1.7 Trends in the prevalence of smoking by socio-economic status

Last updated: November 2015
Suggested citation: Greenhalgh, EM, Bayly, M, & Winstanley, MH. 1.7 Trends in the prevalence of smoking by socio-economic status. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2015. Available from http://www.tobaccoinaustralia.org.au/chapter-1-prevalence/1-7-trends-in-the-prevalence-of-smoking-by-socioec

In Australia1-3 and many other countries,4 smoking behaviour is inversely related to socio-economic status, with disadvantaged groups in the population being more likely to take up and continue smoking. The authors of a seminal British report on poverty and smoking observed that one can ‘almost study social disadvantage itself through variations in smoking prevalence’ (p78).5

Table 1.7.1 sets out data from the National Drug Strategy Household Survey on smoking status by various socio-economic characteristics for Australians 14 years and over in 2013.

Table 1.7.1
Tobacco smoking status, people aged 14 years and older, by SES characteristics, 2013 (per cent)

 

Never smoked*

Ex-smokers†

Smokers‡

All persons, 14+

60

24

16

Education

With post-school qualification

58

26

15

Without post-school qualification

63

21

17

Labour force status

Currently employed

57

26

17

Student

89

3

7

Unemployed

61

13

27

Home duties

57

26

16

Retired or on a pension

54

35

11

Volunteer/charity work

67

25

9

Unable to work

41

25

35

Other

55

21

24

Index of social disadvantage of place of residence

Ist quintile (lowest)

56

21

23

2nd

58

24

18

3rd

59

24

17

4th

62

25

13

5th (highest)

65

25

10

Geography

Major cities

63

23

14

Inner regional

57

25

18

Outer regional

50

27

23

Remote/very remote

49

27

25

Marital status

Never married

74

7

19

Married/de facto

50

29

21

Divorced/separated/widowed

56

30

14

Composition of household among households with dependent children

Single with dependent children

41

26

33

Couple with dependent children

58

28

14

* Never smoked 100 cigarettes (manufactured and/or roll-your-own) or the equivalent amount of tobacco

Smoked 100 cigarettes (manufactured and/or roll-your-own) or the equivalent amount of tobacco and reports no longer smoking
Smoked daily, weekly or less than weekly
# From Index of social disadvantage of place of residence

Source: National Drug Strategy Household Survey 2013,6 Table S3.12

Figure 1.7.1 plots the prevalence of current smoking in the same year.

Figure 1.7.1

Figure 1.7.1
Prevalence of current smoking*, people aged 14 years and older, by SES characteristics, 2013 (per cent)

* Smoked daily, weekly or less than weekly

† Among households with dependent children
Source: National Drug Strategy Household Survey 2013,6 Table S3.12

A number of socio-demographic variables are closely connected with the likelihood of smoking. Siahpush and Borland7 examined the correlation of smoking behaviour with several factors, including education, family income and Index of Relative Socio-economic Disadvantage (IRSD).i This research found that all three measures of socio-economic status—education, income and IRSD—were independently and significantly related to the likelihood of smoking for both sexes. Of these three measures, IRSD was most strongly related to smoking status. Individuals falling within the highest IRSD category of disadvantage were about twice as likely to smoke as individuals in the lowest IRSD category, irrespective of individual levels of education and income. This finding suggests that the influence of neighbourhood is an important contributing factor to whether an individual smokes or not. Siahpush and Borland describe this as a ‘contextual effect’, occurring because smoking is normative behaviour in a particular environment, or because there are other physical, cultural, social or economic factors in those areas that encourage or lead to smoking.7

The relationship between smoking and social disadvantage is discussed in greater detail in Chapter 9. Differences in smoking prevalence among socio-economic groups result in different patterns of tobacco-caused ill health and disease. For discussion, see Chapter 3, Section 3.31.

1.7.1 Trends over time in smoking and educational level

Increasing education levels are associated with decreased likelihood of smoking. Between 1998 and 2013, those with a tertiary (university) level education had significantly lower levels of smoking than other members of the community (controlling for sex and age). Over this period, there was a significant linear decline in regular smoking within each education group other than those who had completed up to year 9 or less, where only a trend toward a decline was observed. For the most recent period of 2010 to 2013, smoking prevalence declined significantly only among those with a year 12 qualification or higher. Figure 1.7.2 shows these trends across time.

