4720.0 - National Aboriginal and Torres Strait Islander Social Survey: User Guide, 2014-15  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 27/05/2016   
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HEALTH RISK FACTORS, NUTRITION AND SLEEP


Overview

People were asked a series of questions relating to lifestyle behaviours that can impact on health. There were five main themes:


Smoking

People aged 15 years and over were asked questions about their smoking habits and the extent to which they were smoking at the time of the interview. Smoking refers to the regular smoking of tobacco products, including:
  • manufactured (packet) cigarettes;
  • roll-your-own cigarettes; and
  • cigars and pipes.

Chewing tobacco and the smoking of non-tobacco products (eg marijuana) were excluded. Based on this information, people were characterised as:
  • current daily smoker
  • current weekly smoker (at least once a week but not daily)
  • current less than weekly smoker
  • ex-smoker—they previously smoked daily or had smoked 100 or more cigarettes in their lifetime or had smoked pipes, cigars or other tobacco products at least 20 times in their lifetime; or
  • never smoked—they had never smoked daily.

If a person smoked at least once a week they were asked how many cigarettes or roll-your-own cigarettes they usually smoked per day or week. These people were also asked whether they had tried to quit or reduce the amount being smoked in the 12 months prior to interview. Responses were based on the following:
  • tried to quit;
  • tried to reduce consumption;
  • both; or
  • no.

If a person had tried to quit and/or reduce consumption they were asked for all the reasons why they tried to do this, based on the following:
  • general health;
  • smoking related health condition;
  • medical advice;
  • cost;
  • increased awareness of risks due to advertisements;
  • encouraged by family or friends to stop/reduce;
  • concerned about effect on others in household;
  • too many non-smoking areas;
  • improve fitness;
  • pregnancy;
  • other; or
  • no reason.

More than one response could be provided.

Household smokers

For each selected household, the household spokesperson (aged 18 years and over) was asked to respond to questions about smoking in the household. This person was asked if anyone in the household smoked regularly, that is, at least once a day. This question related to usual residents only, and the the response could have been yes or no. This question was asked in multi-person households only. In single-person households, the smoker status of that person was used.

The household spokesperson was also asked if anyone ever smoked inside the house. The response could have been yes or no, and if so, the household spokesperson was asked how often. Response categories to this question included:
  • every day;
  • at least weekly;
  • at least monthly;
  • less than monthly; and
  • don't know.

The questions about smoking inside the house related to anyone; not just usual residents.

Comparison to the 2008 NATSISS

Reasons tried to quit or reduce amount smoked in last 12 months included a new category in 2014–15: 'pregnancy'. Both males and females were able to select this response category.

In 2008, household smoking questions were asked of one selected person per household during their personal interview. In the 2014–15 NATSISS, household smoking questions were asked of the household spokesperson. The spokesperson of all households was asked if anyone ever smokes inside the house, regardless of if there were any usual residents who smoke. In 2008 it was assumed that if there were no housheold members who smoked, then nobody smoked inside the house.

The question relating to frequency of smoking inside the house was new in the 2014–15 NATSISS and is unable to be compared to 2008.

Alcohol consumption

People aged 15 years and over were asked about their consumption of alcoholic drinks/grog in the 12 months prior to interview. Where a person had consumed alcohol/grog in the 12 months prior to interview, they were asked how often they drank. Responses were based on the following:
  • every day;
  • six days a week;
  • five days a week;
  • four days a week;
  • three days a week;
  • two days a week;
  • one day a week;
  • three days a fortnight;
  • one day a fortnight or less;
  • one day a month or less; or
  • one day a year or less.

More detailed questions were only asked of people who consumed alcohol/grog more than one day a year. People were asked to think about the days when they had a drink and to indicate the amount which they usually drank in a day. The number of standard drinks was calculated from the type of drink and volumes/quantities provided.

People who had consumed alcohol more than once in the previous 12 months were also asked whether they had a drink of alcohol/grog in the two weeks prior to interview. If they had not, they were sequenced to the substance use module. Those who had consumed alcohol in the previous two weeks were asked to think about the day when they drank the most during that period. The number of standard drinks was calculated from the type of drink and volumes/quantities provided.

