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Feng W, Qin B, Jin X, Li S. Identifying factors influencing local governments' adoption of comprehensive smoke-free policies: an event history analysis based on panel data from 36 key cities in China (2013-2021). Front Public Health 2024; 12:1397803. [PMID: 39005994 PMCID: PMC11240852 DOI: 10.3389/fpubh.2024.1397803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction The issue of tobacco control remains a significant concern for public health worldwide. In recent years, remarkable progress has been made toward adopting smoke-free measures in indoor public places. Although China has yet to introduce a national regulation, specifically for smoke-free public places, more than a dozen cities have successively approved and implemented comprehensive smoke-free regulations. Different cities in China have diverse attitudes and behaviors toward smoke-free policies; however, the reasons for these policy differences and the influencing factors have not received sufficient attention and research. Methods On the basis of the multiple streams framework, this study selects 36 key Chinese cities as research samples and uses a directed dyad-year event history analysis method to analyze the factors influencing the implementation of comprehensive smoke-free policies in cities. Results Results show that the adoption of such policies is positively influenced by scientific evidence, focal events, media coverage, institutional foundations, economic comparisons, and the influence of health departments and of tobacco control groups. By contrast, policy adoption is negatively affected by the differences in administrative levels, central policy signals, and the influence of the tobacco industry. Discussion This study contributes to understanding the internal logic behind local governments' adoption of comprehensive smoke-free policies, offering insights for further advocacy at the city and national levels in China and providing experiences that can promote the global tobacco control movement.
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Affiliation(s)
- Wenting Feng
- School of Journalism and Communication, Renmin University of China, Beijing, China
| | - Binbin Qin
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Xuezheng Jin
- Department of Health Communication, Chinese Center for Health Education, Beijing, China
| | - Shengyu Li
- School of Public Administration and Emergency Management, Jinan University, Guangzhou, China
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Heris CL, Cutmore M, Chamberlain C, Smith N, Simpson V, Sherriff S, Wright D, Slater K, Eades S. Don't Follow the Smoke-Listening to the Tobacco Experiences and Attitudes of Urban Aboriginal Adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4587. [PMID: 36901596 PMCID: PMC10002023 DOI: 10.3390/ijerph20054587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Preventing smoking among young Aboriginal people is important for reducing health inequities. Multiple factors were associated with adolescent smoking in the SEARCH baseline survey (2009-12) and discussed in a follow-up qualitative study that aimed to inform prevention programs. Twelve yarning circles were facilitated by Aboriginal research staff at two NSW sites in 2019 with 32 existing SEARCH participants aged 12-28 (17 female, 15 male). Open discussion around tobacco was followed by a card sorting activity, prioritising risk and protective factors and program ideas. The age of initiation varied by generation. Older participants had established smoking in their early adolescence, whereas the current younger teens had little exposure. Some smoking commenced around high school (from Year 7), and social smoking increased at age 18. Mental and physical health, smoke-free spaces and strong connections to family, community and culture promoted non-smoking. The key themes were (1) drawing strength from culture and community; (2) how the smoking environment shapes attitudes and intentions; (3) non-smoking as a sign of good physical, social and emotional wellbeing; and (4) the importance of individual empowerment and engagement for being smoke-free. Programs promoting good mental health and strengthening cultural and community connections were identified as a priority for prevention.
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Affiliation(s)
- Christina L. Heris
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Acton, Canberra, ACT 2601, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | | | - Catherine Chamberlain
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Natalie Smith
- Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, NSW 2650, Australia
| | - Victor Simpson
- Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, NSW 2650, Australia
| | | | - Darryl Wright
- Tharawal Aboriginal Corporation, Airds, Sydney, NSW 2560, Australia
| | - Kym Slater
- Tharawal Aboriginal Corporation, Airds, Sydney, NSW 2560, Australia
| | - Sandra Eades
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
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Springall TL, McLachlan HL, Forster DA, Browne J, Chamberlain C. Factors associated with breastfeeding initiation and maintenance for Aboriginal and Torres Strait Islander women in Australia: A systematic review and narrative analysis. Women Birth 2023; 36:224-234. [PMID: 35840537 DOI: 10.1016/j.wombi.2022.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/30/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Australian Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) women breastfeed at lower rates than non-Aboriginal women. Little is known about factors associated with breastfeeding specific to Aboriginal women and infants. AIM Determine the protective and risk factors associated with breastfeeding for Aboriginal women in Australia. METHODS CINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched for peer-reviewed literature published between 1995 and 2021. Quantitative studies written in English reporting protective and risk factors associated with breastfeeding for Aboriginal women or women having an Aboriginal infant were included. Ten percent of papers were co-screened, and two reviewers completed data extraction. Narrative data synthesis was used. FINDINGS The initial search identified 12,091 records, with 31 full text studies retrieved, and 17 reports from 14 studies met inclusion criteria. Protective factors included living in a remote area, attending an Aboriginal-specific service, attending a regional service, higher levels of education attainment, increased maternal age, living in larger households, being partnered, and having a higher reported number of stressful events and social health issues. The identified risk factors were smoking in pregnancy, admission to SCN or NICU, and being multiparous. CONCLUSION This review identified factors associated with breastfeeding for Aboriginal women. Government focus, support, and consistent funding are required to plan and implement evidence-based interventions and services for Aboriginal women and infants in urban, rural, remote, and very remote locations. Rigorous research is required to understand the Aboriginal-specific factors associated with breastfeeding to improve rates and health outcomes for Aboriginal women and infants.
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Affiliation(s)
- Tanisha L Springall
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia; School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia.
| | - Helen L McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
| | - Della A Forster
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia; Maternity Services, Royal Women's Hospital, Parkville, Victoria, Australia.
| | - Jennifer Browne
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia.
| | - Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia; Centre for Health Equity, The University of Melbourne, Melbourne, Victoria, Australia; NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Australia; The Lowitja Institute, Australia.
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Chakraborty A, Cargo M, Oguoma VM, Coffee NT, Chong A, Daniel M. Built Environment Features and Cardiometabolic Mortality and Morbidity in Remote Indigenous Communities in the Northern Territory, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159435. [PMID: 35954785 PMCID: PMC9368214 DOI: 10.3390/ijerph19159435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
Abstract
Indigenous Australians experience poorer health than non-Indigenous Australians, with cardiometabolic diseases (CMD) being the leading causes of morbidity and mortality. Built environmental (BE) features are known to shape cardiometabolic health in urban contexts, yet little research has assessed such relationships for remote-dwelling Indigenous Australians. This study assessed associations between BE features and CMD-related morbidity and mortality in a large sample of remote Indigenous Australian communities in the Northern Territory (NT). CMD-related morbidity and mortality data were extracted from NT government health databases for 120 remote Indigenous Australian communities for the period 1 January 2010 to 31 December 2015. BE features were extracted from Serviced Land Availability Programme (SLAP) maps. Associations were estimated using negative binomial regression analysis. Univariable analysis revealed protective effects on all-cause mortality for the BE features of Education, Health, Disused Buildings, and Oval, and on CMD-related emergency department admissions for the BE feature Accommodation. Incidence rate ratios (IRR’s) were greater, however, for the BE features Infrastructure Transport and Infrastructure Shelter. Geographic Isolation was associated with elevated mortality-related IRR’s. Multivariable regression did not yield consistent associations between BE features and CMD outcomes, other than negative relationships for Indigenous Location-level median age and Geographic Isolation. This study indicates that relationships between BE features and health outcomes in urban populations do not extend to remote Indigenous Australian communities. This may reflect an overwhelming impact of broader social inequity, limited correspondence of BE measures with remote-dwelling Indigenous contexts, or a ‘tipping point’ of collective BE influences affecting health more than singular BE features.
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Affiliation(s)
- Amal Chakraborty
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
- Correspondence:
| | - Margaret Cargo
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (M.C.); (N.T.C.); (M.D.)
| | - Victor Maduabuchi Oguoma
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD 4067, Australia;
| | - Neil T. Coffee
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (M.C.); (N.T.C.); (M.D.)
- Deakin Rural Health, Rural Health Multidisciplinary Training (RHMT) Program, School of Medicine, Deakin University, Warrnambool, VIC 3280, Australia
- Australian Centre for Housing Research, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Alwin Chong
- Arney Chong Consulting, Adelaide, SA 5081, Australia;
| | - Mark Daniel
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia; (M.C.); (N.T.C.); (M.D.)
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Cai W, Zhou Y. Men smoke less under the COVID-19 closure policies: The role of altruism. Soc Sci Med 2022; 306:115159. [PMID: 35753168 PMCID: PMC9217683 DOI: 10.1016/j.socscimed.2022.115159] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/21/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022]
Abstract
This study examines whether people smoked more under the Coronavirus Disease 2019 (COVID-19) closure policies which trapped them at home with their families. In such circumstances, the pleasure from smoking could be more tempting than usual, but at the same time smokers’ families are more likely to be victims of passive smoking. This study uses temporal and regional variations in policy strengths with data from the Oxford COVID-19 Government Response Tracker project (OxCGRT) to examine the impact of COVID-19 closure policies on smoking behaviors. With longitudinal data from the China Family Panel Studies (CFPS) in 2018 and 2020, we find diminished smoking behaviors among Chinese male adults when the government implemented strict public health policies for the COVID-19 pandemic. People with more conscientiousness personality traits or stronger pro-family attitudes tend to smoke less as policy stringency increases.
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Affiliation(s)
- Weicheng Cai
- Center for Social Research and Guanghua School of Management, Peking University, China
| | - Yi Zhou
- Center for Social Research and Guanghua School of Management, Peking University, China.
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Quigg R, Marsh L, Clark-Heu B. Indigenous Māori perspectives of smokefree parks. Aust N Z J Public Health 2022; 46:469-476. [PMID: 35678963 DOI: 10.1111/1753-6405.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/01/2021] [Accepted: 02/01/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study aims to understand the context of place associated with smoking in urban Hamilton parks from a Te Ao Māori perspective (the worldview of Māori, the Indigenous people of Aotearoa New Zealand). METHODS Our study approached smokefree environments in Hamilton through a Māori lens, undertaking interviews with family groups and people from organisations involved in the local Smokefree environments policy. RESULTS The majority of the 26 adult participants identified as Māori, with 30% being current smokers. Parks had a place in the sporting memories of participants. Smoking was merged with these memories. Important features of places that influenced smoking behaviours were raised, with signage a key talking point. CONCLUSIONS The colonial construct of parks do not make visible Māori values and historical associations with the land, nor do they set a framework that would promote Māori ways of being and doing, including enacting smokefree spaces and places. IMPLICATIONS FOR PUBLIC HEALTH This study provides the incentive to address change in parks and reserve management that would support Māori aspirations for their health and wellbeing associated with ancestral land, and give meaning to smokefree environments.
