Wayne Hall

The University of Queensland | UQ · Centre for Youth Substance Abuse Research

Background and aims: Alcohol consumption is a leading risk factor for premature mortality globally, but there are limited studies of broader cohorts of people presenting with alcohol-related problems outside of alcohol treatment services. We used linked health administrative data to estimate all-cause and cause-specific mortality among individuals...

In Australia, nicotine vaping products are regulated as prescription-only medicines which can only be sold from a pharmacy, with the aim of preventing youth access and allowing use by adult smokers with a doctor's support. The Therapeutic Goods Administration has acknowledged that this policy has not achieved its goals. Instead, a thriving black ma...

Introduction: Medicinal cannabis is now legal in 44 US jurisdictions. Between 2020 and 2021 alone, four US jurisdictions legalised medicinal cannabis. The aim of this study is to identify themes in medicinal cannabis tweets from US jurisdictions with different legal statuses of cannabis from January to June 2021. Methods: A total of 25,099 histo...

Background and aims: The most available data on the prevalence of cannabis use come from population surveys conducted in high-income countries in North America, Oceania, and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population-level cannabis use in Sub-Saharan Africa sin...

Background One of the objectives of cannabis legalization in Canada is to transition consumers from the illegal to the legal market. Little is known about how legal sourcing varies across different cannabis product types, provinces, and frequency of cannabis use. Methods Data were analyzed from Canadian respondents in the International Cannabis Po...

Introduction: The shifting landscape in Australia's tobacco and cannabis policies and emerging new products and modes of administration may increase experimentation and the risks of addiction to these drugs. Methods: We analysed cross-sectional data from the 2019 National Drug Strategy and Household Survey (n = 22,015) of Australians aged 14 and...

This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping...

Background and aim: From 1 February 2018, codeine was rescheduled from an over-the-counter (OTC) to a prescription-only medicine in Australia. We used wastewater-based epidemiology to measure changes in population codeine consumption before and after rescheduling. Methods: We analysed 3703 wastewater samples from 48 wastewater treatment plants,...

Given the rise in cannabis vaping, it is important to highlight the heterogeneity in vaping different cannabis product because of the potential differences in their health risks. This study aims to estimate the trends and socio-demographic correlates of the use of various cannabis vaping products across jurisdiction with different legal status. Dat...

Background Due to concerns over the public health impact of increasing opioid use, Australia up-scheduled codeine in 2018, requiring codeine-containing pharmaceuticals to be prescription-only. We examined pre-post changes in the prevalence and correlates of non-medical use of pharmaceutical opioids (NMUPO) and other illicit substance use (ISU). Me...

Introduction: This study examines age, time period and birth cohort trends in cannabis use intention and weekly use in Australia over a period in which medicinal cannabis was legalised. Methods: Hierarchical age-period-cohort models were used to analyse the National Drug Strategy Household Survey between 2001 and 2019, including 158,395 particip...

Background In Australia, tobacco smoking rates have declined but inequalities remain with significantly higher smoking prevalence among low-socioeconomic populations. Clinical trial data suggest vaporized nicotine products (VNPs) aid smoking cessation. Most VNP trials have used refillable tank systems, but newer generation (pod) devices now compris...

Background and Aims There is little information on consumption patterns across the diverse range of cannabis product types. This paper examines trends in consumption patterns in Canada and the United States (US) between 2018-2020. Design Repeat cross-sectional surveys were conducted as part of the International Cannabis Policy Study online survey...

Randomised controlled trials (RCTs) are the gold standard for making causal inferences, but RCTs are often not feasible in addiction research for ethical and logistic reasons. Observational data from real world settings have been increasingly used to guide clinical decisions and public health policies. This paper introduces the potential outcomes f...

Background and aim: The prevalence of tobacco smoking has declined in most high-income countries, while cannabis use has been on the rise. Moreover, cannabis use has been found to have increased among cigarette smokers in recent years in jurisdictions where it has been either decriminalized or legalized. This study measured trends in cannabis, tob...

Rationale There has been increasing attention on cannabis use for medical purposes, but there is currently a lack of data on its epidemiology. Objectives To examine the epidemiology of self-reported cannabis use for medical purposes by (1) estimating its prevalence, (2) comparing gender and age differences, and (3) investigating what reasons they...

