Australian Institute of Health and Welfare 2021. Alcohol, tobacco & other drugs in Australia. Cat. no. PHE 221. Canberra: AIHW. Viewed 31 July 2021, https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. (2021). Alcohol, tobacco & other drugs in Australia. Retrieved from https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Alcohol, tobacco & other drugs in Australia. Australian Institute of Health and Welfare, 22 July 2021, https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Jul. 31]. Available from: https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare (AIHW) 2021, Alcohol, tobacco & other drugs in Australia, viewed 31 July 2021, https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
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A number of nationally representative data sources are available to analyse recent trends in tobacco smoking and alcohol consumption. This includes the AIHW National Drug Strategy Household Survey (NDSHS) and the ABS National Health Survey (NHS) for the general population. In addition, the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), National Aboriginal and Torres Strait Islander Social Survey (NATSISS) and the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) collected by the ABS are designed to obtain a representative sample of Indigenous Australians.
Differences in scope, collection methodology and design may account for variation in estimates reported and comparisons between collections should be made with caution.
For a summary of the methodological differences see Table T1: Methodological differences between surveys.
The hospital separation data included in this report were extracted from the AIHW National Hospital Morbidity Database using a selection of codes from the International statistical classification of diseases and related health problems, 10th revision, Australian modification 10th edition (ICD-10-AM) as outlined in the table below.
Drug of concern identified in principal diagnosis
Note: Data for 2018–19 were reported to the NHMD using the ICD-10-AM (10th edition). Revision of ICD-10-AM (10th edition) mapping to drugs of concern were applied in 2017–18. The mapping has been applied to the time series.
The Medical Certificate of Cause of Death includes all diseases, morbid conditions or injuries that either resulted in or contributed to death and the circumstances of the accident or violence that produced any such injuries.
The underlying cause of death is the disease or injury that initiated the train of morbid events (deaths are referred to as being directly attributable to the disease or injury). Associated causes of death are other causes listed on a death certificate, other than the underlying cause.
Causes of death are coded by the ABS to the International Statistical Classification of Diseases and Related Health Problems (ICD). Deaths in this report are counted according to year of registration of death, which is not necessarily the year in which the death occurred. Further, mortality data by geographical regions were derived using the place of a person’s usual residence at the time of death.
Deaths registered in 2016 and earlier are based on the final version of cause of death data; deaths registered in 2017 are based on revised data; deaths registered in 2018 and 2019 are based on preliminary data. Revised and preliminary data are subject to further revision by the ABS.
This report includes data on drug-induced deaths, alcohol-induced deaths and alcohol-related deaths.
Drug-induced deaths are defined as those that can be directly attributable to drug use, as determined by toxicology and pathology reports. The underlying causes of deaths align with the definition of drug-induced deaths used by the ABS reporting on drug-induced deaths as defined in 3303.0 - Causes of Death, Australia. Deaths solely attributable to alcohol and tobacco are excluded. Drug-induced deaths are classified according to their intent—accidental, intentional (including assault and suicide) or undetermined intent. They include deaths from illicit drugs (for example, heroin, amphetamines and cocaine) and licit drugs (for example, benzodiazepines and anti-depressants).
Drug-induced causes exclude accidents, homicides, and other causes indirectly related to drug use. Also excluded are newborn deaths associated with mother’s drug use.
The drug-induced deaths data included in this report were extracted from the AIHW NMD using the codes outlined in the table below.
Natural and semi-synthetic opioids
e.g. Oxycodone, Codeine, Morphine
eg. Fentanyl, Tramadol, Pethidine
T40.0, T40.1, T40.2, T40.3, T40.4, T40.6
All opioids excluding heroin
T40.0, T40.2, T40.3, T40.4, T40.6
T43.0, T43.1, T43.2
T43.3, T43.4, T43.5
Ibuprofen and aspirin
All non-opioid analgesics
T51.0, T51.1, T51.2, T51.3, T51.8, T51.9
Note: The underlying causes of deaths align with the definition of drug-induced deaths used by the ABS reporting on drug-induced deaths as defined in 3303.0 - Causes of Death, Australia. This classification excludes deaths solely attributable to alcohol and tobacco.
