Johnston Vanessa, Thomas David P
Menzies School of Health Research, Institute of Advances Studies, Charles Darwin University, Northern Territory, Australia.
Soc Sci Med. 2008 Dec;67(11):1708-16. doi: 10.1016/j.socscimed.2008.09.016. Epub 2008 Oct 18.
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.
在澳大利亚，吸烟在原住民中的普遍程度是非原住民的两倍多。该国一些吸烟率最高的地区位于澳大利亚北领地的偏远原住民社区。由于吸烟率如此之高，如今吸烟是澳大利亚原住民发病和死亡人数过多的最大单一风险因素。尽管如此，缺乏已发表的研究来定性探讨原住民吸烟行为的社会背景，或原住民对吸烟的意义和看法。本研究的目的是了解原住民开始吸烟的原因、持续吸烟的原因以及戒烟的障碍和动力。我们对北领地两个偏远社区的25名原住民社区成员和13名卫生工作人员进行了有目的抽样的半结构化访谈。结果表明，历史、社会、文化、心理和生理因素之间存在复杂的相互作用，影响着这些社区中原住民成年人的吸烟行为。特别是，结果表明家庭和亲属关系在决定吸烟行为方面的重要性。虽然大多数社区参与者受家庭影响开始并继续吸烟，但家庭的健康和幸福也被认为是尝试戒烟的关键动力。结果凸显了在为该人群设计烟草控制项目时关注社会和文化背景的重要性。具体而言，本研究支持制定以家庭为中心的烟草控制干预措施，同时采取更广泛的政策举措，以抵制吸烟常态化并帮助个人戒烟。
