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Age group 12 to 17 years

Healthy behaviours

Healthy behaviours, such as eating well or exercising, contribute to young people’s wellbeing. In contrast, risky behaviours, such as the misuse of alcohol or other drugs or engaging in unsafe sexual activity, may have a negative effect on their health and wellbeing.1 The impact is not only on the children and young people themselves, but also on their families and communities who may be affected by these behaviours.

It is imperative to address any health concerns or risky behaviours early in order to improve future health and wellbeing outcomes and quality of life for young people.2

Overview and areas of concern

This indicator considers some key measures of positive health behaviours of young people, which include the consumption of alcohol and other drugs, and engagement in sexual activities.

Evidence suggests that the earlier young people commence consuming alcohol and other drugs, the greater the likelihood of dependency and associated problems in later life.1,2,3  Good sexual health is also important for young people’s physical health and overall wellbeing and it is critical that young people are well informed and supported to make healthy choices.

Data overview

The rates of alcohol use in young people aged 12 to 17 years has declined steadily over the past thirty years in WA. Furthermore, the number of young people in WA who have never consumed alcohol has increased from just under one in ten (9%) in 1984 to three in five (38.3%) young people in 2017.

Prevalence and recency of alcohol use for students aged 12 to 17 years, in per cent, WA, 1984 to 2017

Source: Mental Health Commission National Drug Strategy, 2017 ASSAD Alcohol Bulletin, WA Government.

Research indicates that there has been a significant decrease in both Aboriginal and non-Aboriginal young people smoking tobacco in the last decade.

Birth rates for Aboriginal and non-Aboriginal young mothers aged 15 to 19 years in WA has been decreasing over the last 20 years.

Areas of concern

While overall trends highlight that illicit drug use is declining, almost one in five (18.1%) young people in WA reported having ever used an illicit drug in 2017.

Limited data exists on the sexual understandings or experiences of WA young people.

A majority (61.6%) of sexually active Australian young people do not always use a condom during sex and are at risk of contracting a sexually transmissible infection.  

Endnotes

  1. Australian Research Alliance for Children and Youth (ARACY) 2018, ARACY Report Card 2018: The Wellbeing of Young Australians, ARACY, p. 30.
  2. Australian Institute of Health and Welfare (AIHW) 2016, Australia’s health 2016 – Chapter 5.4 Health of young Australians, Australia’s health series no 15, Cat no AUS 199, AIHW.
  3. National Health and Medical Research Council (NHMRC) 2009, Australian guidelines to reduce health risks from drinking alcohol, NHMRC, p. 63.
  4. Stiby A et al 2015, Adolescent cannabis and tobacco use and educational outcomes at age 16: birth cohort study, Society for the Study of Addiction, Vol 110.
  5. Substance Abuse and Mental Health Services Administration 2013, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No (SMA) 13-4795, Substance Abuse and Mental Health Services Administration, p. 79.
Measure: Alcohol consumption

Research indicates alcohol can adversely affect brain development in adolescents and be linked to health complications and alcohol-related complications later in life.Chronic health conditions linked to alcohol include heart problems, cancer and liver damage.2 Alcohol is also a contributing factor to the three leading causes of death among adolescents – unintentional injuries, homicide and suicide.3 Young people’s alcohol use is also associated with increased risk-taking behaviour including risky sexual behaviour, sexual coercion, drug use, anti-social behaviour, violence and self-harm.

It is therefore critical to focus on reducing risk factors that contribute to young people drinking, to improve the health and wellbeing outcomes for young people in Australia.

The National Health and Medical Research Council (NHMRC)’s guidelines specify that the safest option for children and young people under the age of 18 years is to consume no alcohol at all. It specifically states that young people under 15 years are at greatest risk from drinking alcohol.4

The Australian Secondary Students’ Alcohol and Drug (ASSAD) survey is a national survey of young people’s substance use conducted in high schools around Australia every three years. It surveys approximately 20,000 young people aged 12 to 17 years. The following has been produced by the Mental Health Commission reporting WA results from the 2017 survey.

Prevalence and recency of alcohol use for students aged 12 to 17 years, in per cent, WA, 1984 to 2017

Never drank

Past year

Past month

Past week

1984

8.8

79.8

50.0

33.5

1987

7.7

72.5

50.8

37.7

1990

12.1

71.0

43.9

32.4

1993

10.3

70.8

43.7

30.2

1996

10.3

74.2

47.0

33.5

1999

9.9

74.4

50.6

36.2

2002

12.0

73.1

49.6

33.3

2005

12.3

65.2

43.4

39.0

2008

15.8

63.9

40.2

23.6

2011

23.9

53.2

29.5

17.6

2014

31.5

44.2

23.7

13.9

2017

38.3

41.0

23.3

14.5

Prevalence and recency of alcohol use for students aged 12 to 17 years, in per cent, WA, 1984 to 2017

Source: Mental Health Commission National Drug Strategy, 2017 ASSAD Alcohol Bulletin, WA Government.

According to the ASSAD data results, the rates of alcohol use by young people aged 12 to 17 years has declined steadily over the past thirty years in WA.

WA high school students who had consumed alcohol in the past week has reduced to 14.5 per cent in 2017 in comparison to 33.5 per cent in 1984. Furthermore, the reported number of high school students in WA that have never consumed alcohol has increased from nine per cent in 1984 to 38.3 per cent in 2017.

These results may reflect strategies that have been developed to reduce alcohol consumption. These strategies include increasing the price of alcohol, limiting physical availability and educating children and young people on the health and social consequences of alcohol consumption.5,6

Prevalence and recency of alcohol use for students by age, in per cent, WA, 2017

12 years

13 years

14 years

15 years

16 years

17 years

Never drank

62.2

50.1

37.5

30.6

24.6

13.5

Past year

16.0

26.3

35.5

47.9

59.6

76.0

Past month

6.6

12.4

16.1

25.5

35.5

57.6

Past week

2.8

8.0

9.9

14.9

19.0

43.1

Source: Mental Health Commission National Drug Strategy, 2017 ASSAD Alcohol Bulletin, WA Government.

Prevalence and recency of alcohol use for students by age, in per cent, WA, 2017

Source: Mental Health Commission National Drug Strategy, 2017 ASSAD Alcohol Bulletin, WA Government.

When the data is broken down by age there are large differences in alcohol use. The proportion of young people consuming alcohol increases steadily as young people age.

This pattern in the initiation of alcohol consumption supports results in the National Drug Strategy Household Survey where participants reported first drinking alcohol at the age of 15.7 (2013) and 16.1 (2016) years across Australia.7

The NHMRC guidelines do not have risky drinking guidelines for young people, as all alcohol consumption is considered detrimental to their health and wellbeing. However, single occasion risky drinking is believed to be the most common form of risky drinking as most young people do not drink regularly. For adults, risky drinking on a single occasion is more than four standard drinks.8 In general, surveys of young people report against the adult single occasion risky drinking guidelines.

The National Drug Strategy Household Survey (NDSHS) is a triennial survey that in 2016 collected information on drug use patterns, attitudes and behaviours from approximately 24,000 people across Australia.9 It is reported by the Australian Institute of Health and Welfare (AIHW).

Proportion of young people aged 12 to 17 years at risk of injury on a single occasion of drinking at least monthly by jurisdiction, in per cent, 2010 to 2016, Australia

2010

2013

2016

NSW

12.6

7.1

4.8*

VIC

15.3

9.1

4.7*#

QLD

15.3

10.0

8.5

WA

13.7

12.3*

1.4#**

SA

13.4*

4.5*

6.8*

Tas

12.3*

7.9**

3.8**

ACT

21.6*

12.4*

4.6**

NT

12.8*

12.5*

9.8**

Australia

14.1

8.7

5.4#

Source: Australian Institute of Health and Welfare 2018, Alcohol, tobacco and other drugs in Australia: Populations, Table S3.38 Alcohol consumption (2009 guidelines), Additional age groups, 2010 to 2016

*Estimate has a relative standard error of 25 per cent to 50 per cent and should be used with caution

** Estimate has a high level of sampling error (relative standard error of 51% to 90%), meaning that it is unsuitable for most uses.

# Statistically significant change between 2013 and 2016

This national data shows a reduction in single occasion risky drinking from 2010 to 2016 across all states for young people aged 12 to 17 years. There was a statistically significant reduction in single occasion risky drinking from 2013 to 2016 for WA young people from 12.3 per cent to 1.4 per cent, although it should be noted that there is a high level of sampling error associated with these figures.

In 2016, WA young people had the lowest level of single occasion risky drinking (subject to the sampling error) across all jurisdictions, this will be monitored in the future to determine the accuracy of this result.

The high sampling error across almost all jurisdictions in 2016 is of concern, this suggests that the sample sizes were not sufficient to provide valid and reliable estimates for this critical age group by jurisdiction.

The data below from the Australian Secondary Students’ Alcohol and Drug Survey reflects responses from the high risk group of 13.9 per cent of WA young people who had reported consuming alcohol in the last seven days in 2014. Risky drinking is measured as per the recommended adult drinking guidelines; that is, more than four standard drinks on a single occasion.

Prevalence of single occasion risky drinking for students who drank in the last week by age and gender, per cent of risky drinkers, WA, 2014

13 years

14 years

15 years

16 years

17 years

Female

19.0

11.9

28.7

36.1

32.6

Male

16.5

36.5

35.8

49.5

47.3

Total

17.7

25.4

32.6

43.5

40.0

Prevalence of single occasion risky drinking for students who drank in the last week by age and gender, per cent, WA, 2014

Source: Mental Health Commission National Drug Strategy, 2014 ASSAD Alcohol Bulletin

There is a clear difference in risky drinking practices between male and female young people. In 2014, of the 13.9 per cent of young people in WA who reported consuming alcohol in the past seven days, male young people are more likely to be engaging in risky drinking than female young people. The largest gender difference was between 14 year-old male young people (36.5%) and female young people (11.9%).10

The NHMRC guidelines state there is a high level of health risk associated with the consumption of any alcohol for ages 15 years and under, therefore many of these young people are consuming alcohol at a very risky level.

While there has been a welcome increase in the proportion of young people not drinking, for those WA young people who are drinking regularly there has been an increase in the proportion drinking at risky levels on a single occasion from 1984 (16.1%) to 2017 (29.2%).11

However, the proportion of students drinking at risky levels for single occasion harm has not changed significantly since 1996 (27.0%).12

The Young Australians’ Alcohol Reporting System (YAARS) is a national research project that aims to provide insight into the risky drinking patterns of Australian young people. In late 2016 and early 2017, a total of 965 14 to 19 year-olds were interviewed or surveyed in WA. From this group, 479 young people were identified as ‘risky drinkers’.13  

For WA young ‘risky drinkers’ the most popular beverage type was spirits, with 76 per cent of young people drinking spirits at their last risky drinking session. Female young people were more likely to drink spirits (80%) and ready to drink beverages (46%), while male young people were also more likely to drink spirits (71%) followed by beer (67%).14

Parental use of alcohol can have a significant impact on the health and wellbeing of children and young people in their care. For many young people, the family environment is their first introduction to alcohol, with attitudes and behaviours associated with drinking being modelled by carers or parents in the young person’s home. Research has highlighted a parents’ drinking behaviour is positively correlated with adolescents’ use of alcohol.15

In 2011, the Commissioner for Children and Young People consulted with WA young people aged 14 to 17 years about their views on alcohol. More than half of the young people reported that their parents were a significant influence on their decisions about alcohol consumption.16

In the 2017 ASSAD survey, WA young people aged 12 to 17 years who had reported drinking alcohol in the last week also recorded the sources of their alcohol supply. Results highlighted that one in three WA young people sourced their alcohol from their friends (33.6%) and 22.7 per cent sourced it from their parents. A high proportion (15.9%) of 12 to 15 year-olds reported taking alcohol from home without permission.17

Of particular concern is that 24.7 per cent of WA young people aged 12 to 15 years who reported drinking alcohol reported their parents gave it to them.

The Australian Institute of Family Studies conduct the Longitudinal Study of Australian Children and in 2016 it explored parental influences on adolescent’s alcohol use. Results indicated a 10 per cent statistically significant increase in drinking levels for young people who had a mother who drank some alcohol and a 5 per cent increase in drinking levels for young people who had a father who drank some alcohol.18

In a two-parent household the prevalence of a young person having consumed alcohol in the last 12 months was approximately 9 per cent where neither parents drank at a risky level,19 16 per cent where the father drank at a risky level and 23 per cent where both parents reported regularly consuming alcohol.20

Both Aboriginal and non-Aboriginal children and young people in Australia consume alcohol. There are however, significant social factors that contribute to alcohol consumption and increased risky drinking levels among Aboriginal communities. These factors are economic marginalisation, discrimination, cultural dispossession and cultural assimilation, family conflict or violence and family history of alcohol misuse.21

The National Drug Strategy Household Survey reports a decline in single occasion risky alcohol consumption at least monthly for Aboriginal young people and adults (people aged 14 years and over, including adults) from 2010 (45.5%) to 2016 (35.0%). Furthermore, there was an increase in the proportion of Aboriginal people aged 14 years and over who were drinking at low risk levels (20.9% in 2010 compared to 23.0% in 2016).22

In 2012-13, the Australian Bureau of Statistics (ABS) conducted the Australian Aboriginal and Torres Strait Islander Health Survey which included a nationally representative sample of around 13,000 Aboriginal people in remote and non-remote locations. This survey compared alcohol consumption for young people aged 15 to 17 years to the NHMRC guidelines for single occasion risky drinking.

