Published 19 Jun, 2024

Tobacco use is one of the biggest public health risk factors worldwide, killing more than 8 million people a year, including around 1.2 million deaths from exposure to second-hand smoke.1

In Australia in 2018, 8.6% of the total disease burden was attributed to tobacco use, making it the leading risk factor contributing to disease burden and death.2 

 

    Charts
    • Notes
      • Data sourced from ABS National Health Surveys from 1989-90 to 2020-21.
      • 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.
      Table caption
      Proportion of Australian adults not smoking or smoking daily, by year
    • Notes
      • Data sourced from ABS National Health Surveys from 2001 to 2020-21.
      • 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.
      Table caption
      Proportion of Australian adults not smoking or smoking daily, by year and age
    • 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.
      Table caption
      Proportion of Australian adults smoking daily, by Indigenous status
    • 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.
      Table caption
      Proportion of Australian adults smoking daily, by remoteness
    • 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.
      Table caption
      Proportion of Australian adults smoking daily, by socioeconomic status (SES)
    • 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.
      Table caption
      -

    Tobacco use is one of the biggest public health risk factors worldwide, killing more than 8 million people a year, including around 1.2 million deaths from exposure to second-hand smoke.1

    In Australia in 2018, 8.6% of the total disease burden was attributed to tobacco use, making it the leading risk factor contributing to disease burden and death. It is considered responsible for over 76% of the burden due to lung cancer, 73% of the COPD and laryngeal cancer burden, and over 50% of the burden from oesophageal cancer.2 Tobacco use contributed most of the fatal burden, with almost 20,500 deaths (13% of all deaths) attributed to tobacco in 2018.2

    Tobacco use was found to be causally linked to the burden of 41 individual diseases including 19 types of cancer, comprising those with a primary site of lung, oesophagus, breast, lip and oral cavity, pharynx, nasal cavity and accessory sinuses, larynx, stomach, pancreas, colon and rectum, liver, kidney, ureter, bladder, cervix, and ovary, and myeloid leukaemia.2

    In 2022, 12.2% of Australian adults aged 18 years and over were reported to be current smokers (14.5% of males and 9.9% of females). In 2022, 87.9% of Australian adults aged 18 years and over were reported not smoking (90.1% of males and 85.6% of females). In 2022, 10.6% of Australian adults aged 18 years and over were reported to be current daily smokers (12.6% of males and 8.7% of females).3 

    Current smoking prevalence was the highest for ages 55-64 years (16.0%). This age pattern of peak prevalence rates for ages 55-64 years was similar by sex, the peak rates being 13.9% in females and 18.2% in males 18.2%.Similarly, no smoking prevalence was the lowest for ages 55-64 years (84.1%).

    Remoteness and Socioeconomic status (SES)

    In 2022, the reported proportion of current daily smoker was highest among Australians living in Outer regional and Remote areas (excluding very remote areas) at 16.7% and lowest among those living in Major cities at 9.4%.3 

    In 2022, the proportion of current daily smokers in areas of the most disadvantage was more than three times that reported in areas of least disadvantage (18.1% compared to 5.4%).3

    This measure indicates proportions of adult Australians aged 18 years or over reporting that they did not smoke, and those who reported smoking on a daily basis. The proportion of persons not smoking is the sum of persons who are ex-smokers, and persons who have never smoked.

    Respondents were categorised as3

    • Current daily smoker: a respondent who regularly smoked one or more cigarettes, cigars or pipes per day
    • Current smoker – Other: a respondent who smoked cigarettes, cigars or pipes, less frequently than daily
    • Ex-smoker: a respondent who does not smoke currently, but previously smoked daily, or has smoked at least 100 cigarettes, or smoked pipes or cigars at least 20 times in their lifetime
    • Never smoked: a respondent who has never regularly smoked daily, and has smoked less than 100 cigarettes, or smoked less than 20 pipes or cigars in their lifetime.

