E-poster Presentation 2014 World Cancer Congress

Should threat messages be avoided for Aboriginal Australian smokers? Findings from a cross-sectional survey in regional NSW to validate the Risk Behaviour Diagnosis scales (#673)

Gillian S. Gould 1 , Kerrianne Watt 2 , Andy McEwen 3 , Yvonne Cadet-James 4 , Alan R. Clough 5
  1. School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia
  2. School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia
  3. Health Behaviour Research Centre, University College London, London, United Kingdom
  4. School of Indigenous Australian Studies , James Cook University, Townsville, Queensland, Australia
  5. Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia


Smoking rates in Aboriginal Australians are gradually reducing in some age groups, but not for people in the peak reproductive years.1 Smoking cessation is vital for cancer prevention.2 Many regional programs avoid the use of threat messages when targeting Australian Aboriginal smokers.3


To assess, for the first time, the responses of Aboriginal smokers, 18-45 years, to Risk Behaviour Diagnosis scales (RBD)4 and intentions to quit smoking, including gender differences.


We interviewed 121 Aboriginal smokers, using a structured questionnaire including adapted RBD scales. The RBD measured perceived threat (susceptibility and severity of threat) and perceived efficacy (self-efficacy and response efficacy) on Likert scales. Intentions to quit were assessed. Scales were recoded into high-low responses. Face validity was assessed via an Aboriginal panel, and scales assessed for reliability. Chi-square tests investigated the associations between intention to quit, efficacy/threat and gender.


Among men, intention to quit was associated with perceived efficacy (X2=15.23;df=1;p<0.0001), but not with perceived threat. For women, intention to quit was neither associated with efficacy nor threat. Both genders were more likely to have high intention to quit, with high efficacy and high threat (n=54;45%:maleX2=12.6;df=1;p<0.001:femaleX2=5.6;df=1;p<0.05). There was no difference in intention to quit with low efficacy-high threat for either gender (n=39;32%). In contrast, all of the men with low threat-high efficacy (n=5;4%) intended to quit, whereas all of the women with low threat-low efficacy (n=6;5%)  intended to quit.


High-perceived threat was associated with high intention to quit smoking only when perceived efficacy was  high. Gender differences may be a consideration. The RBD scales could be used to tailor messages to the level of efficacy and threat in clinical consultations, and in regional programs. All Aboriginal Australian smokers may benefit from increased efficacy to quit smoking.

  1. Australian Bureau of Statistics. (2013) 4727.0.55.001 - Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13
  2. Davidson, PM, Jiwa, M, Digiacomo, ML, McGrath, SJ, Newton, PJ, Durey, AJ, et al. (2013). The experience of lung cancer in Aboriginal and Torres Strait Islander peoples and what it means for policy, service planning and delivery. Aust Health Rev, 37(1), 70-78.
  3. Gould, GS, Watt, K, Stevenson, L, McEwen, A, Cadet-James, Y, & Clough, AR. (2014). Developing anti-tobacco messages for Australian Aboriginal and Torres Strait Islander peoples: evidence from a national cross-sectional survey. BMC Public Health, 14(1), 250.
  4. Witte, K, Cameron, KA, McKeon, JK, & Berkowitz, JM. (1996). Predicting Risk Behaviors: Development and Validation of a Diagnostic Scale. J Health Commun, 1, 317-341. doi: 10.1080/108107396127988