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Affiliation(s)
- Robin Quigg
- Raukawa, Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Aotearoa, New Zealand
| | - Louise Marsh
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Aotearoa, New Zealand
| | - Bobbi Clark-Heu
- Waikato-Tainui, Department of Public Health, Wellington School of Medicine, University of Otago, Aotearoa, New Zealand
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Huddlestone L, Shoesmith E, Pervin J, Lorencatto F, Watson J, Ratschen E. A systematic review of mental health professionals, patients and carers' perceived barriers and enablers to supporting smoking cessation in mental health settings. Nicotine Tob Res 2022; 24:945-954. [PMID: 35018458 PMCID: PMC9199941 DOI: 10.1093/ntr/ntac004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/20/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022]
Abstract
Introduction Evidence-based smoking cessation and temporary abstinence interventions to address smoking in mental health settings are available, but the impact of these interventions is limited. Aims and Methods We aimed to identify and synthesize the perceived barriers and enablers to supporting smoking cessation in mental health settings. Six databases were searched for articles reporting the investigation of perceived barriers and enablers to supporting smoking cessation in mental health settings. Data were extracted and coded using a mixed inductive/deductive method to the theoretical domains framework, key barriers and enablers were identified through the combining of coding frequency, elaboration, and expressed importance. Results Of 31 included articles, 56 barriers/enablers were reported from the perspectives of mental healthcare professionals (MHPs), 48 from patient perspectives, 21 from mixed perspectives, and 0 from relatives/carers. Barriers to supporting smoking cessation or temporary abstinence in mental health settings mainly fell within the domains: environmental context and resources (eg, MHPs lack of time); knowledge (eg, interactions around smoking that did occur were ill informed); social influences (eg, smoking norms within social network); and intentions (eg, MHPs lack positive intentions to deliver support). Enablers mainly fell within the domains: environmental context and resources (eg, use of appropriate support materials) and social influences (eg, pro-quitting social norms). Conclusions The importance of overcoming competing demands on staff time and resources, the inclusion of tailored, personalized support, the exploitation of patients wider social support networks, and enhancing knowledge and awareness around the benefits smoking cessation is highlighted. Implications Identified barriers and enablers represent targets for future interventions to improve the support of smoking cessation in mental health settings. Future research needs to examine the perceptions of the carers and family/friends of patients in relation to the smoking behavior change support delivered to patients.
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Affiliation(s)
| | | | - Jodi Pervin
- Department of Health Sciences, University of York, York
| | | | - Jude Watson
- Department of Health Sciences, University of York, York
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Thurber KA, Banks E, Joshy G, Soga K, Marmor A, Benton G, White SL, Eades S, Maddox R, Calma T, Lovett R. Tobacco smoking and mortality among Aboriginal and Torres Strait Islander adults in Australia. Int J Epidemiol 2021; 50:942-954. [PMID: 33491081 PMCID: PMC8271186 DOI: 10.1093/ije/dyaa274] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background Despite generally high smoking prevalences, stemming from colonization, the relationship of smoking to mortality has not been quantified reliably in an Indigenous population. We investigate smoking and mortality among Aboriginal and Torres Strait Islander adults in Australia, where current adult daily smoking prevalence is 40.2%. Methods A prospective study of 1388 cardiovascular disease- and cancer-free Aboriginal adults aged ≥45 years, of the 267 153 45 and Up Study participants randomly sampled from the New South Wales general population over 2006–09. Questionnaire and mortality data were linked (through the Centre for Health Record Linkage) to mid-2019. Adjusted hazard ratios (called relative risks, RRs) for all-cause mortality—among current- and past- versus never-smokers—were estimated overall, by smoking intensity and by age at cessation. Smoking-attributable fractions and associated deaths were estimated. Results Over 14 586 person-years’ follow-up (median 10.6 years), 162 deaths accrued. Mortality RRs [95% confidence interval (CI)] were 3.90 (2.52–6.04) for current- and 1.95 (1.32–2.90) for past- versus never-smokers, with age heterogeneity. RRs increased with smoking intensity, to 4.29 (2.15–8.57) in current-smokers of ≥25 cigarettes/day. Compared with never-smokers, RRs were 1.48 (0.85–2.57) for those quitting at <45 years of age and 2.21 (1.29–3.80) at 45–54 years. Never-smokers lived an average >10 years longer than current-smokers. Around half of deaths among adults aged ≥45 years were attributable to smoking, exceeding 10 000 deaths in the past decade. Conclusions In this population, >80% of never-smokers would survive to 75 years, versus ∼40% of current-smokers. Quitting at all ages examined had substantial benefits versus continuing smoking; those quitting before age 45 years had mortality risks similar to never-smokers. Smoking causes half of deaths in older Aboriginal and Torres Strait Islander adults; Indigenous tobacco control must receive increased priority.
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Affiliation(s)
- Katherine A Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia.,Sax Institute, Ultimo, NSW, Australia
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Kay Soga
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Alexandra Marmor
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | | | | | | | - Raglan Maddox
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Tom Calma
- University of Canberra, Bruce, ACT, Australia
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
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Yuliati R, Sarwono BK, Ahsan A, Wibhisono IGLAK, Kusuma D. Effect of Message Approach and Image Size on Pictorial Health Warning Effectiveness on Cigarette Pack in Indonesia: A Mixed Factorial Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6854. [PMID: 34202414 PMCID: PMC8297246 DOI: 10.3390/ijerph18136854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/19/2021] [Accepted: 06/22/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cigarette consumption remains high and increasing in Indonesia. The government implemented a pictorial health warnings requirement of 40% cover of the pack (front and back) using fear appeal messages. OBJECTIVE Our study aims to assess the effectiveness of cigarette pictorial health warnings by message and size. METHODS We conducted a mixed factorial experiment online study using three messaging approaches (fear vs. guilt vs. financial loss) and two picture sizes (40% vs. 75%) among 209 smoking participants. Sociodemographic variables included gender, education, income, employment status, and marital status. Data analysis used a mixed model ANOVA to see the main effect and interaction effect on dependent variables. For subgroup analysis, we used t-test and one-way ANOVA. All analyzes were in SPSS 22. RESULTS We found significant differences in the three message types, in which fear and guilt have higher effectiveness than financial loss. By subgroup, the guilt message was more compelling among female smokers and married smokers. The financial loss message was effective among lower-income smokers. We found no difference in pictorial health warning effectiveness by image size, potentially because participants could zoom in/out the cigarette pack image on the screen. CONCLUSIONS Our finding supports more diverse message types in pictorial health warnings in Indonesia and other countries.
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Affiliation(s)
- Reny Yuliati
- Department of Communication, Faculty of Social and Political Science, Universitas Indonesia, Depok 16424, Indonesia; (R.Y.); (B.K.S.); (I.G.L.A.K.W.)
| | - Billy Koernianti Sarwono
- Department of Communication, Faculty of Social and Political Science, Universitas Indonesia, Depok 16424, Indonesia; (R.Y.); (B.K.S.); (I.G.L.A.K.W.)
| | - Abdillah Ahsan
- Faculty of Economics and Business, Universitas Indonesia, Depok 16424, Indonesia;
| | | | - Dian Kusuma
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London SW7 2AZ, UK
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Xie L, Xu W, Zhou Y. Spillover effects of adult children's schooling on parents' smoking cessation: evidence from China's compulsory schooling reform. J Epidemiol Community Health 2021; 75:1104-1110. [PMID: 33893183 DOI: 10.1136/jech-2020-215326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/24/2021] [Accepted: 04/08/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE As elderly parents today will share a longer life with their children than ever before, the spillover effects of children's human capital on parents' well-being become increasingly important. This study investigated whether children's schooling leads parents to give up smoking and whether the effects were moderated by their education or child-parent contact frequency. METHODS Using data from the China Health and Retirement Longitudinal Study, we conducted an instrumental variable (IV) analysis using China's compulsory schooling reform in the 1980s as a natural experiment. RESULTS The IV estimates suggest that elderly parents of more highly educated children are more likely to quit smoking. Moreover, the effects are more significant among parents who had not finished primary school and also slightly stronger among parents who live close to their children or meet their children frequently. DISCUSSION Our findings add to current evidence regarding spillover effects of education on smoking cessation. A child's education may exert an impact through the spillover of health knowledge.
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Affiliation(s)
- Liyang Xie
- Health Policy Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Wei Xu
- School of Finance, Central University of Finance and Economics, Beijing, China
| | - Yi Zhou
- Center for Social Research and Guanghua School of Management, Peking University, Beijing, China
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11
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Khan RJ, Poder N, Kovai V, Robinson L, Wright D, Spinks M, Heathcote J, Millen E, Welsh K, Bedford K. Culturally tailored tobacco control: Aboriginal community perspectives in Sydney, Australia. Health Promot J Austr 2021; 32:264-273. [PMID: 32196787 DOI: 10.1002/hpja.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 09/13/2019] [Accepted: 03/06/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION A community-based project was developed to support quit attempts and denormalise smoking in Aboriginal communities. This qualitative study evaluates the effectiveness of project strategies, messages and the partnership process, and explores impacts observed by Aboriginal community members, complementing findings from a quantitative evaluation. METHODS The study comprised five focus groups (40 participants) and 14 in-depth interviews (with 15 community members). Data were analysed thematically by manual and NVivo software methods. RESULTS Results demonstrate that the project attracted community attention, was well recalled and messages were considered convincing and persuasive. Participants reported being more likely to quit and to discuss smoking with family and friends, and noticed that many people were quitting. Participants observed an increase in asking people not to smoke in the home and fewer people smoking at events, but noted that many smokers struggled to stay quit. The partnership and participation of Aboriginal Health Workers were viewed as crucial. CONCLUSION The qualitative findings reinforce quantitative evaluation findings suggesting that the project contributed to denormalising smoking and motivating quit attempts. SO WHAT The evaluation provided insight into how the project changed attitudes and motivated community members to make quit attempts and provided ideas to meet the ongoing challenge.
