Objectives: To describe smoking intensity among Indigenous Australians and any changes that occurred between 1994 and 2008.
Design, setting and participants: Analysis of data from two national cross-sectional household surveys conducted among Aboriginal and Torres Strait Islander people — the 1994 National Aboriginal and Torres Strait Islander Survey, and the 2008 National Aboriginal and Torres Strait Islander Social Survey, with 8565 and 7803 respondents aged 15 years and over, respectively.
Main outcome measure: Self-reported number of cigarettes per day (CPD) smoked.
Results: In 2008, the mean number of CPD smoked by Indigenous smokers was 14.8 (95% CI, 14.1–15.4 CPD). The age-standardised proportion of Indigenous people who smoked more than 20 CPD declined from 17.3% in 1994 (95% CI, 15.8%–18.7%) to 9.4% in 2008 (95% CI, 8.4%–10.5%), a 45% relative reduction. The proportion of respondents who smoked 1–10 CPD increased from 16.8% (95% CI, 15.1%–18.5%) to 21.6% (95% CI, 20.1%–23.2%).
Conclusions: Together with reports of the decreasing prevalence of smoking among Indigenous people, this first report of a significant reduction in heavy smoking by Indigenous smokers is good news. Reducing smoking intensity and prevalence will lead to fewer deaths and less illness due to smoking. Reducing the number of heavy smokers will also assist smoking cessation among Indigenous people. These changes in smoking intensity occurred before the recent increase in attention to and investment in tobacco control in Indigenous communities, but at a time of significant mainstream anti-tobacco public health activity. Similar trends in smoking intensity have been reported in the total Australian population.