2008 vol. 32 no. 5 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 491© 2008 The Authors. Journal Compilation © 2008 Public Health Association of Australia

Letters

Nevertheless, in our letter we stated that WT smoking still

needed to be addressed and suggested some specific strategies

focusing on WT smoking in our Arabic speaking population.

Since publication of our letter, Sydney South West Area Health

Service (SSWAHS) has been applying World Health Organization

recommendations5 to control the spread of WT smoking. SSWAHS

commenced an audit of WT retailers6 to ensure compliance with

both New South Wales and Australian public health legislation. We

have also received funding to develop an intervention to increase

awareness of the harms of WT smoking and applicable legislation

in the Arabic-speaking community.

Finally, while we reported that only one ex-CCP smoker smoked

WT daily,2 the number of ex-CCP smokers’ who smoke WT

occasionally was 10 of 144 (7%). Thus the phenomenon of CCP

smokers switching to WT smoking was not common in Arabic-

speaking adults residing in south-west Sydney, although this may

not be reflected in other regional or population settings.

References1. Maziak W, Are premature public health statements warranted? Aust N Z J Public

Health. 2008; 2008;32(5):490.2 Carroll T, Poder N, Perusco A. Is concern about waterpipe smoking warranted?

Aust N Z J Public Health. 2008;32(2):181-2.3. Centers for Disease Control and Prevention. The Health Consequences of

Smoking: A Report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services; 2004.

4. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004;328(7455):1507.

5. World Health Organization Study Group on Tobacco Product Regulation. TobReg Advisory Note. Waterpipe Tobacco Smoking: Health Effects, Research. Needs and Recommended Actions by Regulators. Geneva (CHE): World Health Organization; 2005.

6. Poder N, Perusco A, Carroll T, Kiss A, Birkett J, Sabry M et al. Waterpipe tobacco smoking: Where to next? Proceedings of the Population Health Congress; 2008 July 6-9; Brisbane, Queensland Australia.

Correspondence to: Ms Natasha Poder, Health Promotion Service, Sydney South West Area Health Service, Hugh Jardine Building, Liverpool Hospital, Locked Mail Bag 7017, Liverpool BC, NSW 1871. Fax: (02) 9828 5905; e-mail: Natasha.Poder@sswahs.nsw.gov.au

doi: 10.1111/j.1753-6405.2008.00285.x

Taking care of the public health student and early career community in Australia: their viewsJames A. Smith and Lauren Cordwell

South Western Pacific Regional Committee of the International Union for Health Promotion & Education

IUHPE Student & Early Career Network (ISECN) Global Working Group

We read with interest the editorial in the ANZJPH entitled ‘taking

care of early-career public health researchers and practitioners’.1

We acknowledge that it is useful to ponder, from an academic gaze,

the strategies that should or should not be adopted to ‘take care’ of

the student and early career community in the field of public health.

We also agree that many early career researchers have considerable

experience in other areas, namely practice and policy contexts,

equipping them to act at the research-policy-practice nexus from

the outset of their careers. But in the true spirit of community

consultation, it seems sensible to ask the constituents of the early

career community – the majority young females – what support

mechanisms they perceive are needed to ensure they can be the

most effective public health leaders of tomorrow.

During the recent Population Health Congress in Brisbane, the

International Union for Health Promotion & Education (IUHPE),

through the IUHPE Student & Early Career Community Network

(ISECN),2 facilitated a breakfast workshop. This workshop aimed

to create a forum for the health promotion/public health student and

the early career community (SECC) to network and exchange ideas

about their professional interests, needs and support mechanisms;

and to identify avenues to foster their future participation in the

public health arena. A range of professional organisations with

a public health and/or health promotion orientation were invited

to share what they were doing to support this community. The

organisations that participated included the Australian Health

Promotion Association; the Public Health Association of Australia;

the Asia-Pacific Academic Consortium of Public Health; the

Australasian Society for Behavioural Health & Medicine; the

International Society for Behavioral Medicine; the Victorian Health

Promotion Network; and the LaTrobe University Public Health

Student’s Association. We now take the opportunity to report back

on a few key issues discussed by the 30+ participants.

First, the public health community should congratulate itself for

ensuring that a wide range of professional development and career

enabling initiatives are being offered for the student and early career

community (SECC). These ranged from mentoring programs,

student conferences, student representation within organisational

structures, awards, scholarships and web forums – to name just a few.

However, we should take stock for just a moment. The second issue

identified, was that very few of these initiatives were developed or

implemented in partnership. That is, we are yet to combine limited

human and financial resources across the aforementioned public

health organisations to facilitate a critical mass within the SECC. It

was suggested that combining resources will inevitably strengthen

public health action in Australia. Joint memberships, scholarships,

conferences, and mentoring programs might be a useful starting point

– acknowledging that some state jurisdictions have already started

doing this quite well. This leads to the third issue, which relates to lack

of co-ordination to support the SECC at the national level.

