National Drug Strategy
National Drug Strategy

National Tobacco Strategy 2012-2018: Draft for consultation

6.4 Strengthen efforts to reduce smoking among people in disadvantaged populations with high smoking prevalence

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Smoking among people from low socioeconomic and other disadvantaged groups is much higher than the general population. A quarter of those in low socioeconomic groups (24.6 per cent) reported smoking in the last 12 months.1

The greatest burden of illness and costs due to tobacco occurs among households in the lowest quintile of social advantage.21 It is estimated that smoking is responsible for over half of the SES disparity in mortality. However the deaths are only part of the problem – persistent smokers have more years of disability even though they live 10 years less than non smokers.8

Much of the differential in smoking rates between socioeconomic groups can be explained by higher uptake among young people in low socioeconomic areas. Smokers from low socioeconomic groups are no less likely to make a quit attempt but do seem to be less likely to succeed.22

Exposure to ETS in the home is also higher among disadvantaged groups. In 2007, children in households in the most disadvantaged areas in Australia were more than three times as likely to be exposed to tobacco smoke in the home.27

Prisoners have one of the highest rates of tobacco smoking in the community with around 85 per cent reporting they are current smokers.13 Efforts to reduce the prevalence of smoking among prisoners and to reduce exposure of prisoners and staff working in the correctional setting have commenced but progress to date has been slow.

It should be noted that Aboriginal and Torres Strait Islander people are significantly over-represented in the prison setting. The Australian Bureau of Statistics estimated that just over one quarter (26 per cent) of the total prisoner population were Aboriginal and Torres Strait Islander people. The proportion of prisoners who identified as Aboriginal or Torres Strait Islander varied across states and territories. The Aboriginal and Torres Strait Islander prisoner population in the Northern Territory comprised 82 per cent of the total prisoner population, while Victoria had the lowest proportion of Aboriginal and Torres Strait Islander prisoners (6 per cent).50

Smoking prevalence in people with mental illness is high, with estimates of smoking prevalence of 60 per cent among people with psychosis.12

“Given that people with mental illness are a significant percentage of smokers, population-wide approaches need to reach out specifically to this group.51 There is evidence that with this support, many highly disadvantaged people can quit successfully.51

There is strong evidence demonstrating the effectiveness of whole of population approaches such as tobacco tax increases and mass media campaigns in reducing smoking among smokers from low socioeconomic groups.42 Other measures such as smoke free legislation and legislation prohibiting tobacco advertising and marketing contribute to the continued de-normalisation of smoking. The approach in this draft Strategy is to complement these proven whole of population approaches with more targeted approaches to encourage and support smokers from disadvantaged groups to quit smoking.

A priority will be placed on establishing new or broader partnerships with organisations which are already working closely with these disadvantaged groups, and building their capacity in tobacco control.