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The costs of tobacco, alcohol and illicit drug abuse to Australian Society in 2004/05

Appendix A, Demographic estimates

Use of aetiological fractions and demographic data to estimate the additional numbers of Australian males and females who would have been alive and enumerated in the Australian population in June 2005 had there been no use of illicit drugs, alcohol or tobacco.

This appendix was written by J.H. Pollard, Emeritus Professor of Actuarial Studies,

Macquarie University, who undertook the demographic calculations for this study.

Introduction

The results of the calculations are shown in the attached tables. In each case:

Column (1) indicates the relevant age group;

Column (2) lists the mid-year 2005 population as estimated by the Australian Bureau of Statistics;

Column (3) lists the estimated mid-year population, had there been no use at any time of illicit drugs (but alcohol and tobacco were used at the same historic levels);

Column (4) lists the numbers of additional persons who would still be alive had there been no use of illicit drugs at any time; Column (4) = Column (3) - Column (2);

Column (5) lists the estimated mid-year population had there been no use of either illicit drugs or alcohol at any time (but tobacco was used at the same historic level);

Column (6) lists the numbers of additional persons who would still be alive had there been no use of alcohol at any time; Col. (6) = Col. (5) - Col. (3);

Column (7) lists the estimated mid-year population had there been no use of illicit drugs, alcohol or tobacco at any time;

Column (8) lists the numbers of additional persons who would still be alive had there been no use of tobacco at any time; Col. (8) = Col. (7) - Col. (5).

We note from column (7) that, in the absence of the use of illicit drugs, alcohol and tobacco, the 2005 male population would be 3.5 per cent higher than it is estimated to have been, and that the 2005 female population would be 1 per cent higher.

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The data

The aetiological fractions used in this report are those presented in English, Holman et al. (1995), Ridolfo and Stevenson (2001), and by Codde in Appendix C of this report. For the purposes of this projection, the first set of aetiological fractions are assumed to apply prior to 1988 (but without illicit drug deaths prior to 1962) and those of Ridolfo and Stevenson in 1998, with intermediate fractions for the period 1989–1997. Those of Codde are assumed to apply in 2006, with intermediate fractions from 1999 and 2005.

The other data used in the calculations are as follows:

the population of Australia in 1947 by age (in individual years) and sex
the Australian life tables 1953–55, 1965–67, 1975–77, 1985–87 and 1995–97
ABS Life Tables Australia 2003–2005
the numbers of births in Australia for each calendar year 1947–2005
the numbers of net migrants by age (in broad age groups) and sex for representative years in each decade (1950s, 1960s, 1970s, 1980s,1990s) and 2000-2003
estimate of the Australian population in 2005 by age and sex.

These demographic data were all available from Australian Bureau of Statistics (ABS) publications.

Method

Using the base 1947 population, the history of births, the above-mentioned life tables and the representative migration numbers, it was possible to project forward the Australian population from 1947 to 2005. The resultant estimates for 2005 were close to those provided by ABS.

The projection program was then re-run with modifications to the assumed rates of mortality to reflect the situation which would have existed had there been (a) no illicit drug use, (b) no illicit drug use nor alcohol use, and (c) no illicit drug use, nor alcohol use nor tobacco use.

All calculations were performed using single years of age. The reported results are in five-year age groups.

As in previous reports, no attempt was made to quantify the births that did not take place because of lives lost through drug usage.

Adjustment of the mortality rates

Using the aetiological fractions described above and applying them to the relevant causes of death identified by the same authors, it is possible to estimate the proportions of deaths at each age attributable to illicit drug use, to alcohol use and to tobacco use. These proportions were then applied to the mortality rates in earlier epochs to determine the modified mortality rates for use in the various computer program runs described above. Normal multiple-decrement table formulae were used to calculate the modified rates.

This approach can be criticised on several counts. First, it is doubtful whether exactly the same fractions applied in earlier years, since usage of these drugs has changed over time, and other factors have had major impacts on the numbers dying from the various causes (road accident deaths, for example, have halved in the last decade, as a result of various measures, and circulatory system disease mortality has declined remarkably, presumably as a result of a number of lifestyle and medical changes). Second, the aetiological fractions ought to be applied to the deaths by cause in earlier epochs to derive mortality proportions relevant to those times. This second objection can be addressed, but any improvement in accuracy is likely to be spurious, because of the serious nature of the first limitation.

It is important to note that the current Australian Burden of Disease (ABOD) study (see Begg et al., 2007) reports a substantially lower health benefit due to alcohol compared with the previous study, with only an estimated 2,346 deaths being saved by alcohol in 2003, compared with 7,157 deaths saved in 1996. According to the authors of the current ABOD report, the previous study incorrectly estimated the number of people who abstain from alcohol or drink less than 0.25 drinks per day. In the absence of corrected aetiological fractions for the mid 1990s, the original fractions were incorporated in the projection as described above, and as a result the net numbers of alcohol-related deaths are believed to be underestimated. Further discussion of the issue and consequences is given in the main body of this report in the section "Changes in alcohol attributable fractions".

In the absence of equivalent aetiological fractions for all earlier epochs, the above approach was considered the most reliable.

