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James AL, Caliskan G, Pesce G, Accordini S, Abramson MJ, Bui D, Musk AW, Knuiman MW, Perret JL, Jarvis D, Minelli C, Calciano L, Hui J, Hunter M, Thomas PS, Walters EH, Garcia-Aymerich J, Dharmage SC, Marcon A. Trends in smoking initiation and cessation over a century in two Australian cohorts. PLoS One 2024; 19:e0307386. [PMID: 39298431 DOI: 10.1371/journal.pone.0307386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/04/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND Historical data on smoking can enhance our comprehension of the effectiveness of past tobacco control policies and play a key role in developing targeted public health interventions. This study was undertaken to assess trends in smoking initiation and cessation in Australia for the period 1910-2005. METHODS Rates of smoking initiation and cessation were calculated for participants in two population-based cohorts, the Busselton Health Study and the Tasmanian Longitudinal Health Study. The effects of time trends, gender and age group were evaluated. RESULTS Of the 29,971 participants, 56.8% ever smoked. In males, over the period 1910-1999, the rate of smoking initiation in young adolescents remained high with a peak in the 1970s; in older adolescents it peaked in the 1940s and then declined; in young adults it showed a steady decline. In females, the rate of smoking initiation in young adolescents rose sharply in the 1960s and peaked in the 1970s, in older adolescents it increased throughout the period, and in young adults it declined after 1970. In the period 1930-2005, 27.3% of 9,605 people aged 36-50 years who smoked ceased smoking. Rates of cessation in this age group increased throughout but decreased in males after 1990 and plateaued around 2000 in females. CONCLUSION Our findings show substantial variation in the efficacy of tobacco control policies across age groups, with a notable lack of success among the younger population.
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Affiliation(s)
- Alan L James
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giancarlo Pesce
- Center for Research in Epidemiology and Population Health, INSERM, Paris-Saclay University, Paris-South University, UVSQ, Villejuif, France
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Dinh Bui
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Arthur W Musk
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew W Knuiman
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep (IBAS), Heidelberg, Melbourne, Australia
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Cosetta Minelli
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jennie Hui
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, Perth, Western Australia, Australia
- Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
| | - Michael Hunter
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
| | - Paul S Thomas
- Prince of Wales' Clinical School, UNSW, and Respiratory Medicine, Prince of Wales' Hospital, Randwick, New South Wales, Australia
| | - E Haydn Walters
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Paing PY, Littman AJ, Reese JA, Sitlani CM, Umans JG, Cole SA, Zhang Y, Ali T, Fretts AM. Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS. J Am Heart Assoc 2024; 13:e032918. [PMID: 38456410 PMCID: PMC11010036 DOI: 10.1161/jaha.123.032918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants. METHODS AND RESULTS A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20-year follow-up was 7.43 per 1000 person-years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40-0.68) and 0.25 (95% CI, 0.14-0.44), respectively, after adjustment for age, sex, education, and study site. CONCLUSIONS Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.
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Affiliation(s)
| | | | | | | | | | | | - Ying Zhang
- University of Oklahoma Health Sciences CenterOklahoma CityOK
| | - Tauqeer Ali
- University of Oklahoma Health Sciences CenterOklahoma CityOK
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Courtemanche Y, Poliakova N, Muckle G, Bélanger RE. Smoking cessation attempts and successes among Nunavimmiut. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:126-135. [PMID: 37410367 PMCID: PMC10831029 DOI: 10.17269/s41997-023-00790-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/25/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES The smoking rate in Canada has declined in past decades, yet smoking rates remain high in Nunavik (northern Québec), where an estimated 80% of adult respondents smoke. We investigated sociodemographic factors, smoking behaviours, harm perception, and social support as determinants of smoking cessation attempts and successes among Nunavimmiut. METHODS Past year smoking frequency, quantity smoked, and cessation attempts and aids were documented in a sample of 1326 Nunavimmiut aged 16 and over in the Qanuilirpitaa? 2017 survey. Sociodemographic indicators, social support, cessation aids, and smoking harm perception were investigated as potential determinants. All factors were modeled by logistic regressions and adjusted for age and sex. RESULTS Thirty-nine percent of smokers tried to quit smoking in the preceding year, and 6% of those were successful. Older Nunavimmiut (aOR = 0.84 [0.78, 0.90]) and those smoking 20 + cigarettes/day (aOR = 0.94 [0.90, 0.98]) were less likely to attempt to quit. Ungava coast residents (aOR = 1.87 [1.36, 2.57]), separated/widowed/divorced individuals (aOR = 2.43 [1.09, 5.38]), and occasional smokers (aOR = 2.77 [1.61, 4.76]) compared to those living on the Hudson coast, single individuals, and daily smokers, respectively, were more likely to report cessation attempts. Most used no particular cessation aid (58%), 28% relied on family/self-help/support programs, and 26% used medication. Women were more likely to rely on spirituality/traditional methods (aOR = 1.92 [1.00, 3.71]) and less likely to rely on electronic cigarettes (aOR = 0.33 [0.13, 0.84]), as were older participants (aOR = 0.67 [0.49, 0.94]). Those with more years of schooling were more likely to rely on electronic cigarettes (aOR = 1.47 [1.06, 2.02]). These estimates are prone to biases due to the relatively low participation rate in the survey (37%). CONCLUSION Despite many attempts reported by participants, regional partners of this study underlined that successful smoking cessation remains a challenge for many Nunavimmiut. Key differences were identified in approaches and determinants of smoking cessation attempts, but most smokers did not use cessation aids. These results are in line with the experience of the Inuit partners of this study and can inform targeted public health interventions to support the many Nunavimmiut trying to quit smoking, notably increasing accessibility and acceptability of cessation aids. Inuit partners of this study highlighted the importance for interventions and communication efforts to reflect Nunavik's context.
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Affiliation(s)
- Yohann Courtemanche
- Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Natalia Poliakova
- Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Gina Muckle
- Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
- École de Psychologie, Université Laval, Québec, Québec, Canada
| | - Richard E Bélanger
- Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.
- Département de Pédiatrie, Université Laval, Québec, Québec, Canada.
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Shajahan A, Mathew AC, Gangadharan VP, Chandrasekhar D. Tobacco use and clinical leukoplakia lesions among south Indian tribes. J Basic Clin Physiol Pharmacol 2023; 34:647-654. [PMID: 34342396 DOI: 10.1515/jbcpp-2020-0347] [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: 06/14/2020] [Accepted: 06/28/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Leukoplakia is a white mucosal thickening and perhaps undermining change in the oral mucosa transcendently found in tobacco users. Since the tobacco utilization is extensively higher with the indigenous groups in the Asia Pacific locale, the current examination implicated the prevalence of tobacco consumption and leukoplakial lesions and the relationship between the two. METHODS This cross-sectional study was conducted through six tribal hamlets of Chithalayath Forest range at Wayanad district of Kerala, South India. Leukoplakia screening was led by a senior consultant on the basis of a visual investigation and pathological evaluation was not done. An organized questionnaire was utilized to gather data on demographic details and tobacco usage status and frequency. The prevalence of clinical oral lesions among tobacco users and non users was determined using statistical analysis. RESULTS Clinical oral leukoplakia was diagnosed in 27 (8.5%) subjects among the 317 individuals screened. The prevalence of lesions was considerably higher among tobacco consumers in comparison with non users (11 vs. 3.7%). Also, the tobacco chewers group had a higher percentage of leukoplakia. Another significant finding of this study is that the incidence of provisional leukoplakia was observed to be comparatively high among the most frequent tobacco consumers 15 (65.2%) in comparison with 8 (34.8%) in the frequent and nonfrequent users. CONCLUSIONS Prevalence of abusive habits and clinical oral leukoplakial was substantial among the tribes. The cause and effect relationship and dose-response were also shown to have a significant association.
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Affiliation(s)
- Amina Shajahan
- Department of Pharmacy Practice, Al-Shifa College of Pharmacy, Perinthalmanna, Kerala, India
| | | | | | - Dilip Chandrasekhar
- Department of Pharmacy Practice, Al-Shifa College of Pharmacy, Perinthalmanna, Kerala, India
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Rusk AM, Kanj AN, Murad MH, Hassett LC, Kennedy CC. Smoking Cessation Interventions in Indigenous North Americans: A Meta-Narrative Systematic Review. Nicotine Tob Res 2023; 25:3-11. [PMID: 35869642 PMCID: PMC9717368 DOI: 10.1093/ntr/ntac181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Indigenous North Americans have the highest cigarette smoking prevalence among all racial and ethnic groups in the United States. We seek to identify effective components of smoking cessation interventions in Indigenous people in the United States associated with favorable cessation outcomes. METHODS A review of literature studying smoking cessation interventions in Indigenous North Americans (American Indians and Alaska Natives) from January 2010 through August 2021 was completed. The primary objective of this study was to identify components of interventions associated with positive smoking cessation outcomes in Indigenous people. The studies identified were synthesized in a meta-narrative approach. RESULTS Ten studies out of 608 titles were included (6 randomized trials, 2 single-arm studies, 1 cohort study, and 1 prospective observational study). Five categories of smoking cessation interventions were identified; phone or web-based tools, culturally-tailored interventions, the inclusion of Indigenous study personnel, pharmaceutical cessation aids, and behavioral health interventions. Phone and web tools, cultural tailoring, and inclusion of Indigenous personnel conditions inconsistently influenced smoking cessation. Pharmaceutical aids were viewed favorably among participants. Individualized behavioral counseling sessions were effective at promoting smoking cessation, as was input from local communities in the planning and implementation phases of study. CONCLUSION A successful smoking cessation intervention in Indigenous North Americans includes Tribal or community input in intervention design and implementation; should provide individualized counseling sessions for participants, and offer access to validated smoking cessation tools including pharmacotherapy. IMPLICATIONS This study identifies a paucity of smoking interventions utilizing standard of care interventions in Indigenous North Americans. Standard of care interventions including individualized cessation counseling and pharmacotherapy were effective at promoting cessation. The use of novel culturally tailored cessation interventions was not more effective than existing evidence-based care with the exception of including Tribal and local community input in intervention implementation. Future smoking cessation interventions in Indigenous North Americans should prioritize the use of standard of care cessation interventions.
