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INTRODUCTION

This snapshot presents an overview of the prevalence of tobacco smoking among adults in the Aboriginal and Torres Strait Islander population. It also outlines the relationship between smoking and selected health and socioeconomic factors.

Unless otherwise stated, data in this article are for Indigenous people aged 18 years and over. 'Current daily smokers' or 'regular smokers' are those people who reported currently smoking, on average, one or more cigarettes (or cigars or pipes) per day at the time of interview.

DATA SOURCES

This article draws on information from the 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), the 2004-05 National Health Survey (NHS) and the 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS).

INQUIRIES

For further information, please contact the Assistant Director, National Centre for Aboriginal and Torres Strait Islander Statistics on (02) 6252 6301 or visit www.abs.gov.au

TOBACCO SMOKING

Tobacco smoking was responsible for the greatest burden of disease and injury in Australia in 2003, followed by high blood pressure, high body mass, physical inactivity, and high blood cholesterol (Begg et al. 2007). Smoking tobacco increases the risk of numerous cancers, heart and vascular diseases, respiratory diseases and a variety of other conditions. It is responsible for around 20% of all cancer deaths, 80% of all lung cancer deaths, and 21% of all heart disease in Australia (DoHA 2006, 2006a). Tobacco use is of particular concern for the health of Aboriginal and Torres Strait Islander peoples, amongst whom smoking prevalence is more than double that of the non-Indigenous population (DoHA 2006).

PREVALENCE OF SMOKING

• In 2004-05, half of the adult Indigenous population (50%) were current daily smokers (ABS 2006).
• While smoking rates have decreased slightly for the total Australian population over the ten years to 2004-05 (ABS 2006a), there has been no significant change in smoking rates for the Indigenous population in this period (ABS 2006).
• One in five Indigenous adults (20%) were ex-smokers (footnote 1) and 28% of Indigenous adults reported that they had never smoked (footnote 2) (ABS 2006).
• Rates of current daily smoking were similar for Indigenous men and women (51% and 49%) (ABS 2006).
• Indigenous people living in remote and non-remote areas also reported similar rates of current daily smoking (52% and 49%) (footnote 3) (ABS 2006).
• Indigenous men in remote areas were more likely than those in non-remote areas to smoke on a daily basis (58% compared with 49%) (ABS 2006).
• In the Aboriginal and Torres Strait Islander population, rates of regular smoking were high in younger age groups (reaching 57% for men aged 35-44 years and 54% for women aged 25-34 years and 35-44 years) and lower among those aged 55 years and over. Rates of smoking in the non-Indigenous population followed a similar pattern by age, although at considerably lower levels.
• In 2004-05, the rate of regular smoking among Indigenous men was around twice that of non-Indigenous men (51% compared with 24%) and the rate for Indigenous women was around two-and-a-half times that of non-Indigenous women (49% compared with 18%).

Current daily smokers, Males(a) - 2004-05



Current daily smokers, Females(a) - 2004-05

• In 2004-05, Indigenous adults who had completed Year 12 were less likely to be regular smokers than were those who had completed Year 11 or below (34% compared with 55%).
• Daily smoking was less common among employed Indigenous adults (45%) than among those who were unemployed (66%) or not in the labour force (53%).
• Indigenous people who lived in dwellings that were owned or being purchased by the occupants were less likely to smoke regularly than were those who lived in rented dwellings (36% compared with 55%).
• Indigenous adults with access to higher household incomes were less likely than those in low income households to be regular smokers (40% compared with 55%).
• Similarly, in the non-Indigenous population, lower rates of regular smoking were reported by people who had characteristics associated with socioeconomic advantage (i.e. higher education levels, employment, home ownership or access to higher household incomes).
• After adjusting for age differences (footnote 4) between the Indigenous and non-Indigenous populations, Indigenous adults with these characteristics were still around twice as likely as non-Indigenous adults to be current daily smokers.

