|Last updated: February 2021
Suggested citation: van der Sterren, A, Greenhalgh, EM, Knoche, D, & Winstanley, MH 8.5 Types of tobacco used by and levels of consumption among Aboriginal and Torres Strait Islander peoples. In Greenhalgh, EM, Scollo, MM and Winstanley, MH (editors). Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021. Available from http://www.tobaccoinaustralia.org.au/8-5-types-of-tobacco-used-by-and-levels-of-consump
Similar to the general Australian population, most tobacco used by Aboriginal and Torres Strait Islander peoples is in the form of conventional manufactured cigarettes. A smaller number of smokers prefer roll-your-own tobacco, pipes and chewing tobacco.1 The 2001 National Aboriginal and Torres Strait Islander Tobacco Control Project reported that ‘chop-chop’ (unbranded loose ‘black market’ tobacco) is also used in some communities.2
8.5.1 Manufactured and roll-your-own cigarettes (‘rollies’)
Most tobacco used by Aboriginal people and Torres Strait Islander peoples is in the form of manufactured cigarettes. The 2019 National Drug Strategy Household Survey (NDSHS) found that Aboriginal and Torres Strait Islander smokers aged 14 and over reported consuming, on average, 108 cigarettes each week (about 15 per day).3 The NDSHS data should be interpreted with some caution as sample sizes of Aboriginal and Torres Strait Islander peoples are low, and survey methods may not capture a representative sample (see note i in Section 8.3). Data from the 2018–19 National Aboriginal and Torres Strait Islander Health Survey (which has a larger sample size) provides an estimate of the level of cigarette consumption for Aboriginal and Torres Strait Islander daily smokers aged 15 and over of 12 cigarettes per day. The survey found that among daily smokers, just over one quarter (28%) smoked 20 or more cigarettes per day. The majority reported smoking either 1–9 cigarettes per day (35%), or 10–19 (38%).
The national data sets indicate that most Aboriginal and Torres Strait Islander smokers smoke fewer than 20 cigarettes per day,3, 4 and this is supported by earlier local level studies.5-11 Several studies conducted in communities across the Northern Territory have estimated rates of tobacco consumption using data on the sale of tobacco from local community stores and/or wholesalers.5,11 Using sales data to estimate consumption is a practical and non-invasive method of estimating tobacco consumption in small remote communities with mostly Aboriginal populations, but sales data for lower aggregate levels is not routinely collected across Australian states and territories. Such studies have similarly found that Aboriginal and Torres Strait Islander peoples smoke fewer than 20 cigarettes per day,10 with some finding consumption rates of fewer than 10 cigarettes per day.5,8,9,11 Although smoking prevalence rates may be high in these communities, consumption is often low.11
Studies have also reported low levels of consumption among pregnant Aboriginal and Torres Strait Islander women. A study in north Queensland found that over 60% of pregnant women who were current tobacco users smoked 10 or fewer cigarettes per day; furthermore, 40% of these women were assessed as having low physical nicotine dependence.6 Similarly, a Northern Territory study of maternal smoking found that 71% reported smoking 10 or fewer cigarettes per day.7
It is also important to realise that the above figures represent average consumption levels. A number of reports, specific to Aboriginal and Torres Strait Islander tobacco use, 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. 2,11-13 Research involving 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.14
There are no national data on use of roll-your-own tobacco (‘rollies’) 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 advantage2 and possibly also because of its facility as a product for chewing, or for blending with cannabis (see Section 8.11.2). One study found that more than a third of Aboriginal and Torres Strait Islander smokers surveyed in Northern Territory communities smoked hand-rolled cigarettes in 1986‒87.15 A 2008 cross-sectional survey in three Northern Territory communities reported that of 305 smokers aged 16 years and over, 57% smoked both factory-made cigarettes and loose ‘roll-your-own’ tobacco, 34% smoked factory-made cigarettes only, 2% smoked only loose tobacco, and 1% only chewed tobacco.9
Chop-chop is unbranded loose tobacco leaf, sold on the black market at less than half the price of properly taxed tobacco on a weight for weight basis.16 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 processes, it is has no additives and is less harmful to health.17, 18
The National Aboriginal and Torres Strait Islander Tobacco Control Project report found that people in Aboriginal and Torres Strait Islander communities in Queensland, New South Wales, the Australian Capital Territory, Victoria and Tasmania use chop-chop. Chop-chop is used among people in these communities for the same reasons that it is used among non-Indigenous Australians (i.e., its comparatively low price), but there are 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.2
For further information on chop-chop, refer to Section 1.12.2 and Section 13.7
8.5.3 Chewing tobacco
The national surveys of Aboriginal and Torres Strait Islander smoking behaviour have not reported separately on types of tobacco consumed, and all have excluded chewing tobacco. Information on the chewing of pituri and other bush tobaccos and commercially available loose tobacco comes from local studies, many of which are considerably dated. Studies indicate that prevalence of tobacco chewing is low among Aboriginal and Torres Strait Islander peoples, although it more common in some Central Australian communities (southern NT, northern SA, and eastern WA).