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Affiliation(s)
- Ann M Rusk
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
- The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
- Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester, MN, USA
| | - Amjad N Kanj
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
- Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester, MN, USA
| | - Mohammad H Murad
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Cassie C Kennedy
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
- The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
- Respiratory Health Equity Clinical Research Laboratory at Mayo Clinic, Rochester, MN, USA
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Heris C, Lovett R, Barrett EM, Calma T, Wright A, Maddox R. Deadly declines and diversity - understanding the variations in regional Aboriginal and Torres Strait Islander smoking prevalence. Aust N Z J Public Health 2022; 46:558-561. [PMID: 35924895 DOI: 10.1111/1753-6405.13286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Christina Heris
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory.,Ngiyampaa (Wongaibon), Australia
| | - Eden M Barrett
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory
| | - Tom Calma
- Elder from the Kungarakan tribal group and a member of the Iwaidja tribal group.,Office of the National Coordinator, Tackling Indigenous Smoking, Canberra, Australian Capital Territory.,Poche Indigenous Health Network, Sydney, New South Wales.,Ninti One, Adelaide, South Australia
| | - Alyson Wright
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory
| | - Raglan Maddox
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory.,Bagumani (Modewa) Clan, Papua New Guinea
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Merkin A, Nikolaev A, Nikoforov I, Komarov A, Glover M. Trends in tobacco smoking and smoking cessation in Russia with a focus on Indigenous populations: A narrative review. GLOBAL EPIDEMIOLOGY 2021; 3:100043. [PMID: 37635728 PMCID: PMC10446109 DOI: 10.1016/j.gloepi.2020.100043] [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: 06/21/2020] [Revised: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction Tobacco smoking is one of the main preventable causes of illness and premature death. Globally, more than 7 million people die annually from diseases associated with smoking, and this number is projected to increase to 8 million per year by 2030. Wide disparities in smoking prevalence exist by gender, age, socioeconomic status, rurality and ethnicity. In several countries, smoking is disproportionately high among the Indigenous populations. Objective This review assesses the prevalence and harm of smoking and current trends in smoking cessation among the diverse multi-ethnic populations of Russia, with a particular emphasis on Indigenous populations. Data sources We systematically searched health, nursing, social science and grey literature databases and bibliographies for relevant studies. Search strings combined keywords related to smoking prevalence and smoking cessation with keywords related to Russia and the Indigenous populations of Russia. Study selection Studies were included if they were published between 1 January 2005 and 14 October 2020, and if they reported prevalence of tobacco smoking and/or activities and outcomes of a smoking cessation programme or ban in the Russian Federation. Conclusions Tobacco smoking is significant in the entire Russian population, a higher prevalence of smoking in Indigenous populations compared to the dominant Russian (Slavic) ethnic group is common. Smoking prevalence data for most of the Indigenous ethnic groups of Russia remains unclear. Tobacco control interventions for Indigenous groups are underdeveloped even though they have the potential to deliver proportionately greater reduction in smoking harm.
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Affiliation(s)
| | | | | | - Alexander Komarov
- National Centre for Development of Social Support and Rehabilitation, Moscow, Russia
| | - Marewa Glover
- Centre of Research Excellence: Indigenous Sovereignty & Smoking, Auckland, New Zealand
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Rahman T, Baker AL, Gould GS, Palazzi K, Lambkin D, Kennedy M. Factors Associated with Smoke-Free Pregnancy among Aboriginal and Torres Strait Women and Their Experience of Quitting Smoking in Pregnancy: A Mixed Method Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11240. [PMID: 34769756 PMCID: PMC8583423 DOI: 10.3390/ijerph182111240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/10/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Abstract
Smoke-free pregnancies have long-term health benefits for mothers and babies. This paper quantitatively examines factors associated with smoke-free pregnancies among Aboriginal and Torres Strait Islander women (hereafter Aboriginal women) and qualitatively explores their smoking cessation (SC) experiences during pregnancy. An Aboriginal-led online cross-sectional study on SC was conducted with Aboriginal women and in partnership with Aboriginal communities, between July and October 2020. The present analysis includes participants who made a pregnancy-related quit attempt (N = 103). Chi-squared tests, logistic regression models, and thematic analysis of free-form text responses were performed. The adjusted odds of having smoke-free pregnancies were 4.54 times higher among participants who used Aboriginal Health Services (AHS) (AOR = 4.54, p-value 0.018). Participants living in urban settings had 67% lower odds of having smoke-free pregnancies compared to their regional/remote counterparts (AOR = 0.33, p-value 0.020). Qualitative data revealed strong motivations to reduce tobacco-related harms to the fetus and variability in quitting experiences at different stages of and across pregnancies. Smoking cessation care (SCC) can support Aboriginal women meaningfully if their quitting experiences are considered in SCC development and implementation. Consistent funding for AHS-led SCC is needed to garner health benefits for Aboriginal peoples. More research into urban versus regional/remote differences in maternal SC is recommended.
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Affiliation(s)
- Tabassum Rahman
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Amanda L. Baker
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Gillian S. Gould
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW 2450, Australia;
| | - Kerrin Palazzi
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - David Lambkin
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
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Daley A, Rahman M, Watson B. A breath of fresh air: The effect of public smoking bans on Indigenous youth. HEALTH ECONOMICS 2021; 30:1517-1539. [PMID: 33860551 DOI: 10.1002/hec.4276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
In general, past studies have estimated the average effect of public smoking bans on youth, ignoring differences across sub-populations. We extend the literature by considering Indigenous youth, who are a vulnerable and previously unexamined group (however, our analysis excludes First Nations youth who live on reserve). We also consider previously unexamined outcomes among youth: self-assessed health and subjective well-being. Our difference-in-differences estimates from Canada indicate that public bans reduced youth smoking and second-hand exposure in public places, on average. There was no displacement on the extensive margin, but the bans increased the number of people who smoke in the homes of youth, conditional on the presence of smokers in the household. Beyond average effects, however, we find that public bans reduced second-hand exposure in the homes of Indigenous youth (particularly Métis youth), on the extensive and intensive margins. The same youth experienced concurrent improvements in self-assessed health and life satisfaction. We conclude that public bans mitigate disparities in health and well-being between Indigenous and non-Indigenous youth, but the extent varies across Indigenous sub-populations, even within a particular country.
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Affiliation(s)
- Angela Daley
- School of Economics, University of Maine, Orono, Maine, USA
| | | | - Barry Watson
- Faculty of Business, University of New Brunswick, Saint John, New Brunswick, Canada
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Chellappa LR, Leelavathi L, Indiran MA, Rathinavelu PK. Prevalence and dependency of tobacco use among tribal gypsies in Thoothukudi district - A cross sectional study. J Family Med Prim Care 2021; 10:738-744. [PMID: 34041070 PMCID: PMC8138420 DOI: 10.4103/jfmpc.jfmpc_1344_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/13/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: The Narikuravars or “gypsy” are a semi vagrant groups distributed across borders, but primarily live in Tamil Nadu, India. They are notorious to face discrimination that interprets into low education level, low socio-economic status and lack of pertinent access to health care. The focus of the present study is to determine the prevalence and dependency with tobacco use among tribal gypsies in Thoothukudi district. Materials and Methods: The study design of the present study was a cross sectional which was done in Thoothukudi district in the month of December, 2019. Oral health status of the study population was analysed by WHO assessment form (adults), 2013. Tobacco dependence was analysed by Fagerstrom Nicotine dependency scale. The inclusion criteria were to include every gypsy person who is a citizen of Thoothukudi district and of all ages. The study included all the narikuravars (164) whose origin is Thoothukudi district. SPSS version 20.0 was used for statistical analysis. Descriptive statistics and Chi square tests were done to establish the distribution and association of the variables, respectively. Results: The total study participants of this cross-sectional study were 164, among them 128 were adults and 36 were children. Results revealed that among the adult population 64.55% were using tobacco, among them 29.1% were using smoking tobacco, 63.4% were using smokeless tobacco and 7.5% were using both. Medium nicotine dependency was more prevalent in both smoking and smokeless tobacco users (82.75% and 53.57%). The association between prevalence of tobacco use and gingival bleeding was statistically significant. Gingival bleeding was present in 88.9% of tobacco users and 11% of non-users (p value- 0.01). Significant association was found between gender and tobacco usage (p value- 0.042), dental erosion and tobacco usage (p value- 0.007). There exists significant association established between gender and nicotine dependency. (p value - 0.000). Conclusion: More than 60% of the adult study participants were using some form of tobacco. Medium tobacco dependency was prevalent among tobacco users. The tribal people have no access to all the services as their counterparts and it's our duty to educate them and create an insight about the ill effects of tobacco usage.
