Dr Moana Tane from the Menzies School of Health Research said the finding was significant for Yolngu communities who maintained strong cultural connections with tobacco use and where smoking prevalence was as high as 75%.

"I was interested in the effects associated with stigmatisation as an unintended consequence of de-normalisation strategies," Dr Tane said.

"De-normalisation, which seeks to erode community acceptance and tolerance for smoking, has become a cornerstone of the global tobacco control movement.

"My concern was that de-normalisation and the associated stigmatisation of already vulnerable people may be seen to represent a modern-day tool of oppression that inspired resistance and resentment rather than compliance.

Dr Tane said she interviewed 29 people in seven very remote communities, to explore the perceptions and understandings of tobacco (arali) from traditional and socio-cultural perspectives.

The study also confirmed that the Yolngu did not wish to put aside their valued and traditional connection to arali, an important part of the sacred practices of funeral ceremony.

"Nonetheless, tobacco is the single most preventable cause of death in the world today, and Yolngu communities have expressed their need for help to quit smoking," Dr Tane said.

"A key finding was the importance of caring, trusting relationships between health professionals, Yolngu staff and Yolngu smokers, and having the right people communicating the right message to smokers.

"This approach was essential to mitigate the risk of causing shame when raising the issue of smoking in clinical consultations with Yolngu smokers," she said.

Dr Tane said that while the study found experiences of shame and embarrassment among some health service staff, there was no evidence of smoking-related stigma.

CDU will award Dr Tane her PhD this month.

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