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CAMH Stories Centre for Addiction
and Mental Health

Keeping it sacred: research tackles commercial tobacco impact in Aboriginal communities

TORONTO, November 30, 2016 - For some Aboriginal communities in Canada facing the challenges of unemployment, housing shortages, and physical and mental health crises, the impact of cigarette smoking may not immediately rank high on their priority lists. Yet tobacco smoking rates and related health effects in Aboriginal communities remain disturbingly high.

“While smoking of tobacco among Canadians has declined to about 18 per cent, rates in First Nations, Inuit and Métis communities are estimated to be 35 to 60 per cent,” notes Dr. Robert Schwartz, CAMH Senior Scientist in the Institute for Mental Health Policy Research, and Director of the Ontario Tobacco Research Unit (OTRU). “Commercial tobacco smoking combined with other health challenges contributes to serious diseases such as lung cancer and can take many years off the life of a smoker.”

Robert is co-leading a new study that aims to identify solutions to the impact of commercial tobacco. Key partners include research co-lead and OTRU Scientist Dr. Michael Chaiton, colleagues at UofT’s Waakebiness-Bryce Institute for Indigenous Health and at Cancer Care Ontario and 13 Aboriginal communities across Ontario.

Community driven research
Community-driven research
: Christine Lund (Project Coordinator and RETRAC Peer Researcher, at right) and Jason LeBlanc (Executive Director) of Tungasuvvingat Inuit. The national organization serves as a “home base” for Inuit peoples, offering front-line social and culture programs. Christine and Jason contributed to the RETRAC Knowledge Exchange Advisory Committee (KEAC) meeting in spring 2016.

The $1.7-million RETRAC2 study was funded this fall by the Global Alliance for Chronic Diseases, in which the Canadian Institutes of Health Research is a partner. It’s one of 13 global research projects focusing on the prevention and management of chronic lung diseases.

Closing the gap on health harms

The RETRAC2 study aims to help “close the gap” on tobacco health harms between Aboriginal communities and the Canadian population by:

  • identifying effective initiatives to reduce commercial tobacco consumption
  • sharing those strategies and knowledge
  • implementing a range of strategies at the community level.

Researchers are careful to separate Aboriginal traditions of sacred tobacco used in ceremonies with the consumption of commercial tobacco – a distinction that can be blurred. “For example, there is a tradition of gifting sacred tobacco, but in some communities we see gifting of commercial tobacco,” Robert notes. But with recent local efforts, “communities are reclaiming the traditions and knowledge around sacred tobacco, and separating those traditions from commercial tobacco.”

The study employs a community-driven approach with community peer researchers working in each of the 13 Aboriginal communities, supported by researchers at OTRU, W-B Institute and the Dalla Lana School of Public Health, University of Toronto. They are developing baseline knowledge on:

  • who uses commercial tobacco
  • attitudes towards it and preparedness to address it
  • interventions that have been tried previously
  • what interventions may be accepted and effective going forward.

Community-driven research

“The communities are researching themselves using an open methodology that may involve talking circles, focus groups, interviews with elders, and surveys,” notes Robert.  “We can synthesize that knowledge for communities to use going forward.”

“Indigenous people want to actively participate in research that improves their communities,” said [UofT] Assistant Professor Earl Nowgesic, Interim Director of the W-B Institute for Indigenous Health and RETRAC2 co-researcher. The study design supports that principle, he says.

The study builds on previous research funded by the Ontario Ministry of Health and Long-term care that looked at tobacco use in seven Aboriginal communities. RETRAC2 continues work in these areas, has added six new communities to this effort, and will create a model for sustainable commercial tobacco reduction.

Dr. Robert Schwartz
Dr. Robert Schwartz

The experience of champion or “Exemplar” communities also informs the research, along with a global knowledge synthesis of effective tobacco reduction strategies in Aboriginal communities.

The White Earth Nation community in Minnesota introduced a “keep it sacred’ campaign to “decolonize knowledge around ceremonial tobacco” and maintain old traditions not involving commercial tobacco. The community also introduced education on first-hand, second-hand and third-hand smoke (third-hand smoke may include physical exposure to tobacco on surfaces such as carpets or car seats for example).

The global knowledge synthesis found some improvements in smoke-free spaces such as cars and houses following local interventions such as the Murray Places Smoke-Free spaces initiative in an Australian Aboriginal community. Eight in 31 studies found that people reported less smoking after participating in a local program.

Creating smoke-free spaces

At the general population level, “Canada has been able to introduce many polices to significantly reduce commercial tobacco consumption over the years,” notes Robert. These include policies on smoke-free spaces, education, advertising and taxation. “We are hoping to see a similar positive effect in Aboriginal communities based on interventions coming out of RETRAC2.”

Robert, Michael and Earl are working with Assistant Professor and W-B Institute Associate Director Anita Benoit, and Alethea Keewayosh, Director of the Aboriginal Cancer Care Control Unit at Cancer Care Ontario.

“We’re excited to partner with our new communities to reduce harms from commercial tobacco,” says Robert. “They will also benefit from a rich base of knowledge and teamwork developed by Aboriginal communities in the first phase of this project.”

Learn more about RETRAC2 here -- meet a community Peer Researcher and learn about their RETRAC experience; learn about a Māori smoking reduction/cessation program that was identified in RETRAC’s knowledge synthesis; and speak with two guest Indigenous health researchers about their experiences working to improve Indigenous health and address commercial tobacco use in Australia.

 

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