Patterns and prevalence of daily tobacco smoking in Australia by industry and occupation: 2007-2016

INTRODUCTION: Australian workers' daily tobacco smoking over time was examined by industry, and occupation, to identify factors associated with high/low prevalence.

METHODS: Secondary analyses of 2007, 2010, 2013 and 2016 National Drug Strategy Household Surveys were undertaken (pooled n=49,395). Frequency analyses informed subsequent modelling of select industries and occupations. Four logistic regression models estimated adjusted effects of demographics on daily smoking in industries with high (≥20%) and low (≤15%) daily smoking prevalence, and occupations with high (≥20%) and moderate/low (<20%) daily smoking prevalence.

RESULTS: The sample comprised: 55.7% men; 34.1% 25-39 year olds; 31.4% New South Wales residents; 70.1% metropolitan residents; 66.9% high SES workers; and 70.6% with low psychological distress. Daily smoking prevalence differed by industry and occupation in 2007, generally decreasing between 2007-2016. In high prevalence industries, daily smoking was associated with male gender and age (25-39 year olds); and in low prevalence industries with males and non-metropolitan workers. In high prevalence occupations, daily smoking was associated with males, female non-metropolitan workers, and age 25-39 years; and in moderate/low prevalence occupations with non-metropolitan workers, and negatively associated with females aged 14-24 years. In all models, increased odds of daily smoking were associated with low socio-economic status and very high psychological distress.

CONCLUSIONS: Low socio-economic status and very high psychological distress were risk factors for daily smoking regardless of industry, occupation, or high pre-existing smoking prevalence. Targeted, as well as universal, interventions are required for workplaces and workers with greatest smoking vulnerability and least smoking cessation progress.

IMPLICATIONS: Specific strategies are warranted for identified industries, occupations and subgroups with increased odds of daily tobacco smoking. Industries/occupations with moderate/low smoking prevalence may confer workers some protection but are not without risk; some subgroups in these settings (e.g., non-metropolitan areas), had elevated daily smoking risk. Hence, the following are supported: 1. Universal interventions directed at low socio-economic workers, and workers with very high psychological distress regardless of workplace; 2. Interventions targeted at high prevalence industries; 3. Cessation efforts targeted for young workers in high prevalence industries/occupations, and 4. Focussed interventions addressing specific needs of non-metropolitan at-risk workers in low prevalence industries.