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SUMMARY Tobacco control is a health promotion priority, but there is limited evidence on the effectiveness of campaigns targeting culturally and linguistically diverse (CALD) populations. Being the largest population of non-Englishspeaking smokers residing in New South Wales (NSW), Australia, Arabic-speakers are a priority population for tobacco control. We report findings from baseline and post-intervention cross-sectional telephone surveys evaluating a comprehensive social marketing campaign (SMC) specifically targeting Arabic-speakers residing in south west Sydney, NSW. The project was associated with a decline in self-reported smoking prevalence from 26% at baseline to 20.7% at post (p , 0.05) and an increase in self-reported smoke-free households from 67.1% at baseline to 74.9% at post (p , 0.05). This paper contributes evidence that comprehensive SMCs targeting CALD populations can reduce smoking prevalence and influence smoking norms in CALD populations.

This study assessed the impact of an outdoor gym installation on park users' physical activity levels and examined the characteristics of outdoor gym users. A before-after time series design was employed, consisting of nine data collection periods: three each at baseline, post outdoor gym installation, and at 12-month follow-up. Repeated observational surveys and park intercept interviews were conducted. There was a small but significant increase in senior park users engaging in moderate to vigorous physical activity at follow-up (1.6 to 5.1%; p

Issues addressed: Nicotine replacement therapies are effective, but are mostly under-utilised and often not used for an appropriate duration. The paper reports on a pilot project that used subsidies for NRT as a means to engage community pharmacists to deliver tobacco cessation to the Arabic-speaking community. Method: Arabic-speaking community pharmacists were recruited through direct mail-outs and trained in tobacco cessation brief intervention. Fifteen selected pharmacies recruited Arabic smokers through their pharmacies. Pharmacy follow up was conducted three months after the program was implemented. Results: A total of 65 participants attended the seminar. A total of 31 pharmacy customers received at least one packet of subsidised NRT patches. Twenty (64.5%) clients received both the first and second subsidised pack. Fifteen clients continued to use patches after the third packet, however only three clients continued the patches to the eighth pack. Conclusion: The pilot was successful in improving recruitment of pharmacies into training for smoking cessation counselling as well as engaging community pharmacists to deliver tobacco cessation intervention with small incentive. (author abstract)

Objective: To ascertain cervical screening rates among Vietnamese women attending Vietnamese-speaking general practitioners (GPs) in Sydney, their recall of opportunistic recruitment by these GPs and their preferences for strategies to encourage screening. Method: Women born in Vietnam aged 18–69 years were recruited through the waiting room of their GP and completed questionnaires in either Vietnamese or Chinese before and after their consultation. Results: Of 355 women seen during the survey period, 170 were ineligible. Of those eligible, 118 women (64% response rate) completed waiting room questionnaires. Of 86 women ‘at risk’, 56 (65%) reported having a cervical smear within two years or due on that day; 26 (86%) of those 30 women overdue for screening reported visiting a GP at least twice in the past six months. After adjustment for age and education, women who were more acculturated or had resided in Australia for the most years remained significantly more likely to be screened (p=0.027 and p=0.037 respectively). In the follow-up questionnaire, returned by 49 women (52%) who agreed to receive it, recall of opportunistic advice from the GP was low. Female GPs, free screening and more information in Vietnamese were the three most popular recruitment strategies. Conclusion: Study confirms low participation rates in cervical screening by Vietnamese women using self-report. Recent immigrants and the least acculturated are least likely to be screened. Implications: A community-based strategy involving Vietnamese-speaking GPs shows promise, inviting behavioural evaluation.