Aim: To (i) estimate the prevalence of adolescent vaping in 47 lower-middle, upper-middle and high-income countries, and (ii) test the association between implementation of World Health Organisation (WHO) tobacco control policies and adolescent e-cigarette use (also known as vaping) in 44 countries where implementation data were available. Design...

Methods: A systematic search was conducted for publications in PubMed, EMBASE, and PsycINFO up to October 2019. Six studies with a regionally or nationally representative adult US-based populations were included. A secondary analysis was conducted using data from the National Survey of Drug Use and Health. Hierarchical age-period-cohort analysis a...

Traditionally, opioid-related disease burden was primarily due to heroin use. However, increases in extra-medical (or non-medicinal use of prescription opioids; NMPOs) use has precipitated the current overdose epidemic in North America. We aim to examine the state-level prevalence of heroin and NMPO dependence and their associations with opioid-rel...

Objective: Cannabis use is increasing among midlife and older adults. This study tested the hypotheses that long-term cannabis use is associated with cognitive deficits and smaller hippocampal volume in midlife, which is important because midlife cognitive deficits and smaller hippocampal volume are risk factors for dementia. Methods: Participan...

Objective To review evidence from longitudinal studies on the association between prescription opioid use and common mood and anxiety symptoms. Design We conducted a systematic review and meta-analysis according to PRISMA guidelines. Methods We searched PubMed, Embase and PsycINFO for search terms related to opioids AND (depression OR bipolar OR...

Background: Canada legalized non-medical cannabis in October 2018. Little research has examined the change in perceived access to cannabis after legalization in Canada, including the perceived ease of purchasing cannabis in a legal market. Objectives: To: 1) describe changes in perceived ease of access to cannabis before and one year after legaliza...

Aim: To test if (1) there was a change in self-reported lifetime prevalence of meth/amphetamine use by birth cohort and (2) the extent of under-reporting use was associated with the proportion of the population who nominated meth/amphetamine as a drug problem. Design: Observational study using seven waves of repeated cross-sectional nationally r...

Introduction Tobacco harm reduction has potential to improve individual and population health. However, little research exists on low-intensity interventions, such as encouraging longer-term NRT or e-cigarette use. We aimed to determine whether: 1) encouraging use of nicotine products as long-term tobacco substitutes is more effective for smoking a...

Australia does not allow adult smokers to buy or use electronic nicotine delivery systems (ENDS) that contain nicotine without a prescription. This paper critically evaluates the empirical and ethical justifications provided for the policy by Federal and State governments, public health advocates and health organisations. These are: (1) that ENDS s...

Aim To test the age, cohort, and period effect on past-year use trends in psychedelic drugs and ecstasy. Method Data were from a repeated cross-sectional nationally representative household survey in Australia conducted every three years between 2001 and 2019. An age-period-cohort model was used to test the effect of age, birth cohort, and period...

Importance: Vaping products were initially designed to deliver nicotine as a tobacco cigarette substitute (eg, electronic cigarettes) but are now frequently used to deliver psychoactive substances, such as cannabis and its derivatives. Large, nationally representative surveys, such as Monitoring the Future, found that approximately 1 in 3 grade-12...

Aims To estimate the treatment rate for alcohol use disorders (AUDs) in the general adult population. Treatment rates were also considered in relation to economic differences. Methods Systematic review and meta‐analysis. We searched PubMed, EMBASE, PsycINFO, and CINAHL databases to identify studies that reported treatment rates for alcohol use dis...

Importance: Cytisine is more effective than placebo and nicotine replacement therapy for smoking cessation. However, cytisine has not been tested against the most effective smoking cessation medication, varenicline, which is associated with adverse events known to lead to discontinuation of therapy. Objective: To examine whether standard cytisin...

The legality of cannabis use has been changing in a number of jurisdictions around the world. In the U.S., it has been legalised for medicinal and/or recreational uses in 34 jurisdictions and counting. This study leverages the decades-long experience of legalisation in the U.S. to provide an overview of the associated changes in public attitudes, c...

