Researchers have found half of all Indigenous and Torres Strait Islander people over the age of 45 are dying from smoking related diseases, but in the Northern Territory the statistics could be much more dire.
A new study, published in the International Journal of Epidemiology on Monday, has found that nationally, Indigenous Australians are dying of tobacco-related disease at almost twice the rate than previously thought.
Smoking has been tied to more than 10,000 premature preventable deaths in the past decade alone, but study lead Dr Katherine Thurber said it is possible the percentage of deaths in the Northern Territory is even higher.
Led by researchers from the Australian National University, the study analysed data from 1,388 people from New South Wales over 10 years.
"The results are shocking - smoking is killing one in two older adults, and we found smokers have four times the risk of early death compared to those who have never smoked," Dr Thurber said.
This is the first time researchers have had access to data specific to Indigenous Australians, which is why there has been such a significant jump in the statistics, Dr Thurber said.
"Before they were making assumptions or estimates based on other evidence and we just know that it's more accurate when we've got data specific to the population."
More than half all Indigenous people smoke in the Northern Territory in comparison to around 40 per cent nationally.
And with studies showing time and time again that the burden of disease from tobacco use is highest in the Territory, the researchers say that while they don't have a state and Territory breakdown, "It's possible that given the high prevalence that even more deaths are caused by smoking in the NT than nationally."
"We know that cardiovascular disease and cancers are really leading causes of disease and deaths in the Northern Territory," she said.
Ngiyampaa man from New South Wales Professor Raymond Lovett is the papers co-author. He said there are three main reasons smoking rates have not fallen among Indigenous people.
"The first one is we're dealing with a sort of a legacy issue where people on missions, reserves and often those who worked on farms were paid in tobacco right up untill the 70s. That's specific to the Aboriginal population in the Northern Territory as well," he said.
"The second is we know that if you're marginalised from education, employment and other opportunities that smoking rates are higher in those groups.
"And the third really important one is that nicotine is highly addictive. And so, it takes time and effort to address it."
The study found that Indigenous and Torres Strait Islander people who never smoked lived an extra 10 years, Professor Lovett said.
"Australia Day is a good opportunity to reflect on our colonial history, including how commercial tobacco was introduced to Aboriginal and Torres Strait Islander peoples, and how tobacco was used as a form of payment, which has caused nicotine dependence," he said.
Professor Lovett said the study demonstrated the importance of well resourced programs and services to educate people about the perils of smoking.
"Now that we've got new information that there is almost a doubling of the risk of death from smoking, a really clear way of addressing that Is that at a minimum doubling the resources and effort in this space. So that would be a really a good first step.
"At the moment we have a national tackling Indigenous smoking program, that has about 50 per cent population coverage, so if we doubled that thing we would have, we would have a whole of population coverage so that includes health education groups, individual therapy and targeted education populations."
Dr Thurber said the Northern Territory has "a lot to gain" from reducing tobacco use across the board, with its strong links to cardiovascular disease.
"So we see that about 20 per cent of the burden disease is to do to with cardiovascular disease, and we know that if you quit smoking your risk of CVD drops, really quickly," she said.
"If we have drops in smoking we'll see drops in CVD really early and the NT in particular has a lot to gain by reducing CVD.
"We think that's a positive opportunity that we could see real, real improvements."
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