Ethical publishing practices are vital to tobacco control research practice, particularly research involving Indigenous (Indigenous peoples: For the purposes of this Special Communication, we use the term Indigenous people(s) to include self-identified individuals and communities who frequently have historical continuity with precolonial/presettler societies; are strongly linked to the land on which they or their societies reside; and often maintain their own distinct language(s), belief and social-political systems, economies and sciences. The authors humbly acknowledge, respect and value that Indigenous peoples are diverse and constitute many nations, cultures and language groups. Many Indigenous peoples also exist as governments in treaty relations with settler-colonial societies, and all Indigenous peoples have inherent rights under international law. The language and terminology used should reflect the local context(s) and could include, but are not limited to, terms such as Aboriginal, Bagumani, Cherokee, First Peoples, First Nations, Inuit, Iwaidja, Kungarakan, Lakota, Māori, Mѐtis, American Indian, Navajo, Wagadagam, Wiradjuri, Yurok, etc) people. These practices can minimise, correct and address biases that tend to privilege Euro-Western perspectives. Ethical publishing practices can minimise and address harms, such as appropriation and misuse of knowledges; strengthen mechanisms of accountability to Indigenous peoples and communities; ensure that tobacco control research is beneficial and meaningful to Indigenous peoples and communities; and support Indigenous agency, sovereignty and self-determination. To ensure ethical practice in tobacco control, the research methodology and methods must incorporate tangible mechanisms to include and engage those Indigenous peoples that the research concerns, affects and impacts.
Tobacco Control is currently missing an ethical research and evaluation publishing protocol to help uphold ethical practice. The supporters of this Special Communication call on Tobacco Control to adopt publication practice that explicitly upholds ethical research and evaluation practices, particularly in Indigenous contexts. We encourage researchers, editors, peer reviewers, funding bodies and those publishing in Tobacco Control to reflect on their conduct and decision-making when working, developing and undertaking research and evaluation of relevance to Indigenous peoples.
Tobacco Control and other publishers, funding bodies, institutions and research teams have a fundamental role in ensuring that the right peoples are doing the right work in the right way. We call for Tobacco Control to recognise, value and support ethical principles, processes and practices that underpin high-quality, culturally safe and priority-driven research, evaluation and science that will move us to a future that is commercial tobacco and nicotine free.
- public policy
- human rights
- priority/special populations
- public opinion
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WHAT IS ALREADY KNOWN ON THIS TOPIC
Ethical publishing protocols are often missing, but are required to minimise harms and promote ethical research.
WHAT THIS STUDY ADDS
Indigenous peoples have always held knowledges, data and information generated through our ways of knowing, being and doing (ie, research and evaluation).
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
This study provides a publication protocol to explicitly uphold ethical research.
Contemporary research tends to be dominated by Euro-Western values that have influenced methodologies, what constitutes evidence and evidence hierarchies in which evidence is placed and the way research is carried out. This can lead to unsafe research design, conduct and analysis practices that marginalise Indigenous peoples and knowledges. To address this problem, ethical research and publication protocols that maintain accountability to the respective Indigenous peoples and our relations, such as the interconnectedness of all creation, from people, to animals and plants including tobacco plants, are required in tobacco control.
