“Disadvantaged groups are and should be a key focus of action to reduce smoking further. This has long been recognised, including in the report of the National Preventative Health Taskforce, which specifically called for action in relation to Aboriginal and Torres Strait Islander people and other highly disadvantaged groups, such as people with mental health problems,”
The evidence tells us that we need a mix of approaches. We need whole-of-community approaches, with measures such as tax increases and strong mass media campaigns, which benefit disadvantaged groups disproportionately. We also need specific targeted approaches, as this article notes: the Talking About the Smokes project and the Tackling Indigenous Smoking program have played valuable role in complementing mainstream activity.”
Professor Mike Daube, professor of health policy at Curtin University, welcomed calls for further action on smoking prevalence in disadvantaged groups, and said that a mix of approaches was needed.Professor Daube told MJA InSight.
TARGETED tobacco control strategies are urgently needed to tackle the “remarkably high” smoking rates in some high-risk groups, according to Australian authors, but leading public health experts say reinstatement of mass-reach campaigns should be a priority.
Writing in the MJA, Professor Billie Bonevski, a health behaviour scientist and researcher at the University of Newcastle, and co-authors said that the overall smoking prevalence in Australia was now 14%, but among population subgroups, such as those with severe mental illness and those who had been recently incarcerated, the rates were upwards of 67%.
Tobacco use among Aboriginal and Torres Strait Islander people also remained high, with the prevalence among Indigenous people aged 15 years and older being about 39% in 2014–15.
The authors said that a truly comprehensive approach to tobacco control should include targeted campaigns in high smoking prevalence populations.
“If we are truly concerned about this issue, we must focus more attention on the groups that are being left behind,” they wrote.
Novel, targeted interventions and increased delivery of evidence-based interventions was needed, the authors said, noting that tobacco harm reduction strategies, such as vaporised nicotine, should also be further investigated.
In an MJA InSight podcast, lead author Professor Bonevski said that smoking was still “almost … socially acceptable” in some subgroups, such as those from low socio-economic populations.
“People who have lower incomes end up smoking from a younger age and, by the time they reach adulthood, they are more heavily nicotine dependent and … it becomes much harder to quit,” she said. “This is a vicious cycle in terms of socio-economic status contributing to high smoking rates, and then high smoking rates contributing to poor health, and then poor health keeping you in that low socio-economic status group, and so on.”
Professor Simon Chapman, Emeritus Professor in the University of Sydney’s School of Public Health, said that targeting high smoking prevalence subgroups sounded sensible “until we unpack what targeting involves”.
“The world-acclaimed, highly successful Australian national Quit campaign has been scandalously mothballed since 2013. So, talk of fracturing what is now a zero-budgeted, non-operational population-wide campaign into multiple targeted campaigns is currently a ‘brave’ call,” he said.
Professor Chapman said that Australia’s main goal should be to restore our “family silver”: properly funded, mass reach campaigns that reach all subgroups.
He pointed to research, published in 2014, that found that the decline in smoking prevalence in Australia – from 23.6% in 2001 to 17.3% in 2011 – was largely due (76%) to stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns.
Professor Chapman said that higher smoking rates among disadvantaged groups were more likely to be explained by higher uptake, than by failure to quit.
Professor Chapman said that labour-intensive interventions were inefficient in preventing uptake among young people.
“It remains the case that most kids who don’t start smoking and most smokers who quit do not attribute their status to a discrete intervention,” he said.
Professor Mike Daube, professor of health policy at Curtin University, welcomed calls for further action on smoking prevalence in disadvantaged groups, and said that a mix of approaches was needed.
See opening statement
Professor Daube said that strong action at the public policy and health system levels was crucial.
“At the policy level, this should include immediate resumption by the federal government of national mass media campaigns, which have, incomprehensibly, been absent over the past 4 years; and action to combat the tobacco industry’s cynical strategies to counter the impacts of tax increases and plain packaging,” he said.
“We also need more than lip service within health systems about the physical health of people with mental health problems, not least through support and assistance in quitting smoking. There are some who try, but they are the exception.”
Professor Daube said that the suggestion that vaporised nicotine may play a role in reducing smoking was “very speculative”, and still “some way ahead of the evidence”.
“[We] should await any determination by the [Therapeutic Goods Administration] as to their safety and efficacy,” he said.
“ NACCHO welcomes the government’s commitment to provide $35.2 million for aboriginal controlled community health bodies to lead the fight against smoking in urban remote and regional communities.