Proportion of young people aged 15 to 17 years consuming alcohol: short-term/single occasion risk by Aboriginal status, in per cent, Australia, 2012-13

Aboriginal

Non-Aboriginal

Did not exceed NHMRC guidelines

17.3#

24.9#

Exceeded NHMRC guidelines

23.7

22.4

Consumed alcohol 12 or more months ago

5.7#

2.6*#

Never consumed alcohol

52.0

49.6

Source: Australian Bureau of Statistics, Australian Aboriginal and Torres Strait Islander Health Survey, Table 14 Alcohol Consumption – Short term or single occasion risk by age, Indigenous status and sex, 2012-13 – Australia

* Proportion has a relative standard error between 25 per cent and 50 per cent and should be used with caution.

# The difference between the rate for Aboriginal people and the comparable rate for non-Aboriginal people is statistically significant.

The results show that there was little difference between the proportion of Aboriginal and non-Aboriginal young people aged 15 to 17 years who had exceeded the NHMRC guidelines (23.7% of Aboriginal young people compared to 22.4% of non-Aboriginal young people).

At the same time, 52 per cent of Aboriginal young people had never consumed alcohol compared to 49.6 per cent of non-Aboriginal young people. Furthermore, a higher proportion of Aboriginal young people aged 15 to 17 years consumed alcohol over 12 months ago, but had not consumed alcohol in the last year (5.7% compared to 2.6%).

However, of young people who had consumed alcohol in the last 12 months, a significantly lower proportion of Aboriginal young people did not exceed the guidelines (17.3% of Aboriginal young people and 24.9% of non-Aboriginal young people).

There is no data available on alcohol consumption for Aboriginal children and young people in WA.

Lesbian, gay, bisexual, trans and intersex children

For information on LGBTI young people’s consumption of alcohol, tobacco and other drugs refer to the Measure: Use of other drugs.

Culturally and linguistically diverse young people

For information on culturally and linguistically diverse young people’s consumption of alcohol, tobacco and other drugs refer to the Measure: Use of other drugs.

Young people in the youth justice system

For information on the consumption of alcohol, tobacco and other drugs of young people in youth detention refer to the Measure: Use of other drugs.

Endnotes

  1. National Health and Medical Research Council (NHMRC) 2009, Australian guidelines to reduce health risks from drinking alcohol, NHMRC, p. 61.
  2. Ibid, p. 120.
  3. Australian Drug Foundation (ADF) 2018, Alcohol and young people, ADF.
  4. National Health and Medical Research Council (NHMRC) 2009, Australian guidelines to reduce health risks from drinking alcohol, NHMRC, p. 4.
  5. Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: detailed findings, Drug Statistics series no 31 Cat no PHE 214, AIHW, p. 45.
  6. Department of Health 2017, National Drug Strategy 2017-2026, Australian government.
  7. Australian Institute of Health and Welfare (AIHW), Alcohol, tobacco & other drugs in Australia, Table S3.39 Table S3.39: Age of initiation, recent drinkers and ex–drinkers aged 14–24, 1995 to 2016 (years), AIHW.
  8. National Health and Medical Research Council (NHMRC) 2009, Australian guidelines to reduce health risks from drinking alcohol, NHMRC.
  9. [1] Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: detailed findings, AIHW, p. 3 and 134.
  10. Mental Health Commission (MHC) [undated], Alcohol trends in Western Australia 2014: Australian school students alcohol and drug survey, MHC. This analysis was not provided in the 2017 data for WA.
  11. Mental Health Commission (MHC) 2019, Alcohol trends in Western Australia 2017: Australian school students alcohol and drug survey, MHC.
  12. Ibid.
  13. Pandzic I et al 2017, Young Australians Alcohol Reporting System (YAARS) Report 2016/17 – Western Australian main findings, National Drug Research Institute, Curtin University, p. 7.
  14. Pandzic I et al 2017, Young Australians Alcohol Reporting System (YAARS) Report 2016/17 – Western Australian main findings, National Drug Research Institute, Curtin University, p. 13.
  15. Homel J and Warren D 2016, Parental influences on adolescent alcohol use, in The Longitudinal Study of Australian Children Annual Statistical Report 2015, Australian Institute of Family Studies.
  16. Commissioner for Children and Young People WA 2011, Speaking out about: Alcohol-related harm on children and young people, Commissioner for Children and Young People WA.
  17. Mental Health Commission (MHC) 2019, Alcohol trends in Western Australia 2017: Australian school students alcohol and drug survey, MHC.
  18. Homel J and Warren D 2016, Parental influences on adolescent alcohol use, in The Longitudinal Study of Australian Children Annual Statistical Report 2015, Australian Institute of Family Studies, p. 72-73.
  19. Risky drinking was categorised as five or more drinks on a single occasion, at least twice a month.
  20. Homel J and Warren D 2016, Parental influences on adolescent alcohol use, in The Longitudinal Study of Australian Children Annual Statistical Report 2015, Australian Institute of Family Studies, p. 73.
  21. Australian Institute of Health and Welfare (AIHW) 2011, Substance use among Aboriginal and Torres Strait Islander people, AIHW, p. 11.
  22. Australian Institute of Health and Welfare (AIHW), Alcohol, tobacco & other drugs in Australia, Table S3.1 Drug use by Indigenous status, people aged 14 and over, 2010 to 2016, AIHW.
Measure: Tobacco smoking

Smoking greatly increases the risk of many cancers, cardiovascular disease, chronic obstructive pulmonary disease and other respiratory diseases, peripheral vascular disease and many other serious medical conditions.1 Research has shown that the younger a person starts smoking, the less likely they are to stop.2

The National Drug Strategy Household Survey (NDSHS) is a triennial survey that in 2016 collected information from approximately 24,000 people across Australia. In this survey participants were asked about their drug use patterns, attitudes and behaviours.

The NDSHS reports on the proportion of people who have ‘never smoked’, however this is actually people who have never smoked 100 cigarettes.

There is no measure of young people who have never smoked in the NDSHS.

The WA Mental Health Commission reports some limited WA results for young people from the NDSHS survey. WA data is not yet available for the 2016 NDSHS survey.

Proportion of young people aged 14 to 19 years who had never smoked 100 cigarettes, in per cent, WA, 2007 to 2013

Never smoked 100 cigarettes*

2007

89.3

2010

84.6

2013

88.0

Source: Mental Health Commission, National Drug Strategy Household Survey 2013: 2013 NDSHS WA Supplementary Tables, Table 12 Tobacco smoking status, persons aged 14 years or older by age group and sex, WA 2007 to 2013.

* Never smoked 100 cigarettes (manufactured and/or roll-your-own) or the equivalent amount of tobacco.

The proportion of WA young people aged 14 to 19 years who had never smoked over 100 cigarettes has not changed significantly from 89.3 per cent in 2007 to 88.0 per cent in 2013. This is consistent with the Australian result in 2013 of 89.3 per cent of young people aged 14 to 19 years never smoking over 100 cigarettes.3 

Across Australia, there has been a reduction in the proportion of young people aged 14 to 19 years smoking on a daily basis (6.9% in 2010 to 3.0% in 2016).

Proportion of young people aged 14 to 19 years smoking on a daily basis by state/territory, in per cent, Australia, 2010 to 2016

2010

2013

2016

NSW

6.5

5.9

2.9*

VIC

7.9

7.0

1.8*#

QLD

7.3

8.0

4.7*

WA

6.9*

9.9*

0.9**#

SA

6.4*

3.0**

4.9*

Tas

4.2**

9.7*

4.9**

ACT

3.6**

6.7*

4.0*

NT

6.4*

15.0*

4.8**

Australia

6.9

7.0

3.0#

Source: Australian Institute of Health and Welfare, National Drug Strategy Household Survey 2016: detailed findings, Table 7.5 Daily tobacco smoking status, people aged 12 years or older, by age and state/territory, 2010 to 2016

* Estimate has a relative standard error of 25 per cent to 50 per cent and should be used with caution.

** Estimate has a high level of sampling error (relative standard error of 51% to 90%), meaning that it is unsuitable for most uses.

# Statistically significant change between 2013 and 2016.

In 2010 and 2013, WA young people had a relatively high rate of daily smoking for young people aged 14 to 19 years across Australia. However, this is subject to a high relative standard error. In 2016, the WA data has a relative standard error of greater than 51 per cent, and is therefore not considered suitable for analysis.

It should be noted that in 2016 the data across all jurisdictions was subject to a high margin of error – this suggests that the sample sizes were not sufficient to provide reliable estimates for young people by jurisdiction.

There has been a steady increase in the proportion of young people never smoking more than 100 cigarettes since 2004, including a statistically significant increase in Australian young people aged 12 to 17 years who have never smoked more than 100 cigarettes from 2013 (94.7%) to 2016 (97.6%).

Proportion of young people aged 12 to 17 years by tobacco smoking status, in per cent, Australia, 2004 to 2016

2004

2007

2010

2013

2016

Daily

5.2

3.2

2.5

3.4

1.5*#

Occasional

1.5

0.9*

1.3

1.6*

0.6*#

Ex-smoker

1.7

0.9*

1.6

0.3*

0.4*

Never smoked 100 cigarettes

91.6

95.0

94.6

94.7

97.6#

Source: Australian Institute of Health and Welfare, Alcohol, tobacco and other drugs in Australia, Table S2.17 Tobacco smoking status, people aged 12 and over, by age and sex, 2001 to 2016 (per cent)

* Estimate has a relative standard error of 25 per cent to 50 per cent and should be used with caution.

# Statistically significant change between 2013 and 2016.

Proportion of young people aged 12 to 17 years by tobacco smoking status, in per cent, Australia, 2004 to 2016

Source: Australian Institute of Health and Welfare, Alcohol, tobacco and other drugs in Australia, Table S2.17 Tobacco smoking status, people aged 12 and over, by age and sex, 2001 to 2016

The Australian Secondary Students’ Alcohol and Drug (ASSAD) survey is a national survey of young people’s substance use conducted in high schools around Australia every three years. It surveys approximately 20,000 young people aged 12 to 17 years.

According to results from the 2017 ASSAD survey, 83 per cent of Australian secondary students aged 12 to 17 years had never smoked.

Proportion of Australian high school students who have smoked in the past week, past month, past year or lifetime, by age, in per cent, Australia, 2017

12

13

14

15

16

17

12-17

Never smoked

95.0

93.0

88.0

78.0

72.0

65.0

83.0

More than 100 cigarettes in lifetime

<1.0

<1.0

1.0

3.0

4.0

6.0

2.0

Past year

3.0

5.0

9.0

17.0

23.0

28.0

13.0

Past month

2.0

2.0

5.0

9.0

13.0

16.0

7.0

Current (past 7 days)

2.0

2.0

4.0

6.0

8.0

11.0

5.0

Committed smokers
(3+ days in past 7 days)

1.0

1.0

2.0

3.0

4.0

6.0

3.0

Source: Department of Health, Secondary school students’ use of tobacco, alcohol and other drugs in 2017, Table 3.1 Percentage of secondary students in Australia who have smoked in the past week, past month, past year, or lifetime, by age and sex

This survey also reports that five per cent of young people aged 12 to 17 years had smoked in the past week.4

Unsurprisingly the proportion of young people smoking increases as they get older. The lowest proportion of students who had smoked in the past month was 12 year-olds (2.0%), which increased with age (16.0% for 17 year-olds).

Consistent with the NDSHS survey this survey reported a significant drop in the proportion of Australian high school students smoking from 1999 to 2017. This was across all categories of smoking (ever smoking, smoking in the past year, past month, past week, as well as committed and daily smokers).5

The ASSAD survey reports that male and female Australian young people smoke/do not smoke in similar proportions, although male young people appear slightly more likely to smoke.