One large-scale study, undertaken in the Northern Territory between 1986 and 1987,15 attempted to quantify this form of tobacco use in the Aboriginal and Torres Strait Islander 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. The uptake of chewing occurred at an early age, with young girls being taught to chew by their mothers and grandmothers. 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.15
However, there was also a strong geographic influence on chewing behaviour. In the Top End region, tobacco was chewed by only 5% of women and 1% of males.15 More recent studies in Arnhem Land communities of the Top End have also reported low levels of chewing tobacco use. A 2008 study reported that only 1% reported using chewing tobacco exclusively,9 and in a study from 2000, 7% of current smokers (11 of 161) reported that they also chewed tobacco.19
The rates of chewing tobacco are much higher in the central region of Australia. The 1986–87 NT study found that 61% of women and 20% of men chewed tobacco. Although there have been no recent large-scale studies measuring rates of use of chewing tobacco in Central Australia, one researcher has recently noted that more than 30% of Aboriginal women giving birth at the Alice Springs Hospital regularly chew bush tobacco (pituri).20 Another more recent study found that about one quarter of pregnant Aboriginal women reported using chewing tobacco.21 Qualitative research published in 2017 concluded that use of pituri by Aboriginal populations in the southern, central and western desert regions of Australia is widespread, with girls commencing use between 5 and 7 years of age.21 In the Kimberley region of Western Australia, a 2010 study of Aboriginal people aged 45 year or older reported 39% of participants were current chewing tobacco users.22 Another study in remote South Australia has commented that chewing tobacco ‘is mainly practiced by middle aged and older women who are least likely to smoke’ (pS71).11
Studies in other parts of Australia in the 1990s found that tobacco chewing occurs at comparatively low levels. A study of smoking behaviour in two Victorian country towns showed that a very small number of Aboriginal and Torres Strait Islander men (0.8%), and no women, chewed tobacco. In these populations, smoking was a majority behaviour (67% of men and 63% of women being current cigarette smokers).23 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 over half continued to chew regularly.14
The 2002 National Aboriginal and Torres Strait Islander Tobacco Control Project provided anecdotal evidence that native tobaccos continued to be prepared according to traditional methods and played a valued role in ceremonies. Usage was more popular in remote areas, probably reflecting availability as well as historical patterns. 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.2
The health consequences of chewing tobacco in Aboriginal and Torres Strait Islander communities have not been evaluated. Further, there is evidence that Central Australian Aboriginal people who chew pituri do not consider it to be a tobacco product nor themselves as tobacco users, and therefore feel that the Western health information regarding smoking is not relevant to pituri use.21 However, given the potential health effects and addictiveness of chewing tobacco (see section 18A.3), strategies to address tobacco use in the Central Australia region need to include both chewing and smoking, and need to consider that some people (particularly women) are exclusively chewing tobacco. Smokeless tobacco products can cause addiction and a range of cancers, as well as adverse reproductive developmental effects including stillbirth, pre-term birth, and low birth weight. Some smokeless tobacco products are also associated with increased cardiovascular risks and type 2 diabetes.24 Chewing tobacco is associated with cancers of the lip, oral cavity and pharynx, and for Aboriginal and Torres Strait Islander people in the Northern Territory the incidence of these types of cancers increased by 6.6% annually between 1991 and 2005, while mortality increased by 4.6% annually in the same time period.25 However, it is not possible to separate the causal role of tobacco use in these deaths from other possible contributing factors. An international review of smokeless tobacco use during pregnancy has found indications of an association with poorer birth outcomes, including increased rates of stillbirth and low birth weight;26 it is possible that chewing pituri has similar effects on birth outcomes, and research is currently underway examining this.27
