Tobacco Health Inequity in Australia

This article explains the prevalence and social distribution of tobacco use in Australia, and how public health has defined the tobacco health inequity in Australia in the past. It covers various factors that have led to the health inequity gap, including socio-economic factors, smoking behavior disparities among young people, domestic exposure disparities, physical environment, prisoners, exposure to second-hand smoke disparities, impact on the life course perspective, prevalence of smoking among pregnant women, and prevalence of smoking among health workers. The article also discusses the current public health explanation on tobacco health inequity in Australia, including smoking and social disadvantage, cultural and political factors that influence tobacco health inequities in Australia, daily living, and early childhood and education.

Running Head: HEALTH INEQUITY 1
Tobacco Health Inequity in Australia
Name:
Institution:

Tobacco Health Inequity in Australia 2
Introduction
According to Miller & Hickling (2014, p.74), tobacco health inequity in Australia is most
prevalent in the people with life in a low socio-economic and are more the probable people to
smoke tobacco. Hence, there is a widespread of tobacco use among the Aboriginal and Torres
Strait Islander (ATSI) population because they are the leading community with a lower socio-
economic status compared to other cities and regions in Australia. Further studies show that the
ATSI people aged 15 years and over were in a more probable position to engage in daily
smoking activities compared to the non-indigenous people. Moreover, some factors have caused
the prevalence and social distribution of tobacco use in Australia which people with mental
illnesses, cultural and linguistic diverse communities (Purcell, 2015, p.8). This article is meant to
explain how public health has defined the tobacco health inequity in Australia in the past. The
tobacco health inequity in Australia is of concern because of the health gap it has caused
numerous effects on the Australian population because it has led to diseases that could have been
prevented (Friel, 2009). Therefore, there is a high number of people who are affected by most
non-communicable diseases such as cancer, diabetes, asthma and various circulatory disorders.
Furthermore, the current reasons that the current public health has identified as the causes of the
tobacco health inequity include the nightlife setting which has promoted risky behaviors and the
working environment because most urban employment facilities provide smoking ones for the
addicts ( Newman et al., 2015, p. 126).
Public Health Explanation on Tobacco Health Inequity in Australia
1. Socio-economic Factors
According to Scollo and Winstanley (2016), the ATSI are the most affected by the
socioeconomic factors, but still, they engage in smoking behaviors. It is notable that most of the

Tobacco Health Inequity in Australia 3
ATSI people are disadvantaged due to the educational background of the ATSI, low-income
levels compared to other general Australian population and employment opportunities. Though
the government has put more effect on closing the employment gap, there is still a big difference
because there has been a slight improvement of 7%. Moreover, the population of the non-
Indigenous people has remained steady with a percentage of 76%. Furthermore, the ATSI
background is also affected by the tobacco inequity due to the mental illness inequities that
existed. According to the public health, most of the ATSI people harmed by tobacco use are the
depressed ATSI people, psychological stress in the ATSI population compared to the non-
Indigenous people (Partos et al., 2012, p.653). From the 2004-2005 survey, smoking is more
prevalent in people with psychological distress, and the 2002 national ATSI social Survey show
that most ATSI people are public offenders. Another reason that has led to this health inequity
gap is the homelessness and criminal justice offenders who are addicts of tobacco use.
2. Smoking Behavior Disparities Among Young People
According to the Cancer Council (2012), the young student who some are in secondary school
and living in disadvantaged regions such as the ATSI people were influenced mostly by tobacco
use compared to the students living in the more advantaged region in Australia (AMA, 2007).
According to a survey carried out in 2008 indicate that older students from more advantaged in
Australia were likely to engage in smoking activities compared to those from disadvantaged
areas. However, there was a huge disparity with the younger students (12-15 years old) from the
impoverished regions who were likely to engage in smoking activities compared to those from
privileged areas ( Cancer Council, 2012).
3. Domestic Exposure Disparities

Tobacco Health Inequity in Australia 4
According to the Cancer Council (2012), the National Drug Strategy Household Survey (1998)
states that Australian smokers in 2010-2011 were mostly affected by the low income they earned
and were more probable to allow smoking in their houses. Furthermore, research indicates that
82% of university-educated smokers in (2008-2009) admitted that they never smoked in the
presence of non-smokers in their cars and this was slightly higher than those who had not
completed their secondary education.
4. Physical Environment
According to VicHealth (2014, p.9), this is another factor that has led to the health inequity in
Australia because of the urban design setting which has many retail outlets selling tobacco.
Furthermore, these retail outlets are more concentrated in disadvantaged regions such as the
Indigenous people who live in poverty states which influences the smoking behavior in these
regions. Therefore, there are less retail shops in advantaged areas in Australia which has reduced
is a standard population who smoke in Australia.
5. Prisoners
According to Purcell (2015), smoking is prevalent by prisoners compared to the general
population in Australia. For instance, 84% of the inmates in 2012 were current smokers while
about 80% of the prisoners get reported as current smokers even when they leave the prison
facility. Furthermore, the most affected by these are the unemployed population, the ATSI
people and people with a low educational background which led them to do criminal activities
that got them into prison. For instance, 67% of the inmates in Australia who smoke were
unemployed before they got arrested for crimes they did while 36% were illiterate and had not
completed at least ten years in school.

