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The aim of this study was to assess the change in recording of client population smoking attributes (smoking status recorded and smoking status) in Tackling Indigenous Smoking (TIS)-funded services compared with non-funded services for Aboriginal and Torres Strait Islander people, 2014–16.

Culture can be viewed as an integral part of Aboriginal and Torres Strait Islander health and wellbeing. This study explores the association between caring for country, through participation in a Ranger program, and wellbeing. We analyzed cross-sectional data collected in Central Australia in 2017, comparing health and wellbeing (life satisfaction, general health, psychological wellbeing and family wellbeing) among Aboriginal and Torres Strait Islander peoples employed as Rangers (n = 43) versus not employed as Rangers (n = 160). We tested if any differences in outcomes were explained by differences in key demographic or health factors. Ranger participation was significantly associated with very high life satisfaction (PR = 1.69, 95% CI: 1.29, 2.20) and high family wellbeing (PR = 1.47, 95% CI: 1.13, 1.90); associations remained significant after individual adjustment for education, income, employment, health risk factors and health conditions. The magnitude and direction of associations were similar for very good general health, but results were not significant. We did not identify an association between Ranger participation and psychological wellbeing. While based on a small sample, these findings support the assertion that participation in the Ranger program is associated with positive health and wellbeing outcomes. This supports the continuation of cultural participation and practice through the Ranger program and has implications for funding, program and policy development.

Objective: To examine tobacco knowledge, attitudes and behaviours of community members in Central Australia and to compare these by participant's location (town or remote community). Design: Community-based survey of 165 smokers and recent ex-smokers. Outcome measures: Knowledge was assessed using responses to questions on the health risk of smoking (e.g. lung cancer) and knowledge of quit support services. Attitudes towards smoking were assessed using statements that asked participant whether they agreed or disagreed. Smoking behaviours were assessed by asking participants about quit attempts, cigarettes per day and time to first cigarette (used to calculate the heaviness of smoking index). Results: There were high levels of knowledge about most common diseases associated with smoking, including cancer (93%) and heart disease (89%). There was less knowledge about quit support services that are available through telephone (69%), online (27%) and apps (32%). Responses to attitude statements were suggestive of the normalised practices towards smoking in town and remote participants, with remote participants more likely to disagree that 'ok to smoke close to a building' and to disagree 'if I had my time over again I would not have started'. Over 75% of the participants had attempted to quit smoking and 55% had a sustained quit attempt (>1 month). Conclusion: There are greater challenges to reduce smoking in remote areas due to the social and communal practices of smoking and in providing service needs that encourage quit attempts. This supports the need for continued and increased investment for targeted tobacco control by remote health services.

There is growing evidence that the cultures of Indigenous peoples influence their health and wellbeing. We reviewed articles published between 1997 and 2017 that studied the relationship between culture, and health and wellbeing outcomes, and used an adapted version of the Agency of Healthcare Research Quality Framework to determine their strength of evidence. We examined the literature grouped by six cultural domains: country and caring for country, knowledge and beliefs, language, self-determination, family and kinship, and cultural expression. Seventy-two publications were included in the review, focusing on populations from Australia, Canada, the United States, and New Zealand. Across the literature there were conceptual variations in defining and measuring culture, and in the comparison of differing social constructs across Indigenous groups. The literature largely report that culture is significantly and positively associated with physical health, social and emotional wellbeing, and reduces risk-taking behaviours. The majority of publications presented evidence on the impact that culture, or culturally-based interventions, have on social and emotional wellbeing outcomes. The strength of evidence from most publications was assessed as moderate or low quality, and was limited by a lack of reliable and valid measures, population level studies, and longitudinal studies. Cultural domains including language, cultural expression and connection to country were more likely to be reported in quantitative studies, whereas cultural domains of knowledge, beliefs, kinship, and family were more likely to be reported using qualitative methods. Those studies that used mixed-methods approaches were more likely to be assessed as high or moderate quality. This review encourages future research to consider adopting mixed-methods approaches to investigate the complex, causal pathways through which culture influences health and wellbeing for Indigenous populations.

Background: 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. Methods: 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. Results: 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 i

There is growing evidence that the cultures of Indigenous peoples influences their health and wellbeing. We reviewed articles published between 1997–2017 that studied the relationship between culture, and health and wellbeing outcomes, and used an adapted version of the Agency of Healthcare Research Quality Framework to determine their strength of evidence. We examined the literature grouped by six cultural domains: country and caring for country, knowledge and beliefs, language, self-determination, family and kinship, and cultural expression. Seventy-two publications were included in the review, focusing on populations from Australia, Canada, the United States, and New Zealand. Across the literature there were conceptual variations in defining and measuring culture, and in the comparison of differing social constructs across Indigenous groups. The literature largely report that culture is significantly and positively associated with physical health, social and emotional wellbeing, and reduces risk-taking behaviours. The majority of publications presented evidence on the impact that culture, or culturally-based interventions, have on social and emotional wellbeing outcomes. The strength of evidence from most publications was assessed as moderate or low quality, and was limited by a lack of reliable and valid measures, population level studies, and longitudinal studies. Cultural domains including language, cultural expression and connection to country were more likely to be reported in quantitative studies, whereas cultural domains of knowledge, beliefs, kinship and family were more likely to be reported using qualitative methods. Those studies which used mixed-methods approaches were more likely to be assessed as high or moderate quality. This review encourages future research to consider adopting mixed methods approaches to investigate the complex, causal pathways through which culture influences health and wellbeing for Indigenous populations.