NACCHO Aboriginal Women’s Health and #Smoking #IDM2020 #Midwives2020 News Alert : Dr @michelle_bovill : What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

 ” Let me make it clear right from the start. Aboriginal and Torres Strait Islander women are quitting smoking during pregnancy and care deeply about the health and wellbeing of their babies.

While there has been an acknowledgement that the proportion of Aboriginal and Torres Strait Islander women smoking during pregnancy has declined, reports more frequently measure and monitor smoking rates during pregnancy and compare these to non‐Aboriginal pregnant women.

For example, 43% of Aboriginal and Torres Strait Islander mothers reported smoking during pregnancy compared with 12% of non‐Aboriginal Australians.

I have been privileged to hear Aboriginal and Torres Strait Islander women from Worimi, Awabakal, Biripi, Goomeroi/Kamilaroi/Gamilaraay and Boandik communities share their stories with me about smoking and becoming pregnant.

I acknowledge my responsibility to pass on these stories to inform the conversations about smoking during pregnancy among Aboriginal and Torres Strait Islander women.

What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

What is now owed to these women is more action. Action by health professionals to advise Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, and action to find meaningful support strategies to achieve abstinence. “

Selected extracts from

Michelle Bovill as published in MJA Journal

Download the publication HERE


However, two things happen when we measure and monitor in this way. First, this approach assumes that Aboriginal and Torres Strait Islander communities are homogenous.

We are not; we are extremely diverse in cultures, customs and experiences. Second, it creates the impression that smoking during pregnancy is the issue and that Aboriginal and Torres Strait Islander women present a deficit.

This is detrimental because our lived experiences are not the same, nor have they been for generations. Colonisation, dispossession onto missions and reserves, the removal of children, unpaid labour, and refusal of the equal right to education, employment and health care over generations has led to a gap in social and cultural determinants of health.

This gap is founded on racist policies that positioned Aboriginal and Torres Strait Islander people as inferior to other Australians. The gap and deficit mentality follow us today and can be found in countless government reports on Aboriginal and Torres Strait Islander disadvantage.

When we don’t contextualise in terms of colonisation and the resulting social and cultural determinants of health, and fail to privilege Indigenous knowledges, we cannot truthfully address any area of health inequity.

While it has been identified that Aboriginal and Torres Strait Islander women experience multiple barriers to quitting smoking during pregnancy, little work has been conducted to ask Aboriginal and Torres Strait Islander mothers about their experiences of quitting and what they believe could support them to become smoke‐free during pregnancy.

Quit attempts are being made “A lot of people are more wanting to give up smoking but not having the information”

Across New South Wales, Queensland and South Australia, Aboriginal and Torres Strait Islander women often shared a desire to quit smoking and reported making several quit attempts during pregnancy. Aboriginal and Torres Strait Islander people in general are more likely than other Australians to make a quit attempt but are less likely to succeed, which raises the question, “what is happening when Aboriginal and Torres Strait Islander people make a quit attempt?”.

Stories of quit attempts lasting at least 24 hours but often less than a full week were often shared. If we listen to Aboriginal and Torres Strait Islander women, we can hear that motivation to quit is high.

The problem with reduction “I think doctors need to stop telling people to cut down”

Aboriginal and Torres Strait Islander women across communities yarra (say) reduction in cigarette consumption was suggested by health providers.

This tendency to advise reduction in tobacco consumption rather than recommending to women that they quit completely has been previously reported.

 Advising women to cut down cigarette consumption during pregnancy when they are unable to quit smoking is still being promoted across the country in clinical practice guidelines.

 If we only ever report quit rates, yet Aboriginal and Torres Strait Islander women are only being advised to reduce, how will we ever achieve the lower smoking rates of the non‐Aboriginal population?

“I was doing 10 to 15 cigarettes down to 1 to 2 cigarettes a day. I think that is a big, a big reduce”

Aboriginal and Torres Strait Islander women are proud of their success in reducing cigarette consumption. Why shouldn’t they be? Women are successfully following the advice of their health providers.

The only randomised controlled trial conducted with Aboriginal and Torres Strait Islander women during pregnancy reported that 70% of women who were advised to quit smoking by their health provider made a quit attempt.

A recent survey of Aboriginal women who smoke revealed positive attitudes to advice and support from doctors (61%) and midwives (62%). However, health provider support for planned smoking cessation is reported to be weak.

Pregnancy is a life stage during which there are multiple opportunities to offer cessation support to mothers.

Each opportunity should repeat the unambiguous message that the best thing for mothers’ and babies’ health is to quit smoking completely, explain that they are not alone, and offer cessation support.

We therefore hit a dilemma: what cessation support should even be offered? Systematic reviews on Aboriginal tobacco control have concluded that there is limited evidence of effective programs for Aboriginal and Torres Strait Islander people in general as well as during pregnancy.

Community led initiatives are key to successful outcomes

“Everybody looks up to their Elders and stuff, as you know, maybe just a yarn or a get‐together to discuss smoking could help”

Aboriginal women in NSW yarra (speak) of their desire to receive support from their community and Elders. Elders understand community dynamics and the context of women’s lives in a way that (non‐Aboriginal) health providers cannot

. But what would this look like in a health care setting? How can we ensure that consistent messages are offered throughout community to support being smoke‐free?

“I was just thinking that these products, I wouldn’t use them. I’d think about the side effects”

Aboriginal and Torres Strait Islander pregnant women yarra (speak) of their desire to use non‐pharmacological and stress management approaches for smoking cessation. The use of alternative approaches (such as yoga and mindfulness) has been reported in white populations with high socio‐economic status; however, the effectiveness of some of these approaches is as yet uncertain.,

Aboriginal and Torres Strait Islander health does not focus on the individual, but rather the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential.

It is therefore important that any support program to address health inequities also focuses on community engagement and empowerment. Aboriginal and Torres Strait Islander women want control and ownership of the quitting process and should be empowered to quit smoking.

If we truly want to support Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, we need to privilege their voices in the process of developing effective and meaningful supports.

I have been privileged to hear Aboriginal and Torres Strait Islander women from Worimi, Awabakal, Biripi, Goomeroi/Kamilaroi/Gamilaraay and Boandik communities share their stories with me about smoking and becoming pregnant.

I acknowledge my responsibility to pass on these stories to inform the conversations about smoking during pregnancy among Aboriginal and Torres Strait Islander women.

What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

What is now owed to these women is more action. Action by health professionals to advise Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, and action to find meaningful support strategies to achieve abstinence.

Developing appropriate support strategies for Aboriginal and Torres Strait Islander people should draw on traditional and contemporary knowledges, values and practices.

Over the next 4 years, with the support of a National Health and Medical Research Council Early Career Fellowship and a National Heart Foundation Australian Aboriginal and Torres Strait Islander Award, I will commence this exploratory work in partnership with NSW Aboriginal communities through the Which Way? project.

This project will partner with four communities to explore what Aboriginal and Torres Strait Islander women desire to support smoking cessation and develop an Indigenous led evidence base on smoking cessation.

This work will build on the request for non‐pharmacological support and align with a holistic definition of health and wellbeing. It is my belief that by developing, implementing and evaluating a support strategy that Aboriginal and Torres Strait Islander women desire, our communities can achieve smoking abstinence.

NACCHO Aboriginal Health #AODConnect Resources Alert : Download an app to improve access to #alcohol and other #drugs AOD service information for Aboriginal and Torres Strait Islander communities

The AODconnect app has been developed by the Australian Indigenous HealthInfoNet Alcohol and Other Drugs Knowledge Centre to help alcohol and other drug (AOD) workers, community members and health professionals working in the AOD sector to locate culturally appropriate services.

The app aims to support efforts to reduce harmful substance use among Aboriginal and Torres Strait Islander people.

Read over 200 Aboriginal Health Alcohol and other Drugs articles published by NACCHO over past 8 years 

Aboriginal and Torres Strait Islander people are increasingly using online platforms to share and access information about different health topics.

The ownership and use of mobile phones in rural and remote Aboriginal and Torres Strait Islander communities is widespread and increasing, making apps a viable way to provide people living in these regions with access to health information.

AODconnect provides an Australia-wide directory of over 270 Aboriginal and Torres Strait Islander AOD treatment services.

It delivers a portable way to easily access information about service providers such as contact details and program descriptions, helping to facilitate initial contact and referral.


Once the app has been downloaded, users can search for AOD services even when their internet connection is unstable or not available.

This is especially useful in rural and remote areas of Australia where the Internet coverage is not always extensive or reliable.

The app enables users to search for services by state, territory, region and postcode via either an interactive map of Australia or by alphabetical listing.

Services can be filtered by the type of treatment they provide: counselling and referral, harm reduction and support groups, outreach, mobile patrols and sobering up shelters, residential rehab, withdrawal management and young people.

The services listed on the app are also available through the Alcohol and Other Drugs Knowledge Centre website.

The app is free to download on both iOS and Android devices.

If you would like to have your service added to the app or would like more information about the AODconnect app, please contact the Alcohol and Other Drugs Knowledge Centre email: or Ph: (08) 9370 6336.

Alcohol and other drugs GP education program

NACCHO Aboriginal Health and #Smoking : Download the @RACGP Supporting #smokingcessation Guide : Smoking daily is three times as high in the lowest socioeconomic areas of Australia compared to the highest.

“The likelihood of smoking daily is three times as high in the lowest socioeconomic areas of Australia compared to the highest.

What this means is that smoking-related health problems disproportionately affect those least able to afford the medicines that are essential to helping them quit.

We have made massive inroads, now it’s time for the final, decisive push to reduce daily smoking levels.

These medicines work, we just need to do more to help get them into the hands of people who need them most and removing restrictions on prescribing will do just that.”

RACGP President Dr Harry Nespolon said that the Government should act to assist those who struggle to afford the medicines that are proven to help people quit smoking.

Aboriginal and Torres Strait Islander people

 ” Indigenous Australians are still more than twice as likely as non-Indigenous Australians to be current daily smokers.2 However, there has been a progressive decrease in daily smoking rates for Aboriginal and Torres Strait Islander people, declining from 49% in 2002 to 45% in 2008, and then to 41% in 2012–13.3

People who identify as Aboriginal or Torres Strait Islander qualify for PBS authority listing that provides up to two courses per year of nicotine patches, each of a maximum of 12 weeks. Under this listing, participation in a support and counselling program is recommended but not mandatory. Access t nicotine patches for Aboriginal and Torres Strait Islander people can be facilitated through the Closing the Gap PBS co-payment measure (see page 45).”

Extracts from GUIDE

Download the RACGP Supporting smoking cessation: A guide for health professionals (2nd edition) smoking-cessation

Read over 130 Aboriginal Health and Smoking articles published by NACCHO over past 8 years

Read Aboriginal Health and our partnership with RACGP articles published by NACCHO over past 8 years

The Royal Australian College of General Practitioners (RACGP) has today recommended allowing greater flexibility in prescribing for smoking cessation pharmacotherapy.

