Alcohol use stable, decline in smoking rates: AIHW

Evelyn Lewin

22/01/2020 4:18:51 PM

A new report shows alcohol and cannabis use is steady, while smoking rates are falling.

People drinking alcohol
Nearly 40% of Australians aged 18 and over exceeded the single-occasion risk guidelines in 2017–18 by consuming more than four standard drinks in one sitting.

According to the Australian Institute of Health and Welfare (AIHW) findings, the apparent consumption of alcohol in 2017–18 is equivalent to an average of 2.72 standard drinks per day per consumer of alcohol aged 15 and over – an increase of just 0.02 since 2016–17.
Most Australians aged over 14 years still consume alcohol, but the proportion of people drinking in excess of lifetime risk guidelines continues to decline, from 19.1% in 2013 to 18% in 2016.
When it comes to binge drinking, 39% of Australians aged 18 and over exceeded the single-occasion risk guidelines in 2017–18 by consuming more than four standard drinks in one sitting.
Meanwhile, the proportion of Aboriginal and Torres Strait Islander people aged 15 years and over who exceeded lifetime risk guidelines for alcohol consumption decreased between 2008 and 2014–15, from 19% to 15%.
According to the report, tobacco is the leading cause of cancer in Australia, contributing to 22% of cancer burden. However, there has been a downward trend in daily tobacco smoking since 1991, from 24% to 12% in 2016.
There has also been an increase in the number of people choosing to never take up smoking, rising from 49% in 1991 to 62% in 2016.
Dr Paul Grinzi, a GP and medical educator and with a specific interest in alcohol and other drugs, told newsGP while fewer people are smoking, those who remain ‘have a more embedded habit’ and probably require extra work to help them quit.
In order to help patients make better health decisions, Dr Grinzi said it is imperative GPs ascertain their patient’s current consumption of such substances.
He said GPs have a lot of experience discussing these issues with patients, but believes the way practitioners approach such matters is important.
‘There are plenty of opportunities to bring this up outside of direct questioning of alcohol and other drug use,’ Dr Grinzi said.
‘Most patients that we see present with conditions that give us a window to explore these topics so that the patient perceives the questions as being relevant to the presentation.’
For example, Dr Grinzi believes an opportunity can present when a patient asks for a repeat script for antacid medication for reflux. Because alcohol is a common trigger and risk factor for developing reflux disease, he said that can be used as a launching point to explore a patient’s alcohol use, including their understanding about its potential link to their condition, and their willingness to change.
Dr Grinzi cites further examples of presenting complaints, such as hypertension and psoriasis, which can also act as a springboard towards discussing a patient’s drug and alcohol use.
He feels these are perfect opportunities to discuss alcohol and other drug use, because patients are more receptive to questions relating to drug and alcohol use when it relates to their presenting complaint and current health issues.
‘We know that patients will often find more stigma or judgement if the questions are not framed in a way that’s related to their concerns,’ Dr Grinzi said.
‘We know patients are more than happy to discuss things in a confidential setting in a clinical room provided they see some relevance to their own health, and I think making a link to the presenting complaint may well provide that link.’
There are other opportunities to discuss these issues, such as when meeting a new patient, doing a care plan review or an annual health assessment. 
‘If the opportunity arises, it’s up to the GP to choose those moments,’ Dr Grinzi said. ‘There are lots of opportunities and I don’t think GPs should be frightened of doing this.
‘There’s good research that patients accept this is part of their medical history, provided it’s framed accordingly and not seen to be intrusive or judgemental.’

Dr Paul Grinzi, a GP and medical educator and with a specific interest in alcohol and other drugs, believes there are plenty of opportunities to ask patients about their drug and alcohol use.

Cannabis remains the most commonly used illicit drug in Australia. Recent use among the Australian general population has remained relatively stable between 2001 (12.9%) and 2016 (10.4%).
However, there has been a rapid increase in the number of deaths involving methamphetamines and other stimulants, with the death rate four times higher in 2017 than in 1999 (1.6 deaths per 100,000 compared to 0.4 deaths).
Though deaths relating to methamphetamines have increased, consumption has decreased from 2.1% in 2013 to 1.4% in 2016.
Conversely, reported cocaine use in Australia is on the rise, particularly among people who are employed and those living in high socioeconomic areas.
Of all the findings, Dr Grinzi said the most pressing issues are still related to alcohol and smoking.
‘They’re the number one things that have been around forever and remain,’ he said.
‘A lot of our focus needs to go towards providing patients with information and assistance in minimising the harms around that.’
For more information, visit the RACGP’s Alcohol and other drugs GP education program.
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