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Affiliation(s)
- Raquiba J Khan
- Health Promotion Service, South Western Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - Natasha Poder
- Health Promotion Service, South Western Sydney Local Health District, Campbelltown, NSW, Australia
| | - Vilas Kovai
- Health Promotion Service, South Western Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | | | - Darryl Wright
- Tharawal Aboriginal Corporation, Airds, NSW, Australia
| | - Mark Spinks
- Babana Aboriginal Men's Group Inc., Glebe, NSW, Australia
| | | | - Elizabeth Millen
- Health Promotion Service, South Western Sydney Local Health District, Bankstown Community Health, Bankstown, NSW, Australia
| | - Kerry Welsh
- Health Promotion Service, South Western Sydney Local Health District, Bankstown Community Health, Bankstown, NSW, Australia
| | - Karen Bedford
- Health Promotion Service, Sydney Local Health District, Camperdown, NSW, Australia
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Snijder M, Lees B, Stearne A, Ward J, Garlick Bock S, Newton N, Stapinski L. An ecological model of drug and alcohol use and related harms among Aboriginal and Torres Strait Islander Australians: A systematic review of the literature. Prev Med Rep 2021; 21:101277. [PMID: 33391981 PMCID: PMC7773534 DOI: 10.1016/j.pmedr.2020.101277] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/23/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022] Open
Abstract
Globally, Indigenous populations experience a disproportionately higher burden of disease related to substance use. Effective prevention of harm related to substance use is a key strategy for improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples in Australia. To inform preventative approaches, this review synthesised the evidence of risk and protective factors of substance use and related harms among Aboriginal and Torres Strait Islander peoples. Eight peer-reviewed and two grey literature databases were systematically searched for quantitative or qualitative studies assessing factors associated with substance use and related harms among Aboriginal and Torres Strait Islander peoples, published between 1 January 1990 and 30 April 2018. Study quality was assessed using validated instruments. Risk or odds ratios were extracted or calculated and factors were summarised in an ecological model into individual, relationship, community, societal or culturally-distinct levels. Thirty-eight relevant studies were identified and reviewed. Individual-level risk factors for substance use were identified including low socio-economic status, high psychological distress, poly drug use and being male. Relationship-level factors were peer pressure and partner/family substance use; protective factors were supportive environments and positive role models. Community-level risk factors included availability of substances. Culturally-distinct factors included cultural connection as a protective factor, but cultural obligations around sharing was a risk factor. Societal risk factors included intergenerational trauma caused by government policies. These findings highlight the importance of tailored preventative approaches for Aboriginal and Torres Strait Islander communities that address identified risk factors and promote protective factors across all ecological levels.
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Affiliation(s)
- Mieke Snijder
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | | | - James Ward
- The Poche Centre for Indigenous Health, University of Queensland, St Lucia, 4067 Queensland, Australia
| | - Sophia Garlick Bock
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
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13
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Snijder M, Stapinski L, Lees B, Ward J, Conrod P, Mushquash C, Belone L, Champion K, Chapman C, Teesson M, Newton N. Preventing Substance Use Among Indigenous Adolescents in the USA, Canada, Australia and New Zealand: a Systematic Review of the Literature. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:65-85. [PMID: 31641922 PMCID: PMC6957574 DOI: 10.1007/s11121-019-01038-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This systematic review assessed the current evidence base of substance use prevention programs for Indigenous adolescents in the USA, Canada, Australia and New Zealand. The authors investigated (a) the outcomes, type, setting and context of prevention programs; (b) the common components of beneficial prevention programs; and (c) the methodological quality of evaluations of included prevention programs. The authors searched eight peer-reviewed and 20 grey literature databases for studies published between 1 January 1990 and 31 August 2017. Data extracted included type of program (culturally adapted, culture-based or unadapted), the setting (school, community, family or multi-setting), delivery (computerised or traditional), context (Indigenous-specific or multi-cultural environment) and common components of the programs. Program evaluation methodologies were critically appraised against standardised criteria. This review identified 26 eligible studies. Substance use prevention programs for Indigenous youth led to reductions in substance use frequency and intention to use; improvements in substance-related knowledge, attitudes and resistance strategies; and delay in substance use initiation. Key elements of beneficial programs included substance use education, skills development, cultural knowledge enhancement and community involvement in program development. Five programs were rated as methodologically strong, seven were moderate and fourteen were weak. Prevention programs have the potential to reduce substance use among Indigenous adolescents, especially when they are developed in partnership with Indigenous people. However, more rigorously conducted evaluation trials are required to strengthen the evidence base.
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Affiliation(s)
- Mieke Snijder
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia.
| | - Lexine Stapinski
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Briana Lees
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Patricia Conrod
- Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Christopher Mushquash
- Centre for Rural and Northern Health Research, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Canada
| | - Lorenda Belone
- Department of Health, Exercise & Sports Sciences, College of Education, University of New Mexico, Albuquerque, NM, USA
| | - Katrina Champion
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Cath Chapman
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Maree Teesson
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Nicola Newton
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
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14
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McBride KF, Rolleston A, Grey C, Howard NJ, Paquet C, Brown A. Māori, Pacific, Aboriginal and Torres Strait Islander Women's Cardiovascular Health: Where Are the Opportunities to Make a Real Difference? Heart Lung Circ 2020; 30:52-58. [PMID: 33162366 DOI: 10.1016/j.hlc.2020.06.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/27/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
Māori and Pacific women in New Zealand and Aboriginal and Torres Strait Islander women in Australia are recognised as nurturers and leaders within their families and communities. However, women's wellbeing, and that of their communities, are affected by a high burden of cardiovascular disease experienced at a younger age than women from other ethnic groups. There has been little focus on the cardiovascular outcomes and strategies to address heart health inequities among Māori, Pacific, Aboriginal and Torres Strait Islander women. The factors contributing to these inequities are complex and interrelated but include differences in exposure to risk and protective factors, rates of multi-morbidity, and substantial gaps within the health system, which include barriers to culturally responsive, timely and appropriate cardiovascular care. Evidence demonstrates critical treatment gaps across the continuum of risk and disease, including assessment and management of cardiovascular risk in young women and time-critical access to and receipt of acute services. Cardiovascular disease in women impacts not only the individual, but their family and community, and the burden of living with disease limits women's capacity to fulfil their roles and responsibilities which support and sustain families and communities. Our response must draw on the strengths of Māori, Pacific, Aboriginal and Torres Strait Islander women, acknowledge health and wellbeing holistically, address the health and social needs of individuals, families and communities, and recognise that Indigenous women in New Zealand, Australia and across the Pacific must be involved in the design, development and implementation of solutions affecting their own health.
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Affiliation(s)
- Katharine F McBride
- School of Health Sciences, University of South Australia, Adelaide, SA, Australia; Australian Centre for Precision Health, Cancer Research Institute, University of South Australia, Adelaide, SA, Australia; Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | | | - Corina Grey
- Auckland District Health Board, Auckland, New Zealand
| | - Natasha J Howard
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Catherine Paquet
- School of Health Sciences, University of South Australia, Adelaide, SA, Australia; Australian Centre for Precision Health, Cancer Research Institute, University of South Australia, Adelaide, SA, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
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15
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Cuthbert KE, Brown C, Hammond M, Williams TA, Tayley D, Deemal-Hall E, Thomas DP. Engaging with Aboriginal Shire Councils in remote Cape York communities to address smoke-free environments. Aust J Prim Health 2020; 25:419-423. [PMID: 31581980 DOI: 10.1071/py19023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/27/2019] [Indexed: 11/23/2022]
Abstract
The high prevalence and health effect of tobacco smoking and secondhand smoke exposure among Aboriginal and Torres Strait Islander people is well known. Due to its significance, the responsibility of tackling smoking among Aboriginal and Torres Strait Islander people should not remain solely with health service providers. The creation of supportive environments and collaboration beyond the health sector are critical elements of comprehensive primary health care practised by Aboriginal Community Controlled Health Services. This paper discusses how Apunipima Cape York Health Council worked with three Aboriginal Shire Councils to create more smoke-free places, using local working groups, information sessions and community-based health promotion. The flexibility and the time allocated to the engagement process with councils, community leaders, organisations and community members were important. All three communities acknowledged the benefits of role modelling and working together to improve health, with addressing tobacco smoking seen as 'everyone's business' and 'not just service providers'. Aboriginal Shire Councils can play a critical role, in partnership with Aboriginal Community Controlled Health Services, in creating healthy places that enable healthy choices.
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Affiliation(s)
- Kiarah E Cuthbert
- Apunipima Cape York Health Council, 186 McCoombe Street, Bungalow, Qld 4870, Australia; and Corresponding author.
| | - Clare Brown
- Apunipima Cape York Health Council, 186 McCoombe Street, Bungalow, Qld 4870, Australia
| | - Melinda Hammond
- Apunipima Cape York Health Council, 186 McCoombe Street, Bungalow, Qld 4870, Australia
| | - Tiffany A Williams
- Apunipima Cape York Health Council, 186 McCoombe Street, Bungalow, Qld 4870, Australia
| | - Desmond Tayley
- Wujal Wujal Aboriginal Shire Council, Lot 1 Hartwig Street, Wujal Wujal, Qld 4895, Australia
| | - Eileen Deemal-Hall
- Wujal Wujal Aboriginal Shire Council, Lot 1 Hartwig Street, Wujal Wujal, Qld 4895, Australia
| | - David P Thomas
- Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
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16
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Thomas DP, Davey M, Sterren AE, Panaretto KS, Lyons L. Do stress, life satisfaction, depression and alcohol use predict quitting among Aboriginal and Torres Strait Islander smokers? Aust N Z J Public Health 2020; 44:186-192. [DOI: 10.1111/1753-6405.12993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 02/01/2020] [Accepted: 03/01/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- David P. Thomas
- Menzies School of Health ResearchCharles Darwin University Northern Territory
| | | | - Anke E. Sterren
- Alcohol Tobacco and Other Drug Association ACT Australian Capital Territory
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17
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Thirlway F. Explaining the social gradient in smoking and cessation: the peril and promise of social mobility. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:565-578. [PMID: 31769046 PMCID: PMC7079060 DOI: 10.1111/1467-9566.13039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Smoking in high-income countries is now concentrated in poor communities whose relatively high smoking prevalence is explained by greater uptake but above all by lower quit rates. Whilst a number of barriers to smoking cessation have been identified, this is the first paper to situate cessation itself as a classed and cultural practice. Drawing on ethnographic research carried out in a working-class community in the North of England between 2012 and 2015, I theorise smoking cessation as a symbolic practice in relation to the affective experience of class and social mobility. I show that ambivalence about upward mobility as separation and loss translated into ambivalence about smoking cessation. The reason for this was that the social gradient in smoking operated dynamically at the level of the individual life course, i.e. smoking cessation followed upward mobility. A serious health problem was an appropriate reason to quit but older women continued to smoke despite serious health problems. This was linked to historical gender roles leading to women placing a low priority on their own health as well as the intergenerational reproduction of smoking through close affective links with smoking parents.
