Trends in smoking initiation in Australia over 70 years

Assessing the long-term trends in smoking can help understand the tobacco epidemic and implement tobacco control policies. As part of the ALEC study (EU Horizon 2020 Grant #633212) we evaluated time trends in smoking initiation in samples of the Australian general population. We analysed data collected in the Tasmanian Longitudinal Health Study (TAHS) and Busselton Health Study (BHS) during 1966-2005. We retrospectively estimated trends in the rates of smoking initiation (number of incident smokers divided by total time at risk) between 1920 to 1989, by sex and age group (11-15, 16-20, 21-35 years). The dataset included 15089 males (67986 person-years) and 15228 females (64354 person-years). Lifetime smokers were 57.3%. The rates of smoking initiation during early adolescence (11-15 years) steeply increased after 1950 (Figure 1). Smoking initiation during late adolescence (16-21 years) peaked in the ‘40s for males and decreased afterwards, while in females initiation increased until the mid-‘70s. Among young adults (21-35 years), initiation rates decreased for men, whereas they were relatively low and almost stable among women. In the ‘80s, initiation rates were similar for males and females, and reached 80 per 1000/year in the youngest age group. Our findings highlight a sharp increase in smoking initiation among Australian young adolescents that is consistent with information available from Europe (Marcon, A et al. PLoS One. 2018; 13:e0201881).