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Affiliation(s)
- Lalitha Rani Chellappa
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - L Leelavathi
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Meignana Arumugham Indiran
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Pradeep Kumar Rathinavelu
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Meharg DP, Gwynne K, Gilroy J, Alison JA. Exercise-based interventions for Indigenous adults with chronic lung disease in Australia, Canada, New Zealand, and USA: a systematic review. J Thorac Dis 2021; 12:7442-7453. [PMID: 33447432 PMCID: PMC7797817 DOI: 10.21037/jtd-20-1904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Indigenous peoples in Australia, New Zealand, Canada, and the United States of America (USA) have a higher burden of chronic lung disease than non-Indigenous people. Exercised-based interventions, such as pulmonary rehabilitation, are highly effective to manage chronic lung disease. The outcomes of these interventions for Indigenous people require evaluation. The aim of this review was to critically appraise the literature on the impact of exercise-based interventions on quality of life, exercise capacity and health care utilisation in Indigenous adults with chronic lung disease in Australia, New Zealand, Canada, and USA. The Cochrane Library, Medline, Embase, CINAHL, Scopus, Psychinfo, APAIS-Aboriginal Health and PEDro databases were searched for peer-reviewed and grey literature that evaluated exercise-based interventions, such as pulmonary rehabilitation for Indigenous adults with chronic lung disease in Australia, New Zealand, Canada, and USA. Two authors independently screened and reviewed titles and abstract and full texts of potentially eligible studies for inclusion. An Indigenous decolonisation methodological framework was also applied to evaluate Indigenous governance, involvement, and engagement in the studies. A total of 3,598 records were screened, nine full papers were reviewed, and one was study included, which was a cardiopulmonary rehabilitation program for Indigenous people in Australia. Participants with chronic respiratory or heart disease significantly improved functional exercise capacity and quality of life [six-minute walk distance mean change (95% CI) 79 metres (47 to 111); Chronic Respiratory Questionnaire Dyspnoea 0.9 points (0.2 to 1.5)]. Several items of the decolonisation framework were addressed. Only one study was able to be included in the review, highlighting the paucity of research about culturally safe exercise-based interventions for Indigenous adults with chronic lung disease. There is a need for further research with strong Indigenous governance, involvement, and engagement.
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Affiliation(s)
- David P Meharg
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia.,Poche Centre for Indigenous Health, The University of Sydney, Sydney, Australia
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, The University of Sydney, Sydney, Australia.,Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - John Gilroy
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Jennifer A Alison
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia.,Sydney Local Health District, Sydney, Australia
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Lyall V, Guy J, Egert S, Pokino LA, Rogers L, Askew D. "They Were Willing to Work with Me and Not Pressure Me": A Qualitative Investigation into the Features of Value of a Smoking Cessation in Pregnancy Program for Aboriginal and Torres Strait Islander Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010049. [PMID: 33374701 PMCID: PMC7793509 DOI: 10.3390/ijerph18010049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/16/2022]
Abstract
With tobacco commonly used for stress relief, smoking cessation during pregnancy can present challenges for women facing stressful circumstances. This can be pronounced for Aboriginal and Torres Strait Islander women who experience disproportionately high smoking rates during pregnancy and also have a greater intersection of stressors from social disadvantage, institutional racism and trauma. To contribute understandings into how women can be best supported at this time, this study identified the features of value of an Aboriginal and Torres Strait Islander pregnancy smoking cessation program that addressed the contexts of women's lives in culturally affirming and strength-based ways. A narrative methodology using a yarning approach was used to interview 7 pregnant women, 6 significant others, 3 case managers, and 4 healthcare professionals. Data were analyzed using thematic analysis, guided by an Indigenist research practice of deep and reflexive researcher listening. Features of value included: relationship-based care, holistic wraparound care, flexibility, individualized care, and culturally orientated care. Combined, they enabled highly relevant and responsive women-centered, trauma-informed, and harm-reducing smoking cessation support that was well received by participants, who achieved promising smoking changes, including cessation. This approach strongly departs from standard practices and provides a blueprint for meaningful support for pregnant women experiencing vulnerabilities.
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Affiliation(s)
- Vivian Lyall
- School of Clinical Medicine, Primary Care Clinical Unit, Level 8 Health Sciences Building, Royal Brisbane & Women’s Hospital, The University of Queensland, Herston, QLD 4029, Australia;
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia; (J.G.); (S.E.); (L.-A.P.); (L.R.)
| | - Jillian Guy
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia; (J.G.); (S.E.); (L.-A.P.); (L.R.)
| | - Sonya Egert
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia; (J.G.); (S.E.); (L.-A.P.); (L.R.)
| | - Leigh-Anne Pokino
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia; (J.G.); (S.E.); (L.-A.P.); (L.R.)
| | - Lynne Rogers
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia; (J.G.); (S.E.); (L.-A.P.); (L.R.)
| | - Deborah Askew
- School of Clinical Medicine, Primary Care Clinical Unit, Level 8 Health Sciences Building, Royal Brisbane & Women’s Hospital, The University of Queensland, Herston, QLD 4029, Australia;
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia; (J.G.); (S.E.); (L.-A.P.); (L.R.)
- Correspondence: ; Tel.: +61-421972078
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13
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Halas G, Schultz ASH, Rothney J, Wener P, Holmqvist M, Cohen B, Kosowan L, Enns JE, Katz A. A Scoping Review of Foci, Trends, and Gaps in Reviews of Tobacco Control Research. Nicotine Tob Res 2020; 22:599-612. [PMID: 30715468 DOI: 10.1093/ntr/nty269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/17/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The burden of disease associated with tobacco use has prompted a substantial increase in tobacco-related research, but the breadth of this literature has not been comprehensively examined. This review examines the nature of the research addressing the action areas in World Health Organization's Framework Convention on Tobacco Control (FCTC), the populations targeted and how equity-related concepts are integrated. METHOD A scoping review of published reviews addressing tobacco control within the primary prevention domain. We searched PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Educational Resources Information Centre, and PsycInfo from 2004 to 2018. RESULTS The scoping review of reviews offered a "birds-eye-view" of the tobacco control literature. Within the 681 reviews meeting inclusion criteria, there was a strong focus on smoking cessation targeting individuals; less attention has been given to product regulation, packaging, and labeling or sales to minors. Equity-related concepts were addressed in 167/681 (24.5%); few were focused on addressing inequity through structural and systemic root causes. CONCLUSION This analysis of foci, trends, and gaps in the research pursuant to the FCTC illustrated the particular action areas and populations most frequently addressed in tobacco control research. Further research is needed to address: (1) underlying social influences, (2) particular action areas and with specific populations, and (3) sustained tobacco use through the influence of novel marketing and product innovations by tobacco industry. IMPLICATIONS This scoping review of the breadth of tobacco control research reviews enables a better understanding of which action areas and target populations have been addressed in the research. Our findings alongside recommendations from other reviews suggest prioritizing further research to support policymaking and considering the role of the tobacco industry in circumventing tobacco control efforts. The large amount of research targeting individual cessation would suggest there is a need to move beyond a focus on individual choice and decontextualized behaviors. Also, given the majority of reviews that simply recognize or describe disparity, further research that integrates equity and targets various forms of social exclusion and discrimination is needed and may benefit from working in collaboration with communities where programs can be tailored to need and context.
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Affiliation(s)
- Gayle Halas
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Janet Rothney
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Wener
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Maxine Holmqvist
- Department of Clinical Health Psychology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Benita Cohen
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leanne Kosowan
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer E Enns
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Tackling the Burden of Osteoarthritis as a Health Care Opportunity in Indigenous Communities-A Call to Action. J Clin Med 2020; 9:jcm9082393. [PMID: 32726980 PMCID: PMC7463980 DOI: 10.3390/jcm9082393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022] Open
Abstract
Osteoarthritis is a highly prevalent and disabling disease, causing a significant individual and socioeconomic burden worldwide. Until now, there has been a dearth of research exploring the impact of osteoarthritis in global Indigenous communities. Osteoarthritis has a similar risk factor profile to many chronic diseases that disproportionately affect Indigenous peoples. In this editorial, we argue that osteoarthritis and associated mobility restrictions play a central role in the chronic disease profile of Indigenous peoples. We present a call to action for clinicians and health care providers, researchers and policymakers to begin to recognise the interrelated nature of osteoarthritis and chronic disease. We have an opportunity to change the way we do business, to improve access to culturally secure osteoarthritis care and the health and wellbeing of Indigenous communities.
