Smoking Cessation Strategies for Indigenous Australians

This assignment delves into the complex issue of smoking cessation within Aboriginal and Torres Strait Islander communities in Australia. It analyzes various studies and research papers that shed light on the prevalence of smoking, contributing factors, and effective intervention strategies tailored to this specific population. The analysis considers social, cultural, psychological, and health-related aspects influencing smoking behavior and explores the role of community-controlled health services in promoting cessation.

Title page
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Contents
Introduction.................................................................................................................................................3
Literature Review........................................................................................................................................3
Search strategy............................................................................................................................................7
Conclusion and Recommendations..............................................................................................................8
References.................................................................................................................................................10
Appendix...................................................................................................................................................12
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Introduction
Smoking has been one of the prevalent concerns for the people in Australia especially for the
aboriginal community. Even though Australia is considered one of the countries to have effective
tobacco control strategies in place it has suffered significant issues with growing tobacco
concerns. The harm minimization of tobacco smoking is extremely important for a country and
when the indigenous people contribute largely to the economic and social and environmental
development of a country it becomes much important to take into account this aspect (Abdullah
et al. 2012). It is quite clear that smoking prevalence among the aboriginals is more than that of
the non-indigenous people and hence it is important for the Government to have stronger
strategies to manage smoking and reduce the impact of smoking(Fiorini et al. 2014). Smoking is
an addictive habit and has significant health impacts and hence it is important for to make sure
suitable strategies are in place which would help to minimize the impact of smoking among
aboriginals. The present study will take an opportunity to critically analyses the subject of
smoking among aboriginals and its risk minimization conundrum with the help of suitable
literature. The search of the literature was mainly implemented with the help of the keywords
like “smoking among aboriginals”, smoking “risk minimization” from the different authentic and
reliable database system. The key points of the discussion are smoking among indigenous
community, development of risk prevention strategy et cetera. Overall the present study will
discuss smoking and its risks and its minimization. The literature sources which have been used
in the present systematic study have been considered with the help of the CASP tool to get the
right kind literature sources to complete the study successfully. Literature sources are discussed
in the critical appraisal section and highlighted in the appendix section for effective
understanding.
Literature Review
Smoking is addictive and over the years the numbers of people captivated by this habit has
increased significantly which has posed serious concern over the countries and the governments
(Abdullah et al. 2014). The governments have experienced hard times to rehabilitate people from
smoking. In Australia, it has become one of the biggest concerns with the aboriginals engaged in
addiction more than ever (Bond et al. 2012). The aboriginals and the Torres Strait Islanders have
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been seen to have two to three times more addiction to smoking which is not at all a good sign
for the country (Passey et al. 2012). It could be said that the aboriginals have played a key role in
the overall growth and development of the country and hence it is essential for the government to
make sure it designs suitable strategies that will help to improve the condition effectively (Roche
& Ober 1997). It is also important to note that the indigenous community has lower awareness of
smoking and hence they engage in smoking more than anybody else. As per the records received
from the above study only 3% of the respondents believed that smoking causes drug related
deaths and this could only happen due to lack of knowledge among the people. Even a
substantial number of females have been seen to chew tobacco and also smoke in Australian
Indigenous community which is definitely another sign of concern (Durkin, Brennan &
Wakefield 2012). Critically analyzing this fact, it could be said that it is due to the lack of
information as well as due to the lack of understanding of the usage of drugs and addiction which
has exacerbated the situation to a large extent. There are number of evidences that come in as
strong support to take the research further (Nicholson et al. 2015).
Most of the indigenous community smokers have had their first cigarette before the age of
sixteen which shows lack of awareness and education is one key reason playing in this fact, the
smoking rate among the aboriginals and Torres Strait Islanders are almost double, again this is
showing that lack of awareness mainly leads to smoking and addiction among the indigenous
people (Stewart et al. 2012). The main problem that has been there for a long time in Australia
for the aboriginals and the Torres Strait Islanders is the morbidity and premature mortality of the
indigenous people due to smoking (Bond et al. 2012). The use of tobacco is probably the most
preventable cause of ill health among the aboriginals in the Australia which clearly shows that
better and develop strategies need to be taken for the effective solution of this issue (Passey et al.
2012). Harm reduction stated in this article definitely shows potential to make the aboriginal
community smoke free. The increase in cessation programs and reduction in passive smoking
programs are definitely effective (Thomas, 2012 National trends in Aboriginal and Torres
Strait Islander). The Aboriginals and Torres Strait Islanders are rehabilitated with certain
lifestyle priorities and effective understanding of the key works which clearly state that in order
to manage aboriginal health there are certain complex strategies required which would help to
make sure the aboriginals are kept away from smoking effectively and make the community
healthier and the future generations smoke free (Ivers 2001).
