Torres Health’s mascot Malu with a selection of TIS resources
Developing program resources and health promotion collateral is an important part of the Tackling Indigenous Smoking (TIS) work. Working with the community to co-design and co-create locally relevant resources is recognised as the best way to ensure resources are effective. This is because resources that are developed with the community are more likely to reflect community experiences, priorities and values. This in turn makes them more relatable, believable, and persuasive. Resources co-designed with the community are also evidence-based because they preference local Aboriginal and Torres Strait Islander knowledge and voices. This webinar from The Matilda Centre describes the co-design of vaping resources for Aboriginal and Torres Strait Islander youth.
Building resources with community input is also a good way to increase community engagement with the program. This also empowers the community, giving them ownership of the program and its resources. As the World Health Organization explains, this builds community capacity for change, and supports them to take back control over their the health decisions that affect their lives. Finally, when resource development involves the community, it also becomes another opportunity to share knowledge and information about smoking and vaping and pathways to quitting. This knowledge sharing should be a two-way process. As well as sharing information about the benefits of being smoke and vape free, co-design workshops provide an opportunity to learn more about local experiences and identify program ambassadors.
Locally developed branding that uses recognisable artwork and includes locally meaningful colours, symbols and patterns, is more likely to be seen as reliable and relatable. This means that the message it delivers is more likely to be listen to and believed. This will ensure that any messaging is more effective for changing attitudes, knowledge and behavioural intentions. Where local people have been involved in the development of that branding, community also feel ownership of both the branding and the messaging it delivers.
In marketing terms, a slogan is a powerful brand promise. For health promotion slogans are descriptive one-liners that remind people what a program (brand) is all about. It’s another way of making the health promotion message memorable. Make the message ‘stick’ by using:
Slogans should also be relevant to the program message (this makes them meaningful) and easy to understand. Using plain language and a simple message will also make it easier for people to understanding and remember the main meaning of the message. Using local language and expressions will also help make the slogan memorable and meaningful.
Central Australian Aboriginal Congress slogan – ‘Smoke free, the way to be’
Eye catching branding and short direct messaging are a great way to catch people’s attention. Once you have their attention you need them to understand and believe your message. There are several ways of doing this:
Nganampa Health Council ‘Protect the children from the effects of smoking’ poster by Pitjantjatjara artist and Aboriginal Health Worker Pantjiti Lewis
Research evidence supports the use of strengths-based messaging. Evidence has suggested that the impact of warning messages reduces over time, with people who smoke becoming desensitised or immune to graphic imagery and shock tactics. Deficit messages which reinforce ill-health and disadvantage can also be disempowering for the community. Avoiding messages which suggest individual blame or shame should therefore be avoided. This includes not labelling people by their behaviour. For example, talking about ‘people who smoke,’ not ‘smokers’.
Focusing on strengths-based messaging does not mean that talking about the harm that smoking or vaping causes is taboo. However evidence shows that making the message about the benefits of not smoking or vaping (“gains framed messaging”) rather than the harms of smoking or vaping (“loss framed messaging”) is more effective (see Box 1). Thinking about what will motivate people to quit can help. Important motivators include:
There is also evidence that strengths-based messaging separates individual and cultural identity from smoking behaviours. For example, the message that ‘Tobacco smoke harms, traditional smoke heals’ or the emphasis on ‘Tobacco smoking is not our culture’.
Recent evidence from Canadian First Nations researchers identifies a number of strengths that can be used to reinforce health education messages. These include:
Grand Pacific Health’s ‘Smoking is not a part of our culture’ campaign
Box 1: Gain-Framed and Loss-Framed Health Promotion Messages
Health promotion messages can either be framed positively, highlighting the benefits of quitting (strengths-based or ‘gain-framed’), or negatively, emphasising the risks of continuing to smoke (deficit-based or ‘loss-framed’).
For example:
Gain-framed message: “Quitting smoking reduces your risk of lung cancer.” Loss-framed message: “Smoking increases your risk of lung cancer.”
Anti-smoking campaigns often focus on the dangers of smoking (loss framing). However, research suggests emphasising the positive outcomes of quitting (gain framing) is an effective strategy to encourage people to quit smoking.