Proportion of Australian secondary students aged 12 to 17 years by smoking status by gender, in per cent, Australia, 2017

Male

Female

Never smoked

82.0

83.0

More than 100 cigarettes in lifetime

3.0

2.0

Past year

13.0

13.0

Past month

8.0

7.0

Current (past 7 days)

5.0

4.0

Committed smokers
(3+ days in past 7 days)

3.0

2.0

Source: Department of Health, Secondary school students’ use of tobacco, alcohol and other drugs in 2017, Table 3.1 Percentage of secondary students in Australia who have smoked in the past week, past month, past year, or lifetime, by age and sex, ASSAD 2017

Proportion of Australian secondary students aged 12 to 17 years who have smoked in the past week, past month, past year or lifetime by gender, in per cent, Australia, 2017

Source: Department of Health, Secondary school students’ use of tobacco, alcohol and other drugs in 2017, Table 3.1 Percentage of secondary students in Australia who have smoked in the past week, past month, past year, or lifetime, by age and sex

In contrast, WA data from the NDSHS survey disaggregated by gender reports that in 2013 female young people aged 14 to 19 years were more likely to have never smoked more than 100 cigarettes than male young people of the same age. This may reflect a higher proportion of WA male young people trialling smoking than WA female young people.

Proportion of young people aged 14 to 19 years who had never smoked more than 100 cigarettes, in per cent, WA, 2007 to 2013

2007

2010

2013

Male

88.7

87.3

78.4

Female

90.1

81.7

98.0#

Total

89.3

84.6

88.0

Source: Mental Health Commission, National Drug Strategy Household Survey 2013: 2013 NDSHS WA Supplementary Tables, Table 12 Tobacco smoking status, persons aged 14 years or older by age group and sex, WA 2007 to 2013.

# Estimate is significantly higher than the 2010 result.

The average age at which Australian young people aged 14 to 24 years smoked their first full cigarette has steadily risen from 1995 (14.2 years) to 2016 (16.3 years).

Age of initiation of tobacco use for young people aged 14 to 24 years by age in years and gender, in per cent, Australia, 1995 to 2016

1995

1998

2001

2004

2007

2010

2013

2016

Male

14.2

14.3

14.5

14.8

14.9

15.6

16.0

16.6#

Female

14.2

14.2

14.2

14.4

14.8

15.1

15.7

16.0

Total

14.2

14.2

14.3

14.6

14.9

15.4

15.9

16.3#

Source: Australian Institute of Health and Welfare, Alcohol, tobacco and other drugs in Australia: Populations, Table S3.31 Age of initiation of tobacco use, people aged 14-24, 1995 to 2016 (years)

# Statistically significant change between 2013 and 2016.

Age of initiation of tobacco use for young people aged 14 to 24 years by age in years and gender, in per cent, Australia, 1995 to 2016

Source: Australian Institute of Health and Welfare, Alcohol, tobacco and other drugs in Australia: Populations, Table S3.31 Age of initiation of tobacco use, people aged 14-24, 1995 to 2016 (years)

Australian male young people were generally slightly older than Australian female young people when they smoked their first cigarette. Of note, there was a statistically significant increase in age of initiation for both male young people (16 years to 16.6 years) and female young people (15.9 years to 16.3 years) between 2013 and 2016.

There is no data on the average age of initiation for WA young people.

Aboriginal people aged 14 years and over (including adults) are more than twice as likely to smoke tobacco on a daily basis than non-Aboriginal people (27.4% compared to 11.8%).6

In 2012-13, the Australian Bureau of Statistics (ABS) conducted the Australian Aboriginal and Torres Strait Islander Health Survey which included a nationally representative sample of around 13,000 Aboriginal people in remote and non-remote locations.

In this survey, 17.6 per cent of Aboriginal young people aged 15 to 17 years reported smoking tobacco daily, which was almost four times that reported by non-Aboriginal young people (3.9%). Further to this, there was a statistically significant difference between Aboriginal (76.7%) and non-Aboriginal (90.6%) young people who reported never having smoked tobacco.

Proportion of young people aged 15 to 17 by smoking status and Aboriginal status, in per cent, Australia, 2012-13

Aboriginal

Non-Aboriginal

Never smoked

76.7#

90.6#

Daily smoker

17.6#

3.9#

Ex-smoker

4.3*

4.0

Source: Australian Bureau of Statistics, Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13, Table 10.3 Smoker status by age, Indigenous status and sex, Proportion of persons 2012-2013 Australia

* Proportion has a relative standard error between 25 per cent and 50 per cent and should be used with caution

# The difference between the rate for Aboriginal and Torres Strait Islander people and the comparable rate for non-Indigenous people is statistically significant.

There has however been a significant increase in Aboriginal young people not smoking over the last 25 years. In 1994, 70.3 per cent of Aboriginal young people aged 15–17 years did not smoke; by 2014–15 this had increased to 82.6 per cent.7

Proportion of Aboriginal young people aged 15 to 17 years not smoking, in per cent, Australia, 1994 - 2015

1994

2002

2008

2012-2013

2014-2015

Male

68.2

65.8

79.5

78.3

75.2

Female

72.4

67.6

76.2

84.0

87.9

Total

70.3

66.7

77.9

81.0

82.6

Source: Australian Bureau of Statistics, 4737.0 - Aboriginal and Torres Strait Islander Peoples: Smoking Trends, Australia, 1994 to 2014-15, Table 5.3 Smoker status, by remoteness by sex, Aboriginal and Torres Strait Islander persons aged 15–17 years – 1994 to 2014–15 (proportion)

Proportion of Aboriginal young people aged 15 to 17 years not smoking, in per cent, Australia, 1994 – 2015

Source: Australian Bureau of Statistics, 4737.0 - Aboriginal and Torres Strait Islander Peoples: Smoking Trends, Australia, 1994 to 2014-15, Table 5.3 Smoker status, by remoteness by sex, Aboriginal and Torres Strait Islander persons aged 15–17 years – 1994 to 2014–15 (proportion)

In general, male Aboriginal young people are more likely to smoke than female Aboriginal young people. While the proportion of female Aboriginal young people not smoking has consistently increased since 2002, the proportion of male Aboriginal young people not smoking has decreased since 2008.

Aboriginal young people in remote locations are more likely to smoke than those in non-remote locations (23.5%8 in remote locations compared to 15.6% in non-remote locations in 2014-15).

No data is available on the tobacco use of Aboriginal young people in WA.

Lesbian, gay, bisexual, trans and intersex children

For information on LGBTI young people’s consumption of alcohol, tobacco and other drugs refer to the Measure: Other drugs.

Culturally and linguistically diverse young people

For information on culturally and linguistically diverse young people’s consumption of alcohol, tobacco and other drugs refer to the Measure: Other drugs.

Young people in the youth justice system

For information on the consumption of alcohol, tobacco and other drugs of young people in youth detention refer to the Measure: Other drugs.

Endnotes

  1. Office of the Surgeon General (US) 2004, The Health Consequences of Smoking: A Report of the Surgeon General, Center for Disease Control and Prevention (US), p. 1.
  2. Khuder et al 1999, Age at smoking onset and its effect on smoking cessation, Addictive behaviours, Vol 24, no 5, p. 95.
  3. Mental Health Commission [undated], National Drug Strategy Household Survey 2013: 2013 NDSHS WA Supplementary Tables, Table 12 Tobacco smoking status, persons aged 14 years or older by age group and sex, WA 2007 to 2010 and Australia 2013.
  4. Guerin N and White V 2018, ASSAD 2017 Statistics & Trends: Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances, Cancer Council Victoria, p. 15.
  5. Ibid, p. 16.
  6. Australian Institute of Health and Welfare 2018, Alcohol, tobacco and other drugs in Australia, Table S3.1 Drug use by Indigenous status, people aged 14 and over, 2010 to 2016 (per cent), AIHW.
  7. Australian Bureau of Statistics (ABS) 2017, 4737.0 - Aboriginal and Torres Strait Islander Peoples: Smoking Trends, Australia, 1994 to 2014-15, ABS.
  8. Estimate has a relative standard error of 25 per cent to 50 per cent and should be used with caution.
Measure: Use of illicit drugs

Illicit drug use is a major cause of preventable disease and illness in Australia. Over 80 deaths in WA are attributable to illicit drug use annually, and in 2010 WA residents were hospitalised 5,644 times for conditions related to drug use, costing approximately $30m.1

Aside from the considerable health and behavioural problems associated with illicit drug use, children and young people are at particular risk of harm from drug use, as it negatively impacts the development of neurological pathways and is strongly associated with long-term drug dependency issues.2

The National Drug Strategy Household Survey (NDSHS) is a triennial survey that in 2016 collected information from approximately 24,000 people across Australia. In this survey participants were asked about their drug use patterns, attitudes and behaviours.3

Unfortunately, this report is limited to households and therefore does not include some vulnerable groups of young people at high risk of drug use, such as those who are homeless or institutionalised.

Proportion of young people aged 12 to 17 years recently using illicit drugs by state/territory, in per cent, Australia, 2010 to 2016

2010

2013

2016

NSW

9.5

11.0

7.1

VIC

10.8

8.8

7.6

QLD

9.4

8.7

9.9

WA

12.6

15.3*

10.9*

SA

14.2*

12.2*

10.8*

Tas

8.5*

17.3*

12.8*

ACT

6.4**

12.7*

13.0*

NT

8.1*

19.6*

16.4**

Australia

10.4

10.8

8.8

Source: Australian Institute of Health and Welfare, National Drug Strategy Household Survey 2016 detailed findings, Table 7.17 Recent illicit use of any drug, people aged 14 years or older, by age and state/territory, 2010 to 2016 (per cent), Age group 12-17 years

Note: In this survey, illicit drugs does not include the misuse of prescription drugs such as tranquilisers.

* Estimate has a relative standard error of 25 per cent to 50 per cent and should be used with caution.

** Estimate has a high level of sampling error (relative standard error of 51% to 90%), meaning that it is unsuitable for most uses.

These results should be considered with caution due to the sampling error, however they highlight that while there was a reduction from 2013, approximately 11 per cent of WA young people had used illicit drugs in 2016, which was higher than the national average (8.8%).

The Australian Secondary Students’ Alcohol and Drug (ASSAD) survey is a triennial national survey of secondary students’ use and attitude towards licit and illicit substances. The 2017 survey included 3,361 WA young people aged from 12 to 17 years from 46 randomly selected government, Catholic and independent schools across the state.4

The following has been produced by the Mental Health Commission reporting WA results from the 2017 survey. 

Prevalence and recency of illicit drug use for students aged 12 to 17 years, in per cent, WA, 1996 to 2017

Lifetime

Past year

Past month

Past week

1996

40.7

36.6

24.2

16.5

1999

39.7

34.2

21.6

13.8

2002

32.7

27.8

16.5

10.4

2005

23.7

19.4

10.4

5.7

2008

19.1

16.4

8.6

5.5

2011

18.6

16.4

9.5

5.9

2014

18.5

16.5

10.1

6.5

2017

18.1

16.1

9.6

5.6

Source: Mental Health Commission, Illicit drug trends in Western Australia: Australian school students alcohol and drug survey, Figure 1: Trends in the use of at least one illicit drug, 1996 - 2017

Prevalence and recency of illicit drug use for students aged 12 to 17 years, in per cent, WA, 1996 to 2017

Source: Mental Health Commission, Illicit drug trends in Western Australia: Australian school students alcohol and drug survey, Figure 1: Trends in the use of at least one illicit drug, 1996 - 2017

In 2017, less than one in five (18.1%) WA students aged 12 to 17 years reported ever using one illicit drug, in comparison to more than two in five (40.7%) students in 1996.5

Cannabis was the primary illicit drug used by WA young people in 1996, with 39.7 per cent of WA young people in 1996 using cannabis in their lifetime.6 This has reduced to 16.8 per cent of WA young people in 2017.7

There has been a significant decrease in the proportion of young people who had used illicit drugs from 1996 to 2017 in the past year (36.6% to 16.1%), past month (24.2% to 9.6%) and past week (16.5% to 5.6%).8

The most commonly used illicit drugs in 2014 among WA young people aged 12 to 17 years in the past year were cannabis (16.4% of all WA young people), tranquilisers (13.4%) and inhalants (10.4%).9 Tranquilisers include sleeping tablets, sedatives and benzodiazepines, such as Valium, Temazepam and Serepax. While inhalants include substances that are sniffed such as glue, paint or spray cans.

