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Providing the evidence base to reduce harmful AOD use in
Aboriginal and Torres Strait Islander communities
Reducing second-hand smoke is an important aim. This is because second-hand smoke can be very harmful. The evidence also shows that if smoking is seen as ‘normal’ at a community level, young people are more likely to start smoking, and current smokers will find it harder to quit. Increasing the extent to which a community is smoke-free is associated with less smoking and more success in quitting. Relevant activities include the following:
To be successful, smoke-free policies need community participation – not just consultation – in their development. Policies that have local ownership and commitment are more likely to be followed. There is also evidence that introducing smoke-free policies in the workplace can lead to increased support for smoke-free spaces in other areas such as smoke-free homes and cars. Successful smoke-free workplace policies also result in more workers wanting to quit.
Combining locally owned smoke-free policies with access to quit support services increases the success of these policies. Working in an environment with a smoke free policy can also encourage individuals to quit.
Here are some quick tips on setting up a smoke free environment: How to set up a smoke-free environment
The Aboriginal Health and Medical Research Council (AH&MRC) of New South Wales provide a good set of resources to help you support workplaces to set up smokefree policies.The second module, Workplace smoking policy in the Aboriginal tobacco resistance toolkit provides; advice on how to begin the process, templates for worker consultation, and templates to assess how much smoking happens at work.
Second-hand smoke is a health risk factor, particularly for children. Children are at greater risk for a number of reasons, including their size, faster breathing rates and less developed respiratory and immune systems. Second-hand smoke is associated with a number of childhood illnesses including:
Second-hand smoke is also believed to contribute to the risk of sudden infant death syndrome (SIDS).
There is good evidence that having a smoke-free home and car improves children’s health. There is also some evidence that keeping the home smoke-free helps to prevent uptake of smoking by young people. There are therefore many good reasons to support people to have smoke-free homes and cars.
A recent review found that intensive counselling methods or motivational interviewing with parents to be most effective for reducing children’s tobacco smoke exposure in the home. There is some indication that school-based education, intensive home visits, brief education provided to parents in clinics (including scheduled children’s health checks) and culturally sensitive health promotion brochures may also help reduce second-hand smoke in the home and car.
Menzies developed Healthy starts: reducing the health effects of smoking around Indigenous babies and children, a resource to support health providers when discussing second-hand tobacco smoke with families, and to encourage families to have smoke-free homes.
A number of resources provided by the Asthma Foundation of WA, such as the Newborns asthma parental smoking project: Indigenous women's project resources are also available including brochures, posters and a booklet, all aimed at encouraging a smoke-free environment for mother and baby.
Any opportunity to reduce second-hand smoke is a good investment because there is no safe level of exposure to second-hand smoke, and smoke-free events both denormalise smoking and encourage people to think about quitting. Furthermore a recent survey, Talking About The Smokes (TATS) found that support for smoke-free festivals and events is strong in Aboriginal and Torres Strait Islander communities, particularly among those who don't smoke: for never smokers, support was 71%, for ex-smokers 65%, and for non-daily smokers 70%. Half of all daily smokers were in favour of smoke-free events (51%).
Campbell S, Bohanna I, McKeown-Young D, Esterman A, Cadet-James Y, & McDermott R, (2014) Evaluation of a community-based tobacco control intervention in five remote north Queensland Indigenous communities. International Journal of Health Promotion and Education, 52(2); 78-89, doi: 10.1080/14635240.2013.859444.
Davey M E, Foster R, Van der Sterren A E, et al. (2015) Tobacco control policy and activities in Aboriginal community-controlled health services. Medical Journal of Australia; 202 (10 Suppl): S63-S66.
Raglan M, Comfort J. (2014) Smoke-free policy catalysts, development, implementation and maintenance in Aboriginal and Torres Strait Islander community settings. Australian Aboriginal Studies; 2: 85.
Robertson J, Pointing, B S, Stevenson L, & Clough A R (2013) 'We made the rule, we have to stick to it': towards effective management of environmental tobacco smoke in remote Australian Aboriginal communities. International Journal of Environmental Research and Public Health; 10(10), 4944-4966.
Stevenson L C, Robertson J A, & Clough A R (2013) Aboriginal people in remote communities in Arnhem Land (Northern Territory) restrict their smoking in some environments: Implications for developing and implementing interventions to reduce exposure to environmental tobacco smoke. Drug and Alcohol Review, 32(6), 627-630.