Smoking

Introduction

Tobacco smoking is the leading cause of preventable mortality and morbidity in New South Wales. While the relationship between tobacco smoking, lung cancer, and cardiovascular disease has long been evidenced, a number of other diseases are now known to be associated with smoking. According to the US Surgeon General's Report (2004), tobacco smoking is associated with: cancer, including cancer of the lung, mouth, throat, larynx, esophagus, pancreas, kidney, bladder, stomach, and acute myeloid leukemia; cardiovascular disease, including atherosclerosis, strokes, abdominal aortic aneurysm, hardening and narrowing of the arteries, damage to the cells lining the blood vessels and heart, and blood clots; respiratory disease, including emphysema, chronic obstructive pulmonary disease, and upper and lower respiratory tract infections; reproductive problems, including difficulty becoming pregnant, a higher risk of never becoming pregnant, risk of complications during pregnancy, risk of premature birth, low birthweight infants, stillbirth, and infant mortality including increased risk of sudden infant death syndrome; other health effects, including increased risk of eye diseases, loss of bone mass, and peptic ulcers. Smokers are generally less healthy than nonsmokers. Smoking affects the immune system. Illnesses in smokers last longer and smokers are more likely to be absent from work. Smokers also use more medical services, both outpatient and inpatient services.[1]

As tobacco smokers need to be aware that smoking carries far greater risks than the most widely known diseases, health care providers should use this evidence to counsel their patients against tobacco smoking. Tobacco smokers who quit can lower their risk of a wide range of diseases and improve their health generally.[1]

Exposure to environmental tobacco smoke (passive smoking) is a significant cause of preventable mortality and morbidity in New South Wales. Passive smoking causes lung and nasal and sinus cancer, stroke and ischemic heart disease in adults, lower respiratory infections (croup, bronchitis, bronchiolitis and pneumonia), onset of asthma and worsening of asthma, respiratory symptoms, reduced lung function, middle-ear disease and eye and nasal irritation in children, reduced birthweight, and increased risk of sudden infant death syndrome in infants. There is also a causal association between passive smoking and cervical cancer, decreased pulmonary function and exacerbation of cystic fibrosis in adults, and cardiovascular health and the development of neurodevelopmental and behavioural problems in children. The risk of breast cancer appears to increase with passive smoking during puberty but not with overall lifetime exposure. Most of the evidence of harm caused by passive smoking is based on studies in the home environment; however, passive smoking is harmful wherever it takes place.[2]

The NSW Department of Health's Tobacco website provides information on: NSW Health's policy development on tobacco control; provision of tobacco cessation services; enforcement of legislation relating to the control of tobacco advertising, sale of tobacco, and environmental tobacco smoke; the NSW Tobacco Action Plan 2005-2009; and the National Tobacco Strategy 2004-2009.[3]

The object of the Public Health (Tobacco) Act 2008 is to reduce the incidence of tobacco consumption, particularly by young people, in recognition that the consumption of tobacco products adversely affects the health of the people of New South Wales and places a substantial burden on the State's health and financial resources. This Act aims to achieve that object by: regulating the packaging, advertising and display of tobacco products and non-tobacco smoking products; prohibiting the supply of those products to children; and reducing the exposure of children to environmental tobacco smoke.[4]

Results

Tobacco smoking

In 2008, 13.9 per cent of adults smoked daily, 4.6 per cent smoked occasionally, 23.9 per cent did not smoke now but used to smoke, 10.6 per cent tried smoking a few times but never smoked regularly, and 47.1 per cent never smoked.

In 2008, 18.4 per cent of adults were current (daily or occasional) smokers. A significantly higher proportion of males (19.7 per cent) than females (17.2 per cent) were current smokers. Among males, a significantly higher proportion of those aged 25-34 years (29.8 per cent) and 35-44 years (24.9 per cent), and a significantly lower proportion of those aged 55-64 years (15.6 per cent), 65-74 years (8.1 per cent) and 75 years and over (4.5 per cent) were current smokers, compared with the overall adult male population. Among females, a significantly higher proportion of those aged 25-34 years (23.1 per cent), and a significantly lower proportion of those aged 55-64 years (13.0 per cent), 65-74 years (7.8 per cent), and 75 years and over (3.7 per cent), were current smokers, compared with the overall adult female population.

A significantly higher proportion of adults in the fifth or most disadvantaged quintile (24.2 per cent), and a significantly lower proportion of adults in the first or least disadvantaged quintile (13.2 per cent), were current smokers, compared with the overall adult population.

