Tobacco use is the single largest cause of cancer globally and the predominant cause of lung cancer.1 Smoking prevalence among adolescents is an important indicator to target in cancer prevention, because cigarette smoking can become established in adolescence.2
About this measure
In 2015, tobacco was the leading cause of cancer in Australia.3, 4 About 90% (Australian men) and 65% (Australian women) of lung cancers are attributable to tobacco smoking.5 It is projected that in 2021, 7,460 males and 6,350, females will be diagnosed with lung cancer, and it will be the leading cause of cancer death in Australia.4 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 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 meta-analysis of nearly 32,000 breast cancer cases.1, 5 The risk of developing lung cancer from tobacco smoking has been shown to increase with duration of smoking and the numbers of cigarettes smoked per day. Notably, most smokers are reported to have commenced using tobacco as adolescents and young people who begin to smoke at an earlier age are more likely to develop long-term nicotine addiction.2
These measures show the proportions of Australian secondary school students aged 12-17 years reporting that they have never smoked and those reporting cigarette smoking on a daily basis. Data are also shown for the number of 15-year-old secondary school students reporting smoking at least once in the last 30 days; this is provided for comparison with international measures of adolescent smoking.
Current status
In 2017, 82% of persons (82% of males and 83% of females) aged 12-17 years reported that they had never smoked, and only 1% of persons (1% of males and 1% of females) aged 12-17 years reported smoking on a daily basis.6
Among 15-year-old respondents, 9% of persons (10% of males and 8% of females) reported that they had smoked within the last 30 days.6
Aboriginal and Torres Strait Islander peoples
In 2017, 70% of Aboriginal and Torres Strait Islander peoples aged 12-17 years reported that they had never smoked and 14% reported that they had smoked within the last 30 days.7
International comparisons
International data are available for 15-year-old persons who reported having smoked within the last 30 days. The proportion of Australians in this category was 11%, which was comparable to the figure for New Zealand (12%) and the United States of America (11%).10
Trends
The prevalence of smoking reported among secondary school students aged 12-17 years has decreased over the last three decades, with the proportion reporting that they have never smoked increasing from 31% of persons (29% of males and 33% of females) in 1984 to 82% of persons (82% of males and 83% of females) in 2017.6 Similarly, daily smoking rates for secondary school students aged 12-17 years also decreased from 8% of persons (8% males and 7.5% of females) in 1984, to 1% of persons (1% of males and 1% females) in 2017.6
Aboriginal and Torres Strait Islander peoples
Smoking prevalence data for Aboriginal and Torres Strait Islander peoples aged 12-17 years are available for the period 2005-2017.
The proportion of Aboriginal and Torres Strait Islander peoples aged 12-17 years reporting that they had never smoked, has increased from 49% in 2005 to 70% in 2017.
The proportion of Aboriginal and Torres Strait Islander peoples aged 12-17 years reporting that they had smoked within the last 30 days decreased from 24% in 2005 to 14% in 2017.
Tobacco control in Australia
From 1984 to 2017, there was an overall decrease in the proportion of adolescent smoking in Australia, although this downward trend was not consistent. A decline was observed through the 1980’s until the 1990’s when prevalence plataeued.7 After 1996, prevalence began to decline again and by 2017, only 1% of adolescents aged 12 -17 years reported smoking daily.6, 9 The decrease in smoking prevalence after the late 1990s may have been influenced by the launch of the National Tobacco Campaign in 1997.9 Further decreases in prevalence may have been stimulated by introduction of other tobacco control initiatives such as graphic health warnings on cigarette packs, tobacco excise increases and the introduction of plain packaging.9
Tobacco smoking is a major public health issue in Australia and internationally. Adolescent smoking rates in Australia are lower than for most developed countries, and are very similar to rates for New Zealand and the United States.6, 10 The reduction in adolescent smoking rates in Australia point to the effectiveness of multiple public health interventions over recent decades.9
About the data
Numerator: Secondary students aged 12 to 17 years (in Years 7 to 12) reporting their level of tobacco usage.
Denominator: Secondary students aged 12 to 17 years (in Years 7 to 12) surveyed across Australia at schools which were randomly sampled and weighted so as to represent geographic and educational dispersion of the populations.
Definitions
Proportion of 15-year-olds reporting having smoked once in the previous week:
- The proportion of 15-year-olds reporting having smoked at least one cigarette in the previous week is provided in each report from 1984 to 2017.
- In 2008 -2014, proportions were rounded in source documents to the first decimal place (prior to 2008 and in 2017 they were rounded to the nearest integer).
Confidence intervals:
- From 1984 onwards, 95% confidence interval estimates were provided for different proportions by age and sex.
- 95% confidence intervals are adjusted for the clustering of students at separate schools.
