Search

Aim Materials and Methods Results Conclusions To examine low birth weight (LBW) in First Nations babies born in a large metropolitan health service in Queensland, Australia.A retrospective population‐based study using routinely collected data from administrative data sources. All singleton births in metropolitan health services, Queensland, Australia of ≥20 weeks gestation or at least 400 g birthweight and had information on First Nations status and born between 2019 and 2021 were included. The study measured birthweight and birthweight z‐score, and also identified the predictors of LBW. Multivariate regression models were adjusted by demographic, socioeconomic and perinatal factors.First Nations babies had higher rates of LBW (11.4% vs 6.9%, P < 0.001), with higher rates of preterm birth (13.9% vs 8.8%, P < 0.001). In all babies, the most important factors contributing to LBW were: maternal smoking after 20 weeks of gestation; maternal pre‐pregnancy underweight (body mass index <18.5 kg/m2); nulliparity; socioeconomic disadvantage; geographical remoteness; less frequent antenatal care; history of cannabis use; pre‐existing cardiovascular disease; pre‐eclampsia; antepartum haemorrhage; and birth outcomes including prematurity and female baby. After adjusting for all contributing factors, no difference in odds of LBW was observed between First Nations and non‐First Nation babies.First Nations status was not an independent factor influencing LBW in this cohort, after adjustment for identifiable factors. The disparity in LBW relates to modifiable risk factors, socioeconomic disadvantage, and prematurity. Upscaling culturally safe maternity care, focusing on modifiable risk factors is required to address LBW in Australian women. [ABSTRACT FROM AUTHOR]

This article explores the concept of conviviality: the practice and negotiation of sharing space in suburbs with diverse populations. Australia has a growing Muslim population and reports of Islamophobia remain widespread. While there is some evidence, however, that forming intercultural connections can foster more positive attitudes toward religious minority groups, we know little about how Muslim and non‐Muslim communities share space in Australia. This paper presents the findings of a qualitative investigation into how conviviality is perceived in Australian suburbs with high concentrations of Muslim residents. Following qualitative, thematic analysis of 15 interviews with multicultural service providers who work with Muslims in Melbourne, Victoria, we conclude that conviviality is fostered by a sense of community between people who share similar backgrounds as well as increased opportunities to form intercultural social connections. We discuss the scholarly and policy implications of these findings, with consideration of existing arguments about the practices of sharing space in Australian cities. [ABSTRACT FROM AUTHOR]

In the digital age, the internet has become an essential source of information gathering and maintains a network of social contact. In this paper, we use microdata from the China Family Panel Studies to examine the effects of guardian's internet use on teenager's cognitive skills. Using mobile internet users and base station density as instruments, we found that guardian's internet use had a significant impact on teenager's cognitive abilities as measured by math and verbal tests. Heterogeneity analysis shows that the impact is more substantial for guardians in rural areas and less-educated guardians. Further exploration of the mechanism shows that internet usage affects cognitive skills through monetary investment, time investment, and parental environment. The result suggests that promoting internet usage for less educated families in rural areas can potentially improve children's academic performance and decrease inequality across regions and generations. [ABSTRACT FROM AUTHOR]

Disruptions caused by COVID‐19 have the potential to create long‐term negative impacts on children's well‐being and development, especially among socioeconomically disadvantaged children. However, we know little about how socioeconomically disadvantaged families are coping with the pandemic, nor the types of support needed. This study presents qualitative analysis of responses to an open‐ended question asking parents how children are coping with the restrictions associated with COVID‐19, to identify areas in which these cohorts can be supported. Four main themes were identified: health concerns, schooling difficulties, social isolation and adjustment to restrictions. Health concerns included exacerbation of pre‐existing health conditions, fear about the virus, difficulty getting children to understand the pandemic and increased sedentary behaviour. Schooling difficulties referred to the challenges of home schooling, which were behavioural (e.g. difficulty concentrating) and logistical (e.g. technology). Social isolation, expressed as missing friends, family and/or institutions was common. Finally, parents expressed that children experienced both positive adjustments to restrictions, such as spending more time with family, and negative adjustments such as increased screen time. Many responses from parents touched on topics across multiple themes, indicating a need for comprehensive, holistic assessment of children's and families' needs in the provision of support services. The content of the themes supports calls for resources to support children and families including increased financial and practical accessibility of social services, physical health and exercise support, mental health support and COVID‐19 communication guides. [ABSTRACT FROM AUTHOR]

