Smoking And Health Disparities Among Indigenous And Non-Indigenous Australians

Causes of Smoking Disparities

Discuss about the Smoking As A Health-Related Issue.

Smoking as a health issue continues to remain different in pattern between the indigenous Australians and the non-indigenous Australians due to a number of reasons. The primary causes to smoking and the preventive measures differ among the two groups of people thus contributing to the reason for inequity in smoking health behavior category. Among the indigenous Australians, smoking is viewed to be contributed by the low socioeconomic conditions leading to smoking as a way of relieving stress, socializing among members, sharing tobacco and maintaining social cohesion.

The lack of health related services in lessening the smoking habit and the necessary laws curbing smoking in first hand and passive smoking become reasons for the disparity between the two populations. The non-indigenous people embrace the latest medical information regarding the negative use of smoking thus acting upon the information to cut down or completely remain negative towards smoking. Moreover, the rehabilitation centers and the professional campaigns against smoking and labeling of warning messages on packages of cigarette lead to a reduction and maintenance of low number of smoking activities among the non-indigenous people (Gracey 2007).

On the other hand, people from the indigenous section of the population live in isolation with little or no information on dangers of smoking from a health perspective. As a result, people smoke heavily in first hand and passive smoker categories thus contributing to the high numbers experienced between the two people (Thomas, Briggs, Anderson & Cunningham 2008). Each time the individuals experience stress, smoking is used as a reliever among many as opposed to other means used to relieve stress among the non-indigenous people. The fact serves as a reason towards the disparity in smoking behaviors and patterns among the two categories of individuals in Australia.

Secondly, the existing laws on public smoking and creation of smoking zones creates the difference in habit of smoking and control features leading to low experience of smoking among dwellers in both categories. The non-indigenous people live in areas that are developed and guided by the health related rules that discourage smoking in public places and use education as a deterrent factor whenever outlining the dangers of smoking (Thomas, Briggs, Anderson & Cunningham 2008). The attribute leads to a reduction in the smoking habit and discourages new addiction rates as well as provide support for the rehab centers for those who desire to convert and remain smoke-free.      

Differences in Preventive Measures

However, the situation is different for the indigenous people who smoke at will and lack the laws guiding on smoking and discouraging factors against smoking habits. Lack of resources and sufficient laws gives a thriving ground towards the development and creation of new cases of smoking habits promoted by the socioeconomic status of the individuals (Marmot & Commission on Social Determinants of Health 2007). Moreover, the lack of punitive laws and education on people who disregard the limits in smoking serve as a negative factor in curbing the health related behavior detrimental to the individuals. As a result, the two factor lead to the high disparity level in smoking-related behaviors among the individuals from the non-indigenous and indigenous populations.   

The National Tobacco Strategy 2012-2018 acts as a future action and intervention program aimed at addressing the smoking prevalence among the indigenous population. The campaign encourages a cut down on the smoking in promoting quit behavior pattern and person to person encouragement to others to quit smoking. The campaign aimed at reducing the practice in high-risk and hard to reach groups such as the indigenous people by developing materials and health services tailored for the specific people. 

Since the beginning of the campaign, tobacco products have been encouraged to be sold in plain packaging containing health warnings either in pictorial or written form in discouraging new and existing smokers. The program extended towards the sensitization aspect where the indigenous people enlightened with the knowledge were used to teach the locals on the need to curb the practice using the social challenges experienced therein (Gould, Watt, Cadet-James and Clough 2015). Willing individuals were put into the rehab programs in a bid to capture the growing health related issue in the region. 

In reducing the pace of tobacco consumption trends, the government through the intervention program raised the excise fee on tobacco and its related products by 12.5 and further similar charge in 2014 and 2016 respectively (Gould, Watt, Stevenson, McEwen, Cadet-James and Clough, 2014). The national program featured the introduction of health services in the local areas where the indigenous people featured in the service delivery in a bid to convert the rest from the harmful practice that often led to deaths from the lung complication among the people. The specific target on people in hard to reach locations and high prevalence was strategic in changing the habits of the indigenous people and promoting safe practice among the people.

Lack of Health Services

The program went a long way towards promoting and sensitizing individuals on the dangers of the practice and providing new ways of curbing the growing demand of tobacco. The introduction of high levies on tobacco and its products increased the burden on the purchase and subsequent use of the product which acted as a discouraging factor towards the increased use of the product (Longman and Passey 2013).

 Moreover, the placement of a specific advertisement (Break the chain) placed in a number of indigenous and the mainstream media encouraged a cut down and quitting among several smokers. The advertisement reached a number of people hearing the information for the first time and promoted a change of social and cultural preference on smoking as a stress releaser especially among expectant mothers (Longman and Passey 2013). An evaluation of the Quit for you, quit for Two program recorded high rates of success among pregnant women and their partners in change of attitude and intentions aimed at smoking (Gould, Watt, Stevenson, McEwen, Cadet-James and Clough, 2014).

The medical services forwarded to the hard to reach areas promoted a high rate of health seekers visiting the facility. The trend promoted advise offering to the individuals in the respective locations leading to convert cases from the smoking health issue (Gould, Bittoun and Clarke 2015). In its entirety, the program recorded a high rate of success as an intervention measure as it cut own the new cases of smoking addiction and sensitization among a population that previously experienced a high level of neglect as far as public health measures were concerned.     

