In the early part of this century, few women smoked. Although there is no readily available prevalence data predating 1945, it is evident from past records of female lung cancer death rates that cigarette smoking was not common among women until the 1920s and the 1930s (see Section 16.5 below).
It is a commonly heard fallacy that more women smoke than men. Until the 1989 national survey, women's smoking rates had always been significantly lower than men's. The 1989 survey noted that based on data collected, there was no 'statistically significant' difference between men's and women's smoking rates: they were roughly equivalent.(15) However the most recent national survey (1992) found that the difference between male and female smoking rates was significant once more, men showing a higher prevalence of smoking than women.(16)
Highest smoking rates are measured for both women and men during their early twenties, and more men than women smoke in all age brackets except for the 16-20 age group. As a general observation, the higher educated or more prestigious her job, the less likely a woman is to smoke.
The tables below provide a picture of smoking prevalence among women. Men's rates are included for comparison.
Note: The assistance of Ms Vicki White (Centre for Behavioural Research in Cancer, Anti-Cancer Council of Victoria) in preparing the following tables and statistical comment is gratefully acknowledged.
Since 1945, the year for which reliable prevalence data was first made available and published, men's smoking rates have declined dramatically. Women have always had a lower prevalence of smoking than men, and this was still seen in 1992. Over the last 47 years the prevalence of smoking among women has changed little, although the most recent surveys have shown that the proportion of women smoking is in decline, with a significant decrease seen between 1989 and 1992 (Table 16.1).(15,17,18)
The declines in overall smoking prevalence noted in the Section above have led to an increase in the proportion of people who have ever smoked who are now ex-smokers. This proportion, defined by Hill et al as the quit proportion,(15) has increased steadily between 1974 and 1992, the latest year for which national estimates are available (based on the data in the Hill et al series).(15,16,18) Quit proportions have increased at similar rates in both sexes (Table 16.2).(19,20) For further discussion about quitting trends, see Chapter 12, Section 1.
Smoking rates among adult Australian males have shown a persistent decline since the published maximum of 72% in 1945. Adult female rates increased slightly from 26% in 1945 to reach a maximum of 33% in 1976 before declining, albeit more slowly than in males, thereafter.
Over the next few years, if the trends evident since 1976 continue, smoking rates between men and women will be equal around 2003 at about 18%. Thereafter rates will be lower in men than in women. Hypothetically, male smoking rates will be zero around 2022 when about 8% of women will still be smoking, women not reaching zero until 2034.
National surveys on schoolchildren's smoking rates were undertaken in 1984,(21) 1987,(22) 1990(23) and 1993.(24) Table 16.3 shows the percentage of students by sex and age group who were current smokers (classified on the basis as having smoked in the week prior to the survey) in the four survey years. Between 1984 and 1990, the prevalence of smoking among 12 to 15 year-olds decreased. Among students aged 16 and 17 years old, the prevalence of smoking decreased between 1984 and 1987, but no change was found between 1987 and 1990.(24)
A different trend appears to have emerged between 1990 and 1993. The proportion of male current smokers in 1993 is higher than that found in 1990 in all age groups. Among girls, the proportion of female current smokers in 1993 is greater than or equal to that found in 1990 among all age groups.(24) Among 12 to 15 year-olds, the proportion of secondary school students who are current smokers has increased, the increase among boys being more pronounced than that among girls. The proportion of 16 to 17 year olds who are current smokers may also have increased, but these data do not reach statistical significance.(24) Hill et al observe that the trend towards reduced student smoking seen throughout the 1980s appears to have ended, although the increase noted appears to be among 'experimental' rather than 'committed' smokers (the proportion smoking on three or more days per week).(24)
In all survey years, smoking prevalence was higher among girls than boys in all but the youngest age sample; however in the 1993 survey this difference only reached statistical significance among 15 year olds.(24) In general, boys who smoke, smoke more heavily than girls who smoke (although neither group smokes as heavily as the average adult smoker -- see Chapter 2, Section 3 for further discussion).
In 1993, the prevalence of smoking among students aged 15-16 was close to the adult smoking prevalence, if one considers the proportion who smoke at least once a week. The main developmental period of uptake of current smoking among schoolchildren therefore appears to be between the ages of 12 and 16 years.(23)
It is important to note that because these surveys are confined to schoolchildren, rates measured for the 16 to 17 year-old age groups may not be representative for all teenagers of these ages as they do not account for those who have left school. However in response to Australia's economic downturn in the late 1980s and early 1990s, school retention rates have increased dramatically (from 45% in 1984, to 64% in 1990 and 77% in 1993). Hill et al note that because of this factor, the population in the older age groups is likely to have changed over the study years.(24) It therefore follows that the 1993 data are more likely to be representative of the smoking behaviour of the overall teenage population than in previous years. However, teenagers outside the school system may have a higher prevalence of smoking. Higher achieving students are more likely to remain at school for longer than lower achievers, and academic standard is related to school age smoking.(25) Teenagers who have left school may also receive a greater degree of exposure to tobacco use, whether in the workplace (see also Chapter 10), or in a peer group where unemployment is common (the unemployed in general exhibiting higher smoking rates -- see Table 16.5 below).
Higher prevalence of smoking among girls than boys is not unique to Australia, but has been noted in a number of Western countries.(26) This may be due to factors such as girls' greater tendency to be concerned about being slim compared with boys' greater concerns with fitness, and a response to the imagery of advertising. It has also been suggested that girls' early higher smoking rates are a result of their earlier maturation,(26) and the general inclination for girls to associate with boys of older ages (who tend to have higher smoking rates). However in adult age groups, male prevalence exceeds female prevalence (see below).
Data measuring trends in smoking across age groups show that young adults of both sexes have the highest smoking rates in the community.(15,16,18) Table 16.4 below compares smoking rates for men and women in the four most heavily smoking age groups. Peak prevalence occurred for both sexes in 1992 in the 20-24 age bracket. Between 1980 and 1992, little significant change has been observed; in females, none of the observed differences over the survey period reach statistical significance.
An analysis of smoking rates by occupational level shows that overall, for both sexes, blue collar workers smoke more than white collar workers. For males of all occupational groups, the 1992 prevalence estimates are significantly lower than those found in 1980. Among women, between 1980 and 1992 there was a significant decrease in the proportion of smokers in upper blue and upper white collar occupations (Table 16.5).
Increasing education levels are associated with decreasing smoking prevalence.(15) Table 16.6 shows smoking prevalence by education level between 1980 and 1992. For males in education groups I and II, the 1992 prevalence estimates were significantly lower than those found in 1980. Between 1980 and 1992 there was a significant decline in smoking among females in education group I.
As more educated groups, and those in higher socioeconomic groups, quit smoking or more importantly, never taken it up, smoking has become increasingly concentrated among the less educated and the blue collar worker. The tobacco industry is well aware of its major market: according David Bacon, an executive with WD & HO Wills, concerns about smoking are a phenomenon of the middle and upper classes -- 'It is not an issue with blue-collar workers or out in the western suburbs'.(30) The concentration of women in the lower end of income spectrum, and their lesser likelihood of participation in higher education(31) are factors which help to lock women into the demographic target group of the tobacco industry.
Readers interested in further demographic information about smoking prevalence in Australia are referred to Chapter 1.