The bold proposal, contained in the RACGP’s newly released Supporting smoking cessation: A guide for health professionals (2nd edition) (“the guide”), could prove a game-changer for reducing smoking rates.

Pharmacotherapy options available in Australia include nicotine replacement therapy (NRT, e.g. a transdermal patch or acute forms such as an oral spray, gum, inhaler or lozenge), varenicline (a drug that blocks the pleasure and reward response to smoking) and bupropion hydrochloride (which reduces the urge to smoke and helps with nicotine withdrawal).

Oral forms of NRT subsidised on the Pharmaceutical Benefits Scheme (PBS) are gum and lozenges for use as the sole PBS-subsidised therapy. This means that combination NRT (i.e. using two forms of NRT together such as a patch and gum) is not currently PBS-subsidised.

Under PBS rules, a maximum 12 weeks of PBS-subsidised NRT is available per 12-month period.

Australia has made commendable inroads in tobacco control and smoking rates with daily smoking nearly halved from 24% in 1991 to 12.8% in 2013. However, the job is not complete and there has been a slowing in the rate of decline with little change in prevalence from 2013 to 2016 (12.2%).

The latest National Tobacco Strategy aims to reduce the national adult daily smoking rate to 10% of the population and halve the Aboriginal and Torres Strait Islander adult daily smoking rate.

RACGP President Dr Harry Nespolon said that the Government should act to assist those who struggle to afford the medicines that are proven to help people quit smoking.

“Some people can quit unassisted; however, those who take advantage of behavioural support and vital medicines including combination NRT, varenicline and bupropion will substantially increase their chances of quitting.

“The science is in – a host of randomised clinical trials tell us that these medicines work. Varenicline or combination NRT almost triples the odds of quitting and bupropion and NRT alone almost double the odds of quitting versus a placebo at six months. The evidence is also clear that combination NRT is most effective.

“However, as things stand we have fixed PBS rules that don’t reflect best-practice medical assistance. As a result, people trying to quit smoking miss out on PBS subsidies that could make a real difference.

“We need to improve flexibility in prescribing to cut costs for patients using pharmacotherapy so that people who could really benefit from these medicines can access them.

“It’s vital to allow for PBS-subsidised combination NRT, which is proven to be the most effective form of NRT.

“We should also allow GPs to prescribe a second round of PBS-subsidised NRT within a 12-month period because it will help reduce relapse in people who have stopped smoking at the end of a standard course of NRT. This is a public health policy no-brainer, pure and simple.”

Dr Nespolon noted that the inflexibility in PBS prescribing was particularly troubling given that smoking rates are inverse to socioeconomic status.

Chair of the Expert Advisory Group behind the guide, Professor Nicholas Zwar, said that health professionals including GPs should also be encouraged to embrace the “brief intervention” approach to smoking cessation.

“One of the most often cited barriers to providing smoking cessation advice is that it can prove time consuming.

“Up until now health professionals have used a ‘5A’s approach’ which involves identifying patients who smoke, assessing nicotine dependence and barriers to quitting, advising patients to quit, offering assistance and arranging a follow up. It is sound practice but it does take time.”

Professor Zwar said that under the three-step model developed by Quit Victoria, advice and help for patients trying to quit smoking could be easier to provide and more frequently offered by a range of health professionals.

“This three-step model offers patients best practice smoking cessation treatment by linking into multi-session behavioural interventions such as Quitline and encouraging the use of pharmacotherapy.

“It can be summarised as ask, advise and help. Ask and record a patient’s smoking status, advise people who smoke to quit and on the most effective methods for doing so and help them by offering to arrange referral, encourage use of behavioural intervention and the use of evidence-based pharmacotherapy.”

The guide update was funded by VicHealth and the Australian Government Department of Health.


NACCHO Aboriginal Health and #Cancer #Smoking : Report from Canada where 400 delegates are meeting at #WICC2019 with theme ‘Respect, Reconciliation and Reciprocity “ discussing cancer and its impact on Indigenous peoples.

“Cancer has been largely overlooked amongst Indigenous populations world-wide and remains the second leading cause of death among Aboriginal and Torres Strait Islander people “

Professor Gail Garvey, who convened the first WICC and is co-chair of WICC 2019 :Pictured above with Professor Tom Calma and Blackfoot Fancy Feather Dancer Kyle Agapi.

“Smoking is the single biggest contributor to early deaths, including cancer deaths, of Aboriginal and Torres Strait Islander people – which is why it is so important that we encourage people not to take up smoking and assist smokers to stop “

Professor Tom Calma AO, National Coordinator, Tackling Indigenous Smoking, and member of the Cancer Australia Aboriginal and Torres Strait Islander Cancer Leadership Group

Read over 80 Aboriginal Health and Cancer articles published by NACCHO in past 7 years

Read over 130 Aboriginal Health and Smoking articles published by NACCHO in past 7 years

Indigenous communities, consumers and health experts from around the world have come together at the opening of the second World Indigenous Cancer Conference (WICC) at the Calgary Telus Convention Centre in Canada.

The conference, which has drawn a large contingent of Australian delegates, follows on from the success of the inaugural WICC held in Brisbane, Australia in 2016.

The WICC 2019 theme is ‘Respect, Reconciliation and Reciprocity,’ with over 400 delegates from across the globe discussing cancer and its impact on Indigenous peoples.

World-wide, Indigenous peoples bear a disproportionately higher cancer burden than non-Indigenous peoples, which makes WICC 2019 so very important.

Hosted by the Canadian Indigenous Research Network Against Cancer (CIRNAC) in partnership with the host sponsor Alberta Health Services, this premier event is supported by the Alberta First Nations Information Governance Centre, Canadian Institutes of Health Research, Canadian Partnership Against Cancer, and the International Agency for Research on Cancer (IARC) which is the specialized cancer agency of the World Health Organization.

 Professor Gail Garvey , Blackfoot Piikani Chief Stan Grier and Professor Tom Calma 

WICC 2019 has drawn expertise of leading cancer researchers, public health practitioners, clinicians, advocacy groups, Indigenous community leaders and consumers.

They are coming together to share knowledge about critical issues across the cancer continuum from prevention and treatment to survivorship and end of life.

Several Aboriginal and Torres Strait Islander delegates with a lived experience of cancer are making an important contribution to the conference.

Des McGrady, an Aboriginal cancer survivor, said “An international meeting is important for the information sharing that we can pass on to community and people working in this space. This will allow us to work in partnership to drive positive change.”

The burden of cancer among Indigenous populations is of major public health importance and forums for collaboration such as this conference will strengthen research and service delivery and help accelerate progress in improving cancer outcomes.

Indigenous leadership, culturally sound service delivery and encouragement of mainstream services to prioritise Indigenous cancer are critical to these efforts and central to WICC 2019.

For more details about the conference, please visit the website:

NACCHO Aboriginal Health #amafdw19 #Prevention #Smoking : At #NPC @AMApresident says the Federal Government must commit adequate resources to its proposed long-term national preventive health strategy :

“ Preventive health measures reduce the rate of chronic ill health and improve the health and wellbeing of all Australians, leading to better and healthier lives.

As a nation, we spend woefully too little on preventive health – around two per cent of the overall health budget.

A properly resourced preventive health strategy, including national public education campaigns on issues such as smoking and obesity, is vital to helping Australians improve their lifestyles and quality of life.

The Australian Government must commit adequate resources to its proposed long-term national preventive health strategy, and work with GPs to help improve the health of all Australians.

AMA President, Dr Tony Bartone, who addressed the National Press Club as part of Family Doctor Week, said the AMA is looking forward to working on the strategy, which Health Minister, Greg Hunt, first announced in a video message to the AMA National Conference in May.

Download full speech HERE

AMA President Press Club Address

” The Northern Territory Government has been judged to have been the worst-performing Australian government on tobacco control measures over the last 12 months, and shamed with the Dirty Ashtray Award for 2019.

This year is the 25th anniversary of the National Tobacco Control Scoreboard – run by the AMA and the Australian Council on Smoking and Health (ACOSH) – and the Northern Territory has managed to collect the dubious Dirty Ashtray Award 13 times.”


Read over 130 Aboriginal Health and Smoking articles published by NACCHO in the last 7 years 

Part 1 AMA President, Dr Tony Bartone Prevention Press Release

“Family doctors – GPs – are best placed to manage preventive health, and can assist their patients in managing issues such as weight, alcohol consumption, physical activity, stress, substance use, and quitting smoking.

“Managing weight is a vital part of preventive health. Carrying excess weight contributes to cancers, high blood pressure, and musculoskeletal disorders like bad backs and neck pain. It also affects general health and wellbeing.

“Too many Australians drink at harmful levels, and this is dangerous to their health. Drinking in moderation, and within the guidelines, is a message all Australians should be aware of, and if you are worried about alcohol consumption, talk to your GP.

“Tobacco kills. There is no way to sugar coat the dangers of smoking. If you smoke, you increase your risk of coronary heart disease and cancer.

“Smoking can cause cancer of the lung, oesophagus, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum.

“If you want to quit smoking, start by seeing your family doctor.”

Dr Bartone will also announced the recipient of the 2019 Dirty Ashtray Award, which is presented to the government – Federal, State, or Territory – that has done the least over the past year to combat smoking.

AMA Family Doctor Week runs from 21 to 27 July 2019.


  • In 2017-18, two-thirds of Australian adults and almost one-quarter of Australian children were overweight or obese.
  • Coronary heart disease is the nation’s leading single cause of death.
  • It is estimated that more than 1.2 million Australians have diabetes. The majority (85 per cent) have type 2 diabetes, which is largely preventable.
  • In 2013, diabetes contributed to 10 per cent of all deaths in Australia.
  • Tobacco is the leading cause of cancer in Australia.
  • In 2014-15, more than 1.6 million Australian males aged 15 years and over smoked, 90 per cent of whom smoked daily.
  • More than 1.2 million Australian females aged 15 years and over smoked, 91 per cent of whom smoked daily.
  • About one in 10 mothers smoked in the first 20 weeks of pregnancy.
  • In 2016, 57 per cent of daily smokers were aged over 40, and 20 per cent of daily smokers lived in remote and very remote areas of Australia.
  • Daily tobacco smoking has been trending downward since 1991, from 24 per cent to 12 per cent in 2016.
  • The proportion of people choosing never to take up smoking has increased to 62 per cent in 2016, from 51 per cent in 2001.
  • In 2016, almost one in three (31 per cent) current smokers aged 14 and over have used e-cigarettes.
  • Of current smokers in secondary school aged 16-17, more than one-quarter (26 per cent) smoked daily.