Exposure to adverse environments are risk factors for neurodevelopmental problems in childhood. Children exposed to such environments may benefit from interventions that target social communication abilities, since these are protective factors for healthy neurodevelopment. This randomized controlled trial will test the efficacy of Paediatric Autism Communication Therapy (PACT) in improving social communication development in young children at risk for neurodevelopmental difficulties living in poverty in Brazil. Participants will be 160 children aged 2–4 years with lower‐than‐average social communication abilities and their primary caregivers. Child–caregiver dyads will be recruited from public childhood education centers in impoverished urban regions of the city of São Paulo, Brazil. Lower‐than‐average social communication abilities will be defined by standard scores (≤84) on the socialization and/or communication domains of the Vineland Adaptive Behavior Scales. Child–caregiver dyads will be randomized to receive 12 sessions of the PACT intervention (n = 80) or 5 months of community support as usual plus psychoeducation (n = 80). The primary outcome (parent–child interaction) and secondary outcomes (parent‐reported social communication abilities and neurophysiological activity during a live social interaction) will be measured pre‐ and postintervention. This study may lead to new interventions for vulnerable young children in Brazil and better understanding of the neural mechanisms of PACT. [ABSTRACT FROM AUTHOR]

This paper examines the understanding of social cohesion by policymakers, practitioners and residents, with particular reference to migrant concentration areas in Sydney and Melbourne. Ten suburbs we focus on had a high proportion of Muslim Australian residents and were socioeconomically disadvantaged at the time of the 2016 Australian Census. The paper is based on 52 in‐depth, semi‐structured interviews, mainly with professionals delivering local programmes and services, but also with residents. Based on interview data, the paper seeks to unpack the concept of social cohesion, particularly as it is applied to local programmes and discuss the understandings of the relationship of social cohesion with ethnic diversity and socioeconomic disadvantage. We found that most respondents considered "social cohesion" a positive feature of local and broader society, but the concept was variously understood. The understanding of its relationship with ethnic diversity and socioeconomic status of a local area also varied, but the predominant view was that social cohesion is put under stress by socioeconomic disadvantage. In some cases, "social cohesion" was understood, and criticised, as a coded policy formula for "preventing violent extremism" policies, especially in Muslim concentration areas, therefore with a potential to alienate local communities instead of helping them. [ABSTRACT FROM AUTHOR]

This paper discusses findings from an evaluation of the New Zealand Ministry of Education's Early Childhood Education ( ECE) Participation Programme that targeted local areas where there are high numbers of children starting school who have not participated in ECE. The aim of the programme is to increase participation of these low-income 'priority' children in 'quality' ECE. In this paper, two policy initiatives and features that supported participation in ECE are analysed. Engaging Priority Families ( EPF) involves a coordinator working with families to encourage ECE participation, home learning and a positive transition to school. Targeted Assistance for Provision ( TAP) grants are intended to increase local supply by helping establish new services and child spaces in communities where they are needed. The study used mixed methods: data on enrolments, surveys of Participation Programme providers, interviews with programme staff, surveys of families engaged in each initiative and interviews with a small group of families. The results show that cost, availability and cultural relevance of ECE services are the main barriers to participation of 'priority' families. Through brokering, both initiatives helped address complex social issues faced by the families by connecting families with health, housing and social agencies, and brokering understanding of ECE. The results support the argument that national policy initiatives and local actions can help address inequities in participation in ECE associated with socioeconomic status. [ABSTRACT FROM AUTHOR]

Over the past two decades, births to U.S. teenagers have fallen and no longer follow overall fertility patterns. Yet the unique challenges faced by teenage mothers and their families justify continued research. Across disciplines, newer work has furthered our understanding of teenage motherhood today. In this article, I highlight four areas of progress: processes of selection into teenage motherhood, the broader consequences of teenage childbearing beyond the socioeconomic realm, heterogeneity of effects, and the application of life course principles. Emerging societal trends such as complex family structures, a stalled recovery from the recession for families of low socioeconomic status, and a rapidly evolving political environment for reproductive health care continue to challenge the lives of teenage mothers. Given that the consequences for teenagers of becoming mothers may change, continued research is needed. Shifts in policy to favor supporting teenage mothers and addressing the causes of both teenage pregnancy and social disadvantage may help improve the lives of these mothers and their families. [ABSTRACT FROM AUTHOR]

