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Original research
Fifty-year forecasts of daily smoking prevalence: can Australia reach 5% by 2030?
  1. Stephen Wade1,
  2. Marianne F Weber1,
  3. Peter Sarich1,
  4. Michael Caruana1,
  5. Christina Watts1,
  6. Pavla Vaneckova1,
  7. Preston Ngo1,
  8. Sonya Cressman2,
  9. Michelle Scollo3,
  10. Emily Banks4,
  11. Coral E Gartner5,
  12. Paul B Grogan1,
  13. Tony Blakely6,
  14. Martin C Tammemagi7,
  15. Karen Canfell1,8
  1. 1 The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
  2. 2 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
  3. 3 Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
  4. 4 National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
  5. 5 School of Public Health, The University of Queensland, Saint Lucia, Queensland, Australia
  6. 6 Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  7. 7 Faculty of Applied Health Sciences, Brock University, Saint Catharines, Ontario, Canada
  8. 8 Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Dr Stephen Wade; stephen.wade{at}sydney.edu.au

Abstract

Objective To compare 50-year forecasts of Australian tobacco smoking rates in relation to trends in smoking initiation and cessation and in relation to a national target of ≤5% adult daily prevalence by 2030.

Methods A compartmental model of Australian population daily smoking, calibrated to the observed smoking status of 229 523 participants aged 20–99 years in 26 surveys (1962–2016) by age, sex and birth year (1910–1996), estimated smoking prevalence to 2066 using Australian Bureau of Statistics 50-year population predictions. Prevalence forecasts were compared across scenarios in which smoking initiation and cessation trends from 2017 were continued, kept constant or reversed.

Results At the end of the observation period in 2016, model-estimated daily smoking prevalence was 13.7% (90% equal-tailed interval (EI) 13.4%–14.0%). When smoking initiation and cessation rates were held constant, daily smoking prevalence reached 5.2% (90% EI 4.9%–5.5%) after 50 years, in 2066. When initiation and cessation rates continued their trajectory downwards and upwards, respectively, daily smoking prevalence reached 5% by 2039 (90% EI 2037–2041). The greatest progress towards the 5% goal came from eliminating initiation among younger cohorts, with the target met by 2037 (90% EI 2036–2038) in the most optimistic scenario. Conversely, if initiation and cessation rates reversed to 2007 levels, estimated prevalence was 9.1% (90% EI 8.8%–9.4%) in 2066.

Conclusion A 5% adult daily smoking prevalence target cannot be achieved by the year 2030 based on current trends. Urgent investment in concerted strategies that prevent smoking initiation and facilitate cessation is necessary to achieve 5% prevalence by 2030.

  • Public policy
  • Surveillance and monitoring
  • End game

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/tc-2022-057624

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • SW and MFW are joint first authors.

    • X @marianne_weber, @PeteSarich, @WattsChrissy90, @CoralGartner

    • Contributors SW and MFW contributed equally to this paper. MFW prepared the manuscript. SW conducted the analysis and prepared the results. SW, MFW, MC, PV, SC, EB, CEG, TB and KC contributed to the conception and design of the study. All authors contributed to the interpretation of the data, drafting of the manuscript and/or subsequent revisions. KC accepts full responsibility for the finished work as guarantor.

    • Funding This report was developed as part of an independent programme of work examining the health impacts of e-cigarettes, funded by the Australian Government Department of Health.

    • Competing interests Although not relevant to the current project, KC declares she receives salaray support from the National Health and Medical Research Council Australia (APP1194679). She is also co-PI of an investigator-initiated trial of cervical screening, "Compass", run by the Australian Centre for Prevention of Cervical Cancer (ACPCC), which is a government-funded not-for-profit charity. Compass receives infrastructure support from the Australian government and the ACPCC has received equipment and a funding contribution from Roche Molecular Diagnostics, USA. KC is also co-PI on a major implementation program Elimination of Cervical Cancer in the Western Pacific which has received support from the Minderoo Foundation and the Frazer Family Foundation and equipment donations from Cepheid Inc.

    • Provenance and peer review Not commissioned; externally peer reviewed.