This section discusses the declining smoking prevalence among health professionals in Australia, including physicians, dentists, optometrists and nurses.
Over the past 50 years in Australia, physicians have played a key role in reducing smoking prevalence, setting an example through their own smoking habits, as well as through the development of overall public health policy.1 Although smoking prevalence among health professionals is not systematically reported, studies indicate a significant decline, albeit unevenly, across different sectors of the healthcare workforce.2
Among Australian physicians, smoking prevalence has declined considerably, from around 1 in 3 in the 1960s to approximately 1 in 10 by the late 1990s.3 A 2013 survey of specialty-trained junior doctors in Australia found that 7.4% reported smoking, with a higher prevalence observed among psychiatry, surgery, and emergency medicine trainees.4
Similarly, very low rates of smoking have been reported among dentists and optometrists. A 2004 survey indicated that 3.9% of Queensland members of the Australian Dental Association smoked,5 and a 2013 survey found that only 1% of Optometry Australia members reported smoking6.
Among nurses, smoking has been more common compared to other health professionals, although it has decreased over time, from 29.1% in 1989–90 to 18% by 2004–05.7 A 2014–15 survey of the NSW Nurses and Midwives Association found that 10.3% of nurses and midwives reported smoking.8
The smoking prevalence among Aboriginal and Torres Strait Islander health workers has also been historically high but has declined significantly in recent years2—see Section 8.3.8.
The role of health professionals in providing effective medical interventions to help patients stop smoking is widely recognised.3,9-13 However, in countries where smoking among physicians remains high, translating knowledge about the dangers of smoking into patient care is challenging.14 Physicians15,16 and nurses17,18 who smoke appear to be less likely to provide cessation advice and counselling compared to their non-smoking colleagues. For more on the role of health professionals in delivering smoking cessation, refer to Section 7.10.
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References
1. Smith D and Leggat P. An international review of tobacco smoking in the medical profession: 1974-2004. BMC Public Health, 2007; 7(147):115. Available from: http://www.biomedcentral.com/content/pdf/1471-2458-7-115.pdf
2. Salehin M, Lam L, and Rahman MA. Smoking Among Healthcare Professionals in Australia: A Scoping Review. International Journal of Environmental Research and Public Health, 2025; 22(1):113. Available from: https://www.mdpi.com/1660-4601/22/1/113
3. Smith DR and Leggat PA. The historical decline of tobacco smoking among Australian physicians: 1964–1997. Tobacco Induced Diseases, 2008; 4(1):13. Available from: https://tobaccoinduceddiseases.biomedcentral.com/articles/10.1186/1617-9625-4-13
4. Wong RXY, Farrell M, Degenhardt L, Memedovic S, Harvey SB, et al. Substance use among vocational trainees in Australia: differences between medical specialties. Intern Med J, 2023; 53(6):939-45.
5. Smith DR and Leggat PA. Tobacco Smoking Prevalence among a Cross-section of Dentists in Queensland, Australia. The Kurume Medical Journal, 2005; 52(4):147-51. Available from: https://doi.org/10.2739/kurumemedj.52.147
6. Downie LE and Keller PR. The Self-Reported Clinical Practice Behaviors of Australian Optometrists as Related to Smoking, Diet and Nutritional Supplementation. PLOS ONE, 2015; 10(4):e0124533. Available from: https://doi.org/10.1371/journal.pone.0124533
7. Smith DR. Longitudinal trends of alcohol and tobacco consumption among Australian physicians and nurses, 1989–2005. Journal of Substance Use, 2007; 12(4):267-80. Available from: https://doi.org/10.1080/14659890601157679
8. Perry L, Xu X, Gallagher R, Nicholls R, Sibbritt D, et al. Lifestyle Health Behaviors of Nurses and Midwives: The ‘Fit for the Future’ Study. International Journal of Environmental Research and Public Health, 2018; 15(5):945. Available from: https://www.mdpi.com/1660-4601/15/5/945
9. Russell M, Wilson C, Taylor C, and Baker C. Effect of general practitioners' advice against smoking. British Medical Journal, 1979; 2(6184):231–5. Available from: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1595592&blobtype=pdf
10. Gray N and Daube M. Guidelines for smoking control. UICC technical report series no. 52, Geneva: International Union Against Cancer, 1980.
11. US Department of Health and Human Services. The health benefits of smoking cessation. A report of the Surgeon General. Atlanta, GA: Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/previous_sgr.htm.
12. Richmond R. Physicians can make a difference with smokers: evidence-based clinical approaches. International Journal of Tuberculosis and Lung Disease, 1999; 3(2):100–12. Available from: http://www.ingentaconnect.com/content/iuatld/ijtld/1999/00000003/00000002/art00005?token=00591f58423dfb09016358f5c5f3b3b476728487434707b2a79427b5a4f582a2f4876753375686f49d4da963f
13. World Health Organization. Tools for advancing tobacco control in the XX1st century: Policy recommendations for smoking cessation and treatment of tobacco dependence. Tools for public health. Geneva: WHO, 2003. Available from: http://www.who.int/tobacco/resources/publications/en/intro_chapter3.pdf.
14. Ulbricht S, Baumeister S, Meyer C, Schmidt C, Schumann A, et al. Does the smoking status of general practitioners affect the efficacy of smoking cessation counselling? Patient Education and Counseling, 2009; 74(1):23-8. Available from: http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6TBC-4THJ6CD-1-5&_cdi=5139&_user=10&_orig=search&_coverDate=09%2F24%2F2008&_sk=999999999&view=c&wchp=dGLzVlz-zSkzV&md5=be17cfb0b6e0187d8e0bf6a0e0c255f1&ie=/sdarticle.pdf
15. Azuri J and Nashef S. Primary Care Physicians' Characteristics and Attitudes on Smoking Cessation. American Journal of Health Behavior, 2016; 40(5):578-84. Available from: http://www.ingentaconnect.com/content/png/ajhb/2016/00000040/00000005/art00004
16. Meshefedjian GA, Gervais A, Tremblay M, Villeneuve D, and O’Loughlin J. Physician Smoking Status May Influence Cessation Counseling Practices. Can J Public Health, 2010; 101(4):-196. Available from: http://journal.cpha.ca/index.php/cjph/article/view/2532
17. Kelly M, Wills J, and Sykes S. Do nurses’ personal health behaviours impact on their health promotion practice? A systematic review. International Journal of Nursing Studies; 76:62-77. Available from: http://dx.doi.org/10.1016/j.ijnurstu.2017.08.008
18. Duaso MJ, Bakhshi S, Mujika A, Purssell E, and While AE. Nurses' smoking habits and their professional smoking cessation practices. A systematic review and meta-analysis. Int J Nurs Stud, 2016; 67:3-11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27880873