Sources: Australian Bureau of Statistics’ National Health Survey, Australian Institute of Health and Welfare, Heart Foundation.



To read all the states an Territories scores CLICK HERE

The Northern Territory Government has been judged to have been the worst-performing Australian government on tobacco control measures over the last 12 months, and shamed with the Dirty Ashtray Award for 2019.

This year is the 25th anniversary of the National Tobacco Control Scoreboard – run by the AMA and the Australian Council on Smoking and Health (ACOSH) – and the Northern Territory has managed to collect the dubious Dirty Ashtray Award 13 times.

In contrast, the Queensland Government has achieved a remarkable hat trick by topping the scoring to win the coveted National Tobacco Control Scoreboard Achievement Award for leading the nation in tobacco control measures.

AMA President, Dr Tony Bartone, today released the results of the AMA/Australian Council on Smoking and Health (ACOSH) National Tobacco Control Scoreboard 2019 at the National Press Club in Canberra.

Dr Bartone congratulated Queensland on its strong consistent record in stopping people from smoking, and urged the Northern Territory to build momentum with its efforts on tobacco control, while noting the NT Government had amended and strengthened its tobacco control legislation earlier this year.

“The Queensland Government has continued to protect its community from second-hand smoke in a range of outdoor public areas including public transport, outdoor shopping malls, and sports and recreation facilities,” Dr Bartone said.

“Queensland Health is well ahead of other health services in recording smoking status, delivering brief intervention, and referring patients to evidence-based smoking cessation support such as Quitline.

“The Making Tracks – toward closing the gap in health outcomes for Indigenous Queenslanders by 2033 – Policy and Accountability Framework indicates a commitment to reducing smoking among Indigenous communities.

“Funding continues for the B.Strong Brief Intervention training program to strengthen primary healthcare services for Indigenous smokers by increasing the brief intervention skills of health professionals, access to culturally effective resources, and referral to Quitline.

“A dedicated smoking cessation website – QuitHQ – has been developed for the Queensland community, which includes quit support, information for health professionals, and smoking laws. Promotion of QuitHQ includes on-line messages and billboards.”

Dr Bartone said that the Northern Territory is showing signs of moving ahead with stronger tobacco control programs, but we are yet to see solid action and proper funding.

“The NT Government has  published a new Tobacco Action Plan 2019-2023 stressing the need for  media campaigns, smoke-free spaces, sustaining quit attempts and preventing relapse, and identifying priority populations,” Dr Bartone said.

“But these good intentions are yet to be backed with the necessary funding.”

Dr Bartone said the AMA would like to see the Federal Government take on a greater leadership role to drive stronger nationally coordinated tobacco control to stop people smoking and stop people taking up the killer habit.

“The Federal Government has not run a major, national media campaign against smoking since 2012-13, when plain packaging was introduced,” Dr Bartone said.

“Nor has it implemented any further product regulation or constraints on tobacco marketing in that time.

“We would like to see the National Tobacco Campaign reinstated with additional and sustained funding.

“The $20 million announced during the Federal election health debate is a welcome start, but falls well short of the $40 million a year that is needed for a sustained public education program.

“That is a mere 0.24 per cent of the $17 billion the Government expects to reap from tobacco taxes in 2019-20.

“The Government should also implement a systemic approach to providing support for all smokers to quit when they come into contact with health services.

“These key ingredients should be part of the Minister’s commitment, first announced at the AMA National Conference in May, to develop a National Preventive Health Strategy in consultation with the AMA and other health and medical bodies.

“Smoking remains the leading cause of preventable death and disease in Australia, causing 19,000 premature deaths each year.

“Two-thirds of all current Australian smokers are likely to be killed by their smoking. That is a staggering 1.8 million people.

“While Australia is a world leader in tobacco control, more needs to be done to help people quit smoking, or not take it up in the first place.

“Big Tobacco is attempting to distract attention from evidence-based measures that will reduce smoking, while promoting itself as being concerned about health.

“This is particularly outrageous from an industry whose products kill more than seven million people each year.

“It is crucial that Australia maintains its strong evidence-based policies and avoids being diverted by Big Tobacco’s new distraction strategies, particularly following disturbing evidence from the US and Canada about the epidemic of youth e-cigarette use.

“We must remain vigilant against any attempts to normalise smoking, or make it appealing to young people.

“This includes following the advice of the National Health and Medical Research Council and the Therapeutic Goods Administration in regulating e-cigarettes, and not allowing them to be marketed as quit smoking aids until such time as there is scientific evidence that they are safe and effective.”

The AMA/ACOSH National Tobacco Control Scoreboard is compiled annually to measure performance in combating smoking.

Judges from the Australian Council on Smoking and Health (ACOSH), the Cancer Councils, and the National Heart Foundation allocate points to the State, Territory, and Australian Governments in various categories, including legislation, to track how effective each has been at combating smoking in the previous 12 months.

No jurisdiction received an A or B rating this year or last year.

AMA/ACOSH Award – Judges’ Comments

This year is the Silver Anniversary of the AMA/ACOSH National Tobacco Control Scoreboard. 

Since the introduction of the Award in 1994, daily smoking in Australia has halved from 26.1% in 1993 to 12.8% in 2016.

Importantly, the proportion of 12 to 17-year-old school students who have never smoked in their life has increased significantly from 33% in 1984 to 82% in 2017.

Australia has led the world in its implementation of a comprehensive approach to reduce smoking.

Since the early 1990s, Australia has implemented the following strategies to reduce smoking, many of which have been duplicated in other countries around the globe:

We call on the Australian, State and Territory Governments to implement the following recommendations:

  • allocate adequate funding from tobacco revenue (predicted to be $17 billion in 2019/2020) to ensure strong media campaigns at evidence-based levels;
  • ban all remaining forms of tobacco marketing and promotion and legislate to keep up with innovative tobacco industry strategies;
  • implement tobacco product regulation to decrease the palatability and appeal of tobacco products;
  • implement comprehensive action, including legislation, in line with Article 5.3 of the Framework Convention on Tobacco Control (FCTC) to protect public health policy from direct and indirect tobacco industry interference, and ban tobacco industry political donations;
  • implement positive retail licensing schemes for all jurisdictions;
  • implement best practice support for smoking cessation across all health care settings;
  • ensure consistent funding for programs that will decrease smoking among Aboriginal and Torres Strait Islanders and other groups with a high prevalence of smoking; and
  • ensure further protection for the community from the harms of second-hand smoke.


NACCHO Our Members #Aboriginal Health Deadly Good News Stories : Features #WNTD2019 @TISprogramme Photos from @NACCHOChair #NSW @ahmrc @ReadyMob @Galambila #Redfern ACCHO @awabakalltd #VIC @VACCHO_org #QLD @Apunipima @DeadlyChoices #SA @AHCSA_ #WA @TheAHCWA #NT @CAACongress @Kwhb_OneShield

For World No Tobacco Day 31 May NACCHO celebrates and highlights examples of the great work many of our Aboriginal Community Controlled Health Services throughout Australia are doing in tobacco control.


2.New South Wales



5.Western Australia

6.South Australia


8.Northern Territory


10. Sista Quit

How to submit in 2019 a NACCHO Affiliate  or Members Good News Story ?

Email to Colin Cowell NACCHO Media 

Mobile 0401 331 251 

Wednesday by 4.30 pm for publication Thursday /Friday


On World No Tobacco Day NACCHO participated in the National #CommunityControl Twitter Festival that spotlighted the work of Aboriginal Community Controlled Health Services in tobacco control.

The Festival was sponsored by the Aboriginal Health and Medical Research Council of NSW (AH&MRC) and hosted by Croakey Professional Services.

For full Croakey coverage of the event

Read the first one here

The second one here

And the third here

During the period when Croakey was publishing about the Twitter Festival (13 May-3 June 2019), 299 Twitter accounts sent more than 2,000 tweets using the #CommunityControl hashtag, creating more than 17 million Twitter impressions.

See the Symplur Analytics here, and the Twitter transcript here.

Read all NACCHO Smoking articles HERE 

2.New South Wales



It’s vital that brief tobacco interventions are embedded into routine health care and checks. Our staff love to yarn with community to help them quit. You can read about the #ATRACYarning Tool here: 

We have developed the #ATRAC Yarning Tool which has been incorporated into smoking cessation programs across the country. The tool has assisted many health workers to initiate meaningful smoking cessation discussions with clients.

2.2 Redfern ACCHO

2.3 Ready Mob Coffs Harbour to Port Macquarie

The Tackling Indigenous Smoking program team Ready Mob is a federally funded program based out of Galambila Aboriginal Health Service in Coffs Harbour, covering the Mid North Coast region from Coffs Harbour through to Port Macquarie.

My name is Kristy Pursch and my ancestral ties are to the Butchulla people of Fraser Island in Queensland. I have lived in NSW for the past 20 years and brought my children up in beautiful Gumbaynggirr country for the past 14 years.

Ready Mob is an acronym for Really Evaluate and Decide Yourself, Make Ourselves Better which is all about self determination, we don’t tell our mob what to do we just provide the tools and education so that people can make their own informed decisions.

Our strategy to work in and with our local communities is to use local places and local faces. Our relationships in communities are paramount to our effectiveness as a health promotion program.

There are 8 people in our team and all are Aboriginal people with the majority working within their own ancestral lands. This connection and investment in our own local people is integral at ensuring our approach is both determined by and effective for our local mob.

Second and third hand smoke causes just as much damage to small lungs as smoking resulting in more acute respiratory infections, severe asthma attacks and can cause middle infections.

Encouraging our smokers to ‘take a look around and see, who are you sharing your smoke with?’ A non shame based campaign encouraging introspection and positive decision making especially around the impacts smoking causes to those around you.

As with all our campaigns the call to action is to seek quit support by calling the Quitline or visiting your GP and local Aboriginal Medical Service

2.4 Tharawal ACCHO Dr Tim Senior

And working in #communitycontrol means they know the service is set up for them, and they have friends and relatives employed there and on the board! And we have staff and programs that will help.

So for example, I have access to free nicotine replacement, as well as the medicines on the PBS. And especially important are our health workers and our mums and bubs and social and emotional wellebeing programs. And dentists.

Fundamentally, my goal as a GP in #CommunityControl is to enable people to make decisions about their life, NOT tell people what to do. (We’ve tried that for >200 yrs. It doesn’t work!)

And having a relationship with a patient, means the discussion we have can be very practical.

I’ve never met anyone who doesn’t know that smoking is bad for them. But stress, poverty, boredom, habit, socialising underscored by addiction are all reasons people continue to smoke.

We can offer practical advice for all of these things, in complete confidence, with onward referral as appropriate

FYI, these are the smoking cessation guidelines.

