Smoking prevalence - adults | National Cancer Control Indicators

Published

28 Jun, 2019

Tobacco use is the single largest cause of cancer globally and the predominant cause of lung cancer.¹ The risk of developing lung cancer due to tobacco smoking increases with the duration of smoking and the numbers of cigarettes smoked per day.²

Summary

Smoking prevalence in Australia is decreasingFrom 2001 to 2017-18, the proportion of adults smoking daily decreased from 22.4% to 13.8%. From 1989-90 to 2017-18, the proportion of adults reported as non-smokers increased from 71.6% to 84.9%.

Smoking prevalence is higher among Indigenous personsIn 2014-15, 40.6% of Indigenous adults smoked daily, compared with 14.5% of non-Indigenous adults (age-standardised data).

Smoking prevalence is higher among persons living in regional and remote Australia, and in lower socioeconomic status areasIn 2017-18, approximately 20% of adults smoked daily in Outer Regional and Remote areas, and in areas of greatest socioeconomic disadvantage.

Australia has one of the lowest smoking prevalence rates in the worldCompared with selected developed countries, Australia was among the three countries with the lowest proportion of persons aged 15+ years who were daily smokers (12.4%).

Data

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Not smoking / Daily smoking

Notes

• Data sourced from ABS National Health Surveys from 1989-90 to 2017-18.
• Data for not smoking is the sum of adults reported as either ex-smokers or having never smoked (see 'About the data').
• Error bars indicate 95% margin of error.
• Rates are not age-standardised.

Proportion of Australian adults not smoking or smoking daily, by year
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Persons / Males / Females
Not smoking / Daily smoking

Notes

• Data sourced from ABS National Health Surveys from 2001 to 2017-18.
• Data for not smoking is the sum of adults reported as either ex-smokers or having never smoked (see 'About the data').
• Daily smoking data were not available for the 65-74 and 75+ age groups for 2004-05 and 2007-08.
• Error bars indicate 95% margin of error.

Proportion of Australian adults not smoking or smoking daily, by year and age
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Notes

• Data sourced from ABS National Aboriginal and Torres Strait Islander Health Survey and Social Survey data.
• Rates are age-standardised.
• Error bars indicate 95% margin of error.

Proportion of Australian adults smoking daily, by Indigenous status
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Notes

• Data sourced from ABS National Health Surveys 2001 to 2017-18.
• Remoteness was classified according to the Australian Statistical Geography Standard (ASGS) Remoteness Areas, see 'About the data' for more details.
• Adult daily smoking data by remoteness category are not available for 2007-08.
• Rates are not age-standardised.
• Error bars indicate 95% margin of error.

Proportion of Australian adults smoking daily, by remoteness
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Notes

• Data sourced from ABS National Health Surveys 2004-05 to 2017-18.
• SES was classified according to the Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-economic Disadvantage (IRSD), see 'About the data' for more details.
• SES data only available for SES 1 and SES 5 quintiles in 2004-05. [SES data not available for adults in 2007-08.]
• Rates are not age-standardised.
• Error bars indicate 95% margin of error.

Proportion of Australian adults smoking daily, by socioeconomic status (SES)
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Notes

• Data sourced from OECD.Stat Health Statistics website.
• Rates are not age-standardised.
• See 'About the Data' tab for details of the most recent year of data used for each country.
• International comparability is limited due to the lack of standardisation in the measurement of smoking habits in health interview surveys across OECD countries. There is variation in the wording of the question, the response categories and the related administrative methods.

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About this measure

About 90% (Australian men) and 65% (Australian women) of lung cancers are attributable to tobacco smoking.³ It is projected that in Australia in 2019, 7,184 males and 5,633 females will be diagnosed with lung cancer, and that it will be the most common cause of cancer death.^4,5 Tobacco smoking also causes cancers of the oral cavity, pharynx, nasal cavity and accessory sinuses, larynx, oesophagus, stomach, pancreas, colon and rectum, liver, kidney, ureter, bladder, cervix and ovary, and myeloid leukaemia.¹ An association between tobacco smoking and female breast cancer has also been reported by the International Agency for Research on Cancer (IARC) and this finding is supported by a recent meta-analysis of nearly 32,000 breast cancer cases.⁶ In addition, tobacco use is estimated to be attributable to 22% of the cancer burden on the Australian population.⁷

The data in this measure show proportions of adult Australians aged 18 years or over indicating that they did not smoke, and those reporting smoking on a daily basis.