There was no significant difference between rural and urban health areas. A significantly higher proportion of adults in the Greater Western Area Health Service (23.2 per cent) were current smokers, compared with the overall adult population.

Since 1997, there has been a significant decrease in the proportion of adults who were were current smokers (24.0 per cent to 18.4 per cent). The decrease has been significant in males and females, and in rural and urban health areas.

However, since 2007, there has been no significant change in the proportion of adults who were current smokers.

In 2008, 13.9 per cent of adults were daily smokers. There was no significant difference between males and females. A significantly higher proportion of adults aged 25-34 years (18.6 per cent) and 35-44 years (18.2 per cent), and a significantly lower proportion of adults aged 55-64 years (11.4 per cent), 65-74 years (6.4 per cent) and 75 years and over (3.5 per cent) were daily smokers, compared with the overall adult population.

A significantly higher proportion of adults in the fifth or most disadvantaged quintile (19.4 per cent), and a significantly lower proportion of adults in the first or least disadvantaged quintile (7.4 per cent), were daily smokers, compared with the overall adult population.

A significantly higher proportion of adults in rural health areas (16.3 per cent) than urban health areas (12.8 per cent) were daily smokers. A significantly higher proportion of adults in the Greater Western Area Health Service (19.0 per cent), and a significantly lower proportion of adults in the Northern Sydney & Central Coast Area Health Service (10.3 per cent), were daily smokers, compared with the overall adult population.

Since 1997, there has been a significant decrease in the proportion of adults who were were daily smokers (19.1 per cent to 13.9 per cent). The decrease has been significant in males and females, and in rural and urban health areas.

However, since 2007, there has been no significant change in the proportion of adults who were daily smokers.

Quitting tobacco smoking

In 2008, 61.8 per cent of adults who were current smokers intend to quit smoking in the next 6 months. There was no significant difference between males and females. A significantly lower proportion of adults aged 75 years and over (42.0 per cent) intended to quit smoking in the next 6 months, compared with the overall adult population who were current smokers.

There was no significant difference among quintiles of disadvantage, or between rural and urban health areas, or among health areas.

Since 2002, there has been a significant increase in the proportion of adults who were current smokers who intend to quit smoking in the next 6 months (50.7 per cent to 61.8 per cent). The increase has been significant in males and females, and in rural and urban health areas.

However, since 2007, there has been no significant change in the proportion of adults who were current smokers who intend to quit smoking in the next 6 months.

In 2008, 40.0 per cent of adults who smoked were advised to quit smoking the last time they visited their general practitioner. There was no significant difference between males and females. A significantly higher proportion of adults aged 55-64 years (54.0 per cent) and 65-74 years (65.5 per cent) were advised to quit smoking the last time they visited their general practitioner, compared with the overall adult population.

A significantly lower proportion of adults in the first or least disadvantaged quintile (27.5 per cent) were advised to quit smoking the last time they visited their general practitioner, compared with the overall adult population.

There was no significant difference between rural and urban health areas, or among health areas.

Since 2005, there has been no significant change in the proportion of adults who smoked who were advised to quit smoking the last time they visited their general practitioner; however, there has been a significant decrease in females.

Since 2007, there has been a significant decrease in the proportion of adults who smoked who were advised to quit smoking the last time they visited their general practitioner (50.3 per cent to 40.0 per cent). The decrease has been significant in males and females, and in urban health areas.

Smoke-free homes

In 2008, 89.5 per cent of adults lived in homes that were smoke-free, 5.7 per cent lived in homes where people occasionally smoked, and 4.9 per cent lived in homes where people frequently smoked.

A significantly lower proportion of adults aged 16-24 years (85.5 per cent) and 45-54 years (86.8 per cent), and a significantly higher proportion of adults aged 65-74 years (92.3 per cent) and 75 years and over (94.9 per cent), lived in homes that were smoke-free, compared with the overall adult population.

A significantly higher proportion of adults in the first or least disadvantaged quintile (94.3 per cent), and a significantly lower proportion of adults in the fifth or most disadvantaged quintile (83.8 per cent), lived in homes that were smoke-free, compared with the overall adult population.

There was no significant difference between rural and urban health areas. A significantly higher proportion of adults in the Northern Sydney & Central Coast Area Health Service (92.2 per cent) lived in homes that were smoke-free, compared with the overall adult population.

Since 1997, there has been a significant increase in the proportion of adults who lived in homes that were smoke-free (69.7 per cent to 89.5 per cent). The increase has been significant in rural and urban health areas.

However, since 2007, there has been no significant change in the proportion of adults who lived in homes that were smoke-free.

