The decline of smoking initiation among Aboriginal and Torres Strait Islander secondary students: implications for future policy

Abstract

Objective: Smoking is a major cause of preventable illness for Aboriginal and Torres Strait Islander people, with most commencing in adolescence. Understanding trends in youth tobacco use can inform prevention policies and programs. Methods: Logistic regression models examined smoking trends among Aboriginal and Torres Strait Islander and all students aged 12-17 years, in five nationally representative triennial surveys, 2005-2017. Outcomes measured lifetime, past month, past week tobacco use and number of cigarettes smoked daily (smoking intensity). Results: Aboriginal and Torres Strait Islander students' never smoking increased (2005: 49%, 2017: 70%) with corresponding declines in past month and week smoking. Smoking intensity reduced among current smokers (low intensity increased 2005: 67%, 2017: 77%). Trends over time were similar for Aboriginal and Torres Strait Islander students as for all students (8-10% annual increase in never smoking). Conclusions: Most Aboriginal and Torres Strait Islander students are now never smokers. Comparable declines indicate similar policy impact for Aboriginal and Torres Strait Islander and all students. Implications for Public Health: Comprehensive population-based tobacco control policies can impact all students. Continued investment, including in communities, is needed to maintain and accelerate reductions among Aboriginal and Torres Strait Islander students to achieve equivalent prevalence rates and reduce health inequities.

E‐cigarette use and the relationship to smoking among Aboriginal and Torres Strait Islander and non‐Indigenous Australian Secondary Students, 2017

“…[28][29][30] Between 2005 and 2017 never smoking increased significantly among Aboriginal and Torres Strait Islander students aged 12-17 years from 49% to 70% and a significant decline of current smoking from 21% to 10%. 29 Similarly, for the total population of students aged 12-17 years, never smoking increased from 63% to 81% and current smoking declined from 10% to 5%. However, further and ongoing declines are required to bring Aboriginal and Torres Strait Islander smoking prevalence down in line with the broader population and see improvements in future health outcomes.…”

“…25,26 Despite this, through decades of comprehensive tobacco control, Australia has successfully driven smoking rates down to record lows among the overall population of young people, 27 as well as among Aboriginal and Torres Strait Islander youth specifically. [28][29][30] Between 2005 and 2017 never smoking increased significantly among Aboriginal and Torres Strait Islander students aged 12-17 years from 49% to 70% and a significant decline of current smoking from 21% to 10%. 29 Similarly, for the total population of students aged 12-17 years, never smoking increased from 63% to 81% and current smoking declined from 10% to 5%.…”

“…The higher prevalence of tobacco use among Aboriginal and Torres Strait Islander people is inextricably linked to colonisation, from the introduction of commercial tobacco by settlers and its use as a means of payment and control, including in rations to historical and contemporary processes that entrench inequities in all social determinants of health, reinforcing the conditions that lead to smoking and the normalisation of use, including systemic racism 25,26 . Despite this, through decades of comprehensive tobacco control, Australia has successfully driven smoking rates down to record lows among the overall population of young people, 27 as well as among Aboriginal and Torres Strait Islander youth specifically 28-30 . Between 2005 and 2017 never smoking increased significantly among Aboriginal and Torres Strait Islander students aged 12–17 years from 49% to 70% and a significant decline of current smoking from 21% to 10% 29 .…”

“They Were Willing to Work with Me and Not Pressure Me”: A Qualitative Investigation into the Features of Value of a Smoking Cessation in Pregnancy Program for Aboriginal and Torres Strait Islander Women

“…Tobacco smoking during pregnancy is one of the most important and modifiable risk factors leading to the unacceptable disparity in Indigenous maternal and infant health outcomes internationally [5]. In Australia, despite recent trends showing reductions in tobacco smoking initiation rates among Aboriginal and Torres Strait Islander youth [6], smoking levels remain high, particularly in pregnancy, whereby an estimated 44% of Aboriginal and Torres Strait Islander women smoked during pregnancy in 2018: a notable decrease from 52% in 2009, but still significantly higher than 9.6% observed among their non-Indigenous Australian peers [7].…”

Health‐risk behaviours among Indigenous Australians with diabetes: A study in the integrated Diabetes Education and Eye Screening (iDEES) project

“…Smoking is the leading cause of preventable diseases and death in both non‐Indigenous and Indigenous Australians, and although smoking rates have significantly declined over the years in both groups (Australian Institute of Health & Welfare, 2020c), smoking rates among Indigenous Australians are 37%, and the proportion aged 15 years and over who smoke daily is similar for males (39%) and females (36%; ABS, 2019), almost three‐fold higher (Australian Bureau of Statistics, 2019) compared with non‐Indigenous Australians (Heris et al, 2020). Of those who smoke, the risk of diabetes increases and once diabetes is present, smoking can have adverse effects on blood glucose control, worsening chronic hyperglycaemia and also chronic diabetes complications, including cardiovascular disease and premature mortality (Szwarcbard et al, 2020).…”