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Providing the evidence base to reduce harmful AOD use in
Aboriginal and Torres Strait Islander communities
The TIS Programme aims to improve the health of Aboriginal and Torres Strait Islander people by reducing the prevalence of tobacco use. The Programme has a number of parts:
Figure 1: Elements of the TIS Programme
The TIS Programme is managed and funded by the Australian Government Department of Health's Indigenous Health Division.
A total of 37 organisations have been provided funding through regional tobacco control grants. The funding is for undertaking multi-level approaches to tobacco control, which combine a range of evidence-based tobacco control activities to meet the needs of different population groups within a region.
Rather than funding provided specifically for the employment of a tackling smoking workforce, the new Programme offers flexible funding for organisations to select from various evidence-based approaches with a focus on measurable outcomes for reducing smoking rates. Organisations involved in rolling out the Programme have the flexibility to select evidence-based mechanisms and tools to reduce tobacco use within their region, that suit the local context and utilise their strengths.
NBPU TIS was established to provide tailored support to organisations funded under the national TIS Programme for regional grants. The unit can assist organisations with TIS-related matters, such as:
NBPU TIS is a Ninti One-led consortium which includes the following partners:
The Indigenous Quitline enhancement grants aim to improve the capacity of Quitline services to provide accessible and appropriate services to Aboriginal and Torres Strait Islander people, including enhancements for young people, pregnant women and new mothers.
This training provides brief intervention and motivational training in best-practice intervention methods aimed at increasing the number of suitably trained and qualified professionals working with Aboriginal and Torres Strait Islander smokers and their communities.
The Innovation Grants support innovative and intense activities to reduce smoking prevalence, through collaborative partnerships between research organisations and service providers. The aim is to increase the evidence-base for implementing effective tobacco control activities in regions or with groups requiring special attention, to support intense work in these areas of need. Innovation Grant projects therefore are intended to specifically address reducing the prevalence of smoking in pregnant mothers, young people and Aboriginal and Torres Strait Islander people living in remote areas. Seven Innovation Grant recipients were announced in 2016.
For more information on the Innovation Grants, please click here.
The National Coordinator is Professor Tom Calma AO. Professor Calma delivers advice to the Australian Government in relation to policy development and implementation in relation to Closing the Gap through Tackling Indigenous Smoking. He also provides leadership, support and mentoring to TIS Programme grant recipients.
A national evaluation of the TIS Programme will take place in 2018. The evaluation of the TIS Programme is being led by the Cultural and Indigenous Research Centre Australia (CIRCA), in conjunction with the Incus Group and the Centre for Health Initiatives, University of Wollongong.
Some useful handouts illustrating the TIS Programme:
There have been a number of Australian Government programs and activities over many years aimed at reducing the prevalence of tobacco use among Aboriginal and Torres Strait Islander people. Tackling Indigenous Smoking has been delivered since 2010, initially through funding for Indigenous Tobacco and Healthy Lifestyle regional teams. In 2015 the TIS Programme was revised and updated following a review carried out by the University of Canberra on behalf of the Australian Government.
From 2015 the emphasis for organisations delivering TIS activities (regional grant holders) is to make sure their activities are based on evidence of effectiveness and that the impact which they are having on smoking in their region is measured.
This new focus on evidence and measuring outcomes is why the Tackling Indigenous Smoking Resource and Information Centre (TISRIC) is so important. The TISRIC has been developed to help TIS-funded organisations choose:
Organisations will collect and report data about their TIS activities which will feed into the independent national evaluation of the overall TIS Programme.
Four key documents for collecting and reporting data about TIS activities are provided by the Department of Health:
Population health activities try to change the underlying factors (key causes) contributing to high levels of disease in a population. Examples of population health activities for reducing smoking prevalence include:
Some of these types of activities such as legislation to ban smoking or increasing the tax on cigarettes are best dealt with at a government level. They are important and recent evidence from Talking About the Smokes shows they can impact on smoking behaviours in your community but will not be part of the everyday business of organisations delivering the TIS Programme.
Population health activities are an important feature of overall tobacco control and are recommended by the World Health Organization (WHO). These activities aim to have a small effect on as many smokers in a population as possible. This is why health promotion activities target the whole community. It is also really important that the activities and information are repeated so that the small effect increases over time. Evidence shows that repeating activities and information can be very effective in motivating people to stop harmful behaviours such as smoking. Encouraging people to move in the right direction is therefore a really important feature of TIS activities.
For preventing and reducing smoking prevalence, it is important for activities to happen at many different levels - whole of population (plain packaging, tobacco taxes), local community (TIS health promotion activities) and individual (Quitline, clinical smoking cessation support). This is because all of these activities work together to move smokers towards deciding to quit, and then support them to give up and stay off the smokes. At the same time these activities remind the non-smoker why they should not take up smoking.
TIS activities take a community health promotion approach which aims to inform and support people in their decisions not to smoke or to quit smoking. These activities will:
TIS-funded organisations are part of an overall preventive health system. Access to clinical best practices (behavioural and pharmacological) will help smokers increase their chance of quitting successfully.
A TIS-funded organisation that has clinical services might offer some of these activities itself. Developing referral pathways to the services available locally, whether your own or another service, is a central part of TIS work. Such services include:
Developing skills to deliver brief intervention is also a key activity for TIS-funded organisations, which are expected to promote training opportunities for their staff and to other organisations.
Developing and implementing smoke-free policies within their own organisation, and for other organisations is another key activity that the TIS Programme supports.
Read more about:
WHO (2003). Policy recommendations for smoking cessation and treatment of tobacco dependence.
Sunstein, C. R., & Thaler, R. (2008). Nudge: Improving decisions about health, wealth, and happiness. Yale University Press: New Haven.
Menzies School of Health Research (2015). Talking About the Smokes: Policy and practice brief. Volume 1, Issue 1.
Department of Health (2015). Tackling Indigenous Smoking (TIS).