The historical and cultural elements of native tobacco use are, however, important to the communities in which their use has continued; any future health campaigns dealing with chewing tobacco would need to be sensitively managed 2,15 and take into consideration the dominant role that pituri plays in many central Aboriginal people's lives.21
8.5.4 Pipe and cigar use
National surveys of Aboriginal and Torres Strait Islander 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 historical associations of pipe use among Aboriginal and Torres Strait Islander people, which are particularly strong in parts of Northern Australia, may mean that there are still communities with some levels of pipe smoking (see Section 8.2). Other than anecdotal comments,12, 13 there does not appear to be any published information on this subject.
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. ( Last updated April 2022)
1. Ivers R. Indigenous Australians and tobacco—a literature review. Darwin, Australia: Menzies School of Health Research and the Co-operative Research Centre for Aboriginal and Tropical Health, 2001. Available from: https://www.lowitja.org.au/sites/default/files/docs/Indigenous_Australians_and_Tobacco.pdf
2. Lindorff KJ. Tobacco time for action: National Aboriginal and Torres Strait Islander Tobacco Control Project final report. Canberra, Australia: National Aboriginal Community Controlled Organisations, 2002.
3. Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2019 - 8. Priority population groups supplementary tables. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data
4. Australian Bureau of Statistics. 4715.0 - National Aboriginal and Torres Strait Islander Health Survey, 2018-19. ABS, 2019. Available from: https://www.abs.gov.au/AUSSTATS/abs@.nsf/Latestproducts/4715.0Main%20Features152018-19?opendocument&tabname=Summary&prodno=4715.0&issue=2018-19&num=&view=
5. Thomas DP, Fitz JW, Johnston V, Townsend J, and Kneebone W. Wholesale data for surveillance of Australian Aboriginal tobacco consumption in the Northern Territory. Tobacco Control, 2011; 20(4):291–5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21546515
6. Panaretto KS, Mitchell MR, Anderson L, Gilligan C, Buettner P, et al. Tobacco use and measuring nicotine dependence among urban Indigenous pregnant women. Medical Journal of Australia, 2009; 191(10):554–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19912088
7. Johnston V, Thomas DP, McDonnell J, and Andrews RM. Maternal smoking and smoking in the household during pregnancy and postpartum: findings from an Indigenous cohort in the Northern Territory. Medical Journal of Australia, 2011; 194(10):556–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21644912
8. Clough AR, Guyula T, Yunupingu M, and Burns C. Diversity of substance use in eastern Arnhem Land (Australia): patterns and recent changes. Drug and Alcohol Review, 2002; 21:349–56. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12537704
9. Clough AR, MacLaren DJ, Robertson JA, Ivers RG, and Conigrave KM. Can we measure daily tobacco consumption in remote indigenous communities? Comparing self-reported tobacco consumption with community-level estimates in an Arnhem Land study. Drug Alcohol Rev, 2011; 30(2):166–72. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21355927
10. Ivers RG, Castro A, Parfitt D, Bailie RS, D'Abbs PH, et al. Evaluation of a multi-component community tobacco intervention in three remote Australian Aboriginal communities. Australian and New Zealand Journal of Public Health, 2006; 30(2):132–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16681333
11. Butler R, Chapman S, Thomas DP, and Torzillo P. Low daily smoking estimates derived from sales monitored tobacco use in six remote predominantly Aboriginal communities. Australian and New Zealand Journal of Public Health, 2010; 34 Suppl 1(suppl. 1):S71–5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20618299
12. Brady M. Historical and cultural roots of tobacco use among Aboriginal and Torres Strait Islander people. Australian and New Zealand Journal of Public Health, 2002; 26(2):116–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12054329
13. Briggs VL, Lindorff KJ, and Ivers RG. Aboriginal and Torres Strait Islander Australians and tobacco. Tobacco Control, 2003; 12 Suppl 2(suppl. 2):ii5–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12878767
14. Gilchrist D. Smoking prevalence among Aboriginal women. Aboriginal and Islander Health Worker Journal, 1998; 22(4):4–6. Available from: http://search.informit.com.au/documentSummary;dn=215154326331601;res=IELIND
15. Watson C, Fleming J, and Alexander K. A survey of drug use patterns in Northern Territory Aboriginal communities:1986-1987. Darwin, Australia: Northern Territory Department of Health and Community Services, 1988.