Good health promotion is not just about sharing knowledge and information. Educational resources are a good starting point for changing attitudes and behavioural intentions but are more effective when they include a call to action (CTA). A CTA encourages people to respond the message shared on the resource, for example by committing never to vape, calling the Quitline or pledging to have a smoke and vape free home and car. A CTA should be easy to remember, compelling and appealing. You can read more about CTAs on this page.
You can also watch the video below from the NBPU TIS to learn more about how to create an effective call to action.
In summary, effective resources:
Teams are encouraged to talk to their NBPU TIS Program Officer throughout the resource development process. Program Officers can give feedback to make sure resources are in-line with TIS program principles and take advantage of the latest evidence. They can also act as a proof-reader. See this factsheet for more information.
Community engagement is important for population health promotion programs because according to the evidence this creates successful activities which leads to better outcomes. Partnerships between TIS program funded organisations and members of the communities they work with is empowering for community. Activities and calls to action can be tailored to the values of the community. This gives the community ownership of the program leading to greater engagement with the TIS message.
Building community connections is an important part of activity planning. Co-creating activities with community leaders, community groups or health service providers is part of the program’s success. The community should be engaged at all stages of activity design and development including resource development. You can collaborate to develop any of your activities with community, including mass media and social media campaigns, other social media activities, community education programs, and supporting smoke-free environments. You can read more about building connections on the planning page here.
Evidence suggests that one important reason many adults decide to quit smoking is because they want to be a role model for children, grandchildren, or other family and friends. There is good evidence that role models can champion smoke free behaviours, prevent uptake of smoking and support others to make their homes and cars smoke and vape free. According to the Talking about the Smokes (TATS) study most people who smoked daily (90%) agreed that not smoking sets a good example to children.
Recent evidence tells us that local champions can increase uptake of quit supports like Quitline. Deadly Choices provide a good example of the successful use of champions or ambassadors for Tobacco Control. Their brand ambassadors are sporting heroes who showcase their healthy choices and encourage others to follow their lead. Ambassadors, champions and role models do not need to be famous. Local heroes can also help engage the community and share the TIS message effectively, persuading others to follow their lead and quit for good – or never start smoking or vaping. See below for examples of TIS teams using local ambassadors in their campaigns.
Wellington Aboriginal Corporation Health Service’s Quit B Fit smoke-free signage at a community event
An important way of engaging with community is through interactions at community events such as:
Engagement starts with making sure community is onboard with this being a smoke-free event.
Any opportunity to reduce second-hand smoke is a good investment because there is no safe level of exposure to second-hand smoke, and smoke-free events both denormalise smoking and encourage people to think about quitting. The Talking About The Smokes (TATS) study found that support for smoke-free festivals and events is strong in Aboriginal and Torres Strait Islander communities, particularly among those who don’t smoke:
At the event, keep people engaged with the message by including call outs over the information system reminding people why this is a smoke and vape free event. If there are designated smoking/vaping areas point them to these – remember it is much better if these are outside of the venue and away from the entrance. You might also promote your stall. Make sure you agree this with the event organisers in advance so that it doesn’t get overlooked on the day. Have banners and smoke/vape free messaging across the venue.
Having a stall at the event will allow you to further engage the community with your message. Try to have fun and interesting activities for kids and adults that are engaging but informative about smoking/vaping. You might run a competition, use resources such as jar of tar, smoker’s lungs model, a model cigarette or vape to encourage people to come to your stall to find out more. Have plenty of information and health promotion collateral for them to take away. Call for people to make a pledge to be smoke free at home and in the car. Read this factsheet for more information on designing smoke-free pledges.
Central Australian Aboriginal Congress’s TIS team at a NAIDOC Week event
Very brief advice (VBA) is an evidence-based approach to increasing quit attempts. The purpose of VBA is to engage with people who smoke and get them to think about quitting. The aim is not to tell people how they should behave (quit smoking), but to guide them to the quit support that is available. VBA focuses on offering help by providing:
The video below provides examples of how TIS Workers can engage with someone who smokes or vapes and get them to think about quitting, guiding them to the available support. You can also view the individual examples of yarning with someone at a mums and bubs group; a footy carnival; and a school vaping session.