Current status

In 2017-18, 84.9% of persons (81.7% of males and 87.9% of females) aged 18 years and over reported that they did not smoke, whilst 13.8% (16.5% of males and 11.1% of females) reported smoking on a daily basis.⁸ Smoking prevalence was similar across the age groups from 18 to 64 years of age, and lower among those aged 65 years and over.

Aboriginal and Torres Strait Islander peoples

Smoking prevalence data for Aboriginal and Torres Strait Islander peoples are available for the period 2014-15.

Smoking prevalence is higher among Australia’s Indigenous population. In 2014-15, the age-standardised proportion of daily smokers was 40.6% for Indigenous Australians and 14.5% for the non-Indigenous population.⁹

Remoteness and Socioeconomic status (SES)

In 2017-18, the proportion of persons smoking daily was highest among Australians living in Outer Regional and Remote areas (19.0%) and lowest among those living in Major Cities (12.7%). This pattern was similar for both males (23.2% compared to 15.1%) and females (15.7% compared to 9.7%).⁸

In 2017-18, the proportion of persons smoking daily in the lowest SES areas was about three-fold higher than the proportion smoking daily in the highest SES areas (SES 1; 21.7% compared to SES 5; 6.8%). Among adults living in the lowest SES areas (SES 1), 25.3% of males and 18.1% of females reported smoking daily compared to 8.2% of males and 5.0% of females living in the highest SES areas (SES 5).⁸

International comparisons

International data are available for daily smokers aged 15 years or more. The proportion of Australians who were daily smokers was 12.4%, which was comparable to the USA (11.8%) and Canada (12.5%) figures.¹⁰

Trends

The prevalence of smoking among adult Australians has decreased over the past two-and-a-half decades. From 1989-90 to 2017-18, the proportion of persons reporting that they did not smoke increased from 71.6% to 84.9% (from 67.9% to 81.7% among males, and from 75.3% to 87.9% among females).^8,11-17 Daily smoking rates were first reported in 2001; the proportion of persons reporting that they smoked daily decreased from 22.4% in 2001 to 13.8% in 2017-18 (from 25.4% to 16.5% among males, and from 19.5% to 11.1% among females).^8,13-17

Age groups

For those years where data were available for all age groups (2001 to 2017-18), larger increases in persons reporting that they did not smoke were observed in the 18–24, 25–34 and 35–44 years age groups than in 45–54, 55–64, 65–74 and 75+ years age groups. Similarly, larger decreases in proportions of persons smoking daily were observed for males and females aged under 45 years.^8,13-17

Aboriginal and Torres Strait Islander peoples

Smoking prevalence data for Aboriginal and Torres Strait Islander peoples are available for the period 2014-15.

The age-standardised proportion of Indigenous persons who were daily smokers decreased from 51.0% in 2001 to 40.6% in 2014-15. For the non-Indigenous population, the age-standardised proportions who were daily smokers were 22.4% in 2001 and 14.5% in 2014-15.^9,18

Remoteness and Socioeconomic status (SES)

From 2001 to 2017-18, decreases in daily smoking were seen across all remoteness area groupings, with the largest decrease among Australians living in Major Cities.^8,13-17

For daily smoking rates by socioeconomic status, data were available from 2004-05 for the lowest and highest quintiles. From 2004-05 to 2017-18, there was a greater reduction in daily smoking rates among Australians living in areas of greatest socioeconomic disadvantage than among those living in the least disadvantaged areas.^8,14-17

