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 2010. 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. 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.
4.19.1 General 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 4.19.1). Exposure to secondhand smoke in the home 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
Smokers’ and non-smokers’ perceptions of the effects of tobacco smoke on non-smokers, 2004
* Never or ex-smoker
† Daily, weekly and less than weekly smokers
Source: AIHW 20062
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
4.19.2 Knowledge 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.4-6
Table 4.19.2 presents the findings of a survey undertaken in Victoria in 2007.4 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 of lung cancer, followed by other respiratory problems and heart disease. There was lower awareness about the effects of secondhand smoke on children and babies.4
Illnesses caused by secondhand smoke (prompted recall) by smoking status, Victoria, 2007
* Non-smokers include former smokers and never smokers
† Smokers include those who smoke daily, weekly and less than weekly
Source: Centre for Behavioural Research in Cancer4
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.7
4.19.3 Changes in smoking behaviour due to beliefs about secondhand smoke
The National Drug Strategy Household Survey (2010)8 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 (20%) had been motivated by the concern that their smoking was affecting the health of those around them (Table 4.19.3).9
Factors that motivated change to smoking behaviour, smokers aged 14 years and older by sex, Australia, 2013
Notes: Base is those smokers who reported undertaking measures. Respondents could select more than one response
Source: National Drug Strategy Household Survey (2013)10
4.19.4 Avoidance of cigarette smoke
Results from the National Drug Strategy Household Survey in 20079 show that 85% of non-smokers either always or sometimes take measures to avoid exposure to secondhand smoke. About 44% of non-smokers stated they ‘always’ avoid smoky environments, and a further 41% attempt to avoid exposure to other people’s cigarette smoke ‘sometimes’ (Table 4.19.4). 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.9 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
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 are ex-smokers and people who have never smoked
Source: National Drug Strategy Household Survey 20079
4.19.5 Behaviour 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 4.19.5). 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
Response to someone lighting up a cigarette nearby by smoking status, Victoria, 2004
*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 Cancer12
The author of this report observed 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
Relevant news and research
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1. Hill D. Public opinion in victoria 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. International tobacco control four country data, 2006, Carolyn Ford of the Cancer Council Victoria, Editor 2011, The Cancer Council Victoria: Melbourne, Vic.
4. 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
5. 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.
6. Cancer Institute NSW. New South Wales smoking and health survey 2009. 2011 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
7. Savvas S. International tobacco control four country data (personal communication), Carolyn Ford of the Cancer Council Victoria, Editor 2011, The Cancer Council Victoria: Melbourne, Vic.
8. 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
9. 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
10. Australian Institute of Health and Welfare. National Drug Strategy Household Survey detailed report 2013. Drug statistics series no. 28, AIHW cat. no. PHE 183.Canberra: AIHW, 2014. Available from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848
11. 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
12. 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.