“Never smoked” rate increases in adolescent Aboriginal and Torres Strait Islanders

 Prevention Centre

Using data from the Australian Secondary School Students’ Alcohol and Drug Survey, a Prevention Centre PhD project led by Christina Heris found that the proportionAboriginal and Torres Strait Islander adolescents who have never smoked rose from 49% in 2005 to 70% in 2017.

The proportion of Aboriginal and Torres Strait Islander adolescents who have never smoked has increased by 20 % in just over a decade a new study from the Prevention Centre has found.

Using data from the Australian Secondary School Students’ Alcohol and Drug Survey (ASSAD), PhD candidate, Christina Heris found that the age of initiation — taking up smoking — has risen from 49% in 2005 to 70% in 2017.

A new paper, The decline of smoking initiation among Aboriginal and Torres Strait Islander secondary students: Implications for future policy, published in the Australian and New Zealand Journal of Public Health, looked at the relationship between population-level approach to tobacco control and the impact on smoking rates in Aboriginal and Torres Strait Islander adolescents.

Additionally, rates of low smoking intensity increased by 10% from 67% in 2005 to 77 % in 2017 meaning that, overall, the number of cigarettes smoked in a day has decreased amongst smokers in the 12–17 age group.

Key findings

  • The rate of ‘never smoked’ has risen from 49% in 2005 to 70% in 2017
  • Low smoking intensity increased by 10 % from 67% in 2005 to 77% in 2017 in the 12–17 age group
  • Indigenous-led smoking prevention strategies need to continue across the different life stages to ensure smoking uptake continues to decline.

ASSAD is currently the only national data source on tobacco use among Aboriginal and Torres Strait Islander adolescents aged 12–14 years and the largest sample of adolescents aged 12–17 years. The longitudinal nature of ASSAD — using standard methods and measures since 1984 allowed for analysis of trends covering a period of substantial tobacco control policy change in Australia.

“It’s fantastic to see that tobacco control is working for all students, including driving down rates among Aboriginal young people. But we know that young Aboriginal people experience more of the risk factors for smoking such as stress, racisim and disadvantage. There is a need for governments to address these broader determinants.”

Professor Sandra Eades

“This is very good news, particularly the increased rates of never smoking among the early high school students because we know with earlier uptake people smoke for longer and find it harder to stop, not to mention the long-term health impacts.

“The successful impact of comprehensive tobacco control has been to increase never smoking among all Australian students including young Aboriginal and Torres Strait Islander people. But smoking is still far too high among our young people and so we need something extra to accelerate those changes for Aboriginal adolescents.

“Community controlled programs are likely to be the most effective and urgently needed. This is an important piece of work for our communities and for the future of our young people,” said Christina.

Non-smoking advertising campaigns and community education have had cut-through, but what are the implications now for policy and practice. The research shows the importance of underlying social and cultural determinants of smoking in developing tobacco control policy as well as reducing the appeal and availability of tobacco.

“It can be difficult to determine which factors have had the most impact but policy changes like price, plain packaging, and smokefree legislation may have had more impact than campaigns and education,” said Christina.

Christina’s project is supervised by Prevention Centre investigator Professor Sandra Eades, a Noongar woman and the first Aboriginal medical doctor to be awarded a Doctor of Philosophy. Professor Eades started as the Dean and Head of Curtin Medical School in March 2020, and is understood to be Australia’s first appointment of an Indigenous Dean to a medical school.

“It’s fantastic to see that tobacco control is working for all students, including driving down smoking rates among Aboriginal young people. But we know that young Aboriginal people experience more of the risk factors for smoking such as stress, racism and disadvantage. There is a need for governments to address these broader determinants.

“And we also know that building cultural strengths and community controlled programs are important for resilience, wellbeing and supporting our young people to be smoke-free,” said Professor Eades.

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