Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 10;6(1):135.
doi: 10.1186/s13643-017-0520-9.

Evidence for a comprehensive approach to Aboriginal tobacco control to maintain the decline in smoking: an overview of reviews among Indigenous peoples

Catherine Chamberlain  1   2   3   4   5 , Susan Perlen  6   7 , Sue Brennan  8 , Lucie Rychetnik  9   10 , David Thomas  11 , Raglan Maddox  12   13   14 , Noore Alam  15 , Emily Banks  16 , Andrew Wilson  10   17 , Sandra Eades  6   8   10
Affiliations

Evidence for a comprehensive approach to Aboriginal tobacco control to maintain the decline in smoking: an overview of reviews among Indigenous peoples

Catherine Chamberlain et al. Syst Rev. .

Abstract

Background: Tobacco smoking is a leading cause of disease and premature mortality among Aboriginal and Torres Strait Islander (Indigenous) Australians. While the daily smoking prevalence among Indigenous Australians has declined significantly from 49% in 2001, it remains about three times higher than that of non-Indigenous Australians (39 and 14%, respectively, for age ≥15 years in 2014-15). This overview of systematic reviews aimed to synthesise evidence about reducing tobacco consumption among Indigenous peoples using a comprehensive framework for Indigenous tobacco control in Australia comprised of the National Tobacco Strategy (NTS) and National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) principles and priorities.

Methods: MEDLINE, EMBASE, systematic review and Indigenous health databases were searched (2000 to Jan 2016) for reviews examining the effects of tobacco control interventions among Indigenous peoples. Two reviewers independently screened reviews, extracted data, and assessed review quality using Assessing the Methodological Quality of Systematic Reviews. Data were synthesised narratively by framework domain. Reporting followed the PRISMA statement.

Results: Twenty-one reviews of varying quality were included. There was generally limited Indigenous-specific evidence of effective interventions for reducing smoking; however, many reviewers recommended multifaceted interventions which incorporate Indigenous leadership, partnership and engagement and cultural tailoring. Under the NTS priority areas, reviewers reported evidence for brief smoking cessation interventions and pharmacological support, mass media campaigns (on knowledge and attitudes) and reducing affordability and regulation of tobacco sales. Aspects of intervention implementation related to the NATSIHP domains were less well described and evidence was limited; however, reviewers suggested that cultural tailoring, holistic approaches and building workforce capacity were important strategies to address barriers. There was limited evidence regarding social media and mobile applications, for Indigenous youth, pregnant women and prisoners, and no evidence regarding interventions to protect communities from industry interference, the use of electronic cigarettes, interventions for people experiencing mental illness, juvenile justice, linguistic diversity or 'pubs, clubs and restaurants'.

Conclusions: There is limited Indigenous-specific evidence for most tobacco interventions. A 'comprehensive approach' incorporating NTS and NATSIHP Principles and Priorities of partnership and engagement, evidence from other settings, programme logic and responsive evaluation plans may improve intervention acceptability, effectiveness and implementation and mitigate risks of adapting tobacco evidence for Indigenous Australians.

Keywords: Aboriginal; Framework; Indigenous; Overview; Smoking; Systematic review; Tobacco.

PubMed Disclaimer

Conflict of interest statement

Authors’ information

This overview is led by Indigenous researchers (CC, SE) and conducted in collaboration with other researchers with expertise in tobacco control (SP, DT, RM, NA, EB) and public health (SB, LR, AW).

Ethics approval and consent to participate

Not applicable as this is a systematic review of published data, and no primary data was collected from participants in this study.

Consent for publication

All authors have approved this final manuscript and provided consent for publication.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of included reviews
See this image and copyright information in PMC

References

    1. World Health Organization . MPOWER: a policy package to reverse the tobacco epidemic Geneva. Switzerland: World Health Organization; 2008.
    1. Australian Institute of Health and Welfare . Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2011. Canberra: AIHW; 2016. - PubMed
    1. Australian Institute of Health and Welfare . Australian Burden of Disease Study: impact and causes of illness and death in Australia 2011. Canberra: AIHW; 2016.
    1. Greenhalgh E, Bayly M, Winstanley M. Tobacco in Australia: facts and issues. Melbourne: Cancer Council Victoria; 2015. Prevalence of smoking—young adults.
    1. Australian Bureau of Statistics . In: National Aboriginal and Torres Strait Islander Social Survey, 2014-15. ABS, editor. Canberra: Australian Government; 2016.

Publication types