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Among all the talk this week about a – the most significant in a decade – has been the roll-out of another major document.

The was launched this week.

A key priority of the strategy is Aboriginal and Torres Strait Islander smoking and . We heard the Tackling Indigenous Smoking program would be extended and widened – – to reduce both vaping and smoking among Aboriginal and Torres Strait Islander people.

Here’s why that’s urgently needed and what needs to happen next to reduce smoking rates among Aboriginal and Torres Strait Islander people.

Tobacco is still a killer

Tobacco over 57 Australians a day. That’s equivalent to extinguishing an entire country town of 21,000 every year.

It’s still the single biggest risk factor for disease and premature death. For Aboriginal and Torres Strait Islander , of all deaths are caused by tobacco. Over the past decade we have lost more than Aboriginal and Torres Strait Islander lives due to smoking.

beyond health – from poverty, education, employment, housing, family removals, dislocation and the systematic embedding of tobacco as rations in lieu of wages – mean Aboriginal and Torres Strait Islander people are disproportionately impacted by the harms of Big Tobacco.

So the to expand the is urgently needed to have no more than 27% of Aboriginal and Torres Strait Islander smoking by 2030 (5% of all Australians).

There have been huge achievements in reducing Aboriginal and Torres Strait Islander smoking. In , 40% of Aboriginal and Torres Strait Islander adults smoked daily, down from 50% in 2004-05. A target of 27% is achievable. But to get there we need something “extra” to accelerate those reductions.

We know what works

Tobacco campaigns are one of the most cost-effective interventions when evidence-based, market-tested, sustained and with support services at the end of the call to action. When they are adequately funded, they can impact inequities.

Campaigns must be personally relevant and meaningful . This makes the case for targeted approaches, including local level campaigns, reinforced by general, national activity. Audiences engage with the message when they can see themselves and their community members (sometimes actually) in the advertising.

We saw this nationally with starring Aboriginal actor and comedian Elaine Crombie. Originally this was a targeted campaign for Aboriginal and Torres Strait Islander people. But it then aired nationally targeting all Australians in 2014.

was launched in 2016, as part of the Tackling Indigenous Smoking program. This was created by Indigenous agency Carbon Media, starring musician alongside real stories .

One of the and innovative Aboriginal and Torres Strait Islander tobacco campaigns, it included a for Aboriginal and Torres Strait Islander communities to use and adapt the national campaign to their .

An excellent example of this is from the with its local campaign .

When Aboriginal and Torres Strait Islander people lead and promote smoke-free behaviours, communities are .

What works? Product, price, place and promotion

Social marketing campaigns, like the ones we’ve mentioned, really work well when they take on the of product, price, place and promotion.

The beautifully produced ads, the “promotion”, can’t have impact on their own. This is where the rest of the ³Ô¹ÏÍøÕ¾ Tobacco Strategy comes in.

1. Product

We’ve reduced product appeal with and graphic health warnings. This will be enhanced with new warnings, including on the sticks themselves, plus greater uniformity of standardised packaging and tightened rules around additives and flavours that make smoking palatable.

2. Price

Price increases and we’ll see a tax increase of 5% each year for three years across all different tobacco product types.

3. Place

We have known about the harms of commercial tobacco since at least 1950. Yet we still expect individuals to give up nicotine instead of removing this lethal product from sale at pretty much every supermarket, service station and convenience store.

The ³Ô¹ÏÍøÕ¾ Tobacco Strategy is considering a national licensing scheme, removing online sales and delivery services, and potential for reducing the number, type and location of tobacco outlets.

There will also be more action on smoke-free areas and making sure all health professionals (particularly in remote places) are equipped to support quit attempts.

The strategy states it will explore raising the age you can buy cigarettes and monitor how this works overseas.

4. Promotion

The commitment to close any last promotional loopholes for tobacco and e-cigarettes, particularly online is also important, along with local and national anti-smoking campaigns. But we know these are not enough on their own.

What we also need

Addressing all four Ps is what comprehensive tobacco social marketing would look like. It’s what’s required to accelerate the declines to get to the 27% target for Aboriginal and Torres Strait Islander peoples, and 5% nationally.

Targeted approaches are critical and can be effective, but they need to be supported by bigger, whole of population structural changes. The community-led campaigns, supported by national activity, will reinforce and amplify the policy changes that will come through on the tobacco product, its cost and its availability.

That’s how we realise our goals and ultimately eliminate tobacco related disease and death.

Christina Heris receives funding from the NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (NHMRC GNT1198301), and the Australian Government Department of Health and Aged Care for the Tackling Indigenous Smoking – Regional Grants Impact and Outcomes Assessment.

Lisa J Whop receives funding from the ³Ô¹ÏÍøÕ¾ Health and Medical Research Council and the Australian Research Council. She is also a member and incoming chair of Cancer Australia’s Leadership Group on Aboriginal and Torres Strait Islander Cancer Control.

Michelle Kennedy receives funding from the ³Ô¹ÏÍøÕ¾ Health and Medical Research Council, Medical Research Future Fund and the ³Ô¹ÏÍøÕ¾ Heart Foundation.

Raglan Maddox receives funding from from the NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (NHMRC GNT1198301), and the Australian Government Department of Health and Aged Care for the Tackling Indigenous Smoking – Regional Grants Impact and Outcomes Assessment.

Raymond Lovett receives funding from the NHMRC.

Tom Calma is the ³Ô¹ÏÍøÕ¾ Coordinator, Tackling Indigenous Smoking (TIS). This position is a consultancy to the Commonwealth Department of Health and Aged Care.