Preventing Obesity, Smoking and Excess Alcohol Use: A Major Health Challenge for the Coming Decade

23 Jun 2009

The Challenge

A growing number of Australians are at high risk of serious diseases and premature death due to excess weight, smoking and excess alcohol use.

These conditions account for nearly a third of all illness in Australia, they reduce people’s life expectancy by 5 years on average, and cost the health care system almost $6 billion per year.

Smoking related illnesses cost the Australian economy up to $5.7 billion per year in lost productivity.

Harmful alcohol use costs Australia an estimated $15 billion a year.

The AMA believes that these outcomes are a matter of great concern. Preventative health measures can be effective, and should be an integral part of Australia’s healthcare system. Like any other investment, an investment in prevention needs to be made responsibly, seen as long-term, and balanced with current treatment/acute care needs.

The Way Forward - Supporting the Preventative Role of Doctors

Between 2000 and 2006, nearly 10 million patient encounters per year involved GP advice and counselling on nutrition, weight nd exercise, smoking, lifestyle and alcohol issues.

About 20% of GP patients during 2007-08 were daily smokers, 30% were at-risk drinkers, and nearly 60% were overweight or obese.

The preventative advice doctors provide to their patients is among the top 5 most cost-effective interventions for reducing the potential harms to young people of alcohol misuse.

Prevention is integral to a doctor’s role

Prevention is an integral part of a doctor’s ‘whole-of-patient’ health and medical care, and has been since the advent of modern medicine. Doctors are multi-skilled and highly trained professionals, and have expertise in caring for patients with multiple conditions. Through screening or observation, doctors become aware of the early signs in their patients of problematic drinking, or more frequent tobacco use, or excess weight, and they then determine what action or intervention will best help to turn things around early, before they become worse.

Doctors promote preventative health

Nearly 90% of Australians visit a GP at least once a year. Surveys consistently show that Australians trust the advice their doctor gives them. Doctors’ advice to patients about health risks from smoking, excess alcohol use and excess weight can be effective in motivating their patients to change behaviour. Doctors also know when to refer or recommend further action to their patients.

Maximising Opportunities and Removing Barriers

In a busy medical practice, doctors face many competing demands and priorities. If doctors’ unique opportunities to promote preventative health are to be maximised, the time doctors need to do this should be available and recognised, and there should be greater capacity to use medical practice staff resources more efficiently and flexibly.

 

The AMA believes that doctors could further strengthen their contribution to prevention if:
  1. Patients could receive an MBS rebate for brief preventative interventions or follow-up provided by practice nurses for and on behalf of the patient’s doctor.
  2. Patients could receive an MBS rebate for group preventative health and education sessions provided by medical practices.
  3. There is improved indexation of MBS patient rebates to properly recognise the time doctors spend on preventative healthcare during existing standard and long consultation MBS items.
  4. Grant programs are established to support the development and implementation of ‘whole of practice’ prevention measures and programs, suited to the practice population.

 

Further Ways Forward  - Tackling Risks at the Community-Level

The AMA believes that strategic, long-term, and properly resourced population-based approaches to prevention can be effective in bringing about reductions in obesity, smoking and harmful alcohol use.

There is increasing evidence to support a range of educational, fiscal, regulatory and individual measures that can be taken at a society-wide level to ensure that healthier choices are the easier ones for people when it comes to eating, physical activity, smoking and alcohol use.

The AMA believes that the following measures can be readily implemented, and will be particularly effective in tackling obesity, smoking and harmful alcohol use in the community:
  • Prohibit the broadcast advertising of energy-dense and nutrient-poor food products and beverages to children, particularly in children’s television viewing times.
  • Mandate simple and informative nutritional labelling on food products.
  • Increase taxation on tobacco products by 5% each year, and prohibit the sale of duty-free tobacco.
  • Ban all forms of tobacco promotion, and mandate plain packaging of all tobacco products.
  • Apply taxation to alcohol beverages on a volumetric basis (ie., in proportion to the volume of alcohol contained in the beverage).
  • Prohibit the targeted marketing of alcohol products to adolescents and teenagers, and ban the sponsorship of sporting events by alcohol manufacturers.

 

The AMA believes that a National Preventative Health Strategy should give priority to implementing these measures.


The AMA’s submission to the Preventative Health Taskforce can be found at: http://www.ama.com.au/policy/preventative-health

If you would like further information about the AMA’s views on doctors’ roles in prevention, and other prevention measures for smoking, obesity, or excess alcohol use, please contact the AMA on  ph.  02 6270 5452