Who smokes in Australia? Cross-sectional analysis of Australian Bureau of Statistics survey data, 2017–19

Objectives: To assess the socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked in Australia. Study design: Cross-sectional analysis of Australian Bureau of Statistics (ABS) survey data. Setting, participants: Adult participants (16 370 people aged 18 years or older) in the ABS 2017–18 National Health Survey (NHS); adult participants in the ABS 2018–19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (6423 people aged 18 years or older). Main outcome measures: Socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked, expressed as population-weighted proportions, overall and by Indigeneity. Results: Among adult NHS respondents, an estimated 58.8% of people who smoked daily (95% confidence interval [CI], 56.2–61.4%) were men, 61.3% (95% CI, 58.7–63.9%) were 25–54 years old, 72.5% (95% CI, 70.0–74.8%) were born in Australia, and 65.4% (95% CI, 62.8–67.8%) lived in major cities and 54.3% (95% CI, 51.6–57.0%) in areas in the two socio-economically most disadvantaged quintiles; 75.9% (95% CI, 73.5–78.1%) reported good to excellent health, 73.0% (95% CI, 70.5–75.4%) reported low to moderate psychological distress, 69.0% of those aged 25–64 years (ie, of working age) had completed year 12 (high school), and 68.5% were currently employed. An estimated 2.57 million people smoke daily in Australia: 2.37 million non-Indigenous people (92%) and 195 700 Aboriginal or Torres Strait Islander people (8%). Conclusions: While smoking is more frequent among people living in socio-economically disadvantaged areas and in certain population sub-groups, this first quantitative national profile indicates that most people who smoke daily are in paid employment, are non-Indigenous, are in good physical and mental health, and have completed year 12. Improved comprehensive structural supply- and demand-based tobacco control, informed by the needs of priority groups and the overall profile of people who smoke, is needed to reduce daily smoking prevalence among adults to the 2030 targets of 5% or less for all Australians and 27% or less for Aboriginal and Torres Strait Islander people.