Climatic and community sociodemographic factors associated with remote Indigenous Australian smoking rates: an ecological study of health audit data.
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Date
2019-07-17
Author(s)
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Affiliation(s)
(Carroll, Dale, Daniel) Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, ACT, Australia
(Bailie) University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
(Daniel) Department of Medicine, St. Vincent's Hospital, University of Melbourne, Fitzroy, VIC, Australia
(Bailie) University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
(Daniel) Department of Medicine, St. Vincent's Hospital, University of Melbourne, Fitzroy, VIC, Australia
Year
2019
Citation
BMJ Open. Vol.9(7), 2019.
Journal
BMJ Open
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Grant information
Organisation: (ACSQHC) Australian Commission on Safety and Quality in Health Care Organisation No: 100008999 Country: Australia
No: DP120102482 Organisation: (ARC) Australian Research Council Organisation No: 501100000923 Country: Australia
No: GNT1078927 Organisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
No: GNT545267 Organisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
This work was supported by the Australian Research Council [grant number DP120102482] and drew upon data collected as part of the One21seventy project. One21seventy is a continuous quality improvement (CQI) program developed as part of the ABCD National Research Partnership Project (both the ABCD National Research Partnership Project and the Centre for Research Excellence in Integrated Quality Improvement were funded by the National Health and Medical Research Council [GNT545267; GNT1078927, respectively] and the Lowitja Institute, and by financial and in-kind support from a range of Community Controlled and Government agencies). The Audit and Best Practice for Chronic Disease Extension (ABCDE) Project was supported by funding from the Cooperative Research Centre for Aboriginal Health and the Australian Commission on Safety and Quality in Health Care.
No: DP120102482 Organisation: (ARC) Australian Research Council Organisation No: 501100000923 Country: Australia
No: GNT1078927 Organisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
No: GNT545267 Organisation: (NHMRC) National Health and Medical Research Council Organisation No: 501100000925 Country: Australia
This work was supported by the Australian Research Council [grant number DP120102482] and drew upon data collected as part of the One21seventy project. One21seventy is a continuous quality improvement (CQI) program developed as part of the ABCD National Research Partnership Project (both the ABCD National Research Partnership Project and the Centre for Research Excellence in Integrated Quality Improvement were funded by the National Health and Medical Research Council [GNT545267; GNT1078927, respectively] and the Lowitja Institute, and by financial and in-kind support from a range of Community Controlled and Government agencies). The Audit and Best Practice for Chronic Disease Extension (ABCDE) Project was supported by funding from the Cooperative Research Centre for Aboriginal Health and the Australian Commission on Safety and Quality in Health Care.
Abstract
Australian Indigenous smoking rates are highest in remote communities but likely vary between communities; few studies have assessed community features in relation to Indigenous smoking rates. Design and objective: This ecological study evaluated the associations between smoking rates, and community sociodemographic and climatic characteristics for a large sample of remote Indigenous communities. Setting and sample: Records (n=2689) from an audit of community health centres in the Northern Territory and Queensland were used to estimate smoking rates dichotomised at the median for 70 predominantly Indigenous remote communities. Community characteristics were similarly dichotomised. Method(s): Cross-tabulations were used to calculate the odds of a community classified as high for a sociodemographic or climatic factor also being high for smoking rate. Additional cross-tabulations, stratified by sociodemographic, region (coastal or central) and geographic connectivity levels, were performed to assess potential confounding. Result(s): Community smoking rates ranged from 25% to 96% (median 60.2%). Moderately strong relationships were observed between community smoking rate and population size (OR 6.25,(95% CI 2.18 to 17.95)), education level (OR 3.67 (1.35-10.01)), income (2.86 (11.07-7.67)) and heat (2.86 (1.07-7.67)). Conclusion(s): Smoking rates in Australian remote Indigenous communities are universally high. Smoking rates are associated with greater community-level socioeconomic status and size, most likely reflecting greater means of accessing tobacco with mass of smokers sufficient to sustain a normative influence. Severe heat was also associated with high smoking rates suggesting such a stressor might support smoking as a coping mechanism. Community sociodemographic and climatic factors bear consideration as context-level correlates of community smoking rates.Copyright © 2019 Author(s).
PubMed ID
31292187 [https://www.ncbi.nlm.nih.gov/pubmed/?term=31292187]
Type
Article
Study type
Observational study (cohort, case-control, cross sectional, or survey)
Subjects
Tobacco use