9.0 Introduction

Smoking is undoubtedly one of the major markers of and contributors to social disadvantage in Australia.

As with most other high-risk behaviours, the prevalence of smoking is significantly higher among lower socio-economic groups, particularly so in groups facing multiple personal and social difficulties and challenges. Higher rates of smoking are one of the major factors driving poorer health status in economically disadvantaged areas and groups. Spending on tobacco products and ill-health contribute significantly to financial stress. Over long periods, spending on tobacco works against the accumulation of household savings and assets, and perpetuates intergenerational poverty. Financial stress and poverty create social conditions that may make it more difficult to successfully quit smoking. Smoking by pregnant women has far-reaching effects on the health of offspring, both as infants and much later in life. Continued high levels of tobacco use by parents and peers powerfully models smoking, thus perpetuating continuing high levels within neighbourhoods and across generations.

This chapter provides data to illustrate these trends; it analyses some of the factors that may explain the greater likelihood of smoking among disadvantaged groups; finally it draws out policy implications for addressing disparities and reducing social disadvantage associated with tobacco smoking.

9.0.1 What is social disadvantage?

Social disadvantage can be understood, defined and measured in a variety of ways.1

Social disadvantage is often described in terms of lower socio-economic status as measured by levels of educational attainment, unemployment, being in jobs involving low-skilled manual labour, or earning relatively low levels of income. In Australia, living in a remote as opposed to a rural or an urban area is also often regarded as a form of social disadvantage.

Socio-economic status can be determined at an individual level–based, for instance, on educational attainment, employment status or job type. Alternatively it can be determined at a household level, based on either the income or jobs status of the main income earner, or the combined household income. Or it can be defined at an area level–based on the overall percentages of individuals classified as disadvantaged within particular geographical boundaries.

Socio-economic status can also be quantified in many different ways. People may be categorised into one of two, three, four, five or an even greater number of groups:

  • high, medium and low levels of income or earning an income that puts them in one of three tertiles, four quartiles, five quintiles or 10 deciles
  • employed, unemployed or not in the workforce
  • employed in upper white, lower white, upper blue or lower blue collar jobs or, simply white collar or blue collar
  • living in an area with an index of disadvantage in one of four quartiles, five quintiles or 10 deciles.

After each five-yearly census of population and housing, the Australian Bureau of Statistics produces several socio-economic indexes for areas (SEIFA), which take into account relative levels of educational attainment, employment status and income levels of people living in each census area.2

The Index of Relative Socio-Economic Disadvantage is one of four such indexes currently used. This index of disadvantage summarises attributes such as low income, low educational attainment, high unemployment and jobs in relatively unskilled occupations.i

Other area-based indexes developed by the Australian Bureau of Statistics include:

  • the Index of Advantage/Disadvantage, a more recently developed index which is a continuum of advantage to disadvantage
  • an Index of Economic Resources which includes variables that are associated with economic resources including rent paid, income by family type, mortgage payments, and rental properties and
  • an Index of Education and Occupation, which includes only education and occupation variables.2, 3

None of the indicators described above is entirely satisfactory as a measure of disadvantage. People responding to surveys are often reluctant or unable to describe their current levels of income. Highly skilled tradespeople, while traditionally thought of as 'blue collar' in Australia, may in recent times be earning high incomes due to skill shortages in particular sectors of the economy. Young people competing for jobs in the current decade are much more likely to be economically disadvantaged by lower levels of educational attainment than their grandparents were. Area-level indexes may not work very well in the inner suburbs of the big capital cities, where very wealthy people may live in privately owned dwellings very close to people in subsidised rental dwellings in high-density public housing estates.

Closely related to the concept of socio-economic status are concepts of social differences, social exclusion and social position, which stress people's situation in society relative to other people, and the concept of poverty, usually defined as a measure of family income below a particular level or criteria that has been associated with material deprivation.

In contrast to the highly ordered, categorical variables described above, social disadvantage can also be thought of in terms of more meaningful but less easily quantified indicators of social deprivation, such as: not having good personal relationships and social supportii 5 not having adequate, secure and affordable housing; being subject to discrimination or racism; being in poor health; not having private health insurance or access to timely care in the public health system; not having access to good quality childcare or school education; not having work (paid or unpaid) that is fulfilling; and not having income sufficient to always be able to buy essential items and pay bills.

9.0.2 What is health inequality?

Inequality or disparity refers to a state of being uneven.

Socio-economic inequalities are evident for a wide range of high-risk behaviours and social problems, and much is written about the associated and consequent health disadvantage, health gaps and health gradients.