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Affiliation(s)
- Frances Thirlway
- Department of SociologyWentworth CollegeUniversity of YorkYorkUK
- Anthropology DepartmentDurham UniversityDurhamUK
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18
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Schubert J, Kruavit A, Mehra S, Wasgewatta S, Chang AB, Heraganahally SS. Prevalence and nature of lung function abnormalities among Indigenous Australians referred to specialist respiratory outreach clinics in the Northern Territory. Intern Med J 2019; 49:217-224. [PMID: 30239090 DOI: 10.1111/imj.14112] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/26/2018] [Accepted: 08/26/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Poor lung function is a predictor of future all-cause mortality. In Australia, respiratory diseases are particularly prevalent among the indigenous population, especially in remote communities. However, there are little published pulmonary function tests' (PFT) data of remote-based adult indigenous patients. AIM To evaluate the severity of airflow obstruction and other PFT abnormalities of adults referred to specialist respiratory clinics in remote indigenous communities. METHODS Retrospective analysis of PFT (pre- and post-bronchodilator spirometry, total lung capacity (TLC) and diffusing capacity to carbon monoxide (DLCO)) of indigenous patients collected during specialist respiratory clinics in remote Northern Territory (NT) indigenous communities (Australia) between 2013 and 2015. The National Health and Nutrition Examination Survey (NHANES) III without ethnic correction was used as the reference. RESULTS Of the 357 patients, 150 had acceptable spirometry, and 71 had acceptable DLCO and TLC studies. Despite the relatively young age (mean = 49 years, SD = 12.9), their lung function was generally low; mean % predicted values were FEV1 = 55% (SD = 20.5%), FVC = 61% (SD = 15.6%), DLCO = 64.0% (SD = 19.7%) and TLC = 70.1% (SD = 18.2%). Mean FEV1 /FVC ratio was preserved (0.71, SD = 0.16). Post-bronchodilator airflow obstruction (FEV1 /FVC < 0.7) was observed in 37% of patients, where a large proportion (67%) demonstrated at least a severe airflow obstruction, with a mean FEV1 of 41% predicted. CONCLUSION In this first study of PFT findings of indigenous adults from a remote-based clinical service, we found a high rate of at least moderate airflow limitation and low FVC along with preserved FEV1/FVC ratio. Increased awareness and screening for reduced lung function needs to be considered in this population.
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Affiliation(s)
- Jonathon Schubert
- Department of Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Anuk Kruavit
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Sumit Mehra
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Sanjiwika Wasgewatta
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Subash S Heraganahally
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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19
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Small S, Porr C, Swab M, Murray C. Experiences and cessation needs of Indigenous women who smoke during pregnancy: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2019; 16:385-452. [PMID: 29419622 DOI: 10.11124/jbisrir-2017-003377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The aim of this review was to identify and synthesize the best available evidence to address two questions: i) what is the experience of smoking during pregnancy for Indigenous women? and ii) what are the smoking cessation needs of Indigenous women who smoke during pregnancy? INTRODUCTION Smoking during pregnancy not only affects pregnant women's general health but also causes such serious problems as pre-term delivery, low birth weight, and sudden infant death. Rates of smoking during pregnancy are particularly high among Indigenous women. Learning about Indigenous women's experiences of smoking during pregnancy and associated smoking cessation needs is important to providing informed health care to them. INCLUSION CRITERIA The participants of interest were Indigenous women who smoked during a current or past pregnancy. The phenomena of interest were the experiences of smoking during pregnancy for Indigenous women and the smoking cessation needs of Indigenous women during pregnancy. The context was any community worldwide where pregnant Indigenous women live. Studies considered for this review were those in which qualitative data were gathered and analysed on the phenomena of interest, including mixed methods research. METHODS A comprehensive search was conducted for published studies in academic databases (i.e. PubMed, CINAHL, PsycINFO, Embase, Sociological Abstracts, SocINDEX, and Web of Science), unpublished studies in sources of gray literature (i.e. ProQuest Dissertations and Theses, OAIster, LILACS, MedNar, Google, Google Scholar, OpenGrey and relevant websites), and any additional studies in reference lists. Language and date limiters were not applied. The searches included all studies globally and were carried out on October 31, 2016. Studies that met the inclusion criteria were assessed for methodological quality by two reviewers independently, using the criteria of the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Descriptive details of each study accepted for this review were extracted in accordance with the elements of the JBI Data Extraction Form for Qualitative Research. The research findings that were relevant to the phenomena of interest and had participant voice were extracted from each included study and synthesized using the JBI meta-aggregative approach. The synthesized findings were assigned confidence scores in accordance with the JBI ConQual approach. RESULTS Thirteen studies were included in this review following careful consideration of the methodological quality of each study. The studies yielded a total of 116 research findings, which were grouped into 19 categories and then aggregated to form five synthesized findings. Confidence in the findings was determined to be low to very low (see ConQual Summary of Findings). CONCLUSION There is a small body of research evidence on Indigenous women's experiences of smoking during pregnancy and their smoking cessation needs. Confidence in the synthesized findings is constrained due to methodological limitations in many of the primary studies included in this review, along with mixed credibility of the research findings from across primary studies.
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Affiliation(s)
- Sandra Small
- School of Nursing, Memorial University of Newfoundland, St. John's, Canada.,Memorial University School of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A Joanna Briggs Institute Affiliated Group
| | - Caroline Porr
- School of Nursing, Memorial University of Newfoundland, St. John's, Canada.,Memorial University School of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A Joanna Briggs Institute Affiliated Group
| | - Michelle Swab
- Health Sciences Library, Memorial University of Newfoundland, St. John's, Canada.,Memorial University School of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A Joanna Briggs Institute Affiliated Group
| | - Cynthia Murray
- School of Nursing, Memorial University of Newfoundland, St. John's, Canada.,Memorial University School of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A Joanna Briggs Institute Affiliated Group
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20
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Kerrigan V, Herdman RM, Thomas DP, Hefler M. 'I still remember your post about buying smokes': a case study of a remote Aboriginal community-controlled health service using Facebook for tobacco control. Aust J Prim Health 2019; 25:443-448. [PMID: 31590703 DOI: 10.1071/py19008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/01/2019] [Indexed: 01/27/2023]
Abstract
Many Aboriginal Community Controlled Health Services (ACCHS) embrace Facebook as an organisational tool to share positive stories, which counter the negative narrative surrounding Aboriginal issues. However, the Facebook algorithm prioritises posts on personal pages over organisations. To take advantage of the algorithm, this project paid three Yolŋu employees of a north-east Arnhem Land ACCHS to share quit smoking messages on their personal Facebook pages. Smoking prevalence among Aboriginal and Torres Strait Islander Australians is nearly three-fold higher than non-Indigenous Australians, and previous research has identified the need for culturally appropriate communication approaches to accelerate the decline in Indigenous smoking. This research found Yolŋu participants nurtured healthy behaviours through compassionate non-coercive communications, in contrast to fear-inducing health warnings prevalent in tobacco control. Cultural tailoring of tobacco control messages was achieved by having trusted local health staff sharing, and endorsing, messages regardless of whether the content was Indigenous specific. This research also revealed online Facebook activity does not reflect the reach of posts, which may extend beyond social media users to individuals who do not have a Facebook profile.
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Affiliation(s)
- Vicki Kerrigan
- Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia; and Corresponding author.
| | | | - David P Thomas
- Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
| | - Marita Hefler
- Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
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21
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Heraganahally SS, Wasgewatta SL, McNamara K, Eisemberg CC, Budd RC, Mehra S, Sajkov D. Chronic Obstructive Pulmonary Disease In Aboriginal Patients Of The Northern Territory Of Australia: A Landscape Perspective. Int J Chron Obstruct Pulmon Dis 2019; 14:2205-2217. [PMID: 31576117 PMCID: PMC6769027 DOI: 10.2147/copd.s213947] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 09/05/2019] [Indexed: 12/21/2022] Open
Abstract
Background The Aboriginal population of Australia has a higher burden of chronic health conditions than non-Aboriginal Australians. However, there is a paucity of data on clinical and demographic characteristics of chronic obstructive pulmonary disease (COPD) in this population. Method In this retrospective study we evaluated the clinical, demographic and environmental influences in adult Aboriginal patients with COPD living in the regional and remote communities of the Northern Territory of Australia. Results There were 380 patients (49%) with a diagnosis of COPD of the 767 patients referred to specialist respiratory outreach clinics. The mean age was 57 years (56% were female) and mean±SD BMI was 24.30±7.01 kg/m2. Smoking history was noted in 93% of the study cohort. The most common respiratory symptom was shortness of breath in 62%, and inhaled medications (salbutamol, tiotropium, salmeterol/fluticasone) were used by 79%, 44% and 58% of patients, respectively. Spirometry showed obstructive impairment (FEV1/FVC <0.7) in 79% (0.56±0.17), with mean FEV1 42% of predicted, and a bronchodilator response was present in 28.6%. Comorbid bronchiectasis was diagnosed in 49.8% along with COPD. The relationship between COPD and community demography showed a higher proportion of smokers and those with underlying bronchiectasis to have lower FEV1/FVC ratios. Communities with a higher proportion of asthma were younger and had higher smoking rates. Mortality increased with increasing number of exacerbations and hospital admissions. Conclusion The Aboriginal population with COPD has a higher prevalence of smoking, moderate to severe airflow obstruction on spirometry and frequently co-diagnosed bronchiectasis with increased severity of ventilatory impairment.
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Affiliation(s)
- Subash S Heraganahally
- Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, NT, Australia.,Flinders University - College of Medicine and Public Health, Adelaide, SA, Australia.,Northern Territory Medical School, Charles Darwin University, Darwin, NT, Australia.,Darwin Respiratory and Sleep Health, Darwin, NT, Australia
| | | | - Kelly McNamara
- Flinders University - College of Medicine and Public Health, Adelaide, SA, Australia.,Northern Territory Medical School, Charles Darwin University, Darwin, NT, Australia
| | - Carla C Eisemberg
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Darwin, NT, Australia
| | - Richard C Budd
- Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Sumit Mehra
- Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, NT, Australia.,Northern Territory Medical School, Charles Darwin University, Darwin, NT, Australia.,Respiratory and Sleep Medicine, Flinders Medical Centre, Adelaide, SA, Australia
| | - Dimitar Sajkov
- Flinders University - College of Medicine and Public Health, Adelaide, SA, Australia.,Respiratory and Sleep Medicine, Flinders Medical Centre, Adelaide, SA, Australia.,Australian Respiratory and Sleep Medicine Institute, Adelaide, SA, Australia
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22
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Tane MP, Hefler M, Thomas DP. Smokefree leadership among the Yolŋu peoples of East Arnhem Land, Northern Territory: a qualitative study. Glob Health Promot 2019; 27:100-108. [PMID: 31232171 DOI: 10.1177/1757975919829405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative study examined smokefree leadership among the Yolŋu people, Indigenous landowners of East Arnhem Land. Despite disproportionately high smoking prevalence, the study found that most people enacted smokefree leadership within families and communities. While there was broad concern about not impinging on the autonomy of others, Indigenous health workers regularly advised clients, family and community members to quit smoking. This followed a general belief that the issue of smoking was best raised by health workers, rather than traditional leaders. Protecting children from second-hand smoke and preventing smoking initiation was important to all participants irrespective of their smoking status. An enduring and highly valued cultural connection to ŋarali' (tobacco) remains an essential part of the sacred practices of the funeral ceremony, an important and unique social utility. The study found consensus among participants that this would not change. Navigating traditional connections to ŋarali' in a context where most people are still addicted to commercial tobacco is challenging and requires respectful and culturally compelling approaches. Tobacco control initiatives with the Yolŋu should therefore utilise existing smokefree leaders within the social context in which ŋarali' is valued and used, an approach that may resonate with other Indigenous Australian nations and communities.
