RACGP - Blow Away The Smokes: Tobacco and indigenous health

While most of us hold the stereotype of a researcher as being a hard-nosed, data obsessed number cruncher, GP Associate Professor Gould has a different take. She sees an important role for storytelling, and it’s one that has proven vital in her work on smoking amongst Aboriginal and Torres Strait Islander peoples. In fact the arts, not medicine, were her first love:

‘I always had this very strong leaning towards the arts and drama,’ she says ‘so I had about four years where ... my main focus was in the performing arts.’

Although finally settling on a career in medicine, Associate Professor Gould was able to merge the two as she focussed on her work as a tobacco treatment specialist working within Aboriginal and Torres Strait Islander communities. She saw the importance of using the communities’ own stories about their attitudes towards smoking as a precursor to change.

Aboriginal and Torres Strait Islanders have the worst health outcomes of any group in Australia, experiencing a 17 year lower life expectancy compared with other Australians – and smoking is a significant cause of Aboriginal and Torres Strait Islander increased morbidity and mortality. Although smoking rates have decreased in the general population, its prevalence remains stubbornly high within this community.

In 2008, Associate Professor Gould received her first RACGP Foundation grant. She used it to evaluate the success of a community Quit program in Coffs Harbour. That research led to a series of further grants used to create a new program called No Smokes North Coast, and the development of a DVD resource named Blow Away The Smokes. In 2013 Associate Professor Gould undertook a RACGP Foundation funded project to understand the attitudes of Aboriginal and Torres Strait Islander people towards the risks of smoking, and their intentions toward quitting. Twelve months later a further RACGP Foundation grant was used to research attitudes to smoking and quitting amongst pregnant Aboriginal women.

From her experience working to change behaviour within these communities Associate Professor Gould says understanding the cultural differences is important:

‘There are no generalisations to make because people come from different tribal groups and Australia is a huge country. If you’re going to be involved with [Aboriginal and Torres Strait Islander] research, it is important to build up your cultural awareness ... [have] cultural mentors and preferably work in a more participatory model with communities. You need to do a lot of community engagement.’

In an era where ‘closing the gap’ has become shorthand for improving life expectancy, education and employment opportunities for Aboriginal and Torres Strait Islander communities, Professor Gould’s research is playing an important part. The key, she says, is in developing a deeper understanding of the factors at play – and seeing the research as a partnership with the community in which it takes place.

‘How is it going to benefit the community? How are you going to reciprocate? You’re thinking about how their cultural values and spiritual values need to be upheld,’ she says. ‘And when you report on those things, you need to understand in tandem with Aboriginal researcher methodology, so you’re not just reporting the negatives all the time, because it gets quite depressing. There are positives. One needs to understand how to be truthful in your reporting, but find out the more positive side of it as well.’

Sources:

All quotes taken from the article ‘Laying a foundation’ Good Practice April 2014 issue 4 written by Foundation staff.

Acknowledgements:

RACGP Foundation Indigenous Health Award 2008

RACGP Foundation Indigenous Health Award 2013

RACGP Family Medical Care Education and Research (FMCER) 2014

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We're always looking for partners who want to create a healthier Australia. To find out more about the RACGP Foundation's work, or how you can partner with us to create a healthier Australia, visit www.racgp.org.au/foundation/foundation

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