Standard drinks

The collection of accurate data on the quantity of alcohol consumed is difficult, particularly in a recall situation over the previous 12 months or two weeks. Where possible, information was collected in terms of standard containers or measures (eg stubbie, nip, 10 oz glass). Interviewers were trained to record as much information as possible when questioning about quantities, as the calculation of standard drinks was done at a later time. Reported quantities of drinks consumed were converted to millilitres (mls) of alcohol present in those drinks and then summed. To convert drinks to millilitres of alcohol consumed for any given drink type:

alcohol content of the drink consumed (%) x the number of drinks (of that type) consumed x the vessel size (in mls).

A standard drink contains 12.5 ml of alcohol.

Interviewers calculated the number of standard drinks following interview, using the number of standard drinks provided on the relevant question's prompt card. In some cases alcohol coding was not completed by interviewers. These records were coded by ABS office staff, using the text response and the relevant prompt card to calculate the number of standard drinks in each case.

A standard drink contains 12.5 ml of alcohol. The serving size determines the number of standard drinks per serve, as shown by the following examples:

Table 3.08.1 Standard Drinks, by serving size

Type of alcohol/grog
Serving size
Standard drinks

Light beer
can or stubbie (375 ml)
0.8
Mid-strength beer
can or stubbie (375 ml)
1.0
Full-strength (heavy) beer
can or stubbie (375 ml)
1.4
Fortified wine (port/sherry)
cask (2 l)
28.0
Wine (13.5% alc. vol.)
bottle (750 ml)
8.0
Wine (13.5% alc. vol.)
cask(4 l)
43.0
High strength spirits (30% alc. vol.)
nip (30 ml)
1.0
Pre-mixed spirits and soft drink (5% alc. vol.)
bottle (330 ml)
1.2


The above table serves as an example of common drinks and their corresponding number of standard drinks. Detailed prompt cards with images of drinks were used both during interview and the calculation of standard drinks. A copy of the prompt cards used in questions relating to alcohol consumption can be downloaded via the Downloads tab of National Aboriginal and Torres Strait Islander Social Survey, 2014–15 (cat no. 4714.0).

Where the person reported sharing drinks with other people the number of standard drinks was adjusted.

Alcohol consumption risk level

Alcohol consumption risk levels were assessed using the 2001 and 2009 National Health and Medical Research Council (NHMRC) guidelines for the consumption of alcohol. Risk in the longer term (2001 guidelines) and lifetime risk (2009 guidelines) were based on a person's reported usual daily consumption of alcohol and the frequency of consumption in the 12 months prior to interview. Risk in the short term (2001 guidelines) and single occasion risk (2009 guidelines) were assessed based on the largest quantity of alcohol consumed in a single day during the two weeks prior to interview. Based on these guidelines, the following outputs were created:
  • risky alcohol consumption-12mth-02/08 comparison using 2001 NHMRC Long Term Risk Guide;
  • risky alcohol consumption-2 wks-02/08 comparison using 2001 NHMRC Short Term Risk Guide;
  • lifetime (long-term) alcohol risk (2009 NHMRC guidelines); and
  • single occasion (short-term) alcohol risk (2009 NHMRC guidelines).

Details of how outputs were derived based on these guidelines can be found in the Glossary via the Explanatory Notes tab of National Aboriginal and Torres Strait Islander Social Survey, 2014–15 (cat no. 4714.0).

Comparison to the 2008 NATSISS

The questions on alcohol consumption and the measures used to indicate risk level are comparable for the 2008 and 2014–15 surveys. However, alcohol data for the 2002 and 2008 surveys have been revised since the original 2008 NATSISS publication. Users should therefore refer to Revised 2002 and 2008 NATSISS alcohol data by risk level, Aboriginal and Torres Strait Islander peoples, 2013 (cat no. 4714.0.55.005) when making comparisons for these data items.

Substance use

Substance use refers to the misuse of prescription drugs and/or the use of illicit drugs. The collection method for this topic varied between non-remote and remote areas. Due to the potentially sensitive nature of the questions, responses to these questions were voluntary. In non-remote areas, people answered questions through the voluntary self-completion of a questionnaire on the interviewer's laptop computer. In remote areas, people were personally interviewed.

