Background: Despite recent declines in alcohol consumption for younger generations, risky drinking still peaks in young adulthood (18-29). While men have historically consumed more alcohol than women, there may be changes emerging in gendered patterns of drinking. This study investigated if a 'gender convergence' in young adults' drinking has occurred in Australia, whereby women and men's drinking rates have become more similar over time. Methods: Three national Australian survey data sources were used to assess drinking trends from 2001 to 2023 in young adult women and men, aged 18-29. Gender convergence was tested for annual volume, past-year drinking status, and long-term, risky single-occasion, and high risky single-occasion drinking. Analyses included linear and logistic regressions with interactions between gender and year to assess gender differences in trends over time. Results: Drinking declined for young adults across all measures and surveys between 2001 and 2023. For all surveys, evidence for convergence in annual volume was found from 2013 to 2023. Some evidence for convergence was noted in recent years for past-year drinking (2019-2023) and risky drinking (2021-2022). For all measures, convergence occurred due to men's drinking decreasing at faster rates than women's. Conclusions: This study provides evidence for gender convergences in young adults' drinking in Australia. Notably, this convergence occurs within the context of a broader drinking decline for both women and men, whereby men's drinking has decreased at a faster rate. These findings reflect emerging evidence from other high-income countries and suggest that future research understanding the drivers for men's steeper drinking declines is warranted.

Background Working mothers perform ‘double shifts’ of paid and domestic labour. Increased rates of employment among mothers in high income countries, and the impact of the alcohol industry actively promoting alcohol to working mothers, makes it crucial for preventative efforts to understand the factors driving alcohol use among this population. This systematic review of qualitative and quantitative studies provides an overview of the drinking patterns of working mothers and their predictors. Methods Four databases were systematically searched in August 2024. The population of interest were adult women in high income countries, who were both mothers of at least one dependent child and employed in any capacity. The methodological quality was assessed using the Mixed Methods Appraisal Tool. Following a convergent integrated approach, narrative synthesis was conducted for all studies. Results Of the 4623 records maintained for screening, 22 articles (15 quantitative and 7 qualitative) were included. Working mothers were more often drinkers and consumed a higher quantity per occasion (including binge and risky drinking) in comparison to mid-life women and non-working mothers. Alcohol use was also linked to managing emotional states, as a commodity to ‘cope’ with gendered norms. Living in a society with increased gender equity and being partnered or married had a protective effect on heavy drinking and consumed quantity. Conclusions Working mother’s drinking is governed by gender norms and expectations, and countries who advance policies to improve the acceptability and compatibility of motherhood and employment may reduce working mother’s alcohol use.

Background Interventions to help young people make sense of sex and relationships in the context of widely available pornography are becoming increasingly supported in school settings. However, young people who experience disruptions to their education often have less access to such programs. Digital platforms may offer a more accessible method to deliver tailored sexual health and pornography literacy to young people who are disengaged from mainstream schooling, or who experience other types of structural disadvantage. Objective This study aimed to describe the formative evaluation of “The Gist” a co-designed online sexual health education and pornography literacy prototype designed to meet the sexual health information needs of structurally marginalized young people in Australia. Methods We conducted iterative workshops with 33 young people aged between 15 and 24 years recruited from an alternative education school in Melbourne, Australia. Through interactive activities, participants evaluated the overall prototype design, including its usability, desirability, inclusiveness, and potential for impact. Results Participants reported The Gist to be easy to use (17/20, 85%) and safe (19/23, 83%), with “hot” branding (25/30, 83%). However, perceived content relevance was dependent on the participants’ existing level of sexual health knowledge and experience, with only 31% (7/23) agreeing that “The Gist feels like it was made for me.” The interactive learning activities such as the debunked (myth-busting) and quiz features were among the most used and well-liked on The Gist platform. Low unprompted engagement with the prototype outside of facilitated workshop settings also confirmed previous researcher postulations that The Gist as a standalone digital platform is unlikely to meet the needs of this population group. Further design refinements are needed to improve user experience, including more interactive activities and visual information in place of heavily text-based features. Conclusions This study provides important insights into the design and sexual health information needs of structurally marginalized young people. Further research is needed to assess the overall efficacy of The Gist prototype, as well as its ability to positively influence young people’s sexual attitudes, beliefs, and behaviors. Future iterations should consider hybrid or face-to-face delivery models to better capture student engagement.

