Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care

Tobacco control practices among Aboriginal health professionals in Western Australia

Albert (Sonny) A. G. Pilkington A B C , Owen B. J. Carter D F , Alexander S. Cameron C E and Sandra C. Thompson A B
+ Author Affiliations
- Author Affiliations

A Office of Aboriginal Health, Department of Health Western Australia, East Perth, WA 6004, Australia.

B Centre for International Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.

C National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 0200, Australia.

D Centre for Behavioural Research in Cancer Control, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia.

E Department of Public Health, University of Adelaide, Adelaide, SA 5005, Australia.

F Corresponding author. Email:

Australian Journal of Primary Health 15(2) 152-158
Published: 5 January 2009


Smoking among Aboriginal people is extremely widespread (50 v. 17% of the general population). Aboriginal Health Workers (AHW) are at the vanguard of tackling this problem but many themselves smoke and little is known of their knowledge, attitudes and practices regarding smoking cessation. Structured telephone interviews were conducted with 36 AHW, including 31% current smokers, 31% ex-smokers and 38% non-smokers, to assess their current smoking cessation practices and knowledge of health risks, nicotine dependence, cessation strategies and pharmacotherapies. AHW considered diabetes, alcohol use and heart disease more problematic than smoking among Aboriginal people. Fear of appearing hypocritical stopped many who smoke from discussing smoking cessation with clients but also stopped some non-smoking AHW whose colleagues or family smoked. Cultural concerns about telling others ‘what to do’ was also a major impediment. Knowledge of the health effects of smoking was good, but knowledge of appropriate advice around cessation pharmacotherapies was suboptimal. AHW trained in smoking cessation were more knowledgeable and active in smoking cessation, but most AHW had received no training, despite being keen to do so. Specific smoking cessation training is sought and appears needed by AHW, particularly in the areas of brief interventions, motivational interviewing, dependence assessment and pharmacotherapies.

Additional keywords: behaviour, indigenous, smoking cessation.


This study was conducted by AAG Pilkington, an Aboriginal student, as part of the Master of Applied Epidemiology program at the Australian National University and was funded by Department of Health and Ageing. Pilkington was also supported by funding from Curtin University and the Office of Aboriginal Health, Department of Health Western Australia. Advice in relation to the survey design and research support provided by Associate Professor Deborah Lehmann, Glenn Draper, Caron Molster, Kathy Crouchley and the ‘Say no to smokes’ team and Steering group is gratefully acknowledged. Carter’s position is part funded by Healthway in the form of a Tobacco Control Research Fellowship. The Centre for Behavioural Research in Cancer Control is the supported by funding from the Cancer Council WA.


Andrews B , Stephenson J (1993) ‘Smoking and health report: Orana and far west region.’ (Health Promotion Unit, Orana and far west region: Dubbo, NSW)

Australian Bureau of Statistics, Australian Institute of Health and Welfare (2005) The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples, 2005. ABS Report 4704.0. (ASBS: Canberra)

Australian Institute of Health and Welfare (2007) Aboriginal and Torres Strait Islander health performance framework, 2006 report: detailed analyses. No. IHW 20. (AIHW: Canberra)

Australian Institute of Health and Welfare (2008) 2007 National drug strategy household survey: state and territory supplement. No. PHE 102. AIHW, Canberra.

Carter OBJ (2004) Evaluation of the ‘Fresh start’ smoking cessation course. Curtin University CBRCC Report 040713. Cancer Council WA, West Perth.

Diaz FJ, Jane M, Salto E, Pardell H, Salleras L , et al . (2005) A brief measure of high nicotine dependence for busy clinicians and large epidemiological surveys. The Australian and New Zealand Journal of Psychiatry 39(3), 161–168.
CrossRef | PubMed |

Eureka Strategic Research (2005) ‘Evaluation of NSW campaign regarding young children’s exposure to ETS in homes and cars: 2005 final evaluation [3069].’ (ETS and Children Project Taskforce: Sydney)

Hassard K (1999) ‘Australia’s national tobacco campaign: evaluation report.’ Vol. 1. (Commonwealth Department of Health and Ageing: Canberra)

Ivers R (2001) ‘Indigenous Australians and tobacco: a literature review.’ (CRC for Aboriginal and Tropical Health: Darwin)

Mark A (2004) Koori quit smoking program. Vascular Health Matters 11, 6–7.

Mark A, McLeod I, Booker J, Ardler C (2005) Aboriginal health worker smoking: a barrier to lower community smoking rates? Aboriginal and Islander Health Worker Journal 29(5), 22–26.

Silagy C, Lancaster T, Stead L, Mant D, Fowler G (2004) Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 3, CD000146.
CrossRef |

Soria R, Legido A, Escolano C, Lopez Yeste A, Montoya J (2006) A randomised controlled trial of motivational interviewing for smoking cessation. British Journal of General Practice 56(531), 768–774.
PubMed |

Takahashi K, Saso H, Saka H, Saso H, Iwata M , et al . (2006) A pilot study on inducement of smoking cessation by a simple 5A (asking, advice, assess, assist, and arrange) approach at outpatient clinics. Asian Pacific Journal of Cancer Prevention 7(1), 131–135.
PubMed |

Unwin E , Thomson N , Gracey M (1994) ‘The impact of tobacco smoking and alcohol consumption on Aboriginal mortality and hospitalisation in Western Australia: 1983–1991.’ (Health Department of Western Australia: Perth)

Unwin E, Gracey M, Thomson N (1995) The impact of tobacco smoking and alcohol consumption on Aboriginal mortality in Western Australia. Medical Journal of Australia 162(9), 475–478.
PubMed |

Export Citation Cited By (7)