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

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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 2010.

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

Table 1.7.1
Tobacco smoking status, people aged 14 years and older, by SES characteristics, 2010 (per cent)

 

Never smoked*

Ex-smokers†

Smokers‡

All persons, 14+

57.7

24.1

18.1

Education

With post-school qualification

56.2

26.8

17.0

Without post-school qualification

59.8

20.7

19.5

Labour force status

Currently employed

54.9

25.5

19.6

Student

85.0

4.8

10.3

Unemployed

55.7

16.7

27.6

Home duties

54.2

25.7

20.1

Retired or on a pension

53.7

35.0

11.3

Volunteer/charity work

60.1

20.4

19.5

Unable to work

42.4

22.2

35.4

Other

53.4

22.8

23.8

Index of social disadvantage of place of residence

Ist quintile (lowest)

52.6

22.8

24.6

2nd

55.8

23.5

20.7

3rd

56.7

25.7

17.7

4th

59.6

24.1

16.3

5th (highest)

63.2

24.3

12.5

Geography

Major cities

60.2

23.0

16.8

Inner regional

53.3

26.8

19.9

Outer regional

53.5

25.9

20.7

Remote

45.4

25.7

28.9

Marital status

Never married

71.7

9.0

19.3

Married/de facto

49.5

27.5

23.0

Divorced/separated/widowed

53.3

30.4

16.2

Composition of household among households with dependent children

Single with dependent children

39.5

23.6

36.9

Couple with dependent children

53.9

28.2

17.9

* 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

Source: National Drug Strategy Household Survey 2010,6 Table 3.4 p 27–8

Figure 1.7.1
Prevalence of current smoking*, people aged 14 years and older, by SES characteristics, 2010 (per cent)

* Smoked daily, weekly or less than weekly

Source: National Drug Strategy Household Survey 2010,6 Table 3.4 p 27–8

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 rates 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.

Figure 1.7.2 indicates that between 1980 and 2010, those with a tertiary level education had consistently lower levels of smoking than other members of the community (although levels of smoking were not statistically significant between tertiary education and Year 12/post secondary in 1980) (controlling for sex and age). However, over this period, for each education group, there was a significant linear decline in smoking rates, with the rate of change most substantial among those who had a tertiary level of education as well as those with Year 12/some post-secondary education.

In the more recent period, between 2001 and 2010, smoking rates declined significantly only among those with tertiary education. This trend is shown in Figure 1.7.2. Reflecting long-term trends, Australians who had completed school up to Year 9 (or less), were significantly more likely to be regular smokers across this period, controlling for age and sex, than any other education level except those who had completed up to Year 10 or 11. In 2010, the smoking rate for those with a Year 10/Year 11 education (27%) was significantly higher than that for any other education level (Table 1.7.2). Smoking rates among Australians with a Year 12 education were significantly lower than those with less education or with a trade certificate. As in previous years, in 2010 those with a tertiary education have significantly lower smoking rates than all other education groups.

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.

Figure 1.7.2
Prevalence of regular* smokers† in Australia aged 18+, 1980 to 2010‡—by educational achievement

* See footnote ii in Section 1.2 for explanatory notes regarding methodology used in attaining this data set. Prior to 2001, figures represent those describing themselves as 'current smokers' (no frequency specified). Since 2001 the figures include those reporting that they smoke 'daily' or 'at least weekly'.

Includes persons smoking any combination of cigarettes, pipes or cigars

All data weighted to 2001 census population data and may vary slightly from data presented in previous edition

Source: Centre for Behavioural Research in Cancer, analysis of data from surveys conducted by the Anti-Cancer Council of Victoria from 1980 to 1998 and from the National Drug Strategy Household Survey since 2001

Table 1.7.2
Prevalence of regular* smokers among Australian adults (18 years +) by educational level and sex—2001, 2004, 2007 and 2010

2001

2004

2007

2010

Year 9 or less

Males

27

27

28

28

Females

21

19

20

21

Persons

24

23

26

24

Years 10 and 11

Males

35

34

37

31

Females

27

28

26

24

Persons

30

30

30

27

Year 12/post secondary

Males

25

25

25

24

Females

20

20

19

18

Persons

22

22

21

20

Trade qualification

Males

28

28

25

26

Females

26

28

28

24

Persons

27

28

26

26

Finished university/some university

Males

16

13

12

12

Females

14

13

12

11

Persons

15

13

12

12

Note:
Year 12 or post secondary: completed Year 12 and/or attained a non-trade certificate
Trade qualification: individuals who completed a trade certificate or finished studying at a technical or commercial college
Finished university/some uni: individuals, who started a university course, are still at university or have completed a university degree

* See footnote ii in Section 1.2 for explanatory notes regarding methodology used in attaining this data set. Prior to 2001, figures represent those describing themselves as 'current smokers' (no frequency specified). Since 2001 the figures include those reporting that they smoke 'daily' or 'at least weekly'.

