Aboriginal and Torres Strait Islander Health Performance Framework - 2010
2.18 Tobacco use
Why is it important?:Estimates of the burden of disease and injury in Aboriginal and Torres Strait Islander peoples attribute 12% of the total burden to tobacco smoking. Smoking was identified as one of the key risk factors contributing to the burden of disease for Indigenous Australians (Vos et al. 2007). In the Australian population as a whole, the same study estimated 8% of the burden of disease as attributable to tobacco smoking, consistent with national estimates previously reported (AIHW 2006a).
The health impact of smoking is evident in the incidence of a number of diseases, including chronic lung disease, cardiovascular disease and many forms of cancer. It is estimated that smoking is responsible for 35% of the burden of disease from cancers and 33% of the burden from cardiovascular disease for Aboriginal and Torres Strait Islander Australians (Vos et al. 2007). Environmental tobacco smoke has adverse health effects for others who are in close proximity to a smoker, including asthma in children, lower respiratory tract infections, lung cancer, and coronary heart disease (AIHW 2002a).
Given the adverse impact on the health of the Australian population as a whole, tobacco use is a significant risk factor for the health of Aboriginal and Torres Strait Islander peoples, amongst whom smoking is more prevalent. In relation to the health of Indigenous Australians, the National Tobacco Strategy 2004–2009 noted that ‘encouraging and finding ways to support smokers to quit successfully is probably the single most effective thing that could be done to improve child and maternal health, to reduce chronic diseases and some communicable diseases and to reduce financial stress’.
Findings:In 2008, 47% of Indigenous Australians aged 15 years and over reported that they were current smokers, a reduction from an estimated 51% in 2002 and 52% in 1994. In 2008, current smokers comprised 45% of daily smokers and 2% who did not smoke daily. After accounting for differences in the age profile of the populations, Indigenous Australians are 2.2 times more likely to be smokers than other Australians.
An estimated 49% of Aboriginal and Torres Strait Islander males and 45% of Aboriginal and Torres Strait Islander females aged 15 years and over were current smokers in 2008. Aboriginal and Torres Strait Islander smoking rates were highest in the 25–34 year age group (56%) and lowest in the 55 years and over age group (32%). Compared to other age groups, smoking rates were relatively low among older Indigenous Australians (32% of those aged 55 years and over) and young Indigenous Australians aged 15–17 years (22%).
There is strong evidence that smoking status is associated with socioeconomic factors and that smoking rates are highest for Indigenous Australians in the most socially disadvantaged circumstances (Thomas et al. 2008). In 2008, Indigenous Australians aged 18 years and over were more likely to report being a non-smoker if they were in the highest household income quintiles, were in the most advantaged SEIFA quintiles, were employed, had non-school qualifications and if the highest year of schooling completed was Year 12. Being a non-smoker was also associated with better self-assessed health status. Social and family factors also play important roles (Johnston & Thomas 2008). People reporting having been removed from one’s natural family or not having support in a time of crisis, were more likely to be smokers.
Implications:Tobacco smoking is influenced by social and economic factors. The relative influence of these factors varies across the different community settings and social environments in which Aboriginal and Torres Strait Islander peoples live (Johnston & Thomas 2008). Consequently, it is important that strategies to reduce Indigenous smoking rates are ‘culturally valid, responsive to local needs and controlled by the community’ (Ministerial Council on Drug Strategy 2004). Community empowerment and consultation is vital to successful health promotion strategies in Indigenous communities. Locally or regionally focused programs that are well coordinated and targeted to groups within local communities work best (DoHA 2001).
In May 2008, the Australian Government announced $14.5 million over 4 years from 2008–09 until 2011–12 for the Indigenous Tobacco Control Initiative to identify innovative approaches to addressing the high rates of tobacco smoking in the Indigenous population.
Under the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes (COAG 2008c), Governments have agreed to address high Indigenous smoking rates. The Australian Government is investing $100.6 million between 2009–10 and 2012–13 to:
- Recruit and train a new Tackling Smoking Workforce, to work alongside a newly created Healthy Lifestyle Workforce across 57 regions nationally.
- Work with communities to design and deliver locally relevant social marketing tackling smoking campaigns and activities.
- Implement a training program for health workers and community educators (with up to 1,000 workers trained).
- Enhance Quitlines to provide a more culturally sensitive service for Aboriginal and Torres Strait Islander people.
Legislation to implement a 25 per cent increase in tobacco excise received Royal Assent on 28 June 2010. This is expected to cut the number of smokers by 2 to 3 per cent, or around 87,000 Australians.
The Government will develop legislation to specify plain packaging requirements for tobacco products, designed to reduce the attractiveness and appeal of the product, particularly to young people. The legislation will be gazetted on 1 January 2012 for implementation by 1 July 2012.
Figure 114 – Proportion of Aboriginal and Torres Strait Islander people aged 15 years and over reporting they are a current smoker, 1994, 2002 and 2008
Source: ABS and AIHW analysis of the 1994 NATSIS, 2002 and 2008 NATSISS
Text description of figure 114 (TXT 1KB)
Figure 115 –Proportion of population aged 15 years and over reporting they are a current smoker by Indigenous status and age, 2008
Source: ABS and AIHW analysis of the 2008 NATSISS and the and 2007–08 NHS
Text description of figure 115 (TXT 1KB)
Table 53 –Estimated proportion of Aboriginal and Torres Strait Islander peoples that are current smokers by sex, age, remoteness area and jurisdiction, 2004–05 and 2008
Sex (18 years and over)
Remoteness Area (18 years and over)
State/Territory (18 years and over)