Grant: Travel Awards - Institute Community Support

There are more than 300 million Indigenous people across 70 countries worldwide. Despite significant differences in the circumstances of Indigenous people globally, many themes and issues including persistent inequity in health are shared. The Indigenous experience of colonisation, marginalisation, family dislocation, racism, disconnection from land, loss of traditional diet and lifestyle, and the shift to Western habits and practices is central to patterns of poor health. One commonality among Indigenous populations is the disproportionate burden of non-traditional tobacco related morbidity and mortality when compared to their non-Indigenous counterparts. Furthermore, in many countries including Australia, Canada, New Zealand and the United States of America (USA), the rate of tobacco use among the respective Indigenous peoples are significantly higher than their non-Indigenous counterparts. This research outlines the findings from a realist review to help understand Indigenous tobacco control. This research examined 73 commercial tobacco control interventions in Indigenous communities globally, as well as theory testing in three Indigenous exemplar communities to explore what makes an Indigenous tobacco control program successful. Interventions incorporated numerous tobacco control activities to prevent (n=30), reduce (n=23) and/or cease (n=42) tobacco use; limit physical and social exposure (n=9); and limit access and availability to tobacco (n=2). Interventions were located in Indigenous communities in the USA, Australia, Canada, New Zealand, Fiji, and Taiwan. A number of identified tobacco control mechanisms-the underlying processes that link program activities to specific program outcomes within the Indigenous context-assisted to lead to program success. This included examining and unpacking the evidence of Indigenous community investment-ownership-activation in Indigenous tobacco control.