While it was acknowledged that certain initiatives, such as the

National Health & Medical Research Council Capacity Building

Grants in Population Health 2002-2006, are important,1 they

somehow fall short of what this community is looking for. There

was a general consensus that the establishment of a national

population health agency with a specific focus on supporting the

public health SECC could assist in addressing this gap. Ideally

492 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2008 vol. 32 no. 5© 2008 The Authors. Journal Compilation © 2008 Public Health Association of Australia

Letters

doi: 10.1111/j.1753-6405.2008.00288.x

Water shortage in Australian fast food outletsLesley King, Bridget Kelly

NSW Centre for Overweight and Obesity, University of Sydney, New South Wales

Joey Ho Department of Human Nutrition, University of Sydney, New South Wales

Libby HattersleyNSW Centre for Overweight and Obesity, University of Sydney, New South Wales

The ubiquity of fast food restaurants which promote and provide

energy-dense foods and sugary beverages has been identified as

one significant part of the obesogenic food environment.1 Fast food

restaurants typically offer and promote meal deals that include

a major food item (e.g. burger), fried potato and a soft drink2 in

combination, which is promoted as value for money. One way

of reducing energy intake is to consume water as an alternative

beverage in meal deals. However, recent research indicates that

such an establishment would prevent the duplication of effort and

professional resources directed at SECC. We are not suggesting the

establishment of another professional body – there are already too

many to choose from. Rather, we are suggesting that a consolidated

effort is required to best meet the needs of Australia’s future public

health workforce. Such collaboration may well require some of the

existing professional associations to think more laterally and be

more flexible about the types of activities they offer for the SECC.

Perhaps profit gained from the recent Congress could be used to

build infrastructure at the national level to encourage collaborative

action that supports this group. This is likely to build a more robust

and well networked public health SECC. We see the SECC as

including passionate, intelligent individuals who are committed

to working towards a healthier and equitable future. Co-ordinated

efforts are now needed to ensure their ongoing involvement. Now

is the time for action.

References1. Daly J, Lumley J. Taking care of early-career public health researchers and

practitioners. Aust N Z J Public Health. 2008;32(3):203-4.2. Bull T, Corbin JH. The IUHPE student and early career network (ISECN):

an update. Promot Educ. 2008;15(2):44-5.

Correspondence to: James Smith, C/- Health Promotion Strategy Unit, NT Department of Health & Families, PO Box 40596, Casuarina NT 0811. Fax: (08) 8985 8016; e-mail: james.smith@nt.gov.au

young adults perceive it to be difficult and more expensive to

replace sugary drinks with water in this setting.3

We investigated the types of beverages available at major fast

food restaurants, and particularly those included in meal deals,

through site visits and purchases in a convenience sample of 16 fast

food restaurants in a specific Sydney area. The sample comprised

two outlets from each of eight major chains. The availability of

tap water was tested by observation or request.

Sugary drinks (including soft drinks, juice-based beverages,

flavoured milk, iced teas, and sports drinks)4 and bottled water

were available in all restaurants; however sugary drinks comprised

the majority of beverage types available (71%). Tap water was

available on request in 81% of restaurants.

Sugary drinks were the most frequently promoted beverages

(through menus and displays) and comprised 61% of all within

store promotions. Sugary drinks were also the default beverage

in 80% of meal deals (the remaining 20% explicitly identified a

choice). Half of all meal deals that promoted diet sugary drinks

(16% of all meal deals), also offered bottled water as an alternative.

Bottled water was identified in 16% of within store promotions

and was available on request as an alternative in meal deals, at an

equivalent price in all cases. The meal deal cost was reduced by

10% when tap water was substituted.

This study confirms that meal deals at fast food restaurants

promote the consumption of sugary drinks, however the

availability of bottled water is promising. Nevertheless, there is

room for improvement, through the promotion of water and the

provision of free tap water in fast food restaurants. Currently,

the lack of external cues for water contributes to the obesogenic

nature of these restaurants.

Given that reductions in the consumption of sugary drinks

and energy-dense foods could make a significant contribution to

curbing rising obesity rates, efforts to increase public awareness

and promote healthier meal deal variations are warranted.

References1. Mehta NK, Chang VW. Weight status and restaurant availability: a multilevel

analysis. Am J Prev Med. 2008;43(2):127-33.2. Cameron-Smith D, Bilsborough SA, Crowe TC. Upsizing Australia’s waistline:

the dangers of ‘meal deals’. Med J Aust. 2002;177(11/12):686.3. Hattersley L, Irwin M, KingL, Allman-Farinelli M. Determinants and Patterns

of Soft Drink Consumption in Young Adults. Unpublished communication.4. Hattersley L, Hector D. Building Solutions for Preventing Childhood Obesity. Module

1: Interventions to Promote Consumption of Water and Reduce Consumption of Sugary Drinks. Sydney (AUST): NSW Centre for Overweight and Obesity [homepage on the Internet]; 2008. [cited 2008 July 17]. Available from: www.coo.health.usyd.edu.au

Correspondence to: Lesley King, NSW Centre for Overweight and Obesity, Level 2, K25 Medical Foundation Building, University of Sydney, NSW 2006. Fax: 02 9036 3184; e-mail: lking@health.usyd.edu.au