As part of an era of reforms for the National Health Service in Britain, 'health equality' has been given equal billing with 'health gain' in public health policy, and reducing differences in risk factors such as smoking between groups occupying unequal positions in society is a key strategy for achieving that equity. The government papers Healthy Lives, Healthy People and Equity and Excellence: Liberating the NHS have provided a foundation for the Health and Social Care Act 2012. This Act, and related changes under the National Health Service Act 2006, underpin public health reforms in Britain.6-9

In the US, the Office of Smoking and Health within the government Centers for Disease Control and Prevention has included 'identify and eliminate disparities among population groups'iii as one of its four program goals.10, 11 Governments in Australia are also increasingly emphasising health equality.9, 12–17

The concept of inequality–a state of uneven or unequal enjoyment of goods that society values–can be distinguished from that of inequity, which refers to a lack of fairness in the provision of resources, particularly those resources over which governments and publicly funded agencies have control. Inequity occurs if people are discriminated against or if they are denied access to information or services because of failure of service providers to take into account factors such as limited literacy in English, less fluency in speaking English, or living in a remote area and not having a telephone, mobile coverage or internet access.18, 19 The issue of inequity is discussed in Section 9.8. Tobacco-related disparities

Tobacco-related disparities are not just a matter of varying smoking prevalence, but can be seen in the inequality between social groups in:

  • all forms of exposure to tobacco
    • foetal exposure to tobacco smoke
    • exposure to secondhand smoke in childhood and throughout life
    • exposure through own smoking
  • at all points in the continuum of tobacco use18
    • experimentation
    • reported numbers of cigarettes smoked and patterns of smoking established
    • intention to quit
    • attempts to quit
    • relapse or sustained abstinence or reduction in smoking
  • in the relative harmfulness of the type of tobacco used
  • in the intensity and duration of smoking
  • in the harm that results from use of tobacco
    • financial stress, financial security and accumulation of wealth
    • diseases caused or worsened by smoking
    • deaths and reduced life expectancy. Inequality as deficit, gap or gradient

Tobacco-related inequality can be demonstrated in a variety of ways, most simply by comparing rates of use of and exposure to tobacco in the lowest and highest socio-economic groups. Another test of inequality is the presence of a clear social gradientfor instance where the smoking rate is lower in the most advantaged quartile than in the second quartile, and lower in the second quartile than in the third, and lower in the third quartile than in the fourth (or least advantaged).

Differing understandings of disadvantage give rise to different policy goals in relation to reducing inequalities, each arising from a different set of ethical arguments and each requiring slightly different strategies and approaches.20, 21

If the policy goal is to reduce the extent of the problem of very high levels of high-risk behaviour in the lowest socio-economic group, then the strategy will be to maximise improvement in the most disadvantaged group, regardless of what happens in the more advantaged groups. In this case, the policy goal–of reducing the deficit among the disadvantaged group–could be met even if the gap between least and most advantaged groups worsened, just so long as there was a large improvement in the most disadvantaged group.

If the policy goal is to narrow the gap between the lowest and highest socio-economic group, then the strategy might be to focus efforts in the lowest socio-economic group to the exclusion of other groups. Because targeted interventions use more resources per person reached than population-wide interventions, theoretically a reduction in health gap could occur even though a smaller number of people, including a smaller number of disadvantaged people, achieved a health gain.

If the goal is to reduce the social gradient for tobacco use, then the best strategy will be to focus efforts on the most disadvantaged 40 to 50% of the population, even if this means somewhat less change among the most highly disadvantaged 10 to 20% than could be achieved if the goal was to narrow the gap between the highest and lowest groups. Absolute and relative changes in inequality

To assess progress in reducing tobacco-related health disparities it is necessary to monitor trends in tobacco use across social groups defined in a consistent way across time.

Trends in inequality can be expressed in absolute terms (for instance, the size of the decrease from one time to another in the proportion of people who smoke in one group compared with another), or in relative terms (for instance, the extent to which the proportional difference in smoking rates between high and low groups increases or declines over time.22 Apparent change versus statistically significant change

Sample sizes of surveys used to quantify smoking-related beliefs and behaviour in Australia are generally not very large, particularly compared with similar studies undertaken in the US. Differences between groups and year-on-year changes are often quite small and wide confidence intervals surround estimates relevant to particular social groups in particular years. To assess whether absolute and relative differences and changes among various groups are significant or whether they could be due merely to chance, researchers often need to aggregate data over several years or aggregate subjects into a smaller number of groups (for instance high, medium and low income groups rather than income quintiles) to ensure reasonable sample sizes and to apply appropriate statistical tests.

