4.16 Public attitudes to secondhand smoke

The most recent data published on public attitudes to secondhand smoke are presented in this section, and are largely taken from surveys between 2004 and 2007. It should be noted that public awareness of the damage to health caused by secondhand smoke is likely to have continued to increase with the progressive introduction of further legislation for smokefree workplaces and public places in most Australian states and territories, and the launch of television campaigns to raise awareness of the dangers of exposure to secondhand smoke for children.i The following information may therefore under-represent the current state of public attitudes and perceptions about the extent of the health effects of secondhand smoke.

In general, the community has rapidly responded to the findings that secondhand smoke is harmful to health, in turn influencing broader attitudes to restrictions on smoking in many public places, the workplace, and more recently in private domains such as the home and in motor vehicles. Attitudes to smoking in these settings are explored in Chapter 15.

4.16.1General perception that secondhand smoke is harmful to health

The majority of the population, smokers and non-smokers, believe that living and working with a smoker could affect the health of non-smokers, although non-smokers are more likely to have this perception. The proportion of Australians believing that the health of non-smokers is affected by exposure to secondhand smoke has increased over time. In 1985, a Victorian study showed that 80% of non-smokers and 57% of current smokers agreed that the health of non-smokers could be damaged by secondhand smoke.1 In 2004, the National Drug Strategy Household Survey reported that about 90% of non-smokers and 70% of smokers thought that living, working or socialising with smokers could cause health problems (Table 4.16.1). Living in a smoky environment was considered by both non-smokers and smokers to be slightly more likely to affect a non-smoker's health than working or socialising with smokers.2

In 2006, the International Tobacco Control Four Country Survey asked Australian smokers how often they thought about the harm their smoking might be doing to other people. Thirty-nine per cent of smokers thought about it often or very often, 22% thought about it sometimes and 40% rarely or never thought about it.3

Table 4.16.1
Smokers' and non-smokers' perceptions of the effects of tobacco smoke on non-smokers, 2004

Situation and perception

Non-smokers*

Smokers†

All

 


% (rounded)

Live with smokers

Yes, might be affected

92

73

88

No, won't be affected

4

14

6

Don't know

4

13

6

Work or socialise with smokers

Yes, might be affected

90

67

85

No, won't be affected

5

19

8

Don't know

6

15

7

* Never or ex-smoker

† Daily, weekly and less than weekly smokers

Source: AIHW 20062

4.16.2Changes in smoking behaviour due to beliefs about secondhand smoke

The National Drug Strategy Household Survey (20104) found that among smokers who had modified their smoking behaviour (for example by attempting to quit, by cutting back or by switching to lower tar or nicotine brands), about one in five (18% down from 21% in 20075) had been motivated by the concern that their smoking was affecting the health of those around them (Table 4.16.2).4

Table 4.16.2
Factors that motivated change to smoking behaviour, smokers aged 14 years and older by sex, Australia, 2010

Factor

Males

Females

Persons

 


% (rounded)

Affecting health or fitness

47

42

44

Costing too much

42

46

44

Wanting to get fit

28

21

25

Family/friends asked me to quit

27

27

27

Worried it was affecting the health of others

17

19

18

Anti-smoking advertisements

13

14

14

Health warnings on packets

15

15

15

Advice from doctor

15

15

15

Other

10

12

11

Restrictions on smoking in public places

10

12

11

Pregnant or wanting to start a family

2

9

5

Restrictions smoking in the workplace

9

5

7

Quitline

2

2

2

Tobacco Information Line (advertised on packet)

1

1

1

Notes: Base is those smokers who reported undertaking measures. Respondents could select more than one response

Source: National Drug Strategy Household Survey (2007)4

4.16.3Knowledge of specific health effects

A range of state-based surveys have confirmed that although there is a high general awareness that secondhand smoke is harmful, knowledge about specific health outcomes is less consistent.6–8

