“Under the umbrella of the Tackling Indigenous Smoking (TIS) initiative, Aboriginal and Torres Strait Islander communities have responded to national and local tobacco control efforts with enthusiasm and dedication. I applaud and congratulate all regional teams and the communities they work with for their commitment and interest in taking on the tackling smoking and healthy lifestyle challenge for a longer and healthy life.
We know that most Aboriginal and Torres Strait Islander smokers understand smoking is harmful. Most smokers want to quit and have tried to quit in the past.1 While our people have done a fantastic job in quitting smoking, and not taking it up, we still have much work to do.
Our people live around ten years less than other Australians2 and we experience more than twice the burden of disease due to high rates of chronic diseases.3 Much of this disease is caused by smoking or being exposed to someone else’s smoke. Awareness amongst our mob of the link between a chronic disease such as diabetes and smoking is too low and must be addressed.4 The same can be said for understanding the link between smoking and most major cancers.
Smoking causes 20 percent of deaths among our people,5 that is, one in five of our mob die from a smoking related disease. In addition, many of us are chronically sick because of our smoking. This means that reducing smoking will play a major role in closing the gap in life expectancy between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians within a generation and saving us from being chronically, unendingly sick.Back to top
An area that needs concerted attention is raising awareness of, and reducing the prevalence of, passive smoking; the smoke that non-smokers breathe in. We need to make our homes and workplaces and social spaces smoke free for our children, our elders and those who take on and meet the challenge of not smoking. Many of our mob now know that second hand smoke is very bad for us so we all need to take on the challenge and make our homes, cars, social events, meeting places, council rooms and workplaces smoke free.
We also need to understand that certain members of our mob are more at risk, for example our babies, and those in prison.
Many of us do not know it but Aboriginal and Torres Strait Islander pregnant women are 4 times more likely to smoke during pregnancy than non-Indigenous women. In addition we do not know about the increased risk to the mother of complications such as miscarriage, ectopic pregnancy and gestational diabetes and the poor outcomes for babies such as foetal growth restriction, premature birth, low birthweight, congenital abnormalities and perinatal death.
A baby in the womb is not safe from passive smoking – the second hand smoke a mother is exposed to can also lead to premature birth, low birthweight and perinatal death.6 This highlights the value in all members of a family giving up the smokes together.
Ninety-two percent of Aboriginal and Torres Strait Islander people entering prison are smokers.7 Many prisons and correctional centres around the country are or are moving towards going smoke free, which will touch the lives of a significant proportion of our mob – both inmates and their families. I have lent my voice to the educational campaign developed by Corrective Services NSW to support going Smoke Free project in August 2015.
The review of the TIS initiative in late 2014 highlighted that it could do better in reducing smoking rates if certain elements were redesigned and implementation bolstered. I am confident that the changes being rolled out, including an outcomes focus and establishment of a National Best Practice Unit, will result in significant progress and a body of evidence to strengthen our impact going forward.
As a final word, I would like to share some useful messages from the Talking About The Smokes project which gathered information from 2,522 Aboriginal and Torres Strait Islander people - smokers, ex-smokers and never-smokers - throughout Australia:
- Knowing that most of the smokers they see want to quit, know about the harmful effects of smoking and have a history of recent quit attempts, health staff can be confident that their quit message will be understood and welcomed, so they can then focus on the task of helping people to stay quit,
- Health staff can encourage more smokers to use evidence-based measures to prevent relapse during their next quit attempt, such as stop smoking medication, Quitlines, quit smoking courses, clinics and groups,
- Smokers whose local health service has dedicated tobacco control resources are more likely to try quitting and to use stop-smoking medication compared to smokers attending health services without these resources,
- The majority of smokers agree that Aboriginal Medical Services should ban smoking both indoors and outdoors,
- The majority of smokers agree that being a non-smoker sets a good example to children, but only just over half admit smoking was never allowed anywhere inside their home,
- Those working in health promotion need to continue social marketing campaigns to promote the anti-smoking message about being smoke-free, to encourage quit attempts, and to support smokers trying to stay quit, building on Aboriginal and Torres Strait Islander smokers’ concerns about the harmful effects of their smoking on others.8
I encourage my brothers and sisters, Aunties and Uncles and our young ones to give up smoking, avoid taking it up, and help others you care about to choose the no smoking path, so we can all lead long and healthy lives. We are the longest, continuing and surviving cultures in the world and we need to be the healthiest ones also.”
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1 Thomas, D et al. 2015. Talking About The Smokes, Medical Journal of Australia Supplement, Vol. 202 (10), 1 June (Talking About The Smokes: summary and key findings pp.3-4) www.mja.com.au/journal/2015/202/10/supplement
2 Australian Institute of Health and Welfare 2014. Mortality and life expectancy of Indigenous Australians: 2008 to 2012. Cat. no. IHW 140. Canberra: AIHW. www.aihw.gov.au/publication-detail/?id=60129548470
3 Australian Institute of Health and Welfare 2015. Australian Burden of Disease Study: fatal burden of disease in Aboriginal and Torres Strait Islander people 2010. Australian Burden of Disease Study series 2. Cat. no. BOD 2. Canberra: AIHW. www.aihw.gov.au/publication-detail/?id=60129550618
4 Thomas, D et al. 2015. Talking About The Smokes, Medical Journal of Australia Supplement, Vol. 202 (10), 1 June (Talking About The Smokes: summary and key findings pp.3-4) www.mja.com.au/journal/2015/202/10/supplement
5 Australian Health Ministers’ Advisory Council 2015. Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report, AHMAC: Canberra. www.dpmc.gov.au/indigenous-affairs/publication/aboriginal-and-torres-strait-islander-health-performance-framework-2014-report
8 Thomas, D et al. 2015. Talking About The Smokes, Medical Journal of Australia Supplement, Vol. 202 (10), 1 June (Talking About The Smokes: summary and key findings pp.3-4). www.mja.com.au/journal/2015/202/10/supplement
c Australian Bureau of Statistics 2014. Australian Aboriginal and Torres Strait Islander Health Survey: Updated Results, 20122-13, Cat. No. 4727.0.55.006. Selected Health Risk Factors - Tobacco smoking. Canberra: ABS.
d Australian Bureau of Statistics 2016, National Aboriginal and Torres Strait Islander Social Survey 2014-15, (Released 28 April 2016). Cat. No. 4714.0 Health Risk Factors. Canberra: ABS. Back to top