Culture bears a significant influence on the reception to health care especially if the culture of a particular location differs with that of the people providing a health care service. Cultural conflict and difference in perception among people determine the uptake rates and willingness among individuals to engage in a specific healthcare activity (Brascoupé and Catherine Waters BA 2009). Primary healthcare providers have to bear an in-depth knowledge on the culture of the people operating in a given location to experience utmost response on the medical needs.

Cultural knowledge and sensitivity determines the rate at which patients might return to a medical facility and encourage further visit by new individuals (Constantine, Myers, Kindaichi and Moore 2004). Patients visiting health facilities where they experience discriminatory activities have a lower rate of return compared to those who feel respected and treated with equity. Being sensitive to ones culture promotes the aspect of acceptability and conformity to cultural construct thus promoting the administration of health care needs.

Impact of Laws on Smoking

Understanding of the culture of a given location assists in the creation of a perfect balance between the “western” medicine and that of the parent culture in a way that does not diminish or overshadow that of the parent society. The balance goes a long way in promoting acceptance of a given treatment and sensitization program towards combating a given health related issue. 

Individuals serving such populations must remain culturally competent and be conversant with the local language of the people. A mix of inhabitants of a location and outsiders can assist in learning the cultures as well as training in diversity care and management to avoid raising challenges that might impede full administration of healthcare rights to a given section of people.

The aboriginal people have engaged in smoking for a long time and have been part of their culture in as far as socialization is concerned. Individuals in their free time would engage in tobacco smoking for pleasure and relieve of stress in the society. Over time, the trend would be passed to the younger generation with no limits towards the number of cigars to be used thus developing a health related issue (King, Smith and Gracey 2009). In addressing the health concern, the health providers must approach the issue from a professional manner where the cultural awareness and sensitivity must be studied for best experience to be achieved among the population.

Cultural sensitivity involves accepting the practice as legal among the people and only dealing with the dangers of the same while changing the perceptions of the individuals. In the intervention program against smoking, the health care sector used advertisement on the dangers of smoking as opposed to ruling out smoking as an illegal activity (Papadopoulos, Tilki, and Lees 2004). Once people begin to realize the need to cut down on the smoking patterns, the rate of smoking gradually diminishes reaching the targeted levels observed in other areas of the mainstream society.

As opposed to total banish, the sensitization would record a high rate of visits to the medical facility and rehab centers in search of total healing and delivery from the effects of smoking among the indigenous people. The staff dealing with the people from the sensitization to the treatment stages were conversant with the culture and remained sensitive to avoid damaging their egos and interfering with the beliefs of the people. As a result, the measures succeeded in reducing the smoking rates among the indigenous populations.     

References

Brascoupé, S. and Catherine Waters BA, M.A., 2009. Cultural safety: Exploring the applicability of the concept of cultural safety to Aboriginal health and community wellness. International Journal of Indigenous Health, 5(2), p.6.

Constantine, M.G., Myers, L.J., Kindaichi, M. and Moore, J.L., 2004. Exploring Indigenous Mental Health Practices: The Roles of Healers and Helpers in Promoting Well?Being in People of Color. Counseling and Values, 48(2), pp.110-125.

Gould, G.S., Bittoun, R. and Clarke, M.J., 2015. A pragmatic guide for smoking cessation counselling and the initiation of nicotine replacement therapy for pregnant Aboriginal and Torres Strait Islander smokers. Journal of Smoking Cessation, 10(2), pp.96-105.

Gould, G.S., Watt, K., Cadet-James, Y. and Clough, A.R., 2015. Using the risk behaviour diagnosis scale to understand Australian Aboriginal smoking—a cross-sectional validation survey in regional New South Wales. Preventive medicine reports, 2, pp.4-9.

Gould, G.S., Watt, K., Stevenson, L., McEwen, A., Cadet-James, Y. and Clough, A.R., 2014. Developing anti-tobacco messages for Australian Aboriginal and Torres Strait Islander peoples: evidence from a national cross-sectional survey. BMC Public Health, 14(1), p.250.

Gracey, M. and King, M., 2009. Indigenous health part 1: determinants and disease patterns. The Lancet, 374(9683), pp.65-75.

Gracey, M. S. (2007). Nutrition-related disorders in Indigenous Australians: how things have changed. Medical Journal of Australia, 186(1), 15.

King, M., Smith, A. and Gracey, M., 2009. Indigenous health part 2: the underlying causes of the health gap. The Lancet, 374(9683), pp.76-85.

Longman, J.M. and Passey, M.E., 2013. Children, smoking households and exposure to second-hand smoke in the home in rural Australia: analysis of a national cross-sectional survey. BMJ open, 3(7), p.e003128.

Marmot, M., & Commission on Social Determinants of Health. (2007). Achieving health equity: from root causes to fair outcomes. The Lancet, 370(9593), 1153-1163.

Papadopoulos, I., Tilki, M. and Lees, S., 2004. Promoting cultural competence in health care through a research based intervention in the UK. Diversity in Health and Social Care, 1(2), pp.107-115.

Thomas, D. P., Briggs, V., Anderson, I. P., & Cunningham, J. 2008. The social determinants of being an Indigenous non?smoker. Australian and New Zealand Journal of Public Health, 32(2), 110-116.