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Introduction: Excessive alcohol use is associated with non-communicable diseases and social problems, such as work absence, financial problems and family violence. Expenditure and expenditure shares on alcohol are valuable measures to monitor financial activities on this risk behaviour. The aim of this paper is to report trends in alcohol expenditure in Australia over the last two decades., Methods: Data are from six waves of Australian Household Expenditure Surveys from 1984 to 2015-2016. We explored trends of alcohol expenditure among Australians and in different socio-demographic groups in the last 30 years. We further examined changes of expenditure on different on- and off-premises beverages over time., Results: Absolute alcohol expenditure has remained the same between the 1980s and 2016, after accounting for inflation. However, a declining trend in relative alcohol expenditure as a proportion of total household expenditure was found across nearly all demographic groups (e.g., sex, age, employment, household income), except for women aged 45-54, who showed an increasing trend of alcohol expenditure after 1998-1999., Discussion and Conclusions: The current study shows declines in relative alcohol expenditure, which may reflect declines in alcohol's relative importance within the elements of the person's lifestyle they need to pay for and/or increased awareness of alcohol's health and social harms. Further longitudinal analysis should explore additional predictors of household expenditure on alcohol. Results suggest that current bi-annual indexation increases in alcohol tax should account for increases in income to ensure the effectiveness of pricing. Moreover, attention is needed to address drinking among middle-aged females., (© 2023 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Five patients, comprising nine treatment courses of sargramostim use in pulmonary alveolar proteinosis, are described. The prevailing standard of treatment, whole lung lavage (WLL), is highly invasive, resource intensive and carries some procedural risk. Nebulised recombinant human GM-CSF (sargramostim) offers a pharmacological treatment option, allowing patients to be treated at home, possessing potential advantages in patient experience and wider health resourcing. The majority of reported patients described subjective improvement in symptoms along with radiographical improvement, although this did not translate into significant improvement in pulmonary function testing. Drug scarcity and high drug cost remain potential barriers to accessing this treatment, and so careful patient selection and treatment outcome assessment remain as challenging needs. Incorporating the routine assessment of validated patient symptom scores with objective physiological measures will allow prediction of response to treatment and help guide management. This report describes the largest published experience of sargramostim use in Australia., (© 2022 British Pharmacological Society.)

Background and Aims: Homelessness is one of the most significant harms associated with gambling and appears to affect older adults disproportionately, but the relationship has received little research attention. This exploratory study investigated how gambling and homelessness is linked in older adults., Methods: Using qualitative research methods, we undertook in-depth semi structured face-to-face individual and group interviews to gather data from a purposive sample (n = 48) of key informants working in service provision for older adults (aged 50+ years) experiencing gambling-related harm and/or homelessness in Victoria, Australia. Thematic analysis of data focused on evaluating mechanisms and identifying contextual conditions that activate pathways between gambling and homelessness., Results: The relationship between gambling and homelessness in older adults is often indirect and non-linear, and can represent a reflexive cycle. Experiencing periods of homelessness into older age can contribute to gambling, often because the adverse impacts of homelessness on older adults' mental and material wellbeing increase the appeal of gambling. Additionally, comorbidities (e.g. substance use, mental illness, past trauma) and structural conditions (e.g. gambling accessibility, poverty, housing insecurity) can activate gambling. Furthermore, because gambling in the older homeless adult population is frequently hidden and regularly overlooked by service providers, it often continues unabated. Gambling in older adults can also contribute to the onset of first-time homelessness. Large and rapid losses from high-intensity gambling frequently characterize this route to homelessness. Such gambling is often triggered by major life events and changes (e.g. bereavement, job loss, relationship difficulties), and the outcomes are often worsened by the conduct of gambling operators and creditors., Conclusions: The link between gambling and homelessness in older adults is complex, with connecting mechanisms often contingent upon individual, interpersonal and structural conditions and contexts. There is potential for preventative and ameliorative action given many of the underlying conditions appear modifiable through policy intervention., (© 2021 Society for the Study of Addiction.)

The gambling industry has grown into a global business in the 21st century. This has created the need for a new emphasis on problem prevention. This article highlights the core themes of the book Setting Limits: Gambling, Science and Public Policy, taking a broad view of the consequences of gambling for society as a burden on health, well-being and equality. The book covers the extent of gambling and gambling-related problems in different societies and presents a critical review of research on industry practices, policy objectives and preventive approaches, including services to people suffering from gambling and its consequences. It discusses the developments in game characteristics and gambling environments and provides evidence on how regulation can affect those. Effective measures to minimize gambling harm exist and many are well supported by scientific evidence. They include restrictions on general availability as well as selective measures to prevent gamblers from overspending. The revenue generated from gambling for the industry, governments, and providers of public services funded from gambling returns presents an obstacle to developing policies to implement harm-reduction measures. A public interest approach must weigh these interests against the suffering and losses of the victims of gambling., (© 2020 Society for the Study of Addiction.)

