Deadly declines and diversity – understanding the variations in regional Aboriginal and Torres Strait Islander smoking prevalence

Heris, Christina; Lovett, Raymond; Barrett, Eden M; Calma, Tom; Wright, Alyson; Maddox, Raglan

doi:10.1111/1753-6405.13286

Cited by 4 publications

(9 citation statements)

References 11 publications

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“…The 2015 revised TIS program included regional grants, and in 2018, regional tobacco control grants were being provided to 37 organisations nationally, 10,20,21 the majority of which were ACCHSs 3 . It is estimated that nationally, more than a quarter of Aboriginal and Torres Strait Islander peoples live outside of TIS serviced regions 22 . Despite additional funding committed to the TIS by the Federal Government in 2022, 23 a significant proportion of ACCHSs nationally are not receiving specific TCP funding through the TIS.…”

Section: Discussionmentioning

confidence: 99%

“…In 2021, new Medicare Benefits Scheme items were introduced for patients to access nicotine and smoking cessation counselling through General and Other Medical Practitioners and Other Medical Practitioners 28 . While these national efforts are likely to have contributed to overall declining smoking rates among Aboriginal and Torres Strait Islander Australians, regional variations remain, and reinforce the need for tailored and targeted TCPs to meet local needs 22,29 . Rigorous evaluation of these policies and programs are needed to ensure that limited funding and resources are being used effectively.…”

Section: Discussionmentioning

confidence: 99%

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Delivery of tobacco control programs by Aboriginal Community Controlled Health Organisations in New South Wales, Australia: A cross‐sectional survey

Bryant

Noble

Eades

et al. 2023

Health Prom J of Aust

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Issue AddressedTo describe the characteristics of tobacco control programs (TCPs) delivered by Aboriginal Community Controlled Health Services (ACCHSs) in New South Wales (NSW), Australia.MethodsA key informant from each ACCHS in NSW completed a 30‐item online survey. For each TCP, ACCHSs were asked to provide: the target population group, program aims and activities, funding source, and whether the program had been monitored or evaluated and reflected principles of community control and engagement.ResultsTwenty‐five of 38 eligible ACCHSs completed the survey (66% response rate). Overall, 64% of services reported currently delivering at least one TCP, almost all of which aimed to promote quitting (95%). Programs involved brief intervention for tobacco cessation (71%), referral to quit services (67%), or use of printed resources (67%). Funding sources included Local Health Districts (52% of programs), the Commonwealth Government (48%) and NSW Ministry of Health (43%). Most programs were aimed at all Aboriginal people who smoke (76%); 19% targeted women or families during pregnancy/birth. Many TCPs used culturally tailored resources (86%) and employed Aboriginal staff (86%), and 48% had been evaluated.ConclusionsA third of participating ACCHS did not have a specific TCP to address smoking among Aboriginal people, and delivery of programs was characterised by an uncoordinated approach across the state. Aboriginal staff and culturally tailored messages were a focus of existing TCP programs.So What?Findings highlight the need for more investment in TCPs for Aboriginal people to ensure all ACCHSs can deliver evidence‐based programs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Delivery of tobacco control programs by Aboriginal Community Controlled Health Organisations in New South Wales, Australia: A cross‐sectional survey

Bryant

Noble

Eades

et al. 2023

Health Prom J of Aust

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“…Current smoking prevalence decreased by 8.3 percentage points in regional areas from 1994 to 2018/19, and 23% in urban areas and 5% in remote areas over the same period, 5 reflecting the diversity in smoking behaviours. Overall, the majority (57%) of Aboriginal and Torres Strait Islander adults aged 18 years and above do not smoke, 5 and smoke‐free behaviours are becoming increasingly common in regional communities 8 …”

Section: Introductionmentioning

confidence: 99%

“…Overall, the majority (57%) of Aboriginal and Torres Strait Islander adults aged 18 years and above do not smoke, 5 and smoke-free behaviours are becoming increasingly common in regional communities. 8 Understanding the factors influencing smoke-free behaviours can assist with developing policies and programs to accelerate smoke-free trends, and provide better protection from the Tobacco Industry and affiliates. 9,10 Despite the active role of the Tobacco Industry, 9,10 many relevant factors for being smoke-free include the Social Determinants of Health (SDOH).…”

Section: Introductionmentioning

confidence: 99%

The social determinants of Aboriginal and Torres Strait Islander adults who do not smoke in regional Australia

