Older people make up a considerable proportion of Australia’s population. In 2017, over 1 in 7 people were aged 65 and over and the number and proportion of older Australians is expected to continue to grow (AIHW 2018). Older people have unique health circumstances including pain, co-morbidities, and social circumstances such as isolation (DoH 2017). These factors are important to consider in the context of alcohol and other drug use. Refer to Box OLDER1 for how ‘older people’ are defined in this report.
Box OLDER1: How do we define ‘old’?
Most population data define ‘old’ as persons aged 65 and over to align with the qualifying age for the Age pension. However, this section will generally refer to people aged 50 and over in order to capture people who may be ageing prematurely due to alcohol and other drug use, and to include the ‘Baby Boomer’ cohort (AIHW 2016). The different older age cohorts are specified where relevant.
Tobacco smoking
Tobacco is one of the leading risk factors contributing to the burden of disease for older Australians. Specifically, tobacco is the leading risk factor for males and females aged 65–74 and 75–84 and also for males aged 45–64 (AIHW 2019).
Data from the 2019 National Drug Strategy Household Survey (NDSHS) showed that the proportion of people in their 60s who smoke daily is not declining at the same rate as that for younger age groups, while for people in their 50s it has increased slightly (AIHW 2020b).
Daily smoking
In 2019, people in their 50s were the most likely age cohort to smoke daily (15.9%). In 2007, the proportion of people who smoked daily was highest for people aged 25–29 (26%) (Table S3.30). This effect is largely driven by a shift in the age distribution of daily smokers. Between 2016 and 2019, the proportion of daily smokers who were aged in their 50s increased from 17.7% to 21.2%, while for those in their 60s it increased from 10.6% to 12.7% (Table S3.24). This reflects an ageing cohort of daily smokers, and the tendency for younger people to not take up smoking. Notably, however, daily smoking among those aged 70 and over is lower than for people in their 50s and 60s, and decreased from 6.2% in 2016 to 5.4% in 2019 (AIHW 2020b).
Number of cigarettes
Data from the NDSHS showed that people in older age groups (50 and over) tend to smoke more cigarettes than people in younger age groups. In 2019:
- people in their 50s (16.7 cigarettes), 60s (16.5 cigarettes), and aged 70 and over (15.5 cigarettes) smoked the highest number of cigarettes per day on average. This was around double the number of cigarettes smoked by people aged 18–24 (8.1 cigarettes) (Table S3.25)
- smokers in their 50s (41%), 60s (45%), and aged 70 and over (39%) were the most likely to smoke 20 or more cigarettes per day (pack-a-day smokers)
- the proportion of people aged 14 and over who are pack-a-day smokers significantly declined from 2016 (37%) to 2019 (33%), but remained stable for people in older age groups (50 and over) (AIHW 2020b) (Table S3.26).
Intentions to quit
Estimates from the NDSHS also showed that people in older age groups are the least likely to have intentions to quit smoking (AIHW 2020b). In 2019:
- the proportion of current smokers who were not planning on quitting smoking was higher among people in their 50s (33%), 60s (40%), and aged 70 and over (46%) compared with all current smokers (30%) (Table S3.28)
- the main reason that people in older age groups did not intend to quit was because they enjoy smoking (ranging from 59% for people in their 50s to 69% for those in their 60s).This was consistent with other age groups (Table S3.29).
Alcohol consumption
Data from the 2019 NDSHS indicated that a higher proportion of people in older age groups have given up alcohol, compared with younger people. In 2019, people in their 50s (9.6%), 60s (12.7%), and those aged 70 and over (16.1%) were more likely to be ex-drinkers than were people aged 14 and over (8.9%) (AIHW 2020b) (Table S3.33).
However, people in older age groups who do consume alcohol are more likely to drink in quantities that exceed the NHMRC lifetime risk guidelines (people in their 50s and 60s) or drink daily (those aged 70 and over) (AIHW 2020b). Among people aged 55 years and over, fatal burden was the main contributor to alcohol-attributed burden (AIHW 2019b).
Daily drinking
Estimates from the NDSHS show that the proportion of people who drink daily increases with age. In 2019:
- there was an overall decline in the proportion of people who drink daily from 2016 (6.0%) to 2019 (5.4%) (Table S3.32)
- people aged 70 and over continued to be the most likely to drink daily (12.6%), followed by people in their 60s (9.6%) and 50s (7.3%)
- a higher proportion of males than females were daily drinkers for people in their 50s (8.8% compared with 5.8%), 60s (12.4% and 7%), and aged 70 and over (16.8% and 9.1%) (AIHW 2020b) (Table S3.33).
Lifetime risk
The proportion of people in older age groups who exceed the NHMRC lifetime risk guidelines for alcohol varies according to age (AIHW 2020b). Estimates from the NDSHS show that, in 2019:
- people in their 50s (21%) and 60s (17.4%) were more likely to drink at levels that exceeded the lifetime risk guidelines than the general population aged 14 and over (16.8%), while people aged 70 and over (12.2%) were less likely to do so
- males in their 50s were the most likely age cohort to drink at levels exceeding lifetime risk guidelines (Table S3.34). This is consistent with data from the National Health Survey, where males aged 45–54 and 55–64 were the most likely to exceed lifetime risk guidelines (Table S2.27)
- both females (12.2%) and males (30%) in their 50s were more likely to drink at levels that exceeded the lifetime risk guidelines than the general population (9.4% of females and 24% of males aged 14 and over) (Table 3.34).
Single occasion risk
Similar to lifetime risk, the proportion of people in older age groups who exceed NHMRC single occasion risk guidelines for alcohol varies by age. Estimates from the NDSHS showed that, in 2019:
- people aged 70 and over (8.8%) were the least likely age group to exceed single occasion risk guidelines at least monthly, though this figure had increased since 2016 (7.2%) (Figure OLDER1).
- people in their 60s (17.4%) were also less likely to consume alcohol in excess of single occasion risk guidelines compared with those aged 14 and older (25%), but people in their 50s (27%) were slightly more likely to do so (Figure OLDER1)
- compared with people aged 14 and over (4.4%), people in their 50s (6.8%) were more likely to exceed this guideline most days or every day. This suggests that older people who engage in risky levels of alcohol consumption may do so more regularly (AIHW 2020b) (Table S3.35).