Deaths from external causes are assessed to determine intent. This may also determine how a death is investigated and influence the type of information that can be included on the death record (ABS 2020).
Alcohol-induced deaths are defined as deaths that can be directly attributable to alcohol use, as determined by toxicology and pathology reports. The underlying causes of deaths align with the definition of alcohol-induced deaths used by the ABS as defined in 3303.0 - Causes of Death, Australia.
Alcohol-induced causes exclude accidents, homicides, and other causes indirectly related to alcohol use. This category also excludes newborn deaths associated with maternal alcohol use.
Alcohol-induced deaths may be due to a chronic condition which is directly related to alcohol use (e.g. alcoholic liver cirrhosis) or from an acute condition directly related to harmful consumption (e.g. alcohol poisoning which led to respiratory depression).
Alcohol-related deaths include deaths directly attributable to alcohol use and deaths where alcohol was listed as an associated cause of death (e.g. a death due to a motor vehicle accident where a person recorded a high blood alcohol concentration).
The medications reported from PBS data are classified based on the ATC (Anatomical Therapeutic Chemical) classification system, defined by the World Health Organisation Collaborating Centre for Drug Statistics Methodology.
Data contained in this report include prescriptions for the following patient entitlements:
Medicines dispensed under prescriber bag orders were removed from the dataset prior to analysis.
Drugs selected for this report were chosen using the following ATC codes:
ATC3 = N02A (Opioids)
ATC4 = N05BA (Benzodiazepine derivatives as anxiolytics)
ATC4 = N05CD (Benzodiazepine derivatives as hypnotics and sedatives)
This release includes the following indicator by Primary Health Network (PHN):
New Australian guidelines to reduce health risks from drinking alcohol were released in December 2020. Data for alcohol risk in this report are measured against the 2009 guidelines. NDSHS data relating to the updated guidelines are available here.
Lifetime risky alcohol consumption was determined if alcohol consumption exceeded the 2009 guidelines for reducing health risks associated with alcohol consumption (NHMRC 2009).
The guidelines recommend that healthy men and women drink no more than 2 standard drinks of alcohol per day on average, to reduce their lifetime risk of harm from alcohol-related disease or injury.
Participants in the ABS NHS 2017–18 were asked whether they currently smoked at least once per day. A current daily smoker was defined as a person who smokes one or more cigarettes, roll-your-own cigarettes, cigars or pipes at least once a day. Chewing tobacco, electronic cigarettes (and similar) and the smoking of non-tobacco products were excluded.
Primary Health Networks (PHNs) are local organisations that connect health services across a specific geographic area, with the boundaries defined by the Australian Government Department of Health.
The quality of estimates from the NHS can vary across PHN areas, as the survey was not specifically designed to produce estimates at this level of geography.
As an indication of the accuracy of proportions, 95% confidence intervals were produced. These were calculated by the ABS using relative standard error (RSE) estimates of the proportion.
To ensure robust reporting of these data by PHN areas, suppression or interpret with caution rules were developed and applied by the Australian Institute of Health and Welfare.
Estimates of a percentage or its complement that had a relative standard error greater than 50% were suppressed. These estimates were considered unreliable for most practical purposes.
Data for PHN areas were suppressed if there was the likelihood of a non-representative sample, that is, where the survey sample count in the PHN area was less than 20% of the expected number of adults.
The ‘interpret with caution’ flag was applied to the data if the relative standard error associated with the percentage or its complement was greater than 25%. This indicates the proportion derived is subject to high sampling error and should be used with caution.
Data for Northern Territory should be interpreted with caution as the NHS excluded discrete Aboriginal and Torres Strait Islander communities and Very remote areas, which comprise around 28% of the estimated resident population of the Northern Territory.
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