Proportions of people with selected socioeconomic characteristics(a), who smoke regularly - 2004-05
			Current daily smokers		Age-standardised rate ratio(b)
			Indigenous	Non-Indigenous
Highest year of school completed(c)
	Year 12	%	34.3	16.1	1.9
	Year 11 or below	%	54.8	25.2	1.7
Labour force status
	Employed	%	45.2	22.1	1.9
	Unemployed	%	66.3	40.0	1.9
Housing tenure
	Home owner/purchaser	%	36.2	15.6	2.1
	Renter	%	55.1	33.6	1.6
Household income(d)
	Third income quintile and above	%	39.7	20.1	1.9
	First and second quintile	%	55.4	22.8	1.9
Persons aged 18 years and over		%	50.0	20.9	2.2
		'000	129.2	3 084.5	. .
. . not applicable
(a) Aged 18 years and over.
(b) Indigenous to non-Indigenous rate ratios are calculated by dividing the proportion of Indigenous people with a particular characteristic by the proportion of non-Indigenous people with the same characteristic.
(c) Excludes persons still attending school.
(d) Gross weekly equivalised cash household income. For further information see Appendix 7 in the National Aboriginal and Torres Strait Islander Health Survey: Users' Guide 2004-05 (cat. no. 4715.0.55.004).
National Aboriginal and Torres Strait Islander Health Survey 2004-05, National Health Survey 2004-05

• Indigenous adults who had experienced more than one life stressor in the last 12 months (footnote 5) had higher rates of current daily smoking (54%) than did those who reported that they had experienced one or no stressful circumstances (46%).
• Indigenous people who reported that they had experienced financial stress in the past year (footnote 6) were more likely to be daily smokers than were those whose household had not experienced financial stress (58% compared with 41%).

• In 2004-05, Aboriginal and Torres Strait Islander people who had never smoked were more likely to report being in excellent or very good health (47%) than were ex-smokers (41%) or current daily smokers (35%).
• Correspondingly, Indigenous people who were current daily smokers or ex-smokers were more likely than those who had never smoked to report being in fair or poor health (27% compared with 17%).
• Similarly, non-Indigenous people who were current daily smokers or ex-smokers were more likely than those who had never smoked to report being in fair or poor health (20% and 19% compared with 13%).

Self-assessed health status by smoker status(a) - 2004-05

• In 2004-05, Aboriginal and Torres Strait Islander people who smoked daily were one-and-a-half times as likely as those who had never smoked to report high/very high levels of psychological distress (32% compared with 20%) (footnote 7).
• In 2002, Indigenous people who were current daily smokers were more likely than those who had never smoked to report having a disability or long-term health condition (40% compared with 31%) (footnote 8). They were also more likely than those who had never smoked to report a profound or severe core activity restriction (9% compared with 6%) (footnote 9).

• In 2004-05, among Indigenous people aged 35 years and over, similar proportions of current daily smokers (89%), ex-smokers (94%) and people who had never smoked (90%) had at least one long-term health condition.
• Indigenous people aged 35 years and over who were current daily smokers were less likely than ex-smokers to report heart and circulatory diseases (30% of current smokers compared with 37% of ex-smokers). However, ex-smokers with heart and circulatory diseases were one-and-a-half times more likely than current daily smokers with these conditions to be overweight/obese (footnote 10).
• Indigenous people aged 35 years and over who were current daily smokers were half as likely as ex-smokers to report diabetes/high sugar levels (13% compared with 26%). However, overweight/obesity rates were twice as high among ex-smokers with diabetes/high sugar levels than among current daily smokers with these conditions.
• Similar proportions of current daily smokers and ex-smokers reported respiratory diseases (34% and 37%) or kidney disease (3% and 5%).

• In 2004-05, Indigenous people who smoked regularly were almost twice as likely as non-smokers (includes ex-smokers and people who had never smoked) to report that they did not eat fruit on a daily basis (19% compared with 10%).
• Indigenous smokers were also less likely than non-smokers to meet the nutritionally recommended daily intake of two serves of fruit per day (footnote 11). In non-remote areas, around one-third (30%) of Indigenous current daily smokers met the recommended daily intake of fruit compared with around half (51%) of those who did not smoke.
• Similar proportions of regular smokers and non-smokers reported that they did not consume vegetables on a daily basis (7% and 5%).
• Over half of Indigenous regular smokers (55%) living in non-remote areas reported a sedentary lifestyle (footnote 12) compared with 42% of those who did not smoke.

• Among Indigenous people who reported their height and weight in 2004-05, 40% of current daily smokers were in the healthy weight range compared with 31% of non-smokers (includes ex-smokers and people who had never smoked).
• While a similar proportion of smokers and non-smokers reported that they were overweight (29% and 30%), smokers were less likely than non-smokers to report that they were obese (26% compared with 36%).

