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Tobacco in Australia
Tobacco causes more ill-health and premature death than any other drug used in Australia
If cigarette smokers commence smoking as teenagers and do not quit, then eventually about half of them
will be killed by tobacco.1 In 1998, an Australian Institute of Health and Welfare (AIHW) report2 estimated that
active and passive smoking caused over 19,000 Australian lives to be lost - around 82% of all drug caused
From this we can estimate (using population proportions) that in South Australia around 1500 deaths were
caused by cigarette smoking during that year. This means that each week around 30 South Australians die
from diseases caused by smoking tobacco, compared to around 3 people per week killed in road accidents
in recent years.
Drug Related Deaths: Australia 19982 As well, it reports that the main smoking related
diseases contribute significantly to the total
disease burden in Australia.
“The leading cause of total disease burden in
Illicit Drugs 4%
DALYs* are ischaemic heart disease and stroke,
Alcohol 14% together causing nearly 18% of the total disease
burden. Chronic Obstructive Pulmonary Disease
and lung cancer (also smoking-related diseases)
are the third and fifth leading causes of disease
burden, accounting for another 7.3% of the total
burden.” (One DALY is one lost year of ‘healthy’ life)
In 2000, the Cancer in Australia series4 reported
“Cigarette smoking is estimated to have directly
caused 10,807 new cases of cancer (57.2 new
cases per 100,000 pop) and 7,650 deaths (40.5
Another way of looking at how much tobacco deaths per 100,000 pop) in 2000. Between 1990
related illness contributes to Australian’s ill health, and 2000, the male incidence rate for smoking-
is to consider how they compare with other known related cancers fell by an average of 1.4% per
risk factors. The AIHW report, The burden of year, while the rate for females rose by 0.7% per
disease and injury in Australia3 says that year.”
“Tobacco smoking is the risk factor causing the A recent study5 confirmed that stopping smoking
greatest burden of disease in Australia. It is makes life longer and means that people live more
responsible for 12% of the total burden of disease of those years without illness and disability. As
in males, and 7% in females.” well, non-smokers enjoy fewer years with disability
Health effects of active smoking Heart disease (sometimes known as Coronary
Heart Disease (CHD) or ischaemic heart disease)
(more information about the different health effects of active is the largest single cause of death for men and
smoking can be found in Tobacco in Australia6)
women, with smoking identified as one of the
major risk factors. The risk of developing CHD
increases with length and intensity of exposure to
Proportion of deaths attributable to smoking cigarette smoke.
by disease: 19982
Overall, smokers have a 70% greater rate of
mortality from CHD than non-smokers. Smokers
who consume more than 40 cigarettes per day
have mortality rates between two and three times
ETS 1% that of non-smokers.7
Other 18% Cancer 40%
Among smokers less than 65 years of age, 67% of
ischaemic heart disease in Australian men and
women can be attributed to cigarette smoking.2 In
the general population, around a third can be
attributed to smoking.
Stroke The influence of smoking on stroke is most
COPD 20% evident before the age of 65. Among this group,
Ischaemic heart disease 21% cigarette smoking causes 44% of strokes in men
and 39% in women.3
In combination with the contraceptive pill, smoking
significantly increases a woman’s risk of heart
attack and stroke.
Lung cancer was the first major disease to be Peripheral vascular disease This is a narrowing
causally linked to smoking. According to Cancer in of the leg arteries that can lead to blockages and
Australia 19974, lung cancer (including cancer of in some cases, amputation. Nine out of ten
the trachea and bronchus) is the leading cause of patients with this disease are smokers.
cancer death in Australia.
Chronic obstructive pulmonary disease
Close to twice as many Australian men (4,615) (COPD) is a group of respiratory diseases caused
died from lung cancer as any other cancer type in by smoking, with more than 2/3 of all cases (90%
1997. While breast cancer is the leading cause of in smokers) attributed to it.2 All types of COPD
cancer death in Australian women, there were lead to a progressive loss of lung function and
comparable numbers of deaths for breast (2,596), significant difficulty in breathing.
colorectal (2,134) and lung cancer (2,068).
