Reducing Aboriginal and Torres Strait islander smoking has been a central element in the government’s efforts to Close the Gap. What does the new Health Minister Tanya Plibersek think of Nicola Roxon’s promise to halve the prevalence of indigenous smoking by 2018?
Unlike us, politicians do not have an annual cycle of New Year’s resolutions that are quickly broken or forgotten by mid-January. Politicians can make rash, seemingly bold, promises to fill a sound bite on any day. These may be achievable or be proven to be embarrassingly impossible. Everyone remembers Hawke’s promise that no child will live in poverty. Most are, of course, forgotten by all but a few pedantic political tragics and political foes. And timelines (like 2018) are usually so distant that the promising politician will be long gone and not accountable.
A new report outlines the size of the task ahead. It is well-known that indigenous smoking prevalence is more than double that of other Australians. What is less well known is that indigenous smoking prevalence has been coming down since the first reliable national survey in 1994. Smoking among indigenous men fell by about 0.4% each year, in remote and non-remote areas, from 58.5% in 1994 to 52.6% in 2008. Smoking in indigenous women also fell by 0.5% per annum in non-remote areas. These trends are about the same size as the absolute falls in smoking prevalence among all Australian women, and about half the size of the falls among all Australian men. However, smoking was still increasing in indigenous women living in remote areas.
Despite of few Quit support services or campaigns targeting indigenous people, apart from those provided routinely by doctors and health services, the report found a consistent increase in quitting from 2002 to 2008. The percentage of indigenous people who had ever smoked but had now quit increased by about 1% per annum in men and women in remote and non-remote areas.
These encouraging trends occurred when there was little attention to reducing indigenous smoking. This government has committed $100 million to reducing indigenous smoking, with many new indigenous tobacco workers, an indigenous social marketing campaign (including television ads), and improved access to Quitline services and nicotine replacement therapy. This complements improved mainstream tobacco control policies such as the tobacco tax excise increase, the national social marketing campaigns, plain packaging, and improved smoke-free and retail display legislation.
But to meet Roxon’s promise, indigenous smoking prevalence will have to fall more than six times as quickly as these historical trends, and much faster than smoking fell in the whole population in response to other campaigns in Australia or America.
Roxon’s promise may be very difficult for Plibersek or her successors to realise, but at least it has been matched with clear intent and real funding by this government.
Indigenous smoking will eventually be half the current prevalence, but maybe not by 2018, hopefully soon after. Smoking has been causing far too many deaths and too much sickness in Aboriginal and Torres Strait islander families and communities for too long. In response, the Coalition has only grumbled waste and duplication rather than come up with its own funded plan and targets.
*David Thomas is head of the tobacco control research program at the Menzies School of Health Research, and associate director, research and innovation at the Lowitja Institute in Darwin