Introduction. Most Australian school-aged children bring lunch from home and the school lunchbox is therefore a key context for influencing their overall diet. The aim of this study was to investigate changes in the nutritional profile and labelling of new lunchbox snack products released in Australia coinciding with the introduction of the voluntary Health Star Rating system (HSR).

Methods. Records of new packaged lunchbox snacks released in Australia between 2013 and 2024 (N=228) were extracted from the Mintel Global New Products Database using a combination of keyword searches and manual coding in August 2024. Nutrient values (/100g/mL), HSRs, and level of processing (NOVA classification) were coded from product images.

Results. The most common new lunchbox snack products were muesli bars (27.2%), savoury biscuits/crackers (20.2%), and sweet biscuits/cookies (19.3%). On average, products contained 1428kJ energy per 100g/mL, 4.8g saturated fat per 100g/mL, 17.6g sugar per 100g/mL, and 237.3mg of sodium per 100g/mL. There were significant reductions in sodium and sugar content in new products over time, coinciding with increasing uptake of HSRs. Overall, less than half of products displayed HSRs (44.7%), and those that did were significantly lower in sugar than those that did not display a HSR. Among products displaying HSRs, approximately two-thirds had a HSR of 3.5 or above (67.7%). Most products were classified as ultra-processed (91.2%), including among products displaying a HSR of 3.5 or above (88.4%).

Conclusions. Over the past decade, new packaged lunchbox snack products released in Australia have tended to be high in nutrients of concern and the vast majority are ultra-processed. There have been small reductions in sugar and sodium content coinciding with the modest but selective uptake of HSRs. Mandatory HSRs may encourage reformulation by manufacturers to improve the nutritional profile of lunchbox snack products and assist consumer decision-making, ultimately improving children’s diets.

Problem. Why don’t people exercise, rest or eat healthy food even when they know they need to do so? Is it laziness, ignorance or lack of motivation that’s the problem for unhealthy lifestyles - why do so many people no longer have enough time for their health?
What I did and results. I argue that public health should stop telling people to do more and focus instead on good health being more ‘time affordable’. Problems of combining work and family, technology, and the unrelenting drive to be more efficient and do more for less is making lack of time as important a barrier as lack of money for health prevention. Not all time is usable for health, and this is also a key insight for understanding the problem. Case studies on interventions to improve nutrition and improve children’s early environments reveal the importance of time as a barrier to success and the value of designing time in. Interventions which address time constraints as one of their design principles appear to be much more likely to succeed.
Lessons. Time has become a new health prescription needed to halt chronic diseases; 30 minutes of physical activity every day is a minimum. Lack of time is also a fundamental reason people don’t access services and a key barrier for participating in health-promoting activities. I conclude by offering principles for more time-aware public health that could support the success of prevention policies, services and interventions.

A key element of a comprehensive strategy to prevent obesity in children and support nutritious diets is to implement policies to protect them from unhealthy food marketing.
This presentation will outline the development of a Victorian obesity prevention platform supported by key public health agencies, including for controls on marketing of unhealthy food. It will outline the development of policy frameworks both nationally and in Victoria that promoted this objective leading to a campaign led by Cancer Council Victoria to drive action on this issue.
The aim of the Food Fight campaign was to advocate for the removal of unhealthy food marketing on public transports assets and infrastructure, as well as within 500m of schools in Victoria. It will outline the two phases of the campaign, including the role of research, the paid and earned media strategy as well as liaison with relevant decision makers and politicians.
It will outline acquisition of Food Fight supporters (currently more than 10,000), the use of research - including audits and public opinion data, as well as describing innovative strategies for engagement in advocacy by individuals and state-based agencies motivated to drive change in their communities.
Finally, there will be reflections on lessons learnt to inform those looking to use the voices of the community and institutions to elevate issues, amplify concerns and drive policy reform.

Introduction: Commercially produced infant and toddler foods are increasingly prevalent, yet many fail to meet WHO nutrition standards. Price promotions can impact purchasing patterns and increase quantity of purchasing. However, the extent to which this marketing strategy is used to promote infant and toddler foods in Australia is unclear. This study aimed to evaluate the frequency and magnitude of infant/toddler food price promotions in Australia over a 12-month period and examine whether this varied according to key product characteristics.