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There has been a decrease in smoking among the general population of Australia but slowest
among women aged from 25 to 44 (Stewart et al. 2012). The prevalence of smoking has reduced
significantly in the last 20 years and is likely going to get stagnated due to the deep decline but
among the aboriginals the trend doesn’t move visibly due to the ethnic background of the people
who like to be aloof and tend to believe more on their religion which clearly makes them
nonchalantly ignorant with high reluctance to get knowledge about smoking and its side effects
(Thomas et al. 2012). Numerous surveys and studies have showed that the indigenous
communities are interested in smoking more than the non-indigenous communities (Stewart et al.
2012). Critically analyzing the trend in the indigenous community regarding the subject of
smoking it has been seen that the indulgence in smoking has reduced in indigenous men but
again in females it increased rapidly. The indigenous people have high percentage of young
people and they are largely inclined towards smoking and other forms of addiction which clearly
affect the overall development of the community (Fiorini et al. 2014).
Passive smoking is also considered as another key reason for people being impacted by
environmental smoke. It has been seen that overcrowding of housing may contribute to the
higher exposure of smoking and hence it is important for the Australian Government to focus on
developing effective strategies which would help to improve condition among aboriginals
(Stewart et al. 2012). The author has discussed number of key intervention strategies which
would help to make sure that the indigenous people are made aware of the ill effects of the
condition of smoking. Up to around 85% of the indigenous people smoke and hence a large mass
of indigenous community is consumed in smoke (Passey et al. 2012). It cannot be denied that
smoking contains certain medical conditions which is extremely important to be managed. First
of all, smoking causes lung and respiratory disease which is one of the major problems related to
smoking (Stewart et al. 2012). Apart from that TB, obstructive airways and throat cancer are also
certain key health conditions that come with smoking and hence risk minimization is important.
It could be said that the basic risk minimization involves quitting and health promotion (Durkin,
Brennan & Wakefield 2012). Health promotion focuses on the process of enabling the control
over certain addictive mindsets of people and helps them to identify the how quitting can be
done. Promoting health of indigenous people involves cessation program and curative services.
Several types of tobacco programs also help to create awareness among the indigenous people
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that largely help to minimize risk of smoking for the aboriginals and the Torres Strait Islanders
(Gould et al. 2012).
There has been mainly focused on the key risk minimization strategies which have been used by
the healthcare bodies to focus on improving the health of the aboriginals and also improve the
overall community healthcare on addiction (Durkin, Brennan & Wakefield 2012). The author
highlighted the key problems of smoking where cancerous and vascular disease and heart disease
came into the picture and it also showed that the aboriginals don’t have proper healthcare
awareness due to the socioeconomic weakness of the community (Bond et al. 2012). The
aboriginals and the Torres Strait Islanders feel they have been ostracized or have been
compromised due to their social and economic weakness and feel disadvantaged which make
them take up smoking (Passey et al. 2012). To a large extent cultural and spiritual belief also
plays an important role for them taking up smoking. The study clearly shows that engaging the
aboriginals in quitting smoking becomes tough but proper education and awareness creation
through smoking cessation program and negotiating talks regarding smoking (Gould et al. 2012).
The risk minimization is extremely important and it can only happen when proper awareness
could be given to the aboriginals and this study has showed the best possible way to
communicate and create awareness among the people (Durkin, Brennan & Wakefield 2012). The
cessation programs and curative services organized through social service communities have
been effective in understanding the resistance and resilience among people(Stewart et al. 2012).
Another key strategy that the author discusses in this case has been the one on one counseling
procedure which has been extremely effective for the healthcare body of the Government which
has been effective in reducing the risk of smoking by making a lot of aboriginals to quit
smoking(Durkin, Brennan & Wakefield 2012). Overall it could be said that the discussion
effective states the different procedures to manage risk minimization of smoking and also helps
to effectively manage the aboriginals and the Islanders to leave or reduce smoking which is
important for the overall growth and development of the community (Gould et al. 2012).