Background While developmental surveillance programs promote early identification of child developmental problems, evidence has indicated suboptimal uptake. This study aimed to identify predictors of developmental surveillance completion at 6 months postpartum. Methods Questionnaires were administered to the parents of 510 infants who were born in south western Sydney, Australia over a 22-month period. Attendance for developmental screening and completion of the Parents' Evaluation of Developmental Status (PEDS) at 6 months postpartum were modelled separately using multivariable logistic regression. Results Developmental surveillance attendance was predicted by higher levels of maternal education, annual income and being informed about checks. PEDS completion at 6 months of age was predicted by higher income and being informed, as well as being married, employed, speaking English at home, full-term birth and the professional status of the practitioner completing the check. Conclusions Barriers to developmental surveillance included low socioeconomic status, linguistic diversity and possible gaps in parental knowledge and professional education. Developmental surveillance rates may be increased by the addition of targeted parental and professional support within current universal frameworks. [ABSTRACT FROM AUTHOR]

Background Little is known about the health and well-being of the 'hidden majority' of parents with mild intellectual disability (ID), who are less likely to be in contact with disability services. Method We sought to add to knowledge in this area by examining the health and living conditions of parents with and without intellectual impairment in a large contemporary nationally representative sample of UK parents aged between 16 and 49 years old (n =14 371). Results Our results indicated that, as expected, parents with intellectual impairment were at significantly greater risk than other parents of having poorer self-reported general, mental and physical health. They were also at significantly greater risk of experiencing higher rates of household socio-economic disadvantage and environmental adversities and lower rates of neighbourhood social capital and intergenerational support. Adjusting risk estimates to take account of between group differences in household socio-economic disadvantage eliminated statistically significant differences in health status between parents with and without intellectual impairment on all but one indicator (obesity). Further adjusting risk estimates to take account of between group differences in neighbourhood adversity, neighbourhood social capital and intergenerational support had minimal impact on the results. Conclusions That controlling for between-group differences in exposure to socio-economic disadvantage largely eliminated evidence of poorer health among parents with intellectual impairment is consistent with the view that a significant proportion of the poorer health of people with IDs may be attributable to their poorer living conditions rather than biological factors associated with ID per se. [ABSTRACT FROM AUTHOR]

Objective Up to half of patients assessed for suspected new-onset epileptic seizures report previous undiagnosed events. This suggests that delay to timely and expert assessment is a major issue. Very little is known about the degree of delay or nature of the undiagnosed events, impacting on our understanding of new-onset epilepsy. In this study we aimed to examine events that occur before presentation, as well as the extent and risk factors for delay to assessment. Method Included in this retrospective study were 220 patients diagnosed at the First Seizure Clinic (Austin Health, Australia) between 2003 and 2006 with an epileptic index seizure. Patients with a prior diagnosis of epileptic seizures were excluded. Chart review was undertaken, including detailed interviews conducted by an epileptologist at first assessment. Logistic regression assessed risk factors for delay from first event to presentation, including event characteristics, socioeconomic disadvantage, employment, and distance to medical facility. Results Forty-one percent (n = 90) of patients had one or more event before their index seizure. Of these, 50% had multiple or more than five prior events and 28% experienced one or more convulsive event before the index seizure. Of the total 220 patients, 36% had delayed presentation >4 weeks, 21% delayed >6 months, and 14% delayed >2 years. First events without convulsions or features likely to disrupt behaviour were strongly associated with delay (p = <0.001). Relative socioeconomic disadvantage was also associated with delay to presentation (p = 0.04). Significance Our findings suggest a gap in early diagnosis and care in a sizable proportion of new-onset cases, despite a 'first world' urban environment and the availability of free basic medical care. Delay appears particularly likely when events are nonconvulsive or low-impact, suggesting that these seizure types may be underrepresented in studies of new-onset epilepsy. This has implications for our understanding of the incidence, evolution, impact, and treatment response of new-onset epilepsy. [ABSTRACT FROM AUTHOR]

