Tobacco Related Attitudes and Behaviours in Relation to Exposure to the Tackling Indigenous Smoking Program: Evidence from the Mayi Kuwayu Study.

Rubijayne Cohen,Makayla-May Brinckley,Raglan Maddox,Katherine A Thurber,Eden M Barrett,Mikala Sedgwick,Raymond Lovett

doi:10.3390/ijerph182010962

Abstract

Smoking is the leading contributor to the burden of disease and mortality for Aboriginal and Torres Strait Islander peoples, with an estimated 37% of all Aboriginal and Torres Strait Islander deaths attributed to smoking. The Tackling Indigenous Smoking (TIS) program was implemented to support people to quit smoking, prevent initiation, and reduce exposure to second-hand smoke. Analysis of baseline (2018–2020) data from a large-scale cohort study was conducted to quantify smoking-related attitudes and behaviours among Aboriginal and Torres Strait Islander adults, overall and in relation to exposure to the TIS program. Most results were similar for TIS and non-TIS, but there was a significantly lower prevalence of smoking inside households (PR0.85; 95% CI: 0.74, 0.97), smoking ≥21 cigarettes per day (PR0.79; 95% CI: 0.62, <1.00), and smoking a first cigarette within 5 min of waking (PR0.87; 95% CI: 0.76, <1.00) in TIS-funded compared to non-TIS-funded areas. Findings from the analysis highlight encouraging anti-smoking attitudes and behaviours across TIS-funded and non-TIS-funded areas, and serve as a basis for future analysis of change in outcomes over time associated with exposure to a large multi-mode population health program (TIS).

Highlights

Tobacco products were introduced to Australia through colonisation and were used to establish relationships with Aboriginal peoples and later Torres Strait Islander peoples
The current study is a cross-sectional analysis of Aboriginal and Torres Strait Islander people ≥ 16 years who participated in the Mayi Kuwayu Study and whose data are included in Release 2.0 (N = 9485)
These findings provide a useful understanding into anti-smoking attitudes and behaviours among the Aboriginal and Torres Strait Islander adult population overall, and in relation to exposure to the Tackling Indigenous Smoking (TIS) program—the first large-scale, long-term comprehensive public health programs aimed to address smoking in the population

Summary

Introduction

Tobacco products were introduced to Australia through colonisation and were used to establish relationships with Aboriginal peoples and later Torres Strait Islander peoples. Tobacco was systematically used in government-issued rations and as payment for labour until as late as 1968 [1]. These systemic practices promoted, embedded and normalised widespread tobacco use within the Aboriginal and Torres Strait Islander population. As a result, smoking is the leading contributor to the burden of disease and mortality for Aboriginal and Torres Strait Islander peoples [2], with an estimated 37% of all Aboriginal and Torres Strait Islander deaths attributed to smoking [3]. While tobacco’s contribution to the burden of disease and mortality is substantial, recent analysis of Aboriginal and Torres Strait Islander adult smoking prevalence (≥18 years) Strait Islander tobacco epidemic is unique due to the extended duration of high prevalence, similarity in prevalence among men and women, and distinct trends between urban, regional and remote settings [4].

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