In the 2017 survey, 65 per cent of young people who used tranquilisers for non-medicinal purposes reported sourcing them from their parents, however, this may include incorrectly reported prescribed use.10

Prevalence and recency of illicit drug use for secondary students aged 12 to 17 years, per cent of students, WA, 2017

Past week

Past month

Past year

Lifetime

Cannabis

4.8

8.8

15.2

16.8

Tranquilisers*

3.4

6.0

13.9

19.9

Inhalants

3.5

6.0

11.5

15.8

Meth/Amphetamines

0.3

0.6

0.8

1.2

Dexamphetamine*

0.7

1.4

3.0

4.0

Ecstasy

1.0

1.7

4.0

4.7

Hallucinogens

0.7

1.3

3.0

3.5

Steroids*

0.5

0.8

1.6

2.0

Cocaine

0.4

0.7

1.2

1.6

Source: Mental Health Commission, Illicit drug trends in Western Australia: Australian school students alcohol and drug survey, Figure 2: Prevalence and recency of illicit drug use for students

* Non-medical use

Prevalence and recency of illicit drug use for secondary students aged 12 to 17 years, per cent of students, WA, 2017

Source: Mental Health Commission, Illicit drug trends in Western Australia: Australian school students alcohol and drug survey, Figure 2: Prevalence and recency of illicit drug use for students

There is limited data comparing WA young people’s drug use to other states or Australia. The data in the below table has been collated from the national and WA results from the ASSAD survey in 2017.

Prevalence and recency of illicit drug use for secondary students aged 12 to 17 years, in per cent, WA and Australia, 2017

Past month

Lifetime

WA

Australia

WA

Australia

Cannabis

8.8

8.0

16.8

17.0

Tranquilisers*

6.0

6.0

19.9

20.0

Inhalants

6.0

8.0

15.8

18.0

Ecstasy

1.7

2.0

4.7

6.0

Dexamphetamine*

1.4

1.0

4.0

2.0

Hallucinogens

1.3

1.0

3.5

4.0

Steroids*

0.8

1.0

2.0

3.0

Cocaine

0.7

1.0

1.6

2.0

Meth/amphetamines

0.6

1.0

1.2

2.0

Source: Mental Health Commission, Illicit drug trends in Western Australia: Australian school students alcohol and drug survey, and National Drug Strategy, Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2017

The differences between the WA and Australian results are often small and it is not known if the differences are statistically significant.

For each of the most common illicit drugs, except inhalants, Australian young people aged 16 to 17 years are more likely to have used drugs in the past month than young people aged 12 to 15 years.

This age breakdown is not published for WA young people, although it is reasonable to believe the trends will be similar.

Young people aged 12 to 17 years, use of illicit drugs in the past month by age group, in per cent, Australia, 2011 to 2017

12 to 15 years

16 to 17 years

2011

2014

2017

2011

2014

2017

Cannabis

4.0

5.0

5.0

13.0#

13.0

16.0

Tranquilisers

4.0#

5.0

5.0

5.0#

5.0

7.0

Inhalants

8.0

7.0

8.0

4.0#

4.0#

6.0

Ecstasy

1.0

1.0

1.0

2.0#

3.0

4.0

Amphetamine

1.0

1.0

1.0

2.0

2.0

1.0

Cocaine

<1.0

1.0

1.0

1.0

1.0

2.0

Opiate

1.0

1.0

1.0

1.0

1.0

1.0

Hallucinogen

1.0

1.0

1.0

2.0

1.0

2.0

Steroids

1.0

1.0

1.0

1.0

1.0

1.0

Source: National Drug Strategy, Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2017

# Significantly different from the 2017 result.

Young people aged 16 to 17 years, use of illicit drugs in the past month, in per cent, Australia, 2011 to 2017

Source: National Drug Strategy, Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2017

Trend data for Australian young people aged 16 to 17 years highlights a recent increase in usage of the most common drugs, except amphetamine, from 2014 to 2017.11 These results will continue to be monitored to determine if they represent an ongoing trend.

Interestingly, amphetamine use has been decreasing for high school students in WA since 2002.12 These statistics contrast with concerns surrounding a current ‘ice epidemic’ in Australia. Data shows that while across Australia there has not been an increase in users of amphetamines (including ‘speed’ and ‘ice’), there has been an increase in hospitalisations related to methamphetamine use.13 Research suggests that existing amphetamine users are switching from ‘speed’ to ‘ice’, which is a purer form of amphetamine that causes more harm.14 It is believed that this is because price reductions have increased the availability of methamphetamine with higher purity, which is more harmful.15,16

The 2017 ASSAD survey shows that Australian male young people aged 12 to 17 years are slightly more likely to use illicit drugs (including non-prescribed tranquilisers) than female young people, although in the case of most drugs there was minimal difference.17

No data is available on young people’s use of illicit or non-prescribed drug in metropolitan, regional or remote WA.

The National Drug Strategy Household Survey collects information on the factors that influence young people to use an illicit drug.

Factors influencing first use of an illicit drug by young people aged 12 to 17 years, in per cent, Australia, 2013 to 2016

2013

2016

Friends or family member were using it/
offered by friend or family member

40.2

45.0

Thought it would improve mood/to stop feeling unhappy

22.7

17.9

To do something exciting

28.0

20.9

To see what it was like/curiosity

71.4

62.2

To enhance an experience

11.3*

18.3*

Other

2.9**

5.1**

Source: Australian Institute of Health and Welfare, National Drug Strategy Household Survey 2016 detailed findings, Table 5.61 Factors influencing first use of an illicit drug, lifetime users aged 14 years or older, by age and use status, 2013 to 2016 (per cent)

The most commonly cited reason for Australian young people aged 12 to 17 years to use illicit drugs for the first time was to see what it was like and/or curiosity (62.2%). A significant proportion (45.0%) of young people were also influenced by friends or family who were using it or they were offered it by a friend or family member.

Critically, 17.9 per cent of Australian young people aged 12 to 17 years took illicit drugs for the first time because they thought it would improve their mood or stop them feeling unhappy.

There was no further disaggregation by gender, Aboriginal status or geographic location for this data.

Data from the 2016 National Drug Strategy Household Survey for people aged 14 years and over (including adults) shows that Aboriginal people are more likely to use illicit drugs than non-Aboriginal people (27.0% of Aboriginal peoples have been a recent user of illicit drugs compared to 15.3% of non-Aboriginal people).18

However, analysis of data from the ABS, Australian Aboriginal and Torres Strait Islander Health Survey19and the AIHW NDSHS suggests that Aboriginal young people’s use of illicit drugs is similar to non-Aboriginal young people’s use.20 In contrast, Aboriginal peoples are more likely than non-Aboriginal people to use illicit drugs into adulthood. For example, 26.8 per cent21 of Aboriginal people around Australia aged 25 to 34 years have recently used illicit drugs, compared to 22.8 per cent22 of Australian non-Aboriginal people in the same age group.

Young people use illicit drugs for many different reasons; these may include social connection, experimentation, peer pressure, boredom, stress or to feel good. However, experiences of colonisation, intergenerational trauma and disconnection from communities and cultural values and traditions increases the risk that Aboriginal peoples may use illicit drugs.23 For example, in the ABS Australian Aboriginal and Torres Strait Islander Health Survey, Aboriginal young people aged 15 to 24 years are more likely than non-Aboriginal young people to have experienced a death of a family member (30.9% compared to 21.1%) and been unable to get a job (24.3% compared to 11.7%).24

Data from the Australian Aboriginal and Torres Strait Islander Health Survey25 reports that 23.4 per cent of Aboriginal young people aged 15 to 24 years had used marijuana, hashish or cannabis resin in the last year.

Proportion of Aboriginal young people aged 15 to 24 years using illicit drugs in the past 12 months, in per cent, Australia, 2012-13

15 to 24 years

Analgesics and sedatives for non-medical use(e)

4.6

Amphetamines or speed

3.3

Marijuana, hashish or cannabis resin

23.4

Kava

1.9

Other

4.6

Total used substances in last 12 months

27.6

Source: Australian Bureau of Statistics, Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13

There is no data available for the same age group for the Australian population, however in 2016, a similar proportion (23.5%) of all Australian young people aged 18 to 24 years were reported to have used cannabis in the last 12 months.26

No data is available on illicit drug use for Aboriginal children and young people in WA.

Lesbian, gay, bisexual, trans and intersex children

Lesbian, gay, bisexual, transgender and intersex (LGBTI)27 children and young people are at an increased risk of the consumption of tobacco, alcohol or illicit drugs

Having a diverse sexual orientation, diverse gender identity, or being intersex are not in themselves risk factors for tobacco use, alcohol consumption or illicit drug use. However, the issues that affect LGBTI people such as social and cultural beliefs and assumptions about gender and sexuality, including systemic discrimination at an individual, social, political and legal level mean that young people within this group may use alcohol, tobacco and illicit drugs as a form of self-medication.28

Research suggests that LGBTI young people are more likely to use alcohol, tobacco and illicit drugs than heterosexual young people.29

The 2016 NDSHS reported relatively high rates of alcohol, tobacco and illicit drug use among LGBTI participants aged 14 years and older (including adults), with 18.7 per cent smoking tobacco daily compared to 12.1 per cent of heterosexual participants.30 Almost two in every five (37.5%) LGBTI participants reported that they had recently used an illicit drug, compared to 15.1 per cent of heterosexual people. Similar to non-LGBTI people, cannabis (25.4%), pharmaceuticals (12.2%) and ecstasy (8.7%) were the most common choices.31 The NDSHS does not provide data for LGBTI young people.

In Writing themselves in 3 (WTi3): The third national study on the sexual health and wellbeing of same sex attracted and gender questioning young people,32 conducted in 2010, reported that high proportions of LGBTI young people aged 15 to 18 years were consuming alcohol, tobacco and other drugs. The study does not report on a representative sample of the LGBTI community in Australia, however, does provide valuable insights into the experiences of young people within the LGBTI community.

This study found that 48 per cent of participating LGBTI young people consumed alcohol weekly, 23 per cent smoked cigarettes daily, nine per cent used marijuana weekly and four per cent injected drugs.33 While the data is not directly comparable, this contrasts with 31.8 per cent of Australian young people aged 18 to 24 years consuming alcohol weekly, less than 2 per cent of young people aged 14 to 17 years smoking daily and only 3.5 per cent of 14 to 19 year-olds consuming cannabis weekly.

Furthermore, participating female LGBTI young people were more likely to excessively use a range of drugs (including tobacco) than male LGBTI young people.34

In a WA study, 876 WA lesbian and bisexual women aged 15 to 65 years were asked to complete a questionnaire with questions regarding a range of health issues.35 A quarter of the participants (25.7%) reported exceeding four standard drinks on a single occasion at least weekly and one in three participants (33.6%) reported using an illicit drug in the past six months.36 This study also highlighted that just over one-quarter (28.1%) of LGBTI women smoked tobacco, nearly double the rate of the rest of the female population.37

While the data in this study was not representative of the WA LGBTI female population they did find that younger women sampled (aged 15 to 24 years) were even more likely to use alcohol, tobacco and drugs than older LGBTI women.38

For more information on LGBTI children and young people, refer to the Commissioner’s Issues paper: Lesbian, Gay, Bisexual, Trans and Intersex (LGBTI) children and young people.

Culturally and linguistically diverse children

Some children and young people from CALD backgrounds (and their families) experience language barriers, feeling torn between cultures, intergenerational conflict, racism and discrimination, bullying and resettlement stress.39 Refugee young people are at a higher risk of substance misuse due to dealing with loss, trauma, settlement issues, low socioeconomic status, family breakdowns, intergenerational conflict, youth unemployment, difficulties in school, peer influence, desire for acceptance and the lack of culturally appropriate social and recreational activities.40,41

Data and research also suggests that people from culturally and linguistically diverse (CALD) backgrounds often do not seek help for adjustment and acculturation issues.42 For some, the use of legal and illicit drugs can be a way of coping with these challenges.43 However, there are also many protective factors that assist in reducing substance misuse within the CALD and refugee community. These protective factors include spiritual beliefs, cultural norms, and strong community connections.44

There is limited data on substance misuse of CALD young people, however, the data that is available suggests that across all age groups they are less likely to consume alcohol, tobacco and illicit drugs than other Australian people.

The 2016 NDSHS compared the proportion of drug use between English and language other than English (LOTE) speakers aged 14 years and older (including adults).45 The data highlights that a low proportion of LOTE participants (5.9%) are daily smokers in comparison to English speaking participants (13.1%).46 Similarly, 50.4 per cent of LOTE Australians did not drink alcohol, compared to 18.8 per cent of non-LOTE Australians. While, 82.9 per cent of LOTE Australians had never used an illicit drug compared to 52.6 per cent of non-LOTE Australians.47

For more information on CALD children and young people and their wellbeing concerns, refer to the Commissioner’s report This is Me: Stories from culturally and linguistically diverse children and young people

Young people in the youth justice system

Children and young people in the youth justice system are more likely to have mental health issues which increases the risk of substance use.48 The Banksia Hill Detention Centre is the only facility in WA for the detention of children and young people 10 to 17 years of age who have been remanded or sentenced to custody. During 2017-18, approximately 148 children and young people aged between 10 and 17 years were held in the Banksia Hill Detention Centre in WA on an average day.49

In their 2017 inspection of the Banksia Hill facility, the Officer of the Inspector of Custodial Services noted that although the data had indicated the prevalence of mental health and drug and alcohol issues were high, alcohol and other drug counselling services had been removed from the medical centre.50 

Children and young people entering youth detention have the right to be assessed to determine whether they have a physical or intellectual disability, mental health issues, alcohol and other drug issues or experience other forms of vulnerability and to have those needs met.

