TY - JOUR
T1 - Climatic and community sociodemographic factors associated with remote Indigenous Australian smoking rates
T2 - An ecological study of health audit data
AU - Carroll, Suzanne Jane
AU - Dale, Michael J
AU - Bailie, Ross
AU - Daniel, Mark
N1 - Funding Information:
This work was supported by the Australian Research Council [grant number DP120102482] and drew upon data collected as part of the One21seventy project. One21seventy is a continuous quality improvement (CQI) program developed as part of the ABCD National Research Partnership Project (both the ABCD National Research Partnership Project and the Centre for Research Excellence in Integrated Quality Improvement were funded by the National Health and Medical Research Council [GNT545267; GNT1078927, respectively] and the Lowitja Institute, and by financial and in-kind support from a range of Community Controlled and Government agencies). The Audit and Best Practice for Chronic Disease Extension (ABCDE) Project was supported by funding from the Cooperative Research Centre for Aboriginal Health and the Australian Commission on Safety and Quality in Health Care. The funding sources had no involvement with study design, data collection, analysis and interpretation of results, writing this manuscript or choice of journal.
Funding Information:
Funding This work was supported by the Australian Research Council [grant number DP120102482] and drew upon data collected as part of the One21seventy project. One21seventy is a continuous quality improvement (CQI) program developed as part of the ABCD National Research Partnership Project (both the ABCD National Research Partnership Project and the Centre for Research Excellence in Integrated Quality Improvement were funded by the National Health and Medical Research Council [GNT545267; GNT1078927, respectively] and the Lowitja Institute, and by financial and in-kind support from a range of Community Controlled and Government agencies). The Audit and Best Practice for Chronic Disease Extension (ABCDE) Project was supported by funding from the Cooperative Research Centre for Aboriginal Health and the Australian Commission on Safety and Quality in Health Care. The funding sources had no involvement with study design, data collection, analysis and interpretation of results, writing this manuscript or choice of journal.
Publisher Copyright:
© 2019 Author(s).
PY - 2019
Y1 - 2019
N2 - Australian Indigenous smoking rates are highest in remote communities but likely vary between communities; few studies have assessed community features in relation to Indigenous smoking rates. Design and objective: This ecological study evaluated the associations between smoking rates, and community sociodemographic and climatic characteristics for a large sample of remote Indigenous communities. Setting and sample: Records (n=2689) from an audit of community health centres in the Northern Territory and Queensland were used to estimate smoking rates dichotomised at the median for 70 predominantly Indigenous remote communities. Community characteristics were similarly dichotomised. Methods: Cross-tabulations were used to calculate the odds of a community classified as high for a sociodemographic or climatic factor also being high for smoking rate. Additional cross-tabulations, stratified by sociodemographic, region (coastal or central) and geographic connectivity levels, were performed to assess potential confounding. Results: Community smoking rates ranged from 25% to 96% (median 60.2%). Moderately strong relationships were observed between community smoking rate and population size (OR 6.25,(95% CI 2.18 to 17.95)), education level (OR 3.67 (1.35-10.01)), income (2.86 (11.07-7.67)) and heat (2.86 (1.07-7.67)). Conclusions: Smoking rates in Australian remote Indigenous communities are universally high. Smoking rates are associated with greater community-level socioeconomic status and size, most likely reflecting greater means of accessing tobacco with mass of smokers sufficient to sustain a normative influence. Severe heat was also associated with high smoking rates suggesting such a stressor might support smoking as a coping mechanism. Community sociodemographic and climatic factors bear consideration as context-level correlates of community smoking rates.
AB - Australian Indigenous smoking rates are highest in remote communities but likely vary between communities; few studies have assessed community features in relation to Indigenous smoking rates. Design and objective: This ecological study evaluated the associations between smoking rates, and community sociodemographic and climatic characteristics for a large sample of remote Indigenous communities. Setting and sample: Records (n=2689) from an audit of community health centres in the Northern Territory and Queensland were used to estimate smoking rates dichotomised at the median for 70 predominantly Indigenous remote communities. Community characteristics were similarly dichotomised. Methods: Cross-tabulations were used to calculate the odds of a community classified as high for a sociodemographic or climatic factor also being high for smoking rate. Additional cross-tabulations, stratified by sociodemographic, region (coastal or central) and geographic connectivity levels, were performed to assess potential confounding. Results: Community smoking rates ranged from 25% to 96% (median 60.2%). Moderately strong relationships were observed between community smoking rate and population size (OR 6.25,(95% CI 2.18 to 17.95)), education level (OR 3.67 (1.35-10.01)), income (2.86 (11.07-7.67)) and heat (2.86 (1.07-7.67)). Conclusions: Smoking rates in Australian remote Indigenous communities are universally high. Smoking rates are associated with greater community-level socioeconomic status and size, most likely reflecting greater means of accessing tobacco with mass of smokers sufficient to sustain a normative influence. Severe heat was also associated with high smoking rates suggesting such a stressor might support smoking as a coping mechanism. Community sociodemographic and climatic factors bear consideration as context-level correlates of community smoking rates.
KW - audit
KW - epidemiology
KW - public health
UR - http://www.scopus.com/inward/record.url?scp=85068867721&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/climatic-community-sociodemographic-factors-associated-remote-indigenous-australian-smoking-rates-ec
U2 - 10.1136/bmjopen-2019-032173
DO - 10.1136/bmjopen-2019-032173
M3 - Article
C2 - 31292187
SN - 2044-6055
VL - 9
SP - 1
EP - 10
JO - BMJ Open
JF - BMJ Open
IS - 7
M1 - e032173
ER -