2.5 Awabakal ACCHO

2.6 Yerin ACCHO Gosford 



3.2 Goolum Goolum Aboriginal Co-Operative

World No Tobacco Day @ Goolum. Great day, great feed and celebrating #smokefreemob champions.


4.1 Apunipima ACCHO Cape York

Last week TIS Health Workers Brett and Clara celebrated WNTD in Kowanyama with a morning tea and an educational stall

4.2 Deadly Choices 

5.Western Australia

5.1 AHCWA 

5.2 Join the TIS team now at Wirraka Maya for World no Tobacco Day.

Have your Smoke reading taken, along with Quit Smoking support and information.


6.South Australia


AHCSA Staff came together to raise awareness about World No Tobacco Day today and joined the mob by taking the 2019 Puyu Blasters Pledge.

Are you interested in taking the pledge? Follow the link to find out how..

6.2 Tackling Tobacco Team – Nunkuwarrin Yunti

The Tackling Tobacco Team helped the team and kids of Playford and was given the chance to have a hit of tennis with the Deadly and Legendary Evonne Goolagong-Cawley. The ‘Come and Try’ clinics are for 5 to 15 year old boys and girls, with an emphasis on having fun and being healthy!

6.3 AHCSA Puyu Blaster

Today the Puyu Blaster and the Aboriginal Dental Program visited Berri Primary School to celebrate World No Tobacco Day this week. We look forward to coming back. Thanks for having us!

Who are the Puyu Blasters?

We all are!

Puyu Blasters is a community based approach to addressing the issue of smoking within our communities.

The Puyu Blasters Team is hosted by the Aboriginal Health Council of South Australia and it’s Tackling Indigenous Smoking (TIS) Program.

The AHCSA TIS Program has been funded to support regional approaches to reducing the gap in prevalence of smoking among Aboriginal and Torres Strait Islander People compared to that among non-Indigenous, through;

  • Reducing uptake of smoking
  • Increasing smoking cessation and
  • Reduced exposure to environmental tobacco smoke

7.Tasmania ( TBC )

8.Northern Territory

8.1  Congress Alice Springs

Our Health Promotions team would like to thank everyone who came down to Araluen Park on Saturday to participate in the World No Tobacco Day Colour Smash Fun Run/Walk.

To View all Facebook Photos 

We had a massive turn out and all had a lot of fun!

#filltheskywithcolournotsmoke #smokefreethewaytobe

8.2 Katherine West Health Board

The Quitskills Team would like to acknowledge the traditional people of the Katherine region for welcoming the Quitskills educators onto their country to deliver smoking cessation training.

We would also like to acknowledge the hard work of the team from Katherine West Health Board whose aim is to provide a holistic clinical, preventative and public health service to clients in the Katherine West Region of the Northern Territory of Australia.

We wish you the greatest success in achieving your aim.

Smoke breath 🤢
Keep your breath fresh by staying smoke free!

Yarn with your local Health Centre about how to quit smoking
What’s Your Smoke Free Story?

8.3 Danila Dilba ACCHO

On May 31 Danila Dilba Community Services and Northern Territory Government AOD teams set up information stalls around Darwin and Palmerston for World No Tobacco Day. Thank you to everyone who popped in for a yarn! If you are ready to start your quit journey or thinking about quitting smoking, contact your local Danila Dilba Clinic and book an appointment with a GP, Aboriginal Health Practitioner or Tobacco support team.

Make every day World No Tobacco Day! #Notobacco #WorldNoTobaccoDay#KickinTobacco #LiveLongLiveStrong


10. Sista Quit

Our new centre in Coffs Harbour will support excellence in we are seeking three full-time researchers (as many as possible to be Indigenous) and offering Indigenous PhD scholarship – get in touch

See details here on NACCHO Communique 

Aboriginal Health and Smoking #WNTD2019 31 May News Alerts #CommunityControl #YourHealthYourFuture: Over 7 years 130 Plus articles Including 20 myths about smoking that will not die

“Smoking kills. Smoking robs people, including young people, of their health.

Governments must do more to help people to stop smoking, or to not take up the deadly habit in the first place.

Strong government actions, including making packaging unappealing, keeping tobacco products out of view, and keeping tobacco prices high, have helped to encourage people to quit, or young people not to start.

The Minister for Indigenous Health, Ken Wyatt, is to be commended for continuing funding of $183.7 million over four years for the Tackling Indigenous Smoking program.

Releasing the AMA/ACOSH National Tobacco Control Scoreboard on World No Tobacco Day, AMA President, Dr Tony Bartone

NACCHO and Croakey followers are invited to join Aboriginal Community Controlled Health Services in New South Wales in a Twitter Festival focused on tobacco control initiatives and successes across Australia.

NACCHO will be posting 8.45 to 9.00 AM Follow NACCHO

Follow the discussions on Twitter and contribute your views by using the hashtags #CommunityControl and #YourHealthYourFuture.

Please encourage your networks and organisations to support the event by following the discussion and retweeting as much as possible.

See full program 8.00 to 1.00 Pm HERE

Our special thanks to Tom Calma who has been our NO 1 promoter of our alerts 

Read or subscribe to NACCHO Daily Aboriginal Health News Alerts

“Across forty years I’ve come to recognise many factoid-driven myths about smoking that just won’t die. If I asked for a dollar each time I had to refute these statements, I’d have accumulated a small fortune.

Their persistence owes much to their being a vehicle for those who utter them to express unvoiced but clear sub-texts that reflect deeply held beliefs about women, the disadvantaged, mental illness, government health campaigns and the “natural”.

Let’s drive a stake through the heart of ten of the most common myths.”

Simon Chapman  Emeritus Professor in Public Health, University of Sydney

Originally published in The Conversation 

1. Women and girls smoke more than men and boys

Women have never smoked more than men. Occasionally, a survey will show one age band where it’s the other way around, but from the earliest mass uptake of smoking in the first decades of last century, men streaked out way ahead of women.

In 1945 in Australia, 72% of men and 26% of women smoked. By 1976, men had fallen to 43% and women had risen to 33%.

As a result, men’s tobacco-caused death rates have always been much higher than those of women. Women’s lung cancer rates, for example, seem unlikely to reach even half the peak rates that we saw among men in the 1970s.

Currently in Australia, 15% of men and 12% of women smoke daily.

But what about all the “young girls” you can see smoking, I’m always being told. In 2014, 13% of 17-year-old male high school students and 11% of females smoked. In two younger age bands, girls smoked more (by a single percentage point).

Those who keep on insisting girls smoke more are probably just letting their sexist outrage show about noticing girls’ smoking than their ignorance about the data.

2. Quit campaigns don’t work on low socioeconomic smokers

In Australia, 11% of those in the highest quintile of economic advantage smoke, compared with 27.6% in the lowest quintile. More than double.

So does this mean that our quit campaigns “don’t work” on the least well-off?

Smoking prevalence data reflect two things: the proportion of people who ever smoked, and the proportion who quit.

If we look at the most disadvantaged group, we find that a far higher proportion take up smoking than in their more well-to-do counterparts. Only 39.5% have never smoked compared with 50.4% of the most advantaged – see table 9.2.6).

When it comes to quitting, 46% of the most disadvantaged have quit compared to 66% of the least disadvantaged (see table 9.2.9).

There is a higher percentage of the disadvantaged who smoke mainly because more take it up, not because disadvantaged smokers can’t or won’t quit. With 27.6% of the most disadvantaged smoking today, the good news is that nearly three-quarters don’t. Smoking and disadvantage are hardly inseparable.

3. Scare campaigns ‘don’t work’

Countless studies have asked ex-smokers why they stopped and current smokers about why they are trying to stop. I have never seen such a study when there was not daylight between the first reason cited (worry about health consequences) and the second most nominated reason (usually cost).

For example, this national US study covering 13 years showed “concern for your own current or future health” was nominated by 91.6% of ex-smokers as the main reason they quit, compared with 58.7% naming expense and 55.7% being concerned about the impact of their smoking on others.

If information and warnings about the dire consequences of smoking “don’t work”, then from where do all these ex-smokers ever get these top-of-mind concerns? They don’t pop into their heads by magic. They encounter them via anti-smoking campaigns, pack warnings, news stories about research and personal experiences with dying family and friends. The scare campaigns work.

4. Roll-your-own tobacco is more ‘natural’ than factory made

People who smoke rollies often look you in the eye and tell you that factory made cigarettes are full of chemical additives, while roll-your-own tobacco is “natural” – it’s just tobacco. The reasoning here that we are supposed to understand is that it’s these chemicals that are the problem, while the tobacco, being “natural”, is somehow OK.

This myth was first turned very unceremoniously on its head when New Zealand authorities ordered the tobacco companies to provide them with data on the total weight of additives in factory made cigarettes, roll-your-own and pipe tobacco.

For example, data from 1991 supplied by WD & HO Wills showed that in 879,219kg of cigarettes, there was 1,803kg of additives (0.2%). While in 366,036kg of roll-your-own tobacco, there was 82,456kg of additives (22.5%)!

Roll-your-own tobacco is pickled in flavouring and humectant chemicals, the latter being used to keep the tobacco from drying out when smokers expose the tobacco to the air 20 or more times a day when they remove tobacco to roll up a cigarette.

5. Nearly all people with schizophrenia smoke

It’s true that people with mental health problems are much more likely to smoke than those without diagnosed mental health conditions. A meta-analysis of 42 studies on tobacco smoking by those with schizophrenia found an average 62% smoking prevalence (range 14%-88%). But guess which study in these 42 gets cited and quoted far more than any of the others?

If you said the one reporting 88% smoking prevalence you’d be correct. This small 1986 US study of just 277 outpatients with schizophrenia has today been cited a remarkable 1,135 times. With colleagues, I investigated this flagrant example of citation bias (where startling but atypical results stand out in literature searches and get high citations – “wow! This one’s got a high number, let’s quote that one!”).

By googling “How many schizophrenics smoke”, we showed how this percolates into the community via media reports where figures are rounded up in statements such as, “As many as 90% of schizophrenic patients smoke.”

Endlessly repeating that “90%” of those with schizophrenia smoke does these people a real disservice. We would not tolerate such inaccuracy about any other group.

6. Everyone knows the risks of smoking

Knowledge about the risks of smoking can exist at four levels:

  • Level 1: having heard that smoking increases health risks.
  • Level 2: being aware that specific diseases are caused by smoking.
  • Level 3: accurately appreciating the meaning, severity, and probabilities of developing tobacco related diseases.

Level 4: personally accepting that the risks inherent in levels 1–3 apply to one’s own risk of contracting such diseases.

Level 1 knowledge is very high, but as you move up the levels, knowledge and understanding greatly diminish. Very few people, for example, are likely to know that two in three long term smokers will die of a smoking caused disease, nor the average number of years that smokers lose off normal life expectancy.