There is still a long way to go in reducing smoking rates among Aboriginal and Torres Strait Islander people but we are making some progress through innovative, effective, evidence led programs by our members with the support of research organisations ”
NACCHO Chair Matthew Cooke said Minister Ken Wyatt had recognised the work that NACCHO’s member organisations do to improve health outcomes for Aboriginal and Torres Strait Islander people.
In this NACCHO News Alert you will find
1.NACCHO Press Release
2.Kimberley AMS Tackling Indigenous Smoking Program (Photo above)
The peak body for Aboriginal medical services today welcomed the government’s commitment to provide $35.2 million for aboriginal controlled community health bodies to lead the fight against smoking in urban remote and regional communities.
National Aboriginal Community Controlled Health Care Organisation Chair Matthew Cooke said the funding would go to front line services to prevent people taking up smoking and encourage smokers to quit.
Mr Cooke said 36 Aboriginal medical services would receive the funding to continue leading programs targeting smoking in their local communities.
“Smoking is responsible for 23 per cent of the health gap between Aboriginal and Torres Strait Islander people and other Australians – and is an overwhelming contributor to higher rates of cancer, strokes and heart disease in our communities,” Mr Cooke said,
“Evidence by researchers in Darwin shows that there are historical reasons why smoking rates are higher among Aboriginal and Torres Strait Islander people.
“That’s why it is so critical that any programs tackling smoking are designed, led and implemented on the ground by Aboriginal and Torres Strait Islander people so they are meaningful for our people and they are effective.”
About 40% Aboriginal and Torres Strait Islander people aged 15 and over smoke daily. Aboriginal people living in remote communities smoke at three times the rate of other Australians.
The latest Closing the Gap report shows that while targets to halving the smoking rates by next year are not on track, there has been a 9 per cent reduction in smoking rates among Aboriginal people since 2002.
2.Photo Above : Deadly Dan and local health representatives are urging Kimberley smokers to kick the habit.
A team of Kimberley smoke-busters has been established to help Aboriginal people kick the habit.
The Kimberley Aboriginal Medical Services’ Tackling Indigenous Smoking program was launched in Broome in 2016 to coincide with World No Tobacco Day.
The 13-person team, embedded in Aboriginal Medical Services in Broome, Derby, Halls Creek and Fitzroy Crossing, will provide support to Aboriginal people to become smoke-free through individual and family-based case management, education programs and other training initiatives.
The program has been funded by the Federal Department of Health and will run until June 2018.
To celebrate the launch of the Kimberley TIS program, KAMS and community health partners hosted a barbecue event at Broome Regional Aboriginal Medical Services.
The Australian Government is committed to ensuring that all actions taken to address high rates of smoking are based on available evidence and delivered in the most appropriate, effective and efficient way. To support this, a review of Tackling Indigenous Smoking was commissioned by the Department of Health. The review was undertaken by the University of Canberra in 2014 and included stakeholder input in various forms.
Informed by the review, the revised TIS programme with a budget of $116.8 million over 3 years ($35.3 million in 2015-16; $37.5 million in 2016-17 and $44 million in 2017-18) was announced by the Government, on 29 May 2015.
The programme consists of the following components:
Regional tobacco control grants to support multi-level approaches to tobacco control that are locally designed and delivered to prevent the uptake of smoking and support smoking cessation among Indigenous Australians, Funding for the new grants commenced from 1 January 2016;
A National Best Practice Unit (NBPU) to support regional tobacco control grant recipients through evidence-based resource sharing, information dissemination, advice and mentoring, workforce development, and monitoring and evaluation, with support and leadership provided by the National Coordinator – Tackling Indigenous Smoking, Professor Tom Calma AO. The NBPU was sourced through an open tender process with a consortium led by Ninti One and including the University of Canberra, University of Sydney and Edith Cowan University is operating the NBPU;
Program Evaluation and Monitoring which includes the design of an evaluation and monitoring framework to be used for the development of local and national performance indicators for grant reporting and to guide overall programme evaluation. The Cultural and Indigenous Research Centre (CIRCA) has been contracted to develop the Programme Evaluation and Monitoring Framework and undertake the evaluation of the TIS program as a whole; and
Innovation grants in remote and very remote areas which have high smoking rates and within specific groups such as pregnant women and young people susceptible to taking up smoking, for commencement in mid-2016.
In addition to the Tackling Indigenous Smoking program, the Australian Government provided $10 million for an Indigenous specific campaign for the National Tobacco Campaign 2016, which commenced on 1 May 2016 across various media.
