Knowledge and views about maternal tobacco smoking and barriers for cessation in Aboriginal and Torres Strait Islanders: a systematic review and meta-ethnography
Gould, Gillian S., Munn, Joanne, Watters, Tracey, McEwen, Andy, and Clough, Alan R. (2013) Knowledge and views about maternal tobacco smoking and barriers for cessation in Aboriginal and Torres Strait Islanders: a systematic review and meta-ethnography. Nicotine & Tobacco Research, 15 (5). pp. 863-874.
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View at Publisher Website: http://dx.doi.org/10.1093/ntr/nts211
Introduction: Maternal smoking rates in Australian Aboriginal women are triple that of the general population, with little evidence for successful interventions. We reviewed the literature to understand smoking and cessation in Aboriginal and Torres Strait Islander women and provide recommendations for targeted interventions.
Methods: Six databases were searched using terms related to smoking, pregnancy, and Aboriginal Australians. Two reviewers independently assessed papers for inclusion and quality. Meta-ethnography synthesized first- and second-order constructs from included studies and constructed a line of argument.
Results: Seven relevant studies were analyzed. The synthesis illustrates 11 third-order constructs operating on the levels of self, family, and social networks, the wider Aboriginal community, and broader external influences. Highlighted are social norms and stressors within the Aboriginal community perpetuating tobacco use; insufficient knowledge of smoking harms; inadequate saliency of antismoking messages; and lack of awareness and use of pharmacotherapy. Indigenous Health Workers have a challenging role, not yet fulfilling its potential. Pregnancy is an opportunity to encourage positive change where a sense of a "protector role" is expressed.
Conclusions: This review gives strength to evidence from individual studies across diverse Indigenous cultures. Pregnant Aboriginal and Torres Strait Islander smokers require comprehensive approaches, which consider the environmental context, increase knowledge of smoking harms and cessation methods, and provide culturally targeted support. Long term, broad strategies should de-normalize smoking in Aboriginal and Torres Strait Islander communities. Further research needs to examine causes of resistance to antitobacco messages, clarify contributing roles of stress and depression, and attitudes to pharmacotherapy.
|Item Type:||Article (Refereed Research - C1)|
|Keywords:||Indigenous populations;tobacco smoking; maternal smoking; systematic review; meta-ethnography; qualitative research|
|FoR Codes:||11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 100%|
|SEO Codes:||92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 50%|
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health @ 25%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920414 Substance Abuse @ 25%
|Projects:||No Smokes North Coast, Indigenous Tobacco Control Initiative|
|Funders:||Australian Government Department of Heath and Ageing, NHMRC and National Heart Foundation|
|Deposited On:||22 Oct 2012 15:50|
|Last Modified:||11 Oct 2013 04:32|
Last 12 Months: 7
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