Young people

Smoking among young people

The proportion of young Aboriginal and Torres Strait Islander 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.

Data source: Heris et al. 2020

School-based education and awareness activities

It is important to provide health promotion for primary and secondary school age people. There is evidence that school-based activities have an increased chance of working if they:

  • are interactive
  • include social influences and peer leadership
  • use culturally appropriate activities
  • are tailored for the age of the children.

Graduates of the Deadly Choices Tobacco Education Program

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 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.

For more information on strategies for engaging children and young people to promote anti-smoking messages, view the NBPU TIS’s Child youth and engagement resource package.

Vaping: an emerging priority for action

Around 14% of all Australian secondary school students aged 12-17 years have tried e-cigarettes.  Almost half of youths who said they had ever tried vaping had not previously smoked a cigarette. We do not currently have Aboriginal and Torres Strait Islander specific data on vaping, but anecdotal evidence suggests vaping is an emerging issue in urban and regional communities. This is a concern because evidence suggests:

Source: World Health Organization

  • vaping can be a gateway to smoking
  • it is not harm free
  • e-cigarettes can contain high levels of nicotine (even if labelled as nicotine free)
  • nicotine is a toxin, especially for young people – it affects brain development.

Much of the e-cigarette market is owned by the tobacco industry and evidence suggests that the industry is targeting youth through marketing on social media, particularly Instagram. This marketing glamourises vaping and presents it as being ‘cool’. Products are misrepresented as being harm free and even as healthy. Vaping flavours such as bubble-gum, banana milkshake and strawberry slushie appear to be designed to appeal to young people. Vaping also has its own etiquettes and social scene with its own jargon (e.g. cloud chasing). These social norms support the uptake and maintenance of vaping in the same way that social networks support and normalise tobacco use.

Addressing vaping

The published evidence around addressing vaping in youth comes mainly from mainstream work in the USA and Canada. That evidence shows that effective population health promotion activities are in line with those currently recommended for educating youth about smoking. Recommendations for effective programs include:

  • providing information about e- cigarette ingredients
  • explaining the e-cigarette company/tobacco industry connection
  • describing the negative health effects of e-cigarettes
  • responding to the social use of e-cigarettes
  • addressing perceptions about addiction/cessation/self-efficacy.

    Source: American Indian Cancer Foundation

There is also evidence that Peer-led programs that leverage social networks make programs more persuasive and relevant to challenging social influences and changing social norms. Overall, this suggests that integrating education about vaping into existing programs and activities with youth is the best approach. 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’.

The prevention campaigns below have been developed in the United States and can give you an idea of what is being done internationally to reduce vaping rates among young people. As always, any TIS activities should be tailored to your own communities, using your knowledge of local needs, preferences and values.

For more information on vaping, visit the e-cigarettes page.

Further reading: Australian research

Further reading: International research

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.