Dr Tony Bartone, ABC Radio, National Drug Strategy Household Survey 2016

DAN BOURCHIER: A new report from the Australian Institute of Health and Welfare has highlighted Canberra as one of the most healthy places to live in Australia. We drink less, smoke less, and use less drugs than other cities. It’s complex, so why is this the case, and what’s the significance? Dr Tony Bartone is a GP and Vice President of the Australian Medical Association. He joins me now. Good morning.

TONY BARTONE: Good morning.

DAN BOURCHIER: What was your takeout of this report?

TONY BARTONE: This report is part of a three-yearly report that’s put out by the Australian Institute of Health and Welfare, and looks at patterns. It does show some underlying trends across the nation and across various age groups, as well as various regional and rural and remote differences. But essentially, the proportion of Australians who are smoking has been on a long and steady downward trend that has been slowing down of late. The proportion of tobacco-related illness in the community is still significant, as is the amount of alcohol-related illness in the community.

Drugs and other illicit substances also have a disease burden, and that’s remained steady. But also we’ve found various messaging around the teenagers and younger adults seems to be working in terms of a proportional drop between the 2013 and 2016 data in terms of the rates in those groups. But we still have a long way to go, we still have a lot of work to do ahead of ourselves.

DAN BOURCHIER: And Dr Bartone, can you unpack the details about Canberra, what we’ve found?

TONY BARTONE: So essentially what we found was that, for example, the percentage of ACT residents aged 14 or over who smoked every day was 9.4 compared to an Australian average of 12.4. So that’s a significant difference between the national average. And virtually if you look at any other population size and age demographic, Canberra – the ACT – outperformed on indicators of tobacco use and alcohol and drug use.

DAN BOURCHIER: What do you put that down to?

TONY BARTONE: Look, obviously it’s a complex issue. And information, messaging, public health, access to public health messaging, the information and services, has a lot to do with it. But also it probably has to do with other factors that we still need to work to identify. Because clearly anything which can be of assistance in identifying what are the factors that are working in Canberra are obviously going to be useful in understanding why we’re still not getting the movement or the higher rates in the rest of the country.

DAN BOURCHIER: How much of a role do you think the affluence of Canberra plays?

TONY BARTONE: Socio-economic factors do come into play, especially around access. It would be too much to purely look at affluence as a determining factor. An association needs to be understood and unpacked further, but clearly access to information and access to services would obviously be at a much more significant advantage in a more affluent society or community.

DAN BOURCHIER: My guest here on ABC Radio Canberra is Dr Tony Bartone, a GP and Vice President of the Australian Medical Association. Dr Bartone, there’s often that argument that higher disposable income equates to greater drug use. Is that borne out by this report?

TONY BARTONE: Look, there are certain demographics and certain parts of usage that do show that, especially when we come to alcohol in particular, it does seem to have a factor in the middle-age groupings in that respect. But certainly, what we’re finding and one of the key points is that the rates of drug use and illicit substance and tobacco and alcohol in our younger populations has been significantly falling, and that’s got to be a reflection of public health messaging, beginning in schools, and the strategy around the country.

DAN BOURCHIER: When we talk nationally, are there any jurisdictions that you’re concerned about as a result of this data?

TONY BARTONE: Look, obviously there are some States that are doing worse than the national trend. The Northern Territory, for example, has the highest rate of daily smokers. It’s 16, nearly 17 per cent, and that’s compared to the national average of just over 12. So we need to look at that, obviously.

And again, unfortunately – I don’t want to pick on States – but the Northern Territory has high rates of risky alcohol consumption and illicit drug use. Again, it’s more about understanding the drivers, the reasons behind it, rather than trying to say ‘aren’t we good?’ or ‘we’re better off than the national average’. We really have, especially when it comes to mental health issues and the inter-relationship with drug and alcohol and illicit drug use, we need to really unpack the information and look at what further messaging, what further public health resources, and what might be the primary prevention strategies we need to employ.

DAN BOURCHIER: Yeah, and as you mentioned at the start, there’s more work to be done. Where do you think that needs to be focused?

TONY BARTONE: Prevention is nine-tenths of the issue in my book, and it begins with primary health care, as well as messaging information and public health campaigns. Especially when it comes to alcohol. For example, the community understands the relationship between health and tobacco, but doesn’t put that same relationship when it comes to the burden of health disease that alcohol causes. So we need that’s part of the cultural change, the community information change that needs to occur to understand the impact on health that alcohol – regular and significant alcohol consumption – does have on our health.

DAN BOURCHIER: And certainly it seems that a lot more crunching of this data needs to be done to get the full national picture. Thank you so much for your time this morning.

28 September 2017

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