No data is available on alcohol, tobacco or illicit drugs consumption of WA young people in the youth justice system.

In 2015 the Young People in Custody Health Survey (YPICHS) was conducted in NSW across seven juvenile justice centres. Of the young people invited to participate, 90.4 per cent completed the survey which represented 59.3 per cent of young people in custody at the time across NSW.51

Results from this survey highlighted an overwhelming majority of young people in custody smoked tobacco. Over nine in ten (92.0%) survey participants reported that they had smoked in their lifetime, and four in five participants (85.4%) stated that they had smoked in the last 12 months.52 There were no significant differences in gender or Aboriginality among those who had reported smoking more than 20 cigarettes per day, however, the mean age of smoking initiation among Aboriginal young people was significantly earlier than non-Aboriginal young people (11.7 years and 12.7 years respectively).53

These results are in contrast to the broader population of Australian young people aged 12 to 17 years where 83 per cent have never smoked,54 and the average age of initiation was around 16 years of age.55

Alcohol consumption in the lifetime of the young people in custody was reportedly over nine in ten participants (93.4%), and of those young people, 96.7 per cent had experienced being drunk, with no gender or Aboriginality differences.56 Age of initiation of a young person’s first full serve of alcohol did not differ between male and female young people (13.1 years and 13.4 years), however Aboriginal young people reported initiation at a significantly earlier age (12.7 years).57 Two in every five young people who participated in the survey reported getting drunk weekly prior to custody and just over half of the young people had stated that drinking alcohol had contributed to problems with school, health, friends and family.58

Of those who participated in the survey, a very high 92.5 per cent of young people reported using an illicit drug in their lifetime, there were no gender or Aboriginality differences.59 The most common illicit drugs were cannabis (90.2%), methamphetamine (55.1%) and ecstasy (41.8%).60 Ecstasy, cocaine and hallucinogens were significantly more common in non-Aboriginal young people and Aboriginal young people were more likely to have used methadone or buprenorphine.61 Notably, results highlighted the prevalence of methamphetamine had tripled since 2009, which was 17.7 per cent and had increased to 55.1 per cent in 2015.62

Between 2012 and 2016 the Australian Institute of Health and Welfare compiled a report which contains data from the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) and the Juvenile National Minimum Data Set.63 This longitudinal data collected information on demographics of young people aged 10 to 17 years who were under youth justice supervision and/or had been publicly funded to receive an AOD treatment service.64

It was found that those young people in Australia who were currently under youth justice supervision were thirty times more likely to have accessed an alcohol or drug treatment service in comparison to the rest of the young people in the Australian population.65

Endnotes

  1. Miller J et al 2012, Australian School Student Alcohol and Drug Survey: Illicit Drug Report 2011 – Western Australian results, Surveillance Report Number 9, Drug and Alcohol Office, WA Government, p. 1.
  2. Whyte AJ et al 2018, Editorial: Long-Term Consequences of Adolescent Drug Use: Evidence From Pre-clinical and Clinical Models, Frontiers in behavioral neuroscience, Vol 12, No 83.
  3. Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: detailed findings, Drug Statistics series no 31 Cat no PHE 214, AIHW, p. 3 and 134.
  4. WA Mental Health Commission (MHC) 2019, Bulletin: Ilicit drug trends in Western Australia: Australian school students alcohol and drug survey - 2017, MHC.
  5. Ibid.
  6. Miller J et al 2012, Australian School Student Alcohol and Drug Survey: Illicit Drug Report 2011–Western Australian results, Drug and Alcohol Office Surveillance Report: Number 9. Drug and Alcohol Office, WA Government.
  7. WA Mental Health Commission (MHC) 2019, Bulletin: Ilicit drug trends in Western Australia: Australian school students alcohol and drug survey - 2017, MHC.
  8. Ibid.
  9. Ibid.
  10. Guerin N and White V 2018, ASSAD 2017 Statistics & Trends: Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances, Cancer Council Victoria, p. 28.
  11. In contrast the AIHW National Drug Strategy Household Survey (NDSHS) shows a decrease across all states in illicit drug use from 2013 to 2016 for young people aged 12 to 17 years. There may be multiple reasons for this, including differing time periods, the NDSHS survey does not include the misuse of prescription drugs such as tranquilisers in the illicit drugs category and the age groups differ.
  12. Miller J et al 2012, Amphetamine-type Stimulants in Western Australia: ASSAD Survey 2011, Brief communication no 5, Drug and Alcohol Office, WA Government.
  13. Allan J et al 2019, Increased demand for methamphetamine treatment in rural Australia, Addiction Science and Clinical Practice, Vol 14, No 13.
  14. Roche A et al 2015, Methamphetamine use in Australia, National Centre for Education and Training on Addiction (NCETA), Flinders University.
  15. Lim M et al 2014, ‘Ice epidemic’? Trends in methamphetamine use from three Victorian surveillance systems, Australian and New Zealand Journal of Public Health, Vol 39 No 2.
  16. Scott N et al 2015, High-frequency drug purity and price series as tools for explaining drug trends and harms in Victoria, Australia, Addiction, Vol 110 No 1.
  17. Guerin N and White V 2018, ASSAD 2017 Statistics & Trends: Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances. Cancer Council Victoria, 2018.
  18. Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: detailed findings – Data Table 8.6 Drug use by Indigenous status, AIHW.
  19. This survey includes a nationally representative sample of around 13,000 Aboriginal people in remote and non-remote locations.
  20. The AIHW NDSHS reports that 28.2 per cent of 18 to 24 year old Australian young people have recently used illicit drugs, while the ABS Aboriginal Health Survey: 2012-13 reports that 27.6 per cent of Aboriginal young people aged 15 to 24 years have used illicit drugs in the last 12 months.
  21. Australian Bureau of Statistics, Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13, Table 15.3 Substance use(a)(b) by age, remoteness and sex, Proportion of Aboriginal and Torres Strait Islander persons.
  22. Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: detailed findings, Table 7.17: Recent illicit use of any drug(a), people aged 14 years or older, by age and state/territory, 2010 to 2016 (per cent).
  23. National Indigenous Drug and Alcohol Committee 2014, Alcohol and other drug treatment for Aboriginal and Torres Strait Islander peoples, Australian National Council on Drugs, p. 5.
  24. Australian Bureau of Statistics, Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13, Table 19.3 Selected family stressors(a) by age, Indigenous status and sex, Proportion of persons.
  25. This survey includes a nationally representative sample of around 13,000 Aboriginal people in remote and non-remote locations
  26. Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016 – Detailed Findings report, Chapter 5 Data: Table 5.24 Recent use of cannabis by age group, AIHW.
  27. The Commissioner for Children and Young People understands there are a range of terms and definitions that people use to define their gender or sexuality. The Commissioner’s office will use the broad term LGBTI to inclusively refer to all people who are lesbian, gay, bisexual, trans and intersex, as well as to represent other members of the community that use different terms to describe their diverse sexuality and/or gender.
  28. Hillier L et al 2010, Writing Themselves in 3: The third national study on the sexual health and wellbeing of same sex attracted and gender questioning young people, Australian Research Centre in Sex, Health and Society, La Trobe University, p. 54.
  29. Ibid, p. 54.
  30. Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: Data – Chapter 8 Specific Population Groups, Table 8.9: Drug use by sexuality, people aged 14 years or older 2016 (age-standardised), AIHW.
  31. Ibid.
  32. Australian LGBTI young people aged 14 to 21 years old were provided access to an online questionnaire with both quantitative and qualitative questions regarding their sexual health and wellbeing. The participants came from all states and territories of Australia, from remote (2%), rural (18%) and urban (67%) areas and from a range of culturally and linguistically diverse (CALD) backgrounds. There were more young women (57%) than young men (41%) and a smaller group (3%) who were gender questioning (GQ).
  33. Hillier L et al 2010, Writing Themselves in 3: The third national study on the sexual health and wellbeing of same sex attracted and gender questioning young people, Australian Research Centre in Sex, Health and Society, La Trobe University, p. 54.
  34. Ibid, p. 54.
  35. Hyde Z e al 2007, The Health and Well-Being of Lesbian and Bisexual Women in Western Australia, WA Centre for Health Promotion Research, Curtin University of Technology, p. 3.
  36. Hyde Z et al 2009, Alcohol, tobacco and illicit drug use amongst same-sex attracted women: results from the Western Australian Lesbian and Bisexual Women's Health and Well-Being Survey, BMC Public Health, Vol 9, No 317.  
  37. Ibid.  
  38. Ibid.  
  39. WA Office of Multicultural Interests 2009, Not drowning, waving: Culturally and linguistically diverse young people at risk in Western Australia, p. 5.
  40. Ibid, p. 5.
  41. Foundation House and Centre for Multicultural Youth 2013, Responding to challenges of misuse of alcohol and other drugs by young people of refugee backgrounds: Reflections from two projects, Foundation House and Centre for Multicultural Youth, p. 4-5.
  42. Australian Department of Health, Fact Sheet 20: Suicide prevention and people from culturally and linguistically diverse (CALD) backgrounds, Australian Government.
  43. WA Office of Multicultural Interests 2009, Not drowning, waving: Culturally and linguistically diverse young people at risk in Western Australia, WA Government, p. 5.
  44. Ibid, p. 36.
  45. Australian Institute of Health and Welfare (AIHW) 2017, National Drug Strategy Household Survey 2016: Data – Chapter 8 Specific Population Groups, Table 8.20: Drug use by main language spoken at home, people aged 14 years or older, 2016 (Age standardised per cent), AIHW.
  46. Ibid.
  47. Ibid.
  48. Justice Health & Forensic Mental Health Network and Juvenile Justice NSW 2015, 2015 Young People in Custody Health Survey: Full Report, NSW Government, p. 65.
  49. WA Department of Justice 2018, Annual Report: 2017-18, WA Government, p. 15.
  50. Office of the Inspector of Custodial Services 2018, 2017 Inspection of Banksia Hill Detention Centre, WA Government, p. 51.
  51. Justice Health & Forensic Mental Health Network and Juvenile Justice NSW 2015, 2015 Young People in Custody Health Survey: Full Report, NSW Government, p. xx.
  52. Ibid, p. 56-57.
  53. Ibid, p. 56-57.
  54. Department of Health, Secondary school students’ use of tobacco, alcohol and other drugs in 2017, Table 3.1 Percentage of secondary students in Australia who have smoked in the past week, past month, past year, or lifetime, by age and sex.
  55. Australian Institute of Health and Welfare, Alcohol, tobacco and other drugs in Australia: Populations, Table S3.31 Age of initiation of tobacco use, people aged 14-24, 1995 to 2016 (years).
  56. Justice Health & Forensic Mental Health Network and Juvenile Justice NSW 2015, 2015 Young People in Custody Health Survey: Full Report, NSW Government, p. 58.
  57. Ibid, p. 58.
  58. Ibid, p. 58.
  59. Ibid, p. 60.
  60. Ibid, p. 60.
  61. Ibid, p. 60.
  62. Ibid, p. 60.
  63. Australian Institute of Health and Welfare (AIHW) 2018, Overlap between youth justice supervision and alcohol and other drug treatment services 2012–16, Cat no JUV 126, AIHW, p. 1.
  64. Ibid, p. 1.
  65. Ibid, p. 14.
Measure: Unsafe sexual activity

Sexual development and experimentation is a normal and healthy part of adolescence. However, there are risks associated with sexual activities and it is critical that young people are well informed and supported to make healthy choices. To develop effective policies in the area of sexual health it is critical that government and service providers have a realistic understanding of the knowledge and behaviours of young people.

The ability for young people to be able to openly and comfortably communicate boundaries and concerns with sexual partners, and establishing strong and supportive social connections, allows for the reduction in unsafe or unwanted sexual activity.1

Studies have shown that earlier initiation of sexual intercourse is connected to increased sexual partners, increased sexual activity and increased likelihood of unprotected sexual intercourse. These increased opportunities can lead to long term health implications such as unplanned pregnancies and being diagnosed with a sexually transmitted infection (STI).2,3

This section does not consider unwanted or coercive sexual experiences in any detail. It also does not consider pornography, sexting or young people exhibiting harmful sexual behaviours. These topics are considered to be about safety and abuse rather than sexuality and will be included in the Safe in the community Indicator in the Safe and supported domain.  

Limited data exists on sexual understandings or experiences of WA young people, therefore the data in this measure is principally from Australian research.

