Dr Tom Calma AO, National Coordinator, Tackling Indigenous Smoking, responds to new smoking research with an update on the promising progress being made to tackle Aboriginal and Torres Strait Islander tobacco use and a reminder that more needs to be done if we are to close the health gap between Indigenous and non-Indigenous Australians. He writes:
New findings published this week in the international journal BMC Medicine indicate that up to 1.8 million of our 2.7 million smokers in Australia will die from their habit if they continue to smoke. This is a stark reminder of the benefits of quitting, or not taking up smoking at all.
The research provides an important reminder that while we have had some significant wins in the war on Aboriginal and Torres Strait Islander smoking rates in recent times; the war has not yet been won. Evidence suggests that great work has been undertaken in Aboriginal and Torres Strait Islander tobacco control, as illustrated with the significant reductions in Aboriginal and Torres Strait Islander tobacco use.
The reduction in Aboriginal and Torres Strait Islander smoking rates by 10 percent over the last decade (1), as well as the marked increase in the number of Aboriginal and Torres Strait Islander people not taking up smoking (1), demonstrates that efforts to cut smoking rates are working and that further gains are possible.
However, more work is required.
It is well recognised that many Aboriginal and Torres Strait Islander people experience a disproportionate burden of tobacco related disease due to high smoking rates, which severely reduces life expectancy. Around one in eight Australians smoke, but that rate is significantly higher among Aboriginal and Torres Strait Islander people at close to one in two (approximately 42 per cent of Aboriginal and Torres Strait Islander people smoke age 15 years and over (1)). One in five or 20% of deaths among Aboriginal and Torres Strait Islander people is caused by smoking (2).
Reducing smoking plays a significant role in closing the gap in life expectancy between Aboriginal and Torres Strait Islander people, and non-indigenous Australians within a generation. If the smoking rate among Aboriginal and Torres Strait Islander people was reduced to the rate of the non-Indigenous population, the overall Indigenous burden of disease would fall by around 6.5 per cent and save the lives of around 420 Aboriginal and Torres Strait Islander people each year. This equates to an additional four extra years of life expectancy (3) and would realise significant savings to the healthcare system.
Tackling Indigenous Smoking
In my role as National Coordinator – Tackling Indigenous Smoking, I am overseeing the Tackling Indigenous Smoking Programme funded by the Australian Government to work with Indigenous communities to reduce the number of people smoking and to encourage people not to take up smoking. The national Tackling Indigenous Smoking progamme has seen recent successes in reducing tobacco use by using innovative and culturally appropriate, community-based approaches to address smoking among our Aboriginal and Torres Strait Islander communities. The Tackling Indigenous Smoking programme includes: regional social marketing activity, local smoking cessation campaigns and events; increased access to smoking cessation support and to Health Checks; enhanced Quitline support for Aboriginal and Torres Strait Islander people; regional/local role models and ambassadors; and brief intervention training to help prompt people to quit. These local programs include ‘Deadly Choices’ and ‘Keep it Corka’
‘Deadly Choices’ is a comprehensive program which includes an education component covering: smoking; chronic disease; physical activity; nutrition; harmful substances; leadership; and health services. The programme has used high impact multi-media with strong culturally relevant messages about the impact of choices on individual and family wellbeing. Local Aboriginal and Torres Strait Islander ambassadors help give the programme profile; in a way that empowers participants of all ages to become positive mentors and role models in their community.
‘Keep it Corka’
‘Keep it Corka’ was developed through a partnership between the Aboriginal Health Council of South Australia (ACHSA) and Murray Mallee Community Health to raise awareness of links between lifestyle behaviours and chronic disease, motivate lifestyle behaviour change and provide practical knowledge on how to make these changes. The ‘Keep It Corka’ programme provides a range of activities including: school programmes which emphasise the importance of not taking up smoking; education programmes in prisons and established community groups; targeted quit support groups; physical activity sessions and events; community healthy lunches; cooking and gardening courses focused on healthy eating.
Local focus, national achievement
A significant challenge in addressing smoking has been the recognition that each region around Australia is different and therefore, different tools and mechanisms may work differently in reducing tobacco use. As a result, the Tackling Indigenous Smoking programme has been, and continues to be flexible in supporting innovative and locally tailored measures to meet the needs of local communities in raising awareness, education and challenging norms around smoking and other chronic disease risk factors.
Reducing the number of Aboriginal and Torres Strait Islander people who smoke is essential in realising the goal of closing the gap in health status equality and life expectancy. By working with Aboriginal and Torres Strait Islander people themselves, we can halve the Indigenous smoking rate over the next decade and give Indigenous Australians more opportunity to live long and healthy lives.
As Professor Emily Banks, Scientific Director of the Sax Institute’s 45 and Up Study and an Australian National University researcher said today, “Australia can be proud of its remarkable success in cutting population smoking to just 13% but even with this world-leading result, 2.7 million of us still smoke” … “Our findings show that up to two in every three of these smokers can be expected to die from their habit if they don’t quit and this highlights the importance of staying the course on tobacco control.”
This is an important message to remember as we celebrate some success in Aboriginal and Torres Strait Islander tobacco control. However, we must also remember the importance of keeping up the battle to tackle tobacco use, to help improve health outcomes of Aboriginal and Torres Strait Islander people.
For information on how to stop smoking, please call the Quitline on 13 78 48, visit www.icanquit.com.au or your local Aboriginal Medical Service, GP or medial practitioner.
- Smoking is responsible for one in five of all Indigenous deaths and is the single most preventable cause of poor health and early death among Aboriginal and Torres Strait Islander people.
- Approximately 42 per cent of the combined Aboriginal and Torres Strait Islander population are everyday smokers, more than twice the prevalence among the Australian population as a whole.
- Indigenous mothers were more likely to report smoking during pregnancy than non-Indigenous mothers.
- Smoking during pregnancy is a risk factor for complications such as spontaneous miscarriage and is associated with poor health outcomes. This includes fetal growth restriction, preterm birth, low birth weight, perinatal death and congenital abnormalities.
- Indigenous Australian children are more likely than non-Indigenous children to be exposed to tobacco smoke in the home.
- Passive smoking is also associated with increased risk of respiratory diseases, lung cancer and coronary heart disease.
Other key findings:
- Compared with non-smokers, smokers will die an estimated 10 years earlier
- Compared with non-smokers, smoking just 10 cigarettes a day doubles the risk of dying prematurely and smoking a pack a day increases the risk four- to five-fold.
1. Australian Bureau of Statistics. 2012–13 National Aboriginal and Torres Strait Islander Health Survey. Canberra: Australian Bureau of Statistics,; 2013.
2. Vos T, Barker B, Stanley L, Lopez A. The burden of disease and injury in Aboriginal and Torres Strait Islander peoples 2003. Brisbane: The University of Queensland: School of Population Health2007.
3. Council of Australian Governments. National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. 2008.