Longitudinal Study of Indigenous Children: adolescent never smoking and associations with individual, social, and environmental factors.

Fuelled by the tobacco industry, commercial tobacco use is a major cause of preventable morbidity and mortality among Aboriginal and Torres Strait Islander peoples. Preventing adolescent smoking initiation is critical to reducing uptake. Understanding individual, social, and environmental factors that are protective against smoking can inform prevention strategies. We analysed data from adolescents 12-15 years and their caregivers from Wave 11 (2018) of the Longitudinal Study of Indigenous Children (LSIC). Poisson regression was used to calculate adjusted prevalence ratios (PR) of never smoking in relation to individual, social, and environmental factors adjusted for age and remoteness. Never smoking was reported by 81.3% of adolescents. Half (51.3%) of those who had ever-smoked had smoked in the last year. Never smoking was significantly associated with peer never smoking, no substance use (including e-cigarettes), positive family and school environments, no boredom, no trouble with police, and no family experiences of racism. Never smoking prevalence was twofold among adolescents who had never (versus ever) tried e-cigarettes (PR = 2.10; 95%CI: 1.41, 3.14). Fostering positive social relationships, discouraging substance use, and eliminating racism and discrimination are important in preventing adolescent smoking, offering some protection against the exploitative practices of the tobacco industry. Culturally safe structural supports and comprehensive approaches to individual, social, and environmental wellbeing are required to prevent smoking and promote wellbeing.