Lovett Raymond, Thurber Katherine A, Wright Alyson, Maddox Raglan, Banks Emily
National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT;
National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT.
Public Health Res Pract. 2017 Dec 7;27(5):2751742. doi: 10.17061/phrp2751742.
Tobacco smoking is the leading contributor to the burden of disease among Aboriginal and Torres Strait Islander Australians. Reducing tobacco use in this population is a public health priority. Precise monitoring of smoking prevalence trends is central to implementation and evaluation of effective tobacco control. The way in which trends are reported influences understanding of the extent of progress, with potential implications for policy. Our objective was to quantify absolute changes in Aboriginal and Torres Strait Islander adult (≥18 years old) daily tobacco smoking prevalence from 2004 to 2015, including comparisons with the total Australian population, and by age, sex and remoteness.
We analysed multiple nationally representative surveys of the Aboriginal and Torres Strait Islander, and total Australian, population conducted from 2004 to 2015. Aligned with strength-based approaches, we applied a progress frame, focusing on absolute differences in smoking prevalence within the Aboriginal and Torres Strait Islander population.
The prevalence of current daily smoking among Aboriginal and Torres Strait Islander adults nationally was 50.0% (95% confidence interval [CI] 47.9, 52.2) in 2004-05 and 41.4% (95% CI 39.1, 43.6) in 2014-15, representing an absolute prevalence decrease of 8.6 percentage points (95% CI 5.5, 11.8) over the past decade. This is comparable with the 6.8 percentage point (95% CI 5.6, 7.9) decrease in smoking prevalence in the total Australian population over the same period, from 21.3% in 2004-05 (95% CI 20.5, 22.0) to 14.5% in 2014-15 (95% CI 13.6, 15.4). Particular success in reducing Aboriginal and Torres Strait Islander daily smoking was observed among younger age groups, with a decrease of 13.2 percentage points for 18-24-year-olds (95% CI 5.9, 20.4), 9.0 percentage points for 25-34-year-olds (95% CI 2.7, 15.3) and 8.7 percentage points for 35-44-year-olds (95% CI 2.6, 14.8). Smoking prevalence in those living in urban/regional areas decreased by 10.2 percentage points (95% CI 6.2, 14.1).
Substantial progress has been made in reducing smoking, with an estimated 35 000 fewer Aboriginal and Torres Strait Islander adults smoking every day in 2014-15 compared with if daily smoking remained at 2004-05 prevalence. This will lead to thousands of lives saved. The observed success in the younger age groups is encouraging. Continued resourcing and comprehensive tobacco control efforts are required to ensure positive trends continue.
吸烟是澳大利亚原住民和托雷斯海峡岛民疾病负担的主要成因。减少该人群的烟草使用是一项公共卫生重点工作。精确监测吸烟流行趋势是有效控烟措施实施与评估的核心。趋势报告方式会影响对进展程度的理解，进而可能对政策产生影响。我们的目标是量化2004年至2015年澳大利亚原住民和托雷斯海峡岛民成年人（≥18岁）每日吸烟流行率的绝对变化，包括与澳大利亚总人口进行比较，并按年龄、性别和偏远程度进行分析。
我们分析了2004年至2015年期间对澳大利亚原住民和托雷斯海峡岛民以及澳大利亚总人口进行的多项具有全国代表性的调查。与基于优势的方法一致，我们采用了一个进展框架，重点关注澳大利亚原住民和托雷斯海峡岛民群体内部吸烟流行率的绝对差异。
2004 - 2005年，澳大利亚全国原住民和托雷斯海峡岛民成年人中当前每日吸烟的流行率为50.0%（95%置信区间[CI] 47.9, 52.2），2014 - 2015年为41.4%（95% CI 39.1, 43.6），在过去十年中，绝对流行率下降了8.6个百分点（95% CI 5.5, 11.8）。这与同期澳大利亚总人口吸烟流行率下降6.8个百分点（95% CI 5.6, 7.9）相当，从2004 - 2005年的21.3%（95% CI 20.5, 22.0）降至2014 - 2015年的14.5%（95% CI 13.6, 15.4）。在较年轻年龄组中，减少原住民和托雷斯海峡岛民每日吸烟方面取得了特别显著的成效，18 - 24岁年龄组下降了13.2个百分点（95% CI 5.9, 20.4），25 - 34岁年龄组下降了9.0个百分点（95% CI 2.7, 15.3），35 - 44岁年龄组下降了8.7个百分点（95% CI 2.6, 14.8）。居住在城市/地区的人群吸烟流行率下降了10.2个百分点（95% CI 6.2, 14.1）。
在减少吸烟方面已取得重大进展，与每日吸烟率维持在2004 - 2005年水平相比，估计在2014 - 2015年，每天吸烟的澳大利亚原住民和托雷斯海峡岛民成年人减少了约35000人。这将挽救数千人的生命。在较年轻年龄组中观察到的成功令人鼓舞。需要持续提供资源并开展全面的控烟工作，以确保积极趋势持续下去。
