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The Scottish Health Survey 2013: Volume 1: Main Report

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4 Smoking

Linsay Gray and Alastair H Leyland

SUMMARY

Smoking prevalence

  • In 2013 one in five (21%) of adults reported that they smoked cigarettes. Men remain significantly more likely than women to smoke (23%, compared with 20%). Prevalence was highest among those aged 25 to 54 (24-25%).
  • The decline in cigarette smoking continued in 2013, with a significant drop in the percentage of adults aged 16 and over reporting that they smoked cigarettes since 2012 (from 25% to 21%). The decline between 2012 and 2013 is not matched by a decline in the figures reported by the Scottish Household Survey (SHS). Future years of data from both surveys will be required to determine whether this reduction is due to sampling variation or represents a true decrease in the last year.
  • Smokers, on average, smoked 13.0 cigarettes per day (13.5 for men and 12.4 for women), with those aged 65 to 74 smoking the most per day (average 17.0 cigarettes). The average number of cigarettes smoked per day by smokers aged 16-64 declined from 16.7 cigarettes per day in 1995 to 12.7 in 2013.
  • Once an objective measure of smoking (salivary cotinine) was adjusted for, current cigarette smoking prevalence in 2012/2013 was 27%, four percentage points higher than the estimate based on self-report data only (23% in 2012/2013). The adjusted estimate was the same as in 2008-2011.

Children's exposure to tobacco smoke in the home

  • A new target has been set to reduce children's reported exposure to second-hand tobacco smoke in the home from 12% (the figure in 2012) to 6% by 2020. The figure for 2013, 11%, was not significantly different to the percentage exposed in 2012 (12%). Exposure levels varied significantly by age in 2013, with lower reported exposure among younger children.

Non-smokers exposure to tobacco smoke

  • One in seven (14%) non-smoking adults reported being exposed to second-hand smoke in their own or in someone else's home in 2013, while 17% reported being exposed to smoke in any public place.
  • Non-smokers' (aged 16-74) exposure to tobacco smoke in their own or others' homes has declined over the years (from 33% in 1998 to 15% in 2013) but did not change significantly between 2012 and 2013.
  • Exposure levels were similar for men and women. Younger non-smokers remain most likely to be exposed to second-hand smoke in their own or someone else's home (31% of non-smokers aged 16-24), and in any public place (35% of non-smokers aged 16-24).
  • An objective measure of tobacco exposure is also collected on the survey. The cotinine levels in the saliva samples collected from participants confirmed that there has been a decline in male and female non-smokers exposure to tobacco over the last decade (geometric mean cotinine levels of 0.40ng/ml in 2003 and 0.08ng/ml in 2012/2013). The decline between 2010/2011 and 2012/2013 was also statistically significant.

4.1 INTRODUCTION

4.1.1 Policy background

Reducing smoking is a major priority for improving health in Scotland. Cigarette smoking is the world's leading cause of preventable poor health and premature death.[1] In Scotland, tobacco use is associated with over 13,000 deaths (around a quarter of all deaths) and around 56,000 hospital admissions every year.[2]

Two of the Scottish Government's National Performance Framework (NPF) National Indicators are relevant to smoking.[3] There is a specific indicator on reducing the proportion of adults who are current smokers, as well as a more general indicator on reducing premature mortality (deaths from all causes in those aged under 75)[4] for which smoking is a significant contributory factor.

The Scottish Government launched its Tobacco Control Strategy in March 2013,[5] outlining the intention to create a 'tobacco-free generation' (defined as 'a smoking prevalence among the adult population of 5% or lower') by 2034. Themes covered in the strategy include health inequalities, prevention, protection and cessation, and a range of actions up until 2018 are set out.

One of the 46 actions in the Strategy was to establish a target to reduce the proportion of children exposed to second-hand smoke in the home. The target, announced in March 2014, is to reduce children's exposure from 12% to 6% by 2020; progress towards it will be monitored using data from the Scottish Health Survey (SHeS). A further action was to develop a new NHS Scotland HEAT target[6] to succeed the target on the provision of smoking cessation services, which ended in March 2014 and saw approximately 125,000 successful 'quits' at one month post quit since April 2011[7], including more than 70,000 in the 40% most deprived areas. The new target is to achieve at least 12,000 successful quits at twelve weeks post quit, in the 40% most deprived areas within each NHS Health Board (60% for island boards) over the one year ending March 2015.

4.1.2 Reporting on smoking in the Scottish Health Survey (SHeS)

Good quality data on smoking behaviour and exposure to second-hand smoke are important for monitoring trends relevant to the Strategy. The SHeS data presented in this chapter complement the data provided by the Scottish Household Survey[8] which is used to measure the current NPF indicator on reducing smoking amongst adults. The chapter presents figures for prevalence of smoking among adults aged 16 and over, and for non-smokers' and children's exposure to second-hand smoke. Two sources of data are used: self-reported information and direct objective assessment of smoking status and second-hand smoke exposure via cotinine in saliva samples.

4.1.3 Comparability with other UK statistics

The Health Survey for England, Health Survey for Northern Ireland and Welsh Health Survey provide estimates of smoking prevalence in the other countries within the UK. A Government Statistical Service publication on the comparability of official statistics across the UK advises that the smoking prevalence estimates across these surveys are only partially comparable as they are conducted separately and have different sampling methodologies.[9] Smoking prevalence estimates from UK-wide Integrated Household Survey for Scotland, Wales, England and Northern Ireland have been deemed as fully comparable.