Tobacco Health Inequity in Australia 5
6. Exposure to Second-hand Smoke Disparities
The exposure to second-hand-smoke (SHS) has caused severe health effects on both the children
and the adults because most children are at risk of acquiring respiratory diseases. Moreover, the
implementation of smoke-free laws has resulted in the reduction in disparities in workplace
exposure to SHS through his differences in SHS in homes has nor reduced. The exposure to
tobacco in homes has led to in children smoking most prevalent in the rural areas of Australia
where most Indigenous communities are present (Purcell, 2015, p.10). For instance, children in
areas with low socioeconomic status are more likely to engage in smoking compared to children
from high socioeconomic status because they are not often exposed to tobacco smoking back
home. Moreover, According to the Victorian data in Australia (2008), 73% of the surveyed
reports indicate that most regular smokers used to do this outside their homes while 12% got
reported that most regular smokers sometimes smoked outside their homes. Also, data from the
National ATSI Social Survey (NATSISS) indicate that Indigenous children were more probable
to get exposed to smoke from tobacco in their homes compared to the non-Indigenous children.
According to Purcell (2015, p.11), children were also likely to get exposed to tobacco smoke in
the cars which resulted to the Victorian administration in Australia declaring it illegal to smoke
in a car that children were present.
7. Impact on the Life Course Perspective
According to the WHO (2010, p.44), children who come from desperate and more impoverished
backgrounds were at a higher risk if developing intellectual disabilities due to the tobacco
smoke. Furthermore, these children were at a higher risk of having speech impairment due to the
effects of tobacco smoke that was more prevalent in remote areas compared to the urban
settlement. Furthermore, some conditions such as stomach cancer and stroke were common on

Tobacco Health Inequity in Australia 6
children depending on the physical environment that surrounded them. Also, lung cancer and
violence were common in adults due to their surrounding which got filled with tobacco smoking
activities.
8. Mental Health
According to Purcell (2015, p.9), there is a high prevalence of mental health disorder in patients
who smoke tobacco. It got noted that in 2008 there was 32% of the 3.6 million people in
Australia who got identified as current smokers and they had a mental disorder. Moreover,
people in Australia who live with psychotic disorders are active smokers of tobacco and smoking
was more common in men compared to the women. Furthermore, people with the post-traumatic
disorder, panic disorder and depression were more likely to engage in smoking activities more
compared to the general Australian population.
9. Prevalence of Smoking Among Pregnant Women
According to Scollo and Winstanley (2016), the National Perinatal Data Collection (NPDC),
48% of the Indigenous mothers used to smoke when they were pregnant compared to the 13% of
the non-Indigenous mothers. Also, there was a decrease in tobacco use among pregnant
indigenous women though the number was lower on the non-Indigenous women who were
significant in identifying the tobacco health inequity between these two groups in Australia.
Furthermore, smoking is prevalent by the Indigenous women even after birth compared to the
non-Indigenous women. Also, the public health confirmed that the smoking rate by the
Indigenous women was more common in the rural areas and was lower in the urban settlement
which is a vivid tobacco health inequity (Gould et al., 2011, p.33). The various Indigenous

Tobacco Health Inequity in Australia 7
women that have been affected by smoking when pregnant are from the Queensland, Western
Australia and South Australia (Scollo and Winstanley, 2016).
10. Prevalence of Smoking Among Health Workers
According to a survey conducted on the ATSI health workers have a high tobacco use
prevalence compared to the non-Indigenous health workers (Thompson, 2010, p.3). Moreover,
most of the Indigenous health workers who are tobacco users smoke heavily because the tobacco
helps in coping with the stressful nature of their work shifts and workloads. Therefore, the
survey done in 2012-2013 indicates that prevalence in smoking among the ATSI staff was lower
compared to their communities. Thus, there was a need to educate the health staff on the effects
of tobacco on their health and their tobacco use exposed patients to the secondary-hand-smoke.
Current Public Health Explanation on Tobacco Health Inequity in Australia
1. Smoking and Social Disadvantage
Tobacco use has some severe effects on the human health, and it has caused a notable health gap
in Australia because most of the long-term smokers die due to smoking while an average of
children 13-14-year-old smokers dies. Moreover, the social disadvantages that are caused by
tobacco use increase more on a regular smoker which creates poverty and social inequalities in
the Australian health sector. Also, tobacco smoking is related to some of the dangerous diseases
which affect the quality of life of the affected patient. For instance, people who are affected by
chronic diseases due to smoking have little employment which leads to financial strain because
the patient needs to cater for his or her medical expenses which may be difficult (Purcell, 2015,
p.14). Moreover, tobacco use has impacted especially on the Indigenous community because of
the poverty level they live. It has been caused by inadequate funds which have made it difficult