    Smoker status analysis excludes chewing tobacco and smoking of non-tobacco products. It also excludes e-cigarettes (and similar vaping devices).

    Prior to 2004–05, ex-smokers were those who had previously smoked regularly but were not current smokers. The definition of 'regularly' was self-defined by the respondent.7

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

    In Australia, the AIHW National Drug Strategy Household Survey (NDSHS)10 and the ABS National Health Survey (NHS)11 have large sample sizes and collect self-reported data on tobacco smoking and alcohol consumption. Differences in scope, collection methodology, design and questions may lead to variations in estimates (e.g., data are collected for people aged 14 years and over for the NDSHS and people aged 18 years and over for the NHS).9

    Smoker Status dataset12

    In 2021–22, the National Health Survey (NHS), the National Study of Mental Health and Wellbeing (NSMHW), the Survey of Income and Housing (SIH), and the Survey of Disability and Carers (SDAC) all collected standard information that was pooled to produce the Smoker Status dataset. The Smoker Status dataset provides data on the prevalence of smoking in Australia and can be cross classified by selected demographic and socio-economic characteristics. Smoking data were previously pooled for the 2020-21 and 2017-18 financial years.

    Tobacco control in Australia

    The daily smoking rate in people aged 14 years and over decreased by more than half from 1991 to 2022-23 (24.3% to 8.3%),8-9 attributed to positive outcomes of Australian public health initiatives, especially establishment of the first National Tobacco Campaign in 1997 and the promotion of other tobacco control initiatives at the Commonwealth and State and Territory level. The National Tobacco Strategy is a sub-strategy of the National Drug Strategy that complements the Australian Government’s National Preventive Health Strategy with aims to improve the health of all Australians by reducing tobacco use.13-14

    The proportion of the total burden attributable to tobacco use (from all linked diseases) decreased by 32% between 2003 and 2018 (from 21.5 DALYs to 14.6 DALYs per 1,000 population). The death rate associated with tobacco use decreased by about 31% between 2003 and 2018 (from 1.0 to 0.7 deaths per 1,000 population).2

    Methodology

    The 2022 National Health Survey (NHS) is regarded as comparable to the 2017-18 NHS and previous cycles. The 2020–21 NHS data should be considered a break in the time series from previous NHS collections and used for point-in-time analysis only. The survey was implemented during the COVID-19 pandemic with a changed process for data collection. 

    Changes to the 2022 NHS compared to the 2017-18 NHS in physical activity questions,15 included: 

    • New questions and outputs on use of e-cigarettes and vaping.
    • Removal of questions and output items for smoking level compared to 12 months ago.

    Remoteness

    The Australian Statistical Geography Standard (ASGS) Edition 3 was used to allocate participants to a remoteness area based on their area of usual residence.16 Data for 2004-05 used the 2001 ASGC, 2011-12 used the 2006 ASGC, 2014-15 data used the 2011 ASGC, and 2017-18, 2020-21 and 21-22 data used the ASGS 2016.

    Socioeconomic status

    The 2016 Socio-Economic Indexes for Areas (SEIFA) Index for Relative Socio-Economic Disadvantage was used to allocate participants to a SEIFA quintile based on their usual residence.17 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, 2020-21 and 21-22 data, the 2016 IRSD was used.

    Data for socioeconomic status and remoteness are available for persons in general for 2022. (note: not yet available by sex). 

    Data sources

    • ABS National Health Surveys – 1989-90, 1995, 2001, 2004-05, 2007-08, 2011-12, 2014-15, 2017-18, 2020-21 and 2022.
    • AIHW National Drug Strategy Household Survey 2022–2023.
    • ABS National Aboriginal and Torres Strait Islander Health Surveys – 2001, 2004-05, 2012-13, 2014-15 and 2018-19.
    • OECD.Stat. Health Statistics (database). Non-medical determinants of health. OECD; 2018. Accessed Apr 2023; https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#
    • Smoker Data set 2021-22.