9.0.3 Data available on tobacco-related disparities in Australia

Data about smoking and socio-economic status in Australia can be drawn from several different ongoing surveys.

The Australian Government Department of Health and Ageing has collected data periodically since 1985 to assess the impact of the National Campaign Against Drug Abuse, later renamed the National Drug Strategy.

Since 1998, the Australian Institute of Health and Welfare (AIHW) National Drug Strategy Household Survey has collected data every three years from almost 30 000 people aged 14 years and olderiv who provided information on their drug use patterns, attitudes and behaviours.23–26 The sample is based on households, so homeless and institutionalised people are not includedv. Respondents are asked a number of questions that enable researchers to classify their smoking status. They are also asked about recency of last cigarette and numbers of cigarettes smoked each day or weekly. Similar information was collected in national surveys conducted for the Anti-Cancer Council of Victoriavi for adults 16 years and over in 197427 and 197728 and then every three years until 1998.vii 29–35 Chapter 1 presents data from both these surveys re-analysed to cover consistent age groups (18 years and over), with adjustments for slightly different classifications of socio-economic status.

The Australian Bureau of Statistics' National Health Survey collected data in 1989–90,36 1995,37 2001,38 2004–0539 and 2007–0840 from Australians 18 years and over.viii It provides data on smoking status as well as other risk factors, disability, recent health episodes and chronic health conditions,41 and data are available about smoking rates in various educational, occupational and socio-economic status (SES) categories.

In addition, more detailed data about smoking attitudes and behaviour among various SES groups are available in a number of states from surveys conducted for health departments, and from surveys conducted at research centres based at the Victorian42 and South Australian43 cancer councils. The cancer council data and data collected by the Department of Health and Ageing to assess the impact of the National Tobacco Campaign44 provide information about smoking status and estimated number of cigarettes smoked per day. These and the Australian arm of the International Tobacco Control Policy Evaluation Study45, 46 also provide a wealth of information about smokers, including factors such as: psychological profiles and social environment, awareness and understanding of health effects, awareness of campaigns, the impact of policy interventions, past quit attempts and future intentions to quit.

The Household Income and Labour Dynamics in Australia survey conducted by the Melbourne Institute of Applied Economics and Social Research collects data on smoking status and financial stress among a panel of individuals over a period of time during which they may face changes in household employment status, housing, occupation and income.47

In contrast to these surveys asking directly about smoking, the Australian Bureau of Statistics Household Expenditure Survey provides interesting data about spending on tobacco products among various household types.48

In Australia, surveys of smoking behaviour by secondary school students co-ordinated by Cancer Council Victoria and conducted every three years since 1984 do not ask about the socio-economic status of students' families. However, analysis of the level of disadvantage of the area in which the student resides provides some indication of trends in uptake by socio-economic status.49, 50


i For further information on the Index of Disadvantage, see Chapter 6 of National Health Survey: users' guide – electronic, 2007–08, Australia (cat. no. 4363.0.55.001) and Adhikari 20063

ii The concept of social capital attempts to quantify the resources available to people in the networks in which they live, work and socialise.4 Efforts to promote social capital as a mechanism for reducing poverty and promoting economic development are underway in the UK and Australia.

iii Along with prevention, cessation and elimination of secondhand smoke

iv Since 2004, young people aged 12 and 13 years have been included in the National Drug Strategy Household Surveys. However analysis of the data is mostly based on those aged 14 years and older to allow for comparisons with earlier survey findings.

v In Australia these would represent a very small percentage, probably less than half of one per cent, of the total population (see Section 9.6 for estimates of numbers of homeless, prisoners and institutionalised persons).

vi Now known as 'Cancer Council Victoria'.

vii The surveys conducted for Cancer Council Victoria and for the Australian Bureau of Statistics were face-to-face interviews. The National Drug Strategy Household Survey uses a combination of face-to-face surveys, drop and collect surveys and telephone surveys.

viii Data on smoking are also available from another Australian Bureau of Statistics survey undertaken in 1977.