Issue addressed: The Arabic-speaking population is a priority for tobacco control in Sydney's southwest. Current smoking prevalence and smokers' preferences for evidence-based cessation therapies are reported for this population. Methods: A telephone survey of Arabic speakers conducted in Sydney's southwest between August and November 2004 included: utilisation of tobacco products, tobacco and health knowledge, quit attempts and likelihood to use evidence-based cessation strategies. Results: A 70% response rate was achieved (n=1,102). Twenty six per cent of respondents (95% CI 23.5-28.7) self-reported being current smokers. Logistic regression analysis demonstrated that poor knowledge of the harms of smoking (AOR=7.50, 95% CI 3.20-17.59), being male (AOR=2.63, 95% CI 1.89-3.65), being aged between 40 and 59 (AOR=1.44, 95% CI 1.06-1.96) and non-tertiary educated (AOR=1.44, 95% CI 1.06-1.97) were independent predictors of self-reported smoking. Smokers' preferences for evidence-based cessation strategies included: vouchers for discounted nicotine replacement therapy (NRT) (58.8%, 95% CI 52.9-64.6), standard self-help booklet (56.6%, 95% CI 50.7-62.4) and tailored self-help written materials (mailed) (54.0%, 95% CI 48.1- 59.9). More than one third of all current cigarette smokers (39.4%, n=108, 95% CI 33.6-45.2) indicated they had made a quit attempt in the past 12 months. Conclusion: Well designed trials of efficacy for preferred evidence-based strategies, particularly among middle-aged male Arabic-speaking smokers, appear warranted prior to policy development and implementation. (author abstract)

The aim of this study was to inform the design of a culturally appropriate health communication campaign addressing exposure of young children to Environmental Tobacco Smoke (ETS) in homes and cars, targeted at caregivers of children aged 0-6 years in the Arabic and Vietnamese-speaking communities in Sydney, Australia.Nine focus groups (five Arabic and four Vietnamese) were conducted by qualified bilingual facilitators, recorded, transcribed, then translated and analysed qualitatively.Results revealed concerning levels of knowledge, attitudes and behaviours regarding children's exposure to ETS. A poor understanding existed regarding what constituted passive smoking and the severity and extent of harm that ETS has on children. Smoking attitudes and behaviours described were not always consistent with the concern expressed about children's vulnerability to smoke. Initial changes in smoking patterns at home since the arrival of children were not always sustained. Despite awareness of the harm caused by smoking in the presence of their children, some caregivers continued to smoke in closed environments. Others felt it was sufficient protection to smoke in another room, with doors and/or windows open or by ensuring that visible smoke did not reach the child directly, whilst some smoked in the home or car only when children were not present. Smoking attitudes and behaviours in the presence of children were influenced by cultural and social norms associated with smoking. The desire to be sociable and hospitable often superseded concerns for children's health.The findings suggest that an effective communication campaign focusing on ETS and children in the Arabic and Vietnamese-speaking communities in Sydney should attempt to address knowledge deficits regarding ETS, as well as tackling entrenched culturally related attitudes and behaviours associated with smoking which are strongly linked to sociability and hospitality.

Objective. To evaluate the compliance of hospital staff, inpatients and visitors with Sydney South West Area Health Service’s Smoke-free Environment Policy. Methods. Six sites were observed at two Sydney hospitals 2 weeks before implementation of the policy and at 2 weeks, 6 months, 12 months, 18 months and 2 years after implementation. Results. There was an overall significant 36% (P ≤ 0.05) reduction in observed smoking incidents on hospital grounds 2 years after implementation. Two years after implementation, observed smoking incidents reduced by 44% (P ≤ 0.05) in staff, 37% (P ≤ 0.05) in visitors and remained unchanged among inpatients. Conclusions and implications. The Smoke-free Environment Policy was effective in reducing visitors and staff observed smoking on hospital grounds, but had little effect on inpatients’ smoking. Identifying strategies to effectively manage nicotine addiction and promote cessation amongst hospital inpatients remains a key priority. What is known about the topic? Smoke-free environment policies have been developed and introduced worldwide. These policies reduce tobacco use and protect the community from environmental tobacco smoke. What does this paper add? This paper focusses on a method used to monitor compliance of a smoke-free environment policy in a healthcare setting. The paper tracks what happened over 2 years before and after the policy was implemented. Among staff, there was evidence of compliance with the policy; however, there was no apparent change in policy compliance amongst inpatients. What are the implications for practitioners? Policy makers and staff implementing smoke-free policies should ensure adequate support for staff and inpatients are available, with continued promotion and enforcement of the policy. Further investigations are needed into multi-strategic cessation interventions for inpatients who smoke.