     

    Activity in this area

    Data:

    Policy:

    References

    1. WHO 2022. Tobacco. Accessed May 2024; https://www.who.int/news-room/fact-sheets/detail/tobacco
    2. Australian Institute of Health and Welfare 2021. Australian Burden of Disease Study 2018: Interactive data on risk factor burden. Accessed May 2024; https://www.aihw.gov.au/reports/burden-of-disease/abds-2018-interactive-data-risk-factors/contents/tobacco-use
    3. Australia Bureau of Statistics 2023. Smoking and Vaping. Accessed May 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/smoking-and-vaping/latest-release
    4. Australia Bureau of Statistics 2022. Cat no. 4364.0.00.016. Smoking. Accessed May 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/smoking/2020-21
    5. Australia Bureau of Statistics 2018 Cat no. 4364.0.55.001Smoking. Accessed May 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/smoking-and-vaping/2017-18
    6. Australia Bureau of Statistics 2022. Insights into Australian smokers, 2021-22. Accessed May 2024; https://www.abs.gov.au/articles/insights-australian-smokers-2021-22#:~:text=Adults%20who%20live%20in%20outer,15.7%25%20compared%20to%208.9%25
    7. Australia Bureau of Statistics 2008. Tobacco smoking in Australia, 2007-08. Accessed May 2024; https://www.abs.gov.au/ausstats/abs@.nsf/lookup/4841.0chapter32011
    8. Australian Institute of Health and Welfare 2024. National Drug Strategy Household Survey 2022-2023. Tobacco Smoking in NDSHS. Canberra AIHW. Accessed May 2024; https://www.aihw.gov.au/reports/smoking/tobacco-smoking-ndshs
    9. Australian Institute of Health and Welfare 2024. Alcohol, tobacco & other drugs in Australia. Canberra AIHW. Accessed May 2024; https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/tobacco#harms
    10. Australian Institute of Health and Welfare. National Drug Strategy Household Survey. Accessed May 2024; https://www.aihw.gov.au/about-our-data/our-data-collections/national-drug-strategy-household-survey
    11. Australia Bureau of Statistics. National Health Surveys. Accessed May 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey
    12. Australia Bureau of Statistics. Smoker dataset. Accessed May 2024; https://www.abs.gov.au/statistics/microdata-tablebuilder/available-microdata-tablebuilder/smoker-status#:~:text=The%20Smoker%20Status%20dataset%20provides,and%202017%2D18%20financial%20years
    13. Australian Government. Department of Health. National Tobacco Strategy.  Canberra. Accessed May 2024; https://www.health.gov.au/our-work/national-tobacco-strategy
    14. Australian Government. Department of Health. National Tobacco Campaign. Canberra. Accessed May 2024; https://www.health.gov.au/initiatives-and-programs/national-tobacco-campaign
    15. Australian Bureau of Statistics. National Health Survey methodology. Accessed May 2024; https://www.abs.gov.au/methodologies/national-health-survey-methodology/2022#summary-of-content-changes
    16. Australian Bureau of Statistics. Remoteness Areas. Accessed May 2024; https://www.abs.gov.au/statistics/standards/australian-statistical-geography-standard-asgs-edition-3/jul2021-jun2026/remoteness-structure/remoteness-areas
    17. Australian Bureau of Statistics. Socioeconomic Indexes for areas (SEIFA) 2016. Accessed May 2024; https://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001

    Summary

    Smoking prevalence in Australia is decreasing

    In 2022, 12.2% of adults aged 18 years and over were reported to be current smoker. From 2001 to 2022, the proportion of adults reporting smoking daily approximately halved from 22.4% to 10.6%. 

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

    In 2022, 16.7% of adults in Outer regional and Remote areas reported smoking daily vs 9.4% in Major cities. Also, 18.1% of people in areas of greatest socioeconomic disadvantage were reported to be daily smokers vs 5.4% in areas of lowest disadvantage.

    Over half (58.3%) of the adult Australian population reported they never smoked.