The campaign, “Don’t Make Smokes Your Story” aims to increase sustained efforts to quit smoking and to reduce smoking uptake, targeting Aboriginal and Torres Strait Islander people, by highlighting the risks associated with smoking and avenues of support within a cultural context.
Indigenous Hip Hop Projects was proud to partner with Katherine West Health Board and Bulla Camp to create this follow up deadly Music Video/ Health Resource.
The key message was focused on the tobacco and smoking issues in the community particularly with people smoking in cars and in the house
South Australia Nunkuwarrin Yunti of South Australia
Allan Sumner is a talented South Australian artist. He is a descendant of three Aboriginal peoples being the Ngarrindjeri people from the lower river and lakes of the Murray River along the Coorong, the Adelaide plains Kaurna people and the Yankunytjatjara people from central Australia.
The Nunkuwarrin Yunti Tackling Tobacco Team contracted Ochre Dawn who approached Allan to create an artwork to illustrate the story that Nunkuwarrin Yunti and the community share in tackling tobacco.
Drawing upon his own experience, 20 years of working in health, tobacco control and on personal health battles “It came to me very easy, to create the artwork” said Allan.
“The Tackling Tobacco Teams new artwork is a contemporary view which has traditional elements present, in particular the symbol in reference to the pregnant mothers and children are popular across many cultural groups. Some of the other symbols, you wouldn’t necessarily see in Aboriginal artwork but they do have meaning.
These new symbols will be used into the future. I think that’s how Aboriginal artwork is bold, it was never ever the same before, the fact is, it’s always taken someone to sit down and recreate something to give it meaning to say this is what I want it to represent, and that’s exactly what I’m doing. My artwork in years to come, my children’s children are going to say ‘that symbol means this’. Aboriginal culture is living and always transforming, it’s never set, it changes over a long period of time, and I’m just a part of creating that culture.”
“Quitting smoking isn’t easy and it’s a narrow path. In the Tackling Tobacco Team artwork, I came up with the idea to illustrate that narrow path. There’s always barriers to why people can’t give up the smokes, so I thought it’s like a river, to get across the river there is narrow paths, then there’s stepping stones in the river, you have to find those stepping stones of support to get across to the fresh air on the other side”.
Further “I wanted the artwork to be vibrant and eye catching so that people stop and take a look. I wanted to really portray the messages well, therefore I put a lot of thought into the descriptions of the symbols used, so that when people look at the artwork they understand the full meaning and story behind it”. Allan explained that the artwork being contemporary in nature containing new stories, cultural symbols and significant meaning, will continue to be linked to Aboriginal history, it will in time become a very valuable story to the viewers.
Tackling Tobacco Team & Robert de Castella, Adrian Dodson-Shaw and Elsie Seriat from Indigenous Marathon Foundation.Thanks for dropping in
QLD The Institute for Urban Indigenous Health Deadly Choices
Murri Places, Smoke-free Spaces is an initiative by The Institute for Urban Indigenous Health aimed at reducing the prevalence of tobacco smoking, particularly within health services and other Aboriginal and Torres Strait Islander workplaces.
It includes smoke-free policies, smoking cessation and nicotine dependence education and support programs for staff and their families. It also encourages creating and identifying smoke-free spaces – including workplaces, houses and cars to increase health and wellbeing in the community.
Going smoke-free is a Deadly Choice – why?
Tobacco smoking is the largest single preventable cause of death and disease in Australia
There are approx. 19,000 smoking related deaths each year
47% of Indigenous people smoke compared to 17% of the Australian population
Smokes cost about $20 per pack, so if you smoke 1 pack of cigarettes a day you’ll spend $7280 per year!
Join the Smoke-Free Team today and get your limited edition jersey
If you have been thinking about giving up the smokes, now is a great time to get support from your local Aboriginal Medical Service.
How to get your limited edition Smoke-Free Team jersey:
Tell your AMS you are interested in joining the Smoke-Free Team and giving up the smokes
Attend four (4) Quit appointments
Take home your limited edition Deadly Choices Smoke-Free Team jersey
Not a smoker? You can still get your jersy by referring a friend or family member. Once they have completed their four (4) Quit appointments, you’ll both get a jersey!
Are you interested in finding out more?
Contact your nearest Aboriginal Medical Service and ask about Quit Smoking programs, Nicotine Replacement Therapy and other supports they can offer.
