Tobacco smoking

Tobacco use contributes more to the poor health of Australian people than any other modifiable risk factor.

It’s estimated that Australian smokers die 10 years earlier than non-smokers.

Tobacco smoking is responsible for more than three-quarters of the health burden from lung cancer, and two-thirds of the health burden from chronic obstructive pulmonary disease (COPD) in Australian men.

Smoking doesn’t just affect your lungs. The widespread effects of smoking on your body increases your risk of more than 60% of lifestyle-related diseases, including erectile dysfunction, reduced semen quality and sperm function, diabetes, and even tooth loss.

Smoking rates are higher for men (16.5%) than women (11.1%) in Australia but this gap is narrowing over time. Twenty years ago, most Australian men had smoked at some point, but for at least the last 10 years most men have never smoked.

Some groups of men have higher smoking rates than others, including Aboriginal and Torres Strait Islander men, men with poor mental health and men in prison.

Most Australians who smoke want to quit, mainly because of the cost or the effect of smoking on their health.

Seven out of 10 people who try to quit smoking are successful. There are more Australian men who are ex-smokers (26.7%) than there are men who smoke daily (12.8%) or occasionally (3.8%), highlighting the success of those who try to quit.

Some health benefits of stopping smoking happen quickly:

• Within 20 minutes, your heart rate and blood pressure decrease
• Within 12 hours, your carbon monoxide levels in the blood return to normal
• Within two to 12 weeks, your lungs begin to work better and your circulation improves
• Within one to nine months, you cough less and shortness of breath decreases
• With one year, your risk of coronary heart disease is half of a smoker’s
• Within five years, your risk of stroke is the same as a non-smoker’s
• Within 10 years, your risk of cancers caused by smoking decreases (for lung cancer, to about half that of a smoker’s)
• Within 15 years, your risk of coronary heart disease is the same as a non-smoker’s

The most effective way to stop smoking is with a combination of counselling for behavioural support and nicotine replacement therapy, as both a long-acting skin patch and in an additional fast-acting form (e.g. gum, lozenge, spray, inhaler).

There is limited evidence to suggest that men are more successful than women at quitting long-term when using nicotine replacement therapy. 

Medication that blocks the action of nicotine in the body, and some antidepressant drugs, can be as effective as nicotine replacement therapy.

E-cigarettes and vapes containing nicotine should not be used as a first step in trying to stop smoking because they are not proven to be safe or effective.

It doesn’t matter what type of counselling you use to try and stop smoking — group counselling, individual counselling, telephone counselling and internet-based counselling are all effective. Financial incentives (e.g. someone paying you to stop smoking) can also help you to quit. Other types of support, like hypnotherapy, biofeedback or exercise do not seem to be effective.

More intensive counselling (e.g. longer sessions, more frequent sessions, more sessions) slightly increases the success rate for quitting.

The best way to avoid the negative effects of smoking is to never smoke, and the number of Australians who make the choice not to start is growing. For the minority of men who do smoke, fewer smoke every day than in the past.

If you want to quit smoking or cut back, your doctor is the best person to help you find a way that will suit you. You’ll feel healthier almost right away, have more money (because you won’t be buying cigarettes, cigars or tobacco) and reduce your risk of dying, perhaps back to where it would be if you never smoked.

One quarter of Australian males aged 15-24 have used an e-cigarette and/or vape, and more than 6% use them daily, weekly, or less than weekly. Use is less common with increasing age.

E-cigarettes and vapes haven’t been around long enough for us to know what the long-term health effects are, but there is strong and conclusive evidence of harmful effects including poisoning, seizures, addiction, burns and lung injury.

The liquids used in vaping devices contain many chemicals that are known to be poisonous and damaging to health. Other damaging chemicals are produced when the liquids are heated to generate vapour, and chemicals used in the devices themselves leach out. Even without the dangerous effects of nicotine, vape fluids are toxic.