25 January 2021.

Important new research using data from the Sax Institute’s 45 and Up Study has revealed the devastating impact of smoking on the mortality rates of Aboriginal and Torres Strait Islander people.

The study provides the first direct estimates of deaths attributed to smoking in this community, finding that it causes around half of all deaths in First Nations people over the age of 45. Over the past decade, this represents over 10,000 deaths that could have been avoided.

The researchers from the Australian National University calculated that Aboriginal and Torres Strait Islander people who never smoked were twice as likely to reach the age of 75 compared with smokers, and on average enjoyed an extra decade of life. Overall, smoking accounts for a third of all deaths among all Aboriginal and Torres Strait Islander people of all ages, the data shows.

Smoking’s effect has been underestimated, the authors say, partly due to the lack of good data and analysis. This study is a world first and shows the tremendous impact a reduction in smoking rates would have on Indigenous health.

For the study, the researchers analysed data from 1,388 Indigenous participants in the 45 and Up Study, who at the outset were cancer-free and had no cardiovascular disease. Participants were followed for over 10 years, starting in 2006.

“The results are shocking – smoking is killing one in two older adults, and we found smokers have four times the risk of early death compared to those who have never smoked,” says lead author Dr Katie Thurber of the National Centre for Epidemiology and Population Health at ANU.

“The results show the more cigarettes you smoke, the higher your risk of death. Even smoking between one to 14 cigarettes per day triples your risk of early death compared to never smoking. No amount of smoking is safe.”

Although smoking prevalence is dropping in Aboriginal and Torres Strait Islander communities, experts are calling for more action to reduce smoking.

Senior author Associate Professor Raymond Lovett says Australians should reflect on their colonial history and how commercial tobacco was introduced to Aboriginal and Torres Strait Islander peoples to be used as a form of payment, which has caused nicotine dependence.

But the good news, he says, is the way Indigenous people have stepped up to develop and implement smoking reduction initiatives in their communities.

“Aboriginal and Torres Strait Islander peoples and local communities are leading the way in tobacco control efforts and how they want to address tobacco use in their community through the Tackling Indigenous Smoking program. This is a great example of self-determination.”

The paper is published in the International Journal of Epidemiology.