Evidence hierarchies used to gauge the scientific merit of research studies tend to favour those employing empiricist methods, usually focusing on individual behaviours.1 Randomised controlled trials, meta-analyses and case–control studies are frequently championed as ‘objective’ and ‘scientific’, despite some significant limitations which include moral and ethical implications.2–4 However, in research that involves Indigenous peoples, questions about our underlying assumptions, whether (1) ontological (ways of being, what exists, what is real?); (2) epistemological (ways of knowing, what is knowledge(s) and how do we obtain it?); (3) axiological (ways of doing, value and conduct of research); and (4) methodological (how do we acquire knowledge(s)?), have generally been answered using Euro-Western ways of thinking. Non-white Euro-Western knowledges are subsequently positioned as inferior and ‘othered’ within the colonial racialised hierarchical ways of knowing and knowledges.5 This has suppressed and silenced Indigenous ways of being, knowing and doing, including some Indigenous ceremonies and sacred relationships with the tobacco plant, and undermined Indigenous autonomy over scientific narratives that can have tremendous impact on Indigenous lives. For example, tobacco is often framed as ‘harmful’ or ‘unhealthy’. This is in contrast to some Indigenous understandings of health and well-being, in which the tobacco plant is part of health and well-being, moving beyond physical health and acknowledging the sacred relationship with tobacco.6
Indigenous worldviews are commonly hidden in plain sight under the invisibility cloak of ‘subjugated knowledges’5 (p 7). Foucault5 deemed ‘subjugated knowledges’ were viewed as primitive within dominant-hegemonic Euro-Western sciences and thus lack investment.5 This lack of investment includes, but is not limited to, financial, human, intellectual and physical resourcing. Indigenous knowledges have been subjugated, minimised and othered. Further, research on Indigenous people has been justified through terms such as ‘academic research’, ‘independent research’, ‘outsider research’, ‘white research’,7 ‘white washing’8 and ‘best’ or ‘evidence based’ practice. There is also an underlying set of assumptions that knowledge development is ordered, linear and hierarchical, that knowledge development is consistent, that ‘higher’ knowledge is superior and that all societies are on the same ‘developing’ trajectory, but at different stages.5 This logic is problematic and can decontextualise knowledge(s) development by, for example, minimising the colonial context which has actively aimed to eliminate Indigenous knowledges, silencing and undermining Indigenous ways of knowing, being and doing.5 9 10 Further, this hierarchical conceptualisation of knowledge lends itself to white racialised logics and ways of knowing that support the suppression and silencing of Indigenous ways of being, knowing and doing, including how plants such as tobacco should be considered, treated and managed.5 9 Such assumptions directly and indirectly inform programmes and policies that impact Indigenous peoples in a perpetual cycle.11
Our knowledge systems and worldviews have been considered inferior to those of the Euro-Western world for centuries.5 This has led to research and evaluation grounded, and/or being used in ways that are harmful to Indigenous peoples and fundamental in the justification and rationalisations of colonisation. Colonialist practices create and reinforce purported Indigenous deficits in the eye of the (colonising) beholder, such as imposing Euro-Western education methods, banning Indigenous languages and ceremonies, removing children from Indigenous homes and communities and forcing enculturation to Euro-Western lifeways, while ultimately providing limited benefits and bringing many harms to Indigenous peoples.9 For example, research on the subhumanness of Indigenous peoples was subsequently used to disqualify Indigenous peoples from property ownership, including land.12 Further, such colonialist perspectives have prompted ongoing unsubstantiated hypotheses, research and evaluation about biological differences in risk between Indigenous and non-Indigenous groups (such as the risk of nicotine dependence, COVID-19 and whether such racialised differences represent inequities or inequalities13); discounted our lived experiences; and supported the exclusion of our realities in publications and evidence that shape programmes and policies that affect us.14–17 In contrast, Indigenous-governed and led research that upholds and follows nation-based Indigenous worldviews has greater potential to provide substantial sustained benefits to Indigenous communities, including informing programmes and policies.18
Any research, but especially research that aims to benefit Indigenous peoples, must take into account Indigenous systems and worldviews as well as the dominance of racialised logics held by research institutions and their agents (researchers and non-researchers), and how this may manifest in research activities. This is consistent with ethical approaches of doing no harm, or minimising harms, and the tobacco science goal of applying research to improve well-being. It requires an ethical approach to Indigenous engagement, prioritisation of research, governance and leadership including authorship, methodologies and methods, as well as how findings are interpreted and disseminated.19 As Wilson20 states:
Indigenous researchers develop relationships with ideas in order to achieve enlightenment in the ceremony that is Indigenous research. Indigenous research is the ceremony of maintaining accountability to these relationships. For researchers to be accountable to all our relations, we must make careful choices in our selection of topics, methods of data collection, forms of analysis and finally in the way we present information.
We also need to take into account that Indigenous peoples and communities are diverse and as such, engagement can be time consuming and complex. Local Indigenous protocols and practices that are grounded in lived experience must be acknowledged and upheld. Indigenous autonomy must be acknowledged, and Indigenous governmental systems to regulate research must be observed.