Smoke-free cars

In 2008, 88.2 per cent of adults said smoking was not allowed in their car. A significantly lower proportion of adults aged 16-24 years (82.1 per cent), and a significantly higher proportion of adults aged 55-64 years (90.9 per cent), 65-74 years (92.1 per cent), and 75 years and over (93.8 per cent), said smoking was not allowed in their car, compared with the overall adult population.

A significantly higher proportion of adults in the first or least disadvantaged quintile (92.2 per cent), and a significantly lower proportion of adults in the fifth or most disadvantaged quintile (84.8 per cent), said smoking was not allowed in their car, compared with the overall adult population.

There was no significant difference between rural and urban health areas, or among health areas.

Since 2003, there has been a significant increase in the proportion of adults who said smoking was not allowed in their car (81.2 per cent to 88.2 per cent). The increase has been significant in rural and urban health areas.

However, since 2007, there has been no significant change in the proportion of adults who said smoking was not allowed in their car.

Smoking bans in hotels and licensed premises

In 2008, 39.5 per cent of adults would be more likely, and 4.3 per cent would be less likely, to frequent hotels and licensed premises as a result of the total ban on smoking indoors. For 56.2 per cent of adults, the total ban on smoking indoors in hotels and licensed premises would make no difference.

In 2008, 39.5 per cent of adults would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors. A significantly lower proportion of males (36.7 per cent) than females (42.2 per cent) would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors. Among males, a significantly higher proportion of those aged 55-64 years (42.1 per cent), and a significantly lower proportion of those aged 75 years and over (28.3 per cent), would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors, compared with the overall adult male population. Among females, a significantly lower proportion of those aged 75 years and over (24.9 per cent) would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors, compared with the overall adult female population.

A significantly higher proportion of adults in the first or most disadvantaged quintile (44.6 per cent), and a significantly lower proportion of adults in the fourth disadvantaged quintile (35.7 per cent) and fifth or most disadvantaged quintile (34.9 per cent), would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors, compared with the overall adult population.

A significantly lower proportion of adults in rural health areas (36.5 per cent) than urban health areas (40.8 per cent) would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors. A significantly lower proportion of adults in the Greater Western Area Health Service (30.1 per cent) would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors, compared with the overall adult population.

Since 2003, there has been a significant increase in the proportion of adults who would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors (24.2 per cent to 39.5 per cent). The increase has been significant in males and females, and in rural and urban health areas.

Since 2007, there has been a significant increase in the proportion of adults who would be more likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors (36.9 per cent to 39.5 per cent). The increase has been significant in females.

In 2008, 4.3 per cent of adults would be less likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors. A significantly higher proportion of males (5.0 per cent) than females (3.5 per cent) would be less likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors. Among males, a significantly lower proportion of those aged 55-64 years (2.6 per cent), 65-74 years (1.9 per cent), and 75 years and over (2.6 per cent), would be less likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors, compared with the overall adult male population.

There was no significant difference among quintiles of disadvantage, between rural and urban health areas, or among health areas.

Since 2003, there has been a significant decrease in the proportion of adults who would be less likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors (9.8 per cent to 4.3 per cent). The decrease has been significant in males and females, and in rural and urban health areas.

Since 2007, there has been a significant decrease in the proportion of adults who would be less likely to frequent hotels and licensed premises as a result of the total ban on smoking indoors (5.8 per cent to 4.3 per cent). The decrease has been significant in females, and in urban health areas.

Smoking bans in outdoor dining areas

In 2008, 40.6 per cent of adults would be more likely, and 5.4 per cent would be less likely, to frequent outdoor dining areas if there was a total ban on smoking. For 54.0 per cent of adults, a total ban on smoking in outdoor dining areas would make no difference.

In 2008, 40.6 per cent of adults would be more likely to frequent outdoor dining areas if there was a total ban on smoking. A significantly lower proportion of males (38.0 per cent) than females (43.2 per cent) would be more likely to frequent outdoor dining areas if there was a total ban on smoking. Among males, a significantly higher proportion of those aged 55-64 years (43.0 per cent) would be more likely to frequent outdoor dining areas if there was a total ban on smoking, compared with the overall adult male population. Among females, a significantly lower proportion of those aged 75 years and over (30.6 per cent) would be more likely to frequent outdoor dining areas if there was a total ban on smoking, compared with the overall adult female population.

A significantly higher proportion of adults in the first or least disadvantaged quintile (45.1 per cent), and a significantly lower proportion of adults in the fourth disadvantaged quintile (36.4 per cent), would be more likely to frequent outdoor dining areas if there was a total ban on smoking, compared with the overall adult population.