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15
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Comiford AL, Rhoades DA, Spicer P, Dvorak JD, Ding K, Wagener TL, Doescher MP. Impact of e-cigarette use among a cohort of American Indian cigarette smokers: associations with cigarette smoking cessation and cigarette consumption. Tob Control 2020; 30:103-107. [PMID: 32054728 DOI: 10.1136/tobaccocontrol-2019-055338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/16/2019] [Accepted: 01/13/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Despite American Indian/Alaska Native (AI/AN) people having the highest prevalence of cigarette smoking nationwide, few studies have evaluated e-cigarette use among AI/AN adults who smoke. The primary objective of this observational pilot cohort study was to determine if e-cigarette use is associated with cigarette smoking cessation or reduction among adult AI individuals who smoke. METHODS In 2016, we collected baseline survey and biomarker data among AI adults who smoke. The survey included questions about cigarette consumption and use of e-cigarettes and biomarkers, such as salivary cotinine markers and exhaled carbon monoxide. After 18 months, we repeated data collection, and asked about changes in cigarette smoking status and cigarettes per day (CPD). Comparisons between groups were performed using the χ2 test, Fisher's exact test or Wilcoxon rank-sum test. RESULTS Of 375 baseline participants, 214 (57.07%) returned for follow-up and were included in analyses. Of these, 20 (9.3%) reported having stopped cigarette smoking and had biochemical verification of cigarette smoking abstinence. Among those who quit smoking, 15% were baseline e-cigarette users; while among those who continued to smoke at follow-up, about 11% were baseline e-cigarette users. This difference was not statistically significant (p=0.48). Among all those who continued to smoke at follow-up, there was no overall decrease in CPD, nor a significant difference in change in CPD between baseline e-cigarette users and non-users (p=0.98). CONCLUSIONS E-cigarette use at baseline was not associated with smoking cessation or a change in CPD in this cohort of AI adults who smoke after an 18-month follow-up period.
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Affiliation(s)
- Ashley L Comiford
- Community Health Promotions, Cherokee Nation, Tahlequah, Oklahoma, USA
| | - Dorothy A Rhoades
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Paul Spicer
- Anthropology, University of Oklahoma, Norman, Oklahoma, USA
| | - Justin D Dvorak
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kai Ding
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Theodore L Wagener
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.,Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Mark P Doescher
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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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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17
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Clough AR, Grant K, Robertson J, Wrigley M, Nichols N, Fitzgibbon T. Interventions to encourage smoke-free homes in remote indigenous Australian communities: a study protocol to evaluate the effects of a community-inspired awareness-raising and motivational enhancement strategy. BMJ Open 2018; 8:e018955. [PMID: 29500205 PMCID: PMC5855345 DOI: 10.1136/bmjopen-2017-018955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Rates of secondhand smoke exposure are currently significantly higher among remote indigenous communities in the top end of Australia. By implementing a 'smoke-free home' rule, secondhand smoke exposure can be reduced. Smoke-free homes encourage quit attempts and improve the health of children. The prevalence of indigenous smoking rates in remote, discrete communities in Australia is elevated compared with their non-indigenous counterparts. The primary aim of this project is to examine the feasibility of conducting a health-driven intervention to encourage community members to make their homes a smoke-free zone. METHODS AND ANALYSIS This study uses mixed-methods exploratory evaluation design to obtain data from key informants and community householders to assess their willingness to implement a 'smoke-free' rule in their homes. Initial focus groups will provide guidance on intervention content and deliver evaluation procedures and community requirements. A rapid survey will be conducted to ascertain interest from community members in having the project team visit to discuss study objectives further and to have a particle meter (with consent) placed in the house. Focus groups recordings will be transcribed and analysed thematically. Rapid surveys will be analysed using frequency distributions and tabulations of responses. ETHICS AND DISSEMINATION The National Health and Medical Research Council guidelines on ethical research approaches to indigenous studies will be adhered to. The James Cook University Human Research Ethics Committee has provided ethics approval.
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Affiliation(s)
- Alan R Clough
- Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia
| | - Kristy Grant
- Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia
| | - Jan Robertson
- College of Healthcare Sciences, James Cook University, Cairns, Queensland, Australia
| | - Matthew Wrigley
- Aboriginal Resource Development Services (ARDS), Darwin, Australia
| | - Nina Nichols
- Apunipima Cape York Health Council, Bungalow, Queensland, Australia
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18
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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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19
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Chamberlain C, Perlen S, Brennan S, Rychetnik L, Thomas D, Maddox R, Alam N, Banks E, Wilson A, Eades S. Evidence for a comprehensive approach to Aboriginal tobacco control to maintain the decline in smoking: an overview of reviews among Indigenous peoples. Syst Rev 2017; 6:135. [PMID: 28693556 PMCID: PMC5504765 DOI: 10.1186/s13643-017-0520-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 06/16/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Tobacco smoking is a leading cause of disease and premature mortality among Aboriginal and Torres Strait Islander (Indigenous) Australians. While the daily smoking prevalence among Indigenous Australians has declined significantly from 49% in 2001, it remains about three times higher than that of non-Indigenous Australians (39 and 14%, respectively, for age ≥15 years in 2014-15). This overview of systematic reviews aimed to synthesise evidence about reducing tobacco consumption among Indigenous peoples using a comprehensive framework for Indigenous tobacco control in Australia comprised of the National Tobacco Strategy (NTS) and National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) principles and priorities. METHODS MEDLINE, EMBASE, systematic review and Indigenous health databases were searched (2000 to Jan 2016) for reviews examining the effects of tobacco control interventions among Indigenous peoples. Two reviewers independently screened reviews, extracted data, and assessed review quality using Assessing the Methodological Quality of Systematic Reviews. Data were synthesised narratively by framework domain. Reporting followed the PRISMA statement. RESULTS Twenty-one reviews of varying quality were included. There was generally limited Indigenous-specific evidence of effective interventions for reducing smoking; however, many reviewers recommended multifaceted interventions which incorporate Indigenous leadership, partnership and engagement and cultural tailoring. Under the NTS priority areas, reviewers reported evidence for brief smoking cessation interventions and pharmacological support, mass media campaigns (on knowledge and attitudes) and reducing affordability and regulation of tobacco sales. Aspects of intervention implementation related to the NATSIHP domains were less well described and evidence was limited; however, reviewers suggested that cultural tailoring, holistic approaches and building workforce capacity were important strategies to address barriers. There was limited evidence regarding social media and mobile applications, for Indigenous youth, pregnant women and prisoners, and no evidence regarding interventions to protect communities from industry interference, the use of electronic cigarettes, interventions for people experiencing mental illness, juvenile justice, linguistic diversity or 'pubs, clubs and restaurants'. CONCLUSIONS There is limited Indigenous-specific evidence for most tobacco interventions. A 'comprehensive approach' incorporating NTS and NATSIHP Principles and Priorities of partnership and engagement, evidence from other settings, programme logic and responsive evaluation plans may improve intervention acceptability, effectiveness and implementation and mitigate risks of adapting tobacco evidence for Indigenous Australians.
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Affiliation(s)
- Catherine Chamberlain
- Aboriginal Health Domain, Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
- Judith Lumley Centre, La Trobe University, 217 Franklin St, Melbourne, VIC 3000 Australia
- Healthy Mothers, Healthy Families Group, Murdoch Children’s Research Institute, Royal Children’s Hospital, Flemington Road, Parkville, VIC 3052 Australia
- The Australian Prevention Partnership Centre, 13/235 Jones St, Ultimo, NSW 2007 Australia
| | - Susan Perlen
- Aboriginal Health Domain, Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC 3004 Australia
- Healthy Mothers, Healthy Families Group, Murdoch Children’s Research Institute, Royal Children’s Hospital, Flemington Road, Parkville, VIC 3052 Australia
| | - Sue Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
| | - Lucie Rychetnik
- School of Medicine, University of Notre Dame, 160 Oxford St, Darlinghurst, NSW 2010 Australia
- The Australian Prevention Partnership Centre, 13/235 Jones St, Ultimo, NSW 2007 Australia
| | - David Thomas
- Tobacco Control Research, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811 Australia
| | - Raglan Maddox
- Well Living House, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael’s Hospital, 209 Victoria St, Toronto, Canada
- Faculty of Health, University of Canberra, University Dr, Bruce, Canberra, ACT 2617 Australia
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Noore Alam
- Prevention Division, Department of Health, Queensland Government, 15 Butterfield St, Herston, QLD 4006 Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Mills Road, Canberra, ACT 2601 Australia
| | - Andrew Wilson
- The Australian Prevention Partnership Centre, 13/235 Jones St, Ultimo, NSW 2007 Australia
- Menzies Centre for Health Policy, University of Sydney, Camperdown, NSW 2006 Australia
| | - Sandra Eades
- Aboriginal Health Domain, Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004 Australia
- The Australian Prevention Partnership Centre, 13/235 Jones St, Ultimo, NSW 2007 Australia
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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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Yuke K, Ford P, Foley W, Mutch A, Fitzgerald L, Gartner C. Australian urban Indigenous smokers' perspectives on nicotine products and tobacco harm reduction. Drug Alcohol Rev 2017; 37:87-96. [DOI: 10.1111/dar.12549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/01/2017] [Accepted: 03/06/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Kym Yuke
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care; Brisbane Australia
- School of Public Health; The University of Queensland; Brisbane Australia
| | - Pauline Ford
- School of Dentistry; The University of Queensland; Brisbane Australia
| | - Wendy Foley
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care; Brisbane Australia
- School of Public Health; The University of Queensland; Brisbane Australia
| | - Allyson Mutch
- School of Public Health; The University of Queensland; Brisbane Australia
| | - Lisa Fitzgerald
- School of Public Health; The University of Queensland; Brisbane Australia
| | - Coral Gartner
- School of Public Health; The University of Queensland; Brisbane Australia
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22
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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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23
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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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24
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Boucher J, Konkle ATM. Understanding Inequalities of Maternal Smoking--Bridging the Gap with Adapted Intervention Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E282. [PMID: 26959037 PMCID: PMC4808945 DOI: 10.3390/ijerph13030282] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/25/2016] [Accepted: 02/29/2016] [Indexed: 11/25/2022]
Abstract
Women who are generally part of socially disadvantaged and economically marginalized groups are especially susceptible to smoking during pregnancy but smoking rates are underreported in both research and interventions. While there is evidence to support the short-term efficacy of nicotine replacement therapy (NRT) use in pregnancy, long-term abstinence rates are modest. Current health strategies and interventions designed to diminish smoking in pregnancy have adopted a simplified approach to maternal smoking-one that suggests that they have a similar degree of choice to non-pregnant smokers regarding the avoidance of risk factors, and overlooks individual predictors of non-adherence. As a result, interventions have been ineffective among this high-risk group. For this reason, this paper addresses the multiple and interacting determinants that must be considered when developing and implementing effective strategies that lead to successful smoking cessation: socioeconomic status (SES), nicotine dependence, social support, culture, mental health, and health services. Based on our review of the literature, we conclude that tailoring cessation programs for pregnant smokers may ultimately optimize NRT efficacy and reduce the prevalence of maternal smoking.