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Affiliation(s)
- Moana Pera Tane
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - David P Thomas
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
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23
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Yang X, Jing W, Gao C, Attané I. Smoking behavior of "marriage squeezed" men and its impact on their quality of life: A survey study in China. Am J Mens Health 2019; 13:1557988319859733. [PMID: 31221046 PMCID: PMC6589983 DOI: 10.1177/1557988319859733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 12/01/2022] Open
Abstract
From the 1980s, along with the wide application of the "one-child policy" and new technologies for prenatal sex determination, China's population has experienced a growing male population. China will thus face an increasingly serious male "marriage squeeze," possibly resulting in decreased psychological and sexual well-being of involuntary bachelors, which, in turn, may result in decreased quality of life (QoL). This study used data from the Social Survey on Gender Role and Family Life, which was conducted from August 2014 to January 2015 in Shaanxi Province (N = 1,144; 516 never-married and 628 married rural men). Descriptive analyses, crosstab analyses, and independent sample t-tests were used to compare the scores of three dimensions of QoL (physical and psychological health, and social relationships) and the overall QoL of rural men. Using the linear regression analysis method, this study analyzed involuntary bachelors' smoking behavior and its impact on their QoL. Results indicate that smoking not only fails to alleviate the psychological or sexual problems of involuntary bachelors, it has an independent and negative impact on the physical and psychological health of married and never-married men, which negatively affects their overall QoL. Subjective and objective exposure to marriage squeeze negatively impacts three dimensions of QoL and overall QoL of married and never-married men; however, this influence was moderated by sexual satisfaction. In addition, sexual satisfaction positively affected the three dimensions of QoL and overall QoL of married and never-married men. Since involuntary bachelors may be a high-risk group, further research is warranted.
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Affiliation(s)
- Xueyan Yang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China
| | - Wen Jing
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China
- ShaanXi Provincial Party School of The CPC, Xi’an, Shaanxi Province, People’s Republic of China
| | - Chenzhuo Gao
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi Province, People’s Republic of China
| | - Isabelle Attané
- French National Institute for Demographic Studies, INED, Paris, France
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24
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Thomas DP, Lyons L, Borland R. Predictors and reasons for starting and sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers. Drug Alcohol Rev 2019; 38:244-253. [DOI: 10.1111/dar.12917] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 01/11/2023]
Affiliation(s)
- David P. Thomas
- Tobacco Control Research, Menzies School of Health ResearchCharles Darwin University Darwin Australia
| | - Louise Lyons
- Public Health and ResearchVictorian Aboriginal Community Controlled Health Organisation Melbourne Australia
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25
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Social Norms and Self-Efficacy to Quit Waterpipe Use: Findings from a Tobacco Study among Male Smokers in Rural Viet Nam. J Smok Cessat 2018. [DOI: 10.1017/jsc.2017.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction: Waterpipe use is a significant health concern in low- and middle-income countries like Viet Nam, yet there is a lack of research on factors that may influence use and self-efficacy to quit among adults.Aims: This study examined the relationship between social norms related to waterpipe use and self-efficacy to quit among male waterpipe smokers in Viet Nam.Methods: A cross-sectional survey was conducted with 214 adult male waterpipe smokers enrolled in a large cluster–randomised controlled trial conducted in a rural province in Viet Nam. Associations between social norms related to waterpipe smoking and the participants’ confidence to quit waterpipes were assessed using hierarchical regression models to account for differences among study sites and other covariates.Results: Self-efficacy to quit smoking was positively associated with immediate family members’ not minding participants smoking and with extended family's encouragement to quit smoking.Conclusions: The findings suggest the need for a more comprehensive understanding of the functions and characteristics of the social context of waterpipe smoking, including the social networks of waterpipe smokers, to inform effective cessation interventions for waterpipe smokers.
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Wright A, Cameron H, Roe Y, Lovett R. Analysing aggregate clinical data to support evaluation of the Tackling Indigenous Smoking program, 2014-16. AUST HEALTH REV 2018; 43:441-447. [PMID: 30145996 DOI: 10.1071/ah18009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/05/2018] [Indexed: 11/23/2022]
Abstract
Objective The aim of this study was to assess the change in recording of client population smoking attributes (smoking status recorded and smoking status) in Tackling Indigenous Smoking (TIS)-funded services compared with non-funded services for Aboriginal and Torres Strait Islander people, 2014-16. Methods The study included a cohort of 152 Aboriginal-community controlled services with aggregate client smoking data from 2014 to 2016. Negative binomial regression was used to assess change in smoking status recorded and smoking status between TIS and non-TIS funded organisations. The models controlled for size of client population, jurisdiction and remoteness. Results From 2014 to 2016, the overall reporting rate (change in recording of smoking status) of client smoking status was 1.58-fold higher (95% confidence interval (CI) 1.30-1.91; P<0.001) in TIS-funded than non-TIS-funded services after controlling for year, remoteness and their interaction. The highest change in reporting of client smoking status was for TIS-funded services in remote areas (reporting ratio 6.55; 95% CI 5.18-8.27; P<0.001). In 2016, TIS-funded services reported higher overall levels of recording client smoking status (current, ex- and non-smokers) than non-TIS funded services (RR 1.11; 95% CI 1.00-1.28; P<0.001). There was no significant change in the reporting of smokers, ex-smokers or non-smokers over the three reporting periods. Conclusion The analysis shows higher reporting of the proportion of the service client population for services funded under the TIS program compared with non-TIS-funded services. Existing evidence suggests that following-up smokers with targeted clinical interventions once they have had smoking status recorded could reduce smoking rates in the long term. The public health contribution of this study has defined one method for assessing smoking attributes when using aggregate health service data. This method could be applied to future tobacco control programs in health services. What is known about the topic? Aboriginal and Torres Strait Islander smoking prevalence is high. The Aboriginal and Torres Strait Islander primary healthcare providers' national key performance indicators (nKPIs) are one data source that can track changes over time in smoking in clients of these services. What does this paper add? This paper presents the first analytical study and evaluation of the nKPI dataset items on smoking. What are the implications for practitioners? There is value in analysing routinely collected data in program evaluations. The method used in this paper demonstrates one approach that could be used to assess smoking indicators and their changes over time in TIS program evaluation.
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Affiliation(s)
- Alyson Wright
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Building 54, Mills Road, Acton, ACT 2600, Australia. Email
| | - Helen Cameron
- National Aboriginal and Torres Strait Islander Health Worker Association, PO Box 729, Mawson, ACT 2607, Australia. Email
| | - Yvette Roe
- University of Queensland, Midwifery Research Unit, Mater Research Level 2, Aubigny Place Raymond Terrace, South Brisbane, Qld 4101, Australia. Email
| | - Ray Lovett
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Building 54, Mills Road, Acton, ACT 2600, Australia. Email
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International Approaches to Tobacco Use Cessation Programming and Prevention Interventions among Indigenous Adolescents and Young Adults. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0186-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Establishing Smoke-Free Homes in the Indigenous Populations of Australia, New Zealand, Canada and the United States: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111382. [PMID: 29135950 PMCID: PMC5708021 DOI: 10.3390/ijerph14111382] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/05/2017] [Accepted: 11/08/2017] [Indexed: 11/21/2022]
Abstract
A smoke-free home can have multiple benefits by reducing exposure to secondhand smoke (SHS), supporting quit attempts among active smokers, and discouraging adolescents from taking up smoking. The aim of this review was to summarize the literature on the establishment of smoke-free homes in Indigenous populations and identify the supporting influences and barriers, using the Social Cognitive Theory lens. A search of the Medline, CINAHL, Cochrane Collaboration and PyscINFO databases and manual searches of relevant peer-reviewed literature was completed, focusing on Indigenous populations in developed economies of North America and Oceania. Of 2567 articles identified, 15 studies were included. Ten studies included Indigenous participants only, and of these just three focused entirely on SHS in the home. Knowledge of the harms associated with SHS was the most common theme represented in all the studies. This knowledge fueled parents’ motivation to protect their children from SHS by establishing smoke-free homes. Individuals who approached implementation with confidence, coupled with clear communication about smoke-free home rules were more successful. Barriers included challenges for families with multiple smokers living in the same dwelling. There is limited research regarding managing smoking behaviors in the home among Indigenous populations, even though this approach is a successful catalyst for smoking prevention and cessation. Research to understand the influences that support the establishment of smoke-free homes is required for better-informed intervention studies.
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Bigwanto M, Mongkolcharti A, Peltzer K, Laosee O. Determinants of cigarette smoking among school adolescents on the island of Java, Indonesia. Int J Adolesc Med Health 2017; 29:/j/ijamh.2017.29.issue-2/ijamh-2015-0036/ijamh-2015-0036.xml. [PMID: 26360491 DOI: 10.1515/ijamh-2015-0036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 07/02/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Integrated Model of Change has successfully explained the behavior change process. Cigarette smoking is a social phenomenon, which needs to be understood for devising effective preventive strategies. OBJECTIVES The study aims to apply the Integrated Model of Change to determine predictive factors of cigarette smoking behavior among school adolescents in Indonesia. METHODS A school-based cross-sectional study was designed to collect data in Banten, Indonesia. A total of 698 students from eight high schools were recruited by multi-stage cluster sampling. The association between cigarette smoking and the independent variables was examined by multiple logistic regressions. RESULTS The majority of respondents (86.4%) were between the ages of 15 and 17 years (Mean=16.4 years; SD=1.01). Approximately half (48.8%) of the students ever tried a cigarette while 29.6% were current smokers. Curiosity was reported as the main reason for experimenting with cigarettes (32%). The significant factors regarding current cigarette smoking were attitude [adjusted odds ratio (AOR)=2.68], social norms (AOR=12.80), self-efficacy (AOR=15.85), and accessibility (AOR=4.39). CONCLUSION The study revealed social influence and self-efficacy that were strongly associated with cigarette smoking can help authorities in guiding possible intervention programs for school adolescents.
