Evidence for a comprehensive approach to Aboriginal tobacco control to maintain the decline in smoking: an overview of reviews among Indigenous peoples

Systematic Reviews

Susan Perlen¹  Catherine Chamberlain¹  Sandra Eades¹  Emily Banks²  Noore Alam³  Lucie Rychetnik⁴  Sue Brennan⁵  Andrew Wilson⁶  David Thomas⁷  Raglan Maddox⁸ 

[1] Aboriginal Health Domain, Baker IDI Heart and Diabetes Institute;National Centre for Epidemiology and Population Health, Australian National University;Prevention Division, Department of Health, Queensland Government;School of Medicine, University of Notre Dame;School of Public Health and Preventive Medicine, Monash University;The Australian Prevention Partnership Centre;Tobacco Control Research, Menzies School of Health Research;Well Living House, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael’s Hospital;

关键词: Indigenous;    Aboriginal;    Smoking;    Tobacco;    Overview;    Systematic review;   

DOI  :  10.1186/s13643-017-0520-9

来源: DOAJ

【 摘 要 】

Abstract Background Tobacco smoking is a leading cause of disease and premature mortality among Aboriginal and Torres Strait Islander (Indigenous) Australians. While the daily smoking prevalence among Indigenous Australians has declined significantly from 49% in 2001, it remains about three times higher than that of non-Indigenous Australians (39 and 14%, respectively, for age ≥15 years in 2014–15). This overview of systematic reviews aimed to synthesise evidence about reducing tobacco consumption among Indigenous peoples using a comprehensive framework for Indigenous tobacco control in Australia comprised of the National Tobacco Strategy (NTS) and National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) principles and priorities. Methods MEDLINE, EMBASE, systematic review and Indigenous health databases were searched (2000 to Jan 2016) for reviews examining the effects of tobacco control interventions among Indigenous peoples. Two reviewers independently screened reviews, extracted data, and assessed review quality using Assessing the Methodological Quality of Systematic Reviews. Data were synthesised narratively by framework domain. Reporting followed the PRISMA statement. Results Twenty-one reviews of varying quality were included. There was generally limited Indigenous-specific evidence of effective interventions for reducing smoking; however, many reviewers recommended multifaceted interventions which incorporate Indigenous leadership, partnership and engagement and cultural tailoring. Under the NTS priority areas, reviewers reported evidence for brief smoking cessation interventions and pharmacological support, mass media campaigns (on knowledge and attitudes) and reducing affordability and regulation of tobacco sales. Aspects of intervention implementation related to the NATSIHP domains were less well described and evidence was limited; however, reviewers suggested that cultural tailoring, holistic approaches and building workforce capacity were important strategies to address barriers. There was limited evidence regarding social media and mobile applications, for Indigenous youth, pregnant women and prisoners, and no evidence regarding interventions to protect communities from industry interference, the use of electronic cigarettes, interventions for people experiencing mental illness, juvenile justice, linguistic diversity or ‘pubs, clubs and restaurants’. Conclusions There is limited Indigenous-specific evidence for most tobacco interventions. A ‘comprehensive approach’ incorporating NTS and NATSIHP Principles and Priorities of partnership and engagement, evidence from other settings, programme logic and responsive evaluation plans may improve intervention acceptability, effectiveness and implementation and mitigate risks of adapting tobacco evidence for Indigenous Australians.

【 授权许可】

Unknown