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Affiliation(s)
- Julie Boucher
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, ON K1N 6N5, Canada.
| | - Anne T M Konkle
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, ON K1N 6N5, Canada.
- School of Psychology, University of Ottawa, Ontario, ON K1N 6N5, Canada.
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25
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Ryan CJ, Leatherdale ST, Cooke MJ. A cross-sectional examination of the correlates of current smoking among off-reserve First Nations and Métis adults: Evidence from the 2012 Aboriginal Peoples Survey. Addict Behav 2016; 54:75-81. [PMID: 26735185 DOI: 10.1016/j.addbeh.2015.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the correlates of current smoking among off-reserve First Nations and Métis adults, two Aboriginal Canadian groups that are at higher risk to smoke and more likely to suffer from chronic health conditions relative to their non-Aboriginal counterparts. A particular focus was on culturally specific factors and their associations with current smoking. METHODS We used data from Statistics Canada's, 2012 Aboriginal Peoples Survey to investigate the correlates of smoking among 12,720 First Nations and Métis adults. Sequential binary logistic regression models were estimated to examine associations between smoking and culturally specific, demographic, geographic, socioeconomic and health-related variables. RESULTS Overall, 39.4% were current smokers. Multivariate results found that those who had hunted, fished or trapped within the last year were more likely to be smokers. In addition, respondents who were exposed to an Aboriginal language at home or outside the home were more likely to be smokers. Current smoking was significantly associated with being aged 35 to 49 years, living in a small population center, low income, low education, unemployment, being unmarried, low ratings of self-perceived health, heavy drinking and low body mass index. Respondents aged 65 years and older and those living in British Columbia were less likely to smoke. DISCUSSION The results of this study suggest that it may be useful to consider cultural characteristics, particularly language in efforts to reduce the prevalence of manufactured tobacco use among First Nations and Métis adults. Interventions should also consider demographic, geographic and socioeconomic variables, in addition to co-occurring health-risk behaviors.
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26
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Dolan K, Rodas A, Bode A. Drug and alcohol use and treatment for Australian Indigenous and non-Indigenous prisoners: demand reduction strategies. Int J Prison Health 2016; 11:30-8. [PMID: 25751705 DOI: 10.1108/ijph-02-2014-0005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to compare the use of drugs and alcohol by Indigenous and non-Indigenous prisoners and examine relevant treatment in Australian prisons. DESIGN/METHODOLOGY/APPROACH Prison authorities were surveyed about alcohol and drug use by prisoners prior to and during imprisonment and drug and alcohol treatment programs in prison. The literature was review for information on alcohol and drug use and treatment in Australian prisons. FINDINGS In 2009, over 80 percent of Indigenous and non-Indigenous inmates smoked. Prior to imprisonment, many Indigenous and non-Indigenous inmates drank alcohol at risky levels (65 vs 47 percent) and used illicit drugs (over 70 percent for both groups). Reports of using heroin (15 vs 21 percent), ATS (21 vs 33 percent), cannabis (59 vs 50 percent) and injecting (61 vs 53 percent) were similarly high for both groups. Prison-based programs included detoxification, Opioid Substitution Treatment, counselling and drug free units, but access was limited especially among Indigenous prisoners. RESEARCH LIMITATIONS/IMPLICATIONS Drug and alcohol use was a significant issue in Australian prisons. Prisoners were over five times more likely than the general population to have a substance use disorder. Imprisonment provides an important opportunity for rehabilitation for offenders. This opportunity is especially relevant to Indigenous prisoners who were more likely to use health services when in prison than in the community and given their vast over representations in prison populations. PRACTICAL IMPLICATIONS Given the effectiveness of treatment in reducing re-offending rates, it is important to expand drug treatment and especially culturally appropriate treatment programs for Indigenous inmates. ORIGINALITY/VALUE Very little is known about Indigenous specific drug and alcohol programs in Australian prisons.
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Affiliation(s)
- Kate Dolan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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27
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Minichiello A, Lefkowitz ARF, Firestone M, Smylie JK, Schwartz R. Effective strategies to reduce commercial tobacco use in Indigenous communities globally: A systematic review. BMC Public Health 2016; 16:21. [PMID: 26754922 PMCID: PMC4710008 DOI: 10.1186/s12889-015-2645-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 12/18/2015] [Indexed: 11/30/2022] Open
Abstract
Background All over the world, Indigenous populations have remarkably high rates of commercial tobacco use compared to non-Indigenous groups. The high rates of commercial tobacco use in Indigenous populations have led to a variety of health issues and lower life expectancy than the general population. The objectives of this systematic review were to investigate changes in the initiation, consumption and quit rates of commercial tobacco use as well as changes in knowledge, prevalence, community interest, and smoke-free environments in Indigenous populations. We also aimed to understand which interventions had broad reach, what the common elements that supported positive change were and how Aboriginal self-determination was reflected in program implementation. Methods We undertook a systematic review of peer-reviewed publications and grey literature selected from seven databases and 43 electronic sources. We included studies between 1994 and 2015 if they addressed an intervention (including provision of a health service or program, education or training programs) aimed to reduce the use of commercial tobacco use in Indigenous communities globally. Systematic cross-regional canvassing of informants in Canada and internationally with knowledge of Indigenous health and/or tobacco control provided further leads about commercial tobacco reduction interventions. We extracted data on program characteristics, study design and learnings including successes and challenges. Results In the process of this review, we investigated 73 commercial tobacco control interventions in Indigenous communities globally. These interventions incorporated a myriad of activities to reduce, cease or protect Indigenous peoples from the harms of commercial tobacco use. Interventions were successful in producing positive changes in initiation, consumption and quit rates. Interventions also facilitated increases in the number of smoke-free environments, greater understandings of the harms of commercial tobacco use and a growing community interest in addressing the high rates of commercial tobacco use. Interventions were unable to produce any measured change in prevalence rates. Conclusions The extent of this research in Indigenous communities globally suggests a growing prioritization and readiness to address the high rates of commercial tobacco use through the use of both comprehensive and tailored interventions. A comprehensive approach that uses multiple activities, the centring of Aboriginal leadership, long term community investments, and the provision of culturally appropriate health materials and activities appear to have an important influence in producing desired change. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2645-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexa Minichiello
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Ayla R F Lefkowitz
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Michelle Firestone
- Well Living House Action Research Centre for Indigenous Infant, Child and Family Health and Wellbeing,, St. Michael's Hospital, Toronto, Canada. .,Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Janet K Smylie
- Well Living House Action Research Centre for Indigenous Infant, Child and Family Health and Wellbeing,, St. Michael's Hospital, Toronto, Canada. .,Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Robert Schwartz
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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28
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Paul C, Wolfenden L, Tzelepis F, Yoong S, Bowman J, Wye P, Sherwood E, Rose S, Wiggers J. Nicotine replacement therapy as a smoking cessation aid among disadvantaged smokers: What answers do we need? Drug Alcohol Rev 2015; 35:785-789. [PMID: 26661119 DOI: 10.1111/dar.12362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/03/2015] [Accepted: 10/06/2015] [Indexed: 11/30/2022]
Abstract
In Australia and New Zealand, population groups who experience social disadvantage smoke at much higher rates than the general population. As there are limited data specific to these groups regarding the success of nicotine replacement therapy for smoking cessation, this commentary will provide an overview of the relevant international literature supplemented with observational data relevant to the policy contexts in Australia and New Zealand. [Paul C, Wolfenden L, Tzelepis F, Yoong S, Bowman J, Wye P, Sherwood E, Rose S, Wiggers J. Nicotine replacement therapy as a smoking cessation aid among disadvantaged smokers: What answers do we need? Drug Alcohol Rev 2016;35:785-789].
