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Background: The aim of this study was to examine young people's support for e-cigarette policies in two countries with very different e-cigarette regulatory environments - Australia and the UK., Methods: An online survey was administered to 1,185 15-24 year olds (590 from Australia, 595 from the UK). Survey items assessed demographics, use of vaping and tobacco products, exposure to others' vaping behaviours, exposure to e-cigarette advertising, perceptions of harms associated with e-cigarettes, and support for 14 e-cigarette policies. Frequencies for support were calculated for each policy by country and overall, and a mixed effects negative binomial regression was performed to identify factors associated with support., Results: Majority support was expressed for 10 of the 14 policies in the Australian sample and six in the UK sample. Significantly higher levels support were found among Australian respondents compared to UK respondents for all policies except one where the difference failed to reach statistical significance. Support was strongest for policies relating to preventing access by minors, including warnings on packages, and prohibiting misleading advertising. Support was weakest for policies restricting access to e-cigarettes and flavours. Factors associated with higher levels of support were harm perceptions, never having used e-cigarettes, and older age., Conclusions: The results suggest general support for a broad range of e-cigarette control policies among young people in Australia and the UK, despite very different e-cigarette regulatory environments in these countries. Enhancing awareness of the potential harms associated with e-cigarette use appears to be key to optimising support for the assessed policies among members of this age group., Competing Interests: Declarations of Interest The authors declare they have no conflicts of interest, (Copyright © 2022. Published by Elsevier B.V.)

Objective: The aim of this study was to assess the nature and consequences of student vaping in Australian primary and secondary schools by consulting staff working in these settings., Methods: A national sample of 196 school staff was accessed via a web panel provider and administered an online survey about students' e-cigarette use. Three-quarters of the survey respondents were teachers/teacher aides, with the remainder divided between those in other student-facing roles and office staff., Results: A majority (78%) of respondents expressed concern about current levels of vaping in schools. Around half reported negative outcomes relating to mental well-being, social/peer interactions, and school performance. Only one-third of respondents reported a vaping policy (35%) or vaping-prevention education (31%) being in place at their schools., Conclusions: E-cigarette use in schools is an area of concern for school staff, yet relevant policies and education programs appear to be lacking., Implications for Public Health: Schools represent a key context for encouraging health promoting behaviours and discouraging harmful behaviours, including vaping. These results highlight the need to monitor and address student e-cigarette use in schools and provide staff with greater support to prevent the negative consequences associated with vaping by children at school and beyond., (© 2022 The Authors.)

Background and Aim: To determine risk factors for incident chronic kidney disease (CKD) in a large population-based cohort., Methods: This prospective opt-in population-based cohort study is based on the 45 and Up Study, where New South Wales residents aged ≥45 years were randomly sampled from the Services Australia database and agreed to complete the 45 and Up Study baseline questionnaire and have their responses linked to their health data in routinely collected databases. The primary outcome was the development of incident CKD, defined as eGFR < 60 mL/min/1.73 m 2 . CKD incidence was calculated using Poisson regression. Risk factors for incident CKD were assessed using Cox regression in multivariable models., Results: In 39 574 participants who did not have CKD at enrolment, independent factors associated with developing CKD included: older age, regional residence (HR 1.38 (1.27-1.50) for outer regional vs major city), smoking (1.13 (1.00-1.27) for current smoker vs non-smoker), obesity (1.25 (1.16-1.35) for obese vs normal body mass index), diabetes mellitus (1.41 (1.33-1.50)), hypertension (1.53 (1.44-1.62)), coronary heart disease (1.13 (1.07-1.20)), depression/anxiety (1.16 (1.09-1.24)) and cancer (1.29 (1.20-1.39)). Migrants were less likely to develop CKD compared with people born in Australia (0.88 (0.83-0.94)). Gender, partner status and socioeconomic factors were not independently associated with developing CKD., Conclusions: This large population-based study found multiple modifiable and non-modifiable factors were independently associated with developing CKD. In the Australian setting, the risk of CKD was higher with regional residence. Differences according to socioeconomic status were predominantly explained by age, comorbidities and harmful health-related behaviours., (© 2020 Royal Australasian College of Physicians.)