Methods: Product information for infant and toddler foods was automatically extracted from the online websites of two major supermarket chains (Coles, Woolworths) on a weekly basis between April 2023-March 2024 as part of the PriceTracker database. Data collected included ingredients, nutrient composition, original price and, where applicable, temporary sale price. Each product was coded according to target age group, product category, packaging type, sugar content and level of processing.

Results: A total of 348 unique products were identified, of which 72% were targeted at infants (<12 months) and 28% were targeted at toddlers (12-<36 months). On average, 39% of products were price promoted each week (range: 21%-51%) and this varied based on target age group (42% infant vs. 31% toddler), product category (range: 15% cereals to 51% fruit/veg), packaging type (53% pouch vs. 29% non-pouch), sugar content (36% low vs. 41% high) and level of processing (45% minimally processed, 31% processed, 39% ultra-processed). Among price-promoted products, the mean price reduction was 17%, with larger discounts applied to certain types of products (e.g., toddler foods and snacks/finger foods).

Conclusions: Price promotions are used extensively to market commercial infant and toddler foods to parents in Australian supermarkets, including among products that are least suitable for the healthy development of young children due to their smooth texture (e.g., pouches), high sugar content and ultra-processing.

Problem:
Vaping across Queensland is increasing, especially among young people. Vaping prevalence has doubled among 18-24-year-olds from 2018 (23.5%) to 2022 (45.3%). The current vaping rate is highest among this group at 14.5%. Similarly, the proportion of school students aged 12-17 who have ever vaped more than doubled from 2017 (15.5%) to 2022–2023 (35.6%).

Intervention:
Since 2017, Quitline Queensland has provided intensive quit support (IQS) for select priority populations, initially limited to current tobacco users. IQS combines multiple behavioural counselling calls with 12 weeks of combination Nicotine Replacement Therapy (NRT). In March 2023, eligibility was expanded to include exclusive vapers. In 2024, people under 30 were added as a priority population eligible for IQS.

Delivery:
Historically known as a quit-smoking service, targeted promotions were run to inform the public and health professionals of Quitline’s ability to assist in vaping cessation. Of note was strengthening relationships with universities and youth-focused organisations. Quitline counsellors emphasise a client-led approach when working with young people. Calls can be completed with a support person if the client prefers (e.g., a school nurse or parent).

Results:
From January - June 2024, 31% more clients under 30 (N = 528) registered for an IQS program compared to the same period in 2023 (N = 404). Of those who registered, 50% (N = 263) participated in a program, a comparable conversation rate to Quitline’s other priority groups. IQS participants were 58% female, and 15% identified as Aboriginal and/or Torres Strait Islander. The median age was 25, though clients as young as 14 also participated. Most clients were current or former smokers, with 8% reporting having never smoked tobacco. Comprehensive vaping cessation data will be available in 2025.

Lessons:
The successful uptake of Quitline Queensland’s program by young people demonstrates the potential for increased youth engagement in telephone-based counselling services.

Alcohol is an established Class 1 carcinogen, with an estimated 5,800 cases of cancer in Australia due to alcohol use in 2020. Drinking even small amounts of alcohol increases the risk of developing seven types of cancer. Research by the National Drug Research Institute estimates that alcohol use costs the Australian community $66.8 billion per year. Despite this, there has been no national or coordinated approach to reducing the impact of alcohol-related harms.

We recently updated our Alcohol and Cancer prevention policy to present comprehensive, evidence-based priorities to reduce the risk of alcohol-caused cancer in Australia. This was informed by literature reviews, engagement with key experts in alcohol control policy, and consensus building around priority actions to mobilise national action to reduce alcohol-caused cancer. 

Seven in 10 Australians agree that more action is required by governments to reduce the harms caused by alcohol. Subsequently, we identified four overarching priorities to minimise harms from alcohol: 1) Restriction of alcohol advertising, promotion and sponsorship; 2) Alcohol pricing policy reform; 3) Building community understanding of the risks of alcohol use through evidence informed health warning labels and public education campaigns; and 4) Restricting the physical availability of alcohol through strengthened liquor laws.   

