Indigenous Australians have achieved major progress in reducing smoking, but tobacco’s lethal legacy remains.
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The number of smoking-related deaths among Aboriginal and Torres Strait Islander Australians is predicted to continue to increase, and to peak over the next decade, resulting in thousands of premature deaths that are largely preventable.
New research shows substantial reductions in smoking prevalence among Indigenous Australians – from 55% in 1994 down to 41% in 2014–15.
However the lag between smoking and its associated cancer mortality means the number of smoking deaths is likely to keep climbing in the near future.
Australian National University researcher Raymond Lovett said we are about to see the full effects of tobacco’s lethal legacy on Aboriginal and Torres Strait Islander peoples.
“We have seen significant decreases in smoking prevalence among Aboriginal and Torres Strait Islander adults, which will bring substantial health benefit in both the short and long term.
“However, we will continue to see the health consequences of tobacco use from up to 30 years ago – when smoking prevalence was at its peak – because of the delay between smoking and the onset of diseases such as lung cancer,” he said.
“While warning of these impacts, it is important to also note that there has been substantial progress in reducing tobacco use, particularly in the last decade, and this will not be reflected in current mortality patterns.
“The progress we have seen gives us a clear sign that we can further reduce smoking prevalence and improve Indigenous health. We need a continued comprehensive approach to tobacco control, and the incorporation of Indigenous leadership, long-term investment and the provision of culturally appropriate materials and activities is critical to further reducing tobacco use.”
Indigenous Health minister Minister Ken Wyatt said research now has a greater acknowledgement of the socio-economic, cultural and environmental factors that affect Indigenous health.
“We’re seeing over the past two decades greater referencing made to social determinants of health and the logical framing of the reasons for needing to address education, employment, community safety, training and housing,” Mr Wyatt said.
Mr Wyatt said in the future he would like to see more focus on young Indigenous people, particularly greater understanding of the drivers of resilience and suicide.
The latest report by the Australian Bureau of Statistics (ABS) shows each year more Indigenous Australians are successfully quitting smoking, fewer children are taking up smoking, and so there are fewer smokers.
Menzies School of Health Tobacco Control Research Program head David Thomas who collaborated with the ABS on the report said this was reassuring news for all Aboriginal and Torres Strait Islander people and their communities.
“These statistics may encourage more smokers to quit and more kids to stay smokefree because they give a message that others are doing it and so can they,” Professor Thomas said.
“It is very important to celebrate such improvements which are certain to lead to sustained improvements in Indigenous health outcomes.
“Too often we just focus on the gap between Indigenous and non-Indigenous Australians and what it tells us about fairness in Australia. In this case there has been little change in the gap as there have been improvements in both the Indigenous and non-Indigenous populations.
“These improvements are in part due to the increased attention on tackling Indigenous smoking by Aboriginal health services and governments. The investment of significant government funding for Indigenous smoking is justified and must be sustained,” he said.
Professor Thomas said more support is needed in remote communities to help smokers to stay quit.
“The improvements in both quitting and smoking prevalence were significantly greater in non-remote areas. But even in remote communities, where there has been no significant improvement in smoking prevalence or successful quitting, the report demonstrates that increasing numbers of smokers are trying to quit but are not succeeding,” he said.