Technical notes

Comparison of national data sources on smoking and alcohol consumption

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.

National Hospital Morbidity Database

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.

Relationship between the drug of concern and the ICD-10-AM codes

Drug of concern identified in principal diagnosis 

ICD-10-AM codes 

Analgesics

 
Opioids (includes heroin, opium, morphine and methadone) F11.0–11.9, T40.0–40.4, T40.6
Non-opioid analgesics (includes paracetamol)  F55.2, N14.0, T39.0–39.4, T39.8, T39.9
Sedatives & hypnotics  
Alcohol (includes ethanol) E52, F10.0–10.9, G31.2, I42.6, K29.2, K70.0–70.9, K85.2, K86.0, T51.0–51.9, Z71.4
Benzodiazepines T42.4
Other sedatives and hypnotics (includes barbiturates; excludes ethanol) F13.0–13.9, T41.2, T42.0–42.3, T42.5–42.8
Stimulants and hallucinogens   
Cannabinoids (includes cannabis) F12.0–12.9, T40.7
Hallucinogens (includes LSD) F16.0–16.9, T40.8, T40.9 
Cocaine F14.0–14.9, T40.5
Tobacco and nicotine F17.0–17.9, T65.2, Z58.7, Z71.6
Methamphetamines F15.01–15.02, F15.11–15.12, F15.21–15.22,  F15.31–15.32, F15.41–15.42, F15.51–15.52, F15.61–15.62, F15.71–15.72, F15.81–15.82, F15.91–15.92, T43.61–43.62
Other stimulants (includes other amphetamines and caffeine) 15.00, F15.09, F15.10, F15.19, F15.20, F15.29, F15.30, F15.39, F15.40, F15.49, F15.50, F15.59, F15.60, F15.69, F15.70, F15.79, F15.80, F15.89, F15.90, F15.99.  
Antidepressants and antipsychotics  
Antidepressants and antipsychotics F55.0, T43.0–43.5
Volatile solvents   
Volatile solvents F18.0–18.9, T52.0–52.9, T53.0–9, T59.0, T59.8
Other and unspecified drugs of concern   
Multiple drug use F19.0–19.9
Unspecified drug use and other drugs not elsewhere classified (includes psychotropic drugs not elsewhere classified; diuretics; laxatives; anabolic and androgenic steroids and opiate antagonists) F55.1, F55.3–6, F55.8, F55.9, K85.3, N14.1–3, T38.7, T43.8–9, T47.2–47.4, T50.1–3, T50.7, Z71.5
Fetal and perinatal related conditions  
Fetal and perinatal related conditions (includes conditions caused by the mother’s alcohol, tobacco or other drug addiction) P04.2–4, Q86.0

Source: Data for 2017–18 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.

References

1. ACCD (Australian Consortium for Classification Development) 2016a. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM)—10th edn.—tabular list of diseases, and Alphabetic index of diseases. Adelaide: Independent Hospital Pricing Authority.

2. ACCD 2016b. The Australian Classification of Health Interventions (ACHI)—10th edn.—Tabular list of interventions, and Alphabetic index of interventions. Adelaide: Independent Hospital Pricing Authority.

National Mortality Database

Causes of death are coded by the ABS to the International Statistical Classification of Diseases and Related Health Problems (ICD). The deaths data included in this report were extracted from the AIHW NMD using the codes outlined in the table below.

List of ICD-10 codes used for each drug type

Drug type

ICD-10 codes

 

Heroin

T40.1

 

Natural and semi-synthetic opioids

T40.2

e.g. Oxycodone, Codeine, Morphine

Methadone

T40.3

 

Synthetic opioids

T40.4

eg. Fentanyl, Tramadol, Pethidine

All opioids

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

 

Cocaine

T40.5

 

Cannabinoids

T40.7

 

Benzodiazepines

T42.4

 

All depressants

T42.0–T42.8

 

All psychostimulants

T43.6

 

All antidepressants

T43.0, T43.1, T43.2

 

All antipsychotics

T43.3, T43.4, T43.5

 

Paracetamol

T39.1

 

Ibuprofen and aspirin

T39.3

 

All non-opioid analgesics

T39.0–T39.9

 

Alcohol

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, 2018, Appendix 2. This classification excludes deaths solely attributable to alcohol and tobacco.

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 2015 and earlier are based on the final version of cause of death data; deaths registered in 2016 are based on revised data; deaths registered in 2017 and 2018 are based on preliminary data. Revised and preliminary data are subject to further revision by the ABS.

Primary Health Networks

This release includes the following indicator by Primary Health Network (PHN):

Lifetime risky alcohol consumption

  • Percentage of adults who consume more than 2 standard drinks per day on average.

Lifetime risky alcohol consumption was determined if alcohol consumption exceeded the 2009 National Health and Medical Research Council (NHMRC) guidelines for reducing health risks associated with alcohol consumption.

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.

Daily smokers

  • Percentage of adults who are daily smokers.

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.

About the data

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.