Importance Despite concern about harms related to long-term prescribed opioid use among individuals with chronic noncancer pain (CNCP), no study has examined whether the same patients engage in a risky pattern of use consistently for the long term. Objective To examine the prevalence, incidence, persistence, and cessation of a range of opioid beha...

Introduction and Aims: Increasingly more Australians are in favor of legalizing medical and recreational cannabis use. This paper explored the personal characteristics of those who supported each of these policies in Australia. Design: Cross-sectional national survey. Methods: This study included 21,729 participants aged 18 years and above who resp...

Background and aims: There has been an increase in the potency of cannabis during the last two decades and adoption of a novel method of administration-vaping. YouTube, a social media platform, has become a popular source to access cannabis-related information. This study aimed to identify cannabis vaping YouTube videos from 2016 to 2020 and exami...

Background Cleaner nicotine delivery devices, such as nicotine vaping products (NVPs), could expose smokers to less harm than combustible cigarettes. While use of NVPs is increasing, it is unknown how harm reduction attitudes are related to intention to use these or other “clean nicotine” products and how smokers would prefer to use them. Methods...

Introduction This paper compares consequences of cannabis use initiated after high school with those of cannabis initiation in adolescence, with estimates of the proportion of adverse consequences accounted for by adult‐onset and adolescent‐onset cannabis users. Methods A state‐representative sample in Victoria, Australia (n = 1792) participated i...

Aims The United Kingdom and Australia have developed highly divergent policy responses to electronic nicotine delivery systems (ENDS). To understand the historical origins of these differences, we describe the history of tobacco control in each country and the key roles played in setting ENDS policy in its early stages by public health regulations...

Background: Pregabalin has become widely used as an alternative to opioids in treating certain types of chronic non-cancer pain, but few studies have examined its clinical efficacy outside trials. We address this gap by examining the utilization, correlates and clinical outcomes of pregabalin use among an Australian community-based cohort of peopl...

Background The literature suggests patient characteristics and higher opioid doses and long-term duration are associated with problematic opioid behaviours but no one study has examined the role of all these factors simultaneously in a long-term prospective cohort study. Methods Five-year, community-based, prospective cohort of people prescribed o...

We describe the origins of the 1939 melodrama Reefer Madness, correct some common misconceptions about its role in the prohibition of marijuana in the United States and analyse some common contemporary misuses of the film's title as a catch phrase to discredit evidence that some patterns of cannabis use can harm users.

This review summarizes evidence on the effects of cannabis use on the development of adolescents and young adults. It draws on epidemiological studies, neuroimaging studies, case-control studies, and twin and Mendelian randomization studies. The acute risks include psychiatric symptoms associated with the use of high THC (tetrahydrocannabinol) prod...

In Australia, the precautionary principle has been used to justify an effective sales ban on nicotine vaping products (NVPs) by requiring all NVPs to be approved as medicines. Australia's policy is out of step with other English-speaking countries, which allow the sale of NVPs as consumer products. We provide a brief history of the precautionary pr...

Pain is a global health priority that is challenging to asses. Here we propose a new approach to estimating the burden of pain treatment in a population using wastewater-based epidemiology (WBE). WBE is able to quantify multiple pharmaceutical compounds in order to estimate consumption by a population. Wastewater samples collected from areas repres...

Aims To describe an outbreak of lung injuries in 2019 among people who vaped in the USA (type of injuries, persons afflicted, substances vaped, and cause of the injuries) and to analyse critically the regulatory responses of public health authorities and the media reporting of the outbreak. Methods Case studies of the reporting of the e‐cigarette...

Deaths from opioid overdose in the USA have followed three distinct waves that have all affected baby boomers, generation X and millennials.

Background How addiction treatment providers view different models of addiction has implications for workforce development and addiction treatment, however research exploring their views is limited. This study examined Australian, UK and US treatment providers': (1) levels of support for the psychosocial, disease model of addiction (DMA) and brain...

The COVID‐19 pandemic and the measures required to address it are cutting a swathe through people's lives and the global economy. People with addictive disorders are particularly badly affected as a result of poverty, physical and mental health vulnerabilities and disruption of access to services. The pandemic may well increase the extent and sever...