Table 4.16.3 presents the finding of a survey undertaken in Victoria in 2007.5 This study found that non-smokers were more likely than smokers to believe that exposure to secondhand smoke caused a range of health problems. The highest awareness was for secondhand smoke as a cause lung cancer, followed by other respiratory problems and heart disease. There was lower awareness about the effects of secondhand smoke on children and babies.6

The International Tobacco Control (ITC) Four Country Survey (2008) asked Australian smokers and ex-smokers whether they believed 'smoking caused lung cancer in non-smokers from secondhand smoke' and 'smoking caused asthma in children from secondhand smoke'. Agreement among smokers and ex-smokers respectively was 72% and 80% for lung cancer, and 76% and 84% for asthma in children. The respondents were a mix of people who had participated in previous ITC surveys and new respondents.11

Table 4.16.3
Illnesses caused by secondhand smoke (prompted recall) by smoking status, Victoria, 2007

Illnesses

Non-smokers*

Smokers†

Total

 


% (rounded)

Lung cancer

77

55

73

Asthma

74

56

71

Emphysema‡

70

53

66

Bronchitis

65

50

62

Heart disease

64

49

61

Pneumonia in children

38

33

37

Miscarriage‡

37

26

35

Sudden infant death syndrome (SIDS)

37

30

36

Cancer of the cervix‡

21

16

20

Middle ear infections in children

13

13

13

Note: Illnesses in bold are among those mentioned in the pack health warnings for tobacco products since 2006

* Non-smokers include former smokers and never smokers

† Smokers include those who smoke daily, weekly and less than weekly

‡ The evidence concerning the association of secondhand smoke with emphysema9 and miscarriage9,10 and cancer of the cervix9,10 is not, at this stage, considered conclusive. See Sections 4.10, 4.11.4 and 4.8.4 respectively.

Source: Centre for Behavioural Research in Cancer5

4.16.4Avoidance of cigarette smoke

Results from the National Drug Strategy Household Survey in 20074 show that 85% of non-smokers either always or sometimes take measures to avoid exposure to secondhand smoke. About 44% of non-smokers 'always' avoid smoky environments, and a further 41% attempt to avoid exposure to other people's cigarette smoke 'sometimes' (Table 4.16.4). Some smokers also prefer not to be exposed to secondhand smoke, with 6% 'always' avoiding places where they might be exposed to secondhand smoke and 29% 'sometimes' taking steps to avoid secondhand smoke. Female non-smokers are more likely to report always avoiding secondhand smoke than male non-smokers.4 The 2004 National Drug Strategy Household Survey reported differences in avoidance behaviour between age groups, with the likelihood of consciously avoiding secondhand smoke increasing with age.11

Table 4.16.4
Non-smokers'* avoidance of places where they might be exposed to other people's cigarette smoke: recent and never/ex-smokers aged 14 years and over, Australia, 2007

 

Non-smokers % (rounded)

Avoidance

Males

Females

Persons

Always

40

47

44

Sometimes

42

39

41

Never

18

14

16

Recent smokers % (rounded)

 


Males

Females

Persons

Always

6

6

6

Sometimes

27

30

29

Never

66

64

66

* Non-smokers are ex-smokers and people who have never smoked

Source: National Drug Strategy Household Survey 20074

4.16.5Behaviour around cigarette smoke

A Victorian study asked a sample of smokers and non-smokers how they would respond if someone lit up a cigarette nearby.12 Most non-smokers said that they would move away (71%), and a minority said that they would request the smoker to stop (6%) (Table 4.16.5). Smokers were more likely to do nothing (46%), or to light up a cigarette as well (27%). However one-quarter of smokers said that they would take action to avoid smoke (either by moving away or asking the smoker to stop). Women were more likely than men to say that they would move away from the smoke (68% compared with 53%).12

The author of this report makes the observation that although it is clear that most non-smokers (and many smokers as well) prefer not to be exposed to cigarette smoke, only a minority of individuals are prepared to ask a smoker to put out their cigarette. This indicates that a 'common courtesy' approach to smoking is insufficient on its own to provide protection from secondhand smoke.12

Table 4.16.5
Response to someone lighting up a cigarette nearby by smoking status, Victoria, 2004

