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Abstract
In Australia, tobacco smoking is more than twice as common among Indigenous people
as non-Indigenous people. Some of the highest smoking rates in the country are in
remote Indigenous communities in the Northern Territory of Australia. Owing to this
high prevalence, tobacco use today is the single biggest contributing risk factor
for excess morbidity and mortality among Indigenous Australians. Despite this, there
is a lack of published research which qualitatively explores the social context of
Indigenous smoking behaviour or of meanings and perceptions of smoking among Indigenous
people. The aim of this study was to understand why Indigenous people start to smoke,
the reasons why they persist in smoking and the obstacles and drivers of quitting.
We conducted semi-structured interviews with a purposive sample of 25 Indigenous community
members in two remote communities in the Northern Territory and 13 health staff. The
results indicate that there is a complex interplay of historical, social, cultural,
psychological and physiological factors which influence the smoking behaviours of
Indigenous adults in these communities. In particular, the results signal the importance
of the family and kin relations in determining smoking behaviours. While most community
participants were influenced by family to initiate and continue to smoke, the health
and well being of the family was also cited as a key driver of quit attempts. The
results highlight the importance of attending to social and cultural context when
designing tobacco control programs for this population. Specifically, this research
supports the development of family-centred tobacco control interventions alongside
wider policy initiatives to counter the normalisation of smoking and assist individuals
to quit.