4.2 METHODS AND DEFINITIONS

4.2.1 Questions on smoking

Questions on smoking have been included on SHeS since 1995.[10] Some small changes made to the questions in 2008 and 2012 are outlined in the relevant annual reports.[11],[12]

The questions included in the survey focus on:

  • current smoking status,
  • frequency and pattern of current smoking,
  • the number of cigarettes smoked by current smokers,
  • ex-smokers' previous smoking history,
  • exposure to second-hand smoke,
  • desire to give up smoking, and
  • medical advice on giving up smoking.

4.2.2 Methods of data collection

For adults aged 16 and 17 information on cigarette smoking is collected via a paper self-completion questionnaire, offering them privacy to answer without disclosing their smoking behaviour in front of other household members. At the interviewer's discretion, those aged 18 and 19 can either answer the questions in the self-completion booklet or as part of the main interview. For adults aged 20 and over information is collected as part of the main face to face CAPI interview. The questions included in the self-completion questionnaire and the main interview are mostly similar. However, the self-completion questionnaire excludes questions on: past smoking behaviour, desire to give up smoking and medical advice to stop smoking.

4.2.3 Cotinine

Since its inception in 1995, SHeS has been collecting saliva samples to assess people's cotinine levels. Cotinine, a derivative of nicotine, is an objective measure of smoking and exposure to second-hand smoke. Levels above a certain threshold (12ng/ml) indicate that someone has smoked recently, while levels below the threshold are a measure of exposure to second-hand smoke.

Inclusion of cotinine assessment in the survey allows for an objective cross-check on self-reported smoking behaviour which is known to under-estimate prevalence. Inaccuracies in reporting arise in part from difficulties participants may experience in providing quantitative summaries of variable behaviour patterns, but in some cases arise from a desire to conceal the truth from others, including other household members who may be present during the interview. SHeS is the only data source in Scotland to provide a validated measure of self-reported smoking for the adult population.

All adults aged 16 years and over who took part in the biological module were asked to provide a saliva sample in order to measure cotinine levels. Between 1995 and 2011, saliva samples were collected by a nurse. The change, in 2012, from nurse to interviewer administered sample collection should not affect comparability over time, as the collection and analysis procedures did not change. The protocol for collecting saliva samples is included in Annex B, Volume 2 of this report.

To increase the sample size available for analysis, the figures presented in this chapter are based on data from the 2012 and 2013 surveys combined.

4.2.4 Definitions

The following classifications are used in this chapter:

  • Current smoking status based on self-report: current smoker, ex-regular smoker, never regular smoker/never smoked at all.
  • Mean number of cigarettes smoked by current smokers: this is measured as number per smoker per day, based on self-report.
  • Current smoking status with cotinine adjustment: current smokers, based on self-report, and anyone else with a saliva cotinine level in excess of 12ng/ml are classed as current smokers; non-smokers are those who do not currently smoke, based on self-report, and have a saliva cotinine level below 12ng/ml.

The question on non-smokers' exposure to second-hand smoke was updated in 2012 to include exposure outside buildings (e.g. shops, pubs and hospitals), and in cars. In addition, questions on exposure on public transport and in pubs were dropped in light of the very low level of exposure reported in these places (following the ban on smoking in these locations).

Children's exposure to second-hand smoke is measured in two ways on the survey:

  • Whether there is someone who regularly smokes inside the accommodation where the child lives, as reported in the household questionnaire; and
  • Parents' and older children's (aged 13-15) reports of whether the child is exposed to smoke at home.

The second of these measures is being used to monitor progress towards the target to reduce children's exposure to smoke at home to 6% by 2020.

4.3 TRENDS IN SMOKING PREVALENCE SINCE 1995

Data on the self-reported cigarette smoking status of adults aged 16-64, between 1995 and 2013, are presented in Table 4.1, alongside data on the smoking status of all adults aged 16 and over since 2003.

Since 1995, cigarette smoking among adults aged 16-64 has declined significantly (from 35% to 24% in 2013), mainly due to a significant drop in prevalence between 1995 and 2008 (from 35% to 29%) and, then again, between 2012 and 2013 (from 27% to 24%). The decline in cigarette smoking has been apparent for both men and women. For men, prevalence declined by 9 percentage points (from 34% to 25%) between 1995 and 2013. There has been an even more pronounced drop of 14 percentage points for women aged 16-64 over this same period (from 36% to 22%). The drop in prevalence between 2012 and 2013 was statistically significant for women aged 16-64 (26% to 22%) but not for men

The decline, since 1995, in cigarette smoking levels corresponded with an overall increase in the proportion of 16-64 year olds reporting that they had never smoked or had never smoked regularly (49% in 1995 and 56% in 2013). The percentage of adults aged 16-64 describing themselves as ex-regular smokers also significantly increased between 1995 and 2013 (from 17% to 20%), with some minor fluctuation in intervening years. The trends for never smoked, never regularly smoked and ex-regular smoking were similar for men and women over this period. Figure 4A, Table 4.1

Figure 4A Current cigarette smoking prevalence among adults aged 16-64, 1995-2013, by sex

Smoking trends for men and women aged 16 and over since 2003 were similar to those discussed above for 16-64 year olds (Table 4.1). The percentage of all adults reporting that they were current cigarette smokers declined significantly between 2012 and 2013 (from 25% to 21%). Levels also dropped significantly for women over this period (from 24% to 20%) but not for men (from 25% to 23%).

