8.8 Economic issues relating to tobacco use among Aboriginal and Torres Straits Islander peoples

Section 8.7 reviewed the serious health effects of tobacco use for Aboriginal peoples and Torres Strait Islanders, but tobacco also has a broader economic impact on these communities. Research undertaken by the National Aboriginal and Torres Strait Islander Tobacco Control Project in 2001 included information on the financial effects of tobacco use in a wide number of communities throughout Australia.¹ 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.¹ 

Other research has supported the finding that tobacco purchases are more likely to claim a disproportionate allocation of household expenditure in Indigenous households. One study in five remote central Australian communities estimated that between 12.7% and 9.1% of the maximum $453.30 per fortnight unemployment allowance (at the time) for a single person was being spent on cigarettes.² In a Northern Territory Indigenous community, cigarette purchases accounted for 22% of money spent in local retail outlets,³ compared with the estimated 8% spent on tobacco products by households in the poorest income quintile nationally.⁴

The National Aboriginal and Torres Strait Islander Tobacco Control Project also found that pricing tobacco beyond the means of individual smokers did not completely 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.¹ A study in remote communities in Central Australia has explained the relatively low consumption levels there in terms of access and cultural obligations to share. The remote location and limited store opening times limit access. Furthermore, the cultural obligation to share means that full packs are generally not exclusively smoked by the purchaser but are given to others. This obligatory sharing means that many smokers will not smoke large amounts of cigarettes, but it also means that smaller quantities of cigarettes are available to more people.² 

The National Aboriginal and Torres Strait Islander Tobacco Control Project 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.¹ Increasing the price of tobacco through taxation has long been identified as an important and effective component of a comprehensive tobacco control program,⁵ and has almost certainly been an important contributing factor to declines in national smoking rates in the general Australian population.⁶ There is evidence that increasing the price of tobacco does result in reduced prevalence even among the most disadvantaged in the community; in fact, rates are reduced more in low-income groups than middle- and high-income groups, thus reducing social disparities in smoking.⁷ 

The cost of cigarettes has been cited by many Aboriginal peoples and Torres Strait Islanders as among the reasons why they quit smoking (see Section 8.6.4),^1,8 and the National Aboriginal and Torres Strait Islander Tobacco Control Project report recommends further study into the impact of price increases on tobacco products as a means of tobacco control in the Indigenous populations.¹ One study on the impact of the 25% tobacco tax excise rise in 2010 on remote Indigenous communities found that while there appeared to be no effects on tobacco sales, participants reported increased demands to share cigarettes, with a perception of greater reliance on those with more disposable income to purchase cigarettes for other smokers. These strategies may have served to minimise the effects of the price increase.9 The impact of taxation on Indigenous smoking is discussed further in Section 8.10.14. Further initiatives addressing the economic impact of tobacco use on Indigenous communities are also discussed in Section 8.10: income management has been trialled in remote community stores (Section 8.10.10); and messages that emphasise the financial impact from smoking are being used by several communities in social marketing strategies (Section 8.10.11). Smoking and social disadvantage is discussed further in Chapter 9. 

Relevant news and research

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References

1. 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.

2. 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):S71–5. Available from: http://dx.doi.org/10.1111/j.1753-6405.2010.00557

3. Hoy W, Norman R, Hayhurst B, and Pugsley D. Health profile of adults in a Northern Territory Aboriginal community, with an emphasis on preventable morbidities. Australian and New Zealand Journal of Public Health, 1997; 21(2):121−6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9161065

4. Siahpush M, Borland R, and Scollo M. Smoking and financial stress. Tobacco Control, 2003; 12(1):60–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12612364

5. US Department of Health and Human Services. Reducing tobacco use: A report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/2000/index.htm .

6. White V, Hill D, Siahpush M, and Bobevski I. How has the prevalence of cigarette smoking changed among Australian adults? Trends in smoking prevalence between 1980 and 2001. Tobacco Control, 2003; 12(suppl. 2):ii67–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12878776

7. Siahpush M, Wakefield M, Spittal MJ, Durkin SJ, and Scollo MM. Taxation reduces social disparities in adult smoking prevalence. American Journal of Preventive Medicine, 2009; 36(4):285–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19201146

8. Australian Bureau of Statistics and Australian Institute of Health and Welfare. 4704.0. The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples, 2010  Canberra: ABS, 2010. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4704.0 .

9. Thomas DP, Ferguson M, Johnston V, and Brimblecombe J. Impact and perceptions of tobacco tax increase in remote Australian Aboriginal communities. Nicotine & Tobacco Research, 2013; 15(6):1099–106. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23166311