Facts about smoking Tobacco use has many health impacts, including increasing the risk of chronic diseases such as cardiovascular disease, many forms of cancer, and lung diseases. Tobacco use is also a risk factor for complications during pregnancy, and is associated with preterm birth, low birth weight, and perinatal death. Environmental tobacco smoke (second-hand smoke) is also a risk to health. Children are particularly susceptible to problems caused by breathing in second-hand smoke (passive smoking). This includes a greater risk of middle ear infections, more frequent and severe asthma attacks, and increased risk of sudden infant death syndrome (SIDS). A recent study found that the health impacts of smoking among Aboriginal and Torres Strait Islander people have been underestimated by previous research. However the study also highlighted the benefits of quitting at any age. There is no level of smoking that is risk free. A person’s risk of developing cancer increases the more they smoke, e.g. compared to non-smokers, people who smoke 1-5 cigarettes a day are 10 times more likely to develop lung cancer, while people who smoke more than 35 cigarettes per day are 39 times more likely. The best way to reduce cancer risk is by quitting smoking or not starting. Extent of tobacco use among Aboriginal and Torres Strait Islander people The latest data about smoking prevalence among Aboriginal and Torres Strait Islander people comes from the 2018-19 National Aboriginal and Torres Strait Islander Health Survey. The picture is a positive one, with the strong downward trend in smoking prevalence over the last 15 years leading to fewer tobacco related illnesses and many lives saved. There are now more Aboriginal and Torres Strait Islander people who do not smoke, than do smoke. Smoking among young people The proportion of young people (18-24 years) starting to smoke has decreased which will result in improved health outcomes over time. Aboriginal and Torres Strait Islander young adults are also starting smoking later. Visit our Young people page to learn more about school and community-based initiatives to reduce the number of young people taking up smoking and increase the number of young people who quit smoking. Smoking during pregnancy There has been a substantial decrease in smoking during pregnancy among Aboriginal and Torres Strait Islander women. Find out more about pregnancy and smoking on our Pregnant women and families page. Second-hand smoking among Aboriginal and Torres Strait Islander people Second-hand smoking is when a person breathes in the smoke from a tobacco product but is not smoking the cigarette (or other tobacco product) themselves. Second-hand smoke releases thousands of chemicals into the environment and is bad for health. While many people smoke outdoors to limit exposure to second-hand smoke, some people live with a friend or family member who smokes inside. Many Aboriginal and Torres Strait Islander people are making changes to reduce the impact of second-hand smoke on others. These include stopping people from smoking inside, avoiding social situations where people would be smoking, and changing their clothes after smoking. Read more about second-hand and third-hand smoke and creating smoke-free environments here. Vaping (e-cigarettes) Vapes (e-cigarettes) are battery operated devices that heat a liquid to produce a vapour that can be inhaled. In Australia, it is illegal to sell vapes that contain nicotine. The limited research suggests that a smaller percentage of Aboriginal and Torres Strait Islander peoples may have tried vaping than non-Indigenous people. Visit the Facts about vaping (e-cigarettes) page to learn more. Bush tobacco Bush tobacco is a native Australian tobacco plant, often known as Pituri, Pitjuri or Mingkulpa. The use of bush tobacco varies across regions but seems to be most common within Aboriginal populations in the central desert regions of Australia. Traditionally a mixture is made using dried leaf and stem with ash, and moistened with saliva (called a quid). The quid is chewed and held in the mouth for periods of time or placed behind the ear. Both methods absorb the nicotine. Bush tobacco is mainly used for its nicotine content. In some communities, bush tobacco is also used as topical medicine to treat bites and skin conditions. Many bush tobacco users do not consider it to be a tobacco plant and may not believe it will lead to the same health problems associated with commercial tobacco. We are still learning about the health impacts of bush tobacco. Some information suggests negative health outcomes are similar to that of smoking tobacco. The leaf of bush tobacco contains toxic chemicals, including ones known to cause cancer. Mixing the tobacco leaf with ash might produce other harmful compounds. For women, using bush tobacco while pregnant increases risk of premature birth and lower birth weight babies. A recent study in Central Australia found health outcomes for new born babies whose mothers chewed bush tobacco during pregnancy were poorer than mother’s who smoked tobacco. Bush tobacco is addictive, and users may experience withdrawal symptoms. Bush tobacco has a significant social and cultural role, connecting Aboriginal people to each other, their culture, land, and community. Bush tobacco is sometimes bought and sold, but more frequently it is gifted to family or friends as a sign of ‘being loved’. Population health promotion messages should respect the local knowledge system. Working closely with community to understand local beliefs and the role of bush tobacco is important for ensuring appropriately tailored messages. You can read more about Bush Tobacco on our factsheet. Featured icon artwork by Frances Belle Parker: The HealthInfoNet commissioned Frances Parker, a proud Yaegl woman, mother and artist, to produce a suite of illustrated icons for use in our knowledge exchange products. Frances translates biomedical and statistically based information into culturally sensitive visual representations, to provide support to the Aboriginal and Torres Strait Islander workforce and those participating in research and working with Aboriginal and Torres Strait Islander people and their communities.