Spotlight: Indigenous health

Smoking is known to be a leading contributor to disease and death among Aboriginal and Torres Strait Islander adults. A new study has now put a number on it, finding that smoking causes 50 per cent of deaths among Aboriginal and Torres Strait Islander adults aged 45 years and over, and 37 per cent of deaths at any age.

The study, from the Australian National University, reveals Aboriginal and Torres Strait Islander people who smoked died 10 years earlier than non-smokers. 

“The results are shocking – smoking is killing one in two older adults, and we found smokers have four times the risk of early death compared to those who have never smoked,” says study lead Katie Thurber, from ANU.

“This is the first time we have had data specific to Aboriginal and Torres Strait Islander peoples. Our findings show that we have underestimated the impact of smoking. It causes nearly double the deaths that we previously thought.”

Aboriginal and Torres Strait Islander people are smoking at about 2.5–2.6 times the rate of Australia’s non-Indigenous population – about 40% of Indigenous Australians are smokers, compared to about 13–14% of non-Indigenous Australians.

Thurber says it’s well known in Australia and internationally that people who are disadvantaged or have poor mental health are more likely to be smokers. 

“And we know that Aboriginal and Torres Strait Islander people are disproportionately likely to have been excluded from education due to systemic barriers and also to experience poor mental health,” she says.

“So it’s not about being Aboriginal and Torres Strait Islander that makes people more likely to smoke; we have a concentration of the factors that we know are linked to smoking use and some of these go back all the way to British colonisation.”

The study analysed data from 1,388 people followed over 10 years, starting in 2006.

The researchers highlight that no amount of smoking is safe in their paper published in the International Journal of Epidemiology. 

While the prevalence of smoking is dropping in Aboriginal and Torres Strait Islander communities, experts say more action still needs to be taken to reduce this even more. 

“Our national Aboriginal and Torres Strait Islander tobacco control program currently doesn’t reach the whole population,” says co-author Tom Calma, national coordinator for the Tackling Indigenous Smoking programs.

Co-author Raymond Lovett, also from ANU, says that now it’s understand that the burden of smoking mortality for Aboriginal and Torres Strait Islander peoples is probably double what was previously thought, “a natural conclusion would be that we need to at least double the resources, programs and services that we have dedicated to tobacco control in the Aboriginal and Torres Strait Islander population”. 

“So, at the moment we have a national program that we think only covers about 50% of the population, so rolling or extending that out to the whole population would be a good start. And that’s in addition to what the states and territories are already doing under the Closing the Gap arrangements.”