7. You can reduce the health risks of smoking by just cutting down

It’s true that if you smoke five cigarettes a day rather than 20, your lifetime risk of early death is less (although check the risks for one to four cigarettes a day here).

But trying to “reverse engineer” the risk by just cutting down rather than quitting has been shown in at least four large cohort studies such as this one to confer no harm reduction.

If you want to reduce risk, quitting altogether should be your goal.

8. Air pollution is the real cause of lung cancer

Air pollution is unequivocally a major health risk. By “pollution”, those who make this argument don’t mean natural particulate matter such as pollen and soil dusts, they mean nasty industrial and vehicle pollution.

The most polluted areas of Australia are cities where pollution from industry and motor vehicle emissions are most concentrated. Remote regions of the country are the least polluted, so if we wanted to consider the relative contributions of air pollution and smoking to smoking-caused diseases, an obvious question to ask would be “does the incidence of lung cancer differ between heavily polluted cities and very unpolluted remote areas?”

Yes it does. Lung cancer incidence is highest in Australia in (wait for this …) in the least polluted very remote regions of the country, where smoking prevalence happens also to be highest.

9. Smokers should not try to quit without professional help or drugs

If you ask 100 ex-smokers how they quit, between two-thirds and three-quarters will tell you they quit unaided: on their final successful quit attempt, they did not use nicotine replacement therapy, prescribed drugs, or go to some dedicated smoking cessation clinic or experience the laying on of hands from some alternative medicine therapist. They quit unaided.

So if you ask the question: “What method is used by most successful quitters when they quit?” The answer is cold turkey.

Fine print on this English National Health Service poster states a bald-faced lie by saying that “There are some people who can go cold turkey and stop. But there aren’t many of them.” In the years before nicotine-replacement threapy and other drugs were available, many millions – including heavy smokers – quit smoking without any assistance. That’s a message that the pharmaceutical industry was rather not megaphoned

10. Many smokers live into very old age: so it can’t be that harmful

In just the way that five out of six participants in a round of deadly Russian roulette might proclaim that putting a loaded gun to their head and pulling the trigger caused no harm, those who use this argument are just ignorant of risks and probability.

Many probably buy lottery tickets with the same deep knowing that they have a good chance of winning.

11. Today’s smokers are all hard core, addicted smokers who can’t or won’t give up

This claim is the essence of what is known as the “hardening hypothesis”: the idea that decades of effort to motivate smokers to quit has seen all the low-hanging fruit fall from the tree, leaving only deeply addicted, heavy smokers today.

The key index of addicted smoking is the number of cigarettes smoked per day. This creates a small problem for the hardening hypothesis: in nations and states where smoking has reduced most, the average number of cigarettes smoked daily by continuing smokers has gone down, not up. This is exactly the opposite of what the hardening hypothesis would predict if remaining smokers were mostly hard core.

12. Smoking is pleasurable

Repeated studies have found that around 90% of smokers regret having started, and some 40% make an attempt to quit each year. There’s no other product with even a fraction of such customer disloyalty.

But I’m always amused at some die-hard smokers’ efforts explain that they smoke for pleasure and so efforts to persuade them to stop are essentially just anti-hedonistic tirades. Many studies have documented that the “pleasure” of smoking centres around the relief smokers get when they have not smoked for a while. The next nicotine hit takes away the discomfort and craving they have been experiencing.

This argument is a bit like saying that being beaten up every day is something you want to continue with, because hey, it feels so good when the beating stops for a while.

13. Light and mild cigarettes deliver far less tar and nicotine to the smoker than standard varieties

Several nations have outlawed cigarette descriptors such as “light” and “mild” because of evidence that such products do not deliver lower amounts of tar and nicotine to smokers, and so are deceptive.

The allegedly lower yields from cigarettes labelled this way resulted from a massive consumer fraud.

Cigarette manufacturers obtained these low readings by laboratory smoking machine protocols which took a standardized number of puffs, at a standardized puff velocity. The smoke inhaled by the machine was then collected in glass “lungs” behind the machine and the tar and nicotine weighed to give the readings per cigarette.

But the companies didn’t tell smokers two things. So-called light or mild cigarettes had tiny, near-invisible pin-prick perforations just on the filter (see picture). These holes are not covered by the “lips” or “fingers” of the laboratory smoking machine, allowing extra air to be inhaled and thus diluting the dose of tar and nicotine being collected.

But when smokers use these products, two things happen. Their lips and fingers partially occlude the tiny ventilation holes, thus allowing more smoke to be inhaled. Smokers unconsciously “titrate” their smoking to obtain the dose of nicotine that their brain’s addiction centres demand: they can take more puffs, inhale more deeply, leave shorter butt lengths or smoke more cigarettes.

Today, where use of these descriptors has been stopped, the consumer deception continues with the companies using pack colours to loudly hint to smokers about which varieties are “safer”.

Magnification and location of filter ventilation holes. Author collection

14. Filters on cigarettes remove most of the nasty stuff from cigarettes

We’ve all seen the brown stain in a discarded cigarette butt. But what few have seen is how much of that same muck enters the lungs and how much stays there.

This utterly compelling video demonstration shows how ineffective filters are in removing this deadly sludge. A smoker demonstrates holding the smoke in his mouth and then exhales it through a tissue paper, leaving a tell-tale brown stain. He then inhales a drag deep into his lungs, and exhales it into a tissue. The residue is still there, but in a much reduced amount. So where has the remainder gone? It’s still in the lungs!

15. Governments don’t want smoking to fall because they are addicted to tobacco tax and don’t want to kill a goose that lays golden eggs

This is perhaps the silliest and most fiscally illiterate argument we hear about smoking. If governments really want to maximise smoking and tax receipts, they are doing a shockingly bad job of it. Smoking in Australia has fallen almost continuously since the early 1960s. In five of the 11 years to 2011, the Australian government received less tobacco tax receipts than it did the year before (see Table 13.6.6).

Plainly, as smoking continues to decline, diminishing tax returns will occur, although this will be cushioned by the rising population which will include some smokers.

In the meantime, tobacco tax is a win-win for governments and the community. It reduces smoking like nothing else, and it provides substantial transfer of funds from smokers to government for public expenditure.

Those of us who don’t smoke do not squirrel away what we would have otherwise spent on smoking in a jam jar under the bed. We spend it on other goods and services, benefiting the economy too.

16. Most smokers die from smoking caused diseases late in life, and we’ve all got to die from something

Smoking increases the risk of many different diseases, and collectively these take about ten years off normal life expectancy from those who get them.

Smoking is by far the greatest risk factor for lung cancer. In Australia, the average age of death for people with lung cancer is 71.4 (see Table 4.2), while life expectancy is currently 80.1 for men and 84.3 for women.

This means that, on average, men diagnosed with lung cancer lose 8.7 years and women 12.9 years (mean 10.8 years). Of course, some lose many more (Beatle George Harrison died at just 58, Nat King Cole at 45).

If a 20-a-day smoker starts at 17 and dies at 71, 54 years of smoking would see 394,470 cigarettes smoked. At ten puffs per cigarette, that’s some 3.94 million point-blank lung bastings.

It takes about six minutes to smoke a cigarette. So at 20 a day, smokers smoke for two hours each day. Across 54 years, that’s a cumulative 1,644 days of smoking (4.5 years of continual smoking if you put it all together).

So by losing ten years off life expectancy, each cigarette smoked takes about 2.2 times the time it takes to smoke it off the life expectancy that might otherwise have been enjoyed.

17. Smokers cost the health system far less than the government receives from tobacco tax

In June 2015, a senior staff member of Australian libertarian Senator David Leyonhjelm, Helen Dale tweeted:

In Australia, a now old report looking at 2004/05 data estimated the gross health care costs attributable to smoking “before adjustment for savings due to premature death” were $A1.836 billion. In that financial year, the government received $A7,816.35 billion in customs and excise duty and GST on tobacco.

Someone who thought that the fiscal ledger was all that mattered in good government might conclude from this that smokers easily pay their way and perhaps we should even encourage smoking as a citizen’s patriotic duty.

With smokers being considerate enough to die early, these noble citizens lay down their lives early and thus contribute “savings due to premature death” like failing to draw a state pension or needing aged care services late in life. Philip Morris notoriously gave this advice to the new Czech government in 1999.

Other assessments, though, might well point to the values inherent in such assessments. History’s worst regimes have often seen economically non-productive people as human detritus deserving death. Primo Levi’s unforgettable witnessing of this mentality in Auschwitz comes to mind.

18. Big Tobacco is starting to invade low-income nations, now that smoking is on the wane in the wealthiest nations

Sorry, but US and British manufacturers have been aggressively marketing cigarettes in places such as China since the early years of last century. These collectable posters show many featuring Chinese women.

The large populations, the often lax tobacco-control policies and the higher corruption indexes of many low- and middle-income nations makes many of these nirvanas for Big Tobacco.

There are fewer more nauseating experiences than reading the corporate social responsibility reports of tobacco transnationals and then seeing how they operate in smokers’ paradises such as Indonesia. This documentary says it all.

19. Millions of cigarette butts on the world’s beaches leach lots of toxic chemicals into oceans

Cigarette butts are the most discarded items in all litter. Every year uncounted millions if not billions are washed down gutters in storm water and find their way into rivers, harbours and oceans. Cigarette filters and butts contain toxic residue and experiments have shown that placing laboratory fish in containers for 48 hours with leachate extracted from used cigarette butts, 50% of the fish die. From this, we sometimes hear people exclaim that cigarette butts are not just unsightly, but they “poison the oceans”.

But a confined laboratory container does not remotely mirror real life exposures in oceans or rivers. There are some 1,338,000,000 cubic kilometers of water in the world oceans, so the contribution of cigarette butts to the toxification of all this could only excite a homeopath.

If we want to reduce tobacco litter, we need not wander into such dubious justifications. The best way by far is to keep reducing smoking. Industry attempts at portraying themselves as corporately responsible by running dinky little clean-up campaigns or distributing personal butt disposal canisters avoids their efforts to keep as many smoking as possible.

20. Tobacco companies care deeply about their best customers dying early

Naturally, all businesses would rather their customers lived as long as possible so that the cash registers can keep ringing out long and loud. Tobacco companies wish their products didn’t kill so many, but worship the god nicotine for its iron grip on so many.

Visit any tobacco transnational’s website and you will find lots of earnest and caring talk about the companies’ dedication to doing all they can to reduce the terrible harm caused by their products. All the major companies have now invested heavily in electronic cigarettes, so isn’t this a sign that they taking harm reduction seriously?

It might be if the same companies were showing any sign of taking their feet off the turbo-drive accelerator of opposing effective tobacco control policies. But they are doing nothing of the sort. All continue to aggressively attack and delay any policy like tax hikes, graphic health warnings, plain packaging and advertising bans wherever in the world these are planned for introduction.