 


Non-smokers

Smokers*

Total

 


% (rounded)

Ask them to stop

6

2

6

Move away

71

23

61

Do nothing

18

46

24

Light up too

-

27

6

Other (e.g. depends on situation)

5

3

4

*Smokers include those who smoke daily, weekly and less than weekly

Note: Selected responses shown in table, so columns do not add up to 100

Source: Centre for Behavioural Research in Cancer13


i Such as the Smokefree Home and Car Campaign, launched in Western Australia in May 2007; see http://www.cancerwa.asn.au/prevention/tobacco/makesmokinghistory/campaigns/ for details.

Recent news and research

For recent news items and research on this topic, click here (Last updated January 2017 

References

1. Hill D. Public opinion about the dangers of passive smoking. Medical Journal of Australia 1986;144:615-6.

2. Australian Institute of Health and Welfare. Australia's health 2006. Australia's Health, no. 10, AIHW cat. no. AUS 73. Canberra: AIHW, 2006. Available from: http://www.aihw.gov.au/publications/aus/ah06/ah06-c00.pdf

3. Savvas S, Melbourne, Vic: The Cancer Council Victoria. International Tobacco Control Four Country data, 2006 (personal communication). Carolyn Ford of the Cancer Council Victoria, 2011.

4. Australian Institute of Health and Welfare. 2007 National Drug Strategy Household Survey: detailed findings. Drug statistics series no. 22, AIHW cat. no. PHE 107. Canberra: AIHW, 2008. Available from: http://www.aihw.gov.au/publications/phe/ndshs07-df/ndshs07-df.pdf

5. Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey: survey report. Drug statistics series no. 25, AIHW cat. no. PHE 145. Canberra: AIHW, 2011. Available from: http://www.aihw.gov.au/publication-detail/?id=32212254712&libID=32212254712&tab=2

6. McCarthy M, Germain D, Brennan E and Durkin S. Perceptions about the health effects of smoking and passive smoking among Victorian adults, 2003–2007. CBRC Research Paper Series no. 37. Melbourne, Australia: Centre for Behavioural Research in Cancer, The Cancer Council Victoria, 2009. Available from: http://www.cancervic.org.au/perceptions_smoking_cbrc_09.html

7. Walsh R, Tzelepis F, Paul C and McKenzie J. Environmental tobacco smoke in homes, motor vehicles and licensed premises: community attitudes and practices. Australian and New Zealand Journal of Public Health 2002;26(6):536-42.

8. Cancer Institute NSW. New South Wales Smoking and Health Survey 2009. March 22. Sydney: Cancer Institute NSW, 2009. Available from: http://www.cancerinstitute.org.au/cancer_inst/publications/pdfs/web09-287-02_nsw-smoking-and-health-survey_November-2009.PDF

9. US Department of Health and Human Services. The health consequences of involuntary smoking: a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health, 1986. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/previous_sgr.htm

10. Office of Environmental Health Hazard Assessment and California Air Resources Board. Health effects of exposure to environmental tobacco smoke: final report, approved at the Panel's June 24, 2005 meeting. Sacramento: California Environmental Protection Agency, 2005. Available from: http://www.oehha.ca.gov/air/environmental_tobacco/2005etsfinal.html

11. Savvas S, Melbourne, Vic: The Cancer Council Victoria. International Tobacco Control Four Country data (personal communication) (personal communication). Carolyn Ford of the Cancer Council Victoria, 2011.

12. Australian Institute of Health and Welfare (AIHW). 2004 National Drug Strategy Household Survey: Detailed findings. AIHW cat. no. PHE 66. Drug Statistics Series No. 16. Canberra: Australian Institute of Health and Welfare, 2005. Available from: http://www.aihw.gov.au/publications/index.cfm/title/10190

13. Germain D. Exposure to and perceptions of the dangers and illnesses of passive smoking among Victorians: 2004 CBRC research paper series no.17 Melbourne, Australia: Centre for Behavioural Research in Cancer, Cancer Council Victoria, 2004.

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