Previous alcohol policy changes have had an impact on cancer mortality in Australia and there is strong community support for further government action. However, the pervasive influence of the alcohol industry and cultural perceptions regarding alcohol in Australia mean that the appetite to tackle the harms of alcohol in Australia is not strong. Public health organisations are well placed to leverage current national strategic frameworks and mobilise the latest evidence-based recommendations to agitate for national policy action and achieve our collective goal of reducing the harms associated with alcohol use and improving long-term health outcomes among individuals, families and communities.

In 2022-23, the highest prevalence of e-cigarette use was among people aged 14 to 24 . Formative research by ACT Health (ACTHD) indicated that a significant portion of young people were unaware of the harms associated with e-cigarettes/vaping. Those sampled considered that vaping was ‘normal’, socially acceptable, and that trusted information sources regarding the harms of use were lacking.
Schools present an ideal setting for bridging the issue of (mis)trust, as the teaching profession, and teacher-student relationship dynamic, typically lends itself to an inbuilt relationship of trust and truthfulness in the information that teachers impart on students. As such, this captive audience, at risk population setting, provides an environment to educate on vaping and related harms.
As part of ACTHD research, a need was identified to support school communities feel confident and equipped to have conversations and deliver lessons on vaping to students. In response, the ACT Government developed two Vaping, Youth and Health eLearning packages for teachers and students in Years 5 and 6 and 7 and 8.
Vaping, Youth & Health consists of 3 interactive modules to build teachers’ knowledge and capability to deliver evidence-based lessons on the harms caused by e-cigarettes. The eLearning packages were co-designed with over 150 teachers and students from ACT public, independent and catholic schools. Modules were designed to address both teacher and student needs, increase knowledge surrounding vapes and related harms, and increase confidence in teaching this content while supporting young people to reduce uptake and/or cease use.
Preliminary feedback from the evaluation of the Years 7 & 8 package found 71% of participants reported feeling very confident to teach young people about vaping after completing the course.
An update on the progress of the eLearning resources and evaluation will also be presented.

The introduction of and rapid increase in vape use risks undermining significant progress Australia has made over four decades in tobacco control. Data from the latest Australian Secondary Schools Alcohol and Drug Survey shows one in five Victorian students who had never smoked before trying a vape reported later smoking. Evidence also shows increasing rates of vape use in Australia, particularly among young people and adolescents, with 13.2% in 2022-23 reporting that they vaped in the past month compared to 3.2% in 2017.

Recent recommendations from the Inquiry into Vaping and Tobacco Control from the Public Accounts and Estimate Committee further highlights the need for education and awareness on prevention and cessation support and the crucial role schools, local government and health settings play in delivering programs to young people.

To address vaping among young people, Quit Victoria, in partnership with Victorian education sector experts developed Seeing Through the Haze, an evidence-based, curriculum aligned, teaching and learning resource for secondary schools, focused on years 7-10.

The resource focuses on building health literacies among young people to enable students to better understand vaping harms and increase awareness of industry marketing tactics. The resource also provides students with an opportunity to learn about, and design, a public health campaign. One of the learning outcomes of the resource is that students understand both the social and commercial determinants of health. In adopting this approach, we seek to educate students about the influence of politics, policy and profit with vaping and the benefits of public health prevention.

In this presentation we will share key insights from the development and implementation of the resource and describe future plans to expand prevention and cessation support for young people in primary and secondary education settings.

Background: The ‘Big 6’ lifestyle factors associated with chronic disease are poor diet, physical inactivity, alcohol use, smoking/vaping, sedentary behaviour, and poor sleep. People of low socio-economic status (SES) disproportionately experience these risk factors and chronic disease. Targeting the ‘Big 6’ during adolescence decreases the likelihood of developing chronic disease. Parent-based interventions have shown efficacy for improving youth health outcomes, and web-based delivery has proven effective for delivering parenting interventions. The “Health4Life Parents and Teens” study aims to co-design a maximally effective digital intervention to support low-SES parents to improve the health habits of their adolescent children.

Methods: Focus groups were conducted with parents (N=12) and teenagers (2 classes) in low-SES regions in NSW (June-December 2024). We obtained qualitative data from parents on strengths and challenges of parenting the ‘Big 6’, and insights for developing the intervention components. Teenagers provided insights about acceptability of the pre-existing ‘Health4Life’ school-based intervention. A 2x2x2x2 factorial trial will commence in 2025. 398 parents will be randomised to one of 16 intervention conditions to determine the individual and synergistic effects of each intervention component (see below) for improving parental encouragement of teenage health habits.