Many authors have had a critical take on the changes in the smoking intensity among aboriginals
and Torres Strait. The author states that with more cessation program and creation of awareness
the Aboriginals realize the need of leading healthy lifestyle and hence it becomes easier to drive
them into programs and curative services (Passey et al. 2012). Smoking remains a major
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contributory factor to ill health and premature deaths in the aboriginal community which invites
significant awareness and harm reduction approaches (Abdullah et al. 2014). Harm minimization
and reduction approach provides greater scope for the healthcare bodies to involve more and
more aboriginals in Australia. It could be said that irrespective of the approaches taken to reduce
smoking it is important to put greater emphasis on smoke related training for aboriginal health
worker(Gould et al. 2012). One advantage of harm reduction approach that is being showed in
the study is that the health workers who smoke themselves will be largely interested in quitting
smoking. The harm reduction approach initially feels like a punitive approach that completely
denies personal pleasure but it could be said that harm reduction approach is an excellent risk
minimizing approach for the act of smoking among the aboriginals and hence it is definitely
effective (Kable, Pich & Maslin-Prothero 2012). Finally, it is important to understand how
effective is harm minimization for smoking and how does it work? In this scenario, the author
has focused on understanding the efficacy of the risk minimization approach and its impacts on
the aboriginals ( Twyman et al.2014 Perceived barriers to smoking cessation).
Search strategy
The search strategy is an important aspect of a literature discussion. It could be said that most of
the researches are focused on developing a strong search strategy which helps the researcher to
make sure suitable sources are gathered in order to get effective data gathered for the research
(Aveyard et al. 2012). In this case the literature on the subject of smoking on aboriginals was
searched with the help of the different authentic and reliable database which helps to get
effective data (Kable, Pich & Maslin-Prothero 2012). The electronic search was mainly
implemented which helped to get effective data (Tuckman & Harper 2012). Database like
Medline, Cinahl, Health Star, APAIS, the aboriginals and the Torres Strait Islanders
Clearinghouse have been used to gather the data. The search strategy was paced effectively with
the help of the key words like Risk minimization of smoking, smoking among the aboriginals,
and smoking by indigenous population in Australia et cetera. These searches have been able to
provide suitable research data. All the gathered sources were not used by the researcher and only
relevant data mainly done in English have been used which has helped to get the authentic and
reliable data for the systematic literature review (Aveyard et al. 2012). Demonstration is
extremely important and all the studies discussed above have been done with the help of
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qualitative research which has helped to manage suitable results showing the impact of risk
minimization and harm reduction approach. In addition, the information on program delivery
have been found out from the state and territory health department online sites which has helped
to get valid data (Kable, Pich & Maslin-Prothero 2012). The data extraction was supported by
the use of Systematic Review Data Extraction and Quality Appraisal Form where various aspects
of quality of the data and research methods and outcomes have been discussed which has helped
to get the right literature for the study (Tuckman & Harper 2012). The CASP Tool for Critical
appraisal for the Systematic literature review has been used to make sure the right kind of
literature sources are used for the systematic review (Tong et al. 2012). The CASP tool is a
critical appraisal tool which assesses the literature chosen for the systematic literature review and
discusses their validity, reliability and suitability effectively and helps to get effective result for
the research effectively. The CASP tool is an excellent tool that helps to search and filter the
right kind of literature sources for the systematic review and helps to come to a suitable
conclusion (Tuckman & Harper 2012). The literature review has been done to see how risk
minimization and harm reduction could be done and how awareness can be created to address the
objectives of the systematic literature review. Overall it could be said that the search strategy of
the study has been effective and suitable for the present study and has provided with the best
possible data of the research (Kable, Pich & Maslin-Prothero 2012).
Conclusion and Recommendations
To conclude the study, it could be said that harm reduction and risk minimization are two
different approaches which are mostly used to clearly engage the aboriginals to reduce smoking.
All the studies above have tried to answer the conundrum of risk minimization but there is still a
question which has not been answered that is whether in all communities’ risk minimization and
harm reduction are accepted or not. There are number of key factors which play a key role like
the cultural and religious belief of the aboriginals and whether the awareness is readily accepted
by the aboriginals (Wray, Gass & Tiffany 2013). It cannot be denied that there is a significant
debate over the role of the aboriginals in the society and their willingness to take the education
regarding smoking and accordingly lead their lives (Bunge 2012). It also highlights the role of
the healthcare workers who are not with proper training to handle smoking cessation issues and
how to provide them with training. It is important that the aboriginal healthcare workers
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undertake rigorous training and manage their overall process of work effectively which would
help to make sure the work of awareness creation and distribution of education is properly done
regarding this smoking in the aboriginal communities in Australia (Roche & Ober 1997).
