Preventing young Aboriginal people from starting to smoke
Project title: Understanding what influences smoking initiation for young Aboriginal and Torres Strait Islander people and identifying opportunities for prevention
Start date: July 2016
Estimated end date: January 2020
What is the issue?
Australia is a world leader in tobacco control. Our comprehensive approach of the past decades has resulted in significant declines in adult smoking rates in the Australian population, including for Aboriginal and Torres Strait Islander people, demonstrating change is possible.
Analysis of smoking trends by the Australian Bureau of Statistics found that between 1994 and 2014–15, the proportion of Aboriginal and Torres Strait Islander people who smoked declined from 55% to 45%, although most of these declines were in non-remote areas. Youth smoking rates also declined significantly over this period, with only 17% of young Aboriginal and Torres Strait Islander people aged 15–17 smoking in 2014–15, compared to 30% in 1994. More young people are now identifying as never smokers.
Although the declining rates show a very positive longer-term trend, smoking continues to be the single largest contributor to the gap in disease burden between Aboriginal and non-Aboriginal people, with adult smoking rates almost three times higher. As most smoking commences in adolescence, reducing smoking initiation among young people is critical to reducing the overall smoking prevalence, in combination with efforts to support smoking cessation among established smokers.
If we can understand what has influenced the increase in never smoking among Aboriginal and Torres Strait Islander young people, we will be able to inform the design of more effective prevention programs into the future.
How is the project addressing the issue?
This multi-component PhD project will explore trends in smoking initiation and non-smoking experiences of Aboriginal and Torres Strait Islander adolescents (10–24 years). It will identify the protective individual, social, cultural and environmental factors that influence them to grow up, and stay, smoke-free, and how this varies between groups based on age, location and attitudes/beliefs.
This research program will be conducted within the broader Prevention Centre research project, A Comprehensive Approach to Aboriginal and Torres Strait Islander Tobacco Control.
It will consist of:
- A systematic review of individual, social, cultural and environmental factors that influence smoking among Indigenous adolescents aged 10–24 years living in Australia, New Zealand, Canada and the United States.
- Quantitative analysis of the ABS Aboriginal and Torres Strait Islander Health and Social Surveys (NATSIHS, NATSISS) to explore changes in the age young Aboriginal and Torres Strait Islander people started smoking between 2002 and 2015.
- Quantitative analysis of the Australian Secondary Students’ Alcohol and Drug survey (ASSAD) to explore trends in smoking prevalence among Aboriginal and Torres Strait Islander students and relationship to other substance use between 2005–2017
- Quantitative analysis of data from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH) to identify factors associated with non-smoking among Aboriginal adolescents living in urban and regional New South Wales.
- Qualitative research with Aboriginal adolescents in the SEARCH cohort to explore their stories, attitudes and experiences of non-smoking and to triangulate findings from the quantitative analysis.
Relevance for practice
This project will focus on priority areas as identified by stakeholders. It will work in collaboration with stakeholders to produce findings that are meaningful and actionable for both government and non-government organisations including the Aboriginal Community Controlled Health Sector when developing new programs.
The findings will assist the tobacco control sector to maximise the effectiveness of their youth-targeted projects, in line with the NTS and NATSHIP, and give funding bodies confidence to invest in these types of interventions through an increased understanding of the influences and needs of young Aboriginal and Torres Strait Islander people.
What are the expected outcomes?
At the end of this research, Aboriginal Community Controlled Health Services will have the evidence they need to design programs that reduce smoking by tackling the broader determinants of tobacco use, embedding culture and community connections, and improving health in a holistic way.
Christina Heris, PhD candidate, Prevention Centre, University of Melbourne
Professor Sandra Eades, University of Melbourne
Richard Chenhall, University of Melbourne
Nicola Guerin, Cancer Council Victoria
Lina Gubhaju, University of Melbourne
Louise Lyons, Victorian Aboriginal Community Controlled Health Organisation
Simone Sherriff, Sax Institute
Fiona Skelton, Australian Department of Social Services
Katie Thurber, Australian National University
Vicki White, Cancer Council Victoria
This project was funded by the NHMRC, Australian Government Department of Health, NSW Ministry of Health, ACT Health and the HCF Research Foundation.
- Two papers published
- One paper under review
- Analysis mostly complete for two further papers
- Qualitative research project completed with fieldwork in Wagga Wagga and Sydney; analysis is underway
- Heris C, Thurber K, Wright D, Thomas D, Chamberlain C, Gubhaju L, Sherriff S, McNamara B, Banks E, Smith N, Eades S. Staying smoke‐free: Factors associated with non‐smoking among urban Aboriginal adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Health Promotion Journal of Australia. 2020 Oct 9. do: 10.1002/hpja.430
- Heris CL, Guerin N, Thomas DP, Eades SJ, Chamberlain C, White VM. The decline of smoking initiation among Aboriginal and Torres Strait Islander secondary students: Implications for future policy. Australian and New Zealand Journal of Public Health. 2020. Doi: 10.1111/1753-6405.13022
- Heris C, Guerin N, Thomas D, Chamberlain C, Eades S, White VM. Smoking behaviours and other substance use among Indigenous and non‐Indigenous Australian secondary students, 2017. Drug and Alcohol Review. 2020. doi:10.1111/dar.13130
- Heris CL, Eades SJ, Lyons L, Chamberlain C, Thomas DP. Changes in the age young Aboriginal and Torres Strait Islander people start smoking, 2002–2015. Public Health Res Pract. 2019; Online early publication.
- Heris CL, Chamberlain C, Gubhaju L, Thomas DP, Eades SJ. Factors influencing smoking among Indigenous adolescents aged 10–24 years living in Australia, New Zealand, Canada and the United States: A systematic review. Nicotine Tob Res. 2019. Doi: 10.1093/ntr/ntz219
- 2017 Oceania Tobacco Control Conference
- 2018 Public Health Prevention Conference
- 2018 Australian Public Health Conference
- 2018 Adolescent Health Conference
- 2019 Health Promotion conference, NZ.
- 10 August 2020: Smoking rates falling among Aboriginal and Torres Strait Islander students. Public Health Association of Australia InTouch Magazine.
Prevention Centre News
- Prevention Centre News, March 2019: More Aboriginal people taking up smoking as young adults: study
- Prevention Centre News, March 2017: Learning from the positive stories of Aboriginal teenagers who don’t smoke