoporosis. Therefore, osteoporotic fractures are common in postmenopausal Australian women, and few, despite their substantially increased risk of further fractures, are on any specific anti-osteoporotic therapy. These data support the need for more effective education for the community and medical practitioners of the clinical significance of osteoporotic fractures and alternatives for treatment.