Background:Peers are known to influence the health behaviors and attitudes of adolescents, yet recruitment of these networks is challenging. Previous studies have used web-based respondent-driven sampling methods to recruit this population, yet none have experimentally investigated the impact of financial reimbursements. Objective:This study aimed to (1) compare the effectiveness of two financial reimbursement strategies for recruiting adolescents and their peer networks and (2) explore factors associated with successfully recruiting peers. Methods:A parallel-design randomized controlled trial was conducted in which participants (seeds) were randomly allocated to a fixed cash reimbursement (control) or scaled reimbursement (experimental) group as a strategy to be recruited into a web-based peer network study. Seeds aged 16 to 18 years were recruited through social media advertisements and an online student panel. They completed a web-based survey, which assessed eligibility and included questions about their friends (peers). Allocation occurred through a survey platform using a simple randomization method. In the fixed group, all participants in a peer network received AUD $5 (US $3.29); in the scaled group, all participants in a peer network received an additional AUD $5 (US $3.29) per peer who successfully completed the survey (up to AUD $30 each [US $19.72]). Participants and researchers were not blinded to intervention groups. The primary outcome was recruitment of peers to complete the web-based survey (proportion of nominated peers). The number of peers recruited was a secondary outcome. In secondary analyses, we identified peer-, relationship-, and seed-level variables associated with successfully recruiting peers. Results:Of 463 seeds allocated to an intervention (scaled n=221 and fixed n=242), 319 (68.9%) had complete data for analysis (scaled n=157, 71% and fixed n=162, 67%). A total of 11.9% of seeds successfully referred peers (18.5% scaled group and 5.6% fixed group). Those in the scaled reimbursement intervention were 3.80 times more likely to successfully recruit their peers than those in the fixed reimbursement intervention (proportion ratio 3.80, 95% CI 1.78-8.09). Similarly, the average number of peers recruited differed by 0.19 (95% CI 0.11-0.28) per seed between the scaled and fixed intervention groups. Peer recruitment success was similar regardless of the gender, age, education level, and network size of seeds or the gender, age, and closeness of peers. Seeds recruited through social media were more likely to successfully recruit their nominated peers than those recruited through a research panel (proportion ratio 2.20, 95% CI 1.06-4.55). Conclusions:Scaled reimbursements resulted in significantly greater recruitment of peers than fixed reimbursements; however, the total number of peers recruited was low. Greater-value incentives and stronger initial recruitment through social media may be needed to recruit large numbers of friend networks.

BackgroundThe aims of this study were to assess the impact of the lockdowns on Victorian women's alcohol consumption and to examine impacts by age.Methods149 Victorian women (Mage (SD) = 42.6 (12.7)) completed 2,416 weekly surveys between May 2020 and February 2021. Multi-level models were estimated to assess the impact of COVID-19 lockdown period and age on the frequency and quantity of participants' weekly drinking.ResultsOverall, reductions in Victorian women's alcohol consumption were observed during both lockdowns, although greater reductions were apparent during the stricter lockdown with curfew. Both lockdowns also resulted in larger reductions in weekly drinking quantity, with fewer changes to drinking frequency.ConclusionsThe COVID-19 lockdowns resulted in overall reductions in the quantity, and to a lesser extent, the frequency of women's drinking in Victoria and these effects were significantly larger for younger women (aged 18-29).

