Indigenous women need more help to stop smoking

Indigenous women across four high income countries are not getting the help they need to stop smoking when pregnant.

A study published today in the international journal Nicotine & Tobacco Research found common large disparities between indigenous pregnant women's smoking rates and non-indigenous pregnant women in Australia, New Zealand, Canada and the United States of America.

"Tobacco smoking is the most significant reversible risk factor for the health of Indigenous pregnant women and their babies." Said study lead Associate Professor Gillian Gould of the School of Medicine and Public Health at The University of Newcastle, Australia who led the study. "In each of our countries and in Canada, Indigenous pregnant women have smoking rates that are twice to many times higher than the non-Indigenous women."

The prevalence of smoking while pregnant varied across states and countries, ranging from 18 percent to 83 percent for Inuit women. The inequity varied across countries also with Australian Aboriginal maternal smoking at 48 percent while non-Indigenous Australian women enjoyed a low 13 percent.

Co-author Associate Professor Marewa Glover from New Zealand's Massey University's School of Public Health said the study was looking for successful intervention ideas they could share.

"Despite our cultural differences, the Indigenous people in each country experience similar marginalisation and social disadvantage." She said. "This stems partly from the common way in which we were colonised by Western nation states."

"That colonisation process resulted in all of us receiving proportionately less of society's benefits, whether that's education, healthcare or employment. Our women are disproportionately exposed to environmental risks to health, discrimination and disproportionate incarceration. We are over-represented among the lower paid and unemployed and are more likely to live in deprived areas. The cumulative stress of all this is driving our higher smoking rates and undermining our women's ability to abstain from smoking, even when they are pregnant." Glover said.

Professor Christi Patten from Mayo Clinic's Department of Psychiatry and Psychology in Rochester, Minnesota, USA contributed information for Canada and the USA to the paper titled 'Smoking in pregnancy among indigenous women in high income countries.'

The researchers want more importance to be placed on supportive programmes for Indigenous pregnant women. They want to see the development and testing of Indigenous-led and culturally-based programmes, such as services that fund Indigenous elders and community health care providers to work with families. Existing stop smoking programmes also needed to improve their delivery to ensure they reach pregnant Indigenous women.

In reviewing the literature the researchers identified several evidence gaps, which they propose is partly due to the difficulty securing funding for trials that are focused on a relatively small sub-group. The team hopes that working across countries will improve their chances of gaining research funds in future to continue this important line of investigation.