VBA is an opportunistic, non-intrusive and respectful approach which can be used by anyone, in any setting, including community settings. VBA is not smoking cessation therapy and does not require formal counselling skills or knowledge of the stages of behaviour change because:
In simple terms VBA is a short conversation lasting from 30 seconds to a couple of minutes during which you:
Because of the opportunistic non-clinical nature of VBA, anyone who has contact with people who smoke from Aboriginal and Torres Strait Islander communities should be able to provide this including:
According to a review of the evidence, brief simple advice about quitting smoking increases the likelihood that someone who smokes will successfully quit and remain smoke-free 12 months later.
This document provides TIS teams with examples of eligible activities for the July 2024-2027 funding period and how to monitor and evaluate them. It includes examples of community engagement activities and how they can be monitored and evaluated.
Community education can take place in many settings, from informal community events through to more formal school settings.
Providing health promotion for primary and secondary school age students is an important way to prevent the uptake of smoking and vaping by youth. The published evidence around addressing vaping comes mainly from mainstream work in the USA and Canada. This evidence suggests that effective population health promotion activities are in line with those currently recommended for educating youth about smoking. There is also evidence that Peer-led programs that leverage social networks make anti-vaping education programs more persuasive and relevant to challenging social influences and changing social norms. This suggests that integrating education about vaping into existing programs and activities with youth is the best approach. However, it is also important to present clear and accurate information about the differences between smoking and vaping.
Source: American Indian Cancer Foundation
Recommendations for effective education messages about vaping include:
A recent systematic review suggests that messages about nicotine addiction are less persuasive compared to information about the harmful chemicals in vapes, possible lung harm, and brain effects. It is important to ensure that any activities are tailored for Aboriginal and Torres Strait Islander youth. This will include describing the benefits of never vaping/stopping vaping as well as the harms of vaping. Another suggestion for Indigenous specific messaging comes from the American Indian Cancer Foundation which uses the headline ‘E-cigarettes are not our tradition’.
There is evidence that school-based education activities have an increased chance of working if they:
Danila Dilba staff delivering a school education session
Linking school-based interventions into wider community activities as part of a multi-component program also seems to boost impact. This is thought to be because the effects of school-based smoking and/or vaping prevention programs are sustained when changes in the larger community are also present and when there is reinforcement of the program over time. A review of the evidence also recommended that 15 or more sessions are delivered to young people at school, at least up until the ages of 14 or 15 years.
Evaluated school-based health education activities for Aboriginal and Torres Strait Islander young people, include the Deadly Choices program, an interactive education program of eight weeks which encourages young people to be positive lifestyle role models. Since 2010 this program has been delivered to more than 250 Aboriginal and Torres Strait Islander students across 20 schools and training centres throughout South East Queensland and has been found to have a positive impact in the urban setting on students’ knowledge, attitudes and self-efficacy regarding leadership, chronic disease and the impact of risk factors including smoking. These are recognised as important steps towards reducing the number of young people taking up smoking and increasing the number of young people who quit smoking.
Graduates of the Deadly Choices Tobacco Education Program
Guide to developing a smoke-free workplace policy
Educational activities for adults are often delivered in existing community groups or in workplaces as part of a program to support workplaces to develop, review or implement smoke and vape free policies. Linking into groups where you know priority populations can be found is usually a very successful approach. Examples include: ‘Mums and bubs’ groups, men’s sheds, Aboriginal Land Councils, Indigenous Ranger Groups, and Art and Cultural Centres. Connecting with people wherever they gather in the local community is a great way to enable the program to reach people who do not use community-controlled health services. Outreach programs delivered to remote communities might also include an element of education.
Evidence tells us that effective community education programs:
Information and resources should be tailored to the needs of the audience. Topics to consider include:
Kimberley Aboriginal Medical Service Mums and Bubs brochure
Community education can also be provided through:
For more ideas about community education view the TIS team success stories. Resources to support community education can be found here.
