Indigenous Australians achieve major progress in reducing smoking, but tobacco’s lethal legacy remains

The number of smoking-related deaths among Aboriginal and Torres Strait Islander Australians is predicted to continue to increase, and to peak over the next decade, resulting in thousands of premature deaths that are largely preventable.

In a paper in the latest edition of the Sax Institute’s journal Public Health Research & Practice, researchers report that there have been substantial reductions in smoking prevalence among Indigenous Australians – from 55% in 1994 down to 41% in 2014–15. However the lag between smoking and its associated cancer mortality means the number of smoking deaths is likely to keep climbing in the near future.

“We have seen significant decreases in smoking prevalence among Aboriginal and Torres Strait Islander adults, which will bring substantial health benefit in both the short and long term. However, we will continue to see the health consequences of tobacco use from up to 30 years ago – when smoking prevalence was at its peak – because of the delay between smoking and the onset of diseases such as lung cancer,” said Dr Raymond Lovett, from the National Centre for Epidemiology and Population Health at the Australian National University.

“We are about to see the full effects of tobacco’s lethal legacy on Aboriginal and Torres Strait Islander peoples. While warning of these impacts, it is important to also note that there has been substantial progress in reducing tobacco use, particularly in the last decade, and this will not be reflected in current mortality patterns.

“The progress we have seen gives us a clear sign that we can further reduce smoking prevalence and improve Indigenous health. We need a continued comprehensive approach to tobacco control, and the incorporation of Indigenous leadership, long-term investment and the provision of culturally appropriate materials and activities is critical to further reducing tobacco use.”

The article is part of a special issue of the journal, which celebrates 50 years since the 1967 referendum, when Australians voted to amend the constitution to allow the Commonwealth to create laws for Indigenous people and include them in the Census.

The issue also includes an interview with the Minister for Indigenous Health, Ken Wyatt, discussing achievements and failures in Indigenous health over the past 50 years.

The Minister said research was increasingly being done in partnership with Indigenous researchers and communities, with greater acknowledgement of the socio-economic, cultural and environmental factors that affect Indigenous health.

“We’re seeing over the past two decades greater referencing made to social determinants of health and the logical framing of the reasons for needing to address education, employment, community safety, training and housing,” Mr Wyatt said.

The Minister said in future he would like to see more focus on young Indigenous people, particularly greater understanding of the drivers of resilience and suicide.

Other articles in the issue include a discussion about the impact and causes of illness and death in Indigenous people, and a description of a NSW initiative to strengthen the Aboriginal public health workforce.

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Public Health Research & Practice is a peer-reviewed, Medline-listed quarterly online journal published by the Sax Institute. Subscribe for free at