Heris,

Caudell,

Barrett

et al. 2024

Australian J Rural Health

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IntroductionCommercial tobacco use was systematically embedded as a valuable commodity through colonisation that continues to be exploited for profit by the Tobacco Industry. There have been significant declines in current smoking prevalence among Aboriginal and Torres Strait Islander peoples 18 years and over, from 55% in 1994 to 43% in 2018–2019. This paper seeks to better understand smoke‐free behaviours, and to systematically quantify associations between a range of SDOH and non‐smoking/never‐smoking among Aboriginal and Torres Strait Islander adults (≥18) living in regional Australia.ObjectiveTo explore the social determinants of health (SDOH) related to non‐ and never‐smoking among Aboriginal and Torres Strait Islander peoples in regional Australia.DesignCross‐sectional analysis of the NATSIHS, weighted to the Aboriginal and Torres Strait Islander adult population living in regional Australia, was conducted. Participants were characterised as people who were current smokers, never‐smokers and non‐smokers (ex‐ and never‐smokers). The social determinants of health exposures related to socioeconomic position, well‐being and access to healthcare.SettingRegional Australia is distinct from urban and remote areas, based on the ASGS Remoteness Structure (ABS) 2018–2019.ParticipantsAboriginal and Torres Strait Islander adults (≥18 years) who were selected, consented and asked questions about smoking in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS 2018/19).ResultsHigh income was associated with non‐smoking (Prevalence Ratio [PR] = 2.07; 95% CI: 1.66–2.57) and never‐smoking (PR = 2.02; 1.46–2.79), as was completing year 10 (non‐smoking PR = 1.34; 1.12–1.61 and never‐smoking PR = 1.56; 1.20–2.03). Better food security was associated with a higher prevalence of never‐smoking (PR = 2.42; 1.48–3.98). Lower psychological distress scores were associated with non‐smoking (PR = 1.30; 1.10–1.53) and never‐smoking (PR = 1.56; 1.21–2.01). Never‐smoking was more frequent in participants reporting no experiences of unfair treatment (PR = 1.59; 1.22–2.06). Having a usual healthcare provider was associated with non‐smoking (PR = 1.38; 1.02–1.86). Positive exposure to the SDOH were associated with non‐ and never‐smoking among Aboriginal and Torres Strait Islander adults in regional Australia. Structural and systemic changes to address the SDOH, including discrimination and racism, are expected to accelerate non‐smoking behaviours and improve health outcomes for Aboriginal and Torres Strait Islander peoples.

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“…2 , 3 Smoking rates, factors and associations with smoking are diverse across Aboriginal and Torres Strait Islander people and communities. 1 , 4 , 5 Commercial tobacco smoking is the leading preventable cause of morbidity and mortality for Aboriginal and Torres Strait Islander people. 3 While reducing the rates of commercial tobacco use among Aboriginal and Torres Strait Islander people is included in nearly every health; plan, 6 monitoring framework 7 and strategy, 8 it is seldom discussed or addressed in the context of coloniality to which it became available, embedded and sustained in Indigenous communities globally.…”

Section: Introductionmentioning

confidence: 99%

Which Way?Indigenous-led Smoking Cessation Care: Knowledge, Attitudes and Practices of Aboriginal and Torres Strait Islander Health Workers and Practitioners – A National Cross-sectional Survey

Kennedy

Longbottom

Mersha

et al. 2022

Nicotine &Amp; Tobacco Research

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Introduction Tobacco is the leading preventable cause of morbidity and mortality for Aboriginal and Torres Strait Islander people. Accordingly, the provision of culturally safe and effective smoking cessation strategies are crucial. While previous research has suggested Aboriginal Health Workers/Practitioners are well placed to provide smoking cessation care, no research to date has explored the workforce knowledge, attitudes and practices in offering best practice cessation care. Methods A cross-sectional study was conducted among Aboriginal Health Workers/Practitioners from June to September 2021. Descriptive and inferential statistics were conducted to examine participant characteristics, provision of smoking cessation care, and explore the factors associated with smoking cessation care. Results Out of 1052 registered Aboriginal Health Workers/Practitioners, 256 participants completed the full survey (24.3%). Smoking cessation counselling was always provided by 41.9%; provided some of the time by 42.4%, and never provided by 12.9%. Combination NRT and Quitline referral were always offered by 23.1% and 44.9% of participants respectively. Those that received training, felt smoking cessation care was part of their role, and were based in Aboriginal Community Controlled Health Organisation were significantly more likely to offer best practice smoking cessation care. Conclusion Aboriginal Health Workers/Practitioners and Aboriginal Community Controlled Health Organisations play a critical role in delivering high quality, evidence based and culturally safe care to Aboriginal and Torres Strait Islander people. Aboriginal Health Workers/Practitioners are well placed to offer smoking cessation care. Ongoing funding and implementation of a targeted smoking cessation workforce with appropriate training and resources are urgently required. Implications Aboriginal Health Workers/Practitioners are well placed to offer culturally safe, best practice smoking cessation care. However, due to the magnitude and complexity of Aboriginal Health Workers/Practitioners roles, it is challenging for smoking cessation care to be consistently and feasibly integrated into usual care. Acknowledging Australia’s National Preventative Health Strategy target of 27% or less Aboriginal and Torres Strait Islander people smoking by 2030, urgent investment and resourcing must be directed to building a skilled workforce to support quitting and maintaining smokefree behaviours, ensuring equitable access to smoking cessation care for Aboriginal and Torres Strait Islander peoples.

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Deadly declines and diversity – understanding the variations in regional Aboriginal and Torres Strait Islander smoking prevalence

Cited by 4 publications

References 11 publications

Delivery of tobacco control programs by Aboriginal Community Controlled Health Organisations in New South Wales, Australia: A cross‐sectional survey

Delivery of tobacco control programs by Aboriginal Community Controlled Health Organisations in New South Wales, Australia: A cross‐sectional survey

The social determinants of Aboriginal and Torres Strait Islander adults who do not smoke in regional Australia

Which Way?Indigenous-led Smoking Cessation Care: Knowledge, Attitudes and Practices of Aboriginal and Torres Strait Islander Health Workers and Practitioners – A National Cross-sectional Survey

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