3.31 Morbidity and mortality due to tobacco-caused disease and socioeconomic disadvantage

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3.0 Background

3.1 Tobacco—a leading preventable cause of death and disease

3.2 Cardiovascular diseases

3.3 Lung cancer

3.4 Respiratory diseases

3.5 Other cancers caused by or associated with smoking

3.6 Reproductive health and smoking

3.7 Pregnancy and smoking

3.8 Infant health and smoking

3.9 Increased susceptibility to infection in smokers

3.10 Eye diseases

3.11 Dental diseases

3.12 Gastrointestinal diseases

3.13 Bone density and risk of fractures

3.14 Effects of smoking on the skin

3.15 Smoking and complications in medical treatment

3.16 Smoking and diabetes

3.17 Poorer levels of general health

3.18 Smoking, motor vehicle crashes and other injuries

3.19 Burns and fires caused by tobacco use

3.20 Tobacco poisoning

3.21 Health effects for younger smokers

3.22 Genetic influences on tobacco-caused disease

3.23 Smoking, dementia and cognitive decline

3.24 Lung disease, smoking and occupational exposures

3.25 Air pollution, cigarette smoking and ill health

3.26 Health effects of smoking brands that claim to deliver lower levels of tar, nicotine and carbon monoxide

3.27 Health effects of smoking tobacco in other forms

3.28 Health 'benefits' of smoking?

3.29 Morbidity (ill health) attributable to tobacco-caused disease

3.30 Deaths attributable to tobacco by disease category

3.31 Morbidity and mortality due to tobacco-caused disease and socioeconomic disadvantage

3.32 Health effects of smoking other substances

3.33 Health effects of chewing tobacco, and of other smokeless tobacco products

3.34 Public perceptions of tobacco as a drug, and knowledge and beliefs about the health consequences of smoking

3.35 Health benefits of cessation

3.36 The global tobacco pandemic

Acknowledgments

References

Socioeconomic disadvantage correlates with poorer health and reduced life expectancy. Life expectancy for a boy born in Australia in 2000–01 in an area of greatest disadvantage could be expected to be 76.2, compared to 79.8 for the least advantaged male child, a differential of about three and a half years. For females, the comparable figures are 82.1 and 84.5 respectively, or about two and a half years.28

According to The Burden of Disease and Injury in Australia 2003, the most disadvantaged population groups carried about a 32% total higher burden of disease and injury[10] over the 10 leading causes of death and disease compared with the least disadvantaged population.6 People in lower socioeconomic groups were substantially more likely to suffer death or disability due to diabetes (87%), mental illness (53%), chronic respiratory diseases (39%), cardiovascular disease (32%) and cancer (19%) than those in the highest socioeconomic group.6

A major contribution to this greater burden of ill health and death is the disproportionate incidence of major health risk factors such as smoking, risky drinking, obesity, poor diet and lack of exercise in lower socioeconomic groups.28 (For discussion on smoking rates and socioeconomic factors, see also Chapter 1, Section 1.7). Other influences include experiencing poorer psychosocial health, and engaging less with the health service for preventive purposes.187 Occupational factors may also be implicated (see Section 3.24). This combination of factors leads to a substantially increased burden of diseases such as cancer, coronary heart disease, stroke and respiratory disease among less advantaged Australians.6, 11, 188

More than one third of excess deaths in males of low education in Australia are estimated to be due to smoking.189 Studies of male mortality in England, Wales, Poland and North America have concluded that more than half of the differential in mortality evident between the highest and lowest social strata is due to tobacco use.190

The National Tobacco Strategy has identified the contribution of tobacco use to health inequalities among disadvantaged Australians, and drawn attention to some particular groups with high smoking rates as a priority for support. These include Aboriginal people and Torres Strait Islanders, people with severe mental illness, the prison population, parents and carers in disadvantaged settings, and some migrant groups.177 Tobacco use among Aboriginal people and Torres Strait Islanders is discussed in Chapter 8. Issues relating to smoking and disadvantage are discussed in greater detail in Chapter 9 .