A significantly lower proportion of adults in rural health areas (37.5 per cent) than urban health areas (42.0 per cent) would be more likely to frequent outdoor dining areas if there was a total ban on smoking. A significantly higher proportion of adults in the Northern Sydney & Central Coast Area Health Service (45.1 per cent), and a significantly lower proportion of adults in the Greater Southern (36.3 per cent) and Greater Western (33.5 per cent) Area Health Services, would be more likely to frequent outdoor dining areas if there was a total ban on smoking, compared with the overall adult population.

Since 2006, there has been a significant increase in the proportion of adults who would be more likely to frequent outdoor dining areas if there was a total ban on smoking (38.2 per cent to 40.6 per cent). The increase has been significant in females, and in urban health areas.

However, since 2007, there has been no significant change in the proportion of adults who would be more likely to frequent outdoor dining areas if there was a total ban on smoking.

In 2008, 5.4 per cent would be less likely to frequent outdoor dining areas if there was a total ban on smoking. There was no significant difference between males and females. A significantly lower proportion of adults aged 65-74 years years (3.3 per cent) and 75 years and over (3.6 per cent) would be less likely to frequent outdoor dining areas if there was a total ban on smoking, compared with the overall adult population.

A significantly higher proportion of adults in the fifth or most disadvantaged quintile (7.5 per cent) would be less likely to frequent outdoor dining areas if there was a total ban on smoking, compared with the overall adult population.

There was no significant difference between rural and urban health areas, or among health areas.

Since 2006, there has been no significant change in the proportion of adults who would be less likely to frequent outdoor dining areas if there was a total ban on smoking.

Since 2007, there has been no significant change in the proportion of adults who would be less likely to frequent outdoor dining areas if there was a total ban on smoking.

Regulating the display of cigarettes in shops

In 2008, 80.2 per cent of adults supported a regulation to ensure cigarettes are stored out of sight in shops. A significantly lower proportion of males (77.5 per cent) than females (82.7 per cent) supported a regulation to ensure cigarettes are stored out of sight in shops. Among males, a significantly lower proportion of those aged 16-24 years (69.6 per cent), and a significantly higher proportion of those aged 35-44 years (82.2 per cent) and 45-54 years (82.8 per cent), supported a regulation to ensure cigarettes are stored out of sight in shops, compared with the overall adult male population. Among females, a significantly lower proportion of those aged 16-24 years (76.9 per cent), and a significantly higher proportion of those aged 35-44 years (87.4 per cent), supported a regulation to ensure cigarettes are stored out of sight in shops, compared with the overall adult female population.

A significantly higher proportion of adults in the first or least disadvantaged quintile (83.2 per cent) supported a regulation to ensure cigarettes are stored out of sight in shops, compared with the overall adult population.

There was no significant difference between rural and urban health areas. A significantly higher proportion of adults in the Northern Sydney and Central Coast Area Health Service (84.0 per cent) supported a regulation to ensure cigarettes are stored out of sight in shops, compared with the overall adult population.

References

United States Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: United States Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 2004. Available online at www.surgeongeneral.gov/library/smokingconsequences (accessed 10 July 2009).
Commonwealth Department of Health and Ageing and the National Drug Strategy. Environmental Tobacco Smoke in Australia. Canberra: Commonwealth Department of Health and Ageing, 2002. Available online at www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-publicat-document-env_ets-cnt.htm (accessed 31 March 2009).
NSW Department of Health's Tobacco Website. Sydney: NSW Department of Health, 2009. Available online at www.health.nsw.gov.au/publichealth/healthpromotion/tobacco/index.asp (accessed 31 March 2009).
New South Wales Legislation. Public Health (Tobacco) Act 2008. Sydney: NSW Government, November 2008. Available online at www.health.nsw.gov.au/publichealth/healthpromotion/tobacco/legislation.asp (accessed 10 July 2009).

Graphs

Source:	New South Wales Population Health Survey 2008 (HOIST). Centre for Epidemiology and Research, NSW Department of Health.
Print version:	Although this page can be printed directly from your web browser, a higher quality version is available as a PDF file that can be printed or viewed on screen.
Produced by:	Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.
Last updated on:	1 July 2009

Smoking

Introduction

Results

Tobacco smoking

Quitting tobacco smoking

Smoke-free homes

Smoke-free cars

Smoking bans in hotels and licensed premises

Smoking bans in outdoor dining areas

Regulating the display of cigarettes in shops

References

Graphs

Adult Report

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