1. Graham H, and Kelly MP. Health inequalities: concepts, frameworks and policy. Briefing paper. London: Health Development Agency, 2004. Available from: http://www.nice.org.uk/niceMedia/pdf/health_inequalities_policy_graham.pdf

2. Australian Bureau of Statistics. 2039.0 Information paper: an introduction to Socio-Economic Indexes for Areas (SIEFA) 2006. Canberra: ABS, 2008. Available from: http://abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2039.02006

3. Adhikari P. 1351.0.55.015 Research paper: socio-economic indexes for areas: introduction, use and future directions. Canberra: ABS, 2006. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/1351.0.55.015Main+Features1Sep%202006

4. The World Bank Group. Social capital implementation framework. Washington DC: World Bank, 2008. May 2011 [viewed April 30, 2012] . Available from: http://go.worldbank.org/BSM1HUUIT0

5. Berkman L, and Glass T. Social integration, social networks, social supports and health. In Berkman L, andKawachi I, eds. Social epidemiology. New York: Oxford University Press, 2000: 137–73. Available from: http://www.amazon.com/Social-Epidemiology-Lisa-F-Berkman/dp/0195083318

6. Department of Health. Healthy lives, healthy people: our strategy for public health in England. London: Department of Health, 2010. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/DH_121941

7. Department of Health. Equity and excellence: liberating the NHS. London: Department of Health, 2010. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_117353

8. Health and Social Care Act. 2012 (UK). Available from: http://www.legislation.gov.uk/ukpga/2012/7/notes/division/2

9. National Health Service Act. 2006 (UK). Available from: http://www.legislation.gov.uk/ukpga/2006/41/contents

10. Louis G. Surveillance recommendations for developing effective tobacco prevention and control interventions for low-SES populations. Health Promotion Practice. 2008;10(2):276–83. Available from: http://hpp.sagepub.com/content/10/2/276.long

11. Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs–2007. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2007. Available from: http://www.cdc.gov/tobacco/tobacco_control_programs/ntcp/index.htm

12. Ministerial Council on Drug Strategy. Australian National Tobacco Strategy 2004-2009. Canberra: Department of Health and Ageing, 2005. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-strat

13. Gillard J, and Wong P. An Australian social inclusion agenda: Election 2007. Canberra: Australian Labor Party, 2007. Available from: http://www.alp.org.au/download/now/071122_social_inclusion.pdf

14. National Health Priority Action Council. National Chronic Diseases Strategy. Canberra: Australian Government Department of Health and Ageing, 2006. Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/pq-ncds-strat

15. Boyd M. Reducing health inequalities. Melbourne, Australia: Victorian Health Promotion Foundation, 2007. Available from: http://www.vichealth.vic.gov.au/inequalities

16. VicHealth. VicHealth position statement on health inequalities. Melbourne, Australia: Victorian Health Promotion Foundation, 2005. Available from: http://www.vichealth.vic.gov.au/Publications/Health-Inequalities.aspx

17. Australian Government. Taking preventative action: Government's response to the Australia: the healthiest country by 2020. Canberra: Department of Health and Ageing, 2010. Available from: http://yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/report-preventativehealthcare

18. Fagan P, Moolchan E, Lawrence D, Fernander A, and Ponder P. Identifying health disparities across the tobacco continuum. Addiction. 2007;102(suppl. 2):5–29. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17850611

19. Kawachi I, Subramanian SV, and Almeida-Filho N. A glossary for health inequalities. Journal of Epidemiology and Community Health. 2002;56(9):647–52. Available from: http://jech.bmj.com/cgi/content/full/56/9/647

20. Graham H. Why social disparities matter for tobacco-control policy. American Journal of Preventive Medicine. 2009;37(suppl. 2):S183–4. Available from: http://www.ajpm-online.net/article/PIIS0749379709002888/fulltext

21. Graham H. Tackling inequalities in health in England: remedying health disadvantages, narrowing health gaps or reducing health gradients. Journal of Social Policy. 2004;33:115–31. Available from: http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=198421

22. Mackenbach J, and Kunst A. Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe. Social Science & Medicine. 1997;44(6):757–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9080560

23. Adhikari P, and Summerill A. 1998 National Drug Strategy Household Survey: detailed findings. Drug statistics series no 6, AIHW cat. no. PHE 27. Canberra: Australian Institute of Health and Welfare, 1999. Available from: http://www.aihw.gov.au/publications/index.cfm/title/6243

24. 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

25. Australian Institute of Health and Welfare. 2004 National Drug Strategy Household Survey: detailed findings. Drug statistics series no 16, AIHW cat. no. PHE 66. Canberra: AIHW, 2005. Available from: http://www.aihw.gov.au/publications/phe/ndshsdf04/ndshsdf04.pdf

26. 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/index.cfm/title/10674

27. Gray N, and Hill D. Patterns of tobacco smoking in Australia. Medical Journal of Australia. 1975;2(22):819–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1207580

28. Gray N, and Hill D. Patterns of tobacco smoking in Australia II. Medical Journal of Australia. 1977;2(10):327–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/927253

29. Hill D, and Gray N. Patterns of tobacco smoking in Australia. Medical Journal of Australia. 1982;1(1):23–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7062879