Results: Using an inductive content analyses approach, we will present thematic analysis of parents’ and teenagers’ insights about what an effective parent intervention targeting the ‘Big 6’ entails. Parents insights led to the co-design of five intervention components: web-based modules, health coaching, goal setting, text-messaging, and stress management training. Adolescents in low-SES regions supported the acceptability of the ‘Health4Life’ adolescent intervention, which is a 6-module, cartoon-based e-health program about the ‘Big 6’. Baseline findings and intervention engagement data from the factorial trial will be presented.

Conclusions: This presentation will discuss how to effectively co-design and implement a digital parent-teen intervention targeting lifestyle risk factors for chronic disease, in low-SES communities.

Introduction/Background: Occupational lung diseases (OLDs) is the term given to describe a range of lung conditions caused by breathing in dusts, fumes, gases and other hazardous agents in the workplace. There has been a resurgence of OLDs in Australia, including a recent epidemic of silicosis. OLDs are typically incurable, although they are entirely preventable.
Method: To build awareness of OLDs, including their risk factors, Lung Foundation Australia (LFA) redeveloped the Healthy Lungs at Work Quiz*. This Quiz is an online tool designed to prompt knowledge of lung health hazards and safety practices used in the workplace. The Quiz takes the respondent on a journey to identify their exposure to hazardous agents, the types of safety practices implemented (or not) in their workplace and whether they are experiencing any symptoms. It also includes an option to download a report to take to their doctor to initiate conversations about their workplace exposure and risks. The revised Quiz went live during LFA’s National Silicosis Prevention and Awareness (NSPA) Campaign, launched in October 2023 and again in October 2024. To reach culturally and linguistically diverse (CALD) workers, of which there are a large proportion working in these industries, the Quiz was translated into three languages – Vietnamese, Simplified Chinese and Arabic in 2023 and three additional languages, Punjabi, Nepali and Spanish in 2024.
Findings: This presentation will share and compare the key findings from 2023 and 2024 Quiz results, including the most reported industries where exposure is occurring, the most common type of exposures, workers’ awareness of control measures, and common symptoms experienced.
Conclusion: The results of this Quiz will continue to build on evidence regarding the OLD climate in Australia, with a focus on risk factors. The findings will help inform key stakeholders, including government and industry, with where best to take action.

*This Quiz was initially adapted from the European Lung Foundation’s Is your workplace affecting your breathing Quiz, redeveloped by LFA in 2020. It was further updated in 2024 in response to stakeholder feedback and included an automation journey where they were encouraged to speak with doctors about their workplace exposures.

Introduction
To ensure that preventive health interventions and health promotion programs reach all Australians in need, practitioners must prioritise equity during implementation. To understand how implementation processes can support health equity, we undertook an integrated cross-disciplinary review of international literature. The primary objectives were to
(1) identify implementation strategies and practices used to promote equitable outcomes for children (aged 0-17 years); and
(2) consider what equity-promoting principles underpin them.

Methods
This review consisted of three, discipline-specific search strategies across health, social care and education. Searches were carried out across seven different databases, seeking peer-reviewed literature which described implementation strategies and practices used to strengthen health equity. Discipline-specific databases were Medline, Embase and Cinahl for health; Scopus and PsychINFO for social care; ProQuest Education and ERIC for education. Outcomes of all searches from across the three disciplines were integrated into the same Covidence file. After duplicate removal, 14027 papers were double screened. The results of this presentation will focus on the health and social care outcomes.

Results
A variety of different implementation strategies and practices used to promote equity were identified across the integrated review. Some examples include involvement of community health workers, working with multi-disciplinary teams, purposeful data collection and close collaboration with relevant communities. Of note, there is an overrepresentation of data from the United States (> 50% of included papers) and these data are particularly focused on racial inequities.

Conclusion
This review breaks down disciplinary silos to improve efforts to address inequities in health. The findings are applicable both to the implementation of preventive care and health promotion interventions, and is the first step in developing a taxonomy of equity-promoting implementation strategies and practices. Further research is needed to better understand equitable implementation in the context of other sources of health disparities and in other countries, including Australia.