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Affiliation(s)
- Christine Paul
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia
| | - Luke Wolfenden
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Newcastle, Australia
| | - Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Newcastle, Australia
| | - Serene Yoong
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Newcastle, Australia
| | - Jenny Bowman
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia
| | - Paula Wye
- Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Newcastle, Australia
| | - Emma Sherwood
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia
| | - Shiho Rose
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia
| | - John Wiggers
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, HMRI Building, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Newcastle, Australia
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29
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Katzenellenbogen JM, Woods JA, Teng THK, Thompson SC. Atrial fibrillation in the Indigenous populations of Australia, Canada, New Zealand, and the United States: a systematic scoping review. BMC Cardiovasc Disord 2015; 15:87. [PMID: 26268309 PMCID: PMC4535416 DOI: 10.1186/s12872-015-0081-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 08/03/2015] [Indexed: 11/26/2022] Open
Abstract
Background The epidemiology of atrial fibrillation (AF) among Indigenous minorities in affluent countries is poorly delineated, despite the high cardiovascular disease burden in these populations. We undertook a systematic scoping review examining the epidemiology of AF in the Indigenous populations of Australia, Canada, New Zealand (NZ) and the United States (US). Methods PubMed, Scopus, EMBASE and CINAHL-Plus databases were systematically searched in May 2014. Supplementary full-text searches of Google Scholar and government website searches were also undertaken. Results Key findings from 27 publications with diverse aims and methods were included. Small studies from Canada and NZ suggest higher AF prevalence in Indigenous than other populations. However, this was not reflected in a large sample of US male military veterans. No data were identified on community-based incidence rates of AF in Indigenous populations. Australian and Canadian studies indicate higher first-ever and overall AF hospitalisation rates among Indigenous than other populations, at younger ages and with more comorbidity. Studies in stroke, heart failure and other clinical groups demonstrate AF as a common comorbidity, with AF possibly more prevalent at younger ages in Indigenous people. Indigenous patients have similar early post-hospitalisation adjusted mortality but higher 1-year risk-adjusted mortality than non-Indigenous patients. Conclusions No clear epidemiological pattern of AF frequency across the considered Indigenous populations emerges from the limited available evidence. AF should be included in key conditions reported in national surveillance reports, although Indigenous identifiers are required in administrative data from Canada and the US. Sufficiently powered, community-based studies of AF epidemiology in diverse Indigenous populations are needed. Electronic supplementary material The online version of this article (doi:10.1186/s12872-015-0081-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Judith M Katzenellenbogen
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.,School of Population Health, The University of Western Australia (M431), 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - John A Woods
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.
| | - Tiew-Hwa Katherine Teng
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
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30
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Noble N, Paul C, Carey M, Blunden S, Turner N. A randomised trial assessing the acceptability and effectiveness of providing generic versus tailored feedback about health risks for a high need primary care sample. BMC FAMILY PRACTICE 2015; 16:95. [PMID: 26243144 PMCID: PMC4525725 DOI: 10.1186/s12875-015-0309-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 07/22/2015] [Indexed: 11/20/2022]
Abstract
Background Tailored feedback has been shown to be effective for modifying health risk behaviours and may aid the provision of preventive care by general practitioners (GPs). However, provision of tailored patient feedback for vulnerable or socially disadvantaged groups is not well explored. The aims of this study were to examine the acceptability and effectiveness of providing generic compared to tailored feedback on self-reported health risk behaviours among a high need sample of people attending an Aboriginal Community Controlled Health Service (ACCHS). Methods Participants attending two ACCHSs in regional New South Wales completed a touch screen health risk survey and received either generic or tailored health risk feedback. Participants were asked to complete an exit survey after their appointment. The exit survey asked about feedback acceptability and effectiveness. Self-reported ease of understanding, relevance and whether the generic versus tailored feedback helped patients talk to their GP was compared using Chi-square analysis; The mean number of survey health risks talked about or for which additional actions were undertaken (such as provision of lifestyle advice or referral) was compared using t-tests. Results Eighty seven participants (36 % consent rate) completed the exit survey. Tailored feedback was rated as more relevant and was more likely to be shown to the participant’s GP than generic feedback. There was no difference in the mean number of health risk topics discussed or number of additional actions taken by the GP by type of feedback. Conclusions Tailored and generic feedback showed no difference in effectiveness, and little difference in acceptability, among this socially disadvantaged population. Completing a health risk survey and receiving any type of feedback may have overwhelmed more subtle differences in outcomes between the generic and the tailored feedback. Future work to rigorously evaluate the longer-term effectiveness of the provision of tailored health risk feedback for Aboriginal Australians, as well as other high need groups, is still needed. Trial Registration: Australian New Zealand Clinical Trials Registry ANZCTRN12614001205628. Registered 11 November 2014. Electronic supplementary material The online version of this article (doi:10.1186/s12875-015-0309-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Natasha Noble
- Priority Research Centre for Health Behaviour and School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Christine Paul
- Priority Research Centre for Health Behaviour and School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Mariko Carey
- Priority Research Centre for Health Behaviour and School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Stephen Blunden
- Casino Aboriginal Medical Service, Casino, NSW, 2470, Australia.
| | - Nicole Turner
- School of Medicine and Public Health and Department of Rural Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
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31
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Hemsing N, Greaves L, Poole N. Tobacco Cessation Interventions for Underserved Women. JOURNAL OF SOCIAL WORK PRACTICE IN THE ADDICTIONS 2015; 15:267-287. [PMID: 27226783 PMCID: PMC4867857 DOI: 10.1080/1533256x.2015.1054231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/09/2015] [Accepted: 05/14/2015] [Indexed: 06/05/2023]
Abstract
Despite high rates of smoking among some subgroups of women, there is a lack of tailored interventions to address smoking cessation among women. We identify components of a women-centered approach to tobacco cessation by analyzing 3 bodies of literature: sex and gender influences in tobacco use and addiction; evidence-based tobacco cessation guidelines; and best practices in delivery of women-centered care. Programming for underserved women should be tailored, build confidence and increase motivation, integrate social justice issues and address inequities, and be holistic and comprehensive. Addressing the complexity of women's smoking and tailoring appropriately could help address smoking among subpopulations of women.
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Affiliation(s)
- Natalie Hemsing
- Research Associate, British Columbia Centre of Excellence for Women’s Health, Vancouver, British Columbia, Canada
| | - Lorraine Greaves
- Senior Investigator, British Columbia Centre of Excellence for Women’s Health, Vancouver, British Columbia, Canada
| | - Nancy Poole
- Director, British Columbia Centre of Excellence for Women’s Health, Vancouver, British Columbia, Canada
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32
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Sabesan S, Kelly J, Budden L, Knott V, Garvey G. Telehealth: a new opportunity to discuss smoking cessation with indigenous cancer patients and their families. Psychooncology 2015; 24:1324-1326. [DOI: 10.1002/pon.3892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 05/28/2015] [Accepted: 06/01/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Sabe Sabesan
- Department of Medical Oncology; Townsville Cancer Centre, Townsville Hospital; Townsville Queensland Australia
- College of Medicine and Dentistry; James Cook University; Townsville Queensland Australia
- Tropical Centre for Telehealth Practice and Research; Townsville Hospital and Health Service; Townsville Queensland Australia
| | - Jenny Kelly
- College of Medicine and Dentistry; James Cook University; Townsville Queensland Australia
- Tropical Centre for Telehealth Practice and Research; Townsville Hospital and Health Service; Townsville Queensland Australia
- Centre for Nursing and Midwifery Research; James Cook University; Queensland Australia
| | - Lea Budden
- Centre for Nursing and Midwifery Research; James Cook University; Queensland Australia
- Nursing, Midwifery and Nutrition, College of Healthcare Sciences; James Cook University; Townsville Queensland Australia
| | - Vikki Knott
- Epidemiology and Health Systems Division; Menzies School of Health Research; Brisbane Queensland Australia
| | - Gail Garvey
- Epidemiology and Health Systems Division; Menzies School of Health Research; Brisbane Queensland Australia
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Passey ME, Sanson-Fisher RW, Stirling JM. Supporting pregnant Aboriginal and Torres Strait Islander women to quit smoking: views of antenatal care providers and pregnant indigenous women. Matern Child Health J 2014; 18:2293-9. [PMID: 24150690 PMCID: PMC4220103 DOI: 10.1007/s10995-013-1373-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To assess support for 12 potential smoking cessation strategies among pregnant Australian Indigenous women and their antenatal care providers. Cross-sectional surveys of staff and women in antenatal services providing care for Indigenous women in the Northern Territory and New South Wales, Australia. Respondents were asked to indicate the extent to which each of a list of possible strategies would be helpful in supporting pregnant Indigenous women to quit smoking. Current smokers (n = 121) were less positive about the potential effectiveness of most of the 12 strategies than the providers (n = 127). For example, family support was considered helpful by 64 % of smokers and 91 % of providers; between 56 and 62 % of smokers considered advice and support from midwives, doctors or Aboriginal Health Workers likely to be helpful, compared to 85-90 % of providers. Rewards for quitting were considered helpful by 63 % of smokers and 56 % of providers, with smokers rating them more highly and providers rating them lower, than most other strategies. Quitline was least popular for both. This study is the first to explore views of pregnant Australian Indigenous women and their antenatal care providers on strategies to support smoking cessation. It has identified strategies which are acceptable to both providers and Indigenous women, and therefore have potential for implementation in routine care. Further research to explore their feasibility in real world settings, uptake by pregnant women and actual impact on smoking outcomes is urgently needed given the high prevalence of smoking among pregnant Indigenous women.
