Tobacco and nicotine population health planning for Aboriginal and Torres Strait Islander population growth.

Aboriginal and Torres Strait Islander population growth has important implications for tobacco and nicotine health planning. Using the Australian Bureau of Statistics (ABS) DataLab, we examined weighted estimates of the absolute number of Aboriginal and Torres Strait Islander peoples aged 18 years and over, drawing on the 2012-13 and 2018-19 National Aboriginal and Torres Strait Islander Health Surveys. We compared the absolute number of people who currently smoke, stratified by age, state/territory, and sex. There was a 2.5 percentage point decline in smoking prevalence over this period, but the estimated number of Aboriginal and Torres Strait Islander adults who smoke increased by ∼43 000, reaching 211 000 (95% confidence interval: 199 746-221 616) in 2018. This growth is largely attributable to population increases driven by higher birth rates. Absolute increases in both the number of people who smoked and those who did not smoke varied by age group, jurisdiction, and geography, with the largest increases observed among those aged 55-64 years and in areas experiencing the most rapid population growth. These findings highlight the need for programs, policies, and health services-including tobacco and nicotine resistance measures-to be adequately resourced and responsive to changing Aboriginal and Torres Strait Islander population dynamics. While progress is being made in reducing smoking prevalence, the expanding population means that the total number of people impacted by commerical tobacco remains high. This highlights the need for sustained future-focused planning and investment to eradicate tobacco-related death and disease.