Cancer prevention: Tobacco control
Smoking and cancer
The number of people who smoke in NSW has been falling for some years.
Despite this fall, tobacco smoking is still the leading cause of preventable illness and premature death among the NSW population.[10]
This situation creates considerable pressure on the NSW health system. There are approximately 60,000 hospital admissions each year due to smoking‑related illnesses.[11]
Cigarette smoking causes most lung cancers and is a risk factor for many other cancers, including cancers of the head and neck, pancreas, bladder and oesophagus, and in post‑menopausal women, breast cancer. It increases a person’s risk of premature death, both overall and as a direct result of cancer and other smoking‑related diseases.
Emerging popularity of waterpipe (shisha) smoking is of growing concern. One hour‑long session of waterpipe smoking is equivalent to smoking 100 or more cigarettes.[12]
There is growing evidence to suggest the long‑term inhalation of electronic cigarette (e-cigarette) vapour is likely to pose a risk to health.[16] There is also concern about the potential for uptake of vaping by young people, as this may become a gateway to smoking.[17]
Quitting smoking
Quitting smoking is an important way to improve a person’s health. Quitting smoking at any time results in substantial health gains.[18]
Importantly, people who have been diagnosed with cancer will benefit from quitting. Evidence suggests quitting at the time of a cancer diagnosis can:
- improve a person’s response to treatment
- reduce the side effects of treatment
- reduce the risk of cancer recurrence
- increase overall survival.[18,19]
In 2019, NSW Health released the NSW Health Tobacco Strategy Work Plan 2019–2021, extending the delivery of the established strategy. The plan focuses on addressing smoking in priority populations groups, including Aboriginal people, pregnant women, young people, and people with a mental illness; preventing second‑hand smoke exposure; and enhancing and integrating smoking cessation into routine clinical practice.[20]
Quitting advice from health professionals
The NSW Smoking Cessation Framework supports local health districts (LHDs) to increase the number of people receiving support to stop smoking at the point of care.
All patients and clients should be asked their smoking status – including their use of shisha or waterpipes, e‑cigarettes or vaping products – and provided with advice and support to quit smoking, including access to cessation aids and services. When a health professional gives short, simple, supportive advice about quitting smoking, it is more likely that the person will quit.[21]
All health professionals are encouraged to refer people who smoke to the NSW Quitline (13 QUIT or 13 7848).
Overall key findings
- From 2009 to 2018, the NSW daily smoking rate in adults fell by 3.9 percentage points, from 14.2% to 10.3%. During the same period, an additional 4.5% of adults stated occasional smoking.
- The daily smoking rate among Aboriginal adults in NSW was 22.7% in 2017–18.
- From 2012 to 2017, the NSW smoking rate among all pregnant women fell from 10.4% to 8.8%.
- Over the same period, the smoking rate among Aboriginal pregnant women fell from 49.9% to 42.4%.
Daily smoking rate in adults*, NSW, 2009–2018**
Key finding
- Between 2009 and 2018, the daily smoking rate in NSW adults decreased from 14.2% to 10.3%.
* People aged 16 years and over.
** Mobile phone numbers have been included in the survey sample since 2012. Any significant differences observed between 2011 and 2012 estimates should be reported with caution, because they may reflect both real and survey design changes.
Notes:
1. Data source: NSW Population Health Survey (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed June 2019).
2. There has been a change in the methodology used to report smoking rates. In previous reports, smoking rates were based on the proportion of people who smoked daily or occasionally. In this year's report, we are reporting data for only daily smokers.
Daily smoking rate in adults*, by local health district (LHD) (ranked),
Key finding:
In 2018, the daily smoking rate among adults in NSW was 10.3%, ranging from 5.5% to 16.2% across LHDs.
N= Number of survey respondents in 2018.
* People aged 16 years and over.
Notes:
1. Data source: NSW Population Health Survey (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed June 2019).
2. There has been a change in the methodology used to report smoking rates. In previous reports, smoking rates were based on the proportion of people who smoked daily or occasionally. In this year's report, we are reporting data for only daily smokers.