The Australian Study of Health and Relationships (ASHR) survey is conducted every ten years and provides a snapshot of the sexual health and wellbeing of the Australian population. Key findings of the survey conducted between October 2012 and November 2013 highlighted that the Australian median age of first vaginal intercourse was 17 years.4 The age of initiation differed with sexual identity, with LGBTI male and female young people reporting later ages of first vaginal intercourse, where relevant.5

Historically, the median age of first vaginal intercourse decreased significantly from the 1950s to the 1970s and since the mid-1980s has been mostly stable at 17 years of age for both men and women.6

The National Survey of Australian Secondary Students and Sexual Health is a survey conducted every five years that collects the sexual attitudes, knowledge and experiences of high school students in Years 10 to 12 across Australia. The 2018 survey had a sample of 6,327 Australian students, including 563 WA students. Australia-wide, 3.9 per cent of the sample reported being Aboriginal. The sample was skewed towards metropolitan and inner regional areas.7

Approximately one in three (46.6%) students who participated in the 2018 National Survey of Australian Secondary Students and Sexual Health reported ever having vaginal or anal intercourse.8 This is a significant increase on the 2013 survey, which reported that 34 per cent of participants had experienced sexual intercourse.9  

Proportion of students who have ever had sexual intercourse (vaginal and/or anal), in per cent, Australia, 2013 and 2018

2013

2018

Year 10

22.7

34.3

Year 11

34.3

46.0

Year 12

50.4

55.8

Total

33.7

46.6

Source: La Trobe University, National Survey of Australian Secondary Students and Sexual Health 2013, Table 5.4 Students who have ever had sexual intercourse by year level and National Survey of Australian Secondary Students and Sexual Health 2018, Table 5.13 Students who have ever had sexual intercourse (anal and/or vaginal) by year level

Proportion of students who have ever had sexual intercourse (vaginal and/or anal), in per cent, Australia, 2013 and 2018

Source: La Trobe University, National Survey of Australian Secondary Students and Sexual Health 2013, Table 5.4 Students who have ever had sexual intercourse by year level and National Survey of Australian Secondary Students and Sexual Health 2018, Table 5.13 Students who have ever had sexual intercourse (anal and/or vaginal) by year level

The disaggregation by year group highlights that the numbers of those who had ever had sexual intercourse increased with age with just over one in three (34.3%) Year 10 students having had sexual intercourse, almost one-half of (46.0%) Year 11 students and over one-half of (55.8%) Year 12 students.

For most of these young people (64.6%), their most recent sexual encounter was with their current steady girlfriend or boyfriend. A smaller, but still significant proportion (28.9%) reported that their last encounter was with someone they had known for a while.10

Students who had not had sexual intercourse reported various reasons for this including: they ‘did not feel ready to have sex’ (67.5% high importance), they were ‘proud to say No and mean it’ (79.1% high importance), and/or that they thought it was ‘important to be in love the first time’ (57.9% high importance).11 Ninety‑five per cent of non-sexually active students reported they did not feel at all guilty, while 81.9 per cent of non-sexually active students reported they did not feel at all embarrassed.12

The majority of young people in the survey had engaged in some form of sexual activity.

Prevalence of sexual activities amongst Year 10 to Year 12 students, in per cent, Australia, 2018

Male

Female

Trans and
gender diverse*

Total

Deep kissing

69.4

78.3

70.8

74.4

Touching a partner's genitals

62.7

66.9

64.1

65.0

Being touched on the genitals

61.6

68.7

64.1

65.6

Touching your own genitals

96.4

82.9

88.7

89.0

Giving oral sex

47.1

56.2

46.2

52.1

Receiving oral sex

49.4

53.0

43.1

51.4

Anal sex

14.3

11.2

15.4

12.6

Vaginal sex

38.8

48.9

32.8

44.4

Source: La Trobe University, National Survey of Australian Secondary Students and Sexual Health 2018, Table 5.12 Reported sexual behaviours by year level and gender

*Given the substantial sample size, for the first time in addition to female and male, the national survey report includes results for people who identify as trans and gender diverse (TGD). However, the number of responses from TGD participants were too small to be tested statistically.

Just over 50 per cent of young people had given or received oral sex, which supports the ASHR finding that the current generation of young people experience oral sex earlier than previous generations.13 Only three per cent of men and women born in the 1960s had experienced oral sex before sexual intercourse, compared to approximately 21 per cent of young men and 17 per cent of young women under 20 years of age who had experienced oral sex before sexual intercourse in 2012-13.14

In 2013, Australian Year 10 to Year 12 secondary students who had had sexual intercourse reported on the number of sexual partners they had in the past year.

Proportion of sexually active* students' by number of sexual partners in the past year, in per cent, Australia, 2018

Male

Female

Trans and
gender diverse**

Total

I have not had sex in the past year

5.4

2.8

13.6

3.9

1 person

59.6

63.0

40.9

61.5

2 people

15.5

15.5

18.2

15.5

3 or more people

19.4

18.7

27.3

19.0

Source: La Trobe University, National Survey of Australian Secondary Students and Sexual Health 2018, Table 5.14 Responses to “Over the last year with how many people have you had anal and/or vaginal intercourse?”

* Defined as young people who have had sexual intercourse.

** Given the substantial sample size, for the first time in addition to female and male, the national survey report includes results for people who identify as trans and gender diverse (TGD). However, the number of responses from TGD participants were too small to be tested statistically.

Female students were slightly more likely than male students to report fewer partners in the previous year.15 The numbers are too small to report statistical differences for the trans and gender diverse students.

Studies have suggested that the early initiation of sexual activity may sometimes be unwanted or pressured.16,17 In the National Survey sexually active Year 10 to Year 12 students were asked if they had ever had unwanted sex.18 Results highlighted that sexually active female students were more likely to have had unwanted sex than sexually active male students (36.8% and 15.9% respectively).19

Fifty-two (52%) per cent of young people reported they had unwanted sex because they were influenced by their partner, with similar results for male and female young people, while 34 per cent of male and female young people reported being too drunk. Female young people were more likely to report that they were frightened (32.3% compared to 27.5%), while male young people were more likely to feel pressure from their peers (17.0% compared to 6.6%).20

With almost half (46.6%) of young people in Year 10 to Year 12 reporting that they have had sexual intercourse (vaginal or anal) and a similar prevalence for giving or receiving oral sex, it is important to explore what contraceptive methods, if any, are being used.

Sexually active Year 10 to Year 12 students’ use of condoms during sex in the last year, in per cent, Australia, 2018

Total

Always used condoms

38.4

Often used condoms

23.8

Sometimes used condoms

10.5

Occasionally used condoms

14.5

Never used condoms

12.8

Source: La Trobe University, National Survey of Australian Secondary Students and Sexual Health 2018, Table 5.18 Responses to “When you had sex in the last year, how often were condoms used?”

Only 38.4 per cent of sexually active young people reported always using a condom. This means that 61.6 per cent of sexually active young people are at risk of contracting a sexually transmissible infection.

These results are consistent with a 2018 Australian survey which reported that three quarters (75.1%) of the respondents who were sexually active in the past 12 months engaged at least once in sexual intercourse without using condoms in that time. This included, 69.3 per cent who had sexual intercourse with a regular partner without condoms and 24.1 per cent who had sexual intercourse with a casual partner(s) without condoms.21

Pregnancy is a significant risk for young people who are sexually active. A high proportion of sexually active young people were not using an effective contraceptive method when they last had vaginal sex.

Sexually active Year 10 to Year 12 students’ contraceptive method during last experience of vaginal sex, in per cent, Australia, 2018

Male

Female

Trans and
gender diverse*

Total

Condoms

54.5

53.1

30.4

53.5

The pill

37.7

43.5

30.4

41.0

Withdrawal

17.4

21.2

13.0

19.6

Contraceptive implant

6.7

9.6

26.1

8.5

None

7.2

7.8

13.0

7.6

Emergency contraception

3.0

4.6

8.7

4.0

IUD

1.6

1.4

0.0

1.5

Rhythm method

1.4

1.1

4.3

1.2

Other

0.7

0.7

8.7

0.8

Injection

0.7

0.7

0.0

0.7

Diaphragm

0.3

0.1

0.0

0.2

Source: La Trobe University, National Survey of Australian Secondary Students and Sexual Health 2018, Table 5.29 Responses to “The last time you had vaginal sex which, if any, forms of contraception did you or the person you had sex with use to prevent pregnancy?”

* Given the substantial sample size, for the first time in addition to female and male, the national survey report includes results for people who identify as trans and gender diverse (TGD). However, the number of responses from TGD participants were too small to be tested statistically.

Sexually active Year 10 to Year 12 students’ contraceptive method during last sexual encounter, in per cent, Australia, 2018

Source: La Trobe University, National Survey of Australian Secondary Students and Sexual Health 2018, Table 5.29 Responses to “The last time you had vaginal sex which, if any, forms of contraception did you or the person you had sex with use to prevent pregnancy”

* Given the substantial sample size, for the first time in addition to female and male, the national survey report includes results for people who identify as trans and gender diverse (TGD). However, the number of responses from TGD participants were too small to be tested statistically.

The three most common contraceptive methods reported were condoms (53.5%), the pill (41.0%), and the withdrawal method (19.6%). A significant proportion of young people (7.6%) also reported they used no contraceptive method during their last sexual encounter. Furthermore, the use of the withdrawal method is known to be an ineffective form of birth control and as many as one in five people get pregnant every year with this form of contraception.22

Similar to the general population in WA, there is no data on the sexual experiences and understandings of WA Aboriginal young people.

The Goanna Survey conducted in 2014 considered sexual health and relationships in young Aboriginal peoples aged 16 to 29 years across Australia.23 The age range for this study means that most of the data is not directly comparable to the results above.

This survey found that the median age of initiation of sexual activities for Aboriginal young people was reported as 16 years for female young people and 15 years for male young people.24 This is slightly lower than for the general population.

The proportion of young people that reported being sexually active was lower in remote areas (68%), in comparison to metropolitan and regional areas (83% and 84% respectively).25

Just over one-half of (51%) of Aboriginal young people aged 16 to 19 years had had multiple partners (two or more), with nine per cent reporting that they had had more than five partners in the year of the survey.26 It should be noted that the inclusion of 18 and 19 year-olds in this data makes it not comparable to the data from the National Survey of Australian Secondary Students and Sexual Health.

Just over two in every three (68%) Aboriginal young people aged 16 to 19 years, used a condom in their last sexual encounter, which is higher than the proportion of Australian young people generally (59%).27 Approximately one in every five (22%) Aboriginal young people the same age, reported never using a condom when they had sex.28 This is consistent with the 23.3 per cent of sexually active Australian young people who did not use a condom in the past 12 months.29

A very high proportion (95%) of 16 to 19 year-old respondents reported their last experience of sex was wanted.30

Children and young people in the youth justice system

The Banksia Hill Detention Centre is the only facility in WA for the detention of children and young people 10 to 17 years of age who have been remanded or sentenced to custody. During 2017-18, approximately 148 children and young people aged between 10 and 17 years were held in the Banksia Hill Detention Centre in WA on an average day.31

There is evidence to suggest that young people in juvenile detention centres are at higher risk of STIs,32,33 although there is no data available on the sexual health of young people in detention in WA.

In 2015 the Young People in Custody Health Survey (YPICHS) was conducted in NSW across seven juvenile justice centres. Of the young people invited to participate, 90.4% completed the survey which represented 59.3% of young people in custody at the time across NSW.34

The majority (96.9%) of the participants and 92.2 per cent of the young people under the age of 16 years reported having previously had either vaginal, anal or oral sex. Two in every three (60.8%) of those young people that had reported being sexually active reported having more than one sexual partner in the past year.35 There was no significant differences for these results by gender or Aboriginality.