The decline in smoking prevalence between 2012 and 2013 is not matched by a decline in the figures reported by the Scottish Household Survey (SHS), which (as outlined in Section 4.1) is used to monitor the National Performance Framework National indicator "to reduce the percentage of adults who smoke." Future years of data from both surveys will be required to determine whether this reduction is due to sampling variation or represents a true decrease in the last year.

The proportion of adults aged 16 and over who had never smoked or had never smoked regularly increased from 50% in 2003 to 54% in 2013, while the proportion describing themselves as ex-regular smokers changed little between 2003 and 2013 (22-24%). Patterns in cigarette smoking were largely similar for men and women aged 16 and over between 2003 and 2013.

In addition to the decline in smoking prevalence over time, there has also been a steady and significant drop in the mean number of cigarettes smoked by self-reported smokers aged 16-64 (from 16.7 cigarettes per day in 1995 to 12.7 cigarettes per day in 2013). The reduction in mean cigarettes smoked has been more pronounced for men aged 16-64 (from 18.1 cigarettes per day in 1995 to 13.1 cigarettes in 2013) than for women (15.4 and 12.2 cigarettes per day, respectively). The decline observed between 2012 and 2013 was only statistically significant for male smokers aged 16-64 (from 14.7 cigarettes per day to 13.1).

Since 2003, there has also been a significant decline in the mean number of cigarettes smoked per day by all smokers aged 16 and over (from 15.3 cigarettes to 13.0 cigarettes in 2013). Table 4.1

4.4 SMOKING PREVALENCE IN 2013

4.4.1 Smoking prevalence in 2013, by age and sex

Data on the self-reported cigarette smoking status of adults aged 16 and over in 2013 are shown, by age and sex, in Table 4.2. In 2013, men were significantly more likely than women to be current cigarette smokers (23% compared with 20%). Around one in four (24% of all adults, 25% of men and 23% of women) reported that they used to smoke cigarettes regularly, while over half (54%) had either never smoked cigarettes at all or used to smoke them, but not regularly. Women were more likely than men to report having never smoked or having never smoked regularly (57%, compared with 51%).

Table 4.2, Figure 4B and Figure 4C highlight the marked variations in cigarette smoking status by age, noted in previous SHeS reports.[11],[12] In 2013, cigarette smoking prevalence was highest among those aged 25-54 (24-25%) and lowest among those aged 75 and over (11%). Prevalence estimates for the remaining age groups ranged between 16% and 23%. The overall tendency for lower smoking prevalence among the oldest age group (75 and over) was true for both men (9%) and women (11%).

Figure 4B Men's cigarette smoking status, 2013, by age

Figure 4C Women's cigarette smoking status, 2013, by age

Naturally, the proportion describing themselves as ex-regular smokers was lowest among younger people (6% for 16-24 year olds) and highest for older age groups (40% for those aged 65-74 and 37% for those aged 75 and over) (Table 4.2). This concurred with an age-related pattern to the percentage reporting that they had never smoked or had never smoked regularly (74% for those aged 16-24; 43% for those aged 65-74; 52% for those aged 75 and over). Both these age-related patterns were more pronounced for men than for women (Figures 4B and 4C).

As also shown in Table 4.2, the mean number of cigarettes smoked per day per adult smoker aged 16 and over in 2013 was 13.0. The mean number smoked by male and female smokers were not significantly different (13.5 cigarettes per day, compared with 12.4 cigarettes). Smokers aged 16-24 smoked the fewest cigarettes per day (9.2 cigarettes), while those aged 65-74 smoked the most on average (17.0 cigarettes). The age-related pattern to cigarette consumption was very similar for male and female smokers. Figure 4B, Figure 4C, Table 4.2

4.4.2 Cotinine-adjusted cigarette smoking status in 2012/2013 combined, by age and sex

Elevated cotinine levels present in some self-reported non-smokers indicate exposure beyond the second-hand degree and suggest misreporting, for whatever reason, of smoking behaviour in the main interview. As discussed in Section 4.2.3, self-reported non-smokers with a cotinine level of 12ng/ml or above are very likely to be recent and/or regular smokers. Adjusted smoking prevalence was calculated by classifying participants as smokers if their cotinine level was 12ng/ml or above, even if they reported being a non-smoker during the interview.

Current smoking prevalence for adults, both before and after adjustment for saliva cotinine level, is presented in Table 4.3. Note that the figures presented in Table 4.3 are based on the sub-sample of participants who participated in the biological module and provided a valid saliva sample.[13] As the sample size is reduced relative to the entire survey sample, the figures presented here are based on data from both the 2012 and 2013 surveys combined, hence why the self-reported estimates differ to those presented in Table 4.2.

