About the TIS program

The Tackling Indigenous Smoking (TIS) program aims to improve the health of Aboriginal and Torres Strait Islander people by reducing the prevalence of tobacco use through population health promotion activities. The program has a number of parts:

  • regional tobacco control grants (RTCGs) to organisations
  • a National Best Practice Unit for Tackling Indigenous Smoking (NBPU TIS)
  • a National Coordinator for Tackling Indigenous Smoking
  • enhancements to Quitline services
  • Quitskills training
  • a focus on priority groups (including pregnant women and smokers in remote areas)
  • an evaluation of the overall program (process and impact).

Elements of the TIS program

The TIS program is managed and funded by the Australian Government Department of Health’s Preventive Health Section (Indigenous Tobacco).

Regional Tobacco Control Grants

A total of 37 organisations are funded through regional tobacco control grants (RTCGs). The funding is for a population health promotion approach to tobacco control, combining a range of evidence-based tobacco control activities to meet the needs of different population groups within a region.

The program offers flexible funding for organisations to select from various evidence-based approaches with a focus on measurable outcomes for smoking-related behaviour change. Funded organisations select the evidence-based activities that best suit the local context and utilise their strengths.

National Best Practice Unit for Tackling Indigenous Smoking (NBPU TIS)

NBPU TIS provides tailored support to RTCG-funded organisations. The unit assists organisations with TIS-related matters, such as:

  • accessing research, information and resources on population health promotion and tobacco control
  • developing Activity Work Plans for TIS activities
  • developing local measures and monitoring the impact of TIS activities
  • accessing relevant training and networking opportunities.

NBPU TIS is a Ninti One-led consortium which includes the following partners:

Quitline enhancements

The Indigenous Quitline enhancement grants aim to improve the capacity of Quitline services to provide accessible and appropriate services to Aboriginal and Torres Strait Islander people, including enhancements for young people, pregnant women and new mothers.

Quitskills training

This training provides brief intervention and motivational training. It aims to increase tobacco control capacity by growing the number of suitably trained and qualified professionals working with Aboriginal and Torres Strait Islander smokers and their communities.

Priority groups

Pregnant women and smokers in remote areas have been identified as two priority groups for the program.

Pregnancy is said to provide a unique opportunity for health behaviour change, since the woman usually sees so many different health workers who can all reinforce the smoke-free message. Pregnancy provides an exceptional opportunity to support change not just for mum and bub, but also for immediate and extended family. Capacity building in this area is therefore very important. For the TIS program some of this capacity building is provided by iSISTAQUIT.

Run by academics from Newcastle University, iSISTAQUIT is the implementation phase of the randomised control trial SISTAQUIT. iSISTAQUIT is a training program aimed at improving the smoking cessation support given to pregnant Aboriginal and Torres Strait Islander women. It does this by providing best practice training to health-care workers who have contact with pregnant Aboriginal and Torres Strait Islander women. The program includes:

  • self-paced online training in best practice for smoking cessation in pregnancy
  • online training support from other healthcare practitioners
  • a treatment manual
  • additional resources to support smoking cessation care including a flipchart, a patient booklet and a carbon monoxide meter.

The training will be supported by a social marketing campaign.

National Coordinator Tackling Indigenous Smoking

The National Coordinator is Professor Tom Calma AO. Professor Calma delivers advice to the Australian Government about policy development and implementation in relation to Closing the Gap through Tackling Indigenous Smoking. He also provides leadership, support and mentoring to RTCG recipients.

A national evaluation of the overall program

The evaluation of the TIS program is a two-part process:

  • a process and program improvement evaluation is being carried out by the Cultural and Indigenous Research Centre Australia (CIRCA)
  • an impact and outcome evaluation is being carried out by the Australian National University (ANU).

Reflecting on the TIS program

A number of representatives from the NBPU TIS presented at the 2017 Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) Conference. This presentation was an opportunity to: showcase the first year of the TIS program; reflect on progress to date; describe impacts made as a result of the program; and the changes made through working in partnership with the Department of Health, TIS Grant Recipients and the Consortium members. The presentation is available in audio format here.

