Red Book

Prevention of chronic disease

Smoking

Age range chart

0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-79 >80
                             


​Smoking status and interest in quitting should be assessed and documented in the medical record for every patient >10 years of age.3,13,60 All patients who smoke, regardless of the amount they smoke, should be offered smoking cessation advice. This should include the following actions:

  • Ask about their interest in quitting (B).
  • Advise to stop smoking (A), agreeing on quit goals and offer pharmacotherapy to all patients smoking more than 10 cigarettes per day unless contraindicated, especially if there is evidence of nicotine dependence (A).
  • Offer referral to a proactive telephone call-back cessation service (eg Quitline 13 7848; A).
  • Follow up to support maintenance and prevent relapse using self-help or pharmacotherapy (A).

To assess nicotine dependence, ask about the:60

  • number of minutes between waking and smoking the first cigarette
  • number of cigarettes smoked a day (there is a high likelihood of nicotine dependence if the person smokes within 30 minutes of waking and smokes more than 10–15 cigarettes a day)
  • type of craving or withdrawal symptoms experienced in previous quit attempts.
Smoking: Identifying risks

Table 7.1.1

Smoking: Identifying risks

At an individual patient level, GPs and their teams can influence smoking rates by systematically providing opportunistic advice and offering support to all attending patients who smoke.67 Where this is insufficient, other effective treatment strategies include referral to the Quitline,68 pharmacotherapy 69,70 and motivational interviewing.71,72

Tobacco use is most effectively treated with a comprehensive approach involving behavioural support and pharmacotherapy. Combined pharmacotherapy and behavioural support increases the success of smoking cessation.73

Pregnant women find it especially difficult to quit; pregnancy alters nicotine metabolism and heightens withdrawal symptoms and the support from partners is an important element in quitting. Higher smoking rates in disadvantaged individuals reflect greater neighbourhood disadvantage, less social support, greater negative effect and lower self-efficacy.21,28 Removing access barriers and providing incentives to motivate patients to quit may improve quit rates.

Patients should be reviewed within one week and again after one month of stopping smoking in order to help increase the long-term chance of quitting.

There is a lack of consistent, bias-free evidence that acupuncture, acupressure or laser therapy have sustained benefit on smoking cessation for longer than six months.74 There is insufficient evidence that electronic cigarettes(e-cigarettes) help smokers to stop smoking when compared with nicotine patches or placebo.75

The CEITC provides resources and strategies.

