The social determinants of being an Indigenous non-smoker.

OBJECTIVE: To examine the association between various social factors and being a non-smoker in a national survey of Aboriginal and Torres Strait Islander people aged 15 and over. METHODS: We analysed data from the 2002 National Aboriginal and Torres Strait Islander Social Survey (n=9,400) using logistic regression. RESULTS: About a half (51.2%) of the Aboriginal and Torres Strait Islander population aged 15 years and over smoked, 33.4% had never smoked, and 15.4% were ex-smokers. Higher socio-economic position (as measured by each of nine variables) was strongly associated with being a non-smoker rather than a smoker, after controlling for age and gender. There was a clear income gradient: increasing household income was associated with increasing likelihood of being a non-smoker. Indigenous people who had been arrested in the last five years were 4.5 times less likely to be non-smokers, adjusted for age and gender. Indigenous people who had been removed from their natural family were half as likely to be a non-smoker. CONCLUSIONS: Different groups within the Indigenous population have quite different smoking behaviours, although the prevalence of smoking is very high in all groups. The poorest and most socially disadvantaged are the least likely to be non-smokers. IMPLICATIONS: Indigenous tobacco control programs need to consider additional targeting of more disadvantaged groups. Tobacco control programs should work with broader campaigns to ameliorate social disadvantage among Indigenous peoples.