Tobacco control in Australia

The reduction in prevalence of adult smoking in Australia from 1989-90 to 2017-18 appears to have occurred mostly in age groups under 45 years old. Cigarette smoking often becomes established in adolescence, and young people who begin smoking at an earlier age are more likely to develop long-term nicotine addiction.¹⁹ The reduction in smoking prevalence in age groups less than 45 years old may reflect reductions in teenage smoking prevalence over the last 15-20 years (see NCCI measure Smoking prevalence - Adolescents). The establishment of the first National Tobacco Campaign in 1997 likely contributed to the decline in smoking prevalence,^20,21 and this was complemented by promotion of other tobacco control initiatives at the Commonwealth and state and territory level. This includes: graphic health warnings on cigarette packs, tobacco excise increases and the introduction of plain packaging.²¹

Tobacco smoking remains a major public health problem in Australia and internationally. The decrease in smoking prevalence from 1989-90 to 2017-18, and the observation that daily smoking rates in Australia are broadly similar to the lowest rates for other countries, points to positive effects of Australian public health initiatives in this field.

About the data

Smoking prevalence has been measured in terms of the proportion of the population aged 18 years and older reporting not smoking, and the proportion of the population aged 18 years and older reporting daily smoking. The proportion of persons not smoking is the sum of persons who are ex-smokers, and persons who have never smoked.

For International data daily smoking is defined as the percentage of the population aged 15 years old or over who report that they are daily smokers.

Data for adults aged 18+ is sourced from the National Health Survey, a series of Australia-wide health surveys conducted by the Australian Bureau of Statistics (ABS). Indigenous data was sourced from the National Aboriginal and Torres Strait Islander Health Surveys, and Social Surveys, also conducted by the ABS.

SES quintiles are developed from the Index of Relative Socio-Economic Disadvantage. Attributes summarised by this index include low income, low educational attainment, high unemployment and jobs in relatively unskilled occupations. SES 1 is the most disadvantaged group.

Definitions

Daily smoker was defined as smoking one or more cigarettes, cigars or pipes per day.

Ex-smoker is defined as not currently smoking, but had regularly smoked daily, or had smoked at least 100 cigarettes in their lifetime, or smoked pipes, cigars etc. at least 20 times. Note: from 1989-90 to 2001, an Ex-smoker was defined as not currently smoking but had been a regular (i.e. daily) smoker in the past.

Never smoked is defined as having never regularly smoked, and smoked less than 100 cigarettes in their lifetime and had smoked pipes, cigars, etc. less than 20 times. Note: from 1989-90 to 2001, Never smoking was defined as having never smoked regularly (i.e. daily).

Methodology

Remoteness

The Australian Statistical Geography Standard (ASGS) was used to allocate participants to a remoteness area based on their area of usual residence.

Earlier data used the now superseded Australian Standard Geographical Classification (ASGC), 2001 and 2004-05 data used the 2001 ASGC, 2011-12 used 2006 ASGC, 2014-15 data used the 2011 ASGC, and 2017-18 data used the ASGS 2016.

Socioeconomic status

The Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage (IRSD) was used to allocate participants to a SES quintile based on their usual residence.

For 2004-05 data the 2004-05 IRSD was used, for 2011-12 and 2014-15 data the 2011 IRSD was used, and for 2017-18 data the 2016 IRSD was used.

Data sources

ABS National Health Surveys – 1989-90, 1995, 2001, 2004-05, 2007-08, 2011-12, 2014-15, 2017-18.
ABS National Aboriginal and Torres Strait Islander Health Surveys – 2001, 2004-05, 2012-13, 2014-15.
OECD.Stat. Health Statistics (database). Non-medical determinants of health. OECD; 2018. [Accessed May 2019]; https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#

Data caveats

Definitions of Ex-smokers and Never smoked changed after 2001. The effect of these changes increased the number of ‘ex-smokers’ and decrease the number in the ‘never smoked’ category, but did not affect the overall number classed as ‘not smoking’.