  1. Britt H, Miller G, Henderson J, et al. A decade of Australian general practice activity 2003–04 to 2012–13. Sydney: Sydney University Press, 2013.
  2. World Health Organization. Preventing chronic diseases. A vital investment. Geneva: WHO, 2005 [Accessed 10 October 2015].
  3. Fiore M, Jaen CR, Bake TB, et al. Treating tobacco use and dependence: 2008 Update. Rockville, MD: Department of Health and Human Services, Public Health Service, 2008. [Accessed 10 October 2015].
  4. van Schayck OC, Pinnock H, Ostrem A, et al. IPCRG Consensus statement: Tackling the smoking epidemic – Practical guidance for primary care. Prim Care Respir J 2008;17(3):185–93. [Accessed 10 October 2015].
  5. Greaves CJ, Sheppard KE, Abraham C, et al. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health 2011;11(1):119. [Accessed 10 October 2015].
  6. National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC, 2009. [Accessed 10 October 2015].
  7. Conn VS, Hafdahl AR, Mehr DR. Interventions to increase physical activity among healthy adults: Meta-analysis of outcomes. Am J Public Health 2011;101(4):751–58. [Accessed 10 October 2015].
  8. Foster C, Hillsdon M, Thorogood M. Interventions for promoting physical activity. Cochrane Database Syst Rev 2009;1:CD003180. [Accessed 10 October 2015].
  9. National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Canberra: NHMRC, 2013. [Accessed 10 October 2015].
  10. Wadden TA, Volger S, Sarwer DB, et al. A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med 2011;365(21):1969–79. [Accessed 10 October 2015].
  11. Goldstein MG, Whitlock EP, DePue J, Planning Committee of the Addressing Multiple Behavioral Risk Factors in Primary Care P. Multiple behavioral risk factor interventions in primary care. Summary of research evidence. Am J Prev Med 2004;27(2 Suppl):61–79. [Accessed 10 October 2015].
  12. Dosh SA, Holtrap JS, Torres T, Arnold AK, Bauman J, White LL. Changing organizational constructs into function tools: An assessment of the 5A’s in primary care practices. Ann Fam Med 2005;3(Suppl 2):S50–52. [Accessed 10 October 2015].
  13. Hung DY, Shelley DR. Multilevel analysis of the chronic care model and the 5A services for treating tobacco use in urban primary care clinics. Health Serv Res 2009;44(1):103–27. [Accessed 10 October 2015].
  14. Rueda-Clausen CF, Benterud E, Bond T, Olszowka R, Vallis MT, Sharma AM. Effect of implementing the 5As of Obesity management framework on provider–patient interactions in primary care. Clin Obes 2014;4(1):39–44. [Accessed 10 October 2015].
  15. Jay M, Gillespie C, Schlair S, Sherman S, Kalet A. Physicians’ use of the 5As in counseling obese patients: Is the quality of counseling associated with patients’ motivation and intention to lose weight? BMC Health Serv Res 2010;10:159. [Accessed 10 October 2015].
  16. Mendis S, Banerjee A. Cardiovascular disease. In: Blas E, Kurup AS, editors. Equity, social determinants and public health programmes. Geneva: World Health Organization, 2010. [Accessed 10 October 2015].
  17. Cass A, Snelling P, Brown A. Preventing chronic disease to close the gap in life expectancy for Indigenous Australians. In: Baur LA, Twigg SM, Magnusson RS, editors. Modern epidemic: Expert perspectives on obesity and diabetes. Sydney: Sydney University Press, 2012:120–8. [Accessed 10 October 2015].
  18. Oprea L, Cojocaru D, Sandu A, Bulgaru-Iliescu D. The chronic care model (CCM) and the social gradient in health. Revista De Cercetare Si Interventie Sociala 2013;41:176–89. [Accessed 10 October 2015].
  19. Australian Institute of Health and Welfare. Life expectancy of Aboriginal and Torres Strait Islander people. Canberra: AIHW, 2015 [Accessed 10 October 2015].
  20. Australian Institute of Health and Welfare. Contribution of chronic disease to the gap in adult mortality between Aboriginal and Torres Strait Islander to other Australians. Canberra: AIHW, 2010. [Accessed 10 October 2015].
  21. Zhao Y, Condon JR, Guthridge S, You J. Living longer with a greater health burden – Changes in the burden of disease and injury in the Northern Territory Indigenous population between 1994–1998 and 1999–2003. Aust N Z J Public Health 2010;34:S93–S98. [Accessed 10 October 2015].