Inclusions/exclusions: Secondary school students from all states and territories are included, except the ACT in the period in 1984 to 1993, and South Australia in 1997. Prior to 2015, Year 7 students in Queensland where generally still in primary school; as a result, some primary school students are included. The ASSAD surveys only include those attending school on the day of the survey and having parental consent.
Coverage/Scope:
The ASSAD surveys had sample sizes of 21,904 (1984), 19,166 (1987), 24,892 (1990), 22,696 (1993), 29,850 (1996), 25,486 (1999), 23,417 (2002) 21,805 (2005), 24,408 (2008), 26,194 (2011), 23,007 (2014), and 19,115 (2017).
International data
“Daily smokers” are defined as the percentage of the population aged 15 years or over who reported that they were 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 questions, the response categories, and in related administrative methods.
The most recent year of data availability for international data were used, as listed.
| Country | Most recent reported year |
| Australia | 2019 |
| Canada | 2018 |
| Chile | Data not available |
| France | 2019 |
| Germany | 2017 |
| Ireland | 2019 |
| Japan | 2019 |
| Korea (Republic of) | 2019 |
| New Zealand | 2020 |
| Singapore | Data not available |
| Sweden | 2019 |
| The Netherlands | 2019 |
| United Kingdom | 2019 |
| United States of America | 2019 |
| Uruguay | Data not available |
Data sources
Australian data: Cancer Council Victoria, Tobacco and alcohol use among Australian secondary school students (ASSAD), 1984-2017. https://www.cancervic.org.au/research/behavioural/major-topics-projects/tobacco/australian-secondary-student-smoking-behaviours.html
International data: For 15-year-olds reporting having smoked at least once in the last 30 days, data is sourced from the Organisation of Economic Co-operation and Development (OECD). https://stats.oecd.org/#
The ASSAD data for surveys from 1984 to 2017 were reported separately as follows (in reverse chronological order):
Heris C, Guerin N, Thomas D, Eades S, Chamberlain C, White V. The decline of smoking initiation among Aboriginal and Torres Strait Islander secondary students: implications for future policy. Aust N Z J Public Health 2020; 44:397-403.
Guerin, N. & White, V. (2020). ASSAD 2017 Statistics & Trends: Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances. Second Edition. Cancer Council Victoria.
White V, Williams T. Australian secondary school students’ use of tobacco, alcohol, and over-the- counter and illicit substances in 2014. Prepared for: Drug Strategy Branch Australian Government Department of Health. Centre for Behavioural Research in Cancer, Cancer Council Victoria: Melbourne, Australia, October 2016.
White V, Bariola E. Australian secondary school students’ use of tobacco, alcohol, and over-the- counter and illicit substances in 2011. Prepared for: Drug Strategy Branch Australian Government Department of Health and Ageing. Centre for Behavioural Research in Cancer, Cancer Council Victoria: Melbourne, Australia, December 2012.
White V, Smith G. Australian secondary school students’ use of tobacco, alcohol, and over-the- counter and illicit substances in 2008. Prepared for: Drug Strategy Branch. Australian Government Department of Health and Ageing. Centre for Behavioural Research in Cancer, Cancer Council Victoria: Melbourne, Australia, September 2009.
White V, Hayman J. Australian secondary school students' use of over-the-counter and illicit substances in 2005. Monograph Series No. 60. Australian Government Department of Health and Ageing: Canberra, Australia, 2006.
White V, Hayman J. Australian secondary school students' use of over-the-counter and illicit substances in 2002. Monograph Series No. 56. Australian Government Department of Health and Ageing: Canberra, Australia, 2004.
White V. Australian secondary school students' use of over-the-counter and illicit substances in 1999. Monograph Series No. 46. Prepared for: Commonwealth Department of Health and Aged Care. Centre for Behavioural Research in Cancer, Anti-Cancer Council of Victoria: Melbourne, Australia, May 2001.
Letcher T, White V. Australian secondary school students' use of over-the-counter and illicit substances in 1996. Centre for Behavioural Research in Cancer, Anti-Cancer Council of Victoria: Melbourne, Australia, November 1998.
White V, Hayman J. Smoking behaviours of Australian secondary students in 2005. Prepared for: Drug Strategy Branch. Australian Government Department of Health and Ageing. Centre for Behavioural Research in Cancer. Cancer Council Victoria; 2006.
White V, Hayman J. Smoking behaviours of Australian secondary students in 2002. National Drug Strategy Monograph Series No. 54. Canberra: Australian Government Department of Health and Ageing; 2004.
Hill D, White V, Effendi Y. 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 2002; 26(2):156-63.
Hill D, White V, Letcher T. Tobacco use among Australian secondary students in 1996. Aust N Z J Public Health 1999; 23(3):252-9.
