Stigma, risks, and benefits of medicinal cannabis use among Australians with cancer.

PURPOSE: People with cancer who use medicinal cannabis do so despite risks associated with limited clinical evidence, legalities, and stigma. This study investigated how Australians with cancer rationalise their medicinal cannabis use despite its risks. METHODS: Ten adults (5 males and 5 females; mean age of 53.3) who used cannabis medicinally for their cancer were interviewed in 2021-2022 about how they used and accessed the substance, attitudes and beliefs underpinning their use, and conversations with others about medicinal cannabis. RESULTS: Participants had cancer of the bowel, skin, oesophagus, stomach, thyroid, breast, and Hodgkin lymphoma for which they were receiving treatment (n = 5) or under surveillance (n = 5), with most (n = 6) encountering metastatic disease. Cannabis was used to treat a variety of cancer-related symptoms such as pain, poor sleep, and low mood. Cannabis was perceived as natural and thus less risky than pharmaceuticals. Participants legitimised their medicinal cannabis use by emphasising its natural qualities and distancing themselves from problematic users or riskier substances. Cost barriers and a lack of healthcare professional communication impeded prescription access. Similarly, participants navigated medicinal cannabis use independently due to a lack of guidance from healthcare professionals. CONCLUSION: Findings highlight the need for robust data regarding the harms and efficacy of medicinal cannabis and dissemination of such information among healthcare professionals and to patients who choose to use the substance. Ensuring healthcare professionals are equipped to provide non-judgmental and evidence-based guidance may mitigate potential safety and legal risks.

South Australia's tobacco retail landscape and its intersection with socioeconomic factors and smoking prevalence.

ISSUES ADDRESSED: Tobacco product availability is higher in socioeconomically disadvantaged areas, which can further widen tobacco-related health and disease burden inequities. This study aimed to describe retail availability of tobacco products in South Australia and examine the association between tobacco vendor location, population's socioeconomic status (SES) and tobacco smoking prevalence. METHODS: Cross-sectional 2022 tobacco vendor licence data and 2021-2022 state-wide population health survey data from the South Australian Department of Health were used. Tobacco vendors were enumerated by Statistical Area 2 (SA2) using geocoding software, with SA2s assigned health survey derived smoking prevalence, SES, remoteness category, area size, and population size. RESULTS: As of 2022, there were 1723 tobacco vendors in South Australia and the overall tobacco smoking prevalence across the state was 11.8%. Regression analyses indicated that tobacco vendor density increased with socioeconomic disadvantage and geographic remoteness, and that smoking prevalence was higher in low SES areas. Vendor density was not related to smoking prevalence. CONCLUSIONS: Findings are consistent with existing research indicating greater tobacco availability in socially disadvantaged areas. This supports that tobacco vendor saturation may be directed to areas in a way that promotes tobacco availability for vulnerable populations. Our finding that smoking prevalence was unrelated to tobacco availability contrasts existing literature and should be carefully interpreted. SO WHAT?: This is the first study to map tobacco retailers across South Australia, contributing needed evidence on the intersection of tobacco vendor density, social disadvantage, and smoking prevalence.

Co-designing Healthy Living after Cancer Online: an online nutrition, physical activity, and psychosocial intervention for post-treatment cancer survivors.

PURPOSE: The aim of the present study was to co-design Healthy Living after Cancer Online (HLaC Online), an online intervention supporting cancer survivors to set and meet their healthy living goals. METHODS: Adapted from an initial telephone-delivered Healthy Living after Cancer program, wireframes (PDF black and white mock-ups) of the proposed online program were presented in a series of focus groups and interviews to our stakeholder group, which consisted of cancer survivors, oncology healthcare professionals, and representatives from cancer support organisations. Stakeholders were prompted for feedback on the wireframe and given end-user scenarios to encourage deeper engagement with the co-design process. Transcriptions underwent thematic analysis to determine which features of the program needed change or expansion. RESULTS: 27 participants took part in one of 8 focus groups or 10 interviews. Five themes were identified relating to (a) website design elements, (b) promoting and maintaining long-term engagement, (c) relatability and relevance, (d) navigating professional support, and (e) family and peer support. Recommended changes, such as simple activities and guidance videos, were integrated into the HLaC Online prototype. CONCLUSIONS: Involving end-users in the co-design process ensured the intervention's relevance and specificity to the needs of cancer survivors. Next steps include feasibility testing the prototype, prior to commencing a national randomised control trial of HLaC Online. IMPLICATIONS FOR CANCER SURVIVORS: HLaC Online aims to support cancer survivors to improve their quality of life by making healthy lifestyle changes in their physical activity, healthy eating, weight management, mental health, and fatigue management.

Diet and physical activity practices of South Australian adolescents.

Adequate nutrition and physical activity are integral to health across the life course, with adolescence a crucial time for establishing health behaviours. This report describes self-reported dietary and physical activity behaviours of South Australian adolescents aged 12-17 years (N = 1324) surveyed in 2017. Healthy lifestyle behaviour engagement was low, with most (90.3%) adolescents not meeting Australia's recommended dietary or physical activity guidelines. Almost three-quarters (73.8%) of adolescents consumed the recommended daily amount of fruit. However, only 10.8% of adolescents met the recommended daily intake of vegetables, and large proportions regularly consumed unhealthy snacks (64.5%), fast foods, (30.7%) and sugary drinks (65.8%). Combined with the low adherence to physical activity guidelines, these findings highlight the need for effective targeted health promotion campaigns to improve adolescent's public health outcomes in South Australia.