According to data from the Australian Institute of Health and Welfare (AIHW), 38% of pregnant Aboriginal and Torres Strait Islander women smoked during pregnancy in 2023.
Smoking and vaping during pregnancy can expose the developing baby to harmful substances. Avoiding smoking and vaping during pregnancy is important for the health of both women and their babies.
In 2021, AIHW found that the proportion of Aboriginal and Torres Strait Islander women who quit smoking after 20 weeks of pregnancy was 12%. We know that Aboriginal and Torres Strait Islander women have strong protective feelings for their unborn babies and a desire to quit in pregnancy and data from AIHW shows a high rate of quit attempts by pregnant Aboriginal and Torres Strait Islander women. However, these quit attempts are often not sustained. Some evidence suggests that continued smoking is sometimes seen as a necessary response to stressful situations in life. Educating mums-to-be about how smoking increases stress rather than reduces it, and providing alternative strategies to manage stress is important. To find out more about strategies for people who are quitting smoking to manage stress read the Key facts about smoking and stress factsheet.
Supporting women after pregnancy Pregnancy can be an important time to quit smoking or vaping, but staying smoke-free after the baby is born can be challenging. Ongoing support from family, friends, health professionals and community can help women stay smoke-free. Promoting the benefits of staying smoke-free after the baby is born is therefore important. Creating supportive, smoke and vape-free environments through positive messages about smoke and vape-free homes, and encouraging partners, families and community to support women to stay smoke and vape-free, can help women maintain smoke-free behaviours. Where women want support to quit, connecting them with appropriate health services can also help.
Sustaining Quit attempts Evidence also suggests that Aboriginal and Torres Strait Islander women are unable to sustain their quit attempts because of a lack of culturally appropriate support. They may also be encouraged to cut down rather than quit by health professionals. There is evidence that women’s interest in quitting is hindered by:
The community-led research program Which Way? is being conducted in response to a need for Indigenous-led evidence for smoking cessation care. The study is producing new evidence to inform best practice, privileging the voices and experiences of Aboriginal and Torres Strait Islander people, including during pregnancy.
Which Way? surveyed 428 Aboriginal and Torres Strait Islander women of reproductive age. The survey included women who smoke (63%) as well as those who used to smoke (37%). The survey found that:
The study provides evidence that Aboriginal and Torres Strait Islander women want smoking cessation support that is:
Which Way? has previously reported that smoke-free pregnancies were 4.5 times higher among women who used Aboriginal Health Services.
A survey of Aboriginal Health Workers/Practitioners conducted by the Which Way? team found that best practice smoking cessation support was more likely to be provided by practitioners who:
In response to these findings, the Which Way? team has developed and launched the Gulibaa Project, an Aboriginal and Torres Strait Islander-led initiative designed to support Aboriginal and Torres Strait Islander women to be smoke and vape-free. “Gulibaa” means “Coolamon” in Wiradjuri language—a traditional vessel used for caring for babies, symbolising the program’s focus on women’s and family health. More information on the project can be found at www.whichway.info/gulibaa.
Overall, pregnancy can be a missed opportunity for smoking and vaping behaviour change. The evidence shows that effective population health promotion should:
SISTAQUIT is designed to increase health service capacity by providing best practice training for individual level cessation support to health care workers who have contact with pregnant Aboriginal and Torres Strait Islander women. You can read more about SISTAQUIT here or find them on Facebook and Instagram. This short promotional video describes how SISTAQUIT training and resources provides healthcare professionals (working in a clinical setting) with the skills to support Aboriginal and Torres Strait Islander women to have a smoke-free pregnancy. The SISTAQUIT App is available to download to support pregnant Aboriginal and Torres Strait Islander women who want to quit smoking or vaping.
Second-hand and third-hand smoke and vape aerosol are health risk factors, particularly for babies and children. If mothers are not ready to quit, then finding ways of avoiding smoking or vaping around their children, for example by keeping a smoke and vape-free car and home are important ways of improving child health. This will also encourage other family members not to smoke or vape around the children. Having a smoke and vape free home and car is also associated with sustained quitting, as it provides a supportive environment for all the family to stop quit. For more information on this topic please see the section on reducing second-hand and third-hand smoke.
To find relevant resources, visit the Resources to support activities page and filter resources by ‘Pregnant women and families’.
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.