30. Hill D, and Gray N. Australian patterns of smoking and related health beliefs in 1983. Community Health Studies. 1984;8(3):307–16. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6518750

31. Hill D. Australian patterns of tobacco smoking in 1986. Medical Journal of Australia. 1988;149(1):6–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3386578

32. Hill D, and White V. Australian adult smoking prevalence in 1992. Australian Journal of Public Health. 1995;19(3):305–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7626682

33. Hill DJ, White VM, and Gray NJ. Measures of tobacco smoking in Australia 1974-1986 by means of a standard method. Medical Journal of Australia. 1988;149(1):10–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3386561

34. Hill DJ, White VM, and Scollo MM. Smoking behaviours of Australian adults in 1995: trends and concerns. Medical Journal of Australia. 1998;168(5):209–13. Available from: http://www.mja.com.au/public/issues/mar2/hill/hill.html

35. White V, Hill D, Siahpush M, and Bobevski I. How has the prevalence of cigarette smoking changed among Australian adults? Trends in smoking prevalence between 1980 and 2001. Tobacco Control. 2003;12(suppl. 2):ii67-74. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/12/suppl_2/ii67

36. Australian Bureau of Statistics. 4364.0 National Health Survey 1989-90: summary of results. Canberra: ABS, 1992. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.01995

37. Australian Bureau of Statistics. 4364.0 National Health Survey 1995: summary of results. Canberra: ABS, 1997. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.01995

38. Australian Bureau of Statistics. 4364.0 National Health Survey 2001: summary of results. Canberra: ABS, 2002. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.02001

39. Australian Bureau of Statistics. 4364.0 National Health Survey 2004-05: summary of results. Canberra: ABS, 2006. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.02004-05

40. Australian Bureau of Statistics. 4364.0 National Health Survey: summary of results (re-issue), 2007-08. Canberra: ABS, 2009. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0

41. Australian Bureau of Statistics. 4363.0.55.001 National Health Survey: Users' guide - electronic, 2007-08. Canberra: ABS, 2009. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4363.0.55.001

42. Hayes L, Durkin S, and Wakefield M. Smoking prevalence and consumption in Victoria: key findings from the 1998–2010 population surveys. CBRC Research Paper Series, no. 42. Melbourne, Australia: Centre for Behavioural Research in Cancer, Cancer Council Victoria, 2011. Available from: http://www.cancervic.org.au/about-our-research/centre_behavioural_research_cancer/cbrc_research_paper_series

43. Tobacco Control Research and Evaluation. Key smoking statistics for South Australia, 2008. Adelaide: Cancer Council South Australia, , 2008. Available from: http://www.cancersa.org.au/cms_resources/Key_%20Smoking_Statistic_for_SA_2008_web_layout.pdf

44. The Social Research Centre. National Tobacco Survey: smoking prevalence and consumption 1997-2005. Sydney: SRC for the Research and Marketing Group, Business Group, Department of Health and Ageing, 2006. Available from: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/national-tobacco-campaign-lp

45. Fong GT, Cummings KM, Shopland DR, and ITC Collaboration. Building the evidence base for effective tobacco control policies: the International Tobacco Control Policy Evaluation Project (the ITC Project). Tobacco Control. 2006;15(suppl 3):iii1–2. Available from: http://tc.bmjjournals.com/cgi/content/abstract/15/suppl_3/iii1

46. Thompson ME, Fong GT, Hammond D, Boudreau C, Driezen P, Hyland A, et al. Methods of the International Tobacco Control (ITC) Four Country Survey. Tobacco Control. 2006;15(suppl 3):iii12-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16754941

47. Melbourne Institute of Applied Economic and Social Research. The Household, Income and Labour Dynamics in Australia (HILDA) Survey. Melbourne: University of Melbourne, 2011. 1 Feb 2012 [viewed 30 April 2012] . Available from: http://melbourneinstitute.com/hilda/

48. Australian Bureau of Statistics. 6503.0 Household Expenditure Survey and Survey of Income and Housing: summary of results, 2009-10. Canberra: ABS, 2011. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/6530.02009-10?OpenDocument

49. White VM, Hayman J, and Hill DJ. Can population-based tobacco-control policies change smoking behaviors of adolescents from all socio-economic groups? Findings from Australia: 1987–2005 Cancer Causes & Control. 2008;19(6):631–40. Available from: http://www.springerlink.com/content/x1h33x711616h254/

50. White V, and Smith G. Chapter 3. Tobacco use among Australian secondary students. Australian secondary school students' use of tobacco, alcohol, and over-the-counter and illicit substances in 2008. Canberra: Drug Strategy Branch Australian Government Department of Health and Ageing, 2009. Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/school08

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