Don’t Follow the Smoke—Listening to the Tobacco Experiences and Attitudes of Urban Aboriginal Adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

International Journal of Environmental Research and Public Health · 9 authors, 6 centres

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TL;DR

This qualitative study used yarning circles with 32 Aboriginal adolescents and young adults to explore smoking attitudes and experiences, identifying four key themes: drawing strength from culture and community, the influence of the smoking environment, non-smoking as a sign of wellbeing, and the importance of individual empowerment. The main finding is that strong cultural and community connections, good mental health, and smoke-free environments are protective against smoking, while peer and family smoking, stress, and boredom are risk factors. A key limitation is that the sample is from only two urban/regional NSW sites, so findings may not be generalizable to all Aboriginal communities, particularly remote ones.

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BACKGROUND

Tobacco use remains a major health disparity for Aboriginal and Torres Strait Islander peoples. This study aimed to explore smoking and non-smoking experiences, attitudes, and beliefs among urban Aboriginal adolescents to inform prevention programs, building on quantitative findings from the SEARCH cohort study. Methods: This is the second stage of an explanatory sequential mixed methods project. Twelve yarning circles were conducted in 2019 with 32 existing SEARCH participants aged 12–28 years (17 female, 15 male) at two NSW sites. Data collection involved open discussion and a card sorting activity to prioritize risk and protective factors. Thematic analysis was used, guided by the Theory of Triadic Influence. Key Results: Four key themes emerged: (1) drawing strength from culture and community; (2) how the smoking environment shapes attitudes and intentions; (3) non-smoking as a sign of good physical, social and emotional wellbeing; and (4) the importance of individual empowerment and engagement for being smoke-free. Protective factors included strong community/cultural connections, smoke-free homes, good mental health, and engagement in sport. Risk factors included peer and family smoking, stress, poor mental health, and boredom. Participants recommended interactive, community-led programs that build cultural connections, address mental health, and provide youth-specific cessation support. Limitations: The study is limited to two urban/regional NSW sites, and participants were engaged in a community-controlled study, which may introduce sampling bias. The findings may not reflect experiences in remote Aboriginal communities. Implications: The study highlights the need for comprehensive, community-led tobacco prevention programs that address underlying determinants like mental health and cultural disconnection, while being reinforced by national tobacco control measures.

STUDY TYPE

other

SPECIALTY

public health

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ORIGINAL PAPER

PMC10002023

Don’t Follow the Smoke—Listening to the Tobacco Experiences and Attitudes of Urban Aboriginal Adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

International Journal of Environmental Research and Public Health

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ABSTRACT

Preventing smoking among young Aboriginal people is important for reducing health inequities. Multiple factors were associated with adolescent smoking in the SEARCH baseline survey (2009–12) and discussed in a follow-up qualitative study that aimed to inform prevention programs. Twelve yarning circles were facilitated by Aboriginal research staff at two NSW sites in 2019 with 32 existing SEARCH participants aged 12–28 (17 female, 15 male). Open discussion around tobacco was followed by a card sorting activity, prioritising risk and protective factors and program ideas. The age of initiation varied by generation. Older participants had established smoking in their early adolescence, whereas the current younger teens had little exposure. Some smoking commenced around high school (from Year 7), and social smoking increased at age 18. Mental and physical health, smoke-free spaces and strong connections to family, community and culture promoted non-smoking. The key themes were (1) drawing strength from culture and community; (2) how the smoking environment shapes attitudes and intentions; (3) non-smoking as a sign of good physical, social and emotional wellbeing; and (4) the importance of individual empowerment and engagement for being smoke-free. Programs promoting good mental health and strengthening cultural and community connections were identified as a priority for prevention.

CITATION EXPORT

Christina L. Heris, Mandy Cutmore, Catherine Chamberlain et al.. Don’t Follow the Smoke—Listening to the Tobacco Experiences and Attitudes of Urban Aboriginal Adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). International Journal of Environmental Research and Public Health. (2023). https://doi.org/10.3390/ijerph20054587

AUTHORS

9 · 6 CENTRES

Christina L. Heris, Mandy Cutmore, Catherine Chamberlain, Natalie Smith, Victor Simpson, Simone Sherriff, Darryl Wright, Kym Slater, Sandra Eades

1National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Acton, Canberra, ACT 2601, Australia
2Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
3Sax Institute, Glebe, Sydney, NSW 2037, Australia
4Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
5Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, NSW 2650, Australia
6Tharawal Aboriginal Corporation, Airds, Sydney, NSW 2560, Australia

EDITOR / REVIEWER

Pallav Pokhrel