People from culturally and linguistically diverse backgrounds

Australia has a large culturally and linguistically diverse (CALD) population. As of June 2016, 26% of Australia’s population were born overseas and this has been increasing over the past 10 years (ABS 2017). In 2016, there were over 300 separately identified languages spoken in Australian homes and 21% of Australians spoke a language other than English (ABS 2017). 

Some people from CALD backgrounds are more vulnerable to alcohol and other drug use due to a history of torture, trauma, grief and loss. This can also be exacerbated by family stressors, unemployment, language barriers, and lack of awareness of culturally appropriate services available (DoH 2017).

Key findings

People from culturally and linguistically diverse (CALD) backgrounds (84%) are more likely to report never smoking compared with those whose primary language spoken at home is English (60%)

Tobacco smoking

Compared with primary English speakers, people from CALD backgrounds were more likely to abstain from alcohol (53% compared with 19.2%) and less likely to have recently used illicit drugs (6.4% compared with 18.7%)

Alcohol use

Cannabis is the most commonly used drug among people from CALD backgrounds

Illicit drugs

View the people from CALD backgrounds fact sheet >

For the purposes of this report, people from CALD backgrounds refers to people whose main language spoken at home is not English (for more information refer to Box CALD1).  

Box CALD1: Alcohol and other drug data in CALD populations

There is a lack of publicly available and comprehensive data examining the use of alcohol and other drugs by people from CALD backgrounds. The Australian Institute of Health and Welfare (AIHW)’s National Drug Strategy Household Survey (NDSHS) is one of the only national data sources that specifically disaggregates alcohol and other drug use by main language spoken at home. CALD data from the NDSHS refers to persons who indicated that English was not the main language spoken at home.

The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) also collects CALD data, however this is based on information on clients country of birth instead of main language spoken at home. Most (87%) of the treatment episodes in 2019–20 were provided to clients who were born in Australia (AIHW 2021).

Data from the NDSHS indicate that people from CALD backgrounds are less likely to consume alcohol and other drugs compared with those whose main language spoken at home is English (AIHW 2020).

Tobacco smoking

While there has been an increase between 2016 and 2019 in the proportion of people across Australia reporting never smoking, the proportion of 'never smokers' is greater for people from CALD backgrounds (84%) compared with people who mainly speak English at home (60%) (Table S3.51). This has been the case since 2010. People from CALD backgrounds also continue to be less likely to smoke daily than people who mainly speak English (AIHW 2020).

NDSHS estimates indicate that, after adjusting for age differences, there was a significant reduction in daily smoking among primary English speakers from 13.1% in 2016 to 11.8% in 2019. However, for people from CALD backgrounds, this figure rose from 5.9% in 2016 to 6.2% in 2019) (Table S3.52; Figure CALD1).

People from CALD backgrounds who do smoke tend to smoke fewer cigarettes than primary English speakers. In 2019, among current smokers, people who mainly spoke a language other than English smoked an average of 69 cigarettes per week, compared with 91 cigarettes for people who mainly spoke English (Table S3.51).

Figure CALD1: Tobacco smoking status, by main language spoken at home, people aged 14 and over, 2010 to 2019 (age-standardised per cent)

Figure CALD1: Tobacco smoking status, by main language spoken at home, people aged 14 and over, 2010 to 2019 (age standardised per cent)

The figure shows that, among people who mainly speak English at home, the proportion who smoked daily decreased from 15.8% in 2010 to 11.8% in 2019. Among people who mainly speak a language other than English, the proportion who smoked daily significantly declined from 11.4% in 2013 to 6.2% in 2019.

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Alcohol consumption

New Australian guidelines to reduce health risks from drinking alcohol were released in December 2020. Data for alcohol risk in this report are measured against the 2009 guidelines (see Box ALCOHOL1). National Drug Strategy Household Survey data relating to the updated guidelines are available in the Measuring risky drinking according to the Australian alcohol guidelines report.

Similar to smoking, data from the NDSHS show that people from CALD backgrounds are more likely to abstain from alcohol than people who mostly speak English (AIHW 2020). After adjusting for age differences, over half (53%) of people who mainly spoke a language other than English were abstainers or ex-drinkers, compared with 19.2% of primary English speakers (Table S3.52). Additionally, in 2019:

  • people who mainly spoke a language other than English (3.9%) were much less likely to exceed lifetime risk guidelines for alcohol, compared with people who mainly spoke English at home (18.6%)
  • the proportion of people who consumed 11 or more drinks in a single occasion at least monthly has significantly declined among people from CALD backgrounds, from 4.0% in 2016 to 2.1% in 2019 (AIHW 2020) (Table S3.51)
  • less than 1 in 10 (7.5%) people from CALD backgrounds exceeded the single occasion risk guidelines for alcohol at least once a month, compared with 29% for people who mainly spoke English at home (Table S3.52; Figure CALD2).

Figure CALD2: Alcohol drinking status, by main language spoken at home, people aged 14 and over, 2010 to 2019 (age-standardised per cent)

The figure shows that, among people who mainly speak English at home, the proportion who exceeded the lifetime risk for alcohol use was lower in 2019 (18.8%) than in 2010 (22.3%). Among people who mainly speak a language other than English at home, the proportion remained relatively stable from 5.2% in 2010 to 3.8% in 2019.

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Illicit drugs

In 2019, recent illicit drug use continued to be less common among people from CALD backgrounds than those from English speaking backgrounds (AIHW 2020). In 2019, after adjusting for age differences:

  • people from CALD background were less likely to have recently used illicit drugs (6.4%) than those who mainly speak English at home (18.7%)
  • cannabis (3.6%) was the most commonly used illicit drug among people who mainly spoke a language other than English at home, followed by non-medical use of pharmaceuticals (2.4%). These proportions were much lower than for people who mainly spoke English at home (13.7% for cannabis and 4.5% for pharmaceuticals)
  • use of other drugs was uncommon among people from CALD backgrounds (AIHW 2020) (Table S3.52; Figure CALD3).

Figure CALD3: Recent illicit drug use, by main language spoken at home, people aged 14 and over, 2010 to 2019 (age standardised per cent)

The figure shows that the proportion of people who speak mainly English at home who had used any illicit drug within the past 12 months was slightly higher in 2019 (18.7%) than in 2010 (15.7%). Among people who mainly spoke a language other than English at home, illicit drug use has remained relatively stable from 2010 (7.0%) to 2019 (6.4%).

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Treatment

The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) provides information on treatment provided to clients by publicly funded AOD treatment services, including government and non-government organisations. Data from the AODTS NMDS showed that most (87%) closed treatment episodes in 2019–20 were for clients born in Australia—the same proportion as 2018–19 (AIHW 2021) (Table S3.53). The United Kingdom (2.4%) and New Zealand (2.1%) were the most common countries of birth for clients born outside Australia. Comparatively, in 2014–15, 5% of the Australian population were born in the United Kingdom and 2.5% in New Zealand (ABS 2017).

In over 9 in 10 (95%) closed treatment episodes, the client listed English as their preferred language (AIHW 2021) (Table S3.54).