Aboriginal and Torres Strait Islander Australians and tobacco

• Aboriginal
• indigenous
• tobacco control
• Torres Strait islander

Australia is considered to be a leader among developed nations in the area of tobacco control. Well coordinated and sustained tobacco control programmes are likely to have resulted in long term health gains, including a decrease in mortality rates from cardiovascular disease, and subsequent increases in life expectancy.

However, Aboriginal and Torres Strait Islander people—the indigenous people of Australia—continue to suffer high mortality and morbidity rates from conditions related to tobacco use. Indeed, tobacco is the main cause of preventable mortality among Aboriginal and Torres Strait Islander Australians.1 How is it that a minority group within a wealthy nation can display such marked health status and tobacco use differences from others in that population? What has been done to attempt to redress this disparity? What are the needs and priorities for the future? In this commentary, we describe cultural, historical, and political factors leading to the high prevalence of smoking among Aboriginal and Torres Strait Islander people. We outline and discuss intervention efforts undertaken so far and consider their merits and weaknesses, paying particular attention to resource allocation issues. Finally, we consider priorities for future programme delivery that would be most likely to result in reduced tobacco use among this population.