Aim: In May 2019, Australia's Pharmaceutical Benefits Scheme (PBS) tightened the prescribing restrictions for publicly subsidized high and standard strength proton-pump inhibitors (PPIs). We aimed to determine the impacts on PPI use in Australia., Methods: Population-based interrupted time series analysis of PBS dispensing claims for a 10% sample of PBS-eligible Australian residents from January 2017 to December 2020 and national prescription and over-the-counter sales to pharmacies from January 2017 to October 2020. We examined trends in monthly PPI dispensings, switches from higher to lower strength formulations, and volume (kg) dispensed and sold., Results: From May 2019, we observed a small, immediate decrease (-7830 [95%CI: -8818 to -6842]) in standard strength PPI dispensings/month, which rebounded to exceed pre-intervention levels by December 2020. High strength dispensings decreased until the end of the study period to less than half their pre-intervention average/month; low strength dispensings/month increased until the end of the study period to more than double their pre-intervention average/month. We observed transient increases in switches to lower strength formulations post-intervention. The kilograms of PPIs sold/month followed a similar pattern to PBS kilograms dispensed/month with the exception of standard strength formulations where PBS dispensings decreased by -74 (95%CI: -93 to -55) but total sales remained unchanged (comprising PBS and private prescriptions, and over-the-counter sales)., Conclusions: Tightened prescribing restrictions had an immediate and sustained impact on PPI use in Australia, with decreased high strength use and increased low strength use. Some patients likely switched to private market prescriptions for standard strength PPI, given the observed patterns in total volume sold/dispensed., (© 2021 John Wiley & Sons Ltd.)

The availability of direct-acting antivirals (DAAs) sparked efforts to eliminate hepatitis C virus (HCV) in Australia. We evaluated whether an educational intervention of a 1-h discussion among staff using audit and feedback data from the MedicineInsight GP programme would improve DAA uptake. Of 296 eligible general practices in MedicineInsight, 11% opted out. Randomization stratified by practice caseload allocated 130 practices to the intervention arm and 129 to control. The primary outcome was the number of patients started on DAAs over 6 months using the negative binomial regression model adjusted for DAA prescription history and clustering by practice. Data for analysis were available for 78% of practices, which included 101 practices and 2469 DAA-naive patients with confirmed/possible HCV in the intervention arm, and 100 practices and 2466 patients in the control arm. At baseline, 49.5% of practices had prescribed ≥1 DAA in the past year; 18.9% of HCV patients had already been treated with DAAs; the mean age of DAA-naive HCV patients was 43 years old, and 57% were men. Over 6 months, 43 patients in the intervention arm and 36 in the control arm started DAAs (adjusted IRR 1.19; 95% CI 0.67-2.11, p = 0.55). In the first 3 months, 27 vs 16 patients started DAAs (adjusted IRR 1.77, 0.88-3.58; p = 0.111). Few patients were started on DAAs, and a facilitated discussion in HCV management did not lead to a significant increase. Alternative measures, such as incentivizing GP initiations or patients, are suggested to address remaining barriers to DAA uptake in Australian primary care. Australian New Zealand Clinical Trial Registry (ANZCTR) Registration Number: ACTRN12619000508178p., (© 2021 John Wiley & Sons Ltd.)