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Table 51, The impact of drug abuse upon the Australian male population

Age group	Mid-year population	Mid-year population – no illicit drug abuse	Additional population – no illicit drug abuse	Mid-year population – no alcohol drug abuse	Additional population – no alcohol abuse	Mid-year population – no tobacco abuse	Additional population – no tobacco abuse
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
0	654,879	654,889	10	654,921	32	655,066	145
5	676,395	676,418	23	676,478	61	676,814	335
10	714,009	714,038	29	714,129	92	714,607	478
15	720,491	720,545	54	720,803	258	721,702	898
20	746,088	746,301	213	747,226	924	748,880	1,655
25	706,314	706,972	658	709,122	2,149	712,169	3,047
30	738,918	740,332	1,414	744,510	4,178	749,826	5,316
35	754,177	756,142	1,965	762,142	6,000	769,750	7,608
40	759,679	762,164	2,485	770,188	8,023	780,483	10,296
45	741,193	743,730	2,537	752,718	8,989	765,024	12,305
50	671,491	673,843	2,352	683,228	9,385	697,653	14,425
55	642,234	644,315	2,081	653,954	9,639	671,763	17,808
60	498,115	499,601	1,486	507,437	7,836	526,378	18,940
65	393,033	394,095	1,062	400,853	6,758	425,004	24,152
70	304,612	305,290	678	310,699	5,409	341,372	30,673
75	255,297	255,717	420	259,471	3,753	299,906	40,435
80	169,493	169,672	179	170,371	698	208,991	38,620
85	111,000	111,074	74	107,426	-3,648	146,933	39,508
Total	10,257,418	10,275,139	17,721	10,345,676	70,537	10,612,320	266,644

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Table 52, The impact of drug abuse on the Australian female population

Age group	Mid-year population	Mid-year population – no illicit drug abuse	Additional population – no illicit drug abuse	Mid-year population – no alcohol drug abuse	Additional population – no alcohol abuse	Mid-year population – no tobacco abuse	Additional population – no tobacco abuse
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
0	620,286	620,291	5	620,303	12	620,386	83
5	642,855	642,876	21	642,900	25	643,119	219
10	676,901	676,924	23	676,963	39	677,285	322
15	684,928	684,959	31	685,050	91	685,601	551
20	707,341	707,446	105	707,725	279	708,522	797
25	685,650	685,881	231	686,448	567	687,678	1,230
30	741,858	742,228	370	743,196	967	745,023	1,828
35	760,402	760,843	441	762,210	1,367	764,720	2,510
40	764,490	765,056	566	767,027	1,970	770,491	3,464
45	748,927	749,531	604	751,858	2,326	756,139	4,281
50	680,722	681,301	579	683,814	2,512	688,880	5,067
55	643,087	643,635	548	646,366	2,731	652,650	6,284
60	489,951	490,385	434	492,768	2,383	499,262	6,494
65	398,737	399,097	360	401,166	2,069	409,538	8,372
70	329,759	330,011	252	331,467	1,456	342,159	10,692
75	302,950	303,125	175	303,566	441	318,345	14,780
80	242,233	242,338	105	240,880	-1,458	256,841	15,961
85	226,993	227,040	47	216,353	-10,687	232,100	15,747
Total	10,348,070	10,352,967	4,897	10,360,058	7,091	10,458,739	98,681

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Table 53, The impact of drug abuse upon the Australian male and female population

Age group	Mid-year population	Mid-year population – no illicit drug abuse	Additional population – no illicit drug abuse	Mid-year population – no alcohol drug abuse	Additional population – no alcohol abuse	Mid-year population – no tobacco abuse	Additional population – no tobacco abuse
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
0	1,275,165	1,275,180	15	1,275,223	44	1,275,452	229
5	1,319,250	1,319,293	43	1,319,379	85	1,319,933	554
10	1,390,910	1,390,961	51	1,391,092	131	1,391,892	800
15	1,405,419	1,405,504	85	1,405,853	349	1,407,302	1,449
20	1,453,429	1,453,747	318	1,454,950	1,203	1,457,402	2,452
25	1,391,964	1,392,853	889	1,395,570	2,716	1,399,846	4,277
30	1,480,776	1,482,561	1,785	1,487,706	5,145	1,494,849	7,143
35	1,514,579	1,516,985	2,406	1,524,352	7,368	1,534,470	10,117
40	1,524,169	1,527,221	3,052	1,537,214	9,993	1,550,974	13,760
45	1,490,120	1,493,261	3,141	1,504,576	11,315	1,521,162	16,587
50	1,352,213	1,355,144	2,931	1,367,042	11,898	1,386,533	19,491
55	1,285,321	1,287,950	2,629	1,300,320	12,370	1,324,413	24,093
60	988,066	989,986	1,920	1,000,206	10,219	1,025,639	25,434
65	791,770	793,191	1,421	802,019	8,827	834,542	32,524
70	634,371	635,302	931	642,167	6,865	683,531	41,364
75	558,247	558,842	595	563,036	4,194	618,251	55,215
80	411,726	412,010	284	411,250	-760	465,832	54,582
85	337,993	338,114	121	323,778	-14,335	379,033	55,255
Total	20,605,488	20,628,360	22,872	20,709,491	81,130	21,078,651	369,161

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