1. Encouraging cessation intervention to become routine practice for people working with Aboriginal and Torres Strait Islander clients Toni Mason Aboriginal Tobacco Control Project Coordinator

2. Background on smoking rates and related health effects 52% of Victorian Aboriginal people are daily smokers which is the highest in the country (ABS, 2004) 18.5% of adult Victorians smoke (Germain et al, 2006) 62% of deaths within the Indigenous population before the age of 65 years can be attributed to heart, stroke and vascular diseases (AIHW, 2004) 10% of deaths within the non-Indigenous population before the age of 65 years can be attributed to heart, stroke and vascular diseases (AIHW, 2004)

3. Working to increase cessation in the Aboriginal community Aboriginal Health Worker training tailored resources

4. The important role of health professionals and Aboriginal health and community workers highly respected within the community respected source of information and support providing information and support around stopping smoking is the same as providing information and support for all health matter’s (duty of care) patients are likely to accept advice on changing their smoking habits from an acknowledged health expert on health problems (Slama et al, 1989) this advice encourages people to try to quit

5. Smoking cessation interventions are successful opportunities to give brief advice/extended support brief advice results in 2.5% more smokers quitting (Lancaster & Stead, 2004) individual counselling and group therapy increase the chances of quitting nicotine replacement therapy increases the chance of quitting by 1.5 to 2 times (Lancaster, Stead, Silagy & Snowden, 2000) nicotine replacement therapy combined with counselling has an additive effect

6. Challenges to addressing smoking cessation for health professionals their own smoking status lack of time and competing priorities reluctance due to concerns about upsetting patients confidence – don’t know what to say or whether it will make a difference motivating patients

7. Challenges to addressing smoking cessation for health professionals lack of smoking cessation knowledge lack of resources lack of knowledge about Quit services engaging with clients using cigarettes

8. Quit Victoria’s Aboriginal Health Worker training covers: Setting the scene Understanding smoking behaviour The health effects of smoking Helping clients change – overview of motivational interviewing Helping smokers to quit using the 5As framework Smokefree homes and environments Quit services

9. The 5As Ask patients about their smoking at every contact Assess patients’ willingness and confidence to quit (or to stay quit) Advise patients to quit (or to stay quit) based on health effects of smoking and the benefits of quitting Assist patients with quitting dependent on where they are at with their smoking Arrange for follow up / Ask again at the next visit/contact The model enables very brief or more extended assistance. (US Public Health Service Report, A clinical practice guideline for treating tobacco use and dependence, 2000)

10. Aboriginal training 2006–2007

11. Evaluation results from the training Each training session is evaluated and participants encouraged to complete to ensure that we are meeting the needs and expectations of the community –‘Interesting and easy to follow and easy to understand the damage that smoking can do and how to support potential quitters’ –‘Stating “here to help not criticise” need all the help we can get. Thank you.’ –‘All of it was new to me, a real eye opener’ –‘Very interesting and clear presentation about Quit and the resources’

12. Tailored resources for the Indigenous community created resources that complement Quit courses practice scenario activities with Aboriginal health workers these resources can be used within their consultations with clients

13. Tailored resources

15. For further information Toni Mason Aboriginal Tobacco Control Project Coordinator Quit Victoria Ph: (03) 9635 5524 Toni.Mason@cancervic.org.au