Permission from a parent/guardian was required before people aged 15–17 years could answer any questions. The parent/guardian was able to view the uncompleted form/content of the questions, however, they were not allowed to see/hear the responses, as these are confidential and protected under the Census and Statistics Act.

People aged 15 years and over were asked whether they had used the following types of prescription drugs for non-medical purposes in the 12 months prior to interview:
  • pain killers or analgesics;
  • tranquilisers or sleeping pills; and
  • methadone.

People were also asked whether, in the 12 months prior to the interview, they had:
  • used marijuana, hashish or cannabis resin;
  • sniffed petrol; and
  • used Kava.

In non-remote areas people were asked whether they had used other inhalants (eg glue, chroming, laughing gas, whippits, nitrous, snappers, poppers, pearlers, rushamines, locker room, bolt, bullet, rush, climax, red gold, aerosols) in the 12 months prior to interview. In remote areas this was worded to ask whether people had 'sniffed glue, solvents, paint thinners, aerosols or anything else' in the 12 months prior to interview.

The collection of information on the following types of substance use differed slightly between non-remote and remote areas. In non-remote areas, people were asked a separate question whether they had used each of the following substances in the 12 months prior to interview:
  • amphetamines or speed;
  • heroin;
  • cocaine;
  • LSD or synthetic hallucinogens;
  • naturally occurring hallucinogens;
  • ecstasy or designer drugs; and
  • other.

In remote areas, people were asked if they had used any other other substances that could be injected, sniffed, chewed, smoked or used in some other way in the last 12 months, If a respondent said 'yes' they were asked they were asked 'which ones' from the list above.

If a person said they had used or taken an 'other' type of substance, they were asked to specify what type. These responses were later back-coded where possible.

All questions in the substance use module could be answered 'yes', 'no', or 'prefer not to answer'.

Comparison to the 2008 NATSISS

The questions on illicit substance use in the last 12 months are compatible between the 2008 and 2014–15 surveys. However, collection methods differed slightly in non-remote areas between 2008 and 2014–15. In the 2008 survey, non-remote data was collected via a self-completed paper form, whereas in 2014–15 the module was self-completed electronically on the interviewer's laptop.

In 2008, people in non-remote areas were not asked if they had used or taken an 'other' type of substance.

The following information was collected in 2008, but was not collected in 2014–15:
  • Whether ever used substances;
  • Type of substances ever used; and
  • Number of substances ever used.

Nutrition

Breastfeeding and weaning


Information was collected on the nutrition and feeding experiences of children aged 0–3 years. The child's proxy provided information on whether the child was ever breastfed. If a child was not or if it was unknown if they were breastfed, the proxy was sequenced to later questions about other types of drinks.

If a child aged 0–3 years had been breastfed at some point in their lifetime, the proxy was asked whether the child was still being breastfed. If the proxy did not know, then the proxy was sequenced to later questions about other types of drinks. If the child was not still being breastfed, the proxy was asked how old the child was when they stopped being completely breastfed. Responses could be provided in months or weeks, or they may have said they did not know. Responses were output numerically as a value ranging from 1 to 208 weeks. Where a child was less than one week old when stopped being breastfed, this was coded as 1 week. If the child was less than one week old or the age when they stopped being breastfed was unknown, then the proxy was sequenced to later questions about other types of drinks.

If a child was still being breastfed, the proxy was asked whether the child drank anything other than breast milk. If the child did not or it was unknown, the proxy was sequenced to later questions on solid food for children aged 1–3 years. For children aged less than one year, the proxy was sequenced to questions about sleep.

The proxy was asked whether the child aged 0–3 years regularly drank any other types of drinks, apart from breast milk, based on the following:
  • water;
  • infant formula;
  • milk (eg cow or goat's milk);
  • soy milk;
  • fruit juices;
  • cordial or soft drinks;
  • tea or coffee;
  • herbal drinks;
  • other;
  • don't know; and
  • does not regularly drink other drinks apart from breast milk.

