Indigenous man Joseph Knuth had been smoking for 34 years, since he was 12 years old.
He gave up 10 days ago, after seeing far too many friends and family members die from lung cancer.
“I’ve watched them all drop one by one. They all predominantly around my age, mid forties,” Mr Knuth said.
“I want to live until I’m at least 80 or 90.”
Mr Knuth said he had seen “a lot of people suffering” through tobacco related illnesses.
He is not alone.
Until the person has lung cancer, it won’t start to affect the community, whereas alcohol is disruptive to communities quickly and it’s more visible … and that’s why some communities see alcohol as a problem and they want to focus on fixing [it] instead of smoking.Dr Fadwa Al-Yaman, specialist in Indigenous health
Dr Fadwa Al-Yaman, a specialist in Indigenous health at the Australian Institute of Health and Welfare (AIHW) said lung cancer was the second largest cause of premature death among Indigenous Australians and the rates were increasing, despite the Indigenous smoking rate dropping from 54 to 44 per cent over the past decade.
By comparison, smoking rates in the non-Indigenous population are around 17 per cent.
“Usually it takes a long time between stopping smoking and the appearance of lung cancer, so there’s big lag periods, which is why we’re not seeing it [drops in lung cancer],” Dr Fadwa Al-Yaman said.
“We’ll see it in the future. We are currently seeing in the non-Indigenous population a reduction in lung cancer … that’s because smoking rates have been declining over long period of time.”
AIHW has said once diagnosed with lung cancer, only one in three Indigenous men and one in two Indigenous women would survive it.
Dr Al-Yaman said it was because they were often affected by other chronic health problems, were diagnosed too late and had less access to treatment and screening.
Aboriginal educators key to success
Dr Tom Calma, an Aboriginal elder from the Kungarakan tribal group who runs the national Tackling Indigenous Smoking program, said a consistent approach and more funding was needed.
“One of the key challenges we find with politics is the lack of consistent approach to policy implementation and funding,” Dr Calma said.
He said he hoped the current Coalition Government recognised this and said he had received assurances there would be a renewed focus on Aboriginal health policy in 2016.
“That plan is very important, because it is done in conjunction with other Aboriginal and Torres Strait Islander people and it has a long-term focus,” Dr Calma said.
“That’s the sort of effort we need to see continuing. We need a ramping up of funding and support to tackling Indigenous smoking if we are going to make a difference.”
Mr Knuth enrolled in an anti-smoking program at the Danila Dilba health centre in Darwin.
He credited its success with it using Aboriginal people as the educators and health workers.
“When we talk to them, we can talk to them in a simplified manner that they can understand,” he said.
“We can take things from our tradition and cultures and give a better picture of why [we] need to stop smoking.”
Higher cigarettes price ‘a deterrent’
Dr Calma believes raising excise taxes on cigarettes as a deterrence for smokers would help.
“What we do know is that with the excise increases we see more people attempt to quit or approach quit lines,” Dr Calma said.
“Unfortunately it does have an impact on people who are low socio-economic and low-income people, but this is one of the processes to help them appreciate the need to give up.”
Dr Calma said major behavioural change was needed and called for a different approach to that used with alchohol abuse.
“It’s not the same approach to smoking as with alcohol, because we know that prohibition doesn’t resolve issues that require major behavioural changes and that can only be done by working with the people to help them change their behaviours,” Dr Calma said.
Dr Al-Yaman said while alcohol was more immediately disruptive in a community, the toll from smoking was delayed until a person became sick.
“Until the person has lung cancer, it won’t start to affect the community, whereas alcohol is disruptive to communities quickly and it’s more visible … and that’s why some communities see alcohol as a problem and they want to focus on fixing [it] instead of smoking.”
Mr Knuth said smokers had to realise there would be a price to pay.
“Some people think that they can’t be harmed, they’re untouchables. We need to get across to everyone, that we may all have different metabolisms, but the harm does come to everyone some time down the line.”