  22. Mercer SW, Guthrie B, Furler J, Watt G, Hart JT. Multimorbidity and the inverse care law in primary care. BMJ 2012;344:e4152. [Accessed 10 October 2015].
  23. Mercer SW, Watt GCM. The inverse care law: Clinical primary care encounters in deprived and affluent areas of Scotland. Ann Fam Med 2007;5(6):503–10. [Accessed 10 October 2015].
  24. Benyamini Y, Blumstein T, Boyko V, Lerner-Geva L. Cultural and educational disparities in the use of primary and preventive health care services among midlife women in Israel. Womens Health Issues 2008;18(4):257– 66. [Accessed 10 October 2015].
  25. Australian Institute of Health and Welfare. Access to health services for Aboriginal and Torres Strait Islander people. Canberra: AIHW, 2011. [Accessed 10 October 2015].
  26. Australian Institute of Health and Welfare. The health and welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2015. Canberra: AIHW, 2015. [Accessed 10 October 2015].
  27. Evans SD, Sheffer CE, Bickel WK, et al. The process of adapting the evidence-based treatment for tobacco dependence for smokers of lower socioeconomic status. J Addict Res Ther 2015;6(1):219. [Accessed 10 October 2015].
  28. DiGiacomo M, Davidson PM, Abbott PA, Davison J, Moore L, Thompson SC. Smoking cessation in indigenous populations of Australia, New Zealand, Canada, and the United States: Elements of effective interventions. Int J Environ Res Public Health 2011;8(2):388–410. [Accessed 10 October 2015].
  29. Robertson J, Stevenson L, Usher K, Devine S, Clough A. A review of trends in Indigenous Australian tobacco research (from 2004 to 2013), its associated outputs and evidence of research translation. Nicotine Tob Res 2015;17(8):1039–48. [Accessed 10 October 2015].
  30. Bowden JA, Miller CL, Hiller JA. Smoking and mental illness: A population study in South Australia. Aust N Z J Psychiatry 2011;45(4):325–31. [Accessed 10 October 2015].
  31. Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: A systematic review, 1990–2013. BMC Pediatr 2015;15(1):129. [Accessed 10 October 2015].
  32. Krueger PM, Reither EN. Mind the gap: Race/ethnic and socioeconomic disparities in obesity. Curr Diab Rep 2015;15(11):95. [Accessed 10 October 2015].
  33. Sommer I, Griebler U, Mahlknecht P, et al. Socioeconomic inequalities in non-communicable diseases and their risk factors: An overview of systematic reviews. BMC Public Health 2015;15(1):914. [Accessed 10 October 2015].
  34. Schultz R. Prevalences of overweight and obesity among children in remote Aboriginal communities in central Australia. Rural Remote Health 2012;12:1872. [Accessed 10 October 2015].
  35. Brimblecombe JK, O’Dea K. The role of energy cost in food choices for an Aboriginal population in northern Australia. Med J Aust 2009;190(10):549–51. [Accessed 10 October 2015].
  36. Lo YT, Chang YH, Lee MS, Wahlqvist ML. Health and nutrition economics: Diet costs are associated with diet quality. Asia Pac J Clin Nutr 2009;18(4):598–604. [Accessed 10 October 2015].
  37. Brimblecombe J, Ferguson M, Liberato SC, O’Dea K, Riley M. Optimisation modelling to assess cost of dietary improvement in remote Aboriginal Australia. PLOS ONE 2013;8(12):e83587. [Accessed 10 October 2015].
  38. Chaufan C, Constantino S, Davis M. ‘It’s a full time job being poor’: Understanding barriers to diabetes prevention in immigrant communities in the USA. Critical Public Health 2012;22(2):147–58. [Accessed 10 October 2015].
  39. Australian Institute of Health and Welfare. Australia’s health 2014. Canberra: AIHW, 2014. [Accessed 10 October 2015].
  40. Antai D, Lopez GB, Antai J, Anthony DS. Alcohol drinking patterns and differences in alcohol-related harm: A population-based study of the United States. Biomed Res Int 2014;2014:853410. [Accessed 10 October 2015].
  41. Calabria B, Doran CM, Vos T, Shakeshaft AP, Hall W. Epidemiology of alcohol-related burden of disease among Indigenous Australians. Aust N Z J Public Health 2010;34 Suppl 1:S47–51. [Accessed 10 October 2015].
  42. Probst C, Roerecke M, Behrendt S, Rehm J. Gender differences in socioeconomic inequality of alcoholattributable mortality: A systematic review and metaanalysis. Drug Alcohol Rev 2015;34(3):267–77. [Accessed 10 October 2015].
  43. Livingston M. Socioeconomic differences in alcoholrelated risk-taking behaviours. Drug Alcohol Rev 2014;33(6):588–95. [Accessed 10 October 2015].
