Social stresses like unemployment or family issues coupled with peer pressure and the addictive nature are driving up rates in a town where smoking is seen as the norm.

And in a "a monkey see, monkey do" situation young people are being pushed into temptation.

While the health impacts of just one cigarette are well known by most, Gavin Bell, one of Katherine's two community support workers, says young people are faring the worst.

Katherine is in the grips of a crisis with some of the highest rates of tobacco related diseases in Australia.

A report release late last year called Burden of Tobacco use in Australia found people living in the Territory were 2.6 times more likely to be dying early or dealing with disease from smoking than wealthier parts of Australia.

Mr Bell said the alarming rates of smoking among adults can be blamed on something he calls 'rural stress'.

"If you're a smoker, your kids are more likely to take up smoking especially if they are in that experimentation phase, it is a drug and young people get hooked."

"Somewhere along the line all of the messaging and good work from the government has been lost, the shock messaging has been normalised, there are less adds on TV and what we are left with is a new wave of people taking up and continuing to smoke."

Some parents are forking out hundreds of dollars every fortnight for tobacco jeopardising rent and food on the table.

Cigarettes are even more costly in remote communities, so even if kids are not picking up the habit themselves, they are inadvertent being impacted by second hand smoke or families struggling to keep up with the cost of living, Mr Bell said.

"There is a new wave of young people who seem to think it is cool to smoke. The Government has established rules about where you can and can't smoke and raised taxes, but people are ignoring that advice.

"Smoking is starting at a younger age and they are being pulled out of school because they are being found with cigarettes, so it is not only impacting people's health."

Mr Bell said he often sees teenagers and adults scavenging for cigarette castoffs saturated in tar and raising the chances of contracting diseases like hepatitis.

"The addiction is strong, it is hard to give up especially when you live in a town where a Smokemart is at the entrance of the main supermarket," he said.

"In comparison to larger urban centres it is a big issue here. You just have to walk down the street to see how many people are smoking.

"People still smoke inside their houses in front of children, it is a financial nightmare for people on low wages and there isn't enough resources to change perceptions."

Mr Bell spends large chunks of his week working in town and the surrounding communities, and especially with sporting groups delivering educational workshops on the harmful effects of smoking.

But he says his job is made difficult by a lack of resources to get the message across.

"I think we are doing a really good job with what we have and we are seeing people taking note, but years ago there was more messaging in the public sphere, there were posters everywhere and adds on TV about replacement treatments like nicotine patches.

"Before the 2000's there was shock and dismay, but we have developed a tolerance to the cigarette packaging, it has been normalised."

Mr Bell said the government needs to back education programs and put more funding towards health promotion.

"The message just needs to be constant. There needs to be a re-think about how we get into people's heads.

"There has been a slump, but I see the impact on youth. We need to revise health promotion, because I can provide guidance and information but at the end of the day it's an addictive habit that's extremely hard to break."

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