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Affiliation(s)
- Mouhamad Bigwanto
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phudthamonthon, Nakorn Pathom
| | - Aroonsri Mongkolcharti
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phudthamonthon, Nakorn Pathom
| | - Karl Peltzer
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phudthamonthon, Nakorn Pathom
| | - Orapin Laosee
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phudthamonthon, Nakorn Pathom
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Gould GS, Lim LL, Mattes J. Prevention and Treatment of Smoking and Tobacco Use During Pregnancy in Selected Indigenous Communities in High-Income Countries of the United States, Canada, Australia, and New Zealand: An Evidence-Based Review. Chest 2017; 152:853-866. [PMID: 28694200 DOI: 10.1016/j.chest.2017.06.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 06/09/2017] [Accepted: 06/28/2017] [Indexed: 10/19/2022] Open
Abstract
Tobacco smoking during pregnancy is the most important modifiable risk factor for adverse pregnancy outcomes and long-term health complications for mother and baby. Tobacco use during pregnancy has decreased in high-income countries but not in Indigenous women in Australia, New Zealand, the United States, and Canada. This evidence-based review focuses on tobacco use among Indigenous pregnant women in high-income countries that share a history of European colonization. Indigenous women are more likely to use tobacco because of socioeconomic disadvantage, social norms, and poor access to culturally appropriate tobacco cessation support. Complications arising from tobacco smoking during pregnancy, such as low birth weight, prematurity, perinatal death, and sudden infant death syndrome, are much higher in Indigenous populations. Effective approaches to cessation in pregnant nonindigenous women involves behavioral counseling, with or without nicotine replacement therapy (NRT). Higher nicotine metabolism during pregnancy and poor adherence may affect therapeutic levels of NRT. Only two randomized trials were conducted among Indigenous women: neither found a statistically significant difference in cessation rates between the treatment and comparison arms. Considerations should be given to (1) whole life course approaches to reduce tobacco use in Indigenous women, (2) prohibiting tobacco promotion and reducing access to alcohol for minors to prevent smoking initiation in Indigenous youth, and (3) training health-care professionals in culturally appropriate smoking cessation care to improve access to services. It is critical to ensure acceptability and feasibility of study designs, consult with the relevant Indigenous communities, and preempt implementation challenges. Research is needed into the effect of reducing or stopping smoking during pregnancy when using NRT on subsequent maternal and infant outcomes.
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Affiliation(s)
- Gillian S Gould
- Priority Reseach Centre for Brain and Mental Health Research, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.
| | - Ling Li Lim
- Priority Reseach Centre for Brain and Mental Health Research, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Joerg Mattes
- Priority Research Centre GrowUpWell, Hunter Medical Research Institute and University of Newcastle, and Department of Paediatric Respiratory and Sleep Medicine, John Hunter Children's Hospital, Newcastle, NSW, Australia
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Gould GS, Bovill M, Clarke MJ, Gruppetta M, Cadet-James Y, Bonevski B. Chronological narratives from smoking initiation through to pregnancy of Indigenous Australian women: A qualitative study. Midwifery 2017; 52:27-33. [PMID: 28570858 DOI: 10.1016/j.midw.2017.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/23/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE One in two Indigenous Australian pregnant women smoke, yet little is known about their trajectory of smoking. This study aimed to explore Aboriginal women's narratives from starting smoking through to pregnancy. METHODS A female Aboriginal Researcher conducted individual face-to-face interviews with 20 Aboriginal women from New South Wales, Australia. Recruitment, through Aboriginal services and community networks, continued until saturation was reached. Audio-recorded transcripts were independently open coded by two researchers, inductively analysed and reported using a three-dimensional structure of looking backwards, forwards, inwards, outwards and a sense of place, to elucidate the chronology of events, life stages, characters, environments, and turning points of the stories. RESULTS A chronology emerged from smoking initiation in childhood, coming of age, becoming pregnant, through to attempts at quitting, and relapse post-partum. Several new themes emerged: the role mothers play in women's smoking and quitting; the contribution of nausea to spontaneous quitting; depression as a barrier to quitting; and the hopes of women for their own and their children's future. The epiphany of pregnancy was a key turning point for many - including the interplay of successive pregnancies; and the intensity of expressed regret. CONCLUSIONS Aboriginal women report multiple influences in the progression of early smoking to pregnancy and beyond. Potential opportunities to intervene include: a) childhood, coming of age, pregnancy, post-natal, in-between births; b) key influencers; c) environments, and d) targeting concurrent substance use. Morning sickness appears to be a natural deterrent to continued smoking. Depression, and its relationship to smoking and quitting in Australian Indigenous pregnant women, requires further research.
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Affiliation(s)
- Gillian S Gould
- Centre for Brain and Mental Health Research, School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia.
| | - Michelle Bovill
- Centre for Brain and Mental Health Research, School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia
| | - Marilyn J Clarke
- Clarence Specialist Clinic, Through Street, South Grafton, New South Wales 2460, Australia
| | - Maree Gruppetta
- Wollotuka Institute, The University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia
| | - Yvonne Cadet-James
- Indigenous Centre, James Cook University, Townsville, Queensland 4811, Australia
| | - Billie Bonevski
- Centre for Brain and Mental Health Research, School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia
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Thomas DP, Panaretto KS, Davey M, Briggs V, Borland R. The social determinants and starting and sustaining quit attempts in a national sample of Aboriginal and Torres Strait Islander smokers. Aust N Z J Public Health 2017; 41:230-236. [DOI: 10.1111/1753-6405.12626] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/01/2016] [Accepted: 09/01/2016] [Indexed: 01/28/2023] Open
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Knott VE, Gilligan G, Maksimovic L, Shen D, Murphy M. Gender determinants of smoking practice in Indigenous communities: an exploratory study. Eur J Cancer Care (Engl) 2017; 25:231-41. [PMID: 26918688 DOI: 10.1111/ecc.12478] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 11/30/2022]
Abstract
Despite the need to urgently reduce smoking rates among Indigenous Australians, in order to close-the-gap in life expectancy, little is known regarding how this can be achieved. This study aimed to explore whether a focus on gender specific determinants of smoking among Indigenous Australians could be identified, thus providing a potentially novel approach to underpin future efforts at intervention. A qualitative research design was employed. Eighty-two participants, comprised of 43 Indigenous women (mean age 32.15, SD, 12.47) and 39 Indigenous men (mean age 34.91, SD, 11.26), participated in one of 12 focus groups held in metropolitan, regional and rural locations in South Australia. Facilitators prompted discussion in response to the question: 'What is it like being a smoker these days?' Two experienced coders assessed data for themes using Attride-Stirling's (2002) method of analysis. Two global themes emerged for men and women. The first theme, 'It's Harder to Smoke Nowadays', encompassed sub-themes capturing changed smoking practices in response to tobacco control strategies implemented in Australia. Sub-themes of 'smoking in secrecy' coupled with an 'awareness of the effects of passive smoking' were identified among women. Among men, sub-themes that depicted tension between 'a desire to be a role model' and 'guilt about smoking' emerged. The second theme, 'Push and Pull Factors', identified a range of gender specific determinants of smoking. While similar reasons for smoking ('pull factors') were identified in men and women (e.g. addiction, boredom, stress, pleasure, mood stabiliser), different 'push factors' (reasons for not wanting to smoke) emerged. For men, sport, fitness and children were identified as reasons for not wanting to smoke, whereas women identified factors such as respect for non-smokers, and body image concerns. The current findings suggest that there may be fundamental differences in the determinants of smoking (pull factors) as well as reasons for wanting to quit (push factors) between Indigenous men and women. A focus on interventions that target gender specific determinants, or motivators of smoking, offers a novel, and potentially efficacious approach to reduce smoking rates among Indigenous Australians.
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Affiliation(s)
- V E Knott
- Counselling, Australian Institute of Professional Counsellors, Fortitude Valley, Qld, Australia.,Menzies School of Health Research, Spring Hill, Qld, Australia
| | - G Gilligan
- Menzies School of Health Research, Spring Hill, Qld, Australia.,Charles Darwin University, Casuarina NT, Australia
| | | | - D Shen
- Drug and Alcohol Services SA, Eastwood, SA, Australia
| | - M Murphy
- Michael Murphy Research, Melbourne, Vic., Australia
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Arjunan P, Poder N, Welsh K, Bellear L, Heathcote J, Wright D, Millen E, Spinks M, Williams M, Wen LM. Smoking among Aboriginal adults in Sydney, Australia. Health Promot J Austr 2017; 27:66-69. [PMID: 26235612 DOI: 10.1071/he15020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/23/2015] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Tobacco consumption contributes to health disparities among Aboriginal Australians who experience a greater burden of smoking-related death and diseases. This paper reports findings from a baseline survey on factors associated with smoking, cessation behaviours and attitudes towards smoke-free homes among the Aboriginal population in inner and south-western Sydney. Methods A baseline survey was conducted in inner and south-western Sydney from October 2010 to July 2011. The survey applied both interviewer-administered and self-administered data collection methods. Multiple logistic regression was performed to determine the factors associated with smoking. Results Six hundred and sixty-three participants completed the survey. The majority were female (67.5%), below the age of 50 (66.6%) and more than half were employed (54.7%). Almost half were current smokers (48.4%) with the majority intending to quit in the next 6 months (79.0%) and living in a smoke-free home (70.4%). Those aged 30-39 years (AOR 3.28; 95% CI: 2.06-5.23) and the unemployed (AOR 1.67; 95% CI: 1.11-2.51) had higher odds for current smoking. Participants who had a more positive attitude towards smoke-free homes were less likely to smoke (AOR 0.79; 95% CI: 0.74-.85). Conclusions A high proportion of participants were current smokers among whom intention to quit was high. Age, work status and attitudes towards smoke-free home were factors associated with smoking. So what? The findings address the scarcity of local evidence crucial for promoting cessation among Aboriginal tobacco smokers. Targeted promotions for socio-demographic subgroups and of attitudes towards smoke-free homes could be meaningful strategies for future smoking-cessation initiatives.