16. Sivyer G. Evidence for a large consumption of blackmarket processed-leaf-tobacco throughout the eastern states of Australia [Letter]. Australian and New Zealand Journal of Public Health, 2000; 24:344–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10937423
17. Bittoun R. 'Chop chop' tobacco smoking [Letter]. Medical Journal of Australia, 2002; 77:686–7. Available from: https://pubmed.ncbi.nlm.nih.gov/12464004/
18. Saunders J. 'Chop-chop' tobacco smoking. The Chronicle, 2009; 14(3):13. Available from: http://digitallibrary.health.nt.gov.au/dspace/bitstream/10137/419/2/Chronicle%20August%2009%20WEB.pdf
19. McDonald SP, Maguire GP, and Hoy WE. Validation of self-reported cigarette smoking in a remote Australian Aboriginal community. Australian and New Zealand Journal of Public Health, 2003; 27(1):57–60. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14705268
20. The University of Queensland. Effects of chewing wild tobacco during pregnancy: study. UQ News, 2011. Available from: http://www.uq.edu.au/news/?article=23592
21. Ratsch AM, Mason A, Rive L, Bogossian FE, and Steadman KJ. The Pituri Learning Circle: central Australian Aboriginal women's knowledge and practices around the use of <I>Nicotiana</I> spp. as a chewing tobacco. Rural Remote Health, 2017; 17(3):4044. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28780876
22. Smith K, Flicker L, Dwyer A, Atkinson D, Almeida OP, et al. Factors associated with dementia in Aboriginal Australians. Australian and New Zealand Journal of Psychiatry, 2010; 44(10):888–93. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20932202
23. Guest CS, O'Dea K, Carlin JB, and Larkins RG. Smoking in aborigines and persons of European descent in southeastern Australia: prevalence and associations with food habits, body fat distribution and other cardiovascular risk factors. Aust J Public Health, 1992; 16(4):397–402. Available from: https://www.ncbi.nlm.nih.gov/pubmed/1296789
24. National Cancer Institute and Centers for Disease Control and Prevention, Smokeless tobacco and public health: a global perspective. NIH publication no. 14-7983. Bethesda, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Institutes of Health, National Cancer Institute; 2014. Available from: https://cancercontrol.cancer.gov/brp/tcrb/smokeless-tobacco.
25. Zhang X, Condon J, Dempsey K, and Garling L. Cancer Incidence and Mortality Northern Territory 1991–2005. Darwin, Australia: Department of Health and Families, 2008. Available from: http://digitallibrary.health.nt.gov.au/dspace/bitstream/10137/165/1/Cancer%20Incidence%20%26%20Mortality%20Report2008.pdf
26. Ratsch A and Bogossian F. Smokeless tobacco use in pregnancy: an integrative review of the literature. International Journal of Public Health, 2014; 59(4):599–608. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24794708
27. Ratsch A, Steadman K, Ryu B, and Bogossian F. Tobacco and Pituri Use in Pregnancy: A Protocol for Measuring Maternal and Perinatal Exposure and Outcomes in Central Australian Aboriginal Women. Methods Protoc, 2019; 2(2). Available from: https://www.ncbi.nlm.nih.gov/pubmed/31181680