Figure 1.7.2

Figure 1.7.2
Prevalence of regular* smokers† in Australia aged 18+, 1998 to 2013‡—by educational achievement

Note that in 1998 level secondary school education attainment was asked in a different format to 2001 onwards.
* Smoked daily or weekly
†Includes persons smoking any combination of cigarettes, pipes or cigars

All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition
Source: Centre for Behavioural Research in Cancer, analysis of data from the National Drug Strategy Household Survey since 1998

Table 1.7.2 shows these trends over time for men and women. Although men consistently smoke at higher proportions than women, these differences are more pronounced and always significant in those with lower education levels (controlling for age). Among those who are university educated, differences in prevalence between men and women are much smaller, and often non-significant.

Table 1.7.2
Prevalence of regular* smokers among Australian adults (18+ years) by educational level and sex—1998 to 2013

 

1998

2001

2004

2007

2010 2013

Males

Year 11 or less

35

31

28

29

 26  27

Year 12 or Certificate I-IV

32

26

25

24

 22  19

University (Partial or completed)

16

16

12

11

 11  10

Females

Year 11 or less

27

24

22

21

 20  17

Year 12 or Certificate I-IV

27

22

20

19

 18  16

University (Partial or completed)

17

14

12

11

 10  7

Persons

Year 11 or less

30

27

24

24

 22  21

Year 12 or Certificate I-IV

30

24

23

22

 20  17

University (Partial or completed)

17

15

12

11

 10  9

Note: Certificates III-IV have replaced the previous system of trade certificates
* Smoked daily or weekly

† Includes persons smoking any combination of cigarettes, pipes or cigars
‡ 
All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition
Source: Centre for Behavioural Research in Cancer, analysis of data from the National Drug Strategy Household Surveys

A person’s age also plays an important role in the relationship between smoking prevalence and education level. As the proportion of Australians completing high school to the end of Year 12 and those attaining post-school qualifications have increased over time,8–14 it is likely that higher educational achievement rates have contributed to the overall decline in smoking among the Australian population. As shown in table 1.7.3, smoking prevalence has significantly declined over time within each age and education group (controlling for gender), with the exception of those aged 40–59 years who completed year eleven or lower.  

However, important differences in smoking prevalence by education group exist across age groups. Within the oldest age group (60+), there are no differences between those who did or did not finish high school (except for 1998)—smoking levels are only significantly lower among those who attended university. Finishing year 12 becomes increasingly important for  adults under 60 years in terms of smoking prevalence, which is likely because younger adults who have not attained year 12 reflect a far more disadvantaged group15 than the oldest age group, who completed their education when leaving school early was much more common.16 Within both younger age groups, those who did not complete year 12 were significantly more likely to be regular smokers (although this same pattern was not significant for those aged 40–59 years in 1998). For example, in 2013, those aged 18–39 who had not finished high school were about three times more likely to smoke than those who had attained year 12 or equivalent, and about seven times more likely to smoke than those with a university-level education (adjusting for gender).

Table 1.7.3
Prevalence of regular* smoking† among Australian adults (18+ years) by educational level and age group—1998 to 2013‡

 

1998

2001

2004

2007

2010 2013

18–39 years

Year 11 or less

49

43

41

40

 36  41

Year 12 or Certificate I-IV

34

30

28

25

 23  19

University (Partial or completed)

19

18

15

13

 10  9

40–59 years

Year 11 or less

30

28

27

27

 29  27

Year 12 or Certificate I-IV

29

23

23

24

 22  20

University (Partial or completed)

15

14

14

12

 11  9

60+ uears

Year 11 or less

12

12

10

23

10  10

Year 12 or Certificate I-IV

20

11

10

22

11  11

University (Partial or completed)

11

8

6

6

 7  6

Note: Certificates III-IV have replaced the previous system of trade certificates
*
Smoked daily or weekly
Includes persons smoking any combination of cigarettes, pipes or cigars
‡ 
All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition
Source: Centre for Behavioural Research in Cancer, analysis of data from the National Drug Strategy Household Surveys

1.7.2 Trends over time in smoking and occupation

A person’s employment status is strongly related to their overall health. In general, people who are unemployed experience poorer health and have higher mortality rates than those who are employed.17 As shown in figure 1.7.3, smoking has significantly declined between 1998 and 2013 within all employment status groups. Unemployed individuals had significantly higher levels of regular smoking in each of the survey years than people who were employed, students, retired, or solely engaged in home duties (controlling for sex and age). For the most recent period of 2010 to 2013, smoking prevalence declined significantly among those who were currently employed, engaged in home duties, or students (with no significant changes among unemployed or retired people).

