1. Tobacco control and closing the gap Tom Calma, Aboriginal and Torres Strait Islander Social Justice Commissioner and Chair of the Close the Gap Steering Committee for Indigenous Health Equality Oceania Tobacco Control 09 Conference 7 October 2009

2. Main Campaign elements Partnership between Indigenous peoples/ Aust govts. National plan for health equality by 2030 Ambitious targets and benchmarks

3. Indigenous people more than 1.5 times more likely to die of lung cancer than non-Indigenous Australians. Higher rates recorded in some communities. Overall, death rates from respiratory diseases, approx 4 times higher than non-Indigenous Australians. Heart disease – approx 3 times higher than non- Indigenous Australians. Health impacts of smoking

4. Smoking rates – rapid declines needed in Indigenous population Smoking related death and illness is 100% preventable. Non-Indigenous population, rates as high as 75% in 1945. Today – 18%, due to education and challenge to norms around smoking. Indigenous smoking 50% overall, 80% in some communities. Dramatic and rapid reductions required to catch up.

5. How did we get here? Smoking tobacco is a colonial legacy with no cultural foundation Failure of reach of health promotion and education Symptomatic of deeper social and cultural problems Failure of Indigenous community to face up to and own the extent of the problem – failure of leadership

6. Challenging norms around smoking Awareness raising – education vital Norms changing – role of Indigenous leadership, including community leaders, health workers and parents is vital

7. Role of government Health promotion and education Limiting advertising and tobacco promotion Restricting tobacco usage in pubs and clubs Supporting communities to limit sales (along the lines of alcohol restrictions)

8. Health services No smoking messages across the board (PHC, hospital) Focus on mothers Staff -- Leadership by example NRT – Medicare subsidy Quit lines, support groups

9. Calls National strategy aimed at rapid reductions in the rates of smoking among Indigenous Australians, to support the broader goal of Indigenous life expectation and health status equality by 2030. A commitment from Indigenous leaders and adults to set the example for our kids and to ensure a no-smoking norm for Indigenous Australia

10. Further information www.hreoc.gov.au/social_justice/health/index.html