In 2012/2013 combined, 23% of adults aged 16 and over included in this analysis - 23% of the men and 23% of the women - self-reported as current cigarette smokers. When adjusted for participant cotinine levels, prevalence was higher, at 27%, for all adults (28% for men and 26% for women). The adjusted estimates in 2012/2013 (for men, women and all adults) were identical to those in the 2008-2011 period. The 4 percentage point gap (5 points for men and 4 for women) between self-reported smoking status and the cotinine-adjusted smoking prevalence is consistent with findings from the 2003,[14] 2009,[15] and 2011[16] reports. In absolute terms, the discrepancy between the self-reported and adjusted smoking estimates was greatest for men aged 16-24 (6 percentage point difference); 55-64 (8 percentage points) and 65-74 (7 percentage points) and among women aged 55-64 (6 percentage point difference). Table 4.3

4.5 EXPOSURE TO SECOND-HAND SMOKE

4.5.1 Children's exposure to second-hand smoke since 2012, by age and sex

The proportion of children aged 0-15 living in accommodation where someone smoked is presented in Table 4.6. A second measure, reported exposure to smoke in the home, is also presented. The latter of these is the being used to monitor progress towards the target to reduce children's exposure to smoke in the home to 6% by 2020.

In 2013, one in six (16%) children lived in accommodation in which someone smoked (18% of boys and 15% of girls). The three percentage point drop from 2012 (19%) was not statistically significant.

The percentage of children exposed to second-hand smoke in the home was lower than the percentage living in accommodation in which someone smoked (11%, compared with 16%). Children's exposure to second-hand smoke in the home has not changed significantly since 2012 (12%). Levels of second-hand smoke exposure in the home did not vary significantly between boys and girls (11% and 10%, respectively).

The youngest age groups were least likely to live in accommodation where someone smokes (10% of those aged 0-1), and to be exposed to second-hand smoke in the home (5% of those aged 0-1). Whereas older children (aged 10 and above) were most likely both to live in accommodation in which someone smoked (19-20%) and to be exposed to second-hand smoke in the home (14-15%). Table 4.4

4.5.2 Trends in adult non-smokers' self-reported exposure to second-hand smoke since 1998

Since 2008, self-report non-smoking adult participants have been asked if they are regularly exposed to second-hand smoke in a variety of public and private settings. Previous SHeS reports[11],[12],[15] noted that second-hand smoke exposure had fallen markedly since the introduction of the ban on smoking in public places in 2006. As noted in Section 4.2.4, questionnaire changes introduced in 2012 mean that some trends can no longer be reported across the series (trend figures for the period up to 2011 can be found in Table 4.6 of the 2011[16] report).

Non-smokers' self-reported exposure to smoke in a variety of contexts, since 1998, is presented in Table 4.4. Since the 1998 survey did not include adults aged 75 and over, the following discussion of trends is based on adults aged 16-74 only; figures for all adults aged 16 and over since 2003 are also presented in Table 4.4.

There has been an overall decline in the proportion of non-smokers aged 16-74 reporting being exposed to second-hand smoke in their own or other people's homes (from 33% in 1998 to 15% in 2013). Much of the decline occurred between 1998 and 2010, with little change thereafter (Table 4.4). The three percentage point drop between 2012 and 2013 (from 18% to 15%) was not a statistically significant change.

Due to changes in definitions (see footnotes to Table 4.5), data on second-hand smoke exposure in any public place in 2013 is only comparable with 2012. Under the new definition, the percentage of both male and female non-smokers aged 16 and over exposed in any public place was 17% in 2013, with little change from 2012 (16% for both sexes).

Non-smokers' exposure to second-hand smoke in other public places; at work; and in cars/vans did not change significantly between 2012 and 2013. Similarly, the proportion of male and female non-smokers reporting that they were exposed to second-hand smoke outside buildings (e.g. pubs, shops, hospitals) did not change significantly over this period. Table 4.5

4.5.3 Adult non-smokers' exposure to second-hand smoke in 2013, by age and sex

Data on the percentage of non-smokers aged 16 and over exposed to second-hand smoke in their own or other's home; at work; outside buildings; in cars/vans; and in other public places, in 2013, are presented in Table 4.6. One in seven (14%) non-smokers reported being exposed to second-hand smoke in their own or someone else's home in 2013. Similar proportions reported being exposed to smoke outside public buildings (14%) and in any public place (17%). Seven in 10 non-smokers reported that they were not exposed to second-hand smoke in any of the places asked about.

Rates for male and female non-smokers' exposure to second-hand smoke were very similar in 2013, with the exception that male non-smokers were significantly more likely than females to report second-hand exposure to smoke at work (6% compared with 3%).

The oldest non-smokers (aged 75 and over) were more than twice as likely as the youngest (aged 16-24) to report that they were not exposed to smoke in the places asked about (88% and 42%, respectively) (Figure 4D). Correspondingly, the youngest non-smokers were twice as likely as those aged 25-54 and around three to five times as likely as those aged 55 and over to report that they were exposed to smoke in their own or someone else's home (31%, 13-15% and 6-9%, respectively). Exposure in any public place was also much more common among non-smokers aged 16-24 (35%) and 25-34 (24%) compared with 6-14% for other age groups. Figure 4D, Table 4.6

Figure 4D Percentage of non-smokers exposed to second-hand smoke in own home, other people’s homes, in cars/vans, outside buildings, at work or in other public places, 2013, by age and sex

4.5.4 Trends in adult non-smokers' exposure to second-hand smoke since 2003: cotinine levels

The distribution of cotinine level data for non-smokers is typically very skewed and for this reason geometric means[17] (rather than arithmetic means) have been calculated as these take extreme values into account (the Glossary at the end of this volume contains more details on these terms). To be included in the following analysis, self-reported non-smokers had to have cotinine levels below 12ng/ml (as already mentioned, levels of cotinine which exceed this amount are indicative of exposure beyond the second-hand degree and suggest misreporting of smoking behaviour in the main interview). The geometric mean cotinine levels for validated non-smokers are presented for 2003, 2008/2009, 2010/2011 and 2012/2013 in Table 4.7.