Abstract: Background: The Australian Pharmaceutical Benefits Scheme (PBS) first subsidized cholinesterase inhibitors (CEIs) for Alzheimer's disease in 2001, introducing a novel therapy for a previously untreatable common condition. This study aims to determine Australian rates of CEI use and to assess equality of access to treatment based on socioeconomic status and geographic remoteness. Methods: Pharmaceutical claims records were used to identify all Australians prescribed CEIs between January 2003 and December 2010. Age-standardized and sex-adjusted index prescription rates were derived using the total Australian population as the denominator to examine temporal trends and the impacts of socioeconomic and geographic disadvantage on CEI index prescription rates. Results: Index prescription rates peaked in 2004 at 92.5 per 100,000 person-years, declining to between 70.2 and 73.5 for years 2006 to 2010. Rates were highest in the 85- to 89-year age group and 2.6-fold higher in the least socioeconomic disadvantaged population when compared with the most disadvantaged population. In major cities in Australia, index prescription rates were 1.4 to 1.7 times greater compared with remote areas. Conclusions: Increasing geographic remoteness and socioeconomic disadvantage are associated with lower CEI index prescription rates, indicating inequities in the management of Alzheimer's disease in Australia. [Copyright &y& Elsevier]

Abstract: In a prospective birth cohort study of 5295 girls from the UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the association between biological father absence in childhood and age at menarche whilst adjusting for antenatal indicators of socioeconomic disadvantage and maternal characteristics. We also examined whether exposure to maternal depression and financial problems during middle childhood mediate the association between father absence and age at menarche. There was stronger evidence for an association between father absence during the first 5 years of life and early timing of menarche compared with father absence between 5 and 10 years. There was evidence that maternal depression and major financial problems explained some of the association between early childhood father absence and age at menarche. Although father absence cannot be a direct target of prevention, family-based programs to address family processes influenced by maternal depression and socioeconomic disadvantage may be effective. [Copyright &y& Elsevier]

Issues. This review examines whether area-level disadvantage is associated with increased substance use and whether study results are impacted by the size of the area examined, definition of socioeconomic status (SES), age or ethnicity of participants, outcome variables or analytic techniques. Approach. Five electronic databases and the reference sections of identified papers were searched to locate studies of the effects of area-level SES on substance use published through the end of 2007 in English-language, peer-reviewed journals or books. The 41 studies that met inclusion criteria included 238 effects, with a subsample of 34 studies (180 effects) used for the main analyses. Study findings were stratified by methodological characteristics and synthesised using generalised estimating equations to account for clustering of effects within studies. Key Findings. There was strong evidence that substance use outcomes cluster by geographic area, but there was limited and conflicting support for the hypothesis that area-level disadvantage is associated with increased substance use. Support for the disadvantage hypothesis appeared to vary by sample age and ethnicity, size of area examined, type of SES measure, specific outcome considered and analysis techniques. Implications. Future studies should use rigorous methods to yield more definitive conclusions about the effects of area-level SES on alcohol and drug outcomes, including composite measures of SES and both bivariate and multivariate analyses. Conclusion. Further research is needed to identify confounds of the relationship between area-level SES and substance use and to explain why the effects of area-level SES vary by outcome and residents' age.[Karriker-Jaffe KJ. Areas of disadvantage: A systematic review of effects of area-level socioeconomic status on substance use outcomes. Drug Alcohol Rev 2011;30;84-95] [ABSTRACT FROM AUTHOR]

Objective. To better characterize the relation between socioeconomic disadvantage and small-for-gestational age births (SGA). Design. Analysis of data from a mandatory population-based surveillance system. Setting. Public or private hospitals and at home. Population. All 877,951 singleton births occurring in New South Wales, Australia, between 1994 and 2004. Methods. Multilevel models were developed to determine the factors associated with babies weighing less than the 3rd percentile for gestation and gender. Main outcome measures. Odds of SGA. Results. The risk of SGA increased with increasing socioeconomic disadvantage. Smoking accounted for approximately 40% of the increased risk associated with socioeconomic disadvantage, and delayed antenatal care approximately 5%. While the absolute rate of SGA remained stable over the study period, the odds of SGA in mothers living in the most disadvantaged areas compared to those in the least disadvantaged areas increased from approximately 1.7 to 2.2. This trend persisted after accounting for maternal smoking. The risk of SGA over this period also increased in mothers commencing antenatal care after the first trimester. After accounting for smoking, socioeconomic disadvantage and clinical conditions, mothers under 21 years of age were at reduced risk of SGA, but mothers over 35 were at increased risk. Conclusions. Socioeconomic disadvantage remains one of the dominant determinants of SGA, even in a developed country with universal insurance. This relation appears to be strengthening. Smoking patterns, inadequate antenatal care and clinical conditions partially account for this association and trend, however, most is mediated by other factors. [ABSTRACT FROM AUTHOR]