The last option was only available for children still being breastfed. More than one response could be provided.

Proxies of children aged 1–3 years were sequenced to questions on solid food. For children aged less than one year, the proxy was sequenced to questions about sleep.

Fruit and vegetables


Information was collected on the fruit and vegetable consumption of people aged one year and over. For children aged 1–14 years, a proxy provided the responses on behalf of the child. People were asked about their usual consumption of vegetables each day, including fresh, frozen and tinned vegetables.

Responses were based on the following:
  • 1 serve;
  • 2 serves;
  • 3 serves;
  • 4 serves;
  • 5 serves;
  • 6 serves or more;
  • less than one serve; and
  • does not eat vegetables.

People were then asked about their usual consumption of fruit each day, including fresh, dried, frozen and tinned fruit.

Responses were based on the following:
  • 1 serve;
  • 2 serves;
  • 3 serves;
  • 4 serves;
  • 5 serves;
  • 6 serves or more;
  • less than one serve; and
  • does not eat fruit.

In addition to usual daily serves of both vegetables and fruit, the following NATSISS outputs have been created:
  • whether fruit and vegetable consumption met recommended guidelines (2003);
  • whether vegetable consumption met recommended guidelines (2013 guidelines);
  • whether fruit consumption met recommended guidelines (2013 NHMRC guidelines); and
  • whether daily fruit and vegetable intake meets NHMRC 2013 guidelines.

The guidelines above refer to the 2003 Australian Guidelines for all Australians and the 2013 Australian Dietary Guidelines recommended by the National Health and Medical Research Council (NHMRC). The above outputs have been created consistent with those of the 2014–15 National Health Survey. Details of how outputs were derived based on these guidelines can be found in the Glossary via the Explanatory Notes tab of National Aboriginal and Torres Strait Islander Social Survey, 2014–15 (cat no. 4714.0).

Comparison to the 2008 NATSISS

Types of fluids other than breast milk regularly consumed by child was asked in two questions in 2008; firstly, about other types of milk (including infant formula), before asking about all other types of drinks. In 2014–15, regular consumption of all drinks other than breast milk were included in a single question with a condensed list of response options. Response options from 2008 that were omitted 2014–15 were 'evaporated milk' and 'coconut milk'.

Usual fruit and vegetable consumption questions were revised to be consistent with the 2014–15 National Health Survey (cat no. 4364.0.55.001) and data from these questions are unable to be compared with the 2008 NATSISS. In 2008, fruit and vegetable consumption was asked of children aged 1–14 years only using a different question set.

The following information was collected in 2008, but was not collected in 2014–15:
  • Number of days per week child usually eats fruit;
  • Number of days per week child usually eats vegetables;
  • Age child regularly drank types of milk (weeks) (excluding breast milk);
  • Whether infant ever given solid food; and
  • Age infant first regularly given solid food.

Sleep

Information was collected on the sleep habits of children aged 0–14 years. The child's proxy was asked whether in the month prior to interview the child had any trouble getting to sleep or staying asleep at night. The response could be yes, no or don't know. For children aged 0-2 years, an additional response category, does not sleep through the night, was available.

The proxies of children who had trouble getting to sleep or sleeping were then asked about the reason(s) for the difficulty, based on the following:
  • household noise;
  • bedwetting;
  • nightmares;
  • afraid of the dark/to be alone/other fear;
  • over excitement/over stimulation;
  • child goes to bed late;
  • child wakes up early;
  • noisy neighbourhood/community;
  • too hot or too cold;
  • toothache;
  • illness or pain;
  • other; or
  • don't know.

More than one response could be provided.

The proxies of children aged 0–3 years were asked how many other people sleep in the same room as the child. A response of 0 to 30 was possible, or they may have said they did not know. In some instances, the number of people who slept in the same room as the child equalled or exceeded the total number of people identified as living in the household. This may have been due to visitors being included in the count, the child not being excluded from the count, or because the question does not include reference to the 'usual' situation.

Comparison to the 2008 NATSISS

The following information was collected in 2008, but was not collected in 2014–15:
  • Usual sleeping position.