Critically appraising the sources, it could be said that the sources used in the literature are
properly poised as they have mainly worked with aboriginals to get the findings which has
showed that aboriginals do respond to awareness and cessation campaigns. Mostly the sources
used observation and interview questionnaire to gather data which is strongly a reliable source to
do qualitative research which showed that risk minimization is a good approach if properly
managed and implemented(Bond et al. 2012). Overall to conclude it could be said that even
though risk minimization is an effective approach it should be paired with cessation and curative
services which would provide the best possible service to the aboriginals. To suggest certain
steps for the process of risk minimization are involving collaborative healthcare work on the
aboriginals and the Torres Strait Islanders which would be funded by the Government, training
and development service provision to the employees which would help them to work and
understand the aboriginals and their problems effectively and constant implementation of
cessation, education and awareness programs which would help to get the best possible results
for them.
Based on the above recommendations it could be said that if the above procedure is followed the
risk minimization program paired with cessation and education campaign it will be funded
effectively for the betterment of the aboriginals and the Torres Strait Islanders.
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References
Thomas, D., 2012. National trends in Aboriginal and Torres Strait Islander smoking and
quitting, 1994–2008. Australian and New Zealand journal of public health, 36(1), pp.24-29.
Thomas, D.P., 2012. Changes in smoking intensity among Aboriginal and Torres Strait
Islander people, 1994-2008. Medical Journal of Australia, 197(9), p.503.
Thomas, D.P., Ferguson, M., Johnston, V. and Brimblecombe, J., 2012. Impact and
perceptions of tobacco tax increase in remote Australian Aboriginal communities. nicotine
& tobacco research, 15(6), pp.1099-1106.
Twyman, L., Bonevski, B., Paul, C. and Bryant, J., 2014. Perceived barriers to smoking
cessation in selected vulnerable groups: a systematic review of the qualitative and
quantitative literature. BMJ open, 4(12), pp. 006414.
Abdullah, A, Stillman, F, Yang, L, Luo, H, Zhang, Z & Samet, J 2014, 'Tobacco Use and
Smoking Cessation Practices among Physicians in Developing Countries: A Literature Review
(1987–2010)', International journal of environmental research and public health, vol. 11, no. 1,
p. 429.
Aveyard, P, Begh, R, Parsons, A & West, R 2012, 'Brief opportunistic smoking cessation
interventions: a systematic review and meta‐analysis to compare advice to quit and offer of
assistance', Addiction, vol. 107, no. 6, pp. 1066-73.
Bond, C, Brough, M, Spurling, G & Hayman, N 2012, '‘It had to be my choice’Indigenous
smoking cessation and negotiations of risk, resistance and resilience', Health, Risk & Society,
vol. 14, no. 6, pp. 565-81.
Bunge, M 2012, Scientific research II: The search for truth, Springer Science & Business
Media.
Durkin, S, Brennan, E & Wakefield, M 2012, 'Mass media campaigns to promote smoking
cessation among adults: an integrative review', Tobacco Control, vol. 21, no. 2, pp. 127-38.
Fiorini, T, Musskopf, ML, Oppermann, RV & Susin, C 2014, 'Is there a positive effect of
smoking cessation on periodontal health? A systematic review', Journal of periodontology, vol.
85, no. 1, pp. 83-91.
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Gould, GS, Munn, J, Watters, T, McEwen, A & Clough, AR 2012, 'Knowledge and views about
maternal tobacco smoking and barriers for cessation in Aboriginal and Torres Strait Islanders: a
systematic review and meta-ethnography', Nicotine & Tobacco Research, vol. 15, no. 5, pp. 863-
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Ivers, R 2001, Indigenous Australians and tobacco: a literature review, Menzies School of
Health Research and the Cooperative Research Centre for Aboriginal and Tropical Health.
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pp. 878-86.
Nicholson, AK, Borland, R, Couzos, S, Stevens, M & Thomas, DP 2015, 'Smoking-related
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Passey, ME, D'este, CA, Stirling, JM & SANSON‐FISHER, RW 2012, 'Factors associated with
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Appendix
Author(s) Year Journal Key findings Notes
Robert West,
Witold Zotanski,
Magdalena
Cedzynska,
Dorota
Lewandowska,
Joanna Pazik,
Paul Aveyard
and John
Stapleton
2011 The New
England Journal
of Medicine
Cytisine was
more effective
than placebo in
smoking
cessation.
Randomization
double blind
controlled trail.
Mohammed
Mohsin and
Adrian E
Bauman
2005 BMC Public
Health
Effective anti-
cessation
strategy could
reduce
complication of
pregnancy due to
the smoking.
Smoking was
high among
pregnant women
especially from
aboriginal,
overseas born
mothers and
affluent were
likely to quit
smoking.
Venessa
Johnston and
David P.
Thomas
2008 Elsevier Social, cultural,
psychological
factor all play
important role in
Especially
family and
kinship play the
role to either
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the influencing
the behavior to
smoke.
continue and
discontinue.
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