8.5 Types of tobacco used by and levels of consumption among Aboriginal peoples and Torres Strait Islanders
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As among the general Australian population, most tobacco used by Aboriginal peoples and Torres Strait Islanders is in the form of conventional manufactured cigarettes, but roll-your-own tobacco, pipes and chewing tobacco are preferred by some smokers.7 The National Aboriginal and Torres Strait Islander Tobacco Control Project undertaken during 2001 reported that 'chop-chop' (unbranded, loose 'black market' tobacco) is also used in some communities.6
8.5.1 Manufactured and roll-your-own cigarettes
As already noted, most tobacco used by Aboriginal peoples and Torres Strait Islanders is in the form of manufactured cigarettes. The National Drug Strategy Household Surveys of 200175 and 200441 found that average consumption levels among Indigenous smokers were higher than among other Australian smokers. The 2004 Survey reported that among current smokers aged 14 and over, Indigenous people consumed, on average, 130 cigarettes each week (18.5 cigarettes daily) compared to 97 cigarettes per week (14 per day) for other Australian smokers. Male Indigenous smokers smoked slightly more heavily than female Indigenous smokers (136 cigarettes per week, or
19 per day, compared to 125 cigarettes weekly, or 18 cigarettes daily). Indigenous smokers of both sexes smoked more than their non-Indigenous counterparts. Non-Indigenous men smoked 102 cigarettes per week, or 14.5 cigarettes daily, and non-Indigenous women smoked 92 cigarettes per week, or 13 cigarettes daily.
The earlier NATSIS report of 199437 supports the findings that Indigenous males tend have a higher daily consumption than females, and that most smokers of both sexes smoke fewer than 20 cigarettes per day. This survey also provided information on consumption by age bracket. Numbers of cigarettes smoked per day increased with age. Most smokers aged between 13–17 reported smoking 10 or fewer cigarettes daily, and among the 18–24 age group, 45% of males and 44% of females were smoking at this level. Average consumption levels increased in the 25–44 age bracket, with about a third of males smoking between 11–20 cigarettes each day, and another third smoking between 21–30 per day. Highest average consumption was among women aged 45–54, among whom 35% smoked between 21–30 cigarettes. Overall, only about 8% of Indigenous men, and 5% of Indigenous women reported smoking 31 or more cigarettes daily. Table 8.637 summarises consumption levels among Aboriginal and Torres Strait Islanders by gender.
Table 8.6
Number of cigarettes consumed per day by Aboriginal and Torres Straits Islander smokers aged 13 and over, 1994
|
Males |
Females |
|
|
Number of cigarettes smoked |
(% rounded) |
|
|
1–10 |
33 |
37 |
|
11–20 |
30 |
33 |
|
21–30 |
28 |
24 |
|
31 or more |
8 |
5 |
|
Not stated |
<1 |
1 |
Source:NATSIS 1994.37
The Urban Aboriginal and Torres Strait Islander Supplement to the National Drug Strategy Household Survey,38 also undertaken in 1994, reports that most Indigenous smokers smoke fewer than 20 cigarettes per day. More recent data from a large scale regional survey from Eastern Arnhem Land (in the Northern Territory's 'Top End') shows an average daily consumption of 16 cigarettes, although the authors note that this may be an overestimate.53
It is important to realise that the above figures represent average consumption levels. A number of reports observe that since tobacco is often shared, and its purchase is dependent upon availability of funds, consumption may be sporadic and concentrated around pay days.6, 26, 31 Research on urban Indigenous female smokers in Perth showed that about half of those respondents who smoked less often than daily, only smoked in conjunction with drinking alcohol. About the same proportion did not purchase cigarettes themselves since the cultural expectation of sharing cigarettes catered for their needs.77
There are no national data on use of roll-your-own tobacco in the Aboriginal and Torres Strait Islander population, but it is likely that use among these groups would be at least similar to or possibly higher than levels among the total Australian population, in part due to its price advantage6 and possibly also because of its facility as a product for chewing, or for blending with cannabis (see Section 8.11.2). Watson et al found that more than a third of Indigenous smokers in surveyed Northern Territory communities smoked hand-rolled cigarettes in 1986–1987.72 In Hill et al's national prevalence survey of 1995, 8% of Australian male current smokers and 4% of female current smokers reported having used only roll-your-own tobacco in the month prior to survey.76 The National Drug Strategy Household Survey of 2004 found that about 24% of smokers used roll-your-own tobacco, only 5% of all smokers using it exclusively.41
8.5.2 'Chop-chop'
Chop-chop is untaxed, unbranded loose tobacco leaf, sold on the black market at about half the price of properly taxed tobacco on a weight for weight basis.78 Most of its popularity results from its price, but it is also favoured by some due to the common misconception that because it is has not undergone the usual manufacturing into cigarettes, it is has no additives and is less harmful to health.79
The NATSITCP report found that Aboriginal and Torres Strait Islander communities in Queensland, New South Wales, the ACT, Victoria and Tasmania use chop-chop.6 Chop-chop has a following for the same reasons that it is popular with non-Indigenous Australians, but there is no data on the extent of its usage. As with other tobacco products, its use tends to be cyclical, peaking around pay days. Because chop-chop is generally sold in bulk quantities, it is often purchased communally. The widely held belief in these communities that chop-chop serves as a safer alternative to cigarette smoking is cause for concern and needs to be appropriately addressed.6
For further information on chop-chop, refer to Chapter 3 Section 3.27.2, Chapter 10 Section 10.9.1 and Chapter 13 Section 13.7.2.
