A recent rise in cannabis use in Indigenous communities in northern Australia may have compounded existing patterns of other substance use. This paper describes these patterns in Arnhem Land in the ‘Top End’ of the Northern Territory (NT). Economic impacts of the cannabis trade are also described. In a descriptive cross‐sectional study, random samples included 336 people (169 males, 167 females) aged 13–36 years. Consensus classification of lifetime and current use of cannabis, alcohol, tobacco, kava, inhalants (petrol) and other drugs was derived based on health workers’ proxy assessments. A sample (n = 180, aged 13–36) was recruited opportunistically for interview. Lifetime cannabis users among those interviewed (n = 131, 81 males, 50 females) described their current cannabis use, usual quantities purchased and consumed, frequency and duration of cannabis use and other substance use. In the random samples, 69% (63–75%) of males and 26% (20–31%) of females were lifetime cannabis users (OR = 7.4, 4.5–12.1, p 5 0.001). The proportion of males currently using cannabis was 67% (60–73%) while the proportion of females currently using cannabis was 22% (16–27%) (OR = 7.9, 4.8–13.1, p 5 0.001). Current cannabis users were more likely than non‐users to be also using alcohol (OR = 10.4, 4.7–23.3, p 5 0.001), tobacco (OR = 19.0, 7.9–45.8, p 5 0.001) and to have sniffed petrol (OR = 9.1, 4.6–18.0, p 5 0.001) but were less likely to be using kava (OR = 0.4, 0.2 –0.9, p 5 0.001). Among those interviewed, higher tobacco consumption in current users and greater alcohol use in lifetime users was associated with increased cannabis use. Action is required to reduce cannabis use, especially in combination with other substances.

Australian Aboriginal and Torres Strait Islander peoples (Indigenous Australians) smoke at much higher rates than non-Indigenous people and smoking is an important contributor to increased disease, hospital admissions and deaths in Indigenous Australian populations. Smoking cessation programs in Australia have not had the same impact on Indigenous smokers as on non-Indigenous smokers. This paper describes the outcome of a study that aimed to test the efficacy of a locally-tailored, intensive, multidimensional smoking cessation program.

Alcohol consumption among Indigenous Australians can be irregular, depending on social and geographic context. The Finnish method uses the last four drinking occasions to estimate drinking quantity and pattern. The Grog Survey App is an interactive and visual tablet computer application which uses touch-screen technology to deliver questions on drinking. Alcohol consumption recorded on the Grog Survey App using the last four occasions (Finnish) method was compared with a clinical interview conducted by an Indigenous Australian health professional. To assess convergent validity, Spearman’s ranked correlations between consumption estimates from the App and from interview were calculated. Sensitivity and specificity analyses were used to compare how well the App and clinical interview agreed when classifying drinkers’ risk. To assess criterion validity, average grams alcohol per day as estimated by the App (and by interview) were compared against presence of self-reported withdrawal tremors (from App or interview). Test–retest reliability was assessed by correlations between measures of alcohol consumption recorded on two occasions. The App recorded higher numbers of standard drinks consumed per drinking occasion than the interview. There was reasonable agreement between the App and interview across common reference periods (sensitivity 92.7%, specificity 69.8%, short-term risk; sensitivity 70.7%, specificity 68.8%, long-term risk). Average consumption recorded by the App was as good or better predictor of withdrawal tremors than consumption as estimated by interview. The Finnish method, as delivered by the App, offers an innovative way to collect survey data on alcohol in a population with an intermittent drinking pattern.