• In 2004-05, Aboriginal and Torres Strait Islander people who smoked regularly were more than twice as likely as non-smokers (includes ex-smokers and people who had never smoked) to report long-term risky/high risk levels of alcohol consumption (23% compared with 9%) (footnote 13).
• Similarly, Indigenous current daily smokers were more than twice as likely as non-smokers to have consumed alcohol at short-term risky/high-risk levels (footnote 14) at least once per week in the 12 months prior to interview (26% compared with 11%).

Risky/high risk alcohol consumption by smoker status(a) - 2004-05

• In non-remote areas, Indigenous smokers were twice as likely as non-smokers to report illicit substance use (footnote 15). Half of regular smokers in the 18-34 year age group had used illicit substances in the last 12 months compared with one-quarter (25%) of non-smokers.
• Marijuana use was much more prevalent among Indigenous smokers than non-smokers. In non-remote areas, 46% of regular smokers aged 18-34 years had used marijuana, hashish or cannabis resin in the last 12 months, compared with 16% of non-smokers.

• In 2004-05, around one in ten Indigenous adults who were current daily smokers or ex-smokers had begun smoking regularly before the age of 13 years.
• More than two-thirds of Indigenous current daily smokers and ex-smokers (68%) had begun smoking regularly before the age of 18 years.
• Indigenous people living in non-remote areas tended to commence regular smoking earlier, with 11% starting before the age of 13 years compared with 5% in remote areas.
• In 2004-05, 5% of non-Indigenous current daily smokers and ex-smokers had begun smoking before the age of 13 years and 54% reported having commenced regular smoking before the age of 18 years.
• Indigenous women were around twice as likely as non-Indigenous women to report having begun smoking regularly before the age of 13 years (9% compared with 4%).

• In 2004-05, 111,800 households with Indigenous residents (62%) had at least one regular smoker. Of these households with a regular smoker, 45% had at least one resident who regularly smoked indoors.
• Two-thirds (66%) of Aboriginal and Torres Strait Islander children aged 0-14 years lived in households with one or more regular smokers and 28% lived in households in which at least one resident regularly smoked indoors.
• Around one-third of non-Indigenous children aged 0-14 years (35%) lived in households with a regular smoker and 9% lived in households in which at least one resident regularly smoked indoors.

Children's exposure to environmental tobacco smoke(a) - 2004-05

LIST OF REFERENCES

Australian Bureau of Statistics (ABS) 2006, National Aboriginal and Torres Strait Islander Health Survey 2004–05, ABS cat. no. 4715.0, ABS, Canberra.

ABS 2006a, Tobacco Smoking in Australia: A Snapshot 2004–05, ABS cat. no. 4831.0.55.001, ABS, Canberra.

Australian Bureau of Statistics and Australian Institute of Health and Welfare 2005, The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, ABS cat. no. 4704.0, AIHW cat. no. IHW14, AIHW, Canberra.

Australian Institute of Health and Welfare (AIHW) 2004, Tobacco smoking, http://www.aihw.gov.au/riskfactors/smoking.cfm, December 2004.

AIHW 2006, Australia's Health 2006, AIHW cat. no. AUS73, AIHW, Canberra.

Begg, S, Vos, T, Barker, B, Stevenson, T, Stanley, L & Lopez, A 2007, The Burden of Disease and Injury in Australia 2003, AIHW, Canberra.

Blakely, T, Hales, S & Woodward, A 2004, Poverty: Assessing the Distribution of Health Risks by Socioeconomic Position at National and Local Levels, WHO Environmental Burden of Disease Series, no. 10, WHO, Geneva.

Department of Health and Ageing (DoHA) 2006, Aboriginal and Torres Strait Islander Health Performance Framework - 2006 Report, DOHA, Canberra.

DoHA 2006a, Health Effects of Smoking, http://www.healthinsite.gov.au/content/internal/page.cfm?ObjID=0007918F-0B6A-1D2D-81CF83032BFA006D&CFID=11694254&CFTOKEN=97612010, December 2006.

Turrell, G & Mathers, C 2000, Socio-economic status and health in Australia, Medical Journal of Australia, 172:434-438.