Image for The great big crash in tobacco consumption

Tobacco consumption in Australia has fallen by 48 per cent in the past decade, a new analysis of official statistics shows.

This decline is far greater than was previously thought and is about twice the rate at which people are quitting altogether. The data indicate a massive fall in consumption among people who have not yet given up entirely.

The figures are drawn from the Australian Bureau of Statistics data on state and territory consumption of cigarettes and tobacco products. When adjusted for population growth, these figures show the average per capita decline in consumption for each state and territory, and across the nation.

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Survey data from the ABS and the Australian Institute of Health and Welfare indicate that the number of current smokers fell by about 25% over the same period. Only about half of the consumption decline, therefore, can be attributed to people quitting altogether.

These figures mean that people who are still smoking are, on average, smoking much less than they were ten years ago ‒ probably at least a quarter less.

The ABS has issued state-by-state tobacco demand figures as part of the quarterly National Accounts ever since 1985 but they have not been used by health policy-makers to detect overall consumption of this highly lethal product. People in health policy, myself included, do not expect to find health data in the National Accounts, so we don’t look. And the sharpness of the decline is not evident immediately: you have to strip out the distorting effect of population increase to see what’s happening on an average per-capita basis.

It is impossible to say which tobacco control measure is most responsible for this improvement. But it is clear that restrictions on where people can smoke now make it much more difficult for anyone to be a heavy smoker and almost impossible for them to be chain smokers. Many of these restrictions have been introduced in the past ten years.

For the first half of the ABS’s 30-year data series, there are periods of plateau in consumption, interspersed with sharp and sustained declines, before another plateau and another sharp decline. It is likely that these coincide with major and effective changes in policy, such as banning advertising and sponsorship, increases in tobacco excise and restricting the places in which people can smoke.
But in the past 15 years, that stop-start pattern has been replaced by a continuing and probably accelerating decline.

Plain packaging and sharp price rises are known to have reduced the number of smokers. It is likely that they have also had an effect on people who have not yet quit entirely. Health promotion and quit campaigns are also in the mix of effective measures.

Evidence shows that cutting down, rather than quitting altogether, is unlikely to save many lives. At least two large European studies have shown a substantial decrease in deaths among smokers who have reduced their consumption. But other, larger studies have shown no such effect; the weight of evidence is that cutting down will improve your health in some ways but won’t save your life. To do that, you have to quit altogether.

But it is much easier for someone to quit if they are smoking less and no longer have a major nicotine addiction. These figures show where the next wave of quitters will come from. And that is the real significance of these figures.

Overall, the figures mean Australia’s tobacco control strategy is working better than anyone thought, and ‒ if we take consumption alone as the measure ‒ twice as well. Certainly, the figures indicate that current policies and programs are effective and should not be changed or abandoned without, at least, considering these new figures on consumption and what they may mean.