The geometric mean cotinine level for non-smokers reduced significantly between 2003 and 2012/2013 (from 0.40ng/ml to 0.08ng/ml in 2012/2013). The biggest reduction occurred between 2003 and 2008/2009 (from 0.40 to 0.11ng/ml), with a further significant drop between 2010/2011 and 2012/2013 (from 0.11ng/ml to 0.08ng/ml). Mean cotinine levels have declined significantly since 2003 for both male and female non-smokers and levels have been very similar to for both sexes since 2008/2009 (0.09ng/ml for men and 0.08ng/ml for women in 2012/2013). Table 4.7

Table list

Table 4.1 Cigarette smoking status, 1995 to 2013
Table 4.2 Cigarette smoking status, 2013, by age and sex
Table 4.3 Smoking prevalence estimates without and with saliva cotinine adjustment, 2012/2013 combined, by age and sex
Table 4.4 Children's exposure to second-hand smoke, 2012, 2013, by age and sex
Table 4.5 Non-smokers' exposure to second-hand smoke, 1998 to 2013
Table 4.6 Non-smokers' exposure to second-hand smoke, 2013, by age and sex
Table 4.7 Saliva cotinine levels among self-reported cotinine validated non-smokers, 2003 to 2012/2013 combined

Additional tables available on the survey website include:

  • Cigarette smoking status, by age & key demographics
  • Smokers: Mean number of cigarettes smoke a day, by age & key demographics
  • Smokers: Number of times tried to stop smoking, by age & key demographics
  • Smokers: Whether want to give up smoking, by age & key demographics
  • Smokers: Longest period ever managed to stop smoking, by age & key demographics
  • Past/present smokers: Medical practitioner advised to stop smoking, by age & key demographics
  • Past/present smokers: Nicotine replacement used, by age & key demographics
  • Persons smoking in accommodation (adults & children), by age & demographics
  • Non-smokers (adults & children): Where exposed to smoke, by age & demographics
  • Non-smokers (adults): Does passive smoke bother informant by age & demographics
  • Smoking rules in households (adults & children), by age & demographics

Table 4.1 Cigarette smoking status, 1995 to 2013

Aged 16 and over

1995 to 2013

Cigarette smoking status

1995

1998

2003

2008

2009

2010

2011

2012

2013

%

%

%

%

%

%

%

%

%

Men

Current cigarette smokera

16-64

34

36

32

29

28

29

27

28

25

16+

n/a

n/a

29

27

25

26

24

25

23

Ex-regular cigarette smoker

16-64

18

18

19

19

19

18

18

17

20

16+

n/a

n/a

24

24

24

24

23

23

25

Never regular cigarette smoker / never smoked at all

16-64

49

46

49

51

53

53

55

55

55

16+

n/a

n/a

47

49

51

50

52

52

51

Mean per current smoker per day

16-64

18.1

17.6

15.9

15.6

15.2

14.6

14.2

14.7

13.1

16+

n/a

n/a

15.9

15.7

15.4

14.8

14.3

14.7

13.5

Standard error of the mean

16-64

0.31

0.29

0.35

0.49

0.44

0.46

0.38

0.52

0.51

16+

n/a

n/a

0.33

0.46

0.41

0.43

0.35

0.48

0.49

Women

Current cigarette smokera

16-64

36

33

31

28

27

28

26

26

22

16+

n/a

n/a

28

25

25

25

22

24

20

Ex-regular cigarette smoker

16-64

16

16

17

19

17

19

17

18

21

16+

n/a

n/a

20

22

20

21

20

21

23

Never regular cigarette smoker / never smoked at all

16-64

49

51

52

53

56

54

58

56

57

16+

n/a

n/a

53

53

55

54

57

55

57

Mean per current smoker per day

16-64

15.4

15.2

14.8

13.6

13.5

13.3

13.2

12.3

12.2

16+

n/a

n/a

14.7

13.7

13.4

13.1

13.3

12.4

12.4

Standard error of the mean

16-64

0.21

0.24

0.29

0.33

0.30

0.29

0.33

0.43

0.43

16+

n/a

n/a

0.27

0.31

0.27

0.27

0.30

0.40

0.40

All adults

Current cigarette smokera

16-64

35

35

31

29

28

28

26

27

24

16+

n/a

n/a

28

26

25

25

23

25

21

Ex-regular cigarette smoker

16-64

17

17

18

19

18

18

17

17

20

16+

n/a

n/a

22

23

22

23

22

22

24

Never regular cigarette smoker / never smoked at all

16-64

49

48

51

52

54

54

57

55

56

16+

n/a

n/a

50

51

53

52

55

54

54

Mean per current smoker per day

16-64

16.7

16.4

15.3

14.6

14.3

13.9

13.7

13.5

12.7

16+

n/a

n/a

15.3

14.7

14.4

13.9

13.8

13.5

13.0

Standard error of the mean

16-64

0.19

0.19

0.26

0.31

0.29

0.28

0.28

0.36

0.35

16+

n/a

n/a

0.24

0.28

0.26

0.26

0.26

0.34

0.34

Bases (weighted):