Indigenous diversity: nations, languages and knowledges
Indigenous peoples represent great diversity. We constitute many nations, language groups, political systems, knowledges, experiences, practices and relationships. This includes diversity in relation to country21 22 and traditional medicines,23 such as the tobacco (Tobacco: We recognise that many Indigenous peoples have a sacred relationship with the tobacco plant. Ceremonial tobacco is grown, harvested and prepared for specific ceremonial and cultural purposes, with the intent and spirit to promote wellness for individuals and communities. In contrast to ceremonial tobacco, commercial tobacco is a colonised, adulterated and appropriated commodity—it has been modified, mass produced and distributed for recreational use or ‘misuse’, often in return for profit6) plant. Indigenous relationships, knowledges and ways of knowing, being and doing have been in existence for millennia and have involved generations of observations, analysis and synthesis, experiences and information sharing. In this context, our knowledges are relational; our knowledges can be sacred; and our knowledges are based on careful research and evaluation that is evidenced by the fact that we have continued to survive and adapt to diverse and ever-changing environments, even harmful ones such as our experiences of colonisation.24–27
Just as there is great diversity among Indigenous peoples, there is also diversity in experiences of colonisation and coloniality.28 For many Indigenous peoples, our experience of colonisation is not just in the past—it continues in contemporary society. However, there is much common ground. Coloniality fundamentally, and continually, undermines Indigenous sovereign interests and rights of Indigenous peoples. Consistent with the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP),17 this includes our rights to ‘health’ and our own intellectual sovereignty,29 Indigenous data sovereignty, sciences and traditional medicines.23
The colonial context: tobacco and nicotine research
Studies on interventions to address commercial tobacco use are often framed within Euro-Western worldviews on perspective, ontology, epistemology, axiology and methodologies. For instance, Euro-Western academic research and evaluation typically frames tobacco as harmful due to its commercialisation and use as a recreational product. Thus ‘tobacco’ has come to mean ‘commercial tobacco’. However, in Indigenous contexts, the term ‘tobacco’ can have very different meanings. In Turtle Island (North America), for example, ‘tobacco’ commonly means ‘ceremonial tobacco’.6 It is crucial to use precise language that reflects the research realities within Indigenous contexts and cultures.30 If there is no common understanding of the word ‘tobacco’ then it is challenging to fully appreciate that the Tobacco Control journal aims to ‘study the nature and consequences of tobacco use worldwide; tobacco’s effects on population health, the economy, the environment, and society; efforts to prevent and control the global tobacco epidemic through population level education and policy changes; the ethical dimensions of tobacco control policies; and the activities of the tobacco industry and its allies’.31 While it is important to acknowledge differences between Euro-Western and Indigenous research inquiry paradigms, these are not dichotomous or binary, and there can be common ground. For example, the intersection between Indigenous research paradigms and the Euro-Western transformative paradigm, with its focus on social justice and human rights, has been described.32 This paradigm has been successfully used to address inequities and injustices for a range of population groups and communities in various contexts. In this sense, common ground may be found by more appropriately recognising the impacts of the global commercial tobacco epidemic and the activities of the commercial tobacco industry and its allies. This nomenclature clarifies the research focus on the detrimental and cascading effects of commodification of the tobacco plant rather than the plant itself.
Studies on commercial tobacco use often focus on the individual level and offer little to address structural factors such as basic causes of smoking-related inequities. For example, structural/population-level causes such as Indigenous peoples being excluded from the cash economy and education system are often associated and embedded with histories and ongoing experiences of racism and discrimination.12 33 34 The active exclusion from the cash economy and education systems (eg, Aboriginal and Torres Strait Islander peoples were excluded from the cash economy and education systems in Australia until the 1960s) continues to manufacture extensive but preventable health harms, including implication of racism and associated racialised difference,35–39 as socioeconomic status and education are well-documented risk factors for a range of health-related outcomes. This includes commercial tobacco use and tobacco-related health outcomes, considering, for example, the ongoing impact of commercial tobacco promotion and disproportionate rates of use in contributing to premature mortality and lack of intergenerational wealth, and/or levels of education among many Indigenous populations.35–37 Basic causes such as colonisation, ongoing coloniality and their associated impacts, including appropriation of land and resources and imposition of colonial societal structures (eg, penal systems, assimilationist educational systems and the cash economy), have eroded Indigenous agency, self-determination and sovereignty at an individual, community and population level.
