The retail availability of tobacco in Tasmania: evidence for a socio-economic and geographical gradient.

OBJECTIVES: To describe the retail availability of tobacco and to examine the association between tobacco outlet density and area-level remoteness and socio-economic status classification in Tasmania. DESIGN: Ecological cross-sectional study; analysis of tobacco retail outlet data collected by the Department of Health and Human Services (Tasmania) according to area-level (Statistical Areas Level 2) remoteness (defined by the Remoteness Structure of the Australian Statistical Geographical Standard) and socio-economic status (defined by the 2011 Australian Bureau of Statistics Index of Relative Socioeconomic Advantage and Disadvantage). MAIN OUTCOME MEASURE: Tobacco retail outlet density per 1000 residents. RESULTS: On 31 December 2016, there were 1.54 tobacco retail outlets per 1000 persons. The density of outlets was 79% greater in suburbs or towns in outer regional, remote and very remote Tasmania than in inner regional Tasmania (rate ratio [RR], 1.79; 95% confidence Interval [CI], 1.29-2.50; P < 0.001). Suburbs or towns in Tasmania with the greatest socio-economic disadvantage had more than twice the number of tobacco outlets per 1000 people as areas of least disadvantage (RR, 2.30; 95% CI, 1.32-4.21; P = 0.014). CONCLUSIONS: A disproportionate concentration of tobacco retail outlets in regional and remote Tasmania and in areas of lowest socio-economic status is evident. Our findings are consistent with those of analyses in New South Wales and Western Australia. Progressive tobacco retail restrictions have been proposed as the next frontier in tobacco control. However, the intended and unintended consequences of such policies need to be investigated, particularly for socio-economically deprived and rural areas.

An Outbreak of Paralytic Shellfish Poisoning in Tasmania.

Paralytic shellfish poisoning (PSP) is a rare illness caused by eating shellfish containing paralytic shellfish toxins (PST). Toxins are produced during harmful algal blooms, which occur most years on the east coast of Tasmania. Contaminated seafood looks and tastes normal and toxins are not destroyed by cooking or freezing. Commercial shellfish farms are monitored for harmful algae and shellfish toxins, but wild shellfish are not and pose a potential public health risk. A case of PSP was documented in Tasmania in 2011, and we are aware of anecdotal reports of cases in the 1980s and 1990s. We are not aware of cases elsewhere in Australia but harmful algal blooms have been detected in Victoria, South Australia and New South Wales. Routine monitoring of commercial shellfish in 2015 detected a large bloom of Alexandrium tamarense on the east coast of Tasmania, which can cause PSP. Between 2 and 12 October 2015, four cases of PSP were identified. All were adults who ate wild mussels from the east coast of Tasmania and had onset of numbness or tingling of the face and muscle weakness from 30 minutes to 12 hours later. Two cases were briefly hospitalised, both recovered. Since the outbreak, permanent signage at locations where shellfish are frequently recreationally foraged has been erected. Additional alerts are released during high risk periods based on surveillance of commercial sites by the Tasmanian Shellfish Quality Assurance Program. Several states in Australia are at risk of cases of PSP. We recommend active surveillance and multi-jurisdictional collaboration to manage this risk.