Emphysema Almost all smokers will develop
In South Australia in 1999, 23 % of the 1735 male some form of emphysema. Its severity will
cancer deaths were due to lung cancer, as were increase according to the number of cigarettes per
14% of the 1,311 female cancer deaths. day a person smokes, and the number of years
Unlike many other cancers, lung cancer incidence they have been a smoker. Emphysema is rare
(new cases) and mortality (death) rates closely among non-smokers.
parallel each other once sufferers reach 30 years Other health consequences Cigarette smoking
(AIHW Cancer in Australia 1997). This means that is also a risk factor associated with:
once a person is diagnosed with lung cancer, a • lowered fertility in both men and women
large proportion will die. • miscarriage, stillbirth, low birth weight and
Other cancers Cigarette smoking is also a risk death in early infancy (including SIDS)
factor associated with: • age-related macular degeneration (blindness)
• cancers of the lip, oral and nasal cavities and • osteoporosis
pharynx • asthma
• cancers of the bladder, kidney, pancreas, • back pain and spinal disk degeneration
stomach and cervix. • delayed wound healing
• complications of diabetes
• periodontal disease (tooth & gum problems).
Health effects of passive smoking As well:
(See our Passive Smoking information sheet for more • smoking rates were highest between 20-29
detailed information about passive smoking) years: 26.1% smoked daily, 2.8% weekly and
Research has confirmed that passive smoking
• the lowest proportion of smokers was over 60
increases deaths from heart disease, SIDS, and
lung cancer. Children exposed to ETS are more
• the mean number of cigarettes smoked per
likely to have asthma, and have more serious
week peaked at 140 for the 50-59 year group.
attacks, higher rates of lower respiratory illness,
• one in five (21%) teenage smokers smoked,
middle ear infections, and low birth weight.8
15.1% daily, 2.3% weekly and 2.9% less than
Smoking rates in Australia weekly. 75% of teenagers had never smoked.
The majority of Australians are non-smokers. Less
than a quarter of adults smoke, but this has not The following table compares the 1998 and 2001
always been the case. National Household Drug Survey results, and is
found in the 2001 report.
The graph below shows that smoking by men has
more than halved since 1945, but that smoking by Note that this table uses different descriptions of
women over the same period has remained smoking status than those used in previous years,
relatively stable.6 and so categories used previously (eg in 1995)
may not be directly comparable. For precise
Australian smoking prevalence trends: definitions of status divisions, see the 2001 report.
*Note: Trend information only - sources may not contain directly
Smoking status (%) 1998 2001
Daily Persons 21.8 19.5
70 Male 24.2 21.1
Female 19.6 18.0
Weekly Persons 1.8 1.6
40 Male 2.0 2.0
Female 1.6 1.5
20 < weekly Persons 1.3 2.0
Male 1.6 2.6
Female 1.1 1.5
1945 1955 1964 1969 1974 1976 1980 1983 1986 1989 1992 1995 1998 2001
Year Exsmokera Persons 25.9 26.2
Male 28.3 29.6
Female 23.4 22.9
The AIHW 2001 National Household Drug Survey9
results reported a slight decrease in daily smoking Neverb Persons 49.2 50.6
since 1998. While in 1998, this survey measured Male 43.9 44.7
smoking as regular (smokes daily/most days) and Female 54.3 56.4
occasional (smokes less often than daily/most (a) Ex-smoker:smoked at least 100 cigarettes during lifetime, but no
days), in 2001 smokers were defined as daily,
weekly or less than weekly smokers. (b)Never smoker: Smoked <100 cigarettes during lifetime
In 2001, 19.5% (1998:21.8%) of people aged 14
years and over were daily smokers, with Smoking in CALD communities
statistically significant declines in both males and Smoking varies widely in different Australian
females aged between 20 and 29 years. In 2001, cultural communities. Male smoking is
Australian smokers numbered around 3.5million, significantly higher than female smoking in many,
while there were 4.1m ex-smokers, and 8.0m reflecting trends in their country of origin.
Aboriginal and Torres Strait Islander (ATSI) smoking
Indigenous Australians have a much higher smoking rate than the rest of the population. However, there are wide
variations in smoking rates between different ATSI communities. Many smoking related diseases affect the ATSI
community and contribute to significantly reduced life-expectancy and increased disability.
According to the ABS 2001 National Health Survey10, after adjusting for age differences, 51% of indigenous
Australians were smokers, compared with 24% of non-indigenous persons. Smoking was more commonly
reported in 2001 among indigenous males and females in every age group when compared with the non-
Comparison: Indigenous & non-indigenous male smokers
Smoking rates in South Australia
estimates of the social costs of drug abuse in
The 2001 National Drug Strategy Household Survey 11 Australia in 1998-914, estimates the cost of tobacco
reported that of the South Australian population aged use as $21.06billion* - 61.2% of all drug use.
