1.3 Prevalence of smoking—adults

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1.1 A brief history of tobacco smoking in Australia

1.2 Overview of major Australian data sets

1.3 Prevalence of smoking—adults

1.4 Prevalence of smoking—young adults

1.5 Prevalence of smoking—middle-aged and older adults

1.6 Prevalence of smoking—secondary students

1.7 Trends in the prevalence of smoking by socioeconomic status

1.8 Trends in prevalence of smoking by country of birth

1.9 Prevalence of tobacco use among Aboriginal peoples and Torres Strait Islanders

1.10 Prevalence of smoking in other high risk sub-groups of the population

1.11 Prevalence of use of different types of tobacco product

1.12 Future smoking rates?

1.13 International comparisons of prevalence of smoking

Acknowledgments

References

Measurements of the prevalence of smoking in Australia first became available in 1945. Limited survey data 8  are available for the years between then and 1974, when the (then) Anti-Cancer Council of Victoria conducted its first national survey.9, 10 These early data show that in around the middle of the last century, a clear majority of males aged 16 and over were smokers, compared to about one quarter of females (Table 1.1). In the following decades smoking among men declined, probably in response to the initial publicity regarding the health effects of smoking which first emerged in the 1950s and early 1960s.32–35 Women have always had a lower prevalence of smoking than men, but smoking among women continued to increase in the 1970s.

The findings of the early studies from the Cancer Council Victoria are broadly confirmed by those of a survey by the Australian Bureau of Statistics undertaken in 1977, which found that 36% of the adult population (aged 18 and over) were smokers; 43% of men and 29% of women.36

Table 1.2 shows the proportion of smokers in the population aged 18 and over from 1980 to 2007. The prevalence of smoking declined for both sexes over this period, the most dramatic drop occurring among males between 1983 and 1986, when prevalence decreased by 16%. The differential in smoking rates between the sexes has also continued to close (while remaining statistically significant), largely due to greater numbers of men quitting smoking during the mid-to-late 1980s. However, the overall rate of decline seen during the 1980s did not continue into the 1990s, when the prevalence of smoking levelled at about 26%. The trend of gradual decline resumed for both sexes after 1998, but slowed again between 2001 and 2004. Data for 2007 show a statistically significant decrease in the prevalence of smoking among adult males, females, and the total population since 2004 (Figures 1.1 and 1.2).

Hill and colleagues have suggested that these accelerations and decelerations in decline of smoking prevalence correlate with the level of tobacco control activities occurring at the time.28, 29 The drop in male smoking rates seen in the early 1980s coincided with a period of new, well-funded media-led Quit campaigns29 and an upsurge in debate about tobacco control issues in the media, fuelled by the outspoken campaigning of groups such as the Australian Council on Smoking and Health (ACOSH) and Action on Smoking and Health (ASH Australia), and the widely publicised activities of the fringe groups MOP UP and BUGA UP.[4] Conversely, the steady prevalence rates in both sexes seen during the 1990s corresponds with a lull in legislative activity concerning tobacco advertising and smoking restrictions, and also with a sharp reduction in per capita expenditure on public education campaigns.28 The subsequent downturn in smoking prevalence seen by the end of the 1990s may be attributable to the combined effects of increased tobacco taxes,37 additional smokefree legislation, and the National Tobacco Campaign (NTC), a mass-media led program aimed at encouraging cessation that was launched in June 199738 and concluded in May 200431 (see also Chapter 10).

The ongoing close relationship between tobacco control activities and trends in smoking prevalence confirms the importance of continuous review of policies and prevention programs. Despite the decline in smoking rates shown in Table 1.2, smoking remains a leading cause of death and disease in Australia, killing about 14,900 people annually.39 Since about one-fifth of the adult population currently smokes, and because half of these smokers can be expected to die because of their tobacco use if they do not quit,40 the sequelae of tobacco-caused death and disease will remain for decades to come. Mortality caused by tobacco use is discussed in Chapter 3.

[4] MOP UP and BUGA UP were acronyms for The Movement Opposed to the Promotion of Unhealthy Products and Billboard Utilising Graffitists Against Unhealthy Promotions respectively. Readers interested in the history and activities of these lobbying groups are referred to in the first instance to: Chapman, S. Civil disobedience and tobacco control: the case of BUGA UP. Billboard Utilising Graffitists Against Unhealthy Promotions. Tob Control 1996; 5: 179–85 (Available from http://tobaccocontrol.bmj.com/cgi/reprint/5/3/179)