  44. Probst C, Manthey J, Martinez A, Rehm J. Alcohol use disorder severity and reported reasons not to seek treatment: A cross-sectional study in European primary care practices. Subst Abuse Treat Prev Policy 2015;10:32. [Accessed 10 October 2015].
  45. Romo LK, Dinsmore DR, Watterson TC. ‘Coming out’ as an alcoholic: How former problem drinkers negotiate disclosure of their nondrinking identity. Health Commun 2016;31(3):336–45. [Accessed 10 October 2015].
  46. Walter T, Ford A, Templeton L, Valentine C, Velleman R. Compassion or stigma? How adults bereaved by alcohol or drugs experience services. Health Soc Care Community 2015. [Accessed 10 October 2015].
  47. Taggart J, Williams A, Dennis S, et al. A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors. BMC Fam Pract 2012;13(1):49. [Accessed 10 October 2015].
  48. Adams K, Paasse G, Clinch D. Peer-support preferences and readiness-to-change behaviour for chronic disease prevention in an urban Indigenous population. Australian Social Work 2011;64(1):55–67. [Accessed 10 October 2015].
  49. National Aboriginal Community Controlled Health Organisation and The Royal Australian College of General Practitioners. National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people. 2nd edn. East Melbourne, Vic: The Royal Australian College of General Practitioners, 2012. [Accessed 10 October 2015].
  50. Ackerman E, Falsetti SA, Lewis P, Hawkins AO, Heinschel JA. Motivational interviewing: A behavioral counseling intervention for the family medicine provider. Fam Med 2011;43(8):582–85. [Accessed 10 October 2015].
  51. Fioravanti G, Rotella F, Cresci B, et al. Motivational enhancement therapy in obese patients: A promising application. Obes Res Clin Pract 2015;9(5):536–38. [Accessed 10 October 2015].
  52. Hardcastle S, Blake N, Hagger MS. The effectiveness of a motivational interviewing primary-care based intervention on physical activity and predictors of change in a disadvantaged community. J Behav Med 2012;35(3):318–33. [Accessed 10 October 2015].
  53. Bull ER, Dombrowski SU, McCleary N, Johnston M. Are interventions for low-income groups effective in changing healthy eating, physical activity and smoking behaviours? A systematic review and meta-analysis. BMJ Open 2014;4(11):e006046 [Accessed 10 October 2015].
  54. Jepson RG, Harris FM, Platt S, Tannahill C. The effectiveness of interventions to change six health behaviours: A review of reviews. BMC Public Health 2010;10:538. [Accessed 10 October 2015].
  55. Lim CS, Janicke DM. Barriers related to delivering pediatric weight management interventions to children and families from rural communities. Childrens Health Care 2013;42(3):214–30. [Accessed 10 October 2015].
  56. Lubans DR, Morgan PJ, Okely AD, et al. Preventing obesity among adolescent girls. Pediatr Adolesc Medic 2012;166(9):821–27. [Accessed 10 October 2015].
  57. Pena MM, Dixon B, Taveras EM. Are you talking to ME? The importance of ethnicity and culture in childhood obesity prevention and management. Child Obes 2012;8(1):23–27. [Accessed 10 October 2015].
  58. Dudley DA, Okely AD, Pearson P, Peat J. Engaging adolescent girls from linguistically diverse and low income backgrounds in school sport: A pilot randomised controlled trial. J Sci Med Sport 2010;13(2):217–24. [Accessed 10 October 2015].
  59. Harris MF, Parker SM, Litt J, et al. Implementing guidelines to routinely prevent chronic vascular disease in primary care: The Preventive Evidence into Practice cluster randomised controlled trial. BMJ Open 2015;5(12):e009397. [Accessed 10 October 2015].
  60. The Royal Australian College of General Practitioners. Supporting smoking cessation: A guide for health professionals. South Melbourne, Vic: RACGP, 2011. [Accessed 10 October 2015].
  61. Carson K, Brinn M, Peters M, Esterman A, Smith B. Interventions for smoking cessation in indigenous populations. Cochrane Database Syst Rev 2012;1:CD009046. [Accessed 10 October 2015].
  62. Hartmann-Boyce J, Stead LF, Cahill K, Lancaster T. Efficacy of inteventions to combat tobacco addiction: Cochrane update of 2013 reviews. Addiction 2014;109(9):1414–25. [Accessed 10 October 2015].