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Wicklow BA, Sellers EAC. Maternal health issues and cardio-metabolic outcomes in the offspring: a focus on Indigenous populations. Best Pract Res Clin Obstet Gynaecol 2014; 29:43-53. [PMID: 25238683 DOI: 10.1016/j.bpobgyn.2014.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 04/13/2014] [Indexed: 01/28/2023]
Abstract
Non-communicable diseases (NCDs) including diabetes, obesity and cardiovascular disease are the leading causes of death worldwide. Indigenous populations are disproportionally affected. In an effort to halt the increasing disease burden, the mechanisms underlying the increasing rate of NCDs are an important area of study. Recent evidence has focused on the perinatal period as an influential period impacting the future cardio-metabolic health of the offspring. This concept has been defined as metabolic foetal programming and supports the importance of the developmental origins of health and disease in research and clinical practice, specifically in prevention efforts to protect future generations from NCDs. An understanding of the underlying mechanisms involved is not clear as of yet. However, an understanding of these mechanisms is imperative in order to plan effective intervention strategies. As much of the discussion below is gleaned from large epidemiological studies and animal studies, further research with prospective cohorts is necessary.
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Affiliation(s)
- Brandy A Wicklow
- Department of Paediatric and Child Health, University of Manitoba, FE- 307 685 William Avenue, Winnipeg, Manitoba R3E 0Z2, Canada.
| | - Elizabeth A C Sellers
- Department of Paediatric and Child Health, University of Manitoba, FE- 307 685 William Avenue, Winnipeg, Manitoba R3E 0Z2, Canada.
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Gould GS, Watt K, McEwen A, Cadet-James Y, Clough AR. Validation of risk assessment scales and predictors of intentions to quit smoking in Australian Aboriginal and Torres Strait Islander peoples: a cross-sectional survey protocol. BMJ Open 2014; 4:e004887. [PMID: 24902729 PMCID: PMC4054635 DOI: 10.1136/bmjopen-2014-004887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Tobacco smoking is a very significant behavioural risk factor for the health of Australian Aboriginal and Torres Strait Islanders, and is embedded as a social norm. With a focus on women of childbearing age, and men of similar age, this project aims to determine how Aboriginal and Torres Strait Islander smokers assess smoking risks and how these assessments contribute to their intentions to quit. The findings from this pragmatic study should contribute to developing culturally targeted interventions. METHODS AND ANALYSIS A cross-sectional study using quantitative and qualitative data. A total of 120 Aboriginal and Torres Strait Islander community members aged 18-45 years will be recruited at community events and through an Aboriginal Community Controlled Health Service (ACCHS). Participants will be interviewed using a tablet computer or paper survey. The survey instrument uses modified risk behaviour scales, that is, the Risk Behaviour Diagnosis (RBD) scale and the Smoking Risk Assessment Target (SRAT) (adapted from the Risk Acceptance Ladder) to determine whether attitudes of Aboriginal and Torres Strait Islander smokers to health risk messages are predictors of intentions to quit smoking. The questionnaire will be assessed for face and content validity with a panel of Indigenous community members. The internal consistency of the RBD subscales and their patterns of correlation will be explored. Multivariate analyses will examine predictors of intentions to quit. This will include demographics such as age, gender, nicotine dependence, household smoking rules and perceived threat from smoking and efficacy for quitting. The two risk-assessment scales will be examined to see whether participant responses are correlated. ETHICS AND DISSEMINATION The Aboriginal Health & Medical Research Council Ethics Committee and university ethics committees approved the study. The results will be published in a peer-reviewed journal and a community report will be disseminated by the ACCHS, and at community forums. NOTE ABOUT TERMINOLOGY We use the term Aboriginal and Torres Strait Islander peoples, except where previous research has reported findings from only one group for example, Aboriginal people. Indigenous is used here to refer to Indigenous peoples in the international context, and issues, policies or systems, for example, Indigenous health, Indigenous tobacco control.
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Affiliation(s)
- Gillian Sandra Gould
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kerrianne Watt
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia
| | - Andy McEwen
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Yvonne Cadet-James
- School of Indigenous Australian Studies, 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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Paul CL, Turon H, Bonevski B, Bryant J, McElduff P. A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence? BMC Public Health 2013; 13:1144. [PMID: 24314097 PMCID: PMC3890507 DOI: 10.1186/1471-2458-13-1144] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. METHODS A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. RESULTS A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p's < .0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. CONCLUSIONS Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based.
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Affiliation(s)
- Christine L Paul
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
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Ford P, Clifford A, Gussy K, Gartner C. A systematic review of peer-support programs for smoking cessation in disadvantaged groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5507-22. [PMID: 24169412 PMCID: PMC3863857 DOI: 10.3390/ijerph10115507] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 10/09/2013] [Accepted: 10/12/2013] [Indexed: 11/16/2022]
Abstract
The burden of smoking is borne most by those who are socially disadvantaged and the social gradient in smoking contributes substantially to the health gap between the rich and poor. A number of factors contribute to higher tobacco use among socially disadvantaged populations including social (e.g., low social support for quitting), psychological (e.g., low self-efficacy) and physical factors (e.g., greater nicotine dependence). Current evidence for the effectiveness of peer or partner support interventions in enhancing the success of quit attempts in the general population is equivocal, largely due to study design and lack of a theoretical framework in this research. We conducted a systematic review of peer support interventions for smoking cessation in disadvantaged groups. The eight studies which met the inclusion criteria showed that interventions that improve social support for smoking cessation may be of greater importance to disadvantaged groups who experience fewer opportunities to access such support informally. Peer-support programs are emerging as highly effective and empowering ways for people to manage health issues in a socially supportive context. We discuss the potential for peer-support programs to address the high prevalence of smoking in vulnerable populations and also to build capacity in their communities.
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Affiliation(s)
- Pauline Ford
- School of Dentistry, The University of Queensland, 200 Turbot St., Brisbane, QLD 4000, Australia
| | - Anton Clifford
- The Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, QLD 4006, Australia; E-Mails: (A.C.); (K.G.)
- School of Population Health, The University of Queensland, Herston Road, Brisbane, QLD 4006, Australia
| | - Kim Gussy
- The Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, QLD 4006, Australia; E-Mails: (A.C.); (K.G.)
| | - Coral Gartner
- University of Queensland Centre for Clinical Research, The University of Queensland, Building 71/918 RBWH Site, Herston, QLD 4029, Australia; E-Mail:
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Robertson J, Pointing BS, Stevenson L, Clough AR. "We made the rule, we have to stick to it": towards effective management of environmental tobacco smoke in remote Australian Aboriginal communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:4944-66. [PMID: 24157514 PMCID: PMC3823346 DOI: 10.3390/ijerph10104944] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 08/16/2013] [Accepted: 09/02/2013] [Indexed: 11/17/2022]
Abstract
Smoking prevalence in remote Australian Aboriginal communities remains extraordinarily high, with rates reported of up to 82%. Widespread exposure to environmental tobacco smoke (ETS) is exacerbated by overcrowded housing. Implementation of existing smoke-free policies is challenged by the normalization of smoking and a lack of appropriate regulation resources. This paper celebrates a grassroots approach to control of environmental tobacco smoke (ETS) in these settings. We report on selected findings from a tobacco intervention study in Arnhem Land, Northern Territory in 2007-2012. In community-level tobacco use surveys at baseline (n = 400 ≥ 16 years), participants reported concern about the constant exposure of non-smokers to tobacco smoke. Suggestions for action included restricting smoking in private and public spaces. We selected three case studies illustrating management of ETS from observational data during the study's intervention phase. Using a critical realist approach, the context and mechanisms that contributed to specific strategies, or outcomes, were examined in order to develop a hypothesis regarding more effective management of ETS in these environments. Our results suggest that in discrete, disadvantaged communities, enhanced local ownership of smoke-free policies and development of implementation strategies at the grassroots level that acknowledge and incorporate cultural contexts can contribute to more effective management of ETS.
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Affiliation(s)
- Jan Robertson
- Tropical Medicine & Rehabilitation Sciences, School of Public Health, James Cook University, Cairns, Queensland 4870, Australia; E-Mails: (L.S.); (A.R.C.)