The emerging field of global mental health offers an important framework to address the burden of disease attributable to substance use disorders (SUDs) across the globe. There are, however, different approaches about how to prioritise investment in the treatment of SUDs globally. In this chapter, we review two prioritisation exercises for global m...

Cannabis is the illicit drug that is most often used by adolescents and the one that young people are most likely to develop dependence on. Cannabis dependence is more common in males, especially those who display disruptive and antisocial behavior and, to a lesser extent, in those with anxiety and depression. Problem cannabis use is strongly assoc...

The rapid emergence since the mid-2000s of a large and diverse range of substances originally designed as legal alternatives to more established illicit drugs (pragmatically clustered and termed new psychoactive substances; [NPS]) has challenged traditional approaches to drug monitoring, surveillance, control, and public health responses. In this s...

We assess the current and describe possible future public health impacts of the legalisation of cannabis production, sale, and use in the Americas. First, we describe global patterns of cannabis use and their most probable adverse health effects. Second, we summarise evidence regarding the effectiveness of cannabinoids for medicinal use and describ...

Aims: Alcohol use is a leading risk factor for disease burden among youth. This study estimated sex differences in the prevalence of alcohol use and consequences among adolescents living in low and middle-income countries (LMIC). Design: Multi-staged cross-sectional international standardized self-report questionnaires administered in the classr...

Aim: To (1) identify population-level classes of polysubstance use among young Australians between 2004 and 2016, (2) test if these classes changed over the same period, in terms of class prevalence and probabilities of substance use within each class, and (3) identify demographic and health-related correlates of polysubstance use. Design: Repea...

Aims: In Australia, sales of nicotine containing electronic cigarettes (also known as e-cigarette) are banned unless approved as a therapeutic good. The aims of this study were to estimate the prevalence of e-cigarette use and its correlates in Australia using a nationally representative survey. Method: We analysed data from the largest drug use...

This review summarizes studies that examined the effectiveness of cannabinoids in treating spasticity, with a focus on understanding the relevance of the existing evidence to paediatric populations. MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched to identify studies that examined the use of cannabinoids in spasticity. We identifie...

Alcohol, tobacco, and illicit drug use are key contributors to the global burden of disease. Various international organisations and research groups regularly compute estimates of use, dependence, and associated mortality and burden of disease at the country, regional, and global levels. This chapter reviews and summarises these estimates of preval...

Aim To assess (1) how far smoking patterns, depression and smoking‐related beliefs and intentions predict vaping uptake, current vaping and vaping frequency among daily smokers; and (2) how far the aforementioned predictors and baseline vaping frequency predict current vaping among those who reported ever vaped. Design Analysis of data from six wa...

Pre-clinical research supports that cannabinoids reduce opioid dose requirements, but few studies have tested this in humans. This review evaluates ecological and epidemiological studies that have been cited as evidence that medical cannabis use may reduce opioid use and opioid-related harms. Medline and Embase were searched for relevant articles....

Purpose of Review Since California legalised medical use of cannabis in 1996, 29 other US states have done so. Eight US states have legalised the retail sale of cannabis to adults over the age of 21 years since 2012. Critics of these policy changes have suggested that they will increase the prevalence of cannabis use and cannabis use disorders. Thi...

Wastewater contains a large range of biological and chemical markers of human activity and exposures. Through systematic collection and analysis of these markers within wastewater samples it is possible to measure the public health of whole populations. The analysis of effluent and biosolids can also be used to understand the release of chemicals f...

Background Some university students consume pharmaceutical stimulants without a medical prescription with the goal of improving their academic performance. The prevalence of this practice has been well documented in the US, but less so in other countries. The potential harms of using prescription stimulants require a better understanding of the pre...

Background: Alcohol and drug use can have negative consequences on the health, economy, productivity, and social aspects of communities. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to calculate global and regional estimates of the prevalence of alcohol, amphetamine, cannabis, cocaine, and op...

Background: To examine the longitudinal patterns of amphetamine use over twenty years from adolescence to the mid-thirties; and identify adolescent antecedents of future problematic patterns of use. Design: Ten-wave longitudinal study following participants from age 15 to age 35 in Victoria, Australia. Participants (N = 1755; 47% males) first enrol...