1.5 Prevalence of smoking—middle-aged and older adults

Last updated: December 2021
Suggested citation: Greenhalgh, EM, Bayly, M, & Scollo M. 1.5 Prevalence of smoking—middle-aged and older adults. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021. Available from http://www.tobaccoinaustralia.org.au/chapter-1-prevalence/1-5-prevalence-of-smoking-middle-aged-and-older-ad

1.5.1 Latest estimates of prevalence among middle-aged and older adults

The 2019 National Drug Strategy Household Survey examined smoking prevalence among adults aged 40 years and over.1  As noted in the preceding section, people aged under 40 years are generally more likely to smoke than those in older age groups. Table 1.5.1 shows the prevalence of smoking at various frequencies among middle-aged and older adults in 2019.

 

Table 1.5.1
Middle-aged and older adults: percentage of daily, regular* and current smokers 2019—by age group, sex and total population (%)

 

* Includes persons smoking any combination of cigarettes (factor-made and roll-your-own), pipes or cigars. Data for 2019 weekly and less-than-weekly smoking will be added once the data file for the survey becomes available.

† Smoked more than 100 cigarettes (manufactured or roll-your own) or the equivalent amount of tobacco in their life but reports no longer smoking.

‡ Never smoked more than 100 cigarettes (manufactured or roll-your own) or the equivalent amount of tobacco. 

Source: Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2019 – 2. Tobacco smoking chapter, Supplementary data tables, Table 2.7. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data and Centre for Behavioural Research in Cancer analysis of National Drug Strategy Household Survey data.2

The Australian Bureau of Statistics also collects data on smoking status among Australians aged 15 years and over. In 2020–21, the prevalence of daily smoking among 35–44 year olds was 11.7%, and 12.5% were current smokers. Among 45–54 year olds, 13.6% were daily smokers and 14.3% were current smokers. Among 55–64 year olds 13.7% were daily smokers and 14.6% were current smokers, and among those aged 65+ 6.6% were daily smokers and 7.1% were current smokers. The ABS notes however that due to the impact of COVID-19 on data collection and sample representativeness, this data should not be compared with prior survey years.3

1.5.2 Trends in smoking prevalence among middle-aged and older adults

Consistent with smoking patterns from 2001 onward, data from the AIHW’s National Drug Strategy Household Survey suggests that in 2019, middle-aged (40–59 years) and older (60+ years) men were significantly more likely to have smoked at some time in their lives (that is, to be a current or ex-smoker) than men aged under 40 years. Patterns among women, however, have varied over time. In earlier survey years, middle-aged women were generally more likely to have ever smoked than younger women (aged under 40 years), while older women were less likely than women under 40 years to have ever smoked. From 2013 onwards, both middle-aged and older women were significantly more likely to have ever smoked than women under the age of 40.

Decreasing smoking rates among the older population reflect increased quitting activity, with past studies showing that older age groups of both sexes have the highest quit proportions (defined as the proportion of ever smokers who have quit smoking).4, 5 These patterns were also seen in 2019; men and women over 60 had the highest quit proportions (82% and 79%, respectively), followed by middle-aged men and women (58% and 63%, respectively). Proportions were lowest among men and women under 40 (44% and 49%, respectively). However, tobacco-caused death and illness occurring among smokers in older age groups are also significant factors in the declining smoking rates seen in the older population, with the greatest proportion of burden of disease due to smoking affecting those aged 55–75 years.6

Table 1.5.2 and Figure 1.5.1 show that smoking prevalence has declined significantly among middle-aged and older adults since 2001 (controlling for sex). While there was no significant change between 2016 and 2019 among either age group, the prevalence of regular smoking was significantly lower among adults aged 60+ in 2019 than 2013.

Table 1.5.2
Middle-aged and older adults—percentage of regular* smokers† by age group, sex and total population for age group, 2001–2019‡ (%) 

 

* Includes those reporting that they smoke ‘daily’ or ‘at least weekly’.

† Includes persons smoking any combination of cigarettes, pipes or cigars.

‡ All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition.

Source: Centre for Behavioural Research in Cancer analysis of National Drug Strategy Household Survey data from 2001 to 2019

Figure 1.5.1
Prevalence of regular* smokers† in Australia aged 18+, 1995 to 2019—by age range‡ (%) 

* Includes those reporting that they smoke ‘daily’ or ‘at least weekly’.

† Includes persons smoking any combination of cigarettes, pipes or cigars.

‡ All data weighted to the Australian population appropriate for each survey year and may vary slightly from data presented in previous edition.

Source: Centre for Behavioural Research in Cancer analysis of National Drug Strategy Household Survey data from 1995 to 2019.

Data from the 2019 National Drug Strategy Household Survey provides additional information on smoking prevalence in older Australians. In 2019, 7.9% of people aged between 55 and 64, 3.3% of people aged between 65 and 74, and 5% of people aged 75 or more smoked on a daily basis.1

References 

1. Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2019 - 2. Tobacco smoking chapter, supplementary data tables. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data.

2. Australian Institute of Health and Welfare. National Drug Strategy Household Survey, 2019. ADA Dataverse, 2021. Available from: http://dx.doi.org/10.26193/WRHDUL.

3. Australian Bureau of Statistics. Pandemic insights into Australian smokers, 2020-21.  2021. Available from: https://www.abs.gov.au/articles/pandemic-insights-australian-smokers-2020-21.

4. Hill D, White V, and Scollo M. Smoking behaviours of Australian adults in 1995:  Trends and concerns. Medical Journal of Australia, 1998; 168:209-13. Available from: https://www.mja.com.au/journal/1998/168/5/smoking-behaviours-australian-adults-1995-trends-and-concerns

5. Gartner CE, Barendregt JJ, and Hall WD. Predicting the future prevalence of cigarette smoking in Australia: How low can we go and by when? Tobacco Control, 2009; 18:183-9. Available from: http://tobaccocontrol.bmj.com/cgi/content/abstract/tc.2008.027615v1

6. Begg S, Vos T, Barker B, Stevenson C, Stanley L, et al. The burden of disease and injury in Australia 2003. Phe 82. Canberra: Australian Institute for Health and Welfare, 2007. Available from: https://www.aihw.gov.au/reports/burden-of-disease/burden-of-disease-injury-australia-2003/contents/table-of-contents.