8.5.3 Chewing tobacco
The various series of national statistics on Aboriginal and Torres Strait Islander smoking behaviour have not reported separately on types of tobacco consumed, and all have excluded chewing tobacco, presumably due to the small numbers involved. Therefore the information available is sporadic and much of it is dated, although it is known that among some populations chewing of pituri and other bush tobaccos and commercially available loose tobacco still occurs.26, 31 Only one large scale study, undertaken in the Northern Territory between 1986 and 1987,72 has attempted to quantify this form of tobacco use in the Indigenous population, finding that one quarter of respondents chewed tobacco. Women were more likely to chew tobacco than men (38% compared to 11%), and it was more popular among older age groups of both sexes, with almost half of the population aged over 60 reporting that they chewed tobacco. Three quarters of chewers used commercial loose flake or plug smoking tobacco, and one quarter used bush tobacco. All chewers mixed their tobacco with ash, in the traditional manner (see Section 8.2). Only a small proportion of individuals (4%) both smoked and chewed tobacco.72
There was also a strong geographic influence on chewing behaviour. In the Centre region, 61% of women and 20% of men chewed tobacco. In contrast, tobacco was chewed by only 5% of women and 1% of men living in the Top End region. Uptake of chewing occurred at an early age, young girls being taught to chew by their mothers and grandmothers.72 At least one commentator26 has observed that tobacco chewing still occurs among children in central Australia.
Other studies have shown that tobacco chewing continues at comparatively low levels, with variation between gender usage and regions. A study of smoking behaviour in two Victorian country towns showed that a very small number Indigenous males (0.8%), and no females, chewed tobacco. In these populations, smoking was a majority behaviour (67% of men and 63% of women being current cigarette smokers).80 Another study on tobacco use among urban-dwelling Indigenous women aged 18 and over who attended an Aboriginal Medical Service in Perth found that 6% of respondents had chewed tobacco at some time, and of these women, just more than half continued to chew regularly.77 The National Aboriginal and Torres Strait Islander Tobacco Control Project (NATSITCP) provides more recent, anecdotal evidence about continuing use of tobacco in the traditional way from one of the communities interviewed.6 According to the NATSITCP report, native tobaccos are still prepared according to traditional methods, and controls on its use are recalled from the old days but no longer practised. Usage is more popular in remote areas, probably reflecting availability as well as historical patterns of use. Native leaf is sometimes mixed with commercially available loose-leaf tobacco, such as Drum or Log Cabin, or the commercial tobaccos are chewed on their own.6
The health consequences of chewing tobacco in these communities have not been evaluated. In traditional use, the native tobaccos were typically only seasonally available, and in particular locations. It is not yet clear what impact the chewing of readily available loose smoking tobacco will have on disease prevalence.72
Mortality rates from oropharyngeal cancers increased by 700% in the Northern Territory between 1977 and 2000,81 but it is not possible on the basis of available data to calculate the proportions of these deaths attributable to various forms of tobacco use, there being other contributing factors to causation of these cancers, and overall prevalence of chewing being low. The historical and cultural elements of native tobacco use are, however, important to the communities in which their use has continued, and any future health campaigns dealing with chewing tobacco would need to be sensitively managed.6, 72
8.5.4 Pipe and cigar use
National surveys of Indigenous smoking behaviour have not collected separate data on pipe or cigar smoking. However it is likely that as among the general Australian population, use of tobacco in these forms is minimal. The National Drug Strategy Household Survey of 2004 found that 8% of smokers aged 14 and over reported some level of pipe or cigar use, and only 1.2% of smokers reported pipe or cigar use exclusively.41
The historical associations of pipe use among Indigenous people, particularly strong in parts of Northern Australia, may mean that there remain some communities with higher levels of pipe smoking (see Section 8.2 above). Other than anecdotal comment,26, 31 there do not appear to be any published data on this subject.
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