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Affiliation(s)
- Punitha Arjunan
- Health Promotion Service, South Western Sydney Local Health District, Eastern Campus, Liverpool Hospital, Liverpool BC, NSW 1871, Australia
| | - Natasha Poder
- Health Promotion Service, South Western Sydney Local Health District, Narellan Community Health Centre, 14 Queen Street, Narellan, NSW 2567, Australia
| | - Kerry Welsh
- Health Promotion Service, South Western Sydney Local Health District, Bankstown Community Health, 5/39 Stanley Street, Bankstown, NSW 2200, Australia
| | - LaVerne Bellear
- Aboriginal Medical Service Redfern, 36 Turner Street, Redfern, NSW 2016, Australia
| | - Jeremy Heathcote
- Babana Aboriginal Men's Group Inc., 37-47St John's Road, Glebe, NSW 2016, Australia
| | - Darryl Wright
- Tharawal Aboriginal Corporation, 187 Riverside Drive, Airds, NSW 2560, Australia
| | - Elizabeth Millen
- Health Promotion Service, South Western Sydney Local Health District, Bankstown Community Health, 5/39 Stanley Street, Bankstown, NSW 2200, Australia
| | - Mark Spinks
- Babana Aboriginal Men's Group Inc., 37-47St John's Road, Glebe, NSW 2016, Australia
| | - Mandy Williams
- Health Promotion Service, South Western Sydney Local Health District, Eastern Campus, Liverpool Hospital, Liverpool BC, NSW 1871, Australia
| | - Li Ming Wen
- Health Promotion Service, Sydney Local Health District, Level 9 North, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia
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Everyday tactics in local moral worlds: E-cigarette practices in a working-class area of the UK. Soc Sci Med 2016; 170:106-113. [PMID: 27788410 PMCID: PMC5115649 DOI: 10.1016/j.socscimed.2016.10.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 10/11/2016] [Accepted: 10/14/2016] [Indexed: 02/04/2023]
Abstract
Research into e-cigarette use has largely focused on their health effects and efficacy for smoking cessation, with little attention given to their potential effect on health inequalities. Drawing on three years of ethnographic research between 2012 and 2015, I investigate the emerging e-cigarette practices of adult smokers and quitters in a working-class area of the UK. I first use de Certeau's notion of ‘tactics’ to describe the informal economy of local e-cigarette use. Low-priced products were purchased through personal networks and informal sources for financial reasons, but also as a solution to the moral problems of addiction and expenditure on the self, particularly for older smokers. E-cigarette practices were produced in local moral worlds where smoking and cessation had a complex status mediated through norms of age and gender. For younger men, smoking cessation conflicted with an ethic of working-class hedonism but e-cigarette use allowed cessation to be incorporated into male sociality. Continued addiction had moral implications which older men addressed by constructing e-cigarette use as functional rather than pleasurable, drawing on a narrative of family responsibility. The low priority which older women with a relational sense of identity gave to their own health led to a lower tolerance for e-cigarette unreliability. I draw on Kleinman's local moral worlds to make sense of these findings, arguing that smoking cessation can be a risk to moral identity in violating local norms of age and gender performance. I conclude that e-cigarettes did have some potential to overcome normative barriers to smoking cessation and therefore to reduce health inequalities, at least in relation to male smoking. Further research which attends to local meanings of cessation in relation to age and gender will establish whether e-cigarettes have similar potential elsewhere. Smokers and e-cigarette users bought cheap products for moral and financial reasons. Smoking cessation conflicted with an ethic of hedonism but e-cigarettes did not. Older men saw e-cigarette use as functional in a narrative of family responsibility. Older women gave their health low priority and found e-cigarettes too much trouble. E-cigarettes had potential to overcome some normative barriers to smoking cessation.
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Noble N, Paul C, Sanson-Fisher R, Turon H, Turner N, Conigrave K. Ready, set, go: a cross-sectional survey to understand priorities and preferences for multiple health behaviour change in a highly disadvantaged group. BMC Health Serv Res 2016; 16:488. [PMID: 27619231 PMCID: PMC5020458 DOI: 10.1186/s12913-016-1701-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 08/24/2016] [Indexed: 01/01/2023] Open
Abstract
Background Socially disadvantaged groups, such as Aboriginal Australians, tend to have a high prevalence of multiple lifestyle risk factors, increasing the risk of disease and underscoring the need for services to address multiple health behaviours. The aims of this study were to explore, among a socially disadvantaged group of people attending an Aboriginal Community Controlled Health Service (ACCHS): a) readiness to change health behaviours; b) acceptability of addressing multiple risk factors sequentially or simultaneously; and c) preferred types of support services. Methods People attending an ACCHS in regional New South Wales (NSW) completed a touchscreen survey while waiting for their appointment. The survey assessed participant health risk status, which health risks they would like to change, whether they preferred multiple health changes to be made together or separately, and the types of support they would use. Results Of the 211 participants who completed the survey, 94 % reported multiple (two or more) health risks. There was a high willingness to change, with 69 % of current smokers wanting to cut down or quit, 51 % of overweight or obese participants wanting to lose weight and 44 % of those using drugs in the last 12 months wanting to stop or cut down. Of participants who wanted to make more than one health change, over half would be willing to make simultaneous or over-lapping health changes. The most popular types of support were help from a doctor or Health Worker and seeing a specialist, with less than a quarter of participants preferring telephone or electronic (internet or smart phone) forms of assistance. The importance of involving family members was also identified. Conclusions Strategies addressing multiple health behaviour changes are likely to be acceptable for people attending an ACCHS, but may need to allow flexibility in the choice of initial target behaviour, timing of changes, and the format of support provided. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1701-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Natasha Noble
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Christine Paul
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Robert Sanson-Fisher
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Heidi Turon
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Nicole Turner
- School of Medicine and Public Health & Department of Rural Health, University of Newcastle, Callaghan, NSW, 2308, Australia
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Gould GS, Watt K, West R, Cadet-James Y, Clough AR. Can smoking initiation contexts predict how adult Aboriginal smokers assess their smoking risks? A cross-sectional study using the 'Smoking Risk Assessment Target'. BMJ Open 2016; 6:e010722. [PMID: 27388350 PMCID: PMC4947807 DOI: 10.1136/bmjopen-2015-010722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Smoking prevalence is slow to reduce among Indigenous Australians of reproductive age. We analysed the relationships between age of smoking initiation, recalled initiation influences and self-assessment of smoking risks in Aboriginal smokers. DESIGN, SETTING AND PARTICIPANTS A community-based cross-sectional survey of Aboriginal smokers aged 18-45 years (N=121; 58 men) was undertaken, using single-item measures. The Smoking Risk Assessment Target (SRAT) as the primary outcome measure enabled self-assessment of smoking risks from 12 options, recategorised into 3 groups. Participants recalled influences on their smoking initiation. Multinomial logistic regression modelling included age, gender, strength of urges to smoke, age at initiation (regular uptake) and statistically significant initiation influences on χ(2) tests ('to be cool', alcohol and cannabis). RESULTS Frequent initiation influences included friends (74%; SD 0.44), family (57%; SD 0.5) and alcohol (40%; SD 0.49). 54% (n=65) of smokers had the highest risk perception on the SRAT, selected by those who cared about the smoking risks and intended to quit soon. On multivariate analyses, compared with the highest level of SRAT, male gender, lower age of uptake and strong urges to smoke were significantly associated with the lowest level of SRAT, selected by those who refuted risks or thought they could not quit. Lower age of uptake and alcohol were associated with mid-level of SRAT, selected by those who cared about smoking risks, but did not consider quitting as a priority. CONCLUSIONS Characteristics of smoking initiation in youth may have far-reaching associations with how smoking risks are assessed by adults of reproductive age, and their intentions to quit smoking. Becoming a regular smoker at under the age of 16 years, and influences of alcohol on smoking uptake, were inversely associated with high-level assessment of smoking risks and intention to quit in regional Aboriginal smokers. The SRAT may help tailor approaches to Indigenous smoking cessation.
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Affiliation(s)
- Gillian Sandra Gould
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Robert West
- Health Behaviour Research Centre, Epidemiology and Public Health, University College London, London, UK
| | - Yvonne Cadet-James
- Australian Aboriginal and Torres Strait Islander Centre, James Cook University, Townsville, Queensland, Australia
| | - Alan R Clough
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
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Sinclair C, Stokes A, Jeffries-Stokes C, Daly J. Positive community responses to an arts-health program designed to tackle diabetes and kidney disease in remote Aboriginal communities in Australia: a qualitative study. Aust N Z J Public Health 2016; 40:307-12. [PMID: 27197563 DOI: 10.1111/1753-6405.12522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 06/01/2015] [Accepted: 12/01/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The Western Desert Kidney Health Project (WDKHP) is an innovative clinical screening, arts-health and community development program, staffed by Aboriginal health workers. The WDKHP is aimed at prevention and early detection, improving the chance of better management of kidney disease among people in 10 predominantly Aboriginal communities in rural Western Australia. This paper aimed to understand community responses to the WDKHP in three of these communities. METHODS Interviews were undertaken with 26 Aboriginal people living in three remote communities. Community responses were analysed with attention to the social organisation of participants in each community and a focus on the perspectives of key groups, identified here as 'Community Leaders', 'Homelanders', 'Refuge Seekers' and 'Dislocated'. RESULTS Participants from all groups reported that the WDKHP was highly acceptable, and an effective means of drawing attention to the need for prevention, early detection and management of diabetes and kidney disease. The integration of Aboriginal health workers to explain the project contributed to the high rates of participation in clinical screening. CONCLUSIONS Outreach clinical services can be an appropriate method of engaging people in remote communities in addressing diabetes and kidney disease. IMPLICATIONS The remote community setting can act as an 'enabler' of healthy lifestyle for Aboriginal people, particularly when augmented by well-designed outreach programs.
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Affiliation(s)
- Craig Sinclair
- Rural Clinical School of Western Australia, University of Western Australia
| | - Annette Stokes
- Rural Clinical School of Western Australia, University of Western Australia
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Waterworth P, Dimmock J, Pescud M, Braham R, Rosenberg M. Factors Affecting Indigenous West Australians' Health Behavior: Indigenous Perspectives. QUALITATIVE HEALTH RESEARCH 2016; 26:55-68. [PMID: 25847855 DOI: 10.1177/1049732315580301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The factors driving the disparity in health outcomes between Indigenous and non-Indigenous Australians include socio-economic factors, racism, and history. The current study focused on exploring Indigenous participants' perspectives of the factors that affect the health behavior of their community members. Participatory action research methodology and a grounded theory approach were utilized. In total, 120 members of two urban West Australian Indigenous communities participated in focus group discussions. There was substantial similarity between the themes that emerged within the discussions held in the two communities. Factors relating to culture, social connections, racism, communication, and personal aspects were particularly salient to health behavior of the participants. Several of the themes including culture, racism, communication, and distrust highlight the tension caused by being a member of a minority cultural group that has been marginalized by the practices and attitudes of the dominant cultural group. Personal choice was sometimes prioritized over health.