- Midwifery & Nutrition, School of Nursing, James Cook University, Cairns, Queensland 4870, Australia
| | - Boris Shane Pointing
- Cairns Institute, James Cook University, Cairns, Queensland 4870, Australia; E-Mail:
| | - Leah Stevenson
- Tropical Medicine & Rehabilitation Sciences, School of Public Health, James Cook University, Cairns, Queensland 4870, Australia; E-Mails: (L.S.); (A.R.C.)
| | - Alan R. Clough
- Tropical Medicine & Rehabilitation Sciences, School of Public Health, James Cook University, Cairns, Queensland 4870, Australia; E-Mails: (L.S.); (A.R.C.)
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Athyros VG, Katsiki N, Doumas M, Karagiannis A, Mikhailidis DP. Effect of tobacco smoking and smoking cessation on plasma lipoproteins and associated major cardiovascular risk factors: a narrative review. Curr Med Res Opin 2013; 29:1263-74. [PMID: 23879722 DOI: 10.1185/03007995.2013.827566] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cigarette smoking, active or passive, kills about 6 million people each year worldwide. Cardiovascular disease (CVD) is responsible for 40% of all smoking-related deaths, lung cancer accounts for 20% of all smoking-related deaths, and chronic obstructive pulmonary disease is related to another 20% of deaths. In this narrative review we consider the relationship between cigarette smoking and CVD. We discuss disease states and/or CVD risk factors related to smoking, such as dyslipidaemia, vascular inflammation, endothelial dysfunction, arterial stiffness, insulin resistance, type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and non-alcoholic fatty liver disease (NAFLD) as well as their complex interrelations. Smoking cessation can correct abnormalities related to smoking; however, success rates are relatively low. In cases of inability to quit, measures to minimize the adverse effects of smoking specifically related to CVD should be taken. Smokers should receive best practice treatment, according to guidelines, as for non-smokers.
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Affiliation(s)
- Vassilios G Athyros
- Second Prop. Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital , Thessaloniki , Greece
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Passey ME, Bryant J, Hall AE, Sanson-Fisher RW. How will we close the gap in smoking rates for pregnant Indigenous women? Med J Aust 2013; 199:39-41. [PMID: 23829261 DOI: 10.5694/mja12.11848] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 05/12/2013] [Indexed: 11/17/2022]
Abstract
Aboriginal and Torres Strait Islander women are more than three times more likely to smoke during pregnancy than non-Indigenous women, greatly increasing the risk of poor birth outcomes. Our systematic review found that there is currently no evidence for interventions that are effective in supporting pregnant Aboriginal and Torres Strait Islander women to quit smoking, which impedes development and implementation of evidence-informed policy and practice. There is an urgent need for methodologically rigorous studies to test innovative approaches to addressing this problem.
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Affiliation(s)
- Megan E Passey
- University Centre for Rural Health - North Coast, University of Sydney, Sydney, NSW, Australia.
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Collins R, Hammond M, Carry CL, Kinnon D, Killulark J, Nevala J. Distance education for tobacco reduction with Inuit frontline health workers. Int J Circumpolar Health 2013; 72:21078. [PMID: 23984270 PMCID: PMC3752291 DOI: 10.3402/ijch.v72i0.21078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Tobacco reduction is a major priority in Canadian Inuit communities. However, many Inuit frontline health workers lacked the knowledge, confidence and support to address the tobacco epidemic. Given vast distances, high costs of face-to-face training and previous successful pilots using distance education, this method was chosen for a national tobacco reduction course. OBJECTIVE To provide distance education about tobacco reduction to at least 25 frontline health workers from all Inuit regions of Canada. DESIGN Promising practices globally were assessed in a literature survey. The National Inuit Tobacco Task Group guided the project. Participants were selected from across Inuit Nunangat. They chose a focus from a "menu" of 6 course options, completed a pre-test to assess individual learning needs and chose which community project(s) to complete. Course materials were mailed, and trainers provided intensive, individualized support through telephone, fax and e-mail. The course ended with an open-book post-test. Follow-up support continued for several months post-training. RESULTS Of the 30 participants, 27 (90%) completed the course. The mean pre-test score was 72% (range: 38-98%). As the post-test was done using open books, everyone scored 100%, with a mean improvement of 28% (range: 2-62%). CONCLUSIONS Although it was often challenging to contact participants through phone, a distance education approach was very practical in a northern context. Learning is more concrete when it happens in a real-life context. As long as adequate support is provided, we recommend individualized distance education to others working in circumpolar regions.
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Affiliation(s)
- Rob Collins
- Consultancy for Alternative Education, Montreal, Canada.
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Fu SS, Rhodes KL, Robert C, Widome R, Forster JL, Joseph AM. Designing and evaluating culturally specific smoking cessation interventions for American Indian communities. Nicotine Tob Res 2013; 16:42-9. [PMID: 23892826 DOI: 10.1093/ntr/ntt111] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION American Indians have the highest smoking rates in the United States, yet few randomized controlled trials of culturally specific interventions exist. This study assessed American Indians' opinions about evidence-based treatment and attitudes toward participating in clinical trials. METHODS Six focus groups were conducted based on smoking status (current/former smoker), sex, and elder status (55 years and older or younger). Meetings were held at local American Indian community organizations. This project was accomplished in partnership with the American Indian Community Tobacco Projects, a community-academic research partnership at the University of Minnesota. Thematic qualitative data analyses were conducted. RESULTS Participants desired the following: (a) programs led by trained American Indian community members, (b) the opportunity to connect with other American Indian smokers interested in quitting, and (c) programs promoting healthy lifestyles. Strategies desired for treatment included (a) free pharmacotherapy, including nicotine replacement therapy (NRT); (b) nominal incentives, e.g., gift cards for groceries; and (c) culturally specific program components such as American Indian images, education on traditional tobacco use, and quit-smoking messages that target the value of family and include narratives or story telling in recruitment and program materials. Biochemical verification of smoking abstinence, such as salivary cotinine or carbon monoxide breathalyzers, is likely acceptable. Standard treatment or delayed treatment control groups were viewed as potentially acceptable for randomized study designs. CONCLUSIONS Rigorously conducted randomized controlled trials of culturally specific smoking cessation interventions are sorely needed but will only be accomplished with the commitment of funders, researchers, and collaborative trusting relationships with the community.
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Affiliation(s)
- Steven S Fu
- VA HSR&D Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN
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Gould GS, McEwen A, Watters T, Clough AR, van der Zwan R. Should anti-tobacco media messages be culturally targeted for Indigenous populations? A systematic review and narrative synthesis. Tob Control 2013; 22:e7. [PMID: 22918939 DOI: 10.1136/tobaccocontrol-2012-050436] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To summarise published empirical research on culturally targeted anti-tobacco media messages for Indigenous or First Nations people and examine the evidence for the effectiveness of targeted and non-targeted campaigns. METHODS Studies were sought describing mass media and new media interventions for tobacco control or smoking cessation in Indigenous or First Nations populations. Studies of any design were included reporting outcomes of media-based interventions including: cognitions, awareness, recall, intention to quit and quit rates. Then, 2 reviewers independently applied inclusion criteria, which were met by 21 (5.8%) of the studies found. One author extracted data with crosschecking by a second. Both independently assessed papers using Scottish Intercollegiate Guidelines Network (SIGN; quantitative studies) and Daly et al (qualitative studies). RESULTS A total of 21 studies were found (4 level 1 randomised controlled trials (RCTs), 11 level 2 studies and 6 qualitative studies) and combined with narrative synthesis. Eight evaluated anti-tobacco TV or radio campaigns; two assessed US websites; three New Zealand studies examined mobile phone interventions; five evaluated print media; three evaluated a CD-ROM, a video and an edutainment intervention. CONCLUSIONS Although Indigenous people had good recall of generic anti-tobacco messages, culturally targeted messages were preferred. New Zealand Maori may be less responsive to holistic targeted campaigns, despite their additional benefits, compared to generic fear campaigns. Culturally targeted internet or mobile phone messages appear to be as effective in American Indians and Maori as generic messages in the general population. There is little research comparing the effect of culturally targeted versus generic messages with similar message content in Indigenous people.
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Affiliation(s)
- Gillian Sandra Gould
- School of Public Health,Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville,Queensland, Australia.
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Johnston V, Westphal DW, Glover M, Thomas DP, Segan C, Walker N. Reducing Smoking Among Indigenous Populations: New Evidence From a Review of Trials. Nicotine Tob Res 2013; 15:1329-38. [DOI: 10.1093/ntr/ntt022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Dawson AP, Cargo M, Stewart H, Chong A, Daniel M. Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach. HEALTH EDUCATION RESEARCH 2013; 28:31-45. [PMID: 23221591 DOI: 10.1093/her/cys111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.
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Affiliation(s)
- Anna P Dawson
- Social Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
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Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study. Int J Equity Health 2012; 11:27. [PMID: 22621767 PMCID: PMC3477099 DOI: 10.1186/1475-9276-11-27] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 05/07/2012] [Indexed: 11/11/2022] Open
Abstract
Introduction Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. Methods We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Results Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Conclusions Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.
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