This document provides TIS teams with examples of eligible activities for the July 2024-2027 funding period and how to monitor and evaluate them. It includes examples of community education activities and how they can be monitored and evaluated.
Social media and social networking tools like Facebook, Instagram, TikTok, YouTube and LinkedIn can help tackle smoking and vaping, particularly with youth. One advantage of these platforms is that they are accessible, low cost and familiar to young people. Research suggests Aboriginal and Torres Strait Islander people use social media at higher rates than non-Indigenous Australians. They use platforms like Facebook to connect, share support, and access health information in culturally meaningful ways. Social media helps strengthen mental, emotional, cultural, and social connections that are central to Aboriginal people’s understanding of health.
Social media is popular even in remote communities, where access to the internet can be limited. This makes social media a valuable communication tool and a cost effective way to announce events, increasing their visibility and encouraging community engagement.
Social media can also be used to share health promotion messages as part of a social marketing campaign. Social media platforms like Facebook, and traditional mass media channels like TV and radio are all good ways to deliver a message to an audience. However, social media platforms go one step further, encouraging a response from the audience. Social media posts can promote discussions about smoking and vaping, allow people to share their own stories about quitting, and increase audience engagement with the message. Messages will also be amplified (increase their reach) when users share posts with their wider social network.
Social media platforms like Facebook offer a way to connect with communities and promote smoke and vape free messages. An NT study found that using paid local “champions” to share tobacco control messages through community networks was effective.
Social media infographic
Posts were shared more when they were:
Posts were shared less when they used:
The NBPU TIS have produced an infographic that provide key information for TIS workers about using social media to communicate messages about smoking.
Social media survival guide
The NBPU TIS has produced a Social Media Survival Guide that provides you with key information about using social media to communicate messages about smoking and vaping. The guide was made for teams working across typical social media setups: stand-alone branded pages, shared pages, or fully outsourced content and management.
The guide includes tools and tips all teams can use and tailored advice based on your team’s setup.
The TIS content ideas wheel is a tool developed to assist you generate ideas for your social media accounts. It matches TIS topics with where communities are at in their quitting journey.
Claudine Thornton Creative has created two tailored online courses to support TIS teams to reach their communities using social media. Both courses are free to access and are split into short modules that you can complete at your own pace.
The Tackling Indigenous Smoking Social Media Training, will help you master marketing terminology and understand consumer behaviour tactics, giving you the tools to use emotional intelligence to create and share effective smoke and vape-free messages.
Once you have completed the Tackling Indigenous Smoking Social Media Training, you can move on to: #Health: Using Social Media to Tackle Indigenous Smoking.
In this course you’ll dive into:
This document provides TIS teams with examples of eligible activities for the July 2024-2027 funding period and how to monitor and evaluate them. It includes examples of social media activities and how they can be monitored and evaluated.
Mass media and social media campaigns use social marketing techniques to try and reduce the number of people who smoke and/or vape by changing attitudes, beliefs, and intentions about tobacco and/or vape use. Social marketing uses knowledge about the intended audience to develop targeted marketing messages. Campaigns promote being smoke and vape free as desirable and attainable. They do this by:
Social marketing campaigns use education to:
Effective social marketing campaigns include a clear call to action (CTA). The CTA prompts the audience to respond the campaign message, for example by committing never to vape, calling the Quitline or pledging to have a smoke and vape free home and car. Box 1 has more information about the CTA.
Box 1: What is a call to action?
A call to action (CTA) encourages people to do something after you have provided them with health information. It should be easy to remember, compelling and appealing. An effective CTA will:
Campaign messages can be shared using:
A 2021 publication from the Mayi Kuwayu study showed that education provided by the TIS program has changed awareness and understanding of the impact of smoking on long term health in Aboriginal and Torres Strait Islander adults. We know that negative attitudes towards smoking are an important precursor to smoking behaviour change. Anti-smoking attitudes are more likely to lead to quit attempts, and to successful long term smoke free living.
