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Tobacco is the main cause of preventable mortality among Aboriginal and Torres Strait Islander Australians. The article focuses on the mortality and morbidity rates from conditions related to tobacco in Aboriginal and Torres Strait, Australia. It also describes the cultural, historical and political factors leading to the high prevalence of smoking among Aboriginal and Torres Strait Islander people. It outlines and discusses intervention efforts undertaken so far and consider their merits and weaknesses, paying particular attention to resource allocation issues. Finally, it considers priorities for future programme delivery that would be most likely to result in reduced tobacco use among this population.