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Introduction: The current paper examines the proportion of drinking occasions and total alcohol consumed that takes place at off-premise locations. Comparisons are made between high-income countries: Australia, New Zealand, England and Scotland, and across drinker-types: high-risk and lower-risk., Methods: Data were taken from the International Alcohol Control study in Australia (N = 1789), New Zealand (N = 1979), England (N = 2844) and Scotland (N = 1864). The cross-national survey measures location and beverage-specific alcohol consumption. The number of drinking occasions and mean consumption across on- and off-premise locations and the proportion of drinking occasions that high- and lower-risk drinkers had at on- and off-premise locations was estimated for each country., Results: The majority of drinking occasions among high-risk drinkers occurred at off-premise locations across all four countries; Australia 80.1%, New Zealand 72.0%, England 61.7% and Scotland 60.7%. High-risk drinkers in Australia had significantly larger proportions of drinking occasions occurring at off-premise locations compared to England and Scotland. Across all countries, high-risk drinkers and lower-risk drinkers consumed significantly larger quantities of alcohol per occasion at off-premise locations compared to on-premises locations. Finally, the majority of total alcohol consumed occurred at off-premise locations across all countries for high- and lower-risk drinkers., Discussion and Conclusions: As the accessibility to alcohol outside of licensed premises continues to increase, particularly with the expansion of home delivery services, it is important to be mindful of the high proportion of heavy drinking occasions that occur off-premise., (© 2024 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Aims: The United Kingdom and Australia have developed highly divergent policy responses to electronic nicotine delivery systems (ENDS). To understand the historical origins of these differences, we describe the history of tobacco control in each country and the key roles played in setting ENDS policy in its early stages by public health regulations and policy networks, anti-smoking organizations, 'vaper' activist networks and advocates of harm reduction policies towards injecting drug use., Methods: We analysed key government reports, policy statements from public health bodies and non-government organizations (e.g. cancer councils and medical organizations) on ENDS; submissions to an Australian parliamentary inquiry; media coverage of policy debates in medical journals; and the history of tobacco control policy in Australia and England. Key discourses about ENDS were identified for each country. These were compared across countries during a multi-day face-to-face meeting, where consensus was reached on the key commonalities and divergences in historical approaches to nicotine policy. This paper focuses on England, as different policy responses were apparent in constituent countries of the United Kingdom, and Scotland in particular., Results: Policymakers in Australia and England differ markedly in the priority that they have given to using ENDS to promote smoking cessation or restricting smokers' access to prevent uptake among young people. In understanding the origins of these divergent responses, we identified the following key differences between the two countries' approaches to nicotine regulation: an influential scientific network that favoured nicotine harm reduction in the United Kingdom and the absence of such a network in Australia; the success of different types of health activism both in England and in Europe in opposing more restrictive policies; and the greater influence on policy in England of the field of illicit drug harm reduction., Conclusions: An understanding of the different policy responses to electronic nicotine delivery systems (ENDS) in England and Australia requires an appreciation of how actors within the different policy structures, scientific networks and activist organizations in each country and region have interpreted the evidence and the priority that policymakers have given to the competing goals of preventing adolescent uptake and encouraging smokers to use ENDS to quit smoking., (© 2021 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Aims: This paper presents updated prevalence estimates of awareness, ever-use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing., Design, Setting, Participants and Measurements: A cross-sectional analysis of adult (≥ 18 years) current smokers and ex-smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013-17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country-specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non-daily)., Findings: NVP awareness and use were lowest in NRP countries. Generally, ever- and current use of NVPs were lower in MRP countries (ever-use = 7.1-48.9%; current use = 0.3-3.5%) relative to LRP countries (ever-use = 38.9-66.6%; current use = 5.5-17.2%) and RP countries (ever-use = 10.0-62.4%; current use = 1.4-15.5%). NVP use was highest among high-income countries, followed by upper-middle-income countries, and then by lower-middle-income countries., Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products., (© 2019 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Context: Rather than merely acting professionally, medical students are expected to become professionals. Developing an embodied professional persona is not straightforward as there is no single perspective of what medical professionalism comprises. In the context of this confusion, medical educationalists have been charged with developing a professionalism curriculum that emphasises, supports and measures students' professionalism. This paper focuses on medical students' discourses of medical professionalism in order to understand the means through which students conceptualise professionalism., Methods: Discourse analysis was undertaken. Two hundred students from three medical schools (in England, Australia and Wales) participated in 32 group and 22 individual interviews. Students' explicit definitions of professionalism were inductively coded according to the dimensions of professionalism they identified (n=19) and the discourses of professionalism they used (individual, collective, interpersonal, complexity). Connections were explored between pre-clinical and clinical students' understandings of professionalism across the schools and the respective policies, documents and teaching opportunities available to them., Results: Understandings of professionalism differed between pre-clinical and clinical students and between schools with different approaches to professionalism education. Students who experienced early patient interaction and opportunities to engage in conversations about professionalism within clinician-led small groups demonstrated complex, embodied understandings of professionalism, drawing on all four discourses. Students who learned predominately through lectures used a restricted range of discourses and focused on dressing or acting like a professional., Conclusions: Providing students with opportunities to engage in active sense-making activities within the formal professional curriculum can encourage an embodied and sophisticated understanding of professionalism., (© Blackwell Publishing Ltd 2011.)

Lack of fluency in the language of instruction can form a barrier to medical education. There has been an effort within Australian universities to teach English to students from non-English speaking backgrounds (NESB), but little systematic attention has been given to the teaching of informal or colloquial English. This paper provides evidence that colloquial language is a pervasive and important aspect of doctor-patient communication. It describes a teaching project for NESB medical students which aimed to introduce them to colloquial English, and to provide them with a contextual approach to learning this form of language. Forty-four first year medical students enrolled at the University of Adelaide were required to gather examples of colloquial language by interviewing a native English speaker. Ninety-four examples of colloquial sayings were recorded. These were compiled in the form of a handbook which served as a student resource. Student evaluation of this exercise was positive. The benefits of an interactive method of teaching local and setting-specific language are discussed, and the implications of this approach for clinical teaching and for medical practice are explored.