Introduction: Health authorities are advising smokers to quit to reduce their COVID-related risk. The types of messages that may be effective in alerting smokers to this risk and encouraging a quit attempt are unknown. The aim of this study was to test a series of messages to identify potentially effective communication approaches., Methods: An online survey was completed by 1509 smokers across three countries (Australia: n = 604; New Zealand: n = 304; United Kingdom: n = 601) in April-May 2020. Respondents were randomly assigned to view just one of four quit messages, two of which explicitly referred to the coronavirus, one referred to risk of chest infection, and one encouraged cessation for financial reasons. Outcome variables included quit intentions, further information seeking, message perceptions, and health and financial concerns., Results: All four messages were associated with significant differences in the proportions of respondents intending to quit within the following 2 wk (increase range: 11%-34%) and with substantial proportions of respondents electing to access additional information (range: 37%-50%). The differences in intentions were significantly larger for the two health-related messages that specifically mentioned the coronavirus. All messages were perceived favorably in terms of acceptability, believability, effectiveness, and personal relevance. Negligible differences in health and financial concerns were observed., Conclusions: Smokers in Australia, New Zealand, and the United Kingdom appear likely to be receptive to messages about their COVID-related risk. Such messages have the potential to increase quit intentions and prompt information-seeking behaviors., Implications: The COVID-19 pandemic represents an opportunity to encourage smokers to quit to reduce both their COVID-related risks and their risks of a broad range of noncommunicable diseases., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To identify how best to provide smoking cessation advice and support during the Covid-19 pandemic. Preferences were assessed in relation to: (i) specific forms of tobacco cessation support (eg, nicotine replacement therapy (NRT) and various counseling formats); (ii) information sources (eg, government officials, doctors); and (iii) channels via which to receive relevant information (eg, television, social media)., Methods: An online survey was administered to adults who smoke tobacco in Australia (n = 604) and the UK (n = 600). Descriptive analyses were conducted to identify levels of interest in cessation support and information provision. Differences in responses according to demographic characteristics and smoking history were assessed., Results: Around half of the respondents were interested in receiving personal counseling and/or participating in a text support program over the next month. By far the most popular delivery mechanism for personal counseling was email. Three-quarters of the sample expressed an interest in receiving free, home-delivered NRT. The most popular information sources nominated by respondents seeking more information about smokers' Covid-related risks were government departments and their doctor/general practitioner. Television and online news sources were the most preferred information dissemination channels., Conclusions: The substantial levels of interest expressed in accessing various forms of cessation assistance within the next month suggest that Covid-19 may be increasing receptiveness to quitting. The strong interest in free, home-delivered NRT indicates that this may be a useful mechanism for facilitating quit attempts during the pandemic.

Objective: To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 in people with diabetes., Research Design and Methods: We identified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006-2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m 2 recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m 2 at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m 2 and multivariable Cox regression to examine factors associated with the study outcome., Results: Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m 2 over a median follow-up time of 5.7 years (interquartile range, 3.0-5.9 years). The eGFR <60 mL/min/1.73 m 2 incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4-4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19-1.26), geography (outer regional and remote versus major city: 1.36; 1.17-1.58), obesity (obese class III versus normal: 1.44; 1.16-1.80), and the presence of hypertension (1.52; 1.33-1.73), coronary heart disease (1.13; 1.02-1.24), cancer (1.30; 1.14-1.50), and depression/anxiety (1.14; 1.01-1.27)., Conclusions: In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m 2 was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence., (© 2020 by the American Diabetes Association.)

Objectives: To explore the relationship between timing of continuous renal replacement therapy commencement and clinical outcomes in critically ill patients with acute kidney injury. The primary outcomes were all-cause mortality at 28 and 90 days., Design: Nested observational cohort study using data from the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study., Setting: Twenty-three ICUs in Australia and New Zealand., Patients: Four hundred thirty-nine critically ill patients with acute kidney injury Risk, Injury, Failure, Loss, End-stage kidney disease-injury (RIFLE-I) criteria., Interventions: None., Measurements and Main Results: The time between RIFLE-I acute kidney injury and randomization in the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study (proxy for continuous renal replacement therapy commencement) was the variable of interest. All baseline variables in the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study were assessed. Multivariable Cox, logistic, and linear regression models were used to assess the independent relationship of time of onset of RIFLE-I acute kidney injury and randomization and patient outcomes. The median time between RIFLE-I acute kidney injury and continuous renal replacement therapy commencement was 17.6 hours (interquartile range, 7.1-46 hr). Based on four groups of continuous renal replacement therapy commencement ([group 1; reference]: < 7.1, [group 2]: ≥ 7.1 to < 17.6, [group 3]: ≥ 17.6 to < 46.0, [group 4]: ≥ 46.0 hr), earlier commencement of continuous renal replacement therapy was not associated with a significantly lower risk of death at 28 days (hazard ratio for group 2: 1.06, 95% CI: 0.62-1.81; p = 0.83; hazard ratio for group 3: 1.23, 95% CI: 0.71-2.12; p = 0.46; hazard ratio for group 4: 1.33, 95% CI: 0.77-2.31; p = 0.31). Similar findings were observed for death at 90 days., Conclusions: In a subgroup of participants of the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study, earlier commencement of continuous renal replacement therapy relative to RIFLE-I acute kidney injury was not significantly associated with improved survival. Additional studies with larger sample sizes and broader commencement times are warranted.