Smoking prevalence - adults | National Cancer Control Indicators

Published

02 Sep, 2022

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

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Not smoking / Daily smoking

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.

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 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.

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

It is estimated that almost 20,500 deaths in 2018, or more than one in every 8 deaths in Australia is attributable to tobacco use.³ Lung cancer accounted for almost two-thirds of the estimated cancer burden from tobacco use (65%) in 2018.⁴ It is projected that in Australia in 2021, 7,460 males and 6,350 females would 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 lip and 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 A positive 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, in 2018, is estimated that 8.6% of the Australian burden of disease, and 22% of the Australian cancer burden, are attributable to tobacco use.⁷

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

Current status

In 2020-2021, 88% of persons (87% of males and 90% of females) aged 18 years and over reported that they did not smoke, while 11% (13% of males and 9% of females) reported smoking on a daily basis.⁸ Smoking prevalence was similar across age groups from 18 to 64 years of age, and lower among those aged 75 years and over.

Aboriginal and Torres Strait Islander peoples

Smoking prevalence data for Aboriginal and Torres Strait Islander peoples are available for the period 2018-19. They show smoking prevalence to be higher among the Indigenous population, with the age-standardised proportion reported as daily smokers to be 40% for Indigenous Australians compared with 14% for the non-Indigenous population.⁹

Remoteness and Socioeconomic status (SES)

In 2017-18, the proportion of persons reporting smoking daily was highest among Australians living in Outer Regional and Remote areas (19%) and lowest among those living in Major Cities (13%). This pattern was similar for both males (23% compared to 15%) and females (16% compared to 10%).⁸

In 2017-18, the proportion of persons reporting smoking daily in the lowest SES areas (SES 1) was about three-fold higher than for the highest SES areas (SES 5) (22% compared to 7%). Among adults living in the lowest SES areas, 25% of males and 18% of females reported smoking daily compared to 8% of males and 5% of females living in the highest SES areas.⁸

International comparisons

International data are available for daily smokers aged 5 years or more. In 2019 the proportion of Australians reporting to be daily smokers was 11%, which was comparable to the corresponding USA (11%), Canada (10%) and Sweden (10%) 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 reporting that they did not smoke increased from 72% to 85% (from 68% to 82% for males, and from 75% to 88% 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% in 2001 to 14% in 2017-18 (from 25% to 17% among males, and from 20% to 11% among females).^8,13-17

Age groups

For those years where data were available for all age groups (2001, 2004-05, 2007-08, 2011-12, 2014-15, 2017-18 and 2020-21), larger increases in persons reporting that they did not smoke were observed in the 18–24, 25–34 and 35–44 year age groups than 45–54, 55–64, 65–74 and 75+ year 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 2018-19, indicating a decrease in daily smoking. Specifically, the age-standardised proportion of Indigenous persons reporting to be daily smokers decreased from 51% in 2001 to 40% in 2018-19. For the non-Indigenous population, the age-standardised proportions reporting to be daily smokers were 22% in 2001 and 14% in 2018-19.^9,18

Remoteness and Socioeconomic status (SES)

From 2001 to 2017-18, decreases in daily smoking were reported across all remoteness area groupings, with the largest decrease among Australians living in Remote and Very Remote areas (a 1.9 percentage point decrease from 2014-15).^8,13-17

Daily smoking rates by socioeconomic status are available from 2004-05 to 2017-18, and generally indicate smoking reductions across all SES areas, the largest reduction was seen in the least disadvantaged areas (SES 5), with a 2.6 percentage point decrease in smoking rates from 2014-14 to 2017-18.^8,14-17

Tobacco control in Australia

The reduction in prevalence of adult smoking in Australia from 1989-90 to 2020-21 was most apparent in age groups under 45 years. 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.¹⁹The 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 2020-21, 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.

About the data

Smoking prevalence has been measured as 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+ years 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 summarized 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 once per day (cigarette, cigar or pipe smoking).

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

A Never smoked is defined as a person who never regularly smoked and smoked less than 100 cigarettes in their lifetime and had smoked pipes, cigars, and cigarettes 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. Data for 2004-05 used the 2001 ASGC, 2011-12 used the 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) used the Index of Relative Socio-Economic Disadvantage (IRSD) for allocating 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, and 2020-21 preliminary release.
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 November 2021]; 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’.