Introduction and Aims: Gambling research is characterised by widespread gambling industry involvement. It is likely (as with alcohol and tobacco industry influence) that this will delay or divert effective harm prevention or minimisation measures. Gambling harms are known to be significant and widespread. Effective action to reduce these harms requires concomitant efforts to eliminate industry influence., Design and Methods: Gambling industry influence and activity in three research forums is described. The influence of tobacco and alcohol industry involvement in research directions and outcomes is discussed. Aspects of the discursive elements of industry funded and/or directed research outputs are analysed in the context of industry-friendly discourse and its effects. Industry activity and participation at representative research forums is outlined., Results: The examples and background provided demonstrate that specific material and discursive effects of gambling industry involvement can be discerned in the gambling literature. The consequences of this for the gambling evidence base around harm prevention and minimisation are presented., Discussion and Conclusions: Industry influence operates at multiple levels within the gambling research field. There is increasing awareness of this, and of the effects it may have on the development and deployment of effective harm prevention and minimisation efforts. Key reforms are proposed: (i) the elimination of industry participation and sponsorship of gambling research associations and forums; and (ii) the establishment where necessary of new research forums and international scholarly associations., (© 2018 Australasian Professional Society on Alcohol and other Drugs.)

Commercial gambling is expanding rapidly across the globe. However, the field of gambling research has not kept pace with this expansion, and continues to focus on prevalence studies and individuated treatment regimes, with little attention to the political, economic or technological underpinnings of commercial gambling. The implications of this lack of sophistication in the research agenda are that society is ill-equipped to understand the nature and underlying causes of gambling harms, and how these might best be avoided, minimized or ameliorated. Around the world, various levels of government benefit from gambling revenue, with consequences for the independent regulation of gambling. Further, there is considerable industry influence on the research agenda, often involving similar techniques to those employed previously by the tobacco and alcohol industries to engage researchers. This influence is compounded by a failure of many gambling researchers and journals to adopt traditional academic safeguards, such as the disclosure of conflicts of interest, and by many arguing for a 'partnership model' with industry to advance the research agenda. This paper identifies five basic principles to restore reasonable standards of integrity in gambling studies: (1) research should not be funded by the proceeds of gambling; (2) research priorities should not be influenced by the beneficiaries of gambling; (3) conferences and other research fora should not be influenced by industry; (4) funding sources should be disclosed in journals and at conferences; and (5) meaningful access to gambling products and environments must be part of licensing. We also propose a range of actions to promote greater transparency and independence in the gambling research field., (© 2015 Society for the Study of Addiction.)

Introduction and Aims: This study describes levels and predictors of community attitudes towards alcohol, support for structural alterations to the drinking context, and intention to increase participation in community sports clubs., Design and Methods: Cross-sectional data were obtained from the VicHealth Community Attitudes Survey on Healthy Sporting Environments, administered to a random sample of Victorian adults. Descriptive and multivariate logistic regression analysis was undertaken., Results: Very high support for removing alcohol sponsorship of community sport and for a levy on alcohol advertising was found. The groups most supportive of breaking the nexus between alcohol and community sport were female, older-aged and non-English-speaking citizens and those not involved in sport clubs. If alcohol sales at community sports clubs were reduced, participation may increase among population groups currently identified as least engaged with community sport., Discussion and Conclusions: An optimal climate exists for policy reforms to make community sporting environments healthier by reducing the ties with alcohol. If implemented, these reforms may lead to an increase and diversification of participants in community sport., (© 2011 Australasian Professional Society on Alcohol and other Drugs.)

Aim: To illustrate ways in which industry control over the gambling market and its regulatory system have enabled rapid proliferation in gambling consumption and harm., Method: To discuss the relationship between government regulation and the accessibility, marketing and technologies of electronic gambling machines in Australia and New Zealand., Findings: The regulatory framework for gambling in both countries has encouraged highly accessible,regressively distributed and heavily marketed high-impact electronic gambling machines. This framework has developed in large part through the conjunction of government revenue needs and the adaptation of a folk model of gambling appropriated by gambling businesses and engineered to incorporate a discourse that legitimate their gambling businesses., Conclusion: Governments should be encouraged to invest in 'upstream' public health strategies that contain the economic and social drivers for intensifying gambling consumption. One key aspect involves questioning the most suitable scale, location and marketing of gambling operations, and the reliance of government on gambling revenues (whether directly or as substitution for other government expenditure). Technological solutions to disrupt the development of obsessive gambling habits are also available and are likely to reduce gambling-related harm.