Past quit attempts in a national sample of Aboriginal and Torres Strait Islander smokers

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Objective: To describe factors that predict wanting to quit smoking in a national sample of Aboriginal and Torres Strait Islander people. Design, setting and participants: The Talking About The Smokes (TATS) project used a quota sampling design to recruit participants from communities served by 34 Aboriginal community‐controlled health services and one community in the Torres Strait. Baseline survey data were collected from 1643 current smokers between April 2012 and October 2013. Main outcome measure: Wanting to quit smoking. Results: More than two‐thirds of smokers (70%) said they want to quit. Many factors were associated with wanting to quit, including past quitting activity. Interest in quitting was lower among men and smokers from economically disadvantaged areas, but there was no difference by age, remoteness or other measures of economic disadvantage. Attitudes and beliefs negatively associated with wanting to quit included enjoying smoking and believing quitting to be very difficult, and those positively associated included regretting ever starting to smoke, perceiving that local Aboriginal and Torres Strait Islander community leaders disapprove of smoking, believing non‐smokers set a good example to children, worrying about future smoking‐related health effects and believing quitting to be beneficial. Reporting support from family and friends was predictive of wanting to quit, but factors related to smoking in the social network were not. Associations with health and wellbeing were mixed. While most tobacco control policy exposure variables were positively associated with wanting to quit, two — receiving advice to quit from a health professional, and recall of targeted anti‐tobacco advertising — appeared to have an effect that extended beyond influencing relevant attitudes and beliefs. Conclusion: Interest in quitting among Aboriginal and Torres Strait Islander smokers appears to be influenced by a broad range of factors, highlighting the importance of taking a comprehensive approach to tobacco control. Advice from health professionals and targeted advertising appear to be important intervention strategies.

Section: Discussionmentioning

confidence: 72%

Predictors of wanting to quit in a national sample of Aboriginal and Torres Strait Islander smokers

Nicholson

Borland

Davey

et al. 2015

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“…Aboriginal and Torres Strait Islander smokers' perceptions of greater ease in quitting (quitting self‐efficacy) may be falsely optimistic, perhaps reflecting less experience of unsuccessful quit attempts 23 . In 2012–2013, only 37% of Aboriginal and Torres Strait Islander adults who had ever smoked had successfully quit, compared with 63% of other Australians 10 .…”

Section: Discussionmentioning

confidence: 85%

Dependence in a national sample of Aboriginal and Torres Strait Islander daily smokers

Thomas

Panaretto

Stevens

et al. 2015

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Objectives: To examine indicators of nicotine dependence in a national sample of Aboriginal and Torres Strait Islander daily smokers and their association with sustaining a quit attempt for at least 1 month, and to make comparisons with a national sample of Australian daily smokers. Design, setting and participants: The Talking About The Smokes project used a quota sampling design to recruit 1392 daily smokers from communities served by 34 Aboriginal community‐controlled health services and one community in the Torres Strait from April 2012 to October 2013. These were compared with 1010 daily smokers from the general Australian population surveyed by the International Tobacco Control Policy Evaluation Project from September 2011 to February 2012. Main outcome measures: Cigarettes per day (CPD), time to first cigarette, Heaviness of Smoking Index (HSI), other indicators of dependence, and whether smokers had ever sustained a quit attempt for at least 1 month. Results: There was little difference in the mean HSI scores for Aboriginal and Torres Strait Islander and other Australian daily smokers. A higher proportion of Aboriginal and Torres Strait Islander daily smokers smoked ≤ 10 CPD (40% v 33.4%), but more also smoked their first cigarette within 30 minutes of waking (75% v 64.6%). Lower proportions of Aboriginal and Torres Strait Islander smokers reported having strong urges to smoke at least several times a day (51% v 60.7%) or that it would be very hard to quit (39% v 47.9%). Most Aboriginal and Torres Strait Islander smokers reported experiencing difficulties during their most recent quit attempt. All indicators of dependence, except CPD and strong urges, were positively associated with not having made a sustained quit attempt. Reported difficulties during the most recent quit attempt were more strongly associated with being unable to sustain quit attempts than were traditional measures of dependence. Conclusion: Aboriginal and Torres Strait Islander smokers' experiences of past attempts to quit may be more useful than conventional indicators of nicotine dependence in understanding their dependence.

“…Elsewhere in this supplement, we show that more community members from sites with dedicated tobacco control resources had been advised to quit, 18 recalled noticing cigarette pack warning labels, 19 made quit attempts 20 and used stop‐smoking medicines 21 than those from sites without dedicated resources. However, there were no such significant differences for wanting to quit, 22 smoke‐free homes, 23 recalling advertising and news stories about smoking and quitting, 19 and personal attitudes towards smoking 24 …”

Section: Discussionmentioning

confidence: 97%

Tobacco control policies and activities in Aboriginal community‐controlled health services

Davey

Hunt

Foster

et al. 2015

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Objectives: To describe tobacco control policies and activities at a nationally representative sample of Aboriginal community‐controlled health services (ACCHSs). Design, setting and participants: The Talking About The Smokes (TATS) project used a quota sampling design to recruit 34 ACCHSs around Australia. Between April 2012 and October 2013, a representative at each ACCHS completed a survey about the service's tobacco control policies and activities. Questions about support for smoke‐free policies were also included in the TATS project survey of 2435 Aboriginal and Torres Strait Islander members of the communities served by the ACCHSs. Main outcome measures: ACCHS tobacco control policies and activities. Results: Thirty‐two surveys were completed, covering 34 sites. Most ACCHSs (24/32) prioritised tobacco control “a great deal” or “a fair amount”, and all services had smoke‐free workplace policies. Most had staff working on tobacco control and had provided tobacco control training within the past year. A range of quit‐smoking information and activities had been provided for clients and the community, as well as extra smoking cessation support for staff. There was strong support for smoke‐free ACCHSs from within the Aboriginal communities, with 87% of non‐smokers, 85% of ex‐smokers and 77% of daily smokers supporting a complete ban on smoking inside and around ACCHS buildings. Conclusions: The high level of commitment and experience within ACCHSs provides a strong base to sustain further tobacco control measures to reduce the very high smoking prevalence in Aboriginal and Torres Strait Islander populations.