14 years or over: [*costs not directly comparable with previous estimate]
• 20.1% were regular smokers Tangible costs are costs for which a market place
• 3.1% were occasional smokers (smokes value can be calculated and include loss of
weekly/<weekly) production due to illness and death, and health care
• 28.2% were ex-smokers (had smoked >100 cigs, costs. Intangible costs are those assigned to the
but now quit) value of the life of the deceased such as loss of
• 48.4% had never smoked (never smoked >100 consumption.
cigs) Some costs are more difficult to quantify and may not
From the 1998 National Drug Strategy Household be included. These include passive smoking costs,
Survey12, we know that in South Australia, as in tangible costs such as welfare costs, absenteeism
Australia as a whole, the average age of starting to and ambulance services and property costs of
smoke was between 17 and 19 years. Around 75% of accidental fires. Intangible costs such as pain and
all smokers started daily smoking before they turned suffering of the sick and those around them were also
20. not included.
As well, in common with the rest of Australia,
occasional smokers in South Australia were most
likely to be in the 14-19 years age group (15.8% of
Global smoking trends
occasional smokers in SA were in this group). The It is worth noting that while tobacco consumption in
largest proportion of regular smokers in SA was in the the developed world is declining, there are large
20-29 years age group, as was the case in Australia markets for tobacco products in the developing world.
as a whole. Similarly, a greater proportion of males Included in the 1997 WHO Global Status Report on
were smokers (SA 22.0%, Aust 25.1%) than females Tobacco or Health15 are findings that:
(SA 16.7%, Aust 20.0%).
• the vast majority of smokers are in developing
countries (800 million) and that most of these
are men (700 million)
Economic costs of smoking
• the apparent stability of global cigarette
In 1996, Collins and Lapsley (The social costs of drug consumption per adult is clearly the result of
abuse in Australia in 1988 and 1992)13 estimated that decreasing consumption in industrialised
the total costs of tobacco abuse at 1992 prices were countries, offset by increasing consumption in
$12.7 billion. These costs included tangible and developing countries, where the most rapid
intangible costs. A new report, Counting the cost: increase have been seen, for example, in
Much of the unreferenced material provided in this information sheet comes from Tobacco in Australia: Facts
This information can also be found on the Quit SA website www.quitsa.org.au under Information Sheets -
Tobacco in Australia. Accessing the information this way will enable you to get a great deal more information
from many of the references listed below, as they Smoking and Health, 1983. DHHS Publication
are available in full text online. no (PHS) 84-50204
Peto R, Lopez AD, Boreham J, Thun M, Health National Health and Medical Research Council
C. 1994 Mortality from smoking in developed 1997. The health effects of passive smoking: a
countries, 1950-2000: indirect estimation from scientific information paper. Canberra:AGPS.
national vital statistics. Oxford, OUP. 9
Australian Institute of Health and Welfare 2002.
Ridolpho B, Stevenson C 2001 The 2001 National Drug Strategy Household
quantification of drug caused morbidity and Survey: First results. AIHW Cat no PHE
mortality in Australia, 1998. AIHW Cat no PHE 35. Canberra: AIHW (Drug Statistics
29. Canberra: AIHW (Drug Statistics Series no Series no 9).
7). 10Australian Bureau of Statistics 2002. National
Mathers C, Vos T, Stevenson C 1999. The Health Survey: Aboriginal and Torres Strait
burden of disease and injury in Australia - Islander Results, Australia. 4715.0
summary report. AIHW Cat no PHE 18. 11
Australian Institute of Health and Welfare 2002.
2001 National Drug Strategy Household
Australian Institute of Health and Welfare Survey: State and Territory supplement.
(AIHW) & Australasian Association of Cancer AIHW Cat no PHE 37.Canberra: AIHW
Registries (AACR) 2003. Cancer in Australia (Drug Statistics Series no 10).
2000 AIHW Cat no CAN 18. Canberra: AIHW 12
Fitzsimmons G & Cooper-Stanbury M 2000.
(Cancer Series no 23).
1998 National Drug Strategy Household Survey:
Nusselder WJ et al 2000. ‘Smoking and the State and territory results. AIHW Cat no PHE 26.
compression of morbidity’ Journal of Canberra:AIHW (Drug Statistics Series no 6).
Epidemiology and Community Health 13
Collins DJ & Lapsley HM 1996. The social costs
of drug abuse in Australia in 1988 and 1992.
Winstanley M, Woodward S, Walker N 1995. Canberra: Commonwealth Department of
Tobacco in Australia: facts and issues 2nd edn Human Services and Health (National Drug
Carlton, Vic: Victorian Smoking and Health Strategy Monograph Series No 30).
