2.3 - Exposure to tobacco smoke among non-smokers

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3 - Progress in Australia on recommended policies and programs

Data have not consistently been collected or published over time,⁹ but smoking among pregnant women remains alarmingly high, particularly among those in disadvantaged groups.

Table 1: Women who smoked during pregnancy by Australian state* and territory, 2005

* Excluding Victoria, for which data were not available;^ Smoking status in Queensland was reported from 1 July 2005, so information in the table is for July–December 2005; ** Smoking status in South Australia includes women who quit before the first antenatal visit; §Smoking status in Northern Territory was recorded at the first antenatal visit.

Source: Laws et al.[65]

Of the 10,857 teenagers who had babies in 2004, 42% smoked during pregnancy.[65] Data from the Australian Institute of Health and Welfare (AIHW) National Perinatal Data Collection Unit indicate that Aboriginal and Torres Strait Islander mothers smoke during pregnancy at about three times the rate of non-Indigenous mothers (52% compared to 16%).[66]¹⁰

Action proposed
Include in healthcare agreements a requirement to collect and report data on smoking during pregnancy.

Smoking during pregnancy may have far-reaching and long-lasting effects on the health and wellbeing of offspring. Recent studies point to long-term impacts including programming for cardiovascular disease[67-70] and fertility problems.[71, 72] Maternal smoking is increasingly being linked with¹¹ compromised neuro-behavioural[75, 76] and cognitive functioning.[77, 78] Smoking may play a larger role in contributing to the perpetuation of social disadvantage than has previously been appreciated.

In the most disadvantaged areas in Australia, children are exposed to tobacco smoke at least once every day in around one in five households.
In the most advantaged areas, adults in households without dependent children are half as likely to smoke indoors as adults in households without children. However, in the most disadvantaged areas, adults with dependent children are equally likely to smoke indoors as those without children.

Figure 11: Percentage of households where at least one person smokes inside at least once daily, Australia, 2004

Source: National Drug Strategy Household Survey 2004[79]

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Among single parents with dependent children, an adult smokes indoors at least once each day in one in three households.[79] Children in households in the most disadvantaged areas are four times more likely to be exposed to tobacco smoke inside than children in households in the most advantaged areas.

Among people who still smoke, the number of cigarettes smoked each day has been steadily declining since 1989, corresponding with the increasing adoption of smoke-free workplaces and the increasing price of cigarettes.

Figure 12: Reported number of cigarettes smoked daily by adults aged 18+, Australia, 1980–2004

Source: NDSHS[80]

The percentage of people who can be classified as heavy smokers has also been declining, with corresponding increases in the percentage of people who self-classify as light smokers.[81]

Small reductions in cigarette consumption have not been demonstrated to reduce the incidence of tobacco-related disease; however, lighter patterns of smoking are associated with both a greater likelihood of attempting to quit and greater success in remaining abstinent.[82-84]

⁹The AIHW has recently produced guidance about how data should be collected.
¹⁰Data on smoking in this population group is currently not collected in Queensland or Victoria.
¹¹The increased risk must partly be explained by the more stressful environments shared by offspring and mothers who were able unable to quit during pregnancy. Children in less stressful environments are likely to enjoy more protective behavioural styles, due both to inherited temperamental qualities and the quality of parenting. However, many of the studies cited above did try to control for social conditions. Further, the dose response found in studies of the impact of quitting compared to never, continued and reduced smoking during pregnancy suggest that increased risk of neuro-behavioural problems must also be partly due to the physiological effects of nicotine.
73 Pickett K, Wood C, Adamson J, DeSouza L and Wakshiag L. Meaningful differences in maternal smoking behaviour during pregnancy: implications for infant behavioural vulnerability. J Epidemiol Community Health. 2008;62:318−24. Nicotine exposure has been demonstrated to disrupt fetal brain development in animals.
74 Benowitz N. Nicotine safety and toxicity. New York: Oxford University Press, 1998.

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