Aboriginal and Torres Strait Islander Health Performance Framework - 2010

2.03 Environmental tobacco smoke

Page last updated: 26 May 2011

Why is it important?:

Environmental tobacco smoke, or passive smoking, is now firmly established as a significant cause of morbidity and mortality. The first evidence of harm to children emerged in the early 1970s (Colley 1974; Harlap & Davies 1974; Leeder et al. 1976), and the first evidence of increased lung cancer risk in 1981 (Hirayama 1981). By 1986 the US Surgeon General (Centers for Disease Control and Prevention 2006) and the Australian National Health and Medical Research Council (NHMRC 1986; NHMRC 1997) were able to conclude without doubt that passive smoking was harmful (VicHealth Centre for Tobacco Control 2001).

Environmental tobacco smoke is a significant contaminant of indoor air. There is strong and consistent evidence that passive smoking increases a non-smoker’s risk of lung cancer and ischaemic heart disease. Passive smoking is also associated with increased risk of respiratory disease in adults (NHMRC 1997) and otitis media in children (Jacoby et al. 2008).

The home is the most likely setting for exposure to environmental tobacco smoke for pregnant women, children, and young children living with parents or relatives who smoke—all of whom are particularly vulnerable. Over­crowding in housing (measure 2.02) increases the risk of such exposure. Passive ‘environment’ smoking of tobacco around a new-born child is considered to be one of the major risk factors for sudden infant death syndrome (measure 1.21). Ex­posure to smoke in the atmosphere also increases an in­fant’s risk of ear infections (measure 1.12) and developing asthma (AMA 1999). Smoking in cars is also a significant environment for child exposure to second-hand smoke (Freeman et al. 2008).

The benefits of reducing exposure to environmental tobacco smoke include reducing the incidence of short, medium and long-term health effects in non-smokers, and reducing the uptake of smoking in children of smokers (VicHealth Centre for Tobacco Control 2001).

Findings:

In 2008, there were around 122,000 Aboriginal and Torres Strait Islander children aged 0–14 years living in households with a current daily smoker, repre­senting 65% of all Aboriginal and Torres Strait Islander children in this age range. In comparison, 32% of non-Indigenous children within the same age range lived in households with a current daily smoker.

Aboriginal and Torres Strait Islander children were also 3 times more likely to live in households with a current daily smoker who smoked at home indoors (22% of children) compared with non-Indigenous children (7% of children).

Between 2004–05 and 2008 the proportion of Indigenous children aged 0–14 years living in households with a regular smoker fell from 68% to 65%, however this change is not statistically significant. For non-Indigenous children there was a significant reduction from 37% in 2004–05 to 32% 2007–08.

In 2008, the proportions of Indigenous children aged 0–14 years that were exposed to environmental smoke ranged from 59% in inner regional areas, 71% in remote areas and 77% in very remote areas.

The proportion of Aboriginal and Torres Strait Islander children aged 0–14 years who lived in households with regular smokers ranged from 53% in the ACT to 77% in the Northern Territory. The proportion of Aboriginal and Torres Strait Islander children aged 0–14 years who lived in households with a regular smoker who smoked at home indoors ranged from 13% in the ACT to 25% in the Northern Territory.

Implications:

The policy implications for addressing the dangers of environmental tobacco smoke are similar to those for tobacco smoking in general (measure 2.18) and tobacco smoking during pregnancy (measure 2.19). Exposure to environmental tobacco smoke should be monitored in conjunction with those measures. In May 2008, the Australian Government announced the new Indigenous Tobacco Control Initiative which aims to address the high rates of tobacco smoking in the Indigenous population by investing $14.5 million over four years from 2008–09 until 2011–12. This Initiative complements the comprehensive national approach for reducing Indigenous smoking rates through the Tackling Smoking measure under the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. A major part of the Tackling Smoking measure is establishing a Tackling Smoking Workforce across 57 regions nationally. A successful outcome would reduce the high proportion of children who are exposed to environmental tobacco smoke in their households. More information about current smoking initiatives is provided under measures 2.18 and 2.19.

Table 40 – Children aged 0–14 years living in households with current daily smoker(s), by Indigenous status of children, 2008 and 2007–08

Aboriginal and Torres Strait Islander children aged 0-14
Non-Indigenous children aged 0-14
%
%
Current daily smoker in household:
No
34.9*
67.8*
Yes
65.1*
32.2*
Whether any regular smokers smoke at home indoors:
No
78.4*
93.4*
Yes
21.6*
6.6*
Total number: 187,591 3,907,621
* Difference between Indigenous/non-Indigenous groups is statistically significant at the p<.05 level.
Source: ABS and AIHW analysis of 2008 NATSISS and 2007–08 NHS

Figure 73 – Proportion of children aged 0–14 years who live in households with current daily smoker(s), by remoteness and Indigenous status, 2004–05, 2008 and 2007–08


Figure 73 – Proportion of children aged 0–14 years who live in households with current daily smoker(s), by remoteness and Indigenous status, 2004–05, 2008 and 2007–08
Source: ABS and AIHW analysis of 2004–05 NATSIHS, 2008 NATSISS, 2004–05 NHS, and 2007–08 NHS
Text description of figure 73 (TXT 1KB)

Figure 74 – Children aged 0–14 years living with current daily smoker(s), by Indigenous status and Remoteness Areas, 2008 and 2007–08


Figure 74 – Children aged 0–14 years living with current daily smoker(s), by Indigenous status and Remoteness Areas, 2008 and 2007–08
Source: ABS and AIHW analysis of 2008 NATSISS and 2007–08 NHS
Text description of figure 74 (TXT 1KB)

Figure 75 – Children aged 0–14 years living with current daily smokers inside the household, by Indigenous status and Remoteness Areas, 2008 and 2007–08


Figure 75 – Children aged 0–14 years living with current daily smokers inside the household, by Indigenous status and Remoteness Areas, 2008 and 2007–08
Source: ABS and AIHW analysis of 2008 NATSISS and 2007–08 NHS
Text description of figure 75 (TXT 1KB)

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