Abstracts of theses and treatises
Blignault I (1995) Aborigines who abstain from alcohol. Unpublished Doctor of Philosophy thesis, University of Western Australia, Perth, Western Australia.
In separate studies, samples of Aboriginal males and females aged 15 years and over were recruited from patients attending the Aboriginal Medical Services in Perth and Carnarvon, Western Australia. Data were examined for differences and similarities between lifetime abstainers, former drinkers (abstinent for one year or longer), and hazardous or harmful drinkers. Interpretation of the statistical analyses was supported by qualitative data, and qualitiative analytic methods were used to illuminate the process of cessation of drinking.
Rates of abstinence and drinking cessation were higher than in the general population. Significant predictors of abstinence included sex, source of income, tobacco use, psychological distress, walking as recreation, accommodation, and spouse's alcohol use in the Perth study; and tobacco use, incarceration, social activities, spouse's alcohol use, and housing density in the Carnarvon study. In Perth the significant predictors of cessation in those who had ever used alcohol were sex, age, psychological distress, walking for recreation, church attendance, and spouse's alcohol use; and also, age and severity of alcohol dependence. Predictors in Carnarvon include age, hospitalisation, incarceration, and church attendance; and, also, age and number of alcohol-related negative consequences.
For the former drinkers, many of whom had experienced severe and chronic alcohol-related problems, the change from drinking to non-drinking status was a major life transition and an act of self-determination. They reported a range of precipitating and perpetuating factors; family and health issues were very important, as were connections with other non-drinkers. Almost all had stopped without the aid of formal treatment, although several recounted intervention (including medical advice) and informal assistance as being helpful. Behavioural strategies involving substitute activities for drinking and/or avoidance of alcohol were commonly employed. Some utilised cognitive strategies. Lifestyle changes preceded, accompanied and followed cessation of alcohol use. Social support and a positive self-image contributed to maintenance of abstinence.
The findings suggest several methods for alcohol prevention, intervention and treatment in the two communities studied, and possibly for other urban Aboriginal communities. Public awareness and education programs would do well to emphasise alcohol-related harm within the family. Health workers can make a difference by providing patients with information about alcohol and their own health and well-being. Counselling and treatment should be based on empowerment and competence enhancement, and take into account the influence of the social and physical environment on the individual's capacity to make and sustain change. It is evident that strategies need to be applied at both individual and community levels, giving due attention to both socioeconomic and cultural factors. Aboriginal community-controlled organisations have a crucial role in this area. The role of governments must be to help resource Aborigines to help themselves.
For further information on this subject look in the Australian Indigenous HealthInfoNet Bibliography or return to the theses page.
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