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In this article, the authors discuss the challenges for the policy and intervention on volatile substance misuse (VSM) in Australia. They describe five matters that require continuing consideration and development including the need for a systematic evaluations of treatments for VSM, efficient integration of policies with welfare services, and provision of a site for harm reduction. Also investigated is the interventions for petrol sniffing in the country's indigenous communities.

Recent growing concern in Australia and elsewhere about harm associated with volatile substance misuse (VSM) in both urban and remote settings has prompted an openness to new policies, laws and programs for prevention and treatment. One measure under consideration is product modification of volatile substances (VSPM). This article reviews international literature documenting instances of three kinds of product modification: (1) replacement of particularly harmful or psychoactive components; (2) addition of deterrent chemicals; and (3) package modification. Although VSPM has received considerable attention, few initiatives have been implemented and, of these, even fewer evaluated. Where VSPM has occurred, success in reducing misuse of specific products appears to have occurred in relation to type (1) modifications, many of which have been driven by environmental rather than health concerns. The ready availability of a wide range of VSM products in most urban settings means that even where interventions reduce misuse of targeted substances, other substances are likely to be substituted. We conclude that any VSPM should target substances most strongly associated with harm and be supported by an appropriate range of other strategies. [ABSTRACT FROM AUTHOR]

This paper examines the policy response of Australian governments to petrol sniffing in Indigenous communities from the 1980s until the present. During this period, despite the formation of numerous inquiries, working parties and intergovernmental committees, there has been little accumulation of knowledge about the nature and causes of sniffing, or about the effectiveness of interventions. Policies are fragmentary; programmes are rarely evaluated, and most rely on short-term funding. The paper sets out to explain why this should be so. It draws upon a conceptual framework known as 'analytics of government' to examine the ways in which petrol sniffing comes to the attention of government agencies and is perceived as an issue; the mechanisms deployed by governments to address petrol sniffing; ways in which knowledge about sniffing is generated; and the underlying assumptions about people that inform policy-making. Drawing upon case studies of policy responses, the paper argues that a number of structural factors combine to marginalize petrol sniffing as an issue, and to encourage reliance on short-term, one-off interventions in place of a sustained policy commitment. Four recommendations are advanced to help overcome these factors: (1) agreements should be reached within and between levels of government on steps to be taken to reduce risk factors before the eruption of petrol-sniffing crises; (2) the evidence base relevant to petrol sniffing (and other inhalants) should be improved by funding and directing one or more existing national drug research centres to collate data on inhalant-caused mortality and morbidity, and to conduct or commission research into prevalence patterns, effectiveness of interventions and other gaps in knowledge; (3) the current pattern of short-term, pilot and project funding should be replaced with longer-term, evidence-based interventions that address the multiple risk and protective factors present in communities; and (4) insistence by governments that communities must take 'ownership' of the problem should be replaced by a commitment to genuine partnerships involving governments, non-government and community sectors. [d'Abbs P, Brady M. Other people, other drugs: the policy response to petrol sniffing among Indigenous Australians. Drug Alcohol Rev 2004;23:253-260] [ABSTRACT FROM AUTHOR]

Petrol sniffing (and other forms of inhalant misuse) occur within some Aboriginal communities across Australia. However, there is little documented information about the nature and combination of interventions that are most effective in addressing it. This article reviews published and unpublished literature relevant to petrol sniffing in Australian Aboriginal communities. A range of strategies which have been trialled previously are discussed under the categories of primary, secondary and tertiary intervention.We have adopted Zinberg's schema of 'drug', 'set' and 'setting' in theorizing the mix of interventions most likely to reduce petrol sniffing. We argue that interventions should address as many as possible of these factors. Further, while no strategy is likely to succeed without strong support from local community members, governments also have an important role in addressing petrol sniffing. Consistent funding for strategies directly addressing petrol sniffing and co-ordinated government responses to the broader needs of Aboriginal young people and their communities are critical. [ABSTRACT FROM AUTHOR]