Hill D, White V, Segan C. Prevalence of cigarette smoking among Australian secondary school students in 1993. Aust J Public Health 1995; 19(5):445-9.
Hill D, White V, Williams R, Gardner G. Tobacco and alcohol use among Australian secondary school students in 1990. Med J Aust 1993; 158(4): 228-34.
Hill D, White V, Pain M, Gardner G. Tobacco and alcohol use among Australian secondary school children in 1987. Med J Aust 1990; 152(3): 124-30.
White V, Hill D, Gardner G, Pain M. Cigarette and alcohol consumption among Australian secondary school children in 1987. Centre for Behavioural Research in Cancer, Anti-Cancer Council of Victoria: Melbourne, Australia, 1990. Hill D, Wilcox S, Gardner G, Houston J. Tobacco and alcohol use among Australian secondary school children. Med J Aust 1987; 146(3): 125-30.
Hill D, Wilcox S, Gardner G, Houston J. Cigarette and alcohol consumption among Australian secondary school children in 1984. Anti-Cancer Council of Victoria: Melbourne, Australia, 1986.
References
Data
Cancer Council Victoria, Tobacco and alcohol use among Australian secondary school students (ASSAD), 1984-2017. https://www.cancervic.org.au/research/behavioural/major-topics-projects/tobacco/australian-secondary-student-smoking-behaviours.html
Organisation of Economic Co-operation and Development (OECD) 2021. OECD.Stat: Non-Medical Determinants of Health: Tobacco consumption. Paris. https://stats.oecd.org/#
Policy
Australian Institute of Health and Welfare 2019. National Drug Strategy Household Survey 2019. Cat. no: PHE 270. Canberra: AIHW; 2020.
Australian Institute of Health and Welfare 2017. National Drug Strategy Household Survey 2016: detailed findings. Drug Statistics series no. 31. Cat. no. PHE 214. Canberra: AIHW.
Australian Institute of Health and Welfare 2014. National Drug Strategy Household Survey detailed report 2013. Drug statistics series no. 28. Cat. no. PHE 183. Canberra: AIHW. (Accessed Jan 2022)
National Tobacco Strategy 2012-2018. Australian Government Department of Health. https://www.health.gov.au/resources/publications/national-tobacco-strategy-2012-2018
References
-
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans 2012. A review of human carcinogens: Part E: Personal habits and indoor combustions. volume 100E. Lyon, France: International Agency for Research on Cancer.
-
Stewart BW, Wild CP editors. World cancer report. Lyon: International Agency for Research on Cancer, WHO; 2014.
-
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, 2011. (Accessed Jan 2022)
-
Australian Institute of Health and Welfare 2021. Cancer in Australia 2021. Cancer series no.133. Cat. No. CAN 144. Canberra: AIHW. (Accessed Jan 2022)
-
Gaudet MM, Gapstur SM, Sun J, et al. Active smoking and breast cancer risk: original cohort data and meta-analysis. J Natl Cancer Inst 2013;105(8):515-25
-
Guerin, N. & White, V. (2020). ASSAD 2017 Statistics & Trends: Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances. Second Edition. Cancer Council Victoria. (Accessed Jan 2022)
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White V, Williams T. Australian secondary school students’ use of tobacco, alcohol, and over-the counter and illicit substances in 2014. Prepared for: Drug Strategy Branch Australian Government Department of Health. Centre for Behavioural Research in Cancer, Cancer Council Victoria: Melbourne, Australia, October 2016.
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White V, Smith G. Use of tobacco, alcohol, and over-the-counter and illicit substances among Indigenous students participating in the Australian Secondary Students Alcohol and Drug Survey 2008. Prepared for: Drug Strategy Branch, Australian Government Department of Health and Ageing. Centre for Behavioural Research in Cancer, Cancer Council Victoria: Melbourne, Australia, February 2010.
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Heris C, Guerin N, Thomas D, Eades S, Chamberlain C, White V. The decline of smoking initiation among Aboriginal and Torres Strait Islander secondary students: implications for future policy. Aust N Z J Public Health 2020; 44:397-403.
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Organisation of Economic Co-operation and Development (OECD) 2021. OECD.Stat: Non-Medical Determinants of Health: Tobacco consumption. Paris. https://stats.oecd.org/#
-
EM and Winstanley, MH. Prevalence of smoking—teenagers. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2019. Available from http://www.tobaccoinaustralia.org.au/chapter-1-prevalence/1-6-prevalence-of-smoking-teenagers (Accessed Feb 2022)
-
ESPAD Group (2016), ESPAD Report 2015: Results from the European School Survey Project on Alcohol and Other Drugs, Publications Office of the European Union, Luxembourg. Accessed Feb 2022. Available from http://www.espad.org/sites/espad.org/files/TD0116475ENN.pdf
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