The most common three forms of contraception options for young people in custody in NSW was condoms (44.1%) and the implant, Implanon (12.4%). Approximately one third (34.7%) of young people in the study reported using no contraception.36 Of concern was that just under one in three (27.7%) young people reported having never used a condom; the same proportion of participants reported using condoms all the time.37

Endnotes

  1. Australian Institute of Health and Welfare (AIHW) 2011, Young Australians: their health and wellbeing 2011, Cat no PHE 140, AIHW, p. 80.
  2. Ibid, p. 80.
  3. Sandfort T et al 2008, Long-Term Health Correlates of Timing of Sexual Debut: Results From a National US Study, American Journal of Public Health, Vol 98, No 1.
  4. Australian Study of Health and Relationships (ASHR) 2014, Sex in Australia 2 – Summary, The University of NSW, The University of Sydney, University of Sussex and La Trobe University.
  5. Rissel C et al 2014, First vaginal intercourse and oral sex among a representative sample of Australian adults: the Second Australian Study of Health and Relationships, Sexual Health, Vol 11.
  6. Ibid, p. 409.
  7. Fisher CM et al 2019, National Survey of Australian Secondary Students and Sexual Health 2018, ARCSHS Monograph Series No. 113, Australian Research Centre in Sex, Health & Society, La Trobe University, p. 17.
  8. Ibid, p. 3.
  9. Mitchell A et al 2014, National Survey of Australian Secondary Students and Sexual Health 2013, Australian Research Centre in Sex, Health and Society, La Trobe University, p. v.
  10. Fisher CM et al 2019, National Survey of Australian Secondary Students and Sexual Health 2018, ARCSHS Monograph Series No. 113, Australian Research Centre in Sex, Health & Society, La Trobe University, p. 41.
  11. Ibid, p. 49.
  12. Ibid, p. 54.
  13. Australian Study of Health and Relationships (ASHR) 2014, Sex in Australia 2 – Summary, The University of NSW, The University of Sydney, University of Sussex and La Trobe University.
  14. Rissel C et al 2014, First vaginal intercourse and oral sex among a representative sample of Australian adults: the Second Australian Study of Health and Relationships, Sexual Health, Vol 11, p. 411.
  15. Fisher CM et al 2019, National Survey of Australian Secondary Students and Sexual Health 2018, ARCSHS Monograph Series No. 113, Australian Research Centre in Sex, Health & Society, La Trobe University, p. 38.
  16. Wight D et al 2008, The Quality of Young People’s Heterosexual Relationships: A Longitudinal Analysis of Characteristics Shaping Subjective Experience, Perspectives on Sexual Reproductive Health, Vol No 4.
  17. Dickson N et al 1998, First sexual intercourse: Age, coercion, and later regrets reported by a birth cohort, British Medical Journal, Vol 316, No 7124.
  18. It should be noted that unwanted sex, is not strictly non-consensual sex. The survey question was: ‘have you ever had sex when you didn’t want to?’. This survey did not ask about non-consensual sex.
  19. Fisher CM et al 2019, National Survey of Australian Secondary Students and Sexual Health 2018, ARCSHS Monograph Series No. 113, Australian Research Centre in Sex, Health & Society, La Trobe University, p. 39.
  20. Ibid, p. 39.
  21. Adam P et al 2019, Sexual health-related knowledge, attitudes and practices of young people in Australia. Results from the 2018 Debrief Survey among heterosexual and non-heterosexual respondents, Centre for Social Research in Health, UNSW Sydney, p. 22.
  22. Center for Disease Control and Prevention [undated], Effectiveness of Family Planning Methods, US Department of Health and Human Services.
  23. Just under 3,000 Aboriginal young people aged 16 to 29 years participated in the survey, with data collection points available at community, sporting and cultural events across Australia between 2011 and 2013.
  24. Ward J et al 2014, The Goanna Survey, The Kirby Institute, University of New South Wales, p. 2.
  25. Ibid, p. 21.
  26. Ibid, p. 27.
  27. Ibid, p. 27.
  28. Ibid, p. 27.
  29. Adam P et al 2019, Sexual health-related knowledge, attitudes and practices of young people in Australia. Results from the 2018 Debrief Survey among heterosexual and non-heterosexual respondents, Centre for Social Research in Health, UNSW Sydney, p. 18.
  30. Ward J et al 2014, The Goanna Survey, The Kirby Institute, University of New South Wales, p. 53.
  31. WA Department of Justice 2018, Annual Report: 2017-18, WA Government, p. 15.
  32. Belenko S et al, 2008, Recently arrested adolescents are at high risk for sexually transmitted diseases, Sexually transmitted diseases, Vol 35, No 8.
  33. The Royal Australasian College of Physicians (RACGP) 2011, The health and well-being of incarcerated adolescents, RACGP, p. 32.
  34. Justice Health & Forensic Mental Health Network and Juvenile Justice NSW 2015, 2015 Young People in Custody Health Survey: Full Report, NSW Government.
  35. Ibid, p. 53.
  36. Ibid, p. 54.
  37. Ibid, p. 54.
Measure: Sexual health

Good sexual health is important for young people’s physical health and overall wellbeing. Sexual health includes not only safe sex practices to reduce the risk of sexually transmissible infections (STI) and pregnancy, but also appropriate access to information and services that are inclusive and culturally safe. This section focuses on prevalence of STIs in young people in WA to highlight the importance of education programs and services to support young people to live healthy and happy lives.

STIs are most commonly contracted through unsafe sexual practices and can be either bacterial or viral and have serious long term complications if left untreated.1 These consequences include chronic abdominal pain, infertility and genital, heart and brain damage.2 They are often undiagnosed as they can have no symptoms.3

Young people between the ages of 15 and 29 years account for a significant proportion of STI notifications annually.4 The prevention, testing and treatment of young people is a considerable challenge for a variety of reasons including, young people often underestimated the seriousness of STIs, financial costs can be a barrier and social stigma. This results in many of the cases of STI infection in young people remaining undiagnosed and untreated.5 Young people are particularly vulnerable to STIs due to risk factors such as increased sexual activity, risky alcohol and drug consumption, lack of knowledge about STIs and the prevalence of undiagnosed conditions.6

The most common STIs that are considered a health risk for young people are chlamydia, syphilis and gonorrhoea. These STIs are nationally notifiable diseases. This means state and territory health authorities supply notifications of chlamydia, gonorrhoea and syphilis to the National Notifiable Diseases Surveillance System to collect information relating to diseases of public importance.

Other sexually transmitted conditions include human immunodeficiency virus (HIV), Human Papillomavirus (HPV), genital Herpes (HSV) and Hepatitis (A and B). HIV and Hepatitis are less common, HPV rates are reducing significantly due to the recent introduction of the Gardasil® vaccine and while Herpes is very common, it is generally not considered a significant health risk and is not notifiable.7,8 Therefore, these conditions are not tracked in this measure.

The WA Department of Health Communicable Disease Control Directorate collects notification data of STIs and produces annual and quarterly reports for Western Australia. The data collected highlights that chlamydia was the most common STI to be diagnosed in young people aged 15 to 19 years, with gonorrhoea the second most common.

Rate* of STI notifications by gender and age group, age-specific rate, WA, 2017

10 to 14 years

15 to 19 years

Male

Female

Male

Female

Chlamydia

17.4

114.3

809.8

2,117.1

Gonorrhoea

65.7

68.1

410.8

437.6

Infectious syphilis

0.0

5.1

28.4

17.7

Source: WA Department of Health, Epidemiology of STIs and BBVs in Western Australia, Annual Report: 2017 – Appendix.

* Age-specific rate per 100,000 population.

The prevalence of STIs in young people aged 10 to 14 years is understandably low, however any diagnosis in this age group is still a significant cause for concern.

Female young people across age groups are much more likely to be diagnosed with chlamydia and more likely to be diagnosed with gonorrhoea. A higher rate of male young people aged 15 to 19 years were diagnosed with infectious syphilis than female young people.

The Australian National Notifiable Diseases Surveillance System (NNDSS) reports on STI notifications across Australia. The rates are not age-specific and therefore are not directly comparable to the WA data, however they align with the trend of a higher rate of notification for female young people for chlamydia and gonorrhoea.

Rate of STI notifications by gender and age group, rate, Australia, 2017

10 to 14 years

15 to 19 years

Male

Female

Male

Female

Chlamydia

6.9

54.1

628.9

1,781.4

Gonorrhoea

2.9

20.8

157.5

191.7

Syphilis < 2 years

0.4

2.5

16.8

15.9

Syphilis > 2 years

0.0

0.0

1.2

2.6

Source: Department of Health, National Notifiable Diseases Surveillance System, Notifications of a selected disease by age group, sex and year, notification rates (per 100,000 population)

Data for WA young people aged 12 to 17 years shows that there has been a significant decrease in the rate of chlamydia notifications since 2012, and an increase in the rate of syphilis notifications. Gonorrhoea notifications had decreased until an increase in 2017.

Rate of STI notifications by age group, age-specific rate*, WA, 2012 to 2017

Chlamydia

Gonorrhoea

Infectious syphilis

10 to 14 years

15 to 19 years

10 to 14 years

15 to 19 years

10 to 14 years

15 to 19 years

2012

91.7

1,932.6

51.1

350.0

-

1.3

2013

101.8

1,854.8

48.3

326.5

-

2.0

2014

96.2

1,652.4

44.2

252.0

-

6.3

2015

65.5

1,509.8

34.1

224.8

0.7

8.1

2016

66.3

1,473.6

52.0

334.7

1.3

11.7

2017

65.0

1,442.9

38.5

352.9

2.5

23.2

Source: WA Department of Health, Epidemiology of STIs and BBVs in Western Australia, Annual Report: 2017 – Appendix (and previous years)

* Age-specific rate per 100,000 population.

Rate of STI notifications for young people aged 15 to 19 years, age-specific rate, WA, 2012 to 2017

Source: WA Department of Health, Epidemiology of STIs and BBVs in Western Australia, Annual Report: 2017 – Appendix (and previous years)

The WA Department of Health suggest that the plateau in chlamydia notifications for the whole population since 2015 may have resulted from a combination of increased testing and decreased disease transmission.9

Infectious syphilis notifications increased substantially in the whole WA population from 2012 to 2016 and decreased slightly in 2017.10 This was not the case for WA young people aged 15 to 19 years where syphilis rates have increased significantly over the last six years.

This is principally due to the outbreak of infectious syphilis affecting young Aboriginal people between 15 and 29 years living in northern Australia.11 It is important to emphasise that a significant proportion of these notifications are as a result of sexual activity with same-aged peers and not due to an increase in child sexual abuse.12 Further to this, researchers indicate that this outbreak is influenced by resistance to antibiotics, poor accessibility to sexual health services in remote areas, high health staff turnover and shortages in Aboriginal health practitioners in these areas.13,14 Infectious syphilis is fully curable with a single injection of long-acting penicillin.15

For more information on the syphilis outbreak in northern Australia refer to the Department of Health’s website. 

STI notification rates are generally higher in remote areas across Australia,16 and WA is no exception. The following data reports the number and rate of notifications of STIs for WA young people aged 12 to 17 years by region.

Number of combined notifications for chlamydia, gonorrhoea and syphilis for young people aged 12 to 17 years by region, number, WA, 2017

Male

Female

Total

Goldfields

12

51

63

Great Southern

<5

23

27

Kimberley

107

243

350

Metropolitan

190

540

730

Mid West

17

53

70

Pilbara

20

65

85

South West

12

47

59

Wheatbelt

<5

17

21

Total

366

1,039

1,405

Source: Custom report from the Immunisation, Surveillance and Disease Control Program, Communicable Disease Control Directorate provided by the WA Department of Health to the Commissioner for Children and Young People [unpublished]

Rate of combined notifications for chlamydia, gonorrhoea and syphilis for young people aged 12 to 17 years by region, age-specific rate*, WA, 2017

Male

Female

Total

Goldfields

546.7

2,289.0

1,425.0

Great Southern

163.9

937.8

532.0

Kimberley

7,095.5

15,547.0

11,393.2

Metropolitan

247.0

737.9

486.5

Mid West

630.1

2071.9

1,331.8

Pilbara

1,288.7

4,248.4

2,757.1

South West

163.2

678.0

413.0

Wheatbelt

148.2

686.9

405.9

Total

375.9

1,118.6

738.6

Source: Custom report from the Immunisation, Surveillance and Disease Control Program, Communicable Disease Control Directorate provided by the WA Department of Health to the Commissioner for Children and Young People [unpublished]

* Age-specific rate per 100,000 population.

Rate* of combined notifications for chlamydia, gonorrhoea and syphilis for young people aged 12 to 17 years by region, age-specific rate, WA, 2017

Source: Custom report from the Immunisation, Surveillance and Disease Control Program, Communicable Disease Control Directorate provided by the WA Department of Health to the Commissioner for Children and Young People [unpublished]

The above data highlights that the Kimberley has a proportionally very high rate of STI notifications, considering the much smaller population. In 2017, 52 per cent of STI notifications for WA young people aged 12 to 17 years were in the metropolitan area, while 25 per cent were in the Kimberley.

In 2017, the chlamydia notification rate (for all persons) in the Kimberley was almost four-times greater than the WA rate, the gonorrhoea notification rate was almost ten-times greater than the WA rate and the infectious syphilis notification rate was 13-times the WA rate.17

Aboriginal young people across Australia are disproportionally impacted by STIs in comparison to non-Aboriginal young people. Thirty four per cent (34.4%) of all notifications in 2017 were for female Aboriginal young people, of whom 47.7 per cent were in the Kimberley. In contrast, 38.1 per cent of all notifications in 2017 were for female non-Aboriginal young people, of whom 78.3 per cent were in the metropolitan area.18

The high rate of STIs within the Aboriginal population can be attributed to many factors, which include limited access to high quality and culturally safe health care services, poor sexual health education and living in areas where STIs are more common.19

The Aboriginal surveillance report of HIV, viral hepatitis and STIs 2018 is an annual report that collates, monitors and reports on patterns of HIV, viral hepatitis and STIs in Australia.