Some members of the NBPU TIS, as well as some Grant Recipients, also presented at the Australian Evaluation Society’s Annual International Evaluation Conference 2017. Their presentation was about Building robust evaluation systems in Indigenous health: examples from the Tackling Indigenous Smoking program. A pdf version of the presentation is available here.

In 2019, Desley Thompson and Penney Upton from the NBPU TIS presented at the 15th National Rural Health Conference in Hobart. Their presentation was titled Making connections: a systems approach to Tackling Indigenous Smoking, and it focused on the work being carried out by TIS teams, as well as some of the challenges they face. A recording of the presentation is available here.

What are population health promotion activities for tackling smoking?

Population health promotion activities try to change the underlying factors (key causes) contributing to high levels of disease in a population. Examples of population health promotion activities for reducing smoking prevalence include:

  • health promotion activities which use community development to:
    • empower people to have control over their decisions about smoking, including through having information
    • improve environments and circumstances to encourage smoking avoidance
    • work in collaboration with others
  • policies or laws that ban or restrict smoking – for example restrictions on smoking in public places or workplace policies which limit smoking
  • placing a tax on cigarettes to make them more expensive, to discourage people from taking up or continuing to smoke
  • plain packaging laws which discourage people from buying cigarettes by making the packaging less attractive
  • national mass media campaigns that warn about the dangers of smoking and the benefits of quitting or never starting smoking.

Some of these activities such as legislation to ban smoking or increasing the tax on cigarettes are best dealt with at a government level. They are important and recent evidence from Talking About the Smokes Policy and Practice Brief shows they can impact on smoking behaviours in your community but will not be part of the everyday business of organisations delivering the TIS program.

Why are population health promotion activities important?

Population health promotion activities are an important feature of overall tobacco control and are recommended by the World Health Organization (WHO). These activities aim to have a small effect on as many smokers in a population as possible. This is why health promotion activities target the whole community. It is also really important that the activities and information are repeated so that the small effect increases over time. Evidence shows that repeating activities and information can be very effective in motivating people to stop harmful behaviours such as smoking. Encouraging people to move in the right direction is therefore a really important feature of TIS activities.

For preventing and reducing smoking prevalence, it is important for activities to happen at many different levels – whole of population (plain packaging, tobacco taxes), local community (TIS population health promotion activities) and individual (Quitline, clinical smoking cessation support). This is because all of these activities work together to move smokers towards deciding to quit, and then support them to give up and stay off the smokes. At the same time these activities remind the non-smoker why they should not take up smoking.

What are TIS activities?

TIS activities take a community level population health promotion approach which aims to inform and support people in their decisions not to smoke or to quit smoking. These activities will:

  • encourage community involvement in and support for local tobacco control activities
  • increase community understanding of the dangers of smoking and chewing tobacco and the links between tobacco and chronic disease
  • improve knowledge, skills and understanding of the health impacts of smoking and pathways to quitting among workers and community leaders
  • promote the benefits of never becoming a smoker
  • seek to reduce environmental smoke and exposure to passive smoking
  • improve access to targeted support to quit through clinical and non-clinical services.

TIS-funded organisations are part of an overall preventive health system. Access to clinical best practices (behavioural and pharmacological) will help smokers increase their chance of quitting successfully.

A TIS-funded organisation that also has clinical services might offer some of these activities through separate funding agreements. Developing referral pathways to the services available locally, whether located in your own or another service, is a central part of TIS work. Such services include:

Developing skills to deliver brief intervention is also a key activity for TIS-funded organisations, which are expected to promote training opportunities for their staff and to other organisations.

Developing and implementing smoke-free policies within their own organisation, and for other organisations is another key activity that the TIS program supports.

Read more about:

Population health promotion activities and individual level activities that work.

Further reading

WHO (2003). Policy recommendations for smoking cessation and treatment of tobacco dependence.
Menzies School of Health Research (2015). Talking About the Smokes: Policy and practice brief. Volume 1, Issue 1.
Department of Health (2019). Tackling Indigenous Smoking (TIS).