Background: Despite Australia’s success in reducing total population smoking prevalence, the prevalence among Aboriginal and Torres Strait Islander (Aboriginal) people remains high. A comprehensive framework to guide and monitor Aboriginal tobacco control efforts is needed to assist with ‘‘Closing the Gap’’ in health.
Aim: We describe the process used to identify, review and synthesise existing frameworks relevant for Aboriginal tobacco control and present our recommendations for a Comprehensive Approach to Aboriginal tobacco control (CATs) framework.
Method: Relevant tobacco control and Aboriginal health frameworks were identified through online searching, contacting tobacco control and Aboriginal health experts, and searching reference lists. Two researchers screened frameworks to assess whether they met criteria (published >2005) and assessed the degree of relevance (‘moderate to high’ included). Data extraction included: entity that developed the framework and the purpose, development process, description of any evidence-base or validation processes, framework indicators or measures, strengths and limitations, and an outline of framework domains. All framework domains were discussed with key stakeholders to reach consensus on a comprehensive set of domains relevant for comprehensive tobacco control according to national and international standards, the best fit for working with Aboriginal people, and whether any adaptation was required.
Results: Forty-four relevant frameworks were identified; 26 were assessed as high or moderate relevance and included in the review. Integrating the ‘vision, principles and priorities’ of the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP) with the ‘key priority areas’ of the National Tobacco Strategy (NTS) was assessed as providing the most comprehensive coverage of relevant framework domains. This infuses the important aspects (identified through extensive community consultation) of developing and implementing programs with Aboriginal people, and a comprehensive range of tobacco control strategies aligned closely with the World Health Organisation Framework Convention on Tobacco Control.
Conclusions: Combining the NATSIHP vision, principles and priorities with the NTS key priority areas provides a framework to guide a comprehensive approach to Aboriginal and Torres Strait Islander tobacco control (CATs) over the medium to long term. We will use this framework to review evidence and current strategies to reduce tobacco-related harm among Aboriginal people.