Interventions for tobacco use prevention in Indigenous youth

Clinical Practice Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia. .
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 08/2012; 8(8):CD009325. DOI: 10.1002/14651858.CD009325.pub2
Source: PubMed


In Indigenous populations, the number of people who smoke has not fallen as it has in the wider communities around them. Young people remain at particular risk of taking up smoking. The associated harms to health are unacceptable. This review found that there is not enough published research evaluating programmes aiming to prevent Indigenous youth from starting to use tobacco. Information from the two included studies in this review (1505 participants in total, in Native American communities) does not allow a conclusion to be drawn as to whether tobacco prevention programmes in Indigenous populations prevent Indigenous youth from smoking or using smokeless tobacco. The review highlights the absence of data and need for more research.

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    • "However, the rate of decline differed, with a steady decline across the entire study period for the non-Indigenous students compared to a decline only between 1999 and 2002 for Indigenous students [4]. The majority of cigarette smokers begin smoking in childhood or adolescence [5], with smoking initiation usually completed by 25 years of age [6, 7]. In order to inform different intervention strategies to further reduce initiation and prevalence of smoking in young Australians, it is important to explore the differences in smoking prevalence between adolescent non-Indigenous and Indigenous Australians. "
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    ABSTRACT: Background In this study, we used data from Australia’s Northern Territory to assess differences in self-reported smoking prevalence between the Indigenous and non-Indigenous populations. We also used urinary cotinine data to assess the validity of using self-reported smoking data in these populations. Methods The Aboriginal Birth Cohort (ABC) is a prospective study of 686 Aboriginal babies born in Darwin 1987–90. The Top End Cohort (TEC) is a study of non-Indigenous adolescents, all born in Darwin 1987–91. In both studies, participants aged between 16 and 21 years, were asked whether they smoked. Urinary cotinine measurements were made from samples taken at the same visits. Results Self-reported smoking prevalence was 68% in the ABC and 14% in the TEC. Among the self-reported non-smokers, the median cotinine levels were higher in the ABC (33 ng/ml) than in the TEC (5 ng/ml), with greater percentages of reported non-smokers in the under 50 ng/ml group in the TEC than in the ABC Conclusions Prevalence of smoking was much higher in the ABC than in the TEC. The higher cotinine levels in ABC non-smokers may reflect an underestimated prevalence, but is also likely to reflect higher levels of passive smoking. A broader approach encompassing social, cultural and language factors with increased attention to smoking socialisation factors is required.
    BMC Public Health 08/2014; 14(1):861. DOI:10.1186/1471-2458-14-861 · 2.26 Impact Factor
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    • "We reconsider literature that reports outcomes utilizing similar analytic approaches, and attempt to consider a wide spectrum of program modalities. We do not consider unique populations (e.g., indigenous youth; [15]) or unique types of prevention programming (e.g., use of incentives; [16]), for which only a couple of research studies exist. Rather, we consider five general types of regulatory approaches/policies (tax increases, warning labels, access laws, smoke-free policies, and marketing/advertisement bans), and mass media, school, family, and community agent modalities of programming (see Table 1). "
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    ABSTRACT: Many modalities of tobacco use prevention programming have been implemented including various policy regulations (tax increases, warning labels, limits on access, smoke-free policies, and restrictions on marketing), mass media programming, school-based classroom education, family involvement, and involvement of community agents (i.e., medical, social, political). The present manuscript provides a glance at these modalities to compare relative and combined impact of them on youth tobacco use. In a majority of trials, community-wide programming, which includes multiple modalities, has not been found to achieve impacts greater than single modality programming. Possibly, the most effective means of prevention involves a careful selection of program type combinations. Also, it is likely that a mechanism for coordinating maximally across program types (e.g., staging of programming) is needed to encourage a synergistic impact. Studying tobacco use prevention as a complex system is considered as a means to maximize effects from combinations of prevention types. Future studies will need to more systematically consider the role of combined programming.
    Tobacco Induced Diseases 01/2013; 11(1):2. DOI:10.1186/1617-9625-11-2 · 1.50 Impact Factor
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    ABSTRACT: The purpose of this study was to determine whether there is a growing inequity in tobacco use, susceptibility to future smoking, and quit attempts among Off-Reserve Aboriginal (ORA) youth in Canada relative to Non-Aboriginal youth. Current smoking, susceptibility to future smoking and quit attempts were examined among a nationally representative sample of ORA and Non-Aboriginal Canadian youth. Data are from cross-sectional surveys of 88,661 respondents in Grades 6 to 9 across the 2004, 2006 and 2008 survey waves of the Youth Smoking Survey (YSS). At each wave, ORA youth were more likely to be current smokers (overall OR = 3.91, 95% CI 3.47 to 4.41), to be susceptible to future smoking (overall OR = 1.37, 95% CI 1.27 to 1.48), and less likely to have ever made a quit attempt compared to Non-Aboriginal youth (overall OR = 0.74, 95% CI 0.57 to 0.96). Although susceptibility to future smoking declined for Non-Aboriginal youth, the prevalence of susceptibility remained stable among ORA youth. The percentage of ORA youth reporting making a quit attempt increased, however, current smoking rates among ORA youth did not decline. These findings suggest that the disparity in susceptibility to future tobacco use among ORA and Non-Aboriginal youth has increased over time. Despite increased rates of quit attempts, current smoking rates remain significantly higher among ORA youth. Tobacco control programs for Aboriginal youth should be a public health priority.
    International Journal of Environmental Research and Public Health 02/2013; 10(2):729-41. DOI:10.3390/ijerph10020729 · 2.06 Impact Factor
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