Tobacco smoking is the leading cause of preventable disease and death in Australia today (AIHW 2019). Over one third of CVD deaths and one quarter of acute coronary syndrome hospitalisations in Australia for people aged less than 65 have been attributed to smoking (Banks et al. 2019).

Smoking increases the risk of coronary heart disease by raising blood pressure, decreasing physical activity tolerance and lowering blood levels of HDL (‘good’) cholesterol. As tobacco smoke is absorbed into the bloodstream, it damages blood vessels, increases the risk of plaques and clots, and reduces blood oxygen levels.

Giving up smoking is associated with greatly improved cardiovascular function, improved quality of life and reduced risk of cardiovascular morbidity and mortality.

While there have been reductions in smoking over the past 40 years, largely attributable to public health strategies (OECD 2019), the proportion of people continuing to smoke is still concerning, particularly in some population groups.

In 2019, based on results from the National Drug Strategy Household Survey:

  • 11.0% of people aged 14 and over smoked daily (males 12.2%, females 9.9%) (AIHW 2020)
  • men aged 40–49 had the highest proportion of current daily smokers (18.4%), while the highest proportion among women were aged 50–59 (15.2%)
  • after adjusting for different population age structures over time, the proportion of males aged 14 and over who smoked daily fell from 20.9% in 2001 to 12.2% in 2019, and females from 17.9% in 2001 to 9.9% in 2019
  • daily smoking rates among males aged 15–24 fell from 20.7% in 2001 to 8.5% in 2019, and among females aged 15–24 from 20.4% in 2001 to 6.4% in 2019.

CVD mortality has been estimated to be almost 3 times as high in current smokers than never-smokers. Quitting smoking by age 45 avoids almost all of the excess risk of CVD (Banks et al. 2019).

Figure 1: Tobacco smoking status, people aged 14 and over, 2001 to 2019

The data visualisation shows the proportion of people smoking, by sex and smoking status between 2001 and 2019. Daily smokers fell from 19.4% in 2001 to 11.0% in 2019.

Population groups

After adjusting for different population age structures:

  • 19.6% of people aged 14 and over living in Remote/very remote areas smoked daily in 2019, compared to 9.7% in Major cities (AIHW 2020)
  • 18.1% of persons aged 14 and over living in the lowest socioeconomic areas smoked daily in 2019, compared with 5.0% living in the highest socioeconomic areas
  • 38.4% of Indigenous people aged 15 and over smoked daily in 2018–19, compared to 13.0% of non-Indigenous people in 2017–18 (AIHW & NIAA 2020).