Men 16-64

3901

3937

3156

2520

2916

2795

2926

1868

1882

Men 16+

n/a

n/a

3819

3066

3560

3422

3581

2292

2330

Women 16-64

3994

3966

3307

2618

3047

2925

3045

1939

1968

Women 16+

n/a

n/a

4267

3348

3905

3750

3906

2489

2534

All adults 16-64

7895

7903

6463

5138

5962

5720

5971

3807

3850

All adults 16+

n/a

n/a

8086

6413

7465

7173

7487

4780

4864

Bases (unweighted):

Men 16-64

3523

3356

2749

2072

2387

2273

2409

1510

1596

Men 16+

n/a

n/a

3582

2829

3265

3092

3263

2119

2131

Women 16-64

4406

4194

3442

2679

3198

3067

3162

1963

2068

Women 16+

n/a

n/a

4514

3600

4227

4109

4243

2677

2746

All adults 16-64

7929

7550

6191

4751

5585

5340

5571

3473

3664

All adults 16+

n/a

n/a

8096

6429

7492

7201

7506

4796

4877

a Current cigarette smoker excludes those who reported only smoking cigars or pipes

Table 4.2 Cigarette smoking status, 2013, by age and sex

Aged 16 and over

2013

Cigarette smoking status

Age

Total

16-24

25-34

35-44

45-54

55-64

65-74

75+

%

%

%

%

%

%

%

%

Men

Current cigarette smokera

22

28

28

24

22

20

9

23

Ex-regular cigarette smoker

5

18

23

21

33

47

49

25

Never regular cigarette smoker / never smoked at all

73

54

49

55

45

33

41

51

Mean per current smoker per day

9.4

10.7

12.2

16.8

16.5

17.7

*

13.5

Standard error of the mean

1.03

0.96

0.80

1.17

1.14

1.65

*

0.49

Women

Current cigarette smokera

18

22

20

25

24

13

11

20

Ex-regular cigarette smoker

7

20

24

21

27

35

29

23

Never regular cigarette smoker / never smoked at all

74

58

55

54

48

53

60

57

Mean per current smoker per day

[8.9]

9.8

12.3

14.6

13.7

[16.0]

[10.6]

12.4

Standard error of the mean

[0.99]

0.75

0.91

0.84

0.91

[1.34]

[1.08]

0.40

All adults

Current cigarette smokera

20

25

24

24

23

16

11

21

Ex-regular cigarette smoker

6

19

24

21

30

40

37

24

Never regular cigarette smoker / never smoked at all

74

56

52

55

47

43

52

54

Mean per current smoker per day

9.2

10.3

12.2

15.6

14.9

17.0

11.1

13.0

Standard error of the mean

0.72

0.63

0.65

0.73

0.76

1.22

1.01

0.34

Bases (weighted):

Men

325

367

387

436

366

269

178

2330

Male smokers

73

104

106

97

76

46

14

516

Women

322

389

412

462

383

303

264

2534

Female smokers

57

84

83

114

90

37

30

495

All adults

647

756

799

898

749

572

442

4864

All smokers

130

188

189

211

166

83

44

1011

Bases (unweighted):

Men

200

310

339

394

353

318

217

2131

Male smokers

50

91

97

92

82

52

20

484

Women

235

419

432

540

442

373

305

2746

Female smokers

48

99

90

128

104

44

33

546

All adults

435

729

771

934

795

691

522

4877

All smokers

98

190

187

220

186

96

53

1030

a Current cigarette smoker excludes those who reported only smoking cigars or pipes

Table 4.3 Smoking prevalence estimates without and with saliva cotinine adjustment, 2012/2013 combined, by age and sex

Aged 16 and over with valid saliva cotinine measurement

2012/2013 combined

Smoking prevalence

Age

Total

16-24

25-34

35-44

45-54

55-64

65-74

75+

%

%

%

%

%

%

%

%

Men

Unadjusted self -report: smoke cigarettes

25

33

23

26

23

19

2

23

Adjusted estimate, adding self-reported non-smokers with saliva cotinine of 12ng/ml or over

31

36

27

29

31

26

6

28

Differencea

6

3

4

3

8

7

3

5

Women

Unadjusted self-report: smoke cigarettes

29

27

21

26

26

13

11

23

Adjusted estimate, adding self-reported non-smokers with saliva cotinine of 12ng/ml or over

31

32

26

29

30

17

13

26

Differencea

2

4

6

3

4

4

2

4

All adults

Unadjusted self-report: smoke cigarettes

27

30

22

26

24

16

7

23

Adjusted estimate, adding self-reported non-smokers with saliva cotinine of 12ng/ml or over

31

34

26

29

30

22

10

27

Differencea

4

4

5

3

6

5

3

4

Bases (weighted):

