The Australian Medical Association has urged the Northern Territory Chief Minister Michael Gunner to take action to address Indigenous smoking rates.
Smoking causes about 50 per cent of deaths in the Aboriginal and Torres Strait Islander population aged 45 years and older, the AMA NT says.
It wants parliament to urgently introduce tobacco control reform laws that will help people quit smoking.
AMA NT branch president Robert Parker said research found 180 Indigenous Territorians aged 45 years and older died from smoking-related illnesses in 2019.
"Quite rightly, successive NT governments have devoted considerable energy and resources to reducing the road toll," branch president Robert Parker recently wrote in a letter handed to AAP on Monday.
"Sadly, there has been little similar investment in real tobacco reform in the NT for years," he said in the letter written to Mr Gunner last week.
Dr Parker wrote the letter off the back of a NSW study published in the International Journal of Epidemiology earlier this year.
It found smoking was the single largest contributor to the burden of disease and premature death in the Aboriginal and Torres Strait Islander population.
"The lasting impacts of colonial processes, as well as tobacco marketing, have entrenched commercial tobacco use in the Australian Aboriginal and Torres Strait Islander population," researchers said.
The study analysed data from 1,388 Aboriginal adults.
The NT had won the annual AMA's Dirty Ashtray Award, which is given to the state or territory that's done the least to encourage smoking reform, seven years in a row.
About 30 per cent of the NT's 246,500-strong population is Indigenous.