Feasibility of a Consumer Centred Tobacco Management intervention in Community Mental Health Services in Australia.

This study tested a new program for helping smokers with severe mental illness to reduce their tobacco use, together with determining the feasibility of such research in community mental health settings in Australia. Five Neami National sites trialled a Consumer Centred Tobacco Management program called Kick the Habit (n = 34). The intervention included two weeks of free Nicotine Replacement Therapy (patches only) but participants also used a variety of self-funded delivery types in addition or as an alternative to the subsidised nicotine patch. At the 3-month follow-up, Kick the Habit participants had reduced their number of daily cigarettes, dependency levels and average weekly expenditure on tobacco. Although a larger study is required, Kick the Habit represents a promising intervention for tobacco management in community mental health services. The challenges and lessons learnt for scaling up to a larger trial and integration into business-as-usual practice across multiple sites are discussed.

Active8: Promoting health beyond the absence of mental illness.

OBJECTIVE: We sought to understand and develop the critical elements of a program designed to promote physical health for people living with or experiencing mental illness. DESIGN: The study used a most significant change approach. Participants provided personal accounts of change, and these were analysed in a workshop with a range of stakeholders involved in program design and delivery. Core themes were identified to inform the development of the program. SETTING: The program is delivered by a community managed organisation in the South Eastern Illawarra region of New South Wales and the study took place in this setting. PARTICIPANTS: Participants included people who had accessed the Active8 program, staff who delivered the program, referrers and the funder of the program. MAIN OUTCOME MEASURES: Participants were invited to share stories of how the Active8 program had impacted them or the people they were supporting. RESULTS: Five key themes were identified as being critical to program success and development: (a) the right start at the right time; (b) a program that fits me; (c) health literacy leads to agency, action and change; (d) a chance to explore and establish healthy connections; and (e) change requires time, focus and ongoing support. CONCLUSION: Approaches that steer away from simple advice giving and towards empowering and motivating people in line with their individual needs, aspirations and social context show potential for enhancing health-behaviour change.

COVID-19 vaccine acceptability among people in Australia who inject drugs: Implications for vaccine rollout.

INTRODUCTION: Vaccine acceptability is a key determinant of vaccination uptake. Despite being at risk of adverse outcomes from coronavirus-19 disease (COVID-19), COVID-19 vaccine acceptability among people who inject drugs is unknown. We surveyed people who inject drugs in Melbourne, Australia to assess potential uptake of COVID-19 vaccines prior to distribution. METHODS: Cross-sectional study, comprising interviewer-administered structured telephone interviews completed from 30 November to 22 December 2020 in Melbourne, Australia. Participants were people aged 18 years or older who injected drugs at least monthly in the past 6 months and had resided in Melbourne in the past 12 months recruited via needle-syringe programs and word-of-mouth. MEASUREMENTS: COVID-19 hypothetical vaccine acceptability, participants' demographic, drug use and drug treatment characteristics. RESULTS: Fifty-eight percent (57/99) of the sample reported that they would definitely or probably be vaccinated for COVID-19, with the remainder indicating that they would not (22%) or were undecided (20%). Among those who indicated that they would definitely or probably not be vaccinated or were undecided (n = 42), safety concerns were most often cited as a reason for not wanting to be vaccinated. DISCUSSION AND CONCLUSIONS: Although a majority of sampled people who inject drugs indicated that they would definitely or probably be vaccinated, efforts to reduce hesitancy and allay COVID-19 vaccine safety concerns will be necessary to optimise vaccine uptake among this population.

A prospective cohort of people who use methamphetamine in Melbourne and non-metropolitan Victoria, Australia: Baseline characteristics and correlates of methamphetamine dependence.

INTRODUCTION AND AIMS: Limited research has investigated methamphetamine use and related harms in rural and regional Australia. We investigated whether people who used methamphetamine in non-metropolitan Victoria differed in their sociodemographics and were more likely to be methamphetamine-dependent than those recruited in Melbourne. DESIGN AND METHODS: We used baseline data from an ongoing prospective cohort study, 'VMAX'. Participants were recruited from Melbourne and three non-metropolitan Victorian regions. Sequential multivariable logistic regression of nested models assessed unadjusted and adjusted associations between residential locations and methamphetamine dependence. RESULTS: The sample mostly (77%) comprised people who used methamphetamine via non-injecting means (N = 744). Thirty-nine percent were female. Melbourne-based participants were less likely than non-metropolitan participants to identify as Aboriginal and Torres Strait Islander, be heterosexual, have children and be unemployed. More frequent methamphetamine use (adjusted odds ratio 1.22, 95% confidence interval 1.12-1.34) and using crystal methamphetamine versus 'speed' powder (adjusted odds ratio 2.38, 95% confidence interval 1.26-3.64) were independently (P < 0.05) associated with being classified as methamphetamine-dependent. A significantly higher percentage of participants in every non-metropolitan region were classified as methamphetamine-dependent vs. those in Melbourne, but this relationship was attenuated when adjusting for methamphetamine use frequency and primary form used. Despite 65% of participants being classified as methamphetamine-dependent, less than half had recently (past year) accessed any professional support for methamphetamine, with minimal variation by recruitment location. DISCUSSIONS AND CONCLUSIONS: VMAX participants in non-metropolitan Victoria were more likely to be methamphetamine-dependent than those living in Melbourne. Unmet need for professional support appears to exist among people using methamphetamine across the state, regardless of geographical location.