Notes on the data: Health risk factors

Estimated male, female and total population, aged 18 years and over, who were current smokers, 2017-18

Policy context: Tobacco smoking is recognised as the largest single preventable cause of death and disease in Australia. It is associated with an increased risk of heart disease, stroke, cancer, emphysema, bronchitis, asthma, renal disease and eye disease [1]. In 2017-18, the Australian Health Survey estimated that approximately 8.3 million Australian adults aged 18 years and over had smoked at some time in their lives; and 2.8 million were current smokers, with the vast majority (91%) of these people smoking daily [2]. The negative effects of passive smoking indicate that the risks to health of smoking affect more than just the smoker. Passive smoking increases the risk of heart disease, asthma, and some cancers. It may also increase the risk of Sudden Infant Death Syndrome (SIDS) and may predispose children to allergic sensitisation [3].

Rates of smoking have decreased substantially over time, down from 22.4% in 2001 to 13.8% in 2017–18. Decreases are evident for both males and females; in 2017–18, 16.5% of males and 11.1% of females aged 18 years and over were current daily smokers [2].

In 2017–18, young adults aged 18-24 years were more likely to have never smoked than any other age group, with more than two thirds of men (69.6%) and four in five women (81.5%) in this age group reporting they have never smoked. These proportions have increased from 64.0% and 64.9%, respectively since 2007–08 [4].

References

Australian Medical Association (AMA). Tobacco smoking - Position statement, November 2005. Available from: https://ama.com.au/position-statement/tobacco-smoking-2005; last accessed 29 July 2014.
Australian Bureau of Statistics (ABS). National Health Survey: First Results, 2017–18 — Australia. Canberra: ABS; 2018. Available from: https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012017-18?OpenDocument; last accessed 15 October 2019.
National Public Health Partnership (NPHP). National response to passive smoking in enclosed places and workplaces: a background paper. Canberra: NPHP; 2000.
Australian Bureau of Statistics (ABS). Smoking. National Health Survey: First Results, 2017-18 - Australia. Canberra: ABS; 2018. Available from: https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Smoking~85; last accessed 15 October 2019.

Notes:

Differences from data published by the Australian Bureau of Statistics (ABS):

Data by quintile of socioeconomic disadvantage and Remoteness will differ to the extent that data extracted from Survey TableBuilder have been randomised, whereas those published by the ABS are not. In addition, rates published by the ABS for modelled estimates are generally crude rates; rates published by PHIDU are age-standardised.

Modelled Estimates:

In the absence of data from administrative data sets, estimates are provided at the Population Health Area (PHA) level for selected health risk factors from the 2017–18 National Health Survey (NHS), conducted by the Australian Bureau of Statistics (ABS). The estimates at the Population Health Area (PHA) are modelled estimates produced by the ABS (estimates at the Local Government Area (LGA) and Primary Health Network (PHN) level were derived from the PHA estimates).

Details of the method used and accuracy of results are available from the ABS paper Explanatory Notes: Modelled estimates for small areas based on the 2017-18 National Health Survey, available here.

For the Primary Health Network (PHN) data, differences between the PHN totals and the sum of LGAs within PHNs result from the use of different geographic correspondence files.

Estimates for quintile of socioeconomic disadvantage of area and Remoteness Area are direct estimates, extracted using the ABS Survey TableBuilder.

Users of these modelled estimates should note that they do not represent data collected in administrative or other data sets. As such, they should be used with caution, and treated as indicative of the likely social dimensions present in an area with these demographic and socioeconomic characteristics.

The numbers are estimates for an area, not measured events as are, for example, death statistics. As such, they should be viewed as a tool that, when used in conjunction with local area knowledge and taking into consideration the prediction reliability, can provide useful information that can assist with decision making for small geographic regions. Of particular note is that the true value of the published estimates is also likely to vary within a range of values as shown by the upper and lower limits published in the data (xlsx) and viewable in the column chart in the single map atlases.

What the modelled estimates do achieve, however, is to summarise the various demographic, socioeconomic and administrative information available for an area in a way that indicates the expected level of each health indicator for an area with those characteristics. In the absence of accurate, localised information about the health indicator, such predictions can usefully contribute to policy and program development, service planning and other decision-making processes that require an indication of the geographic distribution of the health indicator.

The relatively high survey response rate in the NHS provides a high level of coverage across the population; however, the response rate among some groups is lower than among other groups, e.g., those living in the most disadvantaged areas have a lower response rate than those living in less disadvantaged areas. Although the sample includes the majority of people living in households in private dwellings, it excludes those living in the very remote areas of Australia and discrete Aboriginal and Torres Strait Islander communities; whereas these areas comprise less than 3% of the total population, Aboriginal people comprise up to one third of the population. The survey does not include persons usually resident in non-private dwellings (hospitals, gaols, nursing homes - and also excludes members of the armed forces).

This and other limitations of the method mean that estimates have not been published for PHAs with populations under 1,000.

The ABS used a number of methods to measure the quality of the estimates, one of which is the relative root mean squared error (RRMSE) of the modelled estimates. The RRMSEs are included with the data. Users are advised that:

estimates with RRMSEs less than 25% are considered reliable for most purposes;
estimates with RRMSEs from 0.25 and to 0.50 have been marked (~) to indicate that they should be used with caution; and
those greater than 0.50 but less than 1 are marked (~~) to indicate that the estimate is considered too unreliable for general use.

Indicator detail

The data on which the estimates are based are self-reported data, reported to interviewers in the 2017-18 NHS. A current smoker is an adult who reported at the time of interview that they smoked manufactured (packet) cigarettes, roll-your-own cigarettes, cigars, and/or pipes at least once per week. It excludes chewing tobacco, electronic cigarettes (and similar) and smoking of non-tobacco products. As part of the NHS, respondents aged 18 years and over were asked to describe their smoking status at the time of interview as:

current smokers: daily, weekly, other;
ex-smokers;
never smoked (those who had never smoked 100 cigarettes, nor pipes, cigars or other tobacco products at least 20 times, in their lifetime).

For the indicator in this atlas, data are for respondents aged 18 years and over who responded that they were "a current, daily or at least once weekly smoker".

Geography: Data available by Population Health Area, Local Government Area, Primary Health Network, Quintile of socioeconomic disadvantage of area and Remoteness Area

Numerator: Estimated number of males, females or persons aged 18 years and over who reported being a current, daily or at least once weekly smoker

Denominator: Male, female or total population aged 18 years and over

Detail of analysis: Indirectly age-standardised rate per 100 population (aged 18 years and over); and/or indirectly age-standardised ratio, based on the Australian standard

Source:

PHA, LGA & PHN: Age-standardised rates are based on Australian Bureau of Statistics data, produced as a consultancy for PHIDU, from the 2017—18 National Health Survey.

Quintiles & Remoteness: Compiled by PHIDU based on direct estimates from the 2017–18 National Health Survey, ABS Survey TableBuilder.