Smoking and vaping in culturally and linguistically diverse communities

Australia has one of the most culturally and linguistically diverse populations in the world. More than one in four Australians residents (27.6%) were born overseas, and more than one in five (22.3%) speak a language other than English at home.¹

Smoking behaviours are shaped by cultural norms, practices and beliefs, and vary significantly across culturally and linguistically diverse (CALD) communities. They are also influenced by external factors such as migration, health literacy, access to information and healthcare services.

In general, Australian residents born overseas are less likely to smoke or vape than those born in Australia, and vaping is also higher in English-speaking households compared with households that mainly speak a language other than English.^2,3

Current data shows that among Australian residents, the prevalence of smoking is higher among people born in North African and Middle Eastern countries, while people born in Asian regions have a lower prevalence of smoking. Across cultural groups, smoking is also more common among men than women.²

Trends of product use

• Smoking: Between 2001 and 2022-23, smoking trends in Australia saw significant declines among adults aged 18 years and over – both for those who were born in Australia and overseas, as well as among those who speak English at home. For people who speak a language other than English at home, the decline was observed from 2001 to 2019, with no change over recent years.²
• Vaping: For vaping, significant increases have been observed between 2016 and 2022-23 across all population groups: for people born in Australia and overseas, and for people who speak English and a language other than English at home.³
• Other products: Importantly, in some cultural groups, smoking goes beyond cigarettes, with tobacco products such as shisha (also known as waterpipes). Patterns of product use also vary between communities. For example, shisha smoking is a common practice among Arabic-speaking communities. These tobacco products carry similar serious health risks to smoking cigarettes.

Reasons for product use

• Cultural and social norms: In some communities, smoking is closely linked with cultural and social norms. For example, offering a cigarette can be seen as a gesture of respect or a way to connect socially in some cultures. Smoking may also be tied to ideas of masculinity among men in some CALD groups in Australia.
• Negative life experiences: Experiences such as discrimination, resettlement stress, and limited social networks, can act as triggers for people to start or continue smoking after migrating to Australia.
• Barriers to accessing support: People from diverse cultural backgrounds may also face barriers to accessing support to quit, including language barriers, lack of culturally relevant resources and limited awareness of cessation support services.

For further insights, see the Tobacco in Australia: Facts & Issues chapter on Culturally and linguistically diverse groups.

Supporting culturally and linguistically diverse communities

Providing culturally safe, relevant and accessible education and cessation support is vital. Tailored programs that consider the unique values, strengths and barriers of CALD communities give people the best chance of successfully quitting smoking or vaping.

Culture can strongly influence smoking and vaping behaviours. It is important that cultural factors – such as traditions, faith and values – are recognised, respected and even built upon, when developing a program or approach to help people quit.

Consider what motivates them, the unique barriers they face and the sources they use for health information and advice.

Common motivators that have been reported across several CALD communities include key life events such as getting married to someone who didn’t smoke, having a baby, and saving money. The influence of non-smoking family members also often plays a significant role – either as a reason to avoid smoking or as people they choose not to smoke around.⁴

Most importantly, CALD communities are not all the same – even within a single cultural group, its members can be diverse. There is no one-size-fits-all approach. Consulting with community members and involving them at every stage of program development is essential to ensure the approach is culturally safe, relevant and suitable for them.

Resources

Quit offers a range of resources to support culturally and linguistically diverse communities to quit smoking and vaping, including materials in multiple languages. Our Quitline service also provides the option to speak with an interpreter. Find out more at Resources to support culturally and linguistically diverse communities.