Background In the Northern Territory (NT) of Australia, there are significant evidence gaps about illicit drug use and harms, despite having established monitoring and reporting systems. This paper reports on illicit drug use, associated harms, contributing factors, service needs and priorities in the NT from the perspective and experiences of key stakeholders engaged in providing services for, or advocating on behalf of, people who use illicit drugs in the NT. Methods Face-to-face and online qualitative interviews were conducted with stakeholders across urban and remote locations in the NT. Key stakeholders were service providers, including acute and primary care clinicians, representatives of Aboriginal community controlled health organisations, lived experience advocates, peak body representatives and public health executives. Qualitative data were analysed thematically. Results Four researchers interviewed 21 participants across urban (62%), and remote areas (38%) of the NT. Themes identified were: 1) Illicit drug use and harms are diverse and distinct; 2) Client support needs are complex and influenced by co-morbidities, socio-demographic and cultural factors; 3) Priority population sub-groups need targeted strategies; 4) Local service strengths can be further developed and enhanced; 5) Local services need better resourcing; 6) Invest in progressive legislative and policy reforms; and 7) Improve routine monitoring and evaluation. Conclusions Key stakeholders described illicit drug use, harms and contributing factors, which provided insights into the local challenges. Participants emphasised that clients have complex care needs, and further investment into targeted strategies are required to improve service engagement with priority groups. Service needs included greater understanding the role of dual diagnosis and its implementation and enhancing integrated and collaborative care in both primary health and acute care contexts. The voices of people with lived experience captured in this paper must inform local strategy and policy development relating to illicit drug use, in alignment with national strategy.

INTRODUCTION:Alcohol sponsorship of sport is associated with increased alcohol consumption. Little research to date has examined the sponsorship of sport by no- and low-alcohol (NoLo) beverage brands, despite concern that the marketing of these products might be harmful to young people. This study had dual aims: to identify sporting partnerships between NoLo beers and Australian sport, and examine marketing tactics used in social media advertising to promote these partnerships. METHODS:Our sample included NoLo beers sold online from three large Australian alcohol retailers. First, we performed a qualitative content analysis of partnerships between NoLo beers and sport using publicly available online information. We then analysed the 118 social media posts of NoLo brands linked to these partnerships using a coding framework adapted from the alcohol literature. RESULTS:Of 34 brands, 13 had sporting sponsorship partnerships across a range of spectator and participatory sports. Key marketing tactics identified on social media were activations, time-and event-specific drinking, influencer marketing, competitions, and corporate social responsibility. In particular, NoLo brands aim to disrupt the sports drink market by advertising their products as healthy recovery drinks, or 'sports beers', through activation events. Brands are also using influencer marketing and competitions, two tactics shown to be particularly persuasive for young people. DISCUSSION AND CONCLUSIONS:NoLo beer brands strategically align with Australian sports to promote NoLo consumption. As they are classified as soft drinks in Australia, NoLo beverages are not regulated like alcohol. Future discussions around sports sponsorship and advertising regulation must consider NoLo products.

Background: During COVID-19 lockdowns, women and parents were more likely to increase their alcohol use. Working mothers in particular faced additional stressors and roles that may have influenced how they drank. In this study, we explored how the experiences of Australian lockdowns affected drinking practices among a sample of working mothers. Methods: Between February and June 2022, we conducted 22 semi-structured interviews with working mothers aged 36-51. Participants reflected on their social roles, everyday routines, and drinking practices, highlighting changes that occurred during lockdowns. We applied a critical realist framework, analysing interviews using reflexive thematic analysis. Results: Women reflected on increased alcohol use during lockdowns, experiencing intensified emotional attachments toward drinking. Women described using alcohol to manage negative affect and stress brought on by additional responsibilities, such as home-schooling. Participants also discussed increased pervasiveness and permissiveness around alcohol, noting that drinking was promoted as a way to maintain relationships within and outside of households during lockdowns. Conclusion: COVID-19 lockdowns provide a case study for examining how working mothers' stresses were reinforced by structural barriers and social conventions. They highlight how the gendered division of domestic labour can amplify gendered drinking practices, particularly when lives are centred around the home.