  63. Stanton A, Grimshaw G. Tobacco cessation interventions for young people. Cochrane Database Syst Rev 2013(8):CD003289. [Accessed 10 October 2015].
  64. Solberg L, Boyle R, Davidson G, Magnan S. Patient satisfaction and discussion of smoking cessation during clinical visits. Mayo Clinic Proceedings 2001;76(2):138. [Accessed 10 October 2015].
  65. Sciamanna C, Novak S, Houston T, Gramling R, Marcus B. Visit satisfaction and tailored health behavior communications in primary care. Am J Prev Med 2004;26(5):426–30. [Accessed 10 October 2015].
  66. Miller WR, Rollnick S. Ten things that motivational interviewing is not. Behav Cogn Psychother 2009;37(2):129–40. [Accessed 10 October 2015].
  67. Stead M, Angus K, Holme I, Cohen D, Tait G. Factors influencing European GPs’ engagement in smoking cessation: A multi-country literature review. Br J Gen Pract 2009;59(566):682–90. [Accessed 10 October 2015].
  68. Schuck K, Bricker J, Otten R, Kleinjan M, Brandon T, Engels R. Effectiveness of proactive quitline counselling for smoking parents recruited through primary schools: Results of a randomized controlled trial. Addiction 2014;109(5):830–41. [Accessed 10 October 2015].
  69. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev 2012;11:CD006103. [Accessed 10 October 2015].
  70. Stead LF, Perera R, Bullen C, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2012;11:CD000146. [Accessed 10 October 2015].
  71. Aveyard P, Begh R, Parsons A, West R. Brief opportunistic smoking cessation interventions: A systematic review and meta-analysis to compare advice to quit and offer of assistance. Addiction 2012;107(6):1066–73. [Accessed 10 October 2015].
  72. Lindson-Hawley N, Thompson TP, Begh R. Motivational interviewing for smoking cessation. Cochrane Database Syst Rev 2015;3:CD006936. [Accessed 10 October 2015].
  73. Stead LF, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev 2012;10:CD008286. [Accessed 10 October 2015].
  74. White A, Rampes H, Liu J, Stead L, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev 2014;1:CD000009. [Accessed 10 October 2015].
  75. McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev 2014;12:CD010216. [Accessed 10 October 2015].
  76. National Vascular Disease Prevention Alliance. Guidelines for the assessment of absolute cardiovascular disease risk. Melbourne: National Heart Foundation of Australia: 2009 [Accessed 10 October 2015].
  77. Schulze MB, Heidemann C, Schienkiewitz A, Bergmann MM, Hoffmann K, Boeing H. Comparison of anthropometric characteristics in predicting the incidence of type 2 diabetes in the EPIC-Potsdam Study. Diabetes Care 2006;29(8):1921–23. [Accessed 10 October 2015].
  78. US Preventive Services Task Force. Final recommendation statement: Obesity in adults: Screening and management. Washington, DC USPSTF, 2014 Page/Document/RecommendationStatementFinal/ obesity-in-adults-screening-and-management [Accessed 23 March 2016].
  79. LeBlanc ES, O’Connor E, Whitlock EP, Patnode CD, Kapka T. Effectiveness of primary care–relevant treatments for obesity in adults: A systematic evidence review for the US Preventive Services Task Force. Ann Int Med 2011;155(7):434–47. [Accessed 23 March 2016].
  80. Sargen G, Pilotto L, Baur L. Components of primary care interventions to treat childhood overweight and obesity: A systematic review of effect. Obes Rev 2011;12:e219–e35. [Accessed 23 March 2016].
  81. US Preventive Services Task Force. Screening for and management of obesity in adults. Ann Intern Med 2012;157(5):373–78. [Accessed 23 March 2016].
  82. The Royal Australian College of General Practitioners. Smoking, nutrition, alcohol, physical activity (SNAP): A population health guide to behavioural risk factors in general practice. 2nd edn. East Melbourne, Vic: RACGP, 2015. [Accessed 23 March 2016].
  83. Dennis SM, Harris M, Lloyd J, Powell Davies G, Faruqi N, Zwar N. Do people with existing chronic conditions benefit from telephone coaching? A rapid review. Aust Health Rev 2013;37(3):381–88. [Accessed 23 March 2016].
  84. O’Hara BJ, Phongsavan P, Venugopal K, et al. Effectiveness of Australia’s Get healthy information and coaching service(R): Translational research with population wide impact. Prev Med 2012 Oct;55(4):292–98. [Accessed 23 March 2016].