For all their unctuous hand-wringing about their mission to reduce harm, they are all utterly determined to keep as many smoking as possible. Big Tobacco’s business plan is not smoking or ecigarettes. It’s smoking and ecigarettes. Smoke when you are able to, vape when you can’t. It’s called dual use and some 70% of vapers are doing just that. The tragedy now playing out in some nations is that too many gormless tobacco control experts are blind to this big picture.

NACCHO and RACGP Podcast

Do you smoke?’ A simple preventive activity for clinicians to engage with every patient.

With over 30 years’ experience in Indigenous health, Professor David Thomas from the Menzies School of Health Research discusses updates to the smoking topic from Chapter 1: Lifestyle, in the third edition

Listen to Episode one:

Smoking & Smoking Cessation with Prof David Thomas on The National Guide Podcast 

NACCHO Aboriginal Health Conferences and Events #SaveADate #NRW2019 : This weeks feature @ahmrc Twitter Festival 31 May #WorldNoTobaccoDay #CommunityControl #YourHealthYourFuture #Smoking Moderated by @amymcquire @timsenior @harleymcquire

This weeks featured NACCHO SAVE A DATE events

31 May AHMRC World No Tobacco Day Twitter Festival 

29th  – 30th  August 2019 NACCHO OCHRE DAY

4 November NACCHO Youth Conference -Darwin NT

5 – 7 November NACCHO Conference and AGM  -Darwin NT

Download the 2019 Health Awareness Days Calendar 

27 May to 5 June National Reconciliation Week #NRW2019

18 -20 June Lowitja Health Conference Darwin

2019 Dr Tracey Westerman’s Workshops 

5 July NAIDOC week Symposium

6 July National NAIDOC Awards Canberra

7 -14 July 2019 National NAIDOC Grant funding round opens

2-5 August Garma Festival 

29th  – 30th  August 2019 NACCHO OCHRE DAY

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

4 November NACCHO Youth Conference -Darwin NT

5 – 7 November NACCHO Conference and AGM  -Darwin NT

5-8 November The Lime Network Conference New Zealand 

This weeks featured NACCHO SAVE A DATE events

NACCHO and Croakey followers are invited to join Aboriginal Community Controlled Health Services in New South Wales in a Twitter Festival focused on tobacco control initiatives and successes across Australia.

Follow the discussions on Twitter and contribute your views by using the hashtags #CommunityControl and #YourHealthYourFuture.

Please encourage your networks and organisations to support the event by following the discussion and retweeting as much as possible.

Bookmark this Twitter list to follow guest tweeters and learn more from community leaders and organisations across the tobacco control space.

World No Tobacco Day program

Draft as at 28 May : Check Croakey for the latest program 

#CommunityControl #YourHealthYourFuture

(All times are AEST)

8am – 8:15am – Launch

#CommunityControl #YourHealthYourFuture moderators:

Amy McQuire (8am-1pm) @amymcquire

Tim Senior (8am-11am) @timsenior

Hayley McQuire (11am-1pm) @HayleyMcQuire

8.15-8:45am – Introductions

Aboriginal Health & Medical Research Council: Your health Your Future, the strengths of the Aboriginal Community Controlled Health Service sector


8.45 -9.00 am – National Perspective

National Aboriginal Community Controlled Health Organisation: Tobacco Control from the Aboriginal Community Controlled Health Service sector nationally


Read over 130 NACCHO Aboriginal Health and Smoking articles HERE

9:00-9:15am – Dead or Deadly

Waminda South Coast Women’s Health and Welfare Aboriginal Corporation


9:15-9:30am – Ministry of Health

NSW Health: The role of the government in supporting tobacco control


9:30-9:45am – Linking Tobacco Control & Culture

Cancer Institute NSW & Aboriginal Quitline



9:45-10:00am – Tackling Indigenous Smoking

Desley Thompson, Ninti One


10:00-10:15am – Awabakal

Awabakal: Celebrating success in tobacco control initiatives in Newcastle and the Hunter Valley NSW


10:15-10:30am – Riverina Medical and Dental Aboriginal Corporation

AH&MRC tweeting live from RivMed: Celebrating success in tobacco control initiatives in the Riverina region NSW


10:30-10:45am – Creating and Leveraging Strategic Partnerships

Cancer Council NSW


10:45-11:15am – Sharing Our Successes

Victorian Aboriginal Community Controlled Health Organisation (VACCHO), Queensland Aboriginal and Islander Health Council (QAIHC), Aboriginal Medical Services Alliance Northern Territory (AMSANT)




11.15 -11.30 am – Ready Mob

Galambila Aboriginal Medical Service


11:30-11:45am – International Perspective



11:45-12:00pm – iSISTAQUIT

Dr Gillian Gould: Successes in reducing the incidence of smoking during pregnancy


12:00-12:15pm – Tobacco Control during Rehabilitation

The Glen Centre – Central Coast Drug and Alcohol Rehabilitation


12:15-12:30pm – A GP’s perspective

Dr Tim Senior


12:30-12:45pm – Walgett Aboriginal Medical Service

Walgett: Celebrating success in tobacco control initiatives in northern NSW


12:45-1:00pm – Wrapping It Up


Amy McQuire  @amymcquire

Hayley McQuire  @HayleyMcQuire

The Twitter festival is hosted by Croakey Professional Services on behalf of the AH&MRC. We thank the AH&MRC for organising the program. Bookmark this link to follow related stories

Download the NACCHO 2019 Calendar Health Awareness Days

For many years ACCHO organisations have said they wished they had a list of the many Indigenous “ Days “ and Aboriginal health or awareness days/weeks/events.

With thanks to our friends at ZockMelon here they both are!

It even has a handy list of the hashtags for the event.

Download the 53 Page 2019 Health days and events calendar HERE

naccho zockmelon 2019 health days and events calendar

We hope that this document helps you with your planning for the year ahead.

Every Tuesday we will update these listings with new events and What’s on for the week ahead

To submit your events or update your info

Contact: Colin Cowell

NACCHO Social Media Editor Tel 0401 331 251

Email :


27 May to 5 June National Reconciliation Week #NRW2019 

At the heart of reconciliation is the relationship between the broader Australian community and Aboriginal and Torres Strait Islander peoples. To foster positive race relations, our relationship must be grounded in a foundation of truth.

Aboriginal and Torres Strait Islander peoples have long called for a comprehensive process of truth-telling about Australia’s colonial history. Our nation’s past is reflected in the present, and will continue to play out in future unless we heal historical wounds.

Today, 80 per cent of Australians believe it is important to undertake formal truth telling processes, according to the 2018 Australian Reconciliation Barometer. Australians are ready to come to terms with our history as a crucial step towards a unified future, in which we understand, value and respect each other.

Whether you’re engaging in challenging conversations or unlearning and relearning what you know, this journey requires all of us to walk together with courage. This National Reconciliation Week, we invite Australians from all backgrounds to contribute to our national movement towards a unified future.

What is National Reconciliation Week?

National Reconciliation Week (NRW) is a time for all Australians to learn about our shared histories, cultures, and achievements, and to explore how each of us can contribute to achieving reconciliation in Australia.

The dates for NRW remain the same each year; 27 May to 3 June. These dates commemorate two significant milestones in the reconciliation journey— the successful 1967 referendum, and the High Court Mabo decision respectively.

Reconciliation must live in the hearts, minds and actions of all Australians as we move forward, creating a nation strengthened by respectful relationships between the wider Australian community, and Aboriginal and Torres Strait Islander peoples.

Resources HERE

18 -20 June Lowitja Health Conference Darwin

At the Lowitja Institute International Indigenous Health and Wellbeing Conference 2019 delegates from around the world will discuss the role of First Nations in leading change and will showcase Indigenous solutions.

The conference program will highlight ways of thinking, speaking and being for the benefit of Indigenous peoples everywhere.

Join Indigenous leaders, researchers, health professionals, decision makers, community representatives, and our non-Indigenous colleagues in this important conversation.

More Info 

2019 Dr Tracey Westerman’s Workshops 

More info and dates

5 July NAIDOC week Symposium

Symposium: Our Voice, Our Truth
Kick off NAIDOC week in Canberra with a Symposium event with keynote speakers and expert panel on the topic of good governance through strong leadership. A daylong event, fully catered with morning and afternoon tea, lunch and post-event drinks and canapes with entertainment to conclude.
This is an exclusive ticketed event in a stunning lakeside venue with limited seats available. Save the date – July 5 – and follow on Facebook to be the first in line to book tickets
6 July National NAIDOC Awards Canberra

7 -14 July 2019 National NAIDOC Grant funding round opens


We invite you to walk with us in a movement of the Australian people for a better future.

The Indigenous voice of this country is over 65,000 plus years old.

They are the first words spoken on this continent. Languages that passed down lore, culture and knowledge for over millennia. They are precious to our nation.

It’s that Indigenous voice that include know-how, practices, skills and innovations – found in a wide variety of contexts, such as agricultural, scientific, technical, ecological and medicinal fields, as well as biodiversity-related knowledge.  They are words connecting us to country, an understanding of country and of a people who are the oldest continuing culture on the planet.

And with 2019 being celebrated as the United Nations International Year of Indigenous Languages, it’s time for our knowledge to be heard through our voice.

For generations, we have sought recognition of our unique place in Australian history and society today. We need to be the architects of our lives and futures.

For generations, Aboriginal and Torres Strait Islander peoples have looked for significant and lasting change.

Voice. Treaty. Truth. were three key elements to the reforms set out in the Uluru Statement from the Heart. These reforms represent the unified position of First Nations Australians.

However, the Uluru Statement built on generations of consultation and discussions among Indigenous people on a range of issues and grievances. Consultations about the further reforms necessary to secure and underpin our rights and to ensure they can be exercised and enjoyed by Aboriginal and Torres Strait Islander peoples.

It specifically sequenced a set of reforms: first, a First Nations Voice to Parliament enshrined in the Constitution and second, a Makarrata Commission to supervise treaty processes and truth-telling.

(Makarrata is a word from the language of the Yolngu people in Arnhem Land. The Yolngu concept of Makarrata captures the idea of two parties coming together after a struggle, healing the divisions of the past. It is about acknowledging that something has been done wrong, and it seeks to make things right.)

Aboriginal and Torres Strait Islander people want their voice to be heard. First Nations were excluded from the Constitutional convention debates of the 1800’s when the Australian Constitution came into force.  Indigenous people were excluded from the bargaining table.

Aboriginal and Torres Strait Islander peoples have always wanted an enhanced role in decision-making in Australia’s democracy.

In the European settlement of Australia, there were no treaties, no formal settlements, no compacts. Aboriginal and Torres Strait Islander people therefore did not cede sovereignty to our land. It was taken away from us. That will remain a continuing source of dispute.