Abstract Background Studies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic. Methods This prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15–29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID–19 public health restrictions related factors and the severity of anxiety and depression symptoms over time. Results Analyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms. Conclusion These findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people’s mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.

Background: In the context of Australian music festivals, including those in the Northern Territory (NT), drug-related harms persist. This study focused on gathering local insights into drug-related behaviours and attitudes, particularly regarding drug checking, among NT festival attendees. Methods: In May 2022, attendees (aged 16+) at a single-day multi-genre music festival in the NT were surveyed onsite about their drug use and harm reduction behaviours. Logistic regression was employed to explore factors influencing attitudes and preferences toward drug checking. Results: Out of 539 participants, 40% reported recent drug use in the past month. About 12% planned drug use at the festival. Notably, 73% supported drug checking, with 81% approval among people who use drugs. Older participants (>25 years) had 2.6 times (p = .001) greater odds of supporting drug checking. Participants with recent drug use had 2.1 times (p = .006) greater odds of supporting it. Among those opting for drug checking (n = 270), people who have recently used drugs had 5.5 times (p <.001) greater odds of preferring an onsite service. Additionally, 67% believed any drug checking service increased their safety. Conclusions: The study reveals NT festivalgoers' widespread support for drug checking and suggests the need for on-site drug checking services in the NT.

Background: During 2017-18, the Northern Territory (NT) introduced a Banned Drinker Register (BDR) and Minimum Unit Price (MUP) NT-wide; Police Auxiliary Liquor Inspectors (PALIs) in three regional towns; and restrictions on daily purchases/opening hours (DPOH) in one regional town. The BDR is an individual-level alcohol ban; MUP is a pricing policy; and PALIs enforce bans on restricted areas at takeaway outlets. This study examines the impact of these policies on adult domestic and family violence (DFV). Methods: We examined DFV assaults and breaches of violence orders from January 2014 - February 2020 using interrupted time series models for NT, Greater Darwin, Katherine, Tennant Creek, and Alice Springs. To account for increasing numbers of individuals on the BDR we tested two timepoints (Sept 2017, March 2018). Findings: Following DPOH, assaults (78 %) and alcohol-involved assaults (92 %) decreased in Tennant Creek. After PALIs, assaults (79 %) in Tennant Creek, and breaches (39 %) and alcohol-involved breaches (58 %) in Katherine decreased. After MUP, assaults (11 %), alcohol-involved assaults (21 %) and alcohol-involved breaches (21%) decreased NT wide. After MUP/PALIs in Alice Springs, alcohol-involved assaults (33 %), breaches (42 %), and alcohol-involved breaches (57 %) decreased. BDR (Sept 2017) found increases in assaults (44 %) and alcohol-involved assaults (39 %) in Katherine and assaults (10%) and alcohol-involved assaults NT-wide (17 %). There were increases of 21 %-45 % in breaches NT-wide, in Darwin, Katherine, and Alice Springs. Following March 2018 found increases in assaults (33 %) and alcohol-involved assaults (48 %) in Katherine. There were increases- from 20 % to 56 %- in breaches in NT-wide, Katherine, and Alice Springs. Conclusion: PALIs and DPOH were associated with some reductions in DFV; the BDR was associated with some increases. The upward trend commences prior to the BDR, so it is also plausible that the BDR had no effect on DFV outcomes. Although MUP was associated with reductions in the NT-wide model, there were no changes in sites without cooccurring PALIs.