Issues addressed: Little research has been conducted on the impact of Aboriginal and Torres Strait Islander brief intervention training programs on health staff participants' own health behaviours. Through the Queensland B.strong program (2017‐2020), brief intervention training in smoking cessation, nutrition and physical activity was provided to the Aboriginal and Torres Strait Islander health workforce and other health and community professionals. This study examined the program's impact on participants' own health behaviours. Methods: Data were collected through four surveys (pre‐ and post‐training workshop, and 3‐month and 6‐month follow‐up) of the 1131 participants in B.strong training workshops from June 2017 to August 2019. Surveys included items on participants' own health behaviours. Pre‐ and post‐workshop surveys were paper‐based, and follow‐up surveys were completed online. For the analysis of data reported in this paper, paired‐samples t tests were used to assess changes between pre‐workshop and 3‐month follow‐up. Results: Statistically significant improvements were found between pre‐workshop and 3‐month follow‐up in the number of serves of vegetables or legumes/beans eaten per day, the number of serves of fruit eaten per day, and in time spent in physical activity. However, there was: no statistically significant change in smoking status, with baseline rates being relatively low; a statistically significant increase in consumption of sugary drinks, and of takeaway foods; a nonsignificant increase in consumption of snack foods; and no significant change in sedentary behaviour of participants. Conclusion: While some positive changes in participants' own health behaviours in nutrition and physical activity were associated with the B.strong program, there was no change in their smoking behaviour. So what?: This study found that some improvements in participants' own health behaviours were associated with the B.strong program. This research may inform future Indigenous brief intervention training programs and health services on how to promote healthy behaviours for health staff themselves. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the potential for reducing the harm resulting from tobacco use through health promotion programmes run in community stores in remote Aboriginal communities. The Tobacco Project utilised data from 111 stakeholder interviews (72 at baseline and 71 at follow-up after 12 months) assessing presence of sales to minors, tobacco advertising, labelling and pricing. It also involved the assessment of observational data from community stores and comments obtained from 29 tobacco vendors derived from community surveys. Sales of tobacco to minors were not reported in community stores and all stores complied with requirements to display the legislated signage. However, tobacco was accessible to minors through a vending machine and through independent vendors. Only one store displayed tobacco advertising; all stores had displayed anti-tobacco health promotion posters or pamphlets. Pricing policies in two stores may have meant that food items effectively subsidised the cost of tobacco. All stores had unofficial no-smoking policies in accessible parts of the store. Remote community stores complied with existing legislation, aside from allowing access of minors to vending machines. There may still be potential for proactive tobacco education campaigns run through community stores and for a trial assessing the effect of changes in tobacco prices on tobacco consumption. [Ivers RG, Castro A, Parfitt D, Bailie RS, Richmond RL, d'Abbs PH. The role of remote community stores in reducing the harm resulting from tobacco to Aboriginal people . Drug Alcohol Rev 2006;25:195 – 199] [ABSTRACT FROM AUTHOR]

Background: Interventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK. However, there are few studies of the extent to which the impact of such interventions has been sustained, or of the impact of such interventions in disadvantaged populations or remote settings. This paper describes the trends in delivery of preventive medical services following a multifaceted intervention in remote community health centres in the Northern Territory of Australia. Methods: The intervention comprised the development and dissemination of best practice guidelines supported by an electronic client register, recall and reminder systems and associated staff training, and audit and feedback. Clinical records in seven community health centres were audited at regular intervals against best practice guidelines over a period of three years, with feedback of audit findings to health centre staff and management. Results: Levels of service delivery varied between services and between communities. There was an initial improvement in service levels for most services following the intervention, but improvements were in general not fully sustained over the three year period. Conclusions: Improvements in service delivery are consistent with the international experience, although baseline and follow-up levels are in many cases higher than reported for comparable studies in North America and the UK. Sustainability of improvements may be achieved by institutionalisation of relevant work practices and enhanced health centre capacity. [ABSTRACT FROM AUTHOR]