Includes persons smoking any combination of cigarettes, pipes or cigars

All data weighted to 2001 census population data and may vary slightly from data presented in previous edition.

Source: Centre for Behavioural Research in Cancer, analysis of data from surveys conducted by the Anti-Cancer Council of Victoria from 1980 to 1998 and from the National Drug Strategy Household Survey since 2001

1.7.2 Trends over time in smoking and occupation

Smoking behaviour is clearly stratified by occupational level, with increasing occupational prestige correlating with a decreased likelihood of smoking. Occupation level is based on the current occupation of survey respondents. In the National Drug Strategy Household Surveys, respondents who were not employed at the time of the survey (such as retirees, or people engaged in domestic duties) were not asked for a previous occupation and are classified as not being in paid work.

In 2010, smoking prevalence among upper white collar workers was significantly lower than for any other occupational group. In 2010, only 13% of individuals in upper white collar employment were smokers, compared with 31% of those working in lower blue collar employment, 26% of upper blue collar workers, 20% of lower white collar workers and 17% of those not in the workforce (Table 1.7.3).

Figure 1.7.3 shows trends in smoking prevalence by occupation level between 1980 and 2010. Due to variability in the way occupation level has been obtained over the survey years, results should be interpreted with some caution.

Table 1.7.3
Prevalence of regular* smoking† by occupational group and sex—2001, 2004, 2007 and 2010‡

2001

2004

2007

2010

Upper white collar

Males

17

15

14

14

Females

15

13

11

12

Persons

16

14

13

13

Lower white collar

Males

25

21

21

20

Females

25

24

22

19

Persons

25

23

22

20

Upper blue collar

Males

31

28

28

26

Females

27

29

26

20

Persons

30

28

28

25

Lower blue collar

Males

35

36

34

30

Females

35

31

33

29

Persons

35

35

34

30

Not in paid work

Males

23

23

21

22

Females

19

19

17

17

Persons

21

21

18

19

Note:
Upper white collar: includes professionals, business owners, executives, farm owners, semi-professionals
Lower white collar: including sales; other white collar
Upper blue collar: includes skilled workers
Lower blue collar: semi-skilled, unskilled, farm workers
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.
Not in paid work: including those engaged in domestic duties, students, retired people, and respondents looking for work

* See footnote ii in Section 1.2 for explanatory notes regarding methodology used in attaining this data set. Prior to 2001, figures represent those describing themselves as 'current smokers' (no frequency specified). Since 2001 the figures include those reporting that they smoke 'daily' or 'at least weekly'.

Includes persons smoking any combination of cigarettes, pipes or cigars

All data weighted to 2001 census population data and may vary slightly from data presented in previous edition

Source: Centre for Behavioural Research in Cancer, analysis of data from surveys conducted by the Anti-Cancer Council of Victoria from 1980 to 1998 and from the National Drug Strategy Household Survey since 2001

Figure 1.7.3
Prevalence of regular* smokers† in Australia aged 18+, 1980 to 2010‡—by occupational status

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.

* See footnote ii in Section 1.2 for explanatory notes regarding methodology used in attaining this data set. Prior to 2001, figures represent those describing themselves as 'current smokers' (no frequency specified). Since 2001 the figures include only reporting that they smoke daily or at least weekly.

Includes persons smoking any combination of cigarettes, pipes or cigars

All data weighted to 2001 census population data and may vary slightly from data presented in previous edition

Source: Centre for Behavioural Research in Cancer, analysis of data from surveys conducted by the Anti-Cancer Council of Victoria from 1980 to 1998 and from the National Drug Strategy Household Survey since 1998

Overall, between 1980 and 2010 (and 2001 and 2010), regular smoking declined linearly among all occupation groups controlling for age and sex. The decline in smoking between 1980 and 2010 has been proportionately greater among upper white collar workers than other workers. Overall, prevalence of smoking among upper white collar workers more than halved over this study period (Error! Reference source not found.), while among lower blue collar workers, prevalence dropped by 42%, suggesting that the differential in prevalence between the highest and the lowest occupational groups is widening over time, a pattern which has been observed in the UK as well.15 The lower prevalence of smoking among those with higher occupational status 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.16

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

References

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2. Siahpush M. Smoking and social inequality. Australian and New Zealand Journal of Public Health 2004;28(3):297. Available from: http://www3.interscience.wiley.com/journal/118803503/abstract

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