Introduction

Pregnancy is an important period to support smoking cessation and improve outcomes. Maternal smoking among Aboriginal and Torres Strait Islander peoples has declined, but regional variations exist. Since 2009/10, Tackling Indigenous Smoking (TIS) teams have been delivering place-based health promotion. To-date a key challenge has been measuring the impact of population health approaches such as TIS beyond cross sectional analyses. This study aims to evaluate the impact of TIS on maternal smoking among women having Aboriginal and Torres Strait Islander babies, and impacts between areas that have ever had TIS or not.


Methods

Interrupted time series analysis (ITSA) of the Australian National Perinatal Data Collection 2005–2017, with interruption (TIS) defined as 2010. A single-group ITSA model estimated overall impact, while controlled models compared impact by TIS and non-TIS areas. Models were stratified by age, parity, and remoteness.


Results

Among 173,733 recorded births, maternal smoking declined from 55.0% (2005) to 41.0% (2017), with pre-2010 declines of 0.7 percentage points annually (p<0.001). Post-implementation, the decline was 1.3 percentage points per year (p=0.001), 0.6 percentage points larger than pre-program trends (p=0.046). The 2017 estimated prevalence was lower than predicted without the investment in tobacco control from 2010 (39.0% vs. 46.0%, p<0.05). Post-2010, TIS-funded areas in particular had greater declines compared to pre-program trends, and lower prevalence in 2017 than predicted without program investment (p<0.05).


Conclusion

Increased tobacco control from 2010 accelerated smoking declines. The greater reductions post-2010 compared to pre-implementation, overall and in TIS areas, suggests targeted programs enhanced existing tobacco control measures. Sustained investment in intensive, community-led interventions to address smoking during pregnancy appear to reduce prevalence.


Indigenous leadership and governance

This study was conceptualised and conducted with Indigenous leadership and engagement, ensuring alignment with principles of self-determination and community governance. It was developed in collaboration with the Tobacco Free Program Executive (RL, MK, LJW, CC) and guided by Thiitu Tharrmay, a national Aboriginal and Torres Strait Islander research reference group. This approach upholds the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), the WHO Framework Convention on Tobacco Control, and best-practice ethical standards in Indigenous health research.

Background: The Northern Territory (NT) has the highest rates of alcohol harm in Australia. A suite of policies were implemented in the Territory in 2018, with a minimum unit price (MUP) of $1.30 per standard drink the only population-wide, rather than targeted, approach. Despite evidence of its efficacy in decreasing alcohol consumption and harms, the MUP was repealed on 1 March 2025. This study aims to explore the immediate impact of the MUP repeal on the price of alcohol in the capital city, Darwin.

Methods: Data were obtained for all available alcohol products on the websites of three major alcohol retailers in the last week of months October 2024 through March 2025. The proportion of products available in March 2025 <$1.30 per standard drink by product type was computed, and a mixed-effects quantile regression was undertaken to test for any shifts in the overall price distribution of alcohol products in March 2025, compared to previous months.

Results: In March 2025, 77 wine and one cider products were available for <$1.30 per standard drink, including 75% of all cask wine in the sample. Overall, the median prices of beers, spirits and wine were lower in March 2025 compared to February 2025.

Conclusions: The MUP repeal resulted in an immediate increase in the availability of cheap alcohol products and appears to have led to a downward shift in the overall price of alcohol in the market. In the absence of MUP, other evidence-based, population-level alcohol policies should be prioritised for implementation. Analysing the factors that led to the repeal of the NT MUP is essential to inform future policy implementation.

Background: Vaping is a global crisis requiring feasible, evidence-based interventions. Financial incentives are an effective, risk-averse approach to smoking cessation and warrant exploration for vaping. In a world first, South Australia’s Tobacco Control Strategy 2023-2027 piloted ‘Incentive to Quit’ (I2Q), a contingency management program for smoking/vaping abstinence.

Methods: An implementation science policy evaluation of a pilot pre-post cohort study, across 4 health service groups in South Australia. Intervention: A co-designed contingency management program offering up to $150 over 3 time-points to incentivise Quitline counselling, return visits with health professionals (HPs) and smoking/vaping cessation. Primary outcome: Biochemically verified 7-day point prevalence abstinence at 6 months. Secondary outcomes: Enrolment of n=350 smokers/vapers; n=70 HPs trained in very brief advice; >28% Quitline enrolment. Outcomes were mapped to the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework. Analysis: Proportion comparison between groups and quitting status, with statistical significance and confidence intervals as relevant.

Results: To date, n=361 smokers and vapers are enrolled, with n=254 completing participation, including n=32 vapers. At 6 months, 50% of vapers (16/32) reported quitting, while 15.6% (n=5) were lost to follow-up and assumed vaping. N=336 HPs were trained, with a statistically significant increase in confidence to help vapers quit (4.71 ± 1.82 vs. 3.10 ± 1.42, p<0.001). Quitline counselling uptake was 59.4% across the I2Q population, with vapers averaging more calls (3.6) than the full cohort (2.8).

Discussion: I2Q may be an efficacious and acceptable program to support vaping cessation however, interpretation is limited by sample size and lack of control group. Interim findings suggest I2Q outperforms current gold-standard nicotine dependency treatments; considering the growing vaping burden and limited evidence for cessation, a fully powered RCT is warranted.
Funding: By Preventive Health South Australia. Scholarships for KS, TG, DP-C and PT from the University of Adelaide and Houd Research Group

Driving Change is not just about changing vaping attitudes and behaviours; it's about doing it together as a community. Focusing on the Liverpool and Fairfield Local Government Areas (LGAs), a diverse region in South Western Sydney Local Health District (SWSLHD), it utilises a community-based approach that's been successful in addressing childhood obesity.

