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smoking

Indigenous News Update – Health

by Robbo on 25/11/2009

News

  • Aboriginal poverty has gotten worse, the winner of the 2009 Sydney Peace Prize Pilger says http://bit.ly/1VgNky

  • THE serious consequences of long-term cannabis use in indigenous communities are beginning to show http://bit.ly/agFWh

  • Protocols for delivery of social and emotional wellbeing and mental health services in Indigenous communities released http://bit.ly/2bb3OI

  • From 1994 to 2004, Indigenous smoking prevalence fell by 5.5% in remote men – really? http://bit.ly/66wXlr

  • Prevalence of smoking among Australian Aborigines in non-remote regions equivalent to the rest of the Australian popn http://bit.ly/5vzEpU

  • Education about basic hygiene will be the key to reducing otitis media in indigenous population http://bit.ly/8zozJX

The Indigenous News Updates are sourced from news and other articles from around the country that I have posted on Twitter.
Image source: OpenClipArt.org, public domain.

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Tagged as: aboriginal, cannabis, health, Indigenous, otitis media, smoking

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Smoking and Indigenous Australians

by Robbo on 27/04/2009

The smoking rate in Australia is a little over 17%. In 2004 18.6% of males smoked and 16.3% of females. Compare this to the indigenous population. In 2004 half of all indigenous Australians smoked (males 51%, females 49%). While the smoking rate across Australia has dropped it has not changed in our indigenous population.

It’s no surprise that smoking of tobacco is the major cause of the burdens of injury and disease. Smoking accounted for 20% of all indigenous deaths and 12.1% of the total burden of disease and injury.

The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended that nicotine patches be placed on the pharmaceutical benefits scheme for indigenous Australians. This has allowed it to be provided in a 28 day pack on an authority prescription or through the Section 100 supply arrangements of pharmaceuticals to remote area Aboriginal Health Services.

Only one strength of one brand was approved. It was approved even before the company had a 28 day PBS pack available! There is now a regular supply of the PBS quantity nicotine patch.

The following was supplied by Graham Perl, Pharmacy Relations Manager, Johnson & Johnson Pacific. (I don’t usually promote companies or products but as this is the only patch available to assist Indigenous Australians I am making an exception.)

PBS Listing for Nicorette Patch 28’s

Nicorette 15mg/16 hour Patch 28-pack is now available as an Authority PBS listed product for Aboriginal and Torres Strait Islander people and Section 100 for those in regional and remote areas

Nicorette treats tobacco dependence by relieving nicotine craving and withdrawal symptoms, facilitating smoking cessation

PBS Indication:
Nicotine dependence in an Aboriginal or a Torres Strait Islander person

PBS Listing details
- Maximum quantity 28 patches (1 pack) plus 2 repeats (12 weeks treatment)
- Available on Section 100 for remote access
- Pack size of 28 patches (28 days treatment)
- Authority
- Maximum 2 courses of 12 week treatment per year

How is Nicorette Patch used?
- place patch on non-hairy, clean dry skin such as upper thigh, hip, under arm or chest (alternate application site each day)
- apply in the morning, remove at night (after about 16 hours)
- dispose by folding sticky sides together and disposal out of reach of children

Contra-indications
- generalised chronic dermatological disorders (eg: psoriasis, dermatitis, urticaria), non-smokers, children under 12 years of age

Precautions
- stable cardiovascular disease (unstable CV conditions require medical supervision)
- diabetes (blood sugar requires closer monitoring)
- Moderate to severe hepatic impairment and severe renal impairment (potential reduced clearance)
- Uncontrolled hyperthyroidism and phaeochromocytoma

Common adverse reactions
- local skin irritation, headache, indigestion, nausea, vomiting

Smoking and using Nicorette patch
- Continuing to smoke with Patch may increase nicotine-related side effects
- Intermittent forms of Nicorette e.g. gum and Inhaler (not PBS listed) while continuing to smoke (and trying to cut down) has not been shown to increase adverse effects related to nicotine)

Pregnancy / lactation and Nicorette
- Nicotine is harmful to the foetus. Ideally smoking cessation should be achieved without NRT. If not possible, it is preferable to use intermittent (gum/microtab/inhaler) forms of nicotine delivery as they provide a lower daily dose of nicotine. Risk with NRT is lower than that of smoking.
- Lactation – intermittent forms of NRT are preferable. Breastfeeding should occur just before using the product

Smoking relapse and continued craving
- combination therapy with Nicorette Patch plus 2 mg Nicorette gum may be necessary in patients who have relapsed in the past or experience cravings using single therapy. The combination is more effective than either product alone, increasing the patient’s chances of successful quitting. No more than12 x 2mg gum with Patch per day.

Nicorette contains nicotine. Stop smoking aid. Use only as directed.

Note that this is general information only and if you follow only this or believe it without speaking to your healthcare professional you are a bit of a wally.