There is evidence that social marketing campaigns can help prevent smoking from starting, encourage people to stop smoking, and prevent relapse among recent quitters by reminding them about why they chose to stop smoking. However one of the biggest effects is in relation to promoting access to cessation support services such as Quitline, counselling and other health professionals. Developing capacity to support people who are ready to quit – by taking the systems approach described under Planning Guidance, is therefore essential if programs are to be sustainable.
Social marketing campaigns also prevent uptake of vaping, encourage cessation and prevent relapse. Because the main audience for anti-vaping campaigns is youth, emerging evidence supports the use of social media to deliver these messages.
A campaign’s impact is influenced by:
Don’t Make Smokes Your Story campaign ad
The relevance of the message has been found to be important for audience engagement. The context, characters and role models used in advertising or community activities must seem believable, if people who smoke are to connect to them. When a campaign does not relate to how people see themselves, they find it hard to become interested in the content. While there is some evidence that mass media campaigns do influence attitudes and beliefs of Aboriginal people and Torres Strait Islander people regarding smoking, more specific local messages tailored for Aboriginal and Torres Strait Islander people seem to be most effective. Evidence from the Talking About The Smokes project also supports the importance of using targeted advertising.
The Australian Government’s Don’t Make Smokes Your Story campaign is a good example of how advertising and community-based activities can work together to encourage behaviour change among Aboriginal and Torres Strait Islander people who smoke. You can adapt and use these materials and resources for your own activities.
In 2024, the Australian Government launched a new national campaign ‘Give Up For Good’. The campaign includes four separate but complementary advertising streams to raise awareness of the health harms of smoking and vaping and encourage Australians to seek support from newly expanded quit support services.
The campaigns will run across television, digital video and audio, social media, gaming, radio, cinema and out-of-home channels like billboards, shopping centres and bus shelters. Box 2 gives more information on the four campaign streams.
Box 2: ‘Give Up For Good’ campaign streams
Why are we still doing this? – young people who vape
This advertising stream seeks to disrupt and counter the high exposure of e-cigarette advertising aimed at young people aged 14 to 24, focusing on the social benefits of quitting together, to increase young people’s confidence in their ability to quit and empower them to take control of their physical and mental health. It shows a clear arc to addiction through demonstrations of nicotine dependency and isolation. It features messaging about how vaping can quickly progress from the early ‘casual’ stage of using vapes, to becoming addictive and causing people to lose enjoyment from their social activities and connections.
Dedicated resources have also been developed for parents and carers, and others who support young people’s efforts to quit. This includes a conversation guide, fact sheet and frequently asked questions.
You can view the campaign materials at health.gov.au/Vaping
Vaping. Are you really choosing anymore? – adults who vape
The creeping nature and emotional impact of nicotine addiction, has the potential to motivate people to question their vaping habits. This creative stream demonstrates the path to addiction and prompts the audience to question whether they are really in control of their vaping. It shows that quit support services can help people reduce their reliance on or addiction to nicotine, regardless of whether they smoke or vape.
You can view the campaign materials at health.gov.au/GiveUpForGood
Choose your hard – adults who smoke
This smoking-specific stream of creative illustrates that whilst quitting is hard, the devastating long-term consequences of smoking are much harder. The creative seeks to drive quit attempts and prevent uptake and product switching, whilst connecting people with evidence-based cessation tools to support them.
Keep at quitting – First Nations adults who smoke
The campaign includes materials to engage with First Nations communities and motivate, empower, and encourage quit attempts. Materials will be supported by a strong community education and engagement strategy.
You can view the campaign materials at health.gov.au/GiveUpForGood.
This document provides TIS teams with examples of eligible activities for the July 2024-2027 funding period and how to monitor and evaluate them. It includes examples of mass media and social media campaigns and how they can be monitored and evaluated.
Reducing second-hand and third-hand smoke is an important aim. This is because second-hand and third-hand smoke can be very harmful. The evidence also shows that if smoking is seen as ‘normal’ at a community level, young people are more likely to start smoking, and people who currently smoke will find it harder to quit. Increasing the extent to which a community is smoke-free is associated with less smoking and more success in quitting. A 2021 publication from the Mayi Kuwayu study showed that areas of Australia where the TIS program is present, compared to non-TIS areas, have a significantly lower prevalence of smoking inside households.