Program. (updated version available at via the 14
Collins DJ & Lapsley HM 2002. Counting the
Quit Victoria website quit.org.au see under links,
cost: estimates of the social costs of drug
abuse in Australia 1998-9. Canberra:
US Department of Health, Education and Commonwealth Department of Health and
Welfare. The health consequences of smoking: Ageing.
cardiovascular disease. A report of the Surgeon 15
World Health Organization 1997. Tobacco or
General. US Department of Health, Education
and Welfare, Public Health Service, Office on
Useful Internet Sites
OxyGen National Tobacco Campaign
An interactive anti-tobacco site for young people A reference to all facets of the current national
Sections include: Tar Wars - Find out about the campaign ‘Every cigarette is doing you damage’,
insidious industry, get involved and have your say; including background information the various
Send a Postcard; Hard Facts - Statistics, Tobacco commercials - lung, tar, eye, tumour, artery and
information sheets; How much does it cost to smoke, stroke. Clicking on Hotspots brings up the two
What’s in a cigarette, Interactive Biopsy; and volumes of the evaluation of the National Tobacco
Resources from around Australia and links to Campaign. The Quit because you can book, and
Australian and International sites. other help with quitting available here online.
Tobacco Control Supersite
This site provides an expanding list of information
This site is maintained by Simon Chapman, a leading
sheets - some not available in hard copy, and links to
Australian and international tobacco control
related sites. Also provides information about Quit
advocate. Great for finding out about the activities of
SA programs and services, and links to publications.
the tobacco industry in Australia, as well as recently
published press and journal articles.
Tobacco in Australia: Facts and Issues
www.quit.org.au - look under Resources It also provides access to Tobacco Documents
System (TDS) Australiasian database, available
This is the full text of the book published in 1995 by through the Tobacco Industry Document Gateway.
Winstanley, Woodward and Walker. It provides a This gives visitors access to the project group's
comprehensive coverage of all tobacco related summaries and the pdfs of the best (or the worst!) of
information in Australia. Some sections have been the tobacco industry's internal documents covering
updated online. Australasia and South East Asia.
Commonwealth Dept of Health & Ageing -
The National Health and Medical Research
www.health.gov.au/nhmrc/ - see under topic
A great overview of tobacco use and regulation in Health Promotion
Australia, with links to full text documents published
From here (the NHMRC home page) you can access
by commonwealth agencies. Also online is the
the full text of the 1997 NHMRC publication The
National Tobacco Strategy with its background
Health Effects of Passive Smoking: A Scientific
papers and publications, links to relevant acts,
taxation information, and the costs of drug abuse in Information Paper.
Australia. Also includes published lists of cigarette
ingredients and emissions from Australia’s cigarette VicHealth Centre for Tobacco Control
This new organisation conducts research that
Action on Smoking and Health (Australia) advances tobacco control efforts in Australia and
www.ashaust.org.au internationally. Look here for links to documents
This site provides links to newsletters, press about tobacco control policy.
releases, advocacy opportunities, information about
litigation. Also links to Australian tobacco control
legislation, information for business, politicians and
Health effects of passive smoking
(See our Passive Smoking information sheet for more detailed information about passive smoking)
Research has confirmed that passive smoking increases deaths from heart disease, SIDS, and lung cancer.
Children exposed to ETS are more likely to have asthma, and have more serious attacks, higher rates of
lower respiratory illness, middle ear infections, and low birth weight.8
Smoking rates in Australia
The majority of Australians are non-smokers. Approximately a quarter of adults smoke, but this has not
always been the case.
The graph below shows that smoking by men has more than halved since 1945, but that smoking by women
over the same period has remained relatively stable.6
*Note: Trend information only - sources may not contain directly comparable data
Australian smoking prevalence trends: 1945-1998*
The AIHW 2001 National Household Drug Survey9 results reported a slight decrease in daily smoking since
1998. In 2001, 19.5% (1998:21.8%) of people aged 14 years and over were daily smokers, with statistically
significant declines in both males and females aged between 20 and 29 years. In 2001, Australian smokers
numbered around 3.5million, while there were 4.1m ex-smokers, and 8.0m never smokers.
• smoking rates were highest between 20-29 years: 26.1% smoked daily, 2.8% weekly and 4.1% <weekly
• the lowest proportion of smokers was over 60 years (9.7%)
• the mean number of cigarettes smoked per week peaked at 140 for the 50-59 year group.
• one in five (21%) teenage smokers smoked, 15.1% daily, 2.3% weekly and 2.9% less than weekly. 75%
of teenagers had never smoked.