Our sovereignty has never been ceded – not in 1788, not in 1967, not with the Native Title Act, not with the Uluru Statement from the Heart. It coexists with the sovereignty of the Crown and should never be extinguished.

Australia is one of the few liberal democracies around the world which still does not have a treaty or treaties or some other kind of formal acknowledgement or arrangement with its Indigenous minorities.

A substantive treaty has always been the primary aspiration of the Aboriginal and Torres Strait Islander movement.

Critically, treaties are inseparable from Truth.

Lasting and effective agreement cannot be achieved unless we have a shared, truthful understanding of the nature of the dispute, of the history, of how we got to where we stand.

The true story of colonisation must be told, must be heard, must be acknowledged.

But hearing this history is necessary before we can come to some true reconciliation, some genuine healing for both sides.

And of course, this is not just the history of our First Peoples – it is the history of all of us, of all of Australia, and we need to own it.

Then we can move forward together.

Let’s work together for a shared future.

Download the National NAIDOC Logo and other social media resources.

2-5 August Garma Festival 

Garma Website

29th  – 30th  Aug 2019 NACCHO OCHRE DAY

Venue: Pullman Hotel – 192 Wellington Parade, East Melbourne Vic 3000

Website to be launched soon

23 -25 September IAHA Conference Darwin

24 September

A night of celebrating excellence and action – the Gala Dinner is the premier national networking event in Aboriginal and Torres Strait Islander allied health.

The purpose of the IAHA National Indigenous Allied Health Awards is to recognise the contribution of IAHA members to their profession and/or improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

The IAHA National Indigenous Allied Health Awards showcase the outstanding achievements in Aboriginal and Torres Strait Islander allied health and provides identifiable allied health role models to inspire all Aboriginal and Torres Strait Islander people to consider and pursue a career in allied health.

The awards this year will be known as “10 for 10” to honour the 10 Year Anniversary of IAHA. We will be announcing 4 new awards in addition to the 6 existing below.

Read about the categories HERE.

24 -26 September 2019 CATSINaM National Professional Development Conference



The 2019 CATSINaM National Professional Development Conference will be held in Sydney, 24th – 26th September 2019. Make sure you save the dates in your calendar.

Further information to follow soon.

Date: Tuesday the 24th to Thursday the 26th September 2019

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761


9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

SAVE THE DATE for the 2019 NATSIHWA 10 Year Anniversary Conference!!!

We’re so excited to announce the date of our 10 Year Anniversary Conference –
A Decade of Footprints, Driving Recognition!!! 

NATSIHWA recognises that importance of members sharing and learning from each other, and our key partners within the Health Sector. We hold a biennial conference for all NATSIHWA members to attend. The conference content focusses on the professional support and development of the Health Workers and Health Practitioners, with key side events to support networking among attendees.  We seek feedback from our Membership to make the conferences relevant to their professional needs and expectations and ensure that they are offered in accessible formats and/or locations.The conference is a time to celebrate the important contribution of Health Workers and Health Practitioners, and the Services that support this important profession.

We hold the NATSIHWA Legends Award night at the conference Gala Dinner. Award categories include: Young Warrior, Health Worker Legend, Health Service Legend and Individual Champion.

Watch this space for the release of more dates for registrations, award nominations etc.

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

The University of Melbourne, Department of Rural Health are pleased to advise that abstract
submissions are now being invited that address Aboriginal and Torres Strait Islander health and

The Aboriginal & Torres Strait Islander Health Conference is an opportunity for sharing information and connecting people that are committed to reforming the practice and research of Aboriginal & Torres Strait Islander health and celebrates Aboriginal knowledge systems and strength-based approaches to improving the health outcomes of Aboriginal communities.

This is an opportunity to present evidence-based approaches, Aboriginal methods and models of
practice, Aboriginal perspectives and contribution to health or community led solutions, underpinned by cultural theories to Aboriginal and Torres Strait Islander health and wellbeing.
In 2018 the Aboriginal & Torres Strait Islander Health Conference attracted over 180 delegates from across the community and state.

We welcome submissions from collaborators whose expertise and interests are embedded in Aboriginal health and wellbeing, and particularly presented or co-presented by Aboriginal and Torres Strait Islander people and community members.

If you are interested in presenting, please complete the speaker registration link

closing date for abstract submission is Friday 3 rd May 2019.
As per speaker registration link request please email your professional photo for our program or any conference enquiries to E.

Kind regards
Leah Lindrea-Morrison
Aboriginal Partnerships and Community Engagement Officer
Department of Rural Health, University of Melbourne T. 03 5823 4554 E.

4 November NACCHO Youth Conference -Darwin NT

Darwin Convention Centre

Website to be launched soon

Conference Co-Coordinator Ben Mitchell 02 6246 9309

5 – 7 November NACCHO Conference and AGM  -Darwin NT

Darwin Convention Centre

Website to be launched soon

Conference Co-Coordinator Ben Mitchell 02 6246 9309

5-8 November The Lime Network Conference New Zealand 

This years  whakatauki (theme for the conference) was developed by the Scientific Committee, along with Māori elder, Te Marino Lenihan & Tania Huria from .

To read about the conference & theme, check out the  website. 

NACCHO Aboriginal Women’s Health and How to #quitsmoking during #pregnancy with @sistaquit Plus #WorldNoTobaccoDay2019 May31 #WNTD2019 #WNTD

” Every year, on 31 May, the World Health Organization (WHO) and global partners celebrate World No Tobacco Day (WNTD). The annual campaign is an opportunity to raise awareness on the harmful and deadly effects of tobacco use and second-hand smoke exposure, and to discourage the use of tobacco in any form.

The focus of World No Tobacco Day 2019 is on “tobacco and lung health.” The campaign will increase awareness on:

  • the negative impact that tobacco has on people’s lung health, from cancer to chronic respiratory disease,
  • the fundamental role lungs play for the health and well-being of all people.

The campaign also serves as a call to action, advocating for effective policies to reduce tobacco consumption and engaging stakeholders across multiple sectors in the fight for tobacco control. ”

See full detail of World No Tobacco Day Part 2 Below

” In 2014 it was reported 45 per cent of surveyed Indigenous mothers smoked during pregnancy, compared to 13 per cent of non-Indigenous pregnant women.

Those figures have spurred University of Newcastle associate professor Gillian Gould to study what can be done to help reduce rates of Indigenous women smoking while pregnant.

It’s not only that they may be born with low birth rate, or have risks of premature birth, but it can set them up for things like obesity, diabetes, a higher risk of heart disease, and lots of respiratory illnesses.”

Smoking rates among pregnant Indigenous women tackled in major research project 

“ It’s imperative that Indigenous women have good access to smoking cessation services as 43 per cent of Indigenous women smoke. Essentially, we’re trying to ensure that Indigenous people have the same health outcomes as non-Indigenous people and we need to start before they’re born. 

Nothing like this is currently available and there are many systematic barriers that prevent women from accessing medical or antenatal care, which is a problem as it means women may present later than usual during their pregnancy,” Associate Professor Gould said.

We want to start the conversation about smoking as early as possible and found that many general practitioners and obstetricians lack the confidence or skills to provide this specialised type of knowledge.

Some women also receive mixed messages about the safety of quitting smoking or using nicotine replacement therapy during their pregnancy, so this initiative will bring health providers up to speed with the latest evidence-based treatment methods.”

Associate Professor Gould see full Press Release Part 1

Read over 130  + NACCHO Aboriginal health and Smoking articles HERE

Part 1

Health professionals and organisations will receive additional training and resources to help support Indigenous women quit smoking during pregnancy under a new multi-million dollar initiative being funded by the Australian Government Department of Health.

Led by renowned smoking cessation expert, Associate Professor Gillian Gould, the initiative will enable health practitioners who treat a pregnant woman in any medical capacity to complete an online training module and access a range of tailored treatment materials.

With smoking in pregnancy having a major impact on the lifelong health of mother and child, including birth complications and low birth weight, Associate Professor Gould said quitting smoking early in pregnancy would help to close the gap on Indigenous health.

As a general practitioner and researcher with the University of Newcastle and Hunter Medical Research Institute (HMRI)*, Associate Professor Gould said the iSISTAQUIT (Supporting Indigenous Smokers to Assist Quitting) initiative would help to provide a culturally sensitive and consistent approach to delivering better care across the country.

Building on lessons and findings from a separate pilot program, also led by Associate Professor Gould, iSISTAQUIT will feature online training via webinars that are self-paced, along with hard copy material such as a treatment manual and patient booklet.

“Many of the resources were developed during the pilot program and trialled across six states, so we’ve adapted them slightly and made them suitable for online delivery,” Associate Professor Gould said.

“Our pilot study revealed that 41 per cent of participants made quit attempts and the resources resulted in a quit rate of 14 per cent and increased engagement between Indigenous women and services.

“Ideally we want these resources to be available to all health practitioners and will look to disseminate them through our existing networks across Aboriginal services, professional colleges and bodies, primary health networks, obstetricians, hospital departments and other medical services throughout Australia when they become available.”

On April 4, 2019 the Department of Health awarded $3,891,801 to the initiative, from the Tackling Indigenous Smoking program. The national development of iSISTAQUIT will commence in the next few months from a newly-established centre in Coffs Harbour.

HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.

 Part 2 How tobacco endangers the lung health of people worldwide

World No Tobacco Day 2019 will focus on the multiple ways that exposure to tobacco affects the health of people’s lungs worldwide.

These include:

Lung cancer. Tobacco smoking is the primary cause for lung cancer, responsible for over two thirds of lung cancer deaths globally. Second-hand smoke exposure at home or in the work place also increases risk of lung cancer. Quitting smoking can reduce the risk of lung cancer: after 10 years of quitting smoking, risk of lung cancer falls to about half that of a smoker.

Chronic respiratory disease. Tobacco smoking is the leading cause of chronic obstructive pulmonary disease (COPD), a condition where the build-up of pus-filled mucus in the lungs results in a painful cough and agonising breathing difficulties. The risk of developing COPD is particularly high among individuals who start smoking at a young age, as tobacco smoke significantly slows lung development. Tobacco also  exacerbates asthma, which restricts activity and contributes to disability. Early smoking cessation is the most effective treatment for slowing the progression of COPD and improving asthma symptoms.

Across the life-course. Infants exposed in-utero to tobacco smoke toxins, through maternal smoking or maternal exposure to second-hand smoke, frequently experience reduced lung growth and function. Young children exposed to second-hand smoke are at risk of the onset and exacerbation of asthma, pneumonia and bronchitis, and frequent lower respiratory infections.