International data

Daily smokers is defined as the percentage of the population aged 15 years old or over who report that they are daily smokers.
International comparability is limited due to the lack of standardisation in the measurement of smoking habits in health interview surveys across OECD countries. There is variation in the wording of the question, the response categories and the related administrative methods.
The most recent year for international data varies between 2016 and 2017. Countries and years of most recent data are as follows:

Country	Most Recent Year
Ireland	2017
Germany	2017
New Zealand	2017
Chile	2016
United Kingdom	2016
Japan	2016
Korea	2016
Canada	2016
Australia	2016
United States	2016

References

Activity in this area

Data:

National Drug Strategy Household Survey 2016. Australian Institute of Health and Welfare 2017. Canberra AIHW. [Accessed May 2019]; https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-key-findings/contents/summary

Social Health Atlases of Australia: Population Health areas – Health risk factors, data; [Accessed May 2019]; http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-population-health-areas

Policy:

National Tobacco Campaign. [Accessed May 2019]; http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/home

National Tobacco Strategy 2012-2018. Australian Government Department of Health. [Accessed May 2019]; http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-strategy

References

1. International Agency for Research on Cancer 2012. Personal Habits and Indoor Combustions. Volume 100E. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: IARC.

2. Stewart BW, Wild CP editors 2014. World cancer report. Lyon: International Agency for Research on Cancer, WHO.

3. Australian Institute of Health and Welfare & Cancer Australia 2011. Lung cancer in Australia: an overview. Cancer series no. 64. Cat. no. CAN 58. Canberra: AIHW.

4. Australian Institute of Health and Welfare 2019. Cancer in Australia 2019. Cancer series no.119. Cat. No. CAN 123. Canberra: AIHW.

5. Lung Cancer statistics. Cancer Australia 2018. [Accessed May 2019]; https://lung-cancer.canceraustralia.gov.au/statistics

6. Cancer Australia 2015. Position Statement: Lifestyle risk factors and the primary prevention of cancer. Surry Hills, NSW: Cancer Australia.

7. Australian Institute of Health and Welfare 2019. Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease series no. 19. Cat. no. BOD 22. Canberra: AIHW.

8. Australian Bureau of Statistics 2018. National Health Survey: First Results 2017-18. Cat. no. 4364.0.55.001. Canberra: ABS.

9. Australian Bureau of Statistics 2016. National Aboriginal and Torres Strait Islander Social Survey, 2014-15. Cat. no. 4714.0. Canberra: ABS.

10. OECD.Stat. [Accessed May 2019]; http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#

11. Australian Bureau of Statistics 1994. National Health Survey: Lifestyle and Health 1989-90. Cat. no. 4366.0. Canberra: ABS.

12. Australian Bureau of Statistics 1997. National Health Survey: Summary of Results 1995. Cat. no. 4364.0. Canberra: ABS.

13. Australian Bureau of Statistics 2002. National Health Survey: Summary of Results, 2001. Cat. no. 4364.0. Canberra: ABS.

14. Australian Bureau of Statistics 2006. National Health Survey: Summary of Results 2004-05. Cat. no. 4364.0. Canberra: ABS.

15. Australian Bureau of Statistics 2009. National Health Survey: Summary of Results 2007-08 (Reissue). Cat. no. 4364.0. Canberra: ABS.

16. Australian Bureau of Statistics 2012. Australian Health Survey: First Results, 2011-12. Cat. no. 4364.0.55.001. Canberra: ABS.

17. Australian Bureau of Statistics 2015. National Health Survey: First Results 2014-15. Cat. no. 4364.0.55.001. Canberra: ABS.

18. Australian Bureau of Statistics 2014. Australian Aboriginal and Torres Strait Islander Health Survey: Updated Results, 2012-13. Cat no. 4727.0.55.006. Canberra: ABS.

19. Centers for Disease Control and Prevention 1994. Preventing tobacco use among young people: a report of the Surgeon General (Executive Summary). MMWR; 43(No. RR-4).

20. Hill D, White V and Effendi Y 2002. Changes in the use of tobacco among Australian secondary students: results of the 1999 prevalence study and comparisons with earlier years. Aust N Z J Public Health; 26(2):156–63.

21. Scollo MM, Winstanley MH 2018. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria. [Accessed May 2019]; www.TobaccoInAustralia.org.au

Revision Type

Minor

Version Number

1.2

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Summary

Smoking prevalence in Australia is decreasing

Smoking prevalence is higher among Indigenous persons

Smoking prevalence is higher among persons living in regional and remote Australia, and in lower socioeconomic status areas

Australia has one of the lowest smoking prevalence rates in the world

Data

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