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Expert pushes for new health question in census to reveal data on smoking habits


Neelima Choahan


30/04/2018 2:49:53 PM

A question on people’s smoking habits in the next census will help experts better understand one of Australia’s greatest health problems, says a leading tobacco control researcher.

Tobacco control researcher Professor David Thomas believes Australian health experts currently lack detailed information on people who smoke.
Tobacco control researcher Professor David Thomas believes Australian health experts currently lack detailed information on people who smoke.

‘Do you currently smoke?’
 
That’s the question that tobacco control researcher Professor David Thomas would like to ask people in the next census.
 
The Australian Bureau of Statistics (ABS) is consulting the public on what would be the most useful information to collect in the 2021 census. Topics include population, cultural diversity, housing and health.
 
Professor Thomas, from the Menzies School of Health Research in Darwin, said health experts lack detailed information on people who smoke and need more data.  
 
‘Smoking is … responsible for 9% of the burden of disease, higher than any behavioural risk factor … in Australia,’ he said.
 
‘Even though smoking prevalence has been coming down – it is now at its lowest levels ever, about 12% people aged 14 and over in the national population – it is still high in some populations.
 
‘And while we have regular population health surveys that provide forward estimates, they do not go down to the fine details.’
 
Professor Thomas, who wrote an opinion piece in the Australian and New Zealand Journal of Public Health, told newsGP smoking rates remain high among particular among disadvantaged populations.
 
‘Among the Aboriginal and Torres Strait Islander, for example, smoking prevalence is still … about 38%,’ he said. ‘So while we know the national picture for Aboriginal and Torres Strait Islander smoking … we don’t have accurate information at smaller geographical level.
 
‘The Federal Government funds the Tackling Indigenous Smoking program. The central element to that is 37 regional teams working on the ground, but those regional teams do not have sufficiently accurate local data.’
 
Professor Thomas said that in 2009 the National Preventative Health Taskforce recommended the inclusion of a question on smoking among Australians aged 18 years and older in the Australian census scheduled for 2011, 2016 and 2021.
 
But the question wasn’t included, as it was felt that other surveys recorded smoking prevalence estimates. However, Professor Thomas believes population surveys like the National Health Survey do not include people who are homeless or living in nonā€private dwellings like hotels, hostels, hospitals and prisons.
 
‘Almost everyone does the census and so you get much more precise data and know where the pockets of high smoking are,’ he said.
 
Professor Thomas said New Zealand had been including a question on smoking in its census for many decades.
 
Professor Mark Harris, lead author on the RACGP’s SNAP (Smoking, Nutrition, Alcohol, Physical Activity) guide, agrees it is an important question to ask. He told newsGP that although the Australian rate of smoking is quite low by international standards, it is important not to become complacent.
 
‘We are still seeing high burden of disease … both the loss of quality of life and loss of life … associated with smoking, including people who used to smoke in the past,’ Professor Harris said.
 
‘Then the remaining … [people] who smoke, it’s very difficult to get improvement in their smoking rates, it’s a challenge. We need to get that down to zero as we can.
 
‘That’s the reason for continued focus on smoking.’
 
Professor Harris, who is based at the UNSW Centre for Primary Health Care and Equity, said the census should also probe about people’s past smoking habits, including how long they smoked and when they quit.
 
‘The limitation with [only asking about current smoking habits] is that it is not going to pick up people who are ex-smokers,’ he said.
 
‘Particularly in the future as the rates get lower, we are going to be interested in the long-term effects of smoking that might occur after people stopped smoking.’
 
ABS 2021 Census Content Development Director Caroline Deans told newsGP the ABS is inviting data users, organisations and members of the community to share their data needs and provide views on the most useful information to collect in the 2021 Census.
 
‘There are currently no health questions collected on the census; however, the inclusion of a health question has been raised as a potential information need,’ she said.
 
‘In the 2016 census consultation process, a number of possible topics were suggested, including long-term health conditions, self-assessed health status and smoking status, with most stakeholders preferring the long-term health conditions question.’

Ms Deans said a submission on whether a new topic should be included in the 2021 Census should address criteria such as if the topic is of current national importance and if there is likely to be a continuing need for data on the topic in the following census.
 
‘It is recommended that submissions don’t focus on the wording of a specific question, but rather focus on providing evidence on why the information is required and how it will be used,’ she said.



australian-bureau-of-statistics smoking-rates snap-guide





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