What’s Your Story, Cape York?’ Facebook page is administrated by the Tackling Indigenous Smoking (TIS) Team at Apunipima Cape York Health Council.
‘Don’t Make Smokes Your Story’ is a national campaign on that shares the real, difficult stories of Aboriginal and Torres Strait Islander people who have smoked tobacco. The campaign was initiated by the Australian Government as part of their plan to …close the gap in Aboriginal and Torres Strait Islander smoking rates.
Winnunga’s Tobacco/Healthy Lifestyle Workers offer health information sessions and stalls at events, schools and workplaces as well as referrals into our No More Boondah (link to be inserted here soon) quit smoking program. Onsite at Winnunga we offer access to a range of programs including healthy cooking and sporting/exercise groups.
Winnunga has a smoke free policy which states that smoking is prohibited on all grounds surrounding Winnunga’s main building, car park and art room.
If you would like to enquire about our team attending your event, workplace or school please call us on 02 6284 6222 and ask for Chanel Webb, Tobacco Action Worker or Ian Bateman, Healthy Lifestyle Worker.
If you would like information about Winnunga’s ‘No More Boondah’ quit smoking program click here or call Perri Chapman, Tobacco Action Worker, on 02 6284 6222.
Be sure to visit our face book page ‘tackling Indigenous smoking & promoting healthy lifestyles’ for the latest updates on smoking and living healthy!
” I want to say some more about New Year Eve resolutions or pledges. Common among smokers around the world is the pledge they make to give up.
This is great, but the common experience is that within a couple of months the pledge is put on the back burner and old habits re-emerge. Now is a good time to mount a campaign to talk to your constituents about the “give up the smokes pledge” and encourage them to call Quitline or visit their doctor to talk about developing a strategy and getting support to quit and stay quit.
It would be great for colleagues to get on the Yarning Place and share successful strategies and to post success stories. We might even want to host a pledge board and to monitor people’s pledges in three and six months’ time.
It has been a big year of learning and successes; please stay safe and healthy over the festive period and enjoy quality family time, drink alcohol responsibly and be smoke free of course “
Professor Tom Calma, National Coordinator for Tackling Indigenous Smoking, in his final Monthly Message of the year : Included in the National Best Practice Unit for Tackling Indigenous Smoking Update of the 12 December 2016 see below , is urging all Aboriginal organisations to take control and resolve in 2017 to implement smoke free workplaces.
‘Our mob have the right to work in a smoke free environment just like everyone else in this country.’
Visit the Tackling Indigenous Smoking portal on Australian Indigenous HealthInfoNet to access resources to help you achieve smoke free workplaces,homes, cars and events:
Tackling smoking in the workplace is often put in the ‘too hard basket’. In 2016 this is no longer excusable.
If we want to make significant inroads into tackling our smoking rates, we must have the courage and will to take control of our workplaces and have Board members, CEOs and Managers and staff step up and set an example to their communities. Our mob have the right to work in a smoke free environment just like everyone else in this country.
On the 30 November this year, the Commonwealth Department of Health celebrated 30 years of being smoke free. Think of the benefits to all those working in this Department over these three decades. Health lead the way in the Commonwealth, with all other Departments becoming smoke free by 1988. Public and private sector offices implemented their own smoke free policies in the mid-1990s. Why is it that Aboriginal and Torres Strait Islander organisations, corporations and workplaces are either not smoke free, or do not enforce smoke free policies?
The Smoke Free Workplace Policy currently operating in the Department bans smoking and use of e-cigarettes/personal vaporisers within 15 metres of all health buildings at all time. There may be elements of this Policy that you can draw on, including ideas on the assistance available to staff to quit. So when you work with or interact with an Aboriginal and Torres Strait Islander organisation or group encourage them to develop a smoke free policy and give them some guidance on how to do it.
The 30 November was also the fourth anniversary of commencement of Australia’s world-leading tobacco plain packaging measures. If we can be world leading on tobacco control for all Australians, we can become leaders in Indigenous tobacco control to save our people, our culture and our languages.
As this is my last message for 2016 I would urge you to place at the top of your New Year resolutions list adopting and enforcing smoke free workplace policies in your organisation and encouraging and helping our Aboriginal and Torres Strait Islander organisations to also realise these goals.
