Remote communities

The 2018-19 National Aboriginal and Torres Strait Islander Health Survey shows a 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. However, this decline in smoking has not been uniform across regions. Whilst the reduction in smoking prevalence is very evident in urban areas, there has been little change in rates of daily smoking among Aboriginal or Torres Strait Islander people living in remote or very remote areas. Reducing the prevalence of tobacco use in remote areas is therefore a priority focus for the TIS Program.

There is some evidence from the ABS data and the Talking About the Smokes Study (TATS), that smoking behaviours in remote areas are beginning to change, although more slowly than in urban or regional areas:

  • fewer young people are taking up smoking in remote as well as non-remote areas.
  • there has been an increase in cessation attempts in remote areas.
  • motivation to quit or making a quit attempt is the same in remote and non-remote areas – it is just that people in remote areas are less likely to sustain their quit attempt for a month or longer.

It is possible that low awareness of quit support services in remote areas and more communal and social patterns of smoking make it harder to sustain a quit attempt. In contrast, evidence suggests that living in a smoke free home and having support from friends and family helps sustain a quit attempt.

Other positive changes are also taking place in services in remote settings. For example, recording client smoking status has been found to be increasing in remote areas, especially in services with TIS Program funding compared to non-funded services. This suggests increased awareness among health professionals of the need to address smoking behaviours in these TIS-funded services.

It has been suggested that increasing the intensity and reach of TIS teams in remote areas could lead to significant reductions in smoking among Aboriginal and Torres Strait Islander people living in remote areas. In accordance with the Australian Federal Department of Health, service remoteness is classified using the Modified Monash Model. In 2019, the Department of Health extended the coverage of the TIS program to include:

  • Tiwi Islands
  • Torres Strait Islands
  • Katherine township and surrounds
  • Remote communities near Alice springs.

 

To view which areas of Australia different TIS Teams service, you can visit the map on the TIS Team Locations page and select the map layer ‘Tackling Indigenous Smoking Service Areas’. Click on the TIS area of interest and a pop-up window will show the organisation’s name.

It is anticipated that increasing the focus on remote areas through more targeted activity would concentrate efforts on the areas of greatest disparity. The emerging evidence suggests effective activities include:

  • promoting and supporting smoke free homes
  • raising awareness of quit support services
  • social marketing campaigns to encourage quit attempts and promote confidence to stop smoking.

On 3 and 4 March 2021, the NBPU TIS hosted an online workshop for the 22 TIS teams who service communities in remote and very remote Australia. Participants joined a three hour Zoom session on both days, with an offline activity undertaken by teams in between the Zoom meetings. The workshop provided an opportunity for teams to share best practice activities and strategies for adaptation at local levels. You can view the presentations and read the workshop report here.

Further reading