  85. National Health and Medical Research Council. Australian Dietary Guidelines. Canberra: NHMRC, 2013. [Accessed 23 March 2016].
  86. Hartleyh L, Igbinedion E, Holmes J, et al. Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases. Cochrane Database Syst Rev 2013;6:CD009874. [Accessed 23 March 2016].
  87. US Preventive Services Task Force. Healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: Behavioral counseling. Washington, DC: USPSTF, 2014 recommendation-summary/healthy-diet-andphysical- activity-counseling-adults-with-high-risk-of-cvd [Accessed 23 March 2016].
  88. National Cancer Control Policy. Position statement – Meat and cancer prevention. Sydney, NSW: Cancer Council Australia, 2013. Available at http://wiki.cancer. prevention#Red_meat [Accessed 23 March 2016].
  89. Hooley M, Skouteris H, Millar L. The relationship between childhood weight, dental caries and eating practices in 83 Guidelines for preventive activities in general practice 9th edition children aged 4–8 years in Australia, 2004–2008. Pediatr Obes 2012;7(6):461–70. [Accessed 23 March 2016].
  90. Kaner E, Bland M, Cassidy P, et al. Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): Pragmatic cluster randomised controlled trial. BMJ 2013;346:e8501. [Accessed 23 March 2016].
  91. Kaner EFS, Dickinson HO, Beyer F, et al. The effectiveness of brief alcohol interventions in primary care settings: A systematic review. Drug Alcohol Rev 2009;28(3):301–23. [Accessed 23 March 2016].
  92. VanBuskirk KA, Wetherell JL. Motivational interviewing with primary care populations: A systematic review and meta-analysis. J Behav Med 2014;37(4):768–80. [Accessed 23 March 2016].
  93. Lundahl B, Moleni T, Burke BL, et al. Motivational interviewing in medical care settings: A systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns 2013;93(2):157–68. [Accessed 23 March 2016].
  94. Smedslund G, Berg RC, Hammerstrom KT, et al. Motivational interviewing for substance abuse. Cochrane Database Syst Rev 2011(5):CD008063. [Accessed 23 March 2016].
  95. Reinert DF, Allen JP. The alcohol use disorders identification test: An update of research findings. Alcohol Clin Exp Res 2007;31(2):185–99. [Accessed 23 March 2016].
  96. Newbury-Birch D, Walker J, Avery L, et al. Impact of alcohol consumption on young people. A systematic review of published reviews. Newcastle, UK: Department for Children, Schools and Families, 2009. [Accessed 23 March 2016].
  97. Thompson KD, Stockwell T, MacDonald S. Is there a ‘low-risk’ drinking level for youth? The risk of acute harm as a function of quantity and frequency of drinking. Drug Alcohol Rev 2012;31(2):184–93. [Accessed 23 March 2016].
  98. Wadd S, Papadopoulos C. Drinking behaviour and alcohol-related harm amongst older adults: Analysis of existing UK datasets. BMC Res Notes 2014;7:741. [Accessed 23 March 2016].
  99. Heuberger RA. Alcohol and the older adult: A comprehensive review. J Nutr Elder 2009 Jul;28(3):203–35. [Accessed 23 March 2016].
  100. Squeglia LM, Boissoneault J, Van Skike CE, Nixon SJ, Matthews DB. Age-related effects of alcohol from adolescent, adult, and aged populations using human and animal models. Alcohol Clin Exp Res 2014 Oct;38(10):2509–16. [Accessed 23 March 2016].
  101. Bekkering GE, Aertgeerts B, Asueta-Lorente JF, et al. Practitioner review: Evidence-based practice guidelines on alcohol and drug misuse among adolescents: A systematic review. J Child Psychol Psychiatry 2014 Jan;55(1):3–21. [Accessed 23 March 2016].
  102. Whitlock EF, Green CA, Polen MR. Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use. Rockville, MD: US Government, 2004. [Accessed 23 March 2016].
  103. Magnusson A, Goransson M, Heilig M. Early onset alcohol dependence with high density of family history is not ‘male limited’. Alcohol 2010;44(2):131–39. [Accessed 23 March 2016].
  104. Fell JC, Voas RB. The effectiveness of a 0.05 blood alcohol concentration (BAC) limit for driving in the United States. Addiction 2014;109(6):869–74. [Accessed 23 March 2016].
  105. Driscoll TR, Harrison JA, Steenkamp M. Review of the role of alcohol in drowning associated with recreational aquatic activity. Inj Prev 2004;10(2):107–13. [Accessed 23 March 2016].
  106. Suter PM, Schutz Y. The effect of exercise, alcohol or both combined on health and physical performance. Int J Obes (Lond) 2008;32 Suppl 6:S48–52. [Accessed 23 March 2016].