Relevant activities include the following:
To be successful, smoke-free policies need community participation – not just consultation – in their development. Policies that have local ownership and commitment are more likely to be followed. There is also evidence that introducing smoke-free policies in the workplace can lead to increased support for smoke-free spaces in other areas such as smoke-free homes and cars. Successful smoke-free workplace policies also result in more workers wanting to quit.
‘Keep our place a smoke and vape free space’ is a resource package developed to support the implementation of smoke and vape free workplace policies. ‘Keep our place a smoke-free space’ was a collaboration between NBPU TIS, the Office of the Registrar of Indigenous Corporations (ORIC) and TIS teams from WA, Qld, SA and NT. You can view the poster presentation about the project that was presented at the Lowitja Institute International Indigenous Health and Wellbeing Conference 2023 here.
Resources include:
Smoke and vape free workplace wallchart
The NBPU TIS has created a free, short online course, Creating a Smoke and Vape Free Workplace, to support people to establish a healthier work environment by implementing effective smoke and vape-free policies.
An information leaflet promoting the initiative to Aboriginal and Torres Strait Islander organisations is available here. TIS teams can download this leaflet and personalise with their contact details before sharing with local businesses.
Combining locally owned smoke-free policies with access to quit support services increases the success of these policies. Working in an environment with a smoke free policy can also encourage individuals to quit.
Second-hand and third-hand smoke is a health risk factor, particularly for children. Children are at greater risk for a number of reasons, including their size, faster breathing rates and less developed respiratory and immune systems. Second-hand smoke is associated with a number of childhood illnesses including:
Second-hand smoke is also believed to contribute to the risk of sudden infant death syndrome (SIDS).
Less well known, but probably just as harmful is third-hand smoke. Third-hand smoke is the tobacco smoke toxins from second-hand smoke that get into people who smoke’s hair and clothes and build up on surfaces and dust in areas where people smoke. Evidence shows that these toxins stay in homes and cars for a long time after the cigarette has been extinguished, even several months later. They may even become more toxic over time.
Bullinah Aboriginal Health Service’s Solid Mob ‘Our home is a smoke free zone’ campaign
Third-hand smoke is an emerging area of research and we don’t yet understand all the health hazards. However, children (especially infants), are more vulnerable to third-hand smoke toxins. This is because infants crawl over contaminated floors and mouth contaminated surfaces like furniture and toys. We also know that infants consume up to a quarter of a gram of dust every day. That’s twice as much as adults.
There is good evidence that having a smoke-free home and car improves children’s health. There is also some evidence that keeping the home smoke-free helps to prevent uptake of smoking by young people. There are therefore many good reasons to support people to have smoke-free homes and cars.
A 2018 review found that intensive counselling methods or motivational interviewing with parents to be most effective for reducing children’s tobacco smoke exposure in the home. There is some indication that school-based education, intensive home visits, brief education provided to parents in clinics (including scheduled children’s health checks) and culturally sensitive health promotion brochures may also help reduce second-hand smoke in the home and car.
Menzies School of Health Research has developed Healthy starts: reducing the health effects of smoking around Indigenous babies and children, a resource to support health providers when discussing second-hand tobacco smoke with families, and to encourage families to have smoke-free homes.
Griffith AMS hosting a smoke-free community event
Pledging to be smoke-free demonstrates an active commitment and motivation to change. Evidence shows that when someone makes a public declaration (pledge) they are more likely to follow through with that promise, both for themselves, but also because of what others might think of them if they don’t maintain their promise. We also know that people are more likely to stick with a commitment that has real value, purpose and meaning to them.
Smoke-free pledges are a good population health promotion tool because:
Read this factsheet for more information on designing smoke-free pledges.
The Wellington Aboriginal Corporation Health Service Quit B Fit Team encouraging people to take a pledge to not smoke in their homes, cars and workplaces
This document provides TIS teams with examples of eligible activities for the July 2024-2027 funding period and how to monitor and evaluate them. It includes examples of smoke-free activities and how they can be monitored and evaluated.
