What works in Indigenous tobacco control? The perceptions of remote Indigenous community members and health staff

Issues addressed: To explore the perceptions of remote Indigenous community members and health staff regarding the acceptability and effectiveness of different tobacco control health promotion interventions. Methods: Qualitative methods were used for this exploratory study, including interviews with remote Indigenous community members and health staff, as well as observations of the delivery of different tobacco control activities in three remote communities in the Northern Territory (NT). Results: Several tobacco control interventions for which there is strong evidence in other settings were generally perceived as acceptable and efficacious in the remote Indigenous setting. Primary care interventions, such as brief advice and pharmaceutical quitting aids, when available and accessible, were perceived as important and effective strategies to help people quit, as were the promotion of smokefree areas. By contrast unmodified Quit programs were perceived to have questionable application in this context and there were conflicting findings regarding taxation increases on tobacco and social marketing campaigns. Conclusions: Several evidence-based 'mainstream' activities are perceived to be acceptable to this population, but we may also need to address the concerns raised by health staff and community members about the acceptability of some unmodified activities. Additionally, organisational barriers within the health system may be contributing to the reduced effectiveness of tobacco control in this setting.