- Tobacco is the only consumer product that kills people when used as the manufacturer intends.
- Half of all continuing smokers will die an average of 14 years early from smoking related diseases.
Tobacco smoking is the most preventable of the many factors which contributed to the poor health status the Australian population. Tobacco smoking causes the greatest burden of disease experienced by all of the Australians and significantly, the Aboriginal and Torres Strait Islander peoples [15].
Aboriginal and Torres Strait Islander peoples are more likely to experience reduced quality of life due to ill health, and to die at younger ages, than other Australians. While the available evidence clearly supports these facts, the exact magnitude of the differences between the Indigenous and non-Indigenous populations is difficult to establish conclusively.
A number of reports including National Aboriginal Community Controlled Health Organisation's (NACCHO's) report Tobacco: time for action, (2002) have found that knowledge of the health effects of tobacco use amongst Indigenous people is generally good, but there is a lack of knowledge about specific harmful effects. These are: tobacco's link to diabetes, tobacco causing other cancers apart from lung cancer; and issues around the harmful effects of environmental tobacco smoke (passive smoking).
For more information see our section on Tobacco and Indigenous People.
Cardio Vascular Disease
- Smoking significantly increases the risk of cardiovascular disease (diseases of the circulatory system that affect the heart and blood vessels), including: coronary heart disease and heart attack, hypertension and stroke.
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- Cardiovascular diseases are a leading cause of death for Indigenous and non-Indigenous Australians. In the period 1998-2000, these diseases accounted for almost 30% of all deaths of Aboriginal and Torres Strait Islander peoples [15].
- Rates of cardiovascular diseases are 4 to 5 times higher in the Indigenous population compared to the general population [36].
- Indigenous males were almost 4 times and Indigenous females are twice as likely to die of heart failure than other Australians [36]
- In 1998-2000, the median age of deaths for Indigenous men from cardiovascular disease was 58 years compared with 78 years for the total male population [37]. For the same period, the median age of death for Indigenous women was 65 years compared to 84 years.
Stroke
- Stroke accounted for 17% of deaths for Indigenous men and 21% for Indigenous women. This rate is around 3 times higher than would be expected in the non-Indigenous population [36].
- Indigenous Australians were hospitalised 1.5 times more and died from stroke at twice the rate of other Australians [36].
Cancer
- Smoking significantly increases the risk of a range of cancers, including: cancer of the lungs, mouth, lip and throat; cancer of the stomach, liver, pancreas, kidney, and bladder, and leukaemia.
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- In 1999-2001, cancer is one of the three leading causes of death for Indigenous people, together with cardiovascular disease and other external causes (accidental deaths, self harm and assault). These causes accounted for 60% of all Indigenous deaths.
- Cancers of the digestive organs and lungs (and other smoking-related cancers) are the most common types of cancer that lead to deaths among Indigenous people [37].The leading specific cause of death from cancer for Indigenous men and women living in Western Australia and the Northern Territory was lung cancer, with other smoking-related cancers (particularly cancers of the oropharynx, oesophagus, stomach and pancreas) also being common causes of death [38].
- Mortality data from 1999-2000 indicate that there were 60% more observed deaths from cancer among Indigenous Australians in Western Australia, South Australia, Queensland and the Northern Territory combined, than would have been expected, if deaths from the disease occurred at the same rates as found in the total population [39].
Respiratory Disease
- Smoking significantly increases the risk of respiratory disease, including: chronic obstructive pulmonary disease (COPD), emphysema, pneumonia, and chronic bronchitis.
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- Respiratory diseases accounted for 8% of total Indigenous deaths in the period 1999-2001 [40].
- COPD was a major cause of respiratory deaths for Aboriginal and Torres Strait Islander peoples at rate of 3.4 %. This represents a rate of 3-4 times that of non-Indigenous people.
Pregancy
Women who smoke during pregnancy not only risk their own health, they also risk the health of their unborn child. Smoking during pregnancy significantly increases the risk of:
- ectopic pregnancy
- miscarriage
- placental complications
- premature labour and complications during delivery;
- a low birth-weight baby;
- stillbirths and early neonatal deaths (infants less than 7 days of age); a baby with poor lung function; and
- death from Sudden Infant Death Syndrome (SIDS).
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- Furthermore, women who smoke during pregnancy pass carbon monoxide and nicotine into the bloodstream of the foetus. As a result, the supply of oxygen to the foetus is decreased, accelerating its heart beat, and depriving it of nutrition.
- Exposure to second-hand smoke after birth also harms young children. The transmission of nicotine through breast milk increases an infant's risk of developing respiratory illnesses, such as bronchitis or pneumonia during the first year of life. Exposure to second-hand smoke in the atmosphere or passive smoking also increases an infant's risk of ear infections, and developing asthma.
- According to the Royal Australasian College of Physicians and the Royal Australian and New Zealand College of Psychiatrists (2005) exposure by infants to second-hand smoke increases the risk of SIDs by 1.5 to 2 times and all respiratory infections (bronchiolitis, pneumonia, ear infections, tonsillitis) by 1.5 to 4 times. This type of exposure also increase the overall rates of hospitalisation; invasive meningococcal disease, and septicaemia; increased severity of asthma; decreased cardio respiratory fitness and lung function, and deaths and burns through house fires. [41] Smoking during pregnancy and Indigenous women.
- In 2002, 58.0% of Aboriginal and Torres Strait Islander mothers reported smoking at some time during their pregnancy, compared to 15.3% of non-Indigenous mothers [42].
- In 2001, the rate of low birth weight among Indigenous babies for Australia was 12.9% and for non-Indigenous mothers was 6.5% [43].
- There is a lack of health promotion resources that specifically address the effect of cigarette smoking on pregnant Indigenous women. Ivers states in her report that interventions to assist pregnant women to quit were successful in decreasing smoking of cigarettes and increasing birth weight in non-Indigenous populations [44].
Other disease (diabetes etc)
- Nicotine can inhibit or block the release of insulin. Insulin enables cells to take up excess glucose from the bloodstream. As a result, nicotine can lead to hyperglycaemia in some smokers - elevated blood sugar levels. This may lead to a loss of appetite because the body and brain recognise the elevated blood sugar levels and respond by decreasing hormone levels.
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- Furthermore, smoking and diabetes increases the risk of heart disease threefold.
- People who are diabetic and smoke cigarettes increase the risk of eye problems that can lead to blindness. Diabetic retinopathy is a condition that occurs in diabetics who experience prolonged periods of elevated blood sugar levels. Elevated levels can destroy the blood vessels in the back of the eye, depriving the retina of sufficient nutrients to maintain vision.
Other conditions: reproductive problems, peptic ulcer, ulcerative colitis, fire injury.
