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CHAPTER 5

SMOKING

WHY IS SMOKING TARGETED

  • smoking kills an estimated 15 000 Australians a year

  • costing Australia $31.5 billion in social (including health) and economic costs each year.

  • Smoking is a preventable risk factor, so all smoking-related diseases and impacts are considered to be avoidable.

  • half of all long-term smokers will die prematurely because they smoked.

  • Exposure to environmental tobacco smoke also causes disease and premature death in

    adults and children who do not smoke.

  • Smoking affects vulnerable population groups disproportionately

  • more likely to smoke tobacco:

    • people living outside major cities

    • people from Indigenous communities

    • low socioeconomic backgrounds

  • 14.7 per cent of those in major cities were smokers

    • 22.8 per cent of those in outer regional and remote areas.

  • 41 per cent of Indigenous Australians were daily smokers

    • which was 2.6 times the rate of non-Indigenous Australians.

  • lowest socioeconomic group smoked at a rate more than two times higher than the highest socioeconomic group

EFFECTIVENESS OF HEALTH PROMOTION

  • despite still being the leading cause of preventable disease in Australia, its contribution to Australia’s burden of disease has decreased over time

  • from 1991 to 2016, the rate of daily smoking halved (from 24% to 12%).

  • the proportion of people who reported having never smoked increased from 49% to 62%.

  • the proportion of children exposed to second-hand smoke decreased, with only 2.8% of households containing someone who smoked in 2016, compared to 31% in 1996.

OTTOWA CHARTER

BUILD HEALTHY PUBLIC POLICY

  • Anti-smoking laws and taxes aim to make not smoking the healthier and easier choice

  • Quit provides advice to the state government to implement legislation related to smoking.

  • Examples of policies include:

    • laws relating to smoking in public places

    • tobacco advertising,

    • the display of cigarettes in retail outlets

    • tobacco packaging

    • tobacco taxes

CREATE SUPPORTIVE ENVIRONMENTS

  • National Tobacco Campaigns provide information on how to access resources to assist in quitting at no cost

  • My QuitBuddy allows users to record personal goals and motivation using pictures, words and audio messages

  • There is a community board where users can gain motivation and support from thousands of other people quitting

STRENGTHEN COMMUNITY ACTION

  • Aboriginal Quitline strengthens community action by using Aboriginal quit specialists

    • additional training to assist people with smoking cessation

    • culturally appropriate way

  • Quit Victoria is a joint venture between:

    • the Victorian Government

    • VicHealth

    • the Heart Foundation

    • Cancer Council.

DEVELOP PERSONAL SKILLS

  • National Tobacco Campaigns work to educate the population on the dangers and consequences of smoking

  • A recent campaign is the ‘Don’t make smokes your story’.

  • Quit provides information regarding tobacco smoking and the benefits associated with not smoking.

    • achieved through a mass advertising campaign

    • downloadable information on its website

REORIENT HEALTH SERVICES

  • Quit invests millions of dollars in smoking prevention research.

    • provides best practice techniques for health professionals in preventing people from starting smoking and assisting smokers to quit

  • Quit provides a free online learning training program for health professionals

  • Quit Victoria’s Smoking Cessation Essentials course and Smoking Cessation Brief Intervention videos provide health professionals with:

    • knowledge and skills relating to assisting smokers to quit

INDIGENOUS HEALTH PROMOTION

CLOSE THE GAP

  • close the gap in life expectancy within a generation

  • ensure all Indigenous four-years-olds in remote communities have access to early childhood education within five years

  • halve the gap for Indigenous students in reading, writing and numeracy within a decade

  • halve the gap for Indigenous students in year 12 attainment or equivalent attainment rates by 2020

  • halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade.

THE PURPLE TRUCK

  • a mobile dialysis unit

  • travels to rural communities to deliver dialysis

  • only has aboriginal nurses - provides culturally appropriate healthcare

CREATE SUPPORTIVE ENVIRONMENTS

  • allows people to receive medical treatment without leaving their communities

  • helps them be able to practice healthy behaviours

  • without mobile units, people will not be able to receive treatment

  • would be distressing to leave the country

STRENGTHEN COMMUNITY ACTION

  • involves the community working together to improve health outcomes

  • provides treatment for remote Indigenous communities who would otherwise face barriers in seeking treatment.

DEVELOP PERSONAL SKILLS

  • provides health information for people about Kidney Disease

  • provides information about the importance of reducing risk factors

    • excessive alcohol consumption

  • They welcome volunteers, students and anyone who wants to come and help or learn.

REORIENT HEALTH SERVICES

  • Indigenous healthcare professionals

  • provide culturally appropriate healthcare

EVALUATING INITIATIVES

  1. Is the initiative culturally appropriate?

  2. Has the program taken into account the specific needs of the target group?

  3. Is there appropriate funding that will ensure the success of the program?

  4. Are the action areas of the Ottawa Charter evident?

  5. Does it involve a community or a number of participants?

  6. Does it address an issue for indigenous Australians?

  7. Does it involve women?

  • if the answer is yes to a couple of these questions, then the program is likely to be effective

  • If no, then it might not be and you can argue this point

EXAMPLE

The ‘Deliver Active and Healthy Lifestyle’ program was developed by the Njernda Aboriginal Corporation (Njernda), based in Echuca, Victoria. The program established an Aboriginal gym with no membership fees to encourage Aboriginal people in the Echuca area to exercise and improve their health outcomes. The building was funded by the Office for Aboriginal and Torres Strait Islander Health, and the equipment and training were resourced through Closing the Gap funding. The community gym was established to offer targeted quality programs, delivered by qualified members of the Aboriginal community, and accessible to all members of the Aboriginal community. The programs were designed to be individually tailored and include physical exercise, health promotion and dietary advice.

Identify two action areas of the Ottawa Charter and describe how they are evident in the ‘Deliver Active and Healthy Lifestyle’ program. 4 marks

Develop personal skills: it is educating people about how to be physically healthy by teaching them about physical exercise, health promotion and nutrition

create supportive environments: by making the program free and accessible to all Aboriginal people in Echuca