Men

143

152

154

184

152

119

77

981

Women

128

139

169

191

161

128

106

1020

All adults

271

291

323

375

313

247

183

2002

Bases (unweighted):

Men

103

120

137

157

145

160

91

913

Women

89

144

190

206

208

147

126

1110

All adults

192

264

327

363

353

307

217

2023

a Because of rounding, the actual differences shown may be different from the apparent difference between the two percentages

Tables 4.4 Children's exposure to second-hand smoke, 2012, 2013, by age and sex

Aged 0 - 15

2012, 2013

Exposure to second-hand smoke in own home

Age

Total

0-1

2-3

4-6

7-9

10-12

13-15

%

%

%

%

%

%

%

Boys

Whether anyone smokes in accommodation

2012

9

23

18

23

21

17

19

2013

8

15

18

22

18

22

18

Reported exposure to second-hand smoke in own home

2012

3

9

8

17

17

13

12

2013

4

9

9

10

15

16

11

Girls

Whether anyone smokes in accommodation

2012

7

16

17

13

26

27

18

2013

12

13

14

11

19

18

15

Reported exposure to second-hand smoke in own home

2012

3

8

11

7

17

20

12

2013

7

6

12

7

14

14

10

All children

Whether anyone smokes in accommodation

2012

8

19

18

18

24

21

19

2013

10

14

16

17

19

20

16

Reported exposure to second-hand smoke in own home

2012

3

8

9

12

17

16

12

2013

5

8

10

9

14

15

11

Bases (weighted):

Boys 2012

111

125

171

164

165

178

914

Boys 2013

110

129

179

169

184

169

941

Girls 2012

113

123

162

148

178

149

873

Girls 2013

110

112

184

154

185

152

898

All children 2012

224

248

333

312

342

327

1787

All children 2013

221

242

363

323

369

321

1839

Bases (unweighted):

Boys 2012

115

119

169

159

151

166

879

Boys 2013

129

139

191

177

155

157

948

Girls 2012

123

132

171

159

169

154

908

Girls 2013

128

135

189

156

151

132

891

All children 2012

238

251

340

318

320

320

1787

All children 2013

257

274

380

333

306

289

1839

Table 4.5 Non-smokers' exposure to second-hand smoke, 1998 to 2013

Non-smokers aged 16 and over

1998 to 2013

Exposure to second-hand smokea

1998

2003

2008

2009

2010

2011

2012

2013

%

%

%

%

%

%

%

%

Men

In own home

16-74

18

15

10

9

9

8

7

6

16+

n/a

14

10

9

8

8

7

6

In other people's home

16-74

21

16

12

10

11

10

11

10

16+

n/a

15

11

9

10

9

10

9

At work

16-74

23

16

6

6

6

5

6

7

16+

n/a

15

5

5

5

5

6

6

Outside buildings, e.g. pubs, shops, hospitals

16-74

n/a

n/a

n/a

n/a

n/a

n/a

12

15

16+

n/a

n/a

n/a

n/a

n/a

n/a

11

14

In cars / vans

16-74

n/a

n/a

n/a

n/a

n/a

n/a

2

2

16+

n/a

n/a

n/a

n/a

n/a

n/a

2

2

In other public places

16-74

25

26

6

5

7

8

8

8

16+

n/a

25

6

5

6

7

7

7

In own or other's home

16-74

31

24

19

18

17

16

17

15

16+

n/a

24

18

17

16

15

16

14

In any public place (12 onwards)b

16+

n/a

n/a

n/a

n/a

n/a

n/a

16

17

Not exposed to smoke in these places (12 onwards)c

16+

n/a

n/a

n/a

n/a

n/a

n/a

69

70

Women

In own home

16-74

18

13

10

8

8

6

9

6

16+

n/a

13

9

8

8

6

8

6

In other people's home

16-74

25

21

13

13

14

10

13

11

16+

n/a

19

12

12

12

9

11

10

At work

16-74

14

9

2

3

2

3

3

4

16+

n/a

8

2

3

2

2

3

3

Outside buildings, e.g. pubs, shops, hospitals

16-74

n/a

n/a

n/a

n/a

n/a

n/a

13

16

16+

n/a

n/a

n/a

n/a

n/a

n/a

12

14

In cars / vans

16-74

n/a

n/a

n/a

n/a

n/a

n/a

2

2

16+

n/a

n/a

n/a

n/a

n/a

n/a

2

1

In other public places

16-74

28

28

6

6

7

7

8

7

16+

n/a

26

5

5

6

7

8

6

In own or other's home

16-74

35

29

21

19

19

14

19

16

16+

n/a

27

19

18

18

14

17

15

In any public place (12 onwards)b

16+

n/a

n/a

n/a

n/a

n/a

n/a

16

17

Not exposed to smoke in these places (12 onwards)c

16+

n/a

n/a

n/a

n/a

n/a

n/a

70

71

All adults

In own or other's home

16-74

33

27

20

19

18

15

18

15

16+

n/a

25

18

17

17

14

17

14

In any public place (12 onwards)b

16+

n/a

n/a

n/a

n/a

n/a

n/a

16

17

Not exposed to smoke in these places (12 onwards)c

16+

n/a

n/a

n/a

n/a

n/a

n/a

70

70

Bases (weighted):