Daily smoking rate in adults*, by gender and age group, NSW, 2018
Key finding:
In 2018, more men than women smoked in NSW, across all age groups.
N= Number of survey respondents in 2018.
* People aged 16 years and over.
Notes:
1. Data source: NSW Population Health Survey (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed June 2019).
2. There has been a change in the methodology used to report smoking rates. In previous reports, smoking rates were based on the proportion of people who smoked daily or occasionally. In this year's report, we are reporting data for only daily smokers.
Proportion of women who smoked during pregnancy, by local health district (LHD) (ranked)*, 2012 and 2017
Key findings:
- Between 2012 and 2017, the NSW smoking rate among all pregnant women fell from 10.4% to 8.8%.
- For most NSW LHDs, the proportion of women who smoked during pregnancy fell between 2012 and 2017.
- In 2017, the proportion of women who smoked during pregnancy ranged from 2.8% to 26.8% across LHDs.
N= Number of pregnant women in 2017.
* The figures for Northern Sydney are not available due to very small numbers.
Notes:
1. Data source: NSW Perinatal Data Collection (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed June 2019).
2. The data presented here include all pregnant women in NSW.
Proportion of women who smoked during pregnancy, by population type, NSW, 2013–2017
Key finding:
Between 2013 and 2017, the smoking rate for Aboriginal pregnant women fell from 46.6% to 42.4%. This rate remains considerably higher than for non‑Aboriginal pregnant women.
N = Number of pregnant women in 2017.
N= Number of pregnant women in 2017.
Notes:
1. Data source: NSW Perinatal Data Collection (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed June 2019).
2. The data presented here include all pregnant women in NSW.
Proportion of Aboriginal women who smoked during pregnancy, by local health district (LHD) (ranked)*, 2012 and 2017
Key findings:
- In 2017, the smoking rate for Aboriginal pregnant women fell in almost every LHD.
- The proportion of Aboriginal women who smoked during pregnancy ranged from 28.3% to 68.6% across LHDs, in 2017.
N = Number of pregnant women in 2017.
* The figures for Northern Sydney are not available because they are very small.
Notes:
1. Data source: NSW Perinatal Data Collection (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed June 2019).
2. The data presented here include all pregnant women in NSW.
Daily smoking rate in Aboriginal adults*, NSW, 2008–2018**
Key finding:
The daily smoking rate for Aboriginal people in NSW was 22.7% in 2017–18. It was almost double the
smoking rate of the overall adult population in NSW.
* People aged 16 years and over.
** Mobile phone numbers have been included in the survey sample since 2012. Any significant differences observed between 2011 and 2012 estimates should be reported with caution, because they may reflect both real and survey design changes.
Notes:
1. Data source: NSW Population Health Survey (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed June 2019).
2. There has been a change in the methodology used to report smoking rates. In previous reports, smoking rates were based on the proportion of people who smoked daily or occasionally. In this year's report, we are reporting data for only daily smokers.
Electronic cigarette use in secondary school students aged 12–17 years, by gender and age group, NSW, 2017
Key finding:
In 2017, male secondary school students aged 16–17 years were almost twice as likely as females to have ever used electronic cigarettes.
N = Number of respondents in 2017.
Notes:
1.Data source: NSW School Students Health Behaviours Survey (sourced from HealthStats NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health). Available at www.healthstats.nsw.gov.au (accessed July 2019).
Why are different time periods and dates reported?
Cancer information is collected from many different sources, so it takes time to review and analyse the data. Different pieces of information may be collected over different time periods, or reported at different times. This means not all the measures reported here have the same dates.
The information presented is the most recent available for each measure at the time this report was written.
Why are confidence intervals reported here?
Confidence intervals are included when a small sample is used to represent the overall population, because there is a chance of an error due to this scaling.
In this report, a 95% confidence interval is presented only on charts where a sample of the population is used. This interval can be thought of as a margin of error.
The larger the sample size, the smaller the confidence interval range. The smaller the sample size, the larger the confidence interval range.