As a group, children from disadvantaged, low-income families perform substantially worse in mathematics than their counterparts from higher-income families. Minority children are disproportionately represented in low-income populations, resulting in significant racial and social-class disparities in mathematics learning linked to diminished learning opportunities. The consequences of poor mathematics achievement are serious for daily functioning and for career advancement. This article provides an overview of children's mathematics difficulties in relation to socioeconomic status (SES). We review foundations for early mathematics learning and key characteristics of mathematics learning difficulties. A particular focus is the delays or deficiencies in number competencies exhibited by low-income children entering school. Weaknesses in number competence can be reliably identified in early childhood, and there is good evidence that most children have the capacity to develop number competence that lays the foundation for later learning. © 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 2009;15:60–68. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present paper was to examine patterns of surgical care and the likelihood of death within 5 years after a diagnosis of colorectal cancer, including the effects of demographic, locational and socioeconomic disadvantage and the possession of private health insurance. Methods: The Western Australian Data Linkage System was used to extract all hospital morbidity, cancer and death records for people with a diagnosis of colorectal cancer from 1982 to 2001. Demographic, hospital and private health insurance information was available for all years and measures of socioeconomic and locational disadvantage from 1991. A logistic regression model estimated the probability of receiving colorectal surgery. A Cox regression model estimated the likelihood of death from any cause within 5 years of diagnosis. Results: People were more likely to undergo colorectal surgery if they were younger, had less comorbidity and were married/defacto or divorced. People with a first admission to a private hospital (odds ratio (OR) 1.31, 95% confidence interval (CI): 1.16−1.48) or with private health insurance (OR 1.27, 95% CI: 1.14−1.42) were more likely to undergo surgery. Living in a rural or remote area made little difference, but a first admission to a rural hospital reduced the likelihood of surgery (OR 0.76, 95% CI: 0.66−0.87). Residency in lower socioeconomic areas also made no difference to the likelihood of having surgical treatment. The likelihood of death from any cause was lower in those who were younger, had less comorbidity, were elective admissions and underwent surgery. Residency in lower socioeconomic status and rural areas, admission to a rural hospital or a private hospital and possession of private health insurance had no effect on the likelihood of death. Conclusions: The present study demonstrates that socioeconomic and locational status and access to private health care had no significant effects on surgical patterns of care in people with colorectal cancer. However, despite the higher rates of surgery in the private hospitals and among those with private health insurance, their survival was no better. [ABSTRACT FROM AUTHOR]

Background In the United States, hospitalizations for pulmonary embolism (PE) are increasing among older adults insured by Medicare. Although efforts to reduce health disparities have intensified, it remains unclear whether clinical outcomes differ between socioeconomically disadvantaged and nondisadvantaged Medicare beneficiaries hospitalized with PE. Methods and Results In this study, there were 53 386 Medicare fee-for-service beneficiaries age ≥65 years hospitalized for PE between October 2015 and January 2017. Of these, 5494 (10.3%) were socioeconomically disadvantaged and 47 892 (89.7%) were nondisadvantaged. Socioeconomically disadvantaged adults were of similar age as nondisadvantaged adults (77.1 versus 77.0), more likely to be female (68.5% versus 54.2%), and less likely to receive advanced therapies (11.0% versus 12.1%). After adjustment for demographics, 90-day all-cause mortality rates were similar between disadvantaged and nondisadvantaged adults. In contrast, 1-year mortality rates were higher among socioeconomically disadvantaged adults (hazard ratio [HR], 1.16; 95% CI, 1.10-1.22), although these differences were partially attenuated after additional adjustments for comorbidities and PE severity (HR, 1.09; 95% CI, 1.02-1.16). Risk-adjusted 30-day and 90-day all-cause readmission rates were substantially higher among socioeconomically disadvantaged patients (30-day HR, 1.14 [95% CI, 1.06-1.22]; 90-day HR, 1.18 [95% CI, 1.12-1.25]). In addition, 90-day readmissions attributed to PE, deep vein thrombosis, and/or bleeding were higher among socioeconomically disadvantaged patients (HR, 1.16; 95% CI, 1.02-1.32). Conclusions Socioeconomically disadvantaged older adults hospitalized with PE have higher 1-year mortality rates compared with their nondisadvantaged counterparts. Nearly 1 in 3 socioeconomically disadvantaged older adults was readmitted within 90 days of a hospitalization for PE. Targeted strategies are needed to improve transitional and ambulatory care for this vulnerable population.

