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ABSTRACT The Western Sydney Health Study is a two‐phase descriptive study that is designed to provide data on the health‐related knowledge, attitudes and behaviour of persons in the Western Metropolitan health region, which has higher‐than‐average death rates of many disorders that are associated with life‐style. In the first phase of the study, 2164 respondents were interviewed in six shopping centres in the region. The prevalence rates of self‐reported cardiovascular disease and diabetes were about twice those that were found in the Australia‐wide National Heart Foundation Risk Factor Prevalence Study in 1983. The prevalence rates of smoking and self‐reported raised blood lipid levels were also high. Doctors and nurses were the main sources of health information, and the media was less important as a source of health information than was found in the Better Health Commission's national survey in 1985. Over 80% of respondents believed that a lowering of the dietary fat intake and an increase in exercise were health‐enhancing behaviours. Given this high level of health knowledge, the major aims for health promotion in the region should be a social change to facilitate choices towards healthy behaviour and the provision of skills to enable individual behavioural changes. (Med J Aust 1988; 148: 277‐280)

To determine the incidence and age distribution of invasive Haemophilus influenzaetype b (Hib) disease in children (0–14 years) in the Sydney Statistical Division (SSD). Retrospective ascertainment from a defined population, 1985–1987. Eligible cases had Hib isolated from a normally sterile site or endoscopically proven epiglottitis. Sydney Statistical Division, which had a population of children aged 0–4 years of 229 165 in 1986. Cases were identified from all potential sources of relevant recorded information. Main outcomes:There were 292 eligible cases. Among 284 previously well children, those under 18 months of age contributed 81 of 143 cases (57%) of meningitis and 22 of 71 (71 %) of cellulitis/arthritis but only 8 of 91 (11%) of epiglottitis and 4 of 18 (22%) of infection in other foci. Overall, 9% of cases had occurred by 6 months of age, 42% by 18 months and 55% by 24 months. The annual incidence of invasive Hib disease was 38.5 per 100 000 children aged 0–4 years. In areas with the lowest proportion of young children (less than 5.5%), the incidence of Hib disease in the first 12 months of life was significantly lower than in the remainder of Sydney, although there were no differences in overall disease incidence in the age group 0–4 years. This study indicates that approximately 1 in 500 urban Australian children develop invasive Hib disease by their fifth birthday. Vaccination of children in Sydney with a conjugate Hib vaccine at 18 months of age would result in a greater potential reduction in Hib disease than in the United States, where universal vaccination at this age is current policy.

Eight hundred and thirty‐eight women who attended 36 general practitioners were asked when they had last undergone a cervical smear‐test. Only 6% of women who were between 25 and 54 years of age had never undergone a smear‐test, but in women who were younger and older than this age range the proportion was one‐third. We estimated from this pattern of use of cervical smear‐tests that only 60% of invasive cervical cancer is being prevented, and the major contribution to the remaining risk factors comes from women of over 55 years of age who either have not undergone a smear‐test or had undergone one a long time previously. This information suggests that general practitioners and the public‐health system should be more active in ensuring that all at‐risk women undergo cervical smear‐tests. (Med J Aust 1988; 148: 128–131)

OBJECTIVE: To assess the associations between stage of age-related maculopathy (ARM) and current, past, and passive smoking. METHODS: A cross-sectional study of 3654 subjects from a defined geographic area west of Sydney, Australia, identified subjects with late age-related macular degeneration (AMD) and early ARM by ocular examination and detailed grading of retinal photographs. Interviewer-administered questionnaires provided data about smoking history for subjects and spouses. Logistic regression, adjusting for age and sex, and 2-way analysis of variance were used to assess associations. RESULTS: Current tobacco smoking was significantly associated with late AMD (odds ratio [OR], 3.92), including neovascular AMD (OR, 3.20) and geographic atrophy (OR, 4.54), and early ARM (OR, 1.75). Having ever smoked was significantly associated with late AMD (OR, 1.83) but not early ARM. Passive smoking was associated with increased but insignificant odds for late AMD. The risk was slightly higher among women compared with men for most exposure categories. CONCLUSIONS: These findings provide convincing evidence that smoking may be causally associated with ARM. The strongest risk was found for current smokers, suggesting potential benefits of targeting education to older people who are current smokers and have signs of early ARM.

ABSTRACT We examined the detection of smoking by 50 randomly‐selected general practitioners. The practitioners said that they should detect smokers among their patients with a high degree of accuracy: a median of 100% of smokers under ideal conditions, and a median of 80% of smokers given the realities of practice. Practitioners actually identified 56.2% of their patients who were smokers — 360 of 641 smokers among 2044 patients in the study. Some 65% of patients with a smoking‐caused or smoking‐exacerbated disease were detected, and this degree of detection was not related to age. For smokers of greater than 50 years of age and without any obvious smoking‐related condition, the detection rates were similar to those of patients with smoking‐related disease; however, in those patients who were less than 30 years of age, only 41% of smokers were detected — although the prevalence of smoking was higher in the younger than it was in the older patients. For all age‐groups, the prevalence of smoking in men was about 15% higher than it was in women, but there was no significant difference between the detection rates in the sexes. In spite of their higher risks from smoking, the detection rates for pregnant women, or women who were taking oral contraceptive agents, were no higher than were those for other women of less than 35 years of age. The doctors said that they had treated for smoking 78% of the detected smokers who had smoking‐caused disease, compared with 35% of detected smokers with no smoking‐related condition. They rated the value of such treatment higher in the former group than in those patients who had not yet developed smoking‐related problems. Doctors appear to respond to the evidence of disease that is caused by smoking more than to the habit itself, which is a handicap in the prevention of smoking‐related disease. (Med J Aust 1989; 150: 420‐426)