Men 16-74

2897

2476

1950

2429

2302

2464

1550

1625

Men 16+

n/a

2695

2137

2655

2524

2707

1709

1786

Women 16-74

3077

2677

2197

2574

2474

2648

1662

1799

Women 16+

n/a

3088

2508

2941

2826

3029

1899

2033

All adults 16-74

5973

5153

4147

5003

4776

5111

3211

3424

All adults 16+

n/a

5783

4645

5596

5350

5736

3608

3819

Bases (unweighted):

Men 16-74

2552

2299

1771

2146

1991

2166

1403

1417

Men 16+

n/a

2576

2031

2466

2281

2482

1612

1611

Women 16-74

3321

2850

2353

2764

2667

2844

1784

1921

Women 16+

n/a

3284

2724

3199

3089

3292

2080

2193

All adults 16-74

5872

5149

4130

4910

4658

5010

3187

3338

All adults 16+

n/a

5860

4755

5665

5370

5774

3692

3804

a Percentages add to more than 100% as the categories are not mutually exclusive
b Since 2012 any public place has been defined as: outside buildings, or in any other public places
c These places defined as: in own home, other people's homes, in cars/vans, outside buildings, at work, or in other public places in 2012

Table 4.6 Non-smokers' exposure to second-hand smoke, 2013, by age and sex

Non-smokers aged 16 and over

2013

Exposure to second-hand smokea

Age

Total

16-24

25-34

35-44

45-54

55-64

65-74

75+

%

%

%

%

%

%

%

%

Men

In own home

18

6

2

4

4

5

4

6

In other people's home

23

9

10

7

4

7

1

9

At work

7

13

7

7

4

1

-

6

Outside buildings (e.g. pubs, shops, hospitals)

25

19

12

13

11

10

3

14

In cars/vans etc

4

4

1

1

1

2

-

2

In other public places

16

10

5

6

6

4

3

7

In own or other's home

37

13

11

10

8

10

6

14

In any public placeb

32

23

14

16

14

12

6

17

Not exposed to smoke in these placesc

43

61

74

74

76

79

89

70

Women

In own home

11

4

6

5

7

4

5

6

In other people's home

19

15

15

11

5

4

3

10

At work

11

3

4

3

2

-

-

3

Outside buildings (e.g. pubs, shops, hospitals)

31

22

13

11

12

6

4

14

In cars/vans etc

4

2

1

1

2

-

1

1

In other public places

18

9

3

4

4

3

2

6

In own or other's home

26

17

19

15

11

7

6

15

In any public placeb

38

25

15

12

13

8

6

17

Not exposed to smoke in these placesc

41

63

69

75

75

85

88

71

All adults

In own home

15

5

4

5

6

4

5

6

In other people's home

21

12

13

9

5

6

2

10

At work

9

8

5

5

3

1

-

5

Outside buildings (e.g. pubs, shops, hospitals)

28

21

13

12

12

8

4

14

In cars/vans etc

4

3

1

1

2

1

0

2

In other public places

17

9

4

5

5

3

2

7

In own or other's home

31

15

15

13

9

9

6

14

In any public placeb

35

24

14

14

14

10

6

17

Not exposed to smoke in these placesc

42

62

72

75

75

82

88

70

Bases (weighted):

Men

253

263

277

332

286

215

162

1786

Women

263

305

329

348

290

265

234

2033

All adults

515

568

606

680

575

479

395

3819

Bases (unweighted):

Men

150

218

238

292

264

255

194

1611

Women

185

319

342

412

335

328

272

2193

All adults

335

537

580

704

599

583

466

3804

a Percentages add to more than 100% as the categories are not mutually exclusive
b Any public place defined as outside buildings, or other public places
c In own home, other people's homes, in cars/vans, outside buildings, at work, or in other public places

Table 4.7 Saliva cotinine levels among self-reported cotinine validated non-smokers, 2003 to 2012/2013 combined

Self-reported non smokers aged 16 and over with valid saliva cotinine measurementa

2003 to 2012/2013 combined

Saliva cotinine level (ng/ml)

2003

2008/2009 combined

2010/2011 combined

2012/2013 combined

%

%

%

%

Men

Geometric mean saliva cotinineb

0.44

0.11

0.11

0.09

Confidence interval

(0.40-0.47)

(0.10-0.13)

(0.10-0.13)

(0.08-0.10)

Women

Geometric mean saliva cotinineb

0.37

0.10

0.11

0.08

Confidence interval

(0.34-0.40)

(0.09-0.11)

(0.10-0.12)

(0.07-0.08)

All adults

Geometric mean saliva cotinineb

0.40

0.11

0.11

0.08

Confidence interval

(0.38-0.43)

(0.10-0.12)

(0.10-0.12)

(0.08-0.09)

Bases (weighted):

Men

1513

681

642

708

Women

1583

694

700

755

All adults

3096

1462

1342

1463

Bases (unweighted):

Men

1472

632

598

659

Women

1746

767

781

824

All adults

3218

1493

1379

1483

a To be included within this category, participants had to be both self-reported non-smokers and have a saliva cotinine level lower than 12ng/ml
b Geometric means have been presented for non-smokers as their cotinine data have a very skewed and exponential distribution. A geometric mean is an average calculated by multiplying the values of the cases in the sample and taking the nth root, where n i