Policy options for endgame planning in tobacco control: a simulation modelling study.

OBJECTIVE: To investigate the potential impacts of several tobacco control interventions on adult daily smoking prevalence in the Australian state of Queensland, using a system dynamics model codeveloped with local and national stakeholders. METHODS: Eight intervention scenarios were simulated and compared with a reference scenario (business as usual), in which all tobacco control measures currently in place are maintained unchanged until the end of the simulation period (31 December 2037). FINDINGS: Under the business as usual scenario, adult daily smoking prevalence is projected to decline from 11.8% in 2017 to 5.58% in 2037. A sustained 50% increase in antismoking advertising exposure from 2018 reduces projected prevalence in 2037 by 0.80 percentage points. Similar reductions are projected with the introduction of tobacco wholesaler and retailer licensing schemes that either permit or prohibit tobacco sales by alcohol-licensed venues (0.65 and 1.73 percentage points, respectively). Increasing the minimum age of legal supply of tobacco products substantially reduces adolescent initiation, but has minimal impact on smoking prevalence in the adult population over the simulation period. Sustained reductions in antismoking advertising exposure of 50% and 100% from 2018 increase projected adult daily smoking prevalence in 2037 by 0.88 and 1.98 percentage points, respectively. CONCLUSIONS: These results suggest that any prudent approach to endgame planning should seek to build on rather than replace existing tobacco control measures that have proved effective to date. Additional interventions that can promote cessation are expected to be more successful in reducing smoking prevalence than interventions focussing exclusively on preventing initiation.

Does physical activity increase the risk of unsafe sun exposure?

ISSUE ADDRESSED: Recent increases in the prevalence of self-reported participation in physical activity are encouraging and beneficial for health overall. However, the implications for sun safety need to be considered, particularly in Australia, which has the highest incidence of skin cancer in the world. This study investigated the relationship between physical activity and sunburn to determine if there is a need for integration of sun safety in physical activity promotion. METHODS: During the 2009/10 southern hemisphere summer, 7802 adults aged 18 to 74 years participated in a computer-assisted telephone interview survey which included a range of self-reported health measures including physical activity, sunburn, skin type, sun protection behaviour and demographic questions. Multivariate logistic regression modelling was undertaken to estimate the association between physical activity and sunburn. RESULTS: Those who reported doing any level of physical activity were significantly more likely to report having experienced sunburn in the past 12 months and on the last weekend, compared with those who did none, with the strongest association among those who undertook 7 hours or more. Each hour of physical activity was associated with a modest increase in the odds of experiencing sunburn in the previous 12 months (OR 1.02, 95% CI 1.010-1.037) and weekend (OR 1.04, 95% CI: 1.023-1.065), after adjusting for potential confounding variables. CONCLUSIONS: This study highlights the need for sun protection to be given more prominence in physical activity promotion in order to optimise health benefits without increasing the prevalence of sunburn and associated skin cancer risk.