A nationally representative repeated cross-sectional study of 10-year substance use trends among culturally and...

To estimate the absolute and relative changes in prevalence of tobacco, e-cigarette, alcohol, and illicit substance use over the past decade among Culturally and Linguistically Diverse (CALD) and non-CALD populations in Australia from 2013 to 2022/23.

Data were drawn from four waves of the National Drug Strategy Household Survey (NDSHS), comprising of 91, 282 respondents (2013: n = 23, 855; 2016: n = 23, 749; 2019: n = 22, 015; 2022/23: n = 21, 663). CALD status (22.5% of weighted sample) was defined as being born outside Australia/New Zealand/United Kingdom and/or speaking a language other than English at home. Analyses calculated weighted prevalence estimates and absolute and relative changes in prevalence between 2013 and 2022/23 with 99% CI.

Between 2013 and 2022/2023, any tobacco product use declined significantly for both CALD (14.4% to 8.5%, 99%CI:8.0%, -3.7%) and non-CALD respondents (18.0% to 9.6%, 99%CI:9.6%, -7.3%). E-cigarette use (measured from 2016) increased in both populations, with CALD showing a 5-fold increase (0.8% to 4.8%; 99%CI: 2.7%, 5.2%) and non-CALD showing a 4.8-fold increase (1.3% to 7.5%; 99%CI: 5.5%, 7.0%). Risky alcohol use declined among CALD (23.2% to 13.1%, 99%CI:12.7%, -7.6%) and non-CALD respondents (43.2% to 33.9%, 99%CI:10.9%, -7.6%). Any illicit substance use remained stable among CALD respondents (10.3% to 9.0%; 99%CI: -3.2%, 0.8%) but increased among non-CALD respondents (16.0% to 18.4%; 99%CI: 1.2%, 3.8%).

In Australia, CALD individuals had lower prevalence of use of most tobacco products, e-cigarettes, alcohol, and illicit drugs than non-CALD individuals. Between 2013 and 2022/23, roll-your-own cigarette and waterpipe use remained stable among CALD individuals despite significant declines in non-CALD individuals. Both groups experienced steep rises in e-cigarette use between 2016 and 2022/23.