Globally, an estimated 165 000 children die before the age of 5 of lower respiratory infections caused by second-hand smoke. Those who live on into adulthood continue to suffer the health consequences of second-hand smoke exposure, as frequent lower respiratory infections in early childhood significantly increase risk of developing COPD in adulthood.

Tuberculosis. Tuberculosis (TB) damages the lungs and reduces lung function, which is further exacerbated by tobacco smoking. About one quarter of the world’s population has latent TB, placing them at risk of developing the active disease. People who smoke are twice as likely to fall ill with TB. Active TB, compounded by the damaging lung health effects of tobacco smoking, substantially increases risk of disability and death from respiratory failure.

Air pollution. Tobacco smoke is a very dangerous form of indoor air pollution: it contains over 7 000 chemicals, 69 of which are known to cause cancer. Though smoke may be invisible and odourless, it can linger in the air for up to five hours, putting those exposed at risk of lung cancer, chronic respiratory diseases, and reduced lung function.

Goals of the World No Tobacco Day 2019 campaign

The most effective measure to improve lung health is to reduce tobacco use and second-hand smoke exposure. But knowledge among large sections of the general public, and particularly among smokers, on the implications for the health of people’s lungs from tobacco smoking and second-hand smoke exposure is low in some countries. Despite strong evidence of the harms of tobacco on lung health, the potential of tobacco control for improving lung health remains underestimated.

The World No Tobacco Day 2019 campaign will raise awareness on the:

  • risks posed by tobacco smoking and second-hand smoke exposure;
  • awareness on the particular dangers of tobacco smoking to lung health;
  • magnitude of death and illness globally from lung diseases caused by tobacco, including chronic respiratory diseases and lung cancer;
  • emerging evidence on the link between tobacco smoking and tuberculosis deaths;
  • implications of second-hand exposure for lung health of people across age groups;
  • importance of lung health to achieving overall health and well-being;
  • feasible actions and measures that key audiences, including the public and governments, can take to reduce the risks to lung health posed by tobacco.

The cross-cutting theme of tobacco and lung health has implications for other global processes, such as international efforts to control noncommunicable diseases (NCDs), TB and air pollution for promoting health. It serves as an opportunity to engage stakeholders across sectors and empower countries to strengthen the implementation of the proven MPOWER tobacco control measures contained in the WHO Framework Convention for Tobacco Control (WHO FCTC).

Call to action

Lung health is not achieved merely through the absence of disease, and tobacco smoke has major implications for the lung health of smokers and non-smokers globally.

In order to achieve the Sustainable Development Goal (SDG) target of a one-third reduction in NCD premature mortality by 2030, tobacco control must be a priority for governments and communities worldwide. Currently, the world is not on track to meeting this target.

Countries should respond to the tobacco epidemic through full implementation of the WHO FCTC and by adopting the MPOWER measures at the highest level of achievement, which involves developing, implementing, and enforcing the most effective tobacco control policies aimed at reducing the demand for tobacco.

Parents and other members of the community should also take measures to promote their own health, and that of their children, by protecting them from the harms caused by tobacco.

NACCHO Aboriginal Health and #SocialDeterminants : Download @AIHW Report : Indicators of socioeconomic inequalities in #cardiovascular disease #heartattack #stroke, #diabetes and chronic #kidney disease @ACDPAlliance

 ” Most apparent are inequalities in chronic disease among Aboriginal and Torres Strait Islander people and non-Indigenous Australians. Social and economic factors are estimated to account for slightly more than one-third (34%) of the ‘good health’ gap between the 2 groups, with health risk factors such as high blood pressure, smoking and risky alcohol consumption explaining another 19%, and 47% due to other, unexplained factors.

 An estimated 11% of the total health gap can be attributed to the overlap, or interactions between the social determinants and health risk factors (AIHW 2018a).

Download the AIHW Report HERE aihw-cdk-12

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’

AIHW spokesperson Dr Lynelle Moonn noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity

AIHW Website for more info 

Government investment is essential to encourage health checks, improve understanding of the risk factors for chronic disease, and implement policies and programs to reduce chronic disease risk, particularly in areas of socioeconomic disadvantage,

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said that the data revealed stark inequities in health status amongst Australians.

Download Press Release Here : australianchronicdiseasepreventionalliance

The Australian Chronic Disease Prevention Alliance is calling on the Government to target these health disparities by increasing the focus on prevention and supporting targeted health checks to proactively manage risk.

AIHW Press Release

Social factors play an important role in a person’s likelihood of developing and dying from certain chronic diseases, according to a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Indicators of socioeconomic inequalities in cardiovascular disease, diabetes and chronic kidney disease, examines the relationship between socioeconomic position, income, housing and education and the likelihood of developing and dying from several common chronic diseases—cardiovascular disease (which includes heart attack and stroke), diabetes and chronic kidney disease.

Above image NACCHO Library

The report reveals that social disadvantage in these areas is linked to higher rates of disease, as well as poorer outcomes, including a greater likelihood of dying.

‘Across the three chronic diseases we looked at—cardiovascular disease, diabetes and chronic kidney disease— we saw that people in the lowest of the 5 socioeconomic groups had, on average, higher rates of these diseases than those in the highest socioeconomic groups,’ said AIHW spokesperson Dr Lynelle Moon.

‘And unfortunately, we also found higher death rates from these diseases among people in the lowest socioeconomic groups.’

The greatest difference in death rates between socioeconomic groups was among people with diabetes.

‘For women in the lowest socioeconomic group, the rate of deaths in 2016 where diabetes was an underlying or associated cause of death was about 2.4 times as high as the rate for those in the highest socioeconomic group. For men, the death rate was 2.2 times as high,’ Dr Moon said.

‘Put another way, if everyone had the same chance of dying from these diseases as people in the highest socioeconomic group, in a one year period there would be 8,600 fewer deaths from cardiovascular disease, 6,900 fewer deaths from diabetes, and 4,800 fewer deaths from chronic kidney disease.’

Importantly, the report also suggests that in many instances the gap between those in the highest and lowest socioeconomic groups is growing.

‘For example, while the rate of death from cardiovascular disease has been falling across all socioeconomic groups, the rate has been falling more dramatically for men in the highest socioeconomic group—effectively widening the gap between groups,’ Dr Moon said.

The report also highlights the relationship between education and health, with higher levels of education linked to lower rates of disease and death.

‘If all Australians had the same rates of disease as those with a Bachelor’s degree or higher, there would have been 7,800 fewer deaths due to cardiovascular disease, 3,700 fewer deaths due to diabetes, and 2,000 fewer deaths due to chronic kidney disease in 2011–12,’ Dr Moon said.

Housing is another social factor where large inequalities are apparent. Data from 2011–12 shows that for women aged 25 and over, the rate of death from chronic kidney disease was 1.5 times as high for those living in rental properties compared with women living in properties they owned. For men, the rate was 1.4 times as high for those in rental properties.

Dr Moon noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity.

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’ she said

Underlying causes of socioeconomic inequalities in health

There are various reasons why socioeconomically disadvantaged people experience poorer health. Evidence points to the close relationship between people’s health and the living and working conditions which form their social environment.

Factors such as socioeconomic position, early life, social exclusion, social capital, employment and work, housing and the residential environment— known collectively as the ‘social determinants of health’—can act to either strengthen or to undermine the health of individuals and communities (Wilkinson & Marmot 2003).

These social determinants play a key role in the incidence, treatment and outcomes of chronic diseases. Social determinants can be seen as ‘causes of the causes’—that is, as the foundational determinants which influence other health determinants such as individual lifestyles and exposure to behavioural and biological risk factors.

Socioeconomic factors influence chronic disease through multiple mechanisms. Socioeconomic disadvantage may adversely affect chronic disease risk through its impact on mental health, and in particular, on depression. Socioeconomic gradients exist for multiple health behaviours over the life course, including for smoking, overweight and obesity, and poor diet.

When combined, these unhealthy behaviours help explain much of the socioeconomic health gap. Current research also seeks to link social factors and biological processes which affect chronic disease. In CVD, for example, socioeconomic determinants of health have been associated with high blood pressure, high cholesterol, chronic stress responses and inflammation (Havranek et al. 2015).

The direction of causality of social determinants on health is not always one-way (Berkman et al. 2014). To illustrate, people with chronic conditions may have a reduced ability to earn an income; family members may reduce or cease employment to provide care for those who are ill; and people or families whose income is reduced may move to disadvantaged areas to access low-cost housing.

Action on social determinants is often seen as the most appropriate way to tackle unfair and avoidable socioeconomic inequalities. There are significant opportunities for reducing death and disability from CVD, diabetes and CKD through addressing their social determinants.


Australians as a whole enjoy good health, but the benefits are not shared equally by all. People who are socioeconomically disadvantaged have, on average, greater levels of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD).

This report uses latest available data to measure socioeconomic inequalities in the incidence, prevalence and mortality from these 3 diseases, and where possible, assess whether these inequalities are growing. Findings include that, in 2016:

  • males aged 25 and over living in the lowest socioeconomic areas of Australia had a heart attack rate 1.55 times as high as males in the highest socioeconomic areas. For females, the disparity was even greater, at 1.76 times as high
  • type 2 diabetes prevalence for females in the lowest socioeconomic areas was 2.07 times as high as for females in the highest socioeconomic areas. The prevalence for males was 1.70 times as high
  • the rate of treated end-stage kidney disease for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. The rate for females was 1.75 times as high
  • the CVD death rate for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. For females, the disparity was slightly less, at 1.33 times as high
  • if all Australians had the same CVD death rate as people in the highest socioeconomic areas in 2016, the total CVD death rate would have declined by 25%, and there would have been 8,600 fewer deaths.

CVD death rates have declined for both males and females in all socioeconomic areas since 2001— however there have been greater falls for males in higher socioeconomic areas, and as a result, inequalities in male CVD death rates have grown.

  • Both absolute and relative inequality in male CVD death rates increased—the rate difference increasing from 62 per 100,000 in 2001 to 78 per 100,000 in 2011, and the relative index of inequality (RII) from 0.25 in 2001 to 0.53 in 2016.

Often, the health outcomes affected by socioeconomic inequalities are greater when assessed by individual characteristics (such as income level or highest educational attainment), than by area.

  • Inequalities in CVD death rates by highest education level in 2011–12 (RII = 1.05 for males and 1.05 for females) were greater than by socioeconomic area in 2011 (0.50 for males and 0.41 for females).

The impact on death rates of socioeconomic inequality was generally greater for diabetes and CKD than for CVD.

  • In 2016, the diabetes death rate for females in the lowest socioeconomic areas was 2.39 times as high as for females in the highest socioeconomic areas. This compares to a ratio 1.75 times as high for CKD, and 1.33 for CVD. For males, the equivalent rate ratios were 2.18 (diabetes), 1.64 (CKD) and 1.52 (CVD).viii

Part 2