Facts on smoking - incidence & health issues: reposted with bloopers corrected

Summary information on the incidence of smoking in Australia is provided for the period 1991-2004. It’s an interesting picture with some obvious policy successes in reducing smoking but with clear problems emerging for women, children and indigenous Australians. Comments welcome.

From 1991-2004 the proportion of people aged 14+ in the Australian population who smoke cigarettes daily has fallen from 24.3% to 17.4%. For men, the fall was from 26.7% to 18.6%, for women, from 22% to 16.3%.

Men are slightly more likely to be smokers than women though this gap is closing. Among 14-19 year olds, more women smoke (11.9%) than men (9.5%).

Of the age groups 14-19, 20-29, 30-39, ….,60+ daily smoking is most heavily concentrated in the 20-29 year group for both men and women with 23.5% smoking compared to the proportion over all age groups oof 17.4%.

Across the whole population the fraction of ex-smokers across age groups increases with age. For women alone, however, it peaks in the 40-49 year bracket simply because older women were less likely to have initiated smoking.

Overall 26.4% of the population aged 14+ are smokers. Among school children aged 12-17 years smoking has declined over 1999-2005 with those having smoked in the week before a survey falling from 19% to 9%.

The average age at which smokers have their first cigarette remained fairly constant from 1995-2004 at 15.9 years.

Smoking is concentrated among the unemployed (41% smoke compared to 23% among employed) and among those of low socioeconomic status (27% in the most disadvantaged socioeconomic quintile smoke compared to 15% among the most advantaged quintile).

AIHW estimate that smoking is concentrated among aborigines (39%) about double the rate of non-indigenous Australians. Other estimates identify smoking prevalences among aboriginals at much higher levels than these – at 51% among aboriginal men and 49% among women.

Men increase their cigarette consumption from around 68 cigarettes per week at age 14-19 to 129.2 at ages 50-59. Likewise, women’s smoking increases in intensity up to age 50-59 (106.3 cigarettes per week), decreasing thereafter. Men smoke more intensively than women in all age groups except in the 14-19 group where women smoke 70 cigarettes weekly compared to men who smoke 68.

Cigarette smokers were 3 times as likely to have ever consumed illicit drugs as non-smokers while 22.8% of drinkers had recently smoked compared to 9.8% of non-drinkers.

Smokers as a group are trying to change their behaviour. In 2004, over the previous 12 months, 39.2% of smokers had tried unsuccessfully to quit, 22.5% had managed to successfully quit for more than a month, 50% had successfully reduced the amount they smoked in a day while 21.6% had failed to cut back their daily smoking. About 26.5% of smokers had successfully switched to a lower tar or nicotine brand. In terms of achieving objectives it was easier to cut back than to quit.

Among the reasons for seeking to change behaviour 51.1% cited health reasons while 43.9% cited cost. Smoking restrictions in public places affected 9.6% and the workplace (5.7%), pregnancy (11.8%) and anti-smoking advertisements (20.5%) and warnings on health packets (16.4%) all exerted powerful influences on the decision to change behaviour. Strong impacts were due to family and friends urging a smoker to quit (26%) and worries that it might impact on the health of others (21%).

On passive smoking about 17.2% of 12-15 year olds live in households where someone smokes within the home. There are severe health damages associated with passive smoking – about 8% of childhood asthma cases are caused by passive smoking and non-smokers who suffer long-term exposure to environmental tobacco smoke have a 20-30% higher incidence of lung cancer. Passive smoking within the home however has fallen dramatically – in 1995 31.3% of households involved smoking within the home while, in 2004, the figure was 12.3%. This is partly due to reduced smoking but also to a big shift in behaviour towards smoking only outside the home – in 1995 only 16.7% only smoked outside the home whereas 28.1% now smoke only outside the home.

Nearly 40% of non-smokers always avoid places where they might be exposed to the cigarette smoke of others. Women are slightly fussier than men – 43% of women always avoid such places whereas only 35% of men do so.

On policies for reducing the problems caused by smoking, smokers are more reticent than non-smokers in enforcing restrictions although both groups favour stronger enforcement of laws against supplying minors (92% of non-smokers, 81% of smokers). Around 28% of smokers favour high tobacco taxes which is surprising!

On health impacts

In 2003 smoking was estimated to be responsible for 7.9% of the total health burden of Australians. In 1998 15% of all deaths – 19,019 people – were due to smoking.

Cancer, and mostly lung cancer, was responsible for 40% of tobacco-related deaths. Coronary heart disease, chronic obstructive pulmonary disease and other causes, including stroke, were responsible for the remaining 60 per cent of tobacco-related death.

The diseases underlying COPD are bronchitis and emphysema. A smoker’s risk of lung cancer or COPD is >10 times that of a non-smoker. The incidence of lung cancers among men has fallen from 80.6 per one hundred thousand in 1985 to 62.1 in 2000. Among women the incidence has risen from 19.2 to 27.4 over the same period parallelling the increase in female smoking.

Giving up smoking helps to reduce lung cancer risks although half of all lung cancers are detected in ex-smokers.

I’ll comment in a separate post on the economic costs of smoking and the policies Australia and other countries have adopted to deal with smoking. There are particular concerns with indigenous Australians, with rising rates of smoking among women and with children being exposed to passive smoking.

Lee Smith collected this information in her work for the 'Harm-Minimisation and the Economics of Controlling Illicit Drug Use' ARC Project. A full report will be published on this project's website.