Euro-Western academic research brings to any study ‘of’ Indigenous peoples a Euro-Western cultural orientation,7 social constructs,40 power structures and hierarchy, values, attitudes, notions and approaches to commonly expressed foundational concepts.7 34 It also brings its own discourse. Differences in hierarchical and racialised logics, structures and systems are reflected in our discourse; manufacturing and rationalising truths, structures of truth and the commercialisation of knowledges and the knowledge economy which feeds capitalism, while perpetuating white Euro-Western racialised logics and continuing to actively marginalise Indigenous knowledges and ways of knowing and doing.7 9 40 41 Indigenous knowledges and definitions that can be fundamentally important have been marginalised, including through academic discourse and peer review processes, referred to as ‘catch phrases’ and ‘buzz words’.42 If research and evaluation involving Indigenous peoples is to lead to meaningful and contextualised results, then it must actively use and engage with the perspectives, worldviews and discourse of those respective peoples. In other words and as numerous population groups have stated, ‘nothing about us, without us in writing.’16 Moreover, to be both ethical most broadly and fundamentally beneficial, research and evaluation involving Indigenous peoples must acknowledge and abide by systems and structures which Indigenous peoples have formed to better regulate research.
Ethical research, evaluation and publication requirements
Ethical research, evaluation and publication protocols include the Society for Research on Nicotine and Tobacco Oceania Ethical Principles, OCAP,43 National Health and Medical Research Council Ethical Conduct in Research with Aboriginal and Torres Strait Islander Peoples and Communities,44 Aboriginal Health and Medical Research Council of New South Wales Ethical Guidelines,45 the CONSolIDated critERtia (CONSIDER) statement,46 and others detailed elsewhere.47 48 Many tribal Nations have formed their own protocols for research review and oversight by, for example, tribal institutional review boards, tribal research review boards, tribal governmental agencies and/or community advisory groups.48–51 So is another ethical protocol needed? Ethical research and publication protocols are required to better support and ideally ensure ethical publishing practices.52 Upholding ethical standards and accountability to Indigenous peoples can help address the power imbalance which has resulted from colonisation and coloniality. Ethical standards acknowledge Indigenous rights must be upheld and that there must be ethical approval(s) and application of ethical processes. This requires Indigenous leadership, collaboration, meaningful engagement and dialogue between the researchers, editors, peer reviewers, funding bodies and respective populations.19 22
We need to implement and uphold ethical publishing practices that foster safer spaces for Indigenous peoples, privileging Indigenous peoples’ intellectual sovereignty by valuing Indigenous knowledges and ways of knowing, being and doing, and abiding by research protocols established by Indigenous people. Ethical principles can help minimise harms, including the appropriation and misuse of knowledges, and ensure mechanisms of accountability to Indigenous peoples and communities, supporting Indigenous agency, sovereignty and self-determination in ethical publication processes.
To make sure that proper engagement occurs, we need ethical research and publication protocols that are accountable to the respective Indigenous peoples. Ethical research and publishing protocols help ensure scientific excellence and community relevance and can lead to more nuanced understandings and interpretation of findings.21 If research involving Indigenous peoples is to be valuable, research publications and journals like Tobacco Control need publication policies that explicitly uphold ethical research and evaluation practices.
Tobacco Control and other publications play a huge part in ensuring that research is done ‘in the right way’.53 We call for the Tobacco Control and BMJ journals to incorporate Indigenous-specific research ethics practices in its publication policies. This should include requiring authors of submitted articles regarding Indigenous peoples to report how the respective Indigenous communities were meaningfully engaged throughout each stage of the research process by answering the questions below (table 1).
We respectfully urge researchers, editors, peer reviewers, funding bodies and those publishing in Tobacco Control to consider their conduct and decision-making when working, developing and undertaking research and evaluation of relevance to Indigenous peoples.
Tobacco Control editors, peer reviewers and those in the publication process need to ensure that such practice is followed, including managing peer reviews that do not reflect ethical principles. For example, this could include consideration of appropriate peer reviewers’ knowledges, expertise and, where possible, lived Indigenous experience to help minimise harms caused through the peer review process, especially harms due to racist peer review feedback. The reporting guide for meaningfully Indigenous engagement (table 1) must apply to all research and evaluation, especially in Indigenous contexts regardless of who is leading the research or whether it involves primary or secondary data. The author must explain how the interpretation and contextualisation of the results take into account the knowledges of the respective Indigenous peoples that the research or evaluation includes, and respects tribal research governance.