I want to say some more about New Year Eve resolutions or pledges. Common among smokers around the world is the pledge they make to give up. This is great, but the common experience is that within a couple of months the pledge is put on the back burner and old habits re-emerge. Now is a good time to mount a campaign to talk to your constituents about the “give up the smokes pledge” and encourage them to call Quitline or visit their doctor to talk about developing a strategy and getting support to quit and stay quit. It would be great for colleagues to get on the Yarning Place and share successful strategies and to post success stories. We might even want to host a pledge board and to monitor people’s pledges in three and six months’ time.
It has been a big year of learning and successes; please stay safe and healthy over the festive period and enjoy quality family time, drink alcohol responsibly and be smoke free of course. J
“Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people and is responsible for around one in five deaths,”
Through the Council of Australian Governments (COAG), the Australian government has committed to six targets to close the gap in disadvantage between Indigenous and non-Indigenous Australians across health, education and employment.
Two of these targets relate directly to the health portfolio: to close the gap in life expectancy within a generation (by 2031); and to halve the gap in mortality rates for Indigenous children under five within a decade (by 2018).”
As the federal government seeks to raise the average lifespan of Indigenous individuals closer to levels enjoyed by the rest of the population smoking remains under the gun, blamed for one-fifth of the Indigenous death rate.
A recent Health Department tender seeks to add a national organisation to run a drive against smoking by Aboriginal and Torres St Island individuals, to complement existing anti-tobacco regional programs run under the banner of Tackling Indigenous Smoking.
The organisation or consortium chosen to support the current TIS program will be referred to as the National Best Practice Unit for TIS.
Closing date for applications is September 1, Melbourne-based tenders specialist TenderSearch says. Contract execution is listed for October-November and release of operational guidelines for January-February 2016.
The NBPU managing supervisory body will be expected to work mainly with grant recipients funded under the TIS program for regional tobacco control activities, with support and leadership from Professor Tom Calma, the national co-ordinator tackling Indigenous smoking.
The to-do list starts with developing and maintaining operational guidelines for tobacco use reduction among Aboriginal and Torres Strait Islander people. It will provide organisational support to grant recipients responsible for implementing evidence-based approaches to tobacco control.
It will help them develop and implement performance indicators and data collection methods, and
The NBPU will facilitate workforce development for the project, disseminating evidence and information on best practice, building a community of practice, and promoting a culture of evaluation and continuous improvement for the TIS program. There will also be advice and assistance to the department.
“Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people and is responsible for around one in five deaths,” the tender document said.
“Through the Council of Australian Governments (COAG), the Australian government has committed to six targets to close the gap in disadvantage between Indigenous and non-Indigenous Australians across health, education and employment.
“Two of these targets relate directly to the health portfolio: to close the gap in life expectancy within a generation (by 2031); and to halve the gap in mortality rates for Indigenous children under five within a decade (by 2018).
“Under the COAG National Healthcare Agreement, Australian governments have committed to halve the daily smoking rate among Aboriginal and Torres Strait Islander adults (18 or older) from 44.8 per cent in 2008 to 22.4 per cent by 2018.
“Work to reduce high rates of smoking has resulted in a reduction of seven percentage points since 2002, accompanied by a significant increase in the proportion of Aboriginal and Torres Strait Islander people who have never smoked.”
Indigenous-specific activities were required because the strong history and impact of mainstream action in Australia had failed to deliver equivalent reductions in smoking rates within the Aboriginal and Torres Strait Islander population, the tender document said.
Panel includes: Dr Tom Calma AO – National Coordinator, Tackling Indigenous Smoking (pictured above second from left at our recent SMOKE FREE event)
Join Dr Norman Swan and a panel of rural health leaders and advocates as they discuss remote and rural health policy, trends, developments, needs and gaps.
What are the policies we need for equal health outcomes for people in rural and remote communities, and how can we ensure a highly-trained, up-to-date and supported rural-based health workforce? Which policies are working, and which aren’t? What needs to change? Are we making the best use of the scarce rural health dollar?
Join the discussion and share your views. What do you want Health Ministers and politicians to hear from those living and working across rural and remote regions?
Panel includes: Dr Tom Calma AO – National Coordinator, Tackling Indigenous Smoking, Alison Fairleigh – Manager Rural Services, Mental Illness Fellowship of NQ Inc., Prof Sabina Knight – Director of MICRRH, Remote Area Nurse and Dr Jenny May – GP Tamworth NSW, Rural GP Academic and past Chair of NRHA.
LIVE on the Rural Health Channel (Channel 600 on VAST):
Thursday 8th August 2013
8pm NSW, ACT, QLD, VIC & TAS
7.30pm SA & NT
We encourage participation through comments and questions to the panel during the live program.