Rates of e-cigarette use are on the rise among young people. 2022-23 data indicated 49% of young people aged 18-24 years, and 28% of those aged 14-17 years, have tried an e-cigarette. Compared to data obtained in 2019, these rates have doubled and tripled, respectively. The number of young people (18-24 years) identifying as current vapers has increased fourfold over this period (5.3% in 2019 and 21% in 2022-23).

The Driving Change study aims to mobilise stakeholders from across all sectors of the community to create a localised, community-led response. To achieve this, the study was designed to comprehensively understand the factors influencing young people's vaping. The research employed a group model-building process, working closely with community leaders and utilising data from workshops, focus groups and questionnaires. This data was then used to construct a causal loop diagram (CLD) with stakeholders. The CLD is a visual representation of how leaders and young people see the vaping system that exists in Liverpool and Fairfield LGAs, this enabled stakeholders to understand the problem and identify potential leverage points in the system.

This study helped engage community members in the public health issue and develop community-led responses. The research team is collecting data throughout the study to track changes in vaping among young people and assess the impact of the community-based systems approach on local policy, programs, practice, and environments.

Background:
Alcohol related harm is a significant public health issue in Australia, causing serious impacts to individuals and their communities. Accessibility of alcohol venues and outlets remains a common challenge. The current regulatory process in New South Wales (NSW) provides the opportunity for communities to provide a response to new liquor licences or when changes are made to an existing licence however, there is limited understanding of community perceptions of this process and the barriers and facilitators to effective engagement in alcohol licensing decisions.

Aim:
This project aimed to better understand the role of community engagement in alcohol licensing decision making in NSW.

Methods:
Semi-structured qualitative interviews were conducted with 14 participants including community advocates, policy advisers, chairpersons of community action teams, community members and experts of engagement in alcohol decision-making. Interview data were thematically analysed using NVivo software to identify key themes and patterns.

Findings and Outcomes:
Key findings included that participants willing to engage in alcohol decision making, but often lacked confidence, knowledge and skills in the advocacy process. Participants faced significant structural barriers in engaging in decision making such as the asymmetry of power and resources between the alcohol industry and the community, the complex nature of the alcohol licence objection process and the lack of formal structures to support community input. These findings highlight the need to close the knowledge and resource gap between the industry and community, while also focusing on empowering the community to engage in the complex, legalistic licencing space.

Future Actions:
Future work should involve a comprehensive review of alcohol-related decision-making processes in NSW to evaluate the scope and effectiveness of community participation mechanisms.

Background:
Given the increased popularity of vaping among young people in Australia, it was crucial to track vaping use over time to detect behaviour change and inform effective policy, programs and education initiatives. Commencing in 2021, the Generation Vape research project, funded by the Australian and NSW Governments, is the first and largest study to track vaping among young Australians over time and is uniquely placed to measure the impact of policy change.

Methods:
The Generation Vape study examines vaping attitudes, beliefs, knowledge and behaviours through 6-monthly online cross-sectional surveys among teenagers aged 14-17 years. This abstract presents survey findings from Wave 4 (February 2023) through to Wave 7 (November 2024) from 8,453 14-17-year-olds. All data for Wave 7 was collected following the October 2024 national legislation changes to assess impacts pre and post reforms.

Results:
Vape use among teenagers has decreased from 19% in 2023 to 16% in 2024. Over two thirds (73%) of teenagers did not buy vapes themselves, compared to 66% in 2023), with friends giving or sharing vapes the most popular access channel (78% in 2024). Fewer young people in 2024 report that they would vape if one of their best friends were to offer them a vape than in 2023 (18% vs 15%), and awareness of the harms of vaping has increased over time.

Conclusions:
Australia is among the first countries in the world to show early indicators of success in slowing the rise of youth vaping. While stronger vaping regulation has been adopted in Australia, ongoing enforcement, monitoring and research are critical in ensuring early indicators of success become a long-term trend. Studies like Generation Vape are instrumental in tracking behaviour change over time and generating and monitoring the impact of policy change.

Background and Aims: There has been a marked increase in the prevalence of vaping among 16-24-years-olds in NSW, with current vapers increasing from 1.7% in 2014-2015 to 18.9% in 2022-2023. In 2023-24, the Cancer Institute NSW launched the ‘Every Vape is a Hit to Your Health’ campaign which aimed to reduce the uptake of vaping and encourage those who vape to quit. The aim of the campaign evaluation was to assess the campaign’s reach, and its impact on young people’s attitudes and behaviours relating to vaping.

Methods: Media performance on each digital media channel was measured using the Impressions delivered. A cross-sectional tracking survey was conducted from February to June 2024 to evaluate the impact of the campaign on young people aged 14-24-years in NSW. Participants completed an online survey which collected measures on campaign recognition and knowledge, attitudes, intentions and behaviours related to vaping. Survey data was weighted and analysed using multivariate logistic regression.

Results: The campaign outperformed planned media impressions across most digital channels. In total n=1,901 young people were surveyed, with 64% of respondents recognising at least one campaign asset. People who recognised the campaign were significantly more likely than non-recognisers to agree with the statement ‘Vaping is not safe’ (aOR 2.1, 95% CI 1.5-2.8). Among people who vape, campaign recognisers were significantly more likely than non-recognisers to be considering quitting vaping in the next six months (aOR 1.9, 95% CI 1.2-3.0) or to have made a quit attempt during the campaign period (aOR 1.8, 95% CI 1.2-2.8).