  107. O’Leary CM, Bower C. Guidelines for pregnancy: What’s an acceptable risk, and how is the evidence (finally) shaping up? Drug Alcohol Rev 2012;31(2):170–83. [Accessed 23 March 2016].
  108. World Health Organization. Guidelines for the identification and management of substance use and substance use disorders in pregnancy. Geneva: WHO, 2014. [Accessed 23 March 2016].
  109. Evert AB, Boucher JL, Cypress M, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 2013;36(11):3821–42. [Accessed 23 March 2016].
  110. Hutchinson SJ, Bird SM, Goldberg DJ. Influence of alcohol on the progression of hepatitis C virus infection: A meta-analysis. Clin Gastroenterol Hepatol 2005;3(11):1150–59. [Accessed 23 March 2016].
  111. Lin CW, Lin CC, Mo LR, et al. Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis. J Hepatol 2013;58(4):730–35. [Accessed 23 March 2016].
  112. Briasoulis A, Agarwal V, Messerli FH. Alcohol consumption and the risk of hypertension in men and women: A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2012;14(11):792–98. [Accessed 23 March 2016].
  113. Strohl KP, Brown DB, Collop N, et al. An official American Thoracic Society clinical practice guideline: Sleep apnea, sleepiness, and driving risk in noncommercial drivers. An update of a 1994 Statement. Am J Respir Crit Care Med 2013;187(11):1259–66. [Accessed 23 March 2016].
  114. Glina S, Sharlip ID, Hellstrom WJ. Modifying risk factors to prevent and treat erectile dysfunction. J Sex Med 2013 Jan;10(1):115–19. [Accessed 23 March 2016].
  115. Grover S, Mattoo SK, Pendharkar S, Kandappan V. Sexual dysfunction in patients with alcohol and opioid dependence. Indian J Psychol Med 2014 Oct;36(4):355– 65. [Accessed 23 March 2016].
  116. Sullivan LE, Fiellin DA, O’Connor PG. The prevalence and impact of alcohol problems in major depression: A systematic review. Am J Med 2005;118(4):330–41. [Accessed 23 March 2016].
  117. Beaulieu S, Saury S, Sareen J, et al. The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid substance use disorders. Ann Clin Psychiatry 2012;24(1):38–55. [Accessed 23 March 2016].
  118. National Collaborating Centre for Mental Health. Generalised anxiety disorder in adults: Management in primary, secondary and community care. Leicester (UK): British Psychological Society and Royal College of Psychiatrists, 2011. [Accessed 23 March 2016].
  119. Moore AA, Whiteman EJ, Ward KT. Risks of combined alcohol/medication use in older adults. Am J Geriatr Pharmacother 2007;5(1):64–74. [Accessed 23 March 2016].
  120. Johnson BA, Seneviratne C. Alcohol-medical drug interactions. Handb Clin Neurol 2014;125:543–59. [Accessed 23 March 2016].
  121. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in communitydwelling older people: A systematic review and meta-analysis. Epidemiology 2010;21(5):658–68. [Accessed 23 March 2016].
  122. Tam CW, Leong LH, Zwar N, Hespe C. Consultation contexts and the acceptability of alcohol enquiry from 84 Guidelines for preventive activities in general practice 9th edition general practitioners – A survey experiment. Aust Fam Physician 2015;44(7):490–96. [Accessed 23 March 2016].
  123. Tam CW, Leong L, Zwar N, Hespe C. Alcohol enquiry by GPs – Understanding patients’ perspectives: A qualitative study. Aust Fam Physician 2015;44(11):833–38. [Accessed 23 March 2016].
  124. Kaner EF, Beyer F, Dickinson HO, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2007;2:CD004148. [Accessed 23 March 2016].
  125. Moyer VA, US Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: US Preventive Services Task Force recommendation statement. Ann Intern Med 2013;159(3):210–18. [Accessed 23 March 2016].
  126. McCambridge J, Kypri K. Can simply answering research questions change behaviour? Systematic review and meta analyses of brief alcohol intervention trials. PLOS ONE 2011;6(10):e23748. [Accessed 23 March 2016].
  127. Jonas DE, Garbutt JC, Amick HR, et al. Behavioral counseling after screening for alcohol misuse in primary care: A systematic review and meta-analysis for the US Preventive Services Task Force. Ann Intern Med 2012;157(9):645–54. [Accessed 23 March 2016].
