Smoking and mortality among Aboriginal and Islander adults in Australia

In Australia, smoking is responsible for 50% of premature deaths among Aboriginal and Torres Strait Islander adults aged 45 and over, and 37% of deaths at all ages, according to a new study from the Australian National University (ANU).[1].

The study, which followed the health of nearly 1,400 adults, found that smoking caused about 10,000 premature deaths among Aboriginal and Torres Strait Islander people over the past decade. At the time they joined the study, participants had not been diagnosed with cancer or cardiovascular disease (the two leading causes of death in these populations). The study found that never smokers were about twice as likely to live to age 75 and had more than a decade of extra life expectancy, compared to current smokers.

This study is the first to directly and reliably quantify mortality attributable to smoking in the Aboriginal and/or Torres Strait Islander population, which is highly prevalent in the population. Although smoking rates vary across regions and communities and have been declining over the past 15 years (approximately 401.3% of Aboriginal adults reported smoking in 2019, compared to 54.5% in 1994), Aboriginal and Torres Strait Islander populations are nearly 3 times more likely to smoke than non-Indigenous Australians.

High tobacco consumption caused by various factors

The lasting effects of colonial processes, together with those of targeted tobacco marketing, have entrenched commercial tobacco use among Australia's Aboriginal and Torres Strait Islander population.^[2]. Until the 1970s, Aboriginal people were paid for their work with tobacco and used tobacco to barter in order to adopt the same lifestyle as Europeans. In the 1980s and 90s, the tobacco industry directly exploited the culture of these populations with targeted advertising.[3] as evidenced by those of the Winfield brand (BAT) representing an Aboriginal man playing a didgeridoo[4] with the slogan "Australians' response to the peace pipe." More recently, Philip Morris International has attempted to engage Aboriginal and Torres Strait Islander organisations and leaders to promote vaping. Similar efforts have been made by PMI in New Zealand, targeting Māori communities to promote its heated tobacco product. Other factors such as lower incomes, difficulties accessing employment, education and discrimination against these populations also contribute to the high smoking rates.

The need for targeted public health policies for these populations

These findings highlight the magnitude of the harms associated with smoking and the urgent need to prevent smoking initiation and support Aboriginal and Torres Strait Islander smokers to quit. The study demonstrated both the importance of having population-specific data and the need for greater investment in tobacco control programs specifically tailored to Aboriginal and Torres Strait Islander communities. The study highlights that quitting smoking at any age has substantial benefits compared with continuing to smoke. Those who quit before the age of 45 have mortality risks similar to those of non-smokers.

Keywords: Australia, Aborigines, Smoking, Mortality

©Generation Without Tobacco

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[1] Katherine A Thurber, Emily Banks, Grace Joshy, Kay Soga, Alexandra Marmor, Glen Benton, Sarah L White, Sandra Eades, Raglan Maddox, Tom Calma, Raymond Lovett, Tobacco smoking and mortality among Aboriginal and Torres Strait Islander adults in Australia, International Journal of Epidemiology, 2021;, dyaa274, https://doi.org/10.1093/ije/dyaa274 [2] Tobacco Free Generation, Australia: Aborigine smoking rates down, June 26, 2020, accessed January 25, 2021 [3] Waa A, Maddox R, Nez Henderson P, Big tobacco using Trojan horse tactics to exploit Indigenous peoples Tobacco Control 2020;29:e132-e133. doi:10.1136/tobaccocontrol-2020-055766 [4] Musical instrument played by the Aborigines of northern Australia National Committee Against Smoking |