Tobacco Health Inequity in Australia 8
for the Indigenous people to cater for their basic needs such as proper housing and clothing.
Furthermore, children who got exposed to tobacco secondary-hand-smoke are at risk of getting
respiratory illnesses which affect their learning in schools. According to Purcell (2015, p.17),
over time tobacco use has declined in Australia due to the attitude that young people have
regarding tobacco smoking. Furthermore, tobacco marketing and advertising are currently almost
eradicated in Australia. Also, restrictions on tobacco smoking in public places has gotten
widespread, and this gets applied to most outdoor settings. Moreover, the tobacco industry and
smoking get portrayed in the media as a negative influence, and the community's attitude
towards tobacco industries has also become negative (Dawson et al., 2012, p.102).
2. Cultural and Political Factors that Influence Tobacco Health Inequities in Australia
The Australian government has made policies, interventions, and legislation that control tobacco
use in Australia. However, the current Australian government favors interventions that favor the
market which reduces the catastrophic harms that get associated with tobacco use. Therefore,
Australia's Tax System states that tobacco is dangerous and addictive and due to the severe
health impacts it is essential to protect the minors from its use. According to Purcell (2015, p.15),
the Australian government has made efforts in making policies and regulatory interventions that
control various tobacco companies’ activities. The government systems also determine the extent
to which various communities and groups in Australia can participate in decision-making
processes. Also, the government influences the extent to which the communities influence the
conditions which affect their health. Also, the current tobacco inequity has decreased due to
Australia's comprehensive control programs on tobacco. Moreover, the various cultural
influences have also impacted on the Australia people to neglect tobacco use due to the many
adverse health effects it has.

Tobacco Health Inequity in Australia 9
3. Daily Living
According to Newton et al. (2016, p.57), different social groups are exposed differently to a
range of daily conditions of living which can either be damaging or protective to the physical
environment, education or even health. Therefore, these conditions may influence the social
distribution and smoking behaviors of the Australian communities. Thus, people who have low
incomes, illiteracy, unemployment and those who live in disadvantaged regions are more prone
to be smokers. Also, the data from the Australian NDSHS show that smokers who are illiterate
and have low-income levels are likely to have smoked for a long time before quitting.
4. Early Childhood and Education
It is essential that the early childhood provides the best foundation for influencing the child's
master skills and education. Therefore, the use of tobacco by children may affect and put them at
risk of mental health issues due to the tobacco use. Furthermore, the World Health Organization
emphasizes that childhood development is essential in that it develops the emotional, physical
and social aspects of the child. According to Duncan (2010, p.26), low level of education often
gets linked to poverty while higher education is related to better health due to limited use of
tobacco. It is important to note that education influences the neural development of the child and
health literacy of the child.
5. Physical Environment
It influences smoking behaviors for instance, when the physical environment is unsafe, poorly
planned and provide limited resources to support the various Australian communities. These got
associated with the prevalence of high smoking activities, and the conditions also undermine
quitting attempts by people who are addicts to tobacco use. Therefore, areas in disadvantaged

Tobacco Health Inequity in Australia 10
regions in Australia such as the Queensland have a high smoking rate due to the poor living
conditions of the Indigenous people which makes it difficult to reinforce smoking policies.
Moreover, tobacco use often gets perceived as a coping mechanism which helps them deal with
life stress such as living in an unsafe environment, financial pressure and boredom. Moreover,
the urban environments there is a greater distribution of retail outlets that sell tobacco, and this
influences smoking behaviors. Also, there is a higher concentration of retail outlets that deal in
tobacco in disadvantaged areas which contributes to the prevalence of tobacco use in these areas
(Purcell, 2015, p.19).
Conclusion
It is notable that tobacco is one of the social determinants that affect the Australian
population especially the Aboriginal and Torres Strait Islander (ATSI) people. The reason for
this is because most of the ATSI people are low income earns, illiterate and are unemployed.
Hence, this has made their health outcomes to be poor because most of the unemployed
Indigenous people end up engaging in criminal activities that land them in prison. Therefore,
there is a high prevalence in tobacco use in prisons due to the illegal activities that the ATSI
people may engage in as they try to acquire basic needs. Furthermore, the article identifies the
current public health explanation about tobacco as a health inequity in Australia. It involves the
cultural and political factors that have influenced the policy-making strategies that the Australian
government has used to control tobacco use in Australia.

Tobacco Health Inequity in Australia 11
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