Human Settlements Theme Report

Australia State of the Environment Report 2001 (Theme Report)
Lead Author: Professor Peter W. Newton, CSIRO Building, Construction and Engineering, Authors
Published by CSIRO on behalf of the Department of the Environment and Heritage, 2001
ISBN 0 643 06747 7

Liveability: human well-being (continued)

Environmental health (continued)

Active and passive tobacco smoking

  • Passive smoking
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    Tobacco smoking is a leading cause of mortality and morbidity in Australia, with well-known health outcomes. Tobacco smoke contains approximately 60 known or suspected carcinogenic chemicals (NHMRC 1997).

    Of all the known risk factors, tobacco smoking is responsible for the greatest burden on the health of Australians (AIHW 2000a). The risk of coronary heart disease, stroke and peripheral vascular disease, as well as a range of cancers and other diseases and conditions, increases significantly with tobacco smoking (AIHW 1999a). Around 85% of new cases of lung cancer (DHFS and AIHW 1997), 13% of deaths from cardiovascular disease and 21% of deaths from cancer are attributed to this health risk (AIHW 1996).

    Almost 30% of males and about 22% of females between the ages of 25 and 64 years smoke tobacco regularly (Table 44). The proportion is highest among those living in remote areas. Approximately one in three living in remote areas report smoking compared with just over one in four males and one in five females from capital cities. There is also a significantly higher proportion of smokers living in other metropolitan centres than in capital cities.

    Table 44: Proportion of Australians aged 25 to 64 who smokeA, by settlement category and sex, 1995.
    Sex Metropolitan zone Rural zone Remote zone All zones
      M1 M2 R1 R2 R3 Rem1 Rem2  
    Males 28.1 36.3B 27.5 28.7 29.1 33.5B 38.4B 29.0
    Females 21.1 24.8B 21.8 25.1B 21.6 28.0 28.9B 21.9

    ARefers to the daily smoking of tobacco products, including packet cigarettes, roll-your-own cigarettes, pipes and cigars. Data are age-standardised to the Australian population at 30 June 1991.
    B
    Significantly different from M1 ('capital cities') at the 5% level.

    Source: AIHW (1998c).

    Tobacco smoking rates have been declining in Australia since the 1960s, and this trend has continued into the 1990s. However, national surveys by the Anti-Cancer Council of Victoria show that the rate of decline of current smokers has slowed in more recent years (AIHW 1999a).

    Passive smoking

    Given the poor health outcomes from smoking and the toxic nature of tobacco smoke, researchers and health authorities have for some time been concerned about the possible health effects of 'passive' smoking; that is, exposure to environmental tobacco smoke. Tobacco smoke in the environment may be derived from sidestream smoke, which passes directly from the burning tobacco into the atmosphere, and exhaled mainstream smoke from the smoker.

    Many children are exposed to tobacco smoke in the home (Table 45). Almost 39% of Australian children live in households where at least one adult smokes. The proportion is greater among children living in remote areas, where over half are exposed to tobacco smoke by at least one adult smoker living in the household.

    Table 45: Percentage of children (under 18 years) living in households where at least one adult smokesAby RRMA category, 1995. [HS Indicator 7.6], [HS Indicator 8.4]
    Indicator Metropolitan zone Rural zone Remote zone All zones
      M1 M2 R1 R2 R3 Rem1 Rem2  
    One or more adult smokers in household 37.8 43.4 42.0 42.0 35.8 50.1 51.1 38.8

    ARefers to the daily smoking of tobacco products, including packet cigarettes, roll-your-own cigarettes, pipes and cigars.

    Source: ABS National Health Survey, 1995 (unpublished).

    The NHMRC has determined that passive smoking in the home contributes to the symptoms of asthma in approximately 46 500 Australian children each year, and causes lower respiratory illness (such as croup, bronchitis, bronchiolitis and pneumonia) in 16 300 children under 18 months of age. Passive smoking is also considered to contribute to the risk of sudden infant death syndrome (SIDS).

    Prevalence of depression and related disorders

    It is estimated that about 18% of Australian adults, based on results from the 1997 ABS Survey of Mental Health and Wellbeing (SMHWB), suffer from a mental disorder (ABS 1998h). Overall, women were more likely than men to experience anxiety disorders (12.1% compared with 7.1%) and affective disorders (7.4% compared to 4.2%). Men, on the other hand, were more than twice as likely (11.1% compared to 4.5%) to have substance use disorders (Table 46).

    Table 46: Prevalence of mental disordersA by sex and type of settlement in people aged 18 and over, 1997. [HS Indicator 8.6 ]
    Mental disorder/condition RRMA zone Total
      Metropolitan Large and small rural centresB Other rural areas/remote zonesC  
    Males
    Anxiety disorders 7.2 8.4 5.5 7.1
    Affective disorders 4.1 5.9 3.2 4.2
    Substance use disorders 11.5 11.5 8.9 11.1
    Females
    Anxiety disorders 11.9 14.2 11.6 12.1
    Affective disorders 7.3 8.1 7.1 7.4
    Substance use disorders 4.5 4.6 4.2 4.5
    Persons
    Anxiety disorders 9.6 11.3 8.5 9.7
    Affective disorders 5.7 7.0 5.1 5.8
    Substance use disorders 7.9 8.0 6.6 7.7

    AA person may have more than one mental disorder. Affective disorders include depression, dysthymia, mania, hypomania and bipolar affective disorder. The survey excluded people in hospitals, nursing homes, hostels and dwellings in 'remote and sparsely settled parts of Australia'.
    B'Large and small rural centres' include the RRMA categories 'large urban centres' and 'small urban centres'.
    C'Other rural areas' include the RRMA category 'other rural areas' and the entire remote zone.

    Source: ABS (1998h).

    There is also a variation in the prevalence of anxiety disorders, affective disorders and substance use disorders between various settlement types. The prevalence of all three types of disorders tends to be higher in large and small rural centres compared with the metropolitan zone for both sexes. In contrast, the rates are the lowest in other rural areas and the remote zone, although among females the prevalence appears to be similar in both the metropolitan and other rural areas/remote groups.