2020-21 National Health Survey (NHS) data

The 2020-21 NHS data should be considered a break in time series from previous NHS collections and useful for a point-in-time national analysis only. The survey was collected during the COVID-19 pandemic which significantly changed the data-collection methodology. To maintain the COVID safety of survey respondents and ABS Interviewers, it was collected via an online, self-complete form. Non-response is usually reduced through Interviewer follow up of households who have not responded. As this was not possible with this methodology, there were lower response rates than for previous NHS cycles, which impacted sample representativeness for some sub-populations. Comparisons to previous health data over time are therefore not possible.

Additional information on the methodology of 2020-21 data collection can be found here: https://www.abs.gov.au/methodologies/national-health-survey-first-results-methodology/2020-21

International data

Daily smokers are defined as the percentage of the population aged 15 years 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 of international data varies between 2019 and 2020, except for Chile (2016) and Germany (2017). Countries and years applying to the most recent data are as follows:

Country	Data Year
Ireland	2019
Germany	2017
New Zealand	2020
Chile	2016
United Kingdom	2019
Japan	2019
Korea	2019
Canada	2019
Australia	2019
United Stated	2019
Sweden	2019
The Netherlands	2019
France	2019

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]; https://phidu.torrens.edu.au/social-health-atlases/data

Australian Bureau of Statistics 2019. National Aboriginal and Torres Strait Islander Health Survey 2018-2019. Canberra: ABS. https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/national-aboriginal-and-torres-strait-islander-health-survey/2018-19

Australian Bureau of Statistics 2022. Health Conditions Prevalence, National Health Survey 2020-21. Canberra: ABS. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/2020-21#key-statistics

Organisation for Economic Co-operation and Development (OECD) 2021. OECD.Stat. Paris. https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#

Policy:

National Tobacco Campaign. [Accessed January 2022]; https://www.health.gov.au/health-topics/smoking-and-tobacco/how-to-quit-smoking?utm_source=quitnow.gov.au&utm_medium=redirect&utm_campaign=digital_transformation

Australian Government Department of Health 2017. National Tobacco Strategy 2012–2018. Canberra. [Accessed May 2022]; https://www.health.gov.au/resources/publications/national-tobacco-strategy-2012-2018

Australian Government Department of Health 2020. National Tobacco Campaign. Canberra. [Accessed January 2022] https://www.health.gov.au/initiatives-and-programs/national-tobacco-campaign

Australian Government Department of Health 2022. Tobacco control enforcement policy. Canberra. [Accessed June 2022] https://www.health.gov.au/resources/publications/tobacco-control-enforcement-policy

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. Wild CP, Weiderpass, E, Stewart BW eds. World cancer report: cancer research for cancer prevention 2020. Lyon: International Agency for Research on Cancer, WHO.

3. The Cancer Council Australia 2019. Tobacco in Australia | Facts and issues: Total burden of death and disease attributable to tobacco by disease category. Cancer Council Australia. https://www.tobaccoinaustralia.org.au/chapter-3-health-effects/3-30-total-burden-of-death-and-disease-attributable-to-tobacco-by-disease-category

4. Australian Institute of Health and Welfare 2021. Cancer in Australia 2021. Cancer series no.133. Cat. No. CAN 144. Canberra: AIHW.

5. Lung Cancer in Australia Statistics 2021. [Accessed January 2022]; 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 2021. Australian Burden of Disease Study: impact and causes of illness and death in Australia 2018. Australian Burden of Disease series no. 23. Cat. no. BOD 29. Canberra: AIHW.

8. Australian Bureau of Statistics 2022. National Health Survey: First Results 2020-21. 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. Organisation for Economic Co-operation and Development (OECD) 2021. OECD.Stat. Paris. https://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 2019. National Aboriginal and Torres Strait Islander Health Survey: 2018-19 financial year. Canberra: ABS.

https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/national-aboriginal-and-torres-strait-islander-health-survey/latest-release#data-download

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]

22. Greenhalgh, EM, Scollo, MM and Winstanley, MH 2021. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021. https://www.tobaccoinaustralia.org.au/home.aspx (Accessed January 2022).

Summary

Smoking prevalence in Australia is decreasingFrom 2001 to 2017-18, the proportion of adults reporting smoking daily decreased from 22% to 14%. From 1989-90 to 2017-18, the proportion of adults reported as non-smokers increased from 72% to 85%.

Smoking prevalence is higher among Indigenous personsIn 2018-19, 40% of Indigenous adults smoked daily, compared with 14% 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 19% of adults reported smoking daily in Outer Regional and Remote areas, and 22% 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 reported being daily smokers (11.2%).

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Data

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

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