Background This feasibility and validity study aimed to evaluate and compare ecological momentary assessment (EMA) surveys and transdermal SCRAM-CAM monitors to measure drinking while watching Australian Rules Football (AFL).Methods During 29 events, 13 participants wore a SCRAM-CAM monitor while completing EMA surveys. Correspondence in the alcohol levels detected and correlation between the self-reported drinks and transdermal alcohol concentration (TAC) were measured. An exit survey assessed participant experiences.Results Alcohol consumption was self-reported on 24 (83.3%) of 29 events, with an average of 5.0 standard drinks consumed over 2.3 hours. Correspondence in the levels of alcohol detected was good at 0.62. TAC curves showed large-sized correlations to the number of self-reported drinks (r = 0.55–0.67). Some participants noted discomfort from the SCRAM-CAM, whilst others reported annoyance completing EMA surveys during a match.Conclusions EMA surveys are a cost effective method for collecting information on drinking as well as contexts and other factors such as harms. A clear benefit of the SCRAM-CAM is the ability to provide detailed information on intoxication trajectories. We suggest that a combination of the two methods will inform the most meaningful approaches for prevention and intervention strategies to reduce harmful drinking among sport spectators.

BackgroundDespite recent increases in alcohol use among Western mid-life women, less is known about working mothers and how their competing social roles and responsibilities might influence their alcohol use. Our study unpacks how the experience of being a working mother creates particular drinking practices and meanings, and how these are influenced by cultural and societal factors.MethodsSemi-structured interviews were conducted among 22 Australian women aged 36-51 years old. Women were mothers of dependent children who were employed more than 15 h per week, with most being professional workers who identified as Anglo-Australian. We asked participants about their daily lives, their employment, their families, and their alcohol use. Underpinned by critical realism, reflexive thematic analysis was utilized as the data analysis strategy.ResultsWomen felt they had to be available to both their employers and their children at the same time. For some, this led to internalized feelings of guilt and fatigue, increasing women's desire to drink, and limiting their capacity to be mindful of the amount of alcohol they were consuming. Women also described feeling overloaded and under-supported, where alcohol was viewed as being relaxing and rewarding, as well as a way to escape, cope, and recover from their day-to-day stressors. Furthermore, through a combination of targeted marketing and broader social normalisation, women felt alcohol was presented as a solution to stress and problems among working mothers.ConclusionsAddressing commercial and social determinants of health and acknowledging these in potential health promotion strategies is necessary.

ISSUE ADDRESSED:E-scooters are sought after for their cost-effectiveness, sustainability, and efficiency in urban transportation. However, this popularity has been accompanied by a surge in injuries, prompting a deeper investigation into the factors influencing risk perceptions among e-scooter users. METHODS:Using a qualitative approach, we conducted 19 interviews with those who attended an emergency department as a result of e-scooter injury. We aimed to understand the psychosocial effects of these incidents and employed thematic analysis to discern recurrent patterns in participants' experiences, focusing on alterations in daily life, community response, perception shifts, and avenues to enhance safety awareness. RESULTS:The findings underscored significant disruptions to daily life due to injuries, demonstrating enduring impacts on lifestyle and wellbeing. Participants exhibited a perceptual shift, transitioning from perceiving e-scooters as enjoyable to viewing them as dangerous. Recommendations for enhancing safety awareness included accessible and clear safety education, pre-ride briefings, real-time safety guidance, temporal rental restrictions, and mandatory breathalysers before e-scooter use. CONCLUSIONS:The study underscores the importance of considering not only the individual experiences and perceptions of e-scooter injuries but also the broader social context, including the night-time economy. Leveraging peer narratives and community engagement is vital to reshape risk perceptions and promote harm reduction messages. SO WHAT?: A comprehensive approach through proactive interventions and robust educational strategies is essential to foster responsible e-scooter usage and prioritise public safety.

