[Public expenditure caused by the consumption of illicit drugs in Germany]. / Schätzung der Ausgaben der öffentlichen Hand durch den Konsum illegaler Drogen in Deutschland.

AIM: A scientifically based overview of public expenditures related to illicit drugs was lacking for Germany. The aim of the present project is to carry out for the first time a comprehensive estimation of direct (labelled and non-labelled) expenditures of the government and the social insurance funds related to the use of illicit drugs in Germany for the year 2006. METHODS: Depending on the respective financing bodies, different ways of data collection were required. Data on drug-related expenditure were searched in publically available budget documents and statistical reports; moreover written requests were sent to the relevant public authorities. Information on the expenditures of social insurance funds was collected through standardised questionnaires, which were sent to the Statutory Pension Insurance Scheme (Rentenversicherung Bund) and the 40 biggest statutory health insurance companies. The collected data were extrapolated for the total statutory health insurance. RESULTS: All in all, on the government side an amount of 3.7-4.6 billion Euro spent on the task of tackling illicit drugs (i. e., for prevention, intervention and law enforcement measures) was identified. The expenditures of the pension funds related to illegal drug use amount to 171.7 million Euro. For the statutory health insurances a total expenditure of 1.4 billion Euro was estimated. CONCLUSION: The aim of the project - a first estimation of the public expenditures concerning illicit drugs in Germany - has been achieved. Nevertheless, there remains some degree of uncertainty regarding the overall result because of the heterogeneous data quality. The approximation of the amount of public expenditures concerning illegal drug use still gives no information about adequate spending or actual benefits. However, it provides the indispensable basis for such an assessment and contributes to a more objective discussion.

[Effectiveness of telephone aftercare following a smoking cessation program for women on inpatient rehabilitation]. / Wirksamkeit telefonischer Nachsorge im Anschluss an ein Tabakentwöhnungsprogramm für Frauen in stationärer Rehabilitation.

BACKGROUND AND AIMS: Rehabilitation centres for mothers are a suitable setting to offer smoking cessation treatment to these women. Telephone aftercare could enhance the effectiveness of an inpatient smoking cessation program. We investigated whether non-directive, supportive aftercare or a structured, smoking specific counselling give more benefit. PATIENTS AND METHOD: 527 smoking mothers participated in a smoking cessation program during their stay in a prevention/rehabilitation centre. Afterwards they were randomly assigned to one of three aftercare conditions: no aftercare (control group), structured telephone aftercare or non-directive telephone aftercare. At the end of the inpatient program and 6 months later the smoking status of the participants was assessed. RESULTS: The structured telephone aftercare resulted in the highest abstinence rates after 6 months (31.5%; odds ratio 2.0; confidence interval: 1.1 - 3.8). The non-directive telephone counselling had no significant effect on abstinence rates. CONCLUSIONS: A structured telephone aftercare proves to be an effective intervention for women, which stabilizes the abstinence rate following a clinic based smoking cessation program.

[Proportion of smokers, stages of preparedness to change and utilisation of a smoking cessation intervention in mother-child rehabilitation]. / Anteil von Raucherinnen, Stadien der Veränderungsbereitschaft und Inanspruchnahme von Tabakentwöhnung in der Mutter-Kind-Rehabilitation.

BACKGROUND: Smoking mothers put their own health as well as that of their children at risk. Mother-child inpatient rehabilitation centres can be a suitable setting for reaching this target group and providing support for smoking cessation. AIM: The aim of the study is to describe for the first time the smoking prevalence and motivation to change of patients in German mother-child inpatient rehabilitation centres and to investigate the actual utilisation of an offered smoking cessation programme. METHOD: In a cross-sectional field study with a consecutive sample from 22 mother-child inpatient rehabilitation centres (N=4329 mothers) smoking prevalence, stage of preparedness to change according to the transtheoretical model and consideration to seek help for cessation were assessed via a questionnaire. In addition, the number of smokers who can be reached by the offer of a quit-smoking programme was assessed by means of reports of the course instructors. RESULTS: 29.2% of patients in mother-child rehabilitation are smokers. Compared to the female general population, a higher proportion of the women were in an advanced stage of preparedness to change (19.4% are in preparation) and the majority of smokers are willing to seek help to quit smoking. 37.6% of smoking mothers participated in the offered smoking cessation intervention. CONCLUSION: There is a high proportion of smokers and a high readiness to change in German mother-child rehabilitation centres. The actual participation rate in an offered smoking cessation programme is quite remarkable, but nevertheless has to be enhanced further. One possible approach is measures to enhance smoking mothers' motivation to quit.