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Tagged as: aboriginal, cessation, Graham Perl, Indigenous, nicotine patch, smoking

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Indigenous News Update – Health

by Robbo on 27/03/2009

  • Australia’s indigenous population suffers higher infant mortality rate & lower life expectancy than in NZ, Can & US http://bit.ly/1ELZBU

  • 30 percent of births in Halls Creek would be Foetal Alcohol Syndrome disorder (mainly indigenous) – Lateline transcript http://bit.ly/VNBmg

  • LICENSEES in Halls Creek will have to explain why alcohol should not be banned. – about bloody time http://bit.ly/n19D

  • Indigenous Implementation Board has stated that forced liquor bans, alone is doomed to fail. http://bit.ly/1uELa

  • Study of Aboriginal people has found that three times as many smoke as the rate in the wider community. – not surprised http://bit.ly/JzOVM

I read a large amount of information each week on indigenous health and affairs. There is no way I can blog about it all. Many of the links I place on Twitter where I can be found as @BiteTheDust.

I will regularly compile these links and place on the blog under the category of Indigenous News Update.

If you like this post and what else you see on the blog please subscribe by RSS feed (the orange button) or by email. Visit my subscription page.

Tagged as: aboriginal, alcohol, FAS, foetal alcohol syndrome, Halls Creek, Indigenous, infant mortality, life expectancy, population, smoke, smoking

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Cancer and Indigenous Australians – Is It all in the Genes?

by Robbo on 23/12/2008

The Australian Institute of Health and Welfare have recently released a report titled Cancer in Australia: an overview, 2008.

I was a little disappointed that there was only a couple of comments, with no explanation, about the much higher incidences of cancer within our remote indigenous population. This is despite a number of studies being done. One has shown those living in the Kakadu around the Ranger Uranium Mine have a 90% higher incidence of cancer than the rest of the Northern Territory.

One paragraph in the report noted that:

Incidence rates for many types of cancer are considerably lower or higher for the Northern Territory than for other states and territories. These differences are mainly due to low or high incidence of these cancers in Aboriginal and Torres Strait Islander peoples, who comprise 29% of the Northern Territory population (d’Espaignet et al. 1996; Condon et al. 2001).

There was no discussion on why the incidence rates would be so much higher despite several studies looking at this issue.

There was some discussion about lower rates of melanoma of the skin and the indigenous population. This discussion was about a quirk in the state based statistics. The largest number of indigenous people in Australia reside in New South Wales. However they are a still a small percentage of the total population in this highly populated state. A high percentage of the people living in the Northern Territory are indigenous. You would expect those living in the warmer northern parts of Australia to have the highest incidence of melanoma.

The incidences of melanoma per state are:

    Queensland (65.3 cases per 100,000 persons)
    Western Australia (53.0)
    New South Wales (47.8)
    Tasmania (45.5)
    Australian Capital Territory (45.2)
    South Australia (40.0)
    Victoria (37.4)
    Northern Territory (32.5)

We could perhaps expect that the Northern Territory would have a similar rate of skin cancer to Queensland. From the AIHW report:

8.2 Melanoma of the skin
The age-standardised rates for all forms of skin cancer are correlated with exposure to ultraviolet radiation (Jelfs et al. 1994). Therefore one would expect to see higher rates in the more northern states and territories, and lower rates in the more southern ones. However, the rates will also be affected by sun-protection behaviour and the percentage of the Indigenous population (which has a lower rate of skin cancer than the non-Indigenous population).

What about all the other cancers that indigenous people have a much higher incidence of. An article, again by Condon in the Medical Journal of Australia in 2004 (free registration required go to PubMed for abstract) explains why.

The NT Indigenous cancer mortality rate was higher than the total Australian rate for cancers of the liver, lungs, uterus, cervix and thyroid…… Differences between Indigenous and total Australian cancer mortality rates were more pronounced among those aged under 64 years for most cancers. NT Indigenous cancer mortality rates increased over the 24-year period for cancers of the oropharynx, pancreas and lung, all of which are smoking-related cancers. CONCLUSIONS: Cancer is an important and increasing health problem for Indigenous Australians. Cancers that affect Indigenous Australians to a greater extent than other Australians are largely preventable (eg, through smoking cessation, Pap smear programs and hepatitis B vaccination).

As well as cancer affecting our indigenous population earlier, the cancers that affect Indigenous Australians to a greater extent than other Australians are largely preventable (eg, through smoking cessation, Pap smear programs and hepatitis B vaccination).

Our indigenous population has smoking rates of 55% compared to the Australian average of 21% (men) 18%(women). The good news is that some money has been put aside for programs to reduce smoking rates in our indigenous people.

The cost of vaccinations on each states vaccination schedule is covered by the federal government’s Immunise Australia Program. As well as Hepatitis B, the Human papillomavirus vaccine for teenage girls is now covered, hopefully reducing the incidences of cervical cancer.

Ngaanyatjarra health has won an award for its vaccination efforts in the past. However, when a new vaccine is introduced there are no funds provided to assist in a program to vaccinate all members of a remote community.

These higher cancer rates in indigenous Australia I feel highlight our health authorities failure to make funding available to ensure this hard to reach population group, who are often moving about in very remote areas, can be followed up and vaccinated.

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Tagged as: aboriginal, cancer, health, immunisation, Indigenous, melanoma, Remote Blogs, smoking, vaccinations

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