Background With greater attention given to midlife women's drinking in research and in media representations of ‘wine mums’, we suggest that focusing on static gender roles (e.g., women as mothers) risks overlooking complex and dynamic features of women's lives. We draw on the concept of thick intersectionality to explore how everyday experiences of women's lives and multiple identities shape their drinking practices. Methods This study draws on interviews with Australian women in their forties and fifties who were employed, had school-aged children and drank alcohol. We present four detailed accounts as interpreted narratives. Results Close analysis of the stories of four women highlights important features of women's lives. Drinking practices were often intertwined with gendered labour, power inequalities and managing stresses borne from these. Gender, class, relationality, life course transitions, affect and various aspects of labour dynamics (temporality, autonomy and unseen labour) were prominent in the accounts. Alongside this health, geography, life histories and culture interacted in women's narratives and the various identities and roles they moved between, co-producing drinking practices in different ways. Conclusion By juxtaposing women's stories with ‘wine mum’ stereotypes, and the broader feminisation of drinking, we highlight how women's drinking practices are influenced not only by static identities, but the complex interplay between gender, a myriad of fluid social categories, and day-to-day life. We suggest that attending to context and women's everyday experiences is crucial for generating a nuanced understanding of drinking beyond women's traditional gender roles.

The Northern Territory (NT) has the highest rates of domestic, family and sexual violence (DFSV) in Australia. Although we know that alcohol and other drug (AOD) use and trauma both contribute to DFSV in the NT, some specifics remain unknown. This paper aims to (a) describe the extent of AOD involvement in criminally serious DFSV, (b) describe the volume of trauma experienced by convicted criminally serious DFSV offenders, and (c) qualitatively explore the judicial recognition of the intersections between alcohol and trauma. To do this we reviewed Judicial Sentencing Remarks (JSRs) from the Supreme Court of the NT. A content analysis of all DFSV JSRs from July to Dec 2020 was undertaken ( n = 64). A structured coding instrument was developed to extract quantitative and qualitative variables through repeated reviews by multiple authors. Descriptive statistics regarding demographics, number of significant traumatic events experienced, and AOD involvement were generated. The qualitative data from which these statistics were generated was used to explore the interplay between trauma and AOD involvement. The majority of offenders had experienced at least one form of trauma. The social determinants of health underpinned a significant amount of this trauma, with housing, poverty, and unemployment frequently described. The use of alcohol as a maladaptive coping mechanism was explicitly recognised. There was frequent judicial recognition of the intersections between trauma, alcohol, and violence, however addressing trauma as an essential part of rehabilitation processes was rare. Trauma and AOD use were widespread among convicted DFSV offenders, with alcohol involved in the majority of incidents. Further research is required to understand the bio-psycho-social factors involved in the relationship between trauma, alcohol, and DFSV. Systematic piloting and trialling of interventions is necessary to determine what approaches are effective for preventing DFSV and reducing recidivism for people with intersecting experiences of trauma and AOD concerns.

INTRODUCTION:Alcohol is a leading cause of morbidity and mortality globally. One significant barrier to the implementation of evidence-based alcohol policy is alcohol industry opposition. Making submissions to national policy processes is one way in which the industry exert influence. The aim of this study was to analyse alcohol industry submissions into Australia's National Alcohol Strategy to determine key assertions made by the alcohol industry and the ways in which they use evidence and refute the effectiveness of public health policies to make their claims.METHODS:Submissions made by alcohol industry actors (n = 12) were analysed using content analysis to determine key industry assertions. A pre-existing framework on alcohol industry use of evidence was then applied to analyse the evidentiary practices used to make these assertions.RESULTS:Five common industry assertions were identified: 'Drinking alcohol in moderation has health benefits'; 'Alcohol isn't the cause of violence'; 'Targeted initiatives, not population level alcohol policies, are needed'; 'Strong alcohol advertising regulations are not necessary'; and 'Minimum unit price and pricing and taxation policies more broadly are not needed'. The industry systematically manipulated, misused and ignored evidence throughout their submissions.DISCUSSION AND CONCLUSIONS:The alcohol industry is misusing evidence in their submissions to government consultations to make their assertions about alcohol policy. It is therefore essential that industry submissions are scrutinised and not accepted on face value. Additionally, it is suggested that the alcohol industry requires a distinct model of governance similarly to that which regulates the tobacco industry to prevent their attempts to undermine evidence-based public health policy.