Information

  • Undertaken to identify risky substance taking behaviour, acknowledge a child’s lifestyle choices and to provide preventative information to promote healthy adulthood outcomes

Child safety notification

  • For a suspicion of harm or neglect refer to Child safety reporting

Health check recommendations

  • All children opportunistically ≥ 8 years old

1. Procedure

  • With parental consent and where appropriate, interview the child alone for honest answers. Reassure the child that any discussions are confidential
  • Ask the alcohol, tobacco and other drugs (ATODs) questions and explore the answers in an age appropriate, nonjudgmental supportive manner. See Table 1.
  • Provide brief intervention if required
  • Determine if the child requires a referral and place on a follow-up and recall register

Table 1. ATODs questions for ≥ 8 years of age

Questions

Explore

Does the child smoke? (vapes, cigarettes, cannabis etc.)

  • How often does the child smoke cigarettes or vapes/drink alcohol/take other drugs? Daily, weekly, sometimes?
  • How many? When?
  • Identify triggers e.g. when stressed? at school? with friends and peers?
  • Where do they get their cigarettes/vapes/alcohol/other drugs from?
  • Clarify type of cigarettes/vapes/alcohol/drugs?
    • nicotine strength, non-nicotine
    • beer, wine, UDLs, premix or spirits
    • inhalants, cannabis, meth etc.
  • Why do they smoke/drink/take drugs?
  • How does it make them feel?

Does the child drink alcohol?

Does the child use drugs or other substances?

2. Results

  • The preferred response to the ATODs questions is ‘no’
  • If the child answers ‘no’, positively reinforce their healthy lifestyle choice
  • If the child answers ‘yes’ provide brief intervention and offer a referral to the appropriate service
  • Depending on the context of an older child’s answers, consider the impacts on their mental and sexual health. See Sexual and reproductive health and Social-emotional wellbeing (child)

3. Brief intervention 1,2

  • Consider Engaging our patients when communicating with children
  • Avoid minimising harmful behaviour and the negative health effects on the body
  • Use a matrix of motivational questions for children to critically think about the effects of taking ATODs. See Table 2.
  • Encourage the child to talk to someone they feel safe with about using ATODs
  • Offer the child:
    • help from the health service to cease ATODs
    • self help materials and cessation support programs for drug taking behaviours. See Resources 1–10.
  • See Alcohol reduction and Smoking cessation

Table 2. Motivational questions 1,2

What are the good things about smoking, drinking alcohol or taking drugs?

What are the bad things about smoking, drinking alcohol or taking drugs?

  • All my friends do it
  • Makes me look cool
  • Relaxes me
  • Gets me started
  • Tastes good
  • Keeps me awake
  • Gives me a boost
  • Costs a lot of money
  • Makes my chest feel tight and short of breath
  • Can’t run around, go diving or play sport because of breathlessness
  • Makes me cough
  • Gives me bad breath
  • Everyone asks for a smoke from me
  • Hate craving for a smoke
  • Causes cancer and damages the body
  • Trouble with family, school and police

What are the good things about STOPPING smoking, drinking alcohol or taking drugs?

What are the bad things about STOPPING smoking, drinking alcohol or taking drugs?

  • Won’t be breathless any more
  • Will have more money
  • Can save up for something special
  • Will feel stronger
  • Friends may not want to play with me
  • Not look cool

4. Referral

  • Refer any child ATODs issues to:
    • the MO/NP or
    • local Mental Health, Alcohol and Other Drugs (MHAODs) services or
    • Child safety reporting
  • If assessment reveals a community wide problem refer to the Population Health Unit for community engagement
  • If any harmful drug taking behaviours are identified, refer to an appropriate source. See Table 3.

Table 3. Referral options

Queensland Health

Other services

5. Follow-up

  • Place the child on a recall register to monitor and support ATODs reduction as required
  • Ensure all referrals are actioned
  • Provide the child or parent with the next scheduled follow-up appointment

6. References

7. Resources

  1. Queensland Government alcohol, tobacco and other drugs resources
  2. Alcohol and Drug Information Service on 1800 177 833 all hours
  3. Turning Point online counselling service
  4. Quit HQ or Quit phone apps available for download from Apple iTunes and Google Play stores
  5. National Alcohol Strategy 2019–2028
  6. Smoking, nutrition, alcohol, physical activity (SNAP) A population health guide to behavioural risk factors in general practice 2nd edition
  7. Australian Alcohol Guidelines revised
  8. Dovetail: A range of fact sheets and professional development resources to support those who engage with young people affected by alcohol and other drugs
  9. Blurred minds, an innovative, evidence-based alcohol and drug education program for Australian secondary schools
  10. Cannabis Information and Support

Last updated: November 2024

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