Authorship is often seen as an indicator of engagement, involvement and leadership. However, authorship is not always prioritised by Indigenous peoples and communities. The level of inclusion and influence implied by authorship is not always commensurate to need, and does not always reflect the reality, sophistication of meaningful Indigenous engagement, involvement and leadership.53 Indigenous engagement, involvement and leadership can be complex and needs to reflect local Indigenous protocols and practices including conflict resolution processes, which can commence from preconception and governance of a research study or evaluation, through to dissemination of findings.
We are calling for transparency and accountability of evidence production. We acknowledge that meaningful research results (from primary and secondary analyses) about Indigenous peoples must include some mechanism to assist in contextualising the results by those they concern, affect and impact to uphold ethical practice and in upholding UNDRIP, Article 31.19 (box 1).16 54 55
United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), Article 31
‘Indigenous peoples have the right to maintain, control, protect and develop their cultural heritage, traditional knowledge and traditional cultural expressions, as well as the manifestations of their sciences, technologies and cultures, including human and genetic resources, seeds, medicines, knowledge of the properties of fauna and flora, oral traditions, literatures, designs, sports and traditional games and visual and performing arts. They also have the right to maintain, control, protect and develop their intellectual property over such cultural heritage, traditional knowledge, and traditional cultural expressions.’(Sewell, p11)17
Indigenous communities have long voiced concerns about their misrepresentation in academic literature, such as that which specifically promotes settler privilege at the expense of Indigenous knowledges, lived experiences and realities and, in turn, commonly reinforces racialised logics and associated deficit discourse. Consistent with the Tobacco Control values,31 it is fundamentally important that Tobacco Control implement policies that move away from colonial practices of research, evaluation, publishing and sharing of Indigenous stories, knowledges and perspectives. We strongly recommend the inclusion of ethical publishing protocols which will help ensure accountability and transparency. Editors should enforce such protocols through ensuring, for example, that authors of work concerning Indigenous peoples have through their responses to the guideline questions amply demonstrated that they privilege Indigenous perspectives, knowledges and worldviews in any research and evaluation concerning Indigenous-related tobacco control.53
The foundation of this Special Communication
This Special Communication was led by Indigenous interests, needs and rights as Indigenous peoples, consistent with UNDRIP, the WHO Framework Convention on Tobacco Control and ethical practice. The Special Communication was conceptualised with Indigenous leadership and engagement, including but not limited to our Indigenous lived experience (RM, AD, MK, SAM, AW, PNH, HC, E-ST, SB, TC and LJW), to better ensure ethical publishing practices.
It is important to recognise relationality and our credentials, founded in our respective relational roles, community accountability and responsibilities, acknowledging our connections, biases and worldviews.54 Relationality is a distinct Indigenous social research presupposition and forms the ‘epistemic scaffolding shaping’ (p 69) and supporting the possibility for coming to know and generating knowledge(s) in the respective time, place and land.21 By privileging and following our logic(s) of knowledge(s), we come to know who we are and who we claim to be, as well as who claims us and how we are connected to our lands. This is a matter of ontology and epistemological consideration, our being and how relationality informs an Indigenous social research paradigm and critical to this Special Communication and how it was informed—not merely a matter of identity.20 21 27
Patient consent for publication
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Contributors RM, AD, MK, SAM, AW, PNH, HC, PU, JPL, B-JH, E-ST, SKB, TC and LJW planned the work. RM drafted the first draft at the direction of all authors (AD, MK, SAM, AW, PNH, HC, PU, JPL, B-JH, E-ST, SKB, TC and LJW). RM, AD, MK, SAM, AW, PNH, HC, PU, JPL, B-JH, E-ST, SKB, TC and LJW met, discussed and then provided several rounds of written and oral input and feedback. RM, AD, MK, SAM, AW, PNH, HC, PU, JPL, B-JH, E-ST, SKB, TC and LJW finalised the Special Communication.
Funding LJW is funded through a National Health and Medical Research Council (NHMRC) Investigator Grant (2009380). MK is funded by an NHMRC Early Career Fellowship (1158670). JPL is funded through a grant from the University of California Office of the President Tobacco-Related Disease Research Program (T32CF5371).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.