Evaluation of a community-based tobacco control intervention in five remote north Queensland Indigenous communities

This study aimed to assess the impact of a complex community-based tobacco control program in eight remote north Queensland Indigenous communities with high rates of tobacco use. A community-based tobacco intervention trial was conducted over one year in five intervention sites and three control sites in far north Queensland with predominantly Aboriginal and Torres Strait Islander populations. The intervention was composed of six components: a school-based education program Smokin No Way, SmokeCheck tobacco brief intervention training for health workers, assistance to develop workplace smoke-free policies, an Event Support Program, Smoke Rings support group and enforcement of tobacco sales legislation. Household surveys of self-reported tobacco use were conducted at baseline and one year after the interventions, along with interviews with key individuals and organisations, to assess intervention implementation. It was found that there was a modest effect on self-reported daily tobacco use and mean number of cigarettes smoked weekly after 12 months in intervention communities. There were non-significant declines in self-reported smoking and mean cigarettes smoked per week in aggregated control communities. Independent evaluation of fidelity of implementation found major shortcomings in actual program delivery. To enhance success of future interventions, fidelity of implementation should be ensured and a longer implementation period utilised.