Background Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy. Current guidelines endorse management in expert centers, but patient socioeconomic status can affect access to specialty care. The effect of socioeconomic status and specialty care access on HCM outcomes has not been examined. Methods and Results We conducted a retrospective cohort study that examined outcomes among HCM patients receiving care in the Yale New Haven Health System between June 2011 and December 2017. Patients were assigned to lower or higher socioeconomic status groups (LSES/HSES) based on medical insurance provider and to receivers of specialty care (SC) at Yale's Inherited Cardiomyopathy clinic or general cardiology care (GC). The primary outcome was all-cause death, and the secondary outcome was all-cause hospitalization. We identified 953 HCM patients; 820 (86%) were HSES and 133 (14%) were LSES. Forty-three (4.5%) patients died from cardiac and noncardiac causes. LSES patients within the general cardiology care cohort had significantly higher all-cause mortality compared with HSES patients (adjusted hazard ratio, [95% CI]=10.06 [4.38-23.09]; P <0.001). This was not noted in the specialty care cohort (adjusted hazard ratio, [95% CI]=2.87 [0.56-14.73]; P =0.21). The moderator effect of specialty care on mortality difference between LSES versus HSES, however, did not reach statistical significance (hazard ratio, 0.29 [0.05-1.77]; P =0.18). Specialist care was associated with increased hospitalization (adjusted hazard ratio, [95% CI]=3.28 [1.11-9.73]; P =0.03 for LSES; 2.19 [1.40-3.40]; P =0.001 for HSES). Conclusions Socioeconomically vulnerable HCM patients had higher mortality when not referred to specialty care. Further study is needed to understand the underlying causes.

Introduction and Aims: This study aimed to compare current and ex-smokers' sociodemographic and psychosocial characteristics, use of cessation aids and abrupt versus gradual quitting approaches.Design and Methods: A cross-sectional survey of financially disadvantaged adults attending a community service organisation was conducted in New South Wales, Australia, between February 2012 and December 2013. Sociodemographic and psychosocial factors, use of cessation aids and gradual versus abrupt quit approach were assessed. χ2 tests and logistic regression compared characteristics of current and ex-smokers.Results: Of 905 individuals who completed the survey, 639 (71%) were current smokers and 107 (12%) were ex-smokers. Ex-smokers were older [odds ratio (OR) = 1.03, 95% confidence interval (CI) = 1.01, 1.05], had higher odds of being female (OR = 1.67, 95% CI = 1.06, 2.65), lower odds of being financially stressed (OR = 0.87, 95% CI = 0.76, 0.99), lower odds of anxiety and depression symptoms (OR = 0.91, 95% CI = 0.84, 0.98) and lower odds of having friends and family who were smokers (ORs ranged from 0.30-0.43). Ex-smokers had lower odds of using cessation aids and higher odds of reporting abrupt quitting during their last quit attempt (OR = 4.48, 95% CI = 2.66, 7.54).Conclusions: Lower levels of disadvantage, less smoking in social networks, less use of cessation aids and abrupt (vs. gradual) quitting approaches were associated with being an ex-smoker. Lower use of evidence based methods to quit by disadvantaged ex-smokers requires further exploration. [Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, D'este C, Oldmeadow C, Palazzi K. What factors are associated with abstinence amongst socioeconomically disadvantaged smokers? A cross-sectional survey of use of cessation aids and quitting approach. Drug Alcohol Rev 2017;00:000-000]. [ABSTRACT FROM AUTHOR]