Figure 1.7.3

Figure 1.7.3
Prevalence of regular* smokers† in Australia aged 18+, 1998 to 2013‡—by employment status

* Smoked daily or weekly
Includes persons smoking any combination of cigarettes, pipes or cigars
All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition
Source: Centre for Behavioural Research in Cancer, analysis of data from the National Drug Strategy Household Surveys

Smoking behaviour among those who are employed is also stratified by occupational level, with a decreased likelihood of smoking associated with white-collar occupation. Table 1.7.3 shows trends in smoking prevalence by occupation level between 1998 and 2013. Due to the change in occupation classifications in the 2010 survey onward, trends should be interpreted with some caution. Reflecting prior years, in 2013 smoking prevalence among upper white collar workers was significantly lower than for any other occupational group. In 2013, only 10% of individuals in upper white collar employment were smokers, compared with 26% of those working in lower blue collar employment, 22% of upper blue collar workers, and 15% of lower white collar workers. While men tend to have higher smoking prevalence than women within each occupation level, between 1998 and 2013 the magnitude of these differences has varied and has typically been non-significant. In 2013, men were significantly more likely to be smokers than women only within the upper white collar group.

Table 1.7.4
Prevalence of regular* smokingby occupational level and sex among employed Australian adults (aged 18+ years)—1998 to 2013

 

1998

2001

2004

2007

2010 2013

Upper white collar

Male

19

16

14

13  13  11

Female

15

15

11

11

 11  8

Persons

17

16

13

12

 12  10

Lower white collar

Male

24

24

19

20  19  16

Female

30

23

23

20

 18  14

Persons

28

24

21

20

 18 15

Upper blue collar

Male

37

30

27

26

 23  22

Female

31

27 25

23

 19  19

Persons

36

29

26

25

 22 22
Lower blue collar

Male

44

35

33

31  26  26

Female

30

35

29 29  27  26

Persons

40

35

32

31

 26  26

Upper white collar: includes professionals, business owners, executives, farm owners, semi-professionals
Lower white collar: includes sales, other white collar
Upper blue collar: includes skilled workers
Lower blue collar: includes semi-skilled, unskilled, farm workers.
Note: classifications changed in 2010 such that some occupations that would have been classed as Upper Blue in 2007 may be classified as Lower Blue in 2010. Tradepersons are classified as Upper Blue in 2010 but would have been classified as Lower White in previous years. For more information see the ABS website18
* Smoked daily or weekly

† Includes persons smoking any combination of cigarettes, pipes or cigars
‡ 
All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition
Source: Centre for Behavioural Research in Cancer, analysis of data from the National Drug Strategy Household Surveys

Figure 1.7.4 also shows these trends from 1998 to 2013. Over this time period, regular smoking declined linearly among all occupation levels (controlling for age and sex). However, between 2010 and 2013, smoking only significantly declined among white collar workers; prevalence of smoking among blue collar workers remained the same. The lower prevalence of smoking among white collar workers may be a result of fewer individuals in these groups having taken up smoking in the first place, rather than being more successful at quitting smoking.19

Figure 1.7.4

Figure 1.7.4
Prevalence of regular* smokers† in Australia aged 18+, 1998 to 2013‡—by occupation level

* Smoked daily or weekly
Includes persons smoking any combination of cigarettes, pipes or cigars
All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition
Source: Centre for Behavioural Research in Cancer, analysis of data from the National Drug Strategy Household Surveys

i IRSD is an area-specific socio-economic measure applied by the Australian Bureau of Statistics, which takes into account a number of variables including income, education, occupation, housing, household composition and English fluency of residents. See Siahpush and Borland7

Recent news and research

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