8.8 Economic and social issues relating to tobacco use among Aboriginal peoples and Torres Straits Islanders
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Section 8.1 reported that Aboriginal and Torres Strait Islander populations are more likely to live in disadvantaged circumstances than their non-Indigenous counterparts, including having significantly lower income, reduced likelihood of employment, and lower attained education levels. These factors, along with historical and cultural influences, contribute to the high ongoing levels of smoking in these communities (Sections 8.2 and 8.3).
Research undertaken by the National Aboriginal and Torres Strait Islander Tobacco Control Project (NATSITCP) in 2001 studied the economic effects of tobacco use in a wide number of communities throughout Australia.6 This report found that expenditure on tobacco represented a significant proportion of family income among households with one or more smokers, and that purchases of tobacco were perceived as a priority, if necessary at the expense of food and other essentials. Tobacco consumption varied with stages in the pay cycle. As available funds declined, many reported using 'chop-chop' (unbranded, loose 'black market' tobacco), or buying roll-your-own tobacco, cheaper cigarette brands and sharing packs. Some resorted to recycling cigarette butts into roll-your-own cigarettes. Smokers compensated for the lean times by smoking more heavily following pay day.
The NATSITCP also found that pricing tobacco beyond the means of individual smokers did not tend to halt their access to the product, since the cultural obligation to share goods if requested means that it is likely that smokers who do have tobacco will be prevailed upon to share it. This in itself caused increased stress in some communities, interviewees reporting discomfort at high levels of 'humbugging' and 'hassling' for cigarettes or for the money with which to buy them. Young people put pressure on the elders to provide cigarettes, who in turn felt obliged to supply them. Some also reported episodes of coercion and intimidation. At worst, there have been reports of burglaries, violence and threats of self-harm in order to obtain tobacco.6
Other research has confirmed that tobacco purchases are more likely to claim a disproportionate allocation of household expenditure in Indigenous households. In one Northern Territory Indigenous community, cigarette purchases accounted for 22% of money spent in local retail outlets.52 Although the studies are not directly comparable, this is in stark contrast with the estimated 8% spent on tobacco products by households in the poorest income quintile nationally.110
The NATSITCP report concludes that in addition to health issues, tobacco use causes serious financial and social problems for many Aboriginal and Torres Strait Islander communities. It contributes to poor nutrition, especially in children, undermines family and community structures, and leads to concerns for personal safety.6 Increasing the price of tobacco through taxation has long been identified as an important and effective component of a comprehensive tobacco control program,111 and has almost certainly been an important contributing factor to declines in national smoking rates in Australia.44 However there is evidence that among the most disadvantaged in the community, increasing the price of tobacco exacerbates financial hardship.110 The NATSITCP report recommends further study into the impact of price increases on tobacco products as a means of tobacco control in the Indigenous populations.6 Smoking and social disadvantage is discussed further in Chapter 9.
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