  128. Gaume J, McCambridge J, Bertholet N, Daeppen JB. Mechanisms of action of brief alcohol interventions remain largely unknown – A narrative review. Front Psychiatry 2014;5:108. [Accessed 23 March 2016].
  129. McCambridge J, Rollnick S. Should brief interventions in primary care address alcohol problems more strongly? Addiction 2014;109(7):1054–58. [Accessed 23 March 2016].
  130. Riper H, van Straten A, Keuken M, Smit F, Schippers G, Cuijpers P. Curbing problem drinking with personalizedfeedback interventions: A meta-analysis. Am J Prev Med 2009;36(3):247–55. [Accessed 23 March 2016].
  131. O’Donnell A, Anderson P, Newbury-Birch D, et al. The impact of brief alcohol interventions in primary healthcare: A systematic review of reviews. Alcohol Alcohol 2014;49(1):66–78. [Accessed 23 March 2016].
  132. Saitz R. Alcohol screening and brief intervention in primary care: Absence of evidence for efficacy in people with dependence or very heavy drinking. Drug Alcohol Rev 2010;29(6):631–40. [Accessed 23 March 2016].
  133. Ballesteros J, Duffy JC, Querejeta I, Arino J, GonzalezPinto A. Efficacy of brief interventions for hazardous drinkers in primary care: Systematic review and metaanalyses. Alcohol Clin Exp Res 2004;28(4):608–18. [Accessed 23 March 2016].
  134. Beich A, Thorsen T, Rollnick S. Screening in brief intervention trials targeting excessive drinkers in general practice: Systematic review and meta-analysis. BMJ 2003 6;327(7414):536–42. [Accessed 23 March 2016].
  135. Brown W, Bauman A, Bull F, et al. Development of evidence-based physical activity recommendations for adults (18–64 years). Canberra: Department of Health, 2012. [Accessed 23 March 2016].
  136. Okely AD, Salmon J, Vella SA, et al. A systematic review to inform the Australian sedentary behaviour guidelines for children and young people. Canberra: Department of Health and Ageing, 2012. [Accessed 23 March 2016].
  137. Sims J, Hill K, Hunt S et al. National physical activity recommendations for older Australians: Discussion document. Canberra: Department of Health and Ageing, 2006. [Accessed 23 March 2016].
  138. Michael YL, Whitlock EP, Lin JS, Fu R, O’Connor EA, Gold R. Primary care – Relevant interventions to prevent falling in older adults: A systematic evidence review for the US Preventive Services Task Force. Ann Int Med 2010;153(12):815–25. [Accessed 23 March 2016].
  139. Bauman A, Bellew B, Vita P, Brown W, Owen N. Getting Australia active: Towards better practice for the promotion of physical activity. Melbourne: National Public Health Partnership, 2002. [Accessed 23 March 2016].
  140. LeFevre ML. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: US Preventive Services Task Force recommendation statement. Ann Int Med 2014;161(8):587–93. [Accessed 23 March 2016].
  141. Mammen G, Faulkner G. Physical activity and the prevention of depression. A systematic review of prospective studies. Am J Prev Med 2013;45(5):649–57. [Accessed 23 March 2016].
  142. Orrow G, Kinmonth AL, Sanderson S, Sutton S. Effectiveness of physical activity promotion based in primary care: Systematic review and meta-analysis of randomised controlled trials. BMJ 2012;344:e1389. [Accessed 23 March 2016].
  143. Pavey TG, Anokye N, Taylor AH, et al. The clinical effectiveness and cost-effectiveness of exercise referral schemes: A systematic review and economic evaluation. Health Technol Assess 2011;15(44):i–xii, 1–254. [Accessed 23 March 2016].
  144. Kolt GS, Schofield GM, Kerse N, Garrett N, Ashton T, Patel A. Healthy Steps trial: Pedometer-based advice and physical activity for low-active older adults. Ann Fam Med 2012;10(3):206–12. [Accessed 23 March 2016].
  145. Muller AM, Khoo S. Non face-to-face physical activity interventions in older adults: A systematic review. Int J Behav Nutr Phys Act 2014;11(35). [Accessed 23 March 2016].
  146. Goode AD, Reeves MM, Eakin EG. Telephone-delivered interventions for physical activity and dietary behavior change: An unpdated systematic review. Am J Prev Med 2012;42(1):81–88. [Accessed 23 March 2016].
  147. Pavey T, Taylor A, Hillsdon M, et al. Levels and predictors of exercise referral scheme uptake and adherence: A systematic review. J Epidemiol Community Health 2012;66(8):737–44. [Accessed 23 March 2016].
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