Tobacco control practices among Aboriginal health professionals in Western Australia
Albert (Sonny) A. G. Pilkington A B C , Owen B. J. Carter D F , Alexander S. Cameron C E and Sandra C. Thompson A BA Office of Aboriginal Health, Department of Health Western Australia, East Perth, WA 6004, Australia.
B Centre for International Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
C National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 0200, Australia.
D Centre for Behavioural Research in Cancer Control, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia.
E Department of Public Health, University of Adelaide, Adelaide, SA 5005, Australia.
F Corresponding author. Email: o.carter@curtin.edu.au
Australian Journal of Primary Health 15(2) 152-158 https://doi.org/10.1071/PY08066
Published: 5 January 2009
Abstract
Smoking among Aboriginal people is extremely widespread (50 v. 17% of the general population). Aboriginal Health Workers (AHW) are at the vanguard of tackling this problem but many themselves smoke and little is known of their knowledge, attitudes and practices regarding smoking cessation. Structured telephone interviews were conducted with 36 AHW, including 31% current smokers, 31% ex-smokers and 38% non-smokers, to assess their current smoking cessation practices and knowledge of health risks, nicotine dependence, cessation strategies and pharmacotherapies. AHW considered diabetes, alcohol use and heart disease more problematic than smoking among Aboriginal people. Fear of appearing hypocritical stopped many who smoke from discussing smoking cessation with clients but also stopped some non-smoking AHW whose colleagues or family smoked. Cultural concerns about telling others ‘what to do’ was also a major impediment. Knowledge of the health effects of smoking was good, but knowledge of appropriate advice around cessation pharmacotherapies was suboptimal. AHW trained in smoking cessation were more knowledgeable and active in smoking cessation, but most AHW had received no training, despite being keen to do so. Specific smoking cessation training is sought and appears needed by AHW, particularly in the areas of brief interventions, motivational interviewing, dependence assessment and pharmacotherapies.
Additional keywords: behaviour, indigenous, smoking cessation.
Acknowledgements
This study was conducted by AAG Pilkington, an Aboriginal student, as part of the Master of Applied Epidemiology program at the Australian National University and was funded by Department of Health and Ageing. Pilkington was also supported by funding from Curtin University and the Office of Aboriginal Health, Department of Health Western Australia. Advice in relation to the survey design and research support provided by Associate Professor Deborah Lehmann, Glenn Draper, Caron Molster, Kathy Crouchley and the ‘Say no to smokes’ team and Steering group is gratefully acknowledged. Carter’s position is part funded by Healthway in the form of a Tobacco Control Research Fellowship. The Centre for Behavioural Research in Cancer Control is the supported by funding from the Cancer Council WA.
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