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Affiliation(s)
- Pippa Waterworth
- The University of Western Australia, Perth, Western Australia, Australia
| | - James Dimmock
- The University of Western Australia, Perth, Western Australia, Australia
| | - Melanie Pescud
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rebecca Braham
- The University of Western Australia, Perth, Western Australia, Australia
| | - Michael Rosenberg
- The University of Western Australia, Perth, Western Australia, Australia
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Maddox R, Durkin S, Lovett R. Plain packaging implementation: perceptions of risk and prestige of cigarette brands among Aboriginal and Torres Strait Islander people. Aust N Z J Public Health 2015; 40:221-5. [PMID: 26713418 DOI: 10.1111/1753-6405.12489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 07/01/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the impact of plain packaging with larger graphic health warnings on perceptions of risk and prestige related to different cigarette brands among Aboriginal and Torres Strait Islander people in the Australian Capital Territory. We hypothesised that the changes would decrease perceptions that 'some cigarette brands are more harmful than others', and that 'some brands are more prestigious than others', and this would be stronger among participants aged ≤35 years, and among smokers compared with non-smokers. METHODS Participants completed the survey prior to packaging changes, and were followed up 12 months later (n=98). Repeated measures ANCOVAs assessed perception changes. RESULTS Following plain packaging implementation, there was a significant reduction in perceptions that 'some cigarette brands are more harmful than others'. There was no overall change in perceptions of prestige. However, there was a significant interaction for age. Analyses indicated a reduction in perceptions that 'some cigarette brands are more prestigious than others' among younger participants (p=0.05), but no change among older participants (p>0.20). There was no interaction for smoking status for perceptions of prestige, indicating smokers' and non-smokers' perceptions did not differ on this measure. CONCLUSIONS These findings provide support for the packaging changes.
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Affiliation(s)
- Raglan Maddox
- Centre for Research on Inner City Health, St. Michael's Hospital, Ontario, Canada.,Centre for Research and Action in Public Health, Faculty of Health, University of Canberra, Australian Capital Territory
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria
| | - Ray Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Australian Capital Territory
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Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People. PLoS One 2015; 10:e0142323. [PMID: 26599437 PMCID: PMC4658065 DOI: 10.1371/journal.pone.0142323] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/19/2015] [Indexed: 11/28/2022] Open
Abstract
Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people.
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Purcell KR, O'Rourke K, Rivis M. Tobacco control approaches and inequity—how far have we come and where are we going? Health Promot Int 2015; 30 Suppl 2:ii89-101. [DOI: 10.1093/heapro/dav075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nicholson AK, Borland R, Couzos S, Stevens M, Thomas DP. Smoking-related knowledge and health risk beliefs in a national sample of Aboriginal and Torres Strait Islander people. Med J Aust 2015; 202:S45-50. [PMID: 26017256 DOI: 10.5694/mja14.00877] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 02/12/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe general knowledge and perceived risk of the health consequences of smoking among Aboriginal and Torres Strait Islander people; and to assess whether knowledge varies among smokers and whether higher knowledge and perceived risk are associated with quitting. DESIGN, SETTING AND PARTICIPANTS The Talking About The Smokes project used quota sampling to recruit participants from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. Baseline survey data were collected from 2522 Aboriginal and Torres Strait Islander adults from April 2012 to October 2013. MAIN OUTCOME MEASURES Knowledge of direct effects of smoking and harms of second-hand smoke (SHS), risk minimisation, health worry, and wanting and attempting to quit. RESULTS Most Aboriginal and Torres Strait Islander participants who were daily smokers demonstrated knowledge that smoking causes lung cancer (94%), heart disease (89%) and low birthweight (82%), but fewer were aware that it makes diabetes worse (68%). Similarly, almost all daily smokers knew of the harms of SHS: that it is dangerous to non-smokers (90%) and children (95%) and that it causes asthma in children (91%). Levels of knowledge among daily smokers were lower than among non-daily smokers, ex-smokers and never-smokers. Among smokers, greater knowledge of SHS harms was associated with health worry, wanting to quit and having attempted to quit in the past year, but knowledge of direct harms of smoking was not. CONCLUSION Lack of basic knowledge about the health consequences of smoking is not an important barrier to trying to quit for Aboriginal and Torres Strait Islander smokers. Framing new messages about the negative health effects of smoking in ways that encompass the health of others is likely to contribute to goal setting and prioritising quitting among Aboriginal and Torres Strait Islander people.
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Affiliation(s)
| | - Ron Borland
- Cancer Council Victoria, Melbourne, VIC, Australia
| | | | | | - David P Thomas
- Menzies School of Health Research, Darwin, NT, Australia
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Thomas DP, Panaretto KS, Stevens M, Bennet PT, Borland R. Smoke‐free homes and workplaces of a national sample of Aboriginal and Torres Strait Islander people. Med J Aust 2015; 202:S33-8. [DOI: 10.5694/mja14.00876] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 02/05/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - Pele T Bennet
- Queensland Aboriginal and Islander Health Council, Brisbane, QLD
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Nicholson AK, Borland R, Bennet PT, Sterren AE, Stevens M, Thomas DP. Personal attitudes towards smoking in a national sample of Aboriginal and Torres Strait Islander smokers and recent quitters. Med J Aust 2015; 202:S51-6. [DOI: 10.5694/mja14.01535] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 04/07/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Pele T Bennet
- Queensland Aboriginal and Islander Health Council, Brisbane, QLD
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46
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Nicholson AK, Borland R, Davey ME, Stevens M, Thomas DP. Predictors of wanting to quit in a national sample of Aboriginal and Torres Strait Islander smokers. Med J Aust 2015; 202:S26-32. [DOI: 10.5694/mja15.00199] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/11/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Maureen E Davey
- Aboriginal Health Service, Tasmanian Aboriginal Centre, Hobart, TAS
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Thomas DP, Panaretto KS, Stevens M, Borland R. Dependence in a national sample of Aboriginal and Torres Strait Islander daily smokers. Med J Aust 2015; 202:S39-44. [DOI: 10.5694/mja15.00105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/07/2015] [Indexed: 11/17/2022]
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Nicholson AK, Borland R, Sterren AE, Bennet PT, Stevens M, Thomas DP. Social acceptability and desirability of smoking in a national sample of Aboriginal and Torres Strait Islander people. Med J Aust 2015; 202:S57-62. [DOI: 10.5694/mja14.01534] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/19/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - Pele T Bennet
- Queensland Aboriginal and Islander Health Council, Brisbane, QLD
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Gould GS, Watt K, McEwen A, Cadet-James Y, Clough AR. Predictors of intentions to quit smoking in Aboriginal tobacco smokers of reproductive age in regional New South Wales (NSW), Australia: quantitative and qualitative findings of a cross-sectional survey. BMJ Open 2015; 5:e007020. [PMID: 25770232 PMCID: PMC4360823 DOI: 10.1136/bmjopen-2014-007020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To assess the predictors of intentions to quit smoking in a community sample of Aboriginal smokers of reproductive age, in whom smoking prevalence is slow to decline. DESIGN, SETTING AND PARTICIPANTS A cross-sectional survey involved 121 Aboriginal smokers, aged 18-45 years from January to May 2014, interviewed at community events on the Mid-North Coast NSW. Qualitative and quantitative data were collected on smoking and quitting attitudes, behaviours and home smoking rules. Perceived efficacy for quitting, and perceived threat from smoking, were uniquely assessed with a validated Risk Behaviour Diagnosis (RBD) Scale. MAIN OUTCOME MEASURES Logistic regression explored the impact of perceived efficacy, perceived threat and consulting previously with a doctor or health professional (HP) on self-reported intentions to quit smoking, controlling for potential confounders, that is, protection responses and fear control responses, home smoking rules, gender and age. Participants' comments regarding smoking and quitting were investigated via inductive analysis, with the assistance of Aboriginal researchers. RESULTS Two-thirds of smokers intended to quit within 3 months. Perceived efficacy (OR=4.8; 95% CI 1.78 to 12.93) and consulting previously with a doctor/HP about quitting (OR=3.82; 95% CI 1.43 to 10.2) were significant predictors of intentions to quit. 'Smoking is not doing harm right now' was inversely associated with quit intentions (OR=0.25; 95% CI 0.08 to 0.8). Among those who reported making a quit attempt, after consulting with a doctor/HP, 40% (22/60) rated the professional support received as low (0-2/10). Qualitative themes were: the negatives of smoking (ie, disgust, regret, dependence and stigma), health effects and awareness, quitting, denial, 'smoking helps me cope' and social aspects of smoking. CONCLUSIONS Perceived efficacy and consulting with a doctor/HP about quitting may be important predictors of intentions to quit smoking in Aboriginal smokers of reproductive age. Professional support was generally perceived to be low; thus, it could be improved for these Aboriginal smokers. Aboriginal participants expressed strong sentiments about smoking and quitting.
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Affiliation(s)
- Gillian Sandra Gould
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Andy McEwen
- Health Behaviour Research Centre, Epidemiology and Public Health, University College London, London, UK
| | - Yvonne Cadet-James
- Indigenous Centre, James Cook University, Townsville, Queensland, Australia
| | - Alan R Clough
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
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Cosh S, Hawkins K, Skaczkowski G, Copley D, Bowden J. Tobacco use among urban Aboriginal Australian young people: a qualitative study of reasons for smoking, barriers to cessation and motivators for smoking cessation. Aust J Prim Health 2015; 21:334-41. [DOI: 10.1071/py13157] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 06/03/2014] [Indexed: 11/23/2022]
Abstract
Smoking prevalence among Aboriginal Australian young people greatly exceeds the prevalence in the broader population of Australian young people, yet limited research has explored the social context in which young Aboriginal Australians smoke. Four focus groups were conducted in 2009 with South Australian Aboriginal smokers aged 15–29 years residing in urban areas (n = 32) to examine attitudes and experiences surrounding smoking and quitting. The primary reasons for smoking initiation and maintenance among Aboriginal Australian young people were identified as stress, social influence and boredom. Motivators for quitting were identified as pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons. The barriers to cessation were identified as social influence, the perception of quitting as a distant event and reluctance to access cessation support. However, it appears that social influences and stress were particularly salient contributors to smoking maintenance among Aboriginal Australian young people. Smoking cessation interventions targeted at young urban Aboriginal Australian smokers should aim to build motivation to quit by utilising the motivators of pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons, while acknowledging the pertinent role of social influence and stress in the lives of young urban Aboriginal Australian smokers.
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