Aboriginal STI notification rate by age group and gender, rate*, Australia, 2017

0 to 14 years

15 to 19 years

Male

Female

Male

Female

Chlamydia

44.7

262.3

3,438.8

7,450.0

Gonorrhoea

22.4

162.6

1,809.8

2,706.2

Infectious syphilis

3.1

15.3

138.1

238.0

Source: The Kirby Institute, Aboriginal Surveillance Report on HIV, viral hepatitis and STIs 2018, Blood borne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people

* Rate is per 100,000 population

STI notification rate for young people aged 15 to 19 years by Aboriginal status and gender, rate*, Australia, 2017

Aboriginal

Non-Aboriginal

Male

Female

Male

Female

Chlamydia

3,438.8

7,450.0

649.2

1,958.8

Gonorrhoea

1,809.8

2,706.2

95.3

105.3

Infectious syphilis

138.1

238.0

10.0

3.5

Source: The Kirby Institute, Aboriginal Surveillance Report on HIV, viral hepatitis and STIs 2018, Blood borne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people

* Rate is per 100,000 population

STI notification rate for young people aged 15 to 19 years by Aboriginal status and gender, rate, Australia, 2017

Source: The Kirby Institute, Aboriginal Surveillance Report on HIV, viral hepatitis and STIs 2018, Blood borne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people

Across Australia, female Aboriginal young people have a significantly higher rate of notifications for chlamydia, gonorrhoea and syphilis. This pattern is similar for female non-Aboriginal young people, who are more likely to have notifications for chlamydia and gonorrhoea than male non-Aboriginal young people. However, male non-Aboriginal young people have a higher rate of syphilis notifications than female non-Aboriginal young people. This is principally because in the metropolitan area there is a higher rate of syphilis among young gay men, while in northern Australia the outbreak of syphilis is mainly affecting heterosexual Aboriginal young people.20

Lesbian, gay, bisexual, trans and intersex children

Lesbian, gay, bisexual, transgender and intersex (LGBTI)21 young people are at an increased risk of a range of sexual health problems, in particular sexually transmitted infections (STIs).22

LGBTI young people are at a higher risk of contracting an STI for a variety of reasons including lower condom use and higher likelihood of risky alcohol and drug-taking behaviour which can lead to risky sexual activities.23,24

In the Writing themselves in 3 (WTi3) survey conducted in 2010, Australian LGBTI young people aged 14 to 21 years old were provided access to an online questionnaire with both quantitative and qualitative questions regarding their sexual health and wellbeing. Due to the ‘opt-in’ nature of this survey, it cannot be considered representative of LGBTI young people, however it provides an indication of LGBTI young people’s sexual experiences.

The survey found that approximately one in three (28%) LGBTI respondents aged 14 to 21 years that participated in the survey had never had sex.25

Just under half (45%) of the LGBTI young people aged 15 to 18 years who had had sexual intercourse (vaginal or anal) reported using a condom when they last had sexual intercourse.26 This is low compared to the general population with 59 per cent of sexually active secondary students reporting using a condom.27

There is no other data on the experience of sexual health issues by WA young people who identify as LGBTI.

For more information on LGBTI children and young people, refer to the Commissioner’s issues paper:

Commissioner for Children and Young People WA 2018, Lesbian, Gay, Bisexual, Trans and Intersex (LGBTI) children and young people, Commissioner for Children and Young People WA

Culturally and linguistically diverse young people

Data and research also suggests that people from culturally and linguistically diverse (CALD) backgrounds often have low sexual health literacy, which means that they are less likely to access the services that they need, experience social isolation, and have lower levels of knowledge and understanding of sexual health issues.28

Some children and young people from CALD backgrounds (and their families) experience language barriers, feeling torn between cultures, intergenerational conflict, racism and discrimination, bullying and resettlement stress.29 Some of these children and young people have traumatic pre-migration experiences, including family separation, war, violence and immigration detention, which can also impact their mental health and wellbeing.

Through either migration or forced resettlement, many CALD and refugee young people may have experienced a disruption to their education, reduced access to health care and family and social disruptions.30 In addition, current sexual health education and sexual health services may be discriminatory or exclusive, and reduce the possibility of CALD and refugee young people feeling comfortable to ask questions, and seek help or advice.31

There is no data available on the sexual health of young people in WA of a CALD background.

For more information on children and young people from culturally and linguistically diverse backgrounds in WA, refer to the Commissioner’s policy brief:

Commissioner for Children and Young People WA 2013, The mental health and wellbeing of children and young people: Children and Young People from Culturally and Linguistically Diverse Backgrounds, Commissioner for Children and Young People WA.

Young people in the youth justice system

The Banksia Hill Detention Centre is the only facility in WA for the detention of children and young people 10 to 17 years of age who have been remanded or sentenced to custody. During 2017-18, approximately 148 children and young people aged between 10 and 17 years were held in the Banksia Hill Detention Centre in WA on an average day.32

Studies have indicated that adult custodial settings may be high-risk environments for the transmission of STIs.33 There is evidence to suggest that this may also be the case in juvenile detention centres,34,35 although there is no data available on the sexual health of young people in detention in WA.

In 2015 the Young People in Custody Health Survey (YPICHS) was conducted in NSW across seven juvenile justice centres. Of the young people invited to participate, 90.4% completed the survey which represented 59.3% of young people in custody at the time across NSW.36

The majority (96.9%) of the participants and 92.2 per cent of the young people under the age of 16 years reported having previously had either vaginal, anal or oral sex. Two in every three (60.8%) of those young people that had reported being sexually active reported having more than one sexual partner in the past year.37 There was no significant differences for these results by gender or Aboriginal status.

The most common three forms of contraception options for young people in custody in NSW was condoms (44.1%) and the implant, Implanon (12.4%). Approximately one third (34.7%) of young people in the study reported using no contraception.38 Of concern was that just under one in three (27.7%) young people reported having never used a condom; the same proportion of participants reported using condoms all the time.39

This study also found that one in ten (10.1%) young people in custody had been diagnosed with an STI in the past, with Chlamydia the most common (9.6%).40

Endnotes

  1. Australian Bureau of Statistics 2012, Australian Social Trends: June 2012 – Sexually transmissible infections, ABS.
  2. Ibid.
  3. Ibid.
  4. Department of Health 2018, Fourth National Sexually Transmissible Infections Strategy 2018–2022, Australian Government.
  5. Ibid, p. 20.
  6. Ibid, p. 20.
  7. Australian Bureau of Statistics 2012, Australian Social Trends: June 2012 – Sexually transmissible infections, ABS.
  8. Department of Health 2018, Fourth National Sexually Transmissible Infections Strategy 2018–2022, Australian Government.
  9. WA Department of Health, Epidemiology of STIs and BBVs in Western Australia, Annual Report: 2017, WA Government, p. 10.
  10. Ibid, p. 20.
  11. Department of Health 2019, Infectious syphilis outbreak, Australian Government[website].
  12. Ward J et al 2015, Northern Australia syphilis outbreak is about government neglect, not child abuse, The Conversation [website].
  13. Ibid.
  14. Kirby Institute 2018, Bloodborne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people: annual surveillance report 2018, Kirby Institute, UNSW Sydney, p. 9.
  15. Ibid, p. 103.
  16. Kirby Institute 2017, HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2017, Kirby Institute, UNSW Sydney, p. 124, 142 and 159.
  17. WA Department of Health, The Epidemiology of Notifiable Sexually Transmitted Infections and Blood-Borne Viruses in Western Australia 2017, WA Government.
  18. Sourced from an unpublished custom report from the Immunisation, Surveillance and Disease Control Program, Communicable Disease Control Directorate provided by the WA Department of Health to the Commissioner for Children and Young People.
  19. Australian Institute of Health and Welfare (AIHW) 2013, Demonstration projects for improving sexual health in Aboriginal and Torres Strait Islander youth: Evaluation report, Cat no IHW 81, AIHW
  20. Department of Health 2018, Fourth National Sexually Transmissible Infections Strategy 2018–2022, Australian Government, p. 15.
  21. The Commissioner for Children and Young People understands there are a range of terms and definitions that people use to define their gender or sexuality. The Commissioner’s office will use the broad term LGBTI to inclusively refer to all people who are lesbian, gay, bisexual, trans and intersex, as well as to represent other members of the community that use different terms to describe their diverse sexuality and/or gender.
  22. Hillier L et al 2010, Writing Themselves in 3: The third national study on the sexual health and wellbeing of same sex attracted and gender questioning young people, Australian Research Centre in Sex, Health and Society, La Trobe University, p. ix.
  23. Hegazi A and Pakianathan M 2018, LGBT Sexual Health, Medicine, Vol 46, No 5.
  24. Hillier L et al 2010, Writing Themselves in 3: The third national study on the sexual health and wellbeing of same sex attracted and gender questioning young people, Australian Research Centre in Sex, Health and Society, La Trobe University, p. 35.
  25. Ibid, p. 33.
  26. Ibid, p. 34.
  27. Mitchell A et al 2014, 5th National Survey of Australian Secondary Students and Sexual Health 2013, Australian Research Centre in Sex, Health and Society, La Trobe University, p. 35.
  28. Ethnic Communities Council of Victoria 2013, Sexual Health, Cultural Diversity and Young People: What Do We Know?, Ethnic Communities Council of Victoria, p. 3.
  29. WA Office of Multicultural Interests 2009, Not drowning, waving: Culturally and linguistically diverse young people at risk in Western Australia, WA Government, p. 5.
  30. Claudine Ngum Chi Watts M et al 2015, Factors Influencing Contraception Awareness and Use: The Experiences of Young African Australian mothers, Journal of Refugee Studies, Vol 28, No 3.
  31. Brown G et al 2011, How they got it and how they wanted it: Marginalised young people's perspective on their experiences of sexual health education, Sex Education, Vol 12, No 5.
  32. WA Department of Justice 2018, Annual Report: 2017-18, WA Government, p. 15.
  33. Department of Health 2018, Fourth National Sexually Transmissible Infections Strategy 2018-2022, Australian Government, p. 23.
  34. Belenko S et al, 2008, Recently arrested adolescents are at high risk for sexually transmitted diseases, Sexually transmitted diseases, Vol 35, No 8.
  35. The Royal Australasian College of Physicians (RACGP) 2011, The health and well-being of incarcerated adolescents, RACGP, p. 32.
  36. Justice Health & Forensic Mental Health Network and Juvenile Justice NSW 2015, 2015 Young People in Custody Health Survey: Full Report, NSW Government.
  37. Ibid, p. 53.
  38. Ibid, p. 54.
  39. Ibid, p. 54.
  40. Ibid, p. 54.
Measure: Teenage pregnancies

Births to teenage mothers1 are associated with less favourable health, education and economic outcomes for both mother and baby. Parenthood during the teenage years often means that the mother’s education is interrupted, her future job prospects are limited, and there is a higher likelihood that she will be more dependent on government assistance over her lifetime.2,3

Babies of teenage mothers are also at a greater risk of low birth weight and pre-term birth.4 This can be due to the age of the mother, but also reflects certain risk factors which are more prevalent among teenage mothers. These include socioeconomic disadvantage and higher likelihood of smoking during pregnancy.5,6 Teenage mothers are also less likely to attend antenatal care, which can be a protective factor against these risks.7

The Australian Bureau of Statistics collects all birth registrations within Australia each year; this data does not include stillbirths or foetal deaths. This data is used to calculate fertility rates per 1,000 women by age.

Fertility rates for female young people aged 15 to 19 years, age-specific rate*, WA, 2006 to 2017

15 years

16 years

17 years

18 years

19 years

15 to 19 years

2006

3.2

8.7

18.1

28.7

40.5

19.8

2007

4.6

9.6

19.1

28.8

40.4

20.6

2008

4.2

11.7

19.1

30.4

46.9

22.8

2009

4.9

8.2

19.1

26.9

40.0

20.2

2010

4.8

8.3

15.5

28.5

38.1

19.3

2011

3.8

8.6

16.4

26.6

40.6

19.4

2012

3.9

7.5

17.7

25.7

37.1

18.6

2013

3.9

7.5

15.9

22.2

36.2

17.4

2014

3.5

6.0

12.8

21.5

33.0

15.6

2015

2.8

7.2

12.6

19.0

31.3

14.7

2016

3.6

6.2

11.2

17.3

27.7

13.3

2017

2.9

5.7

9.6

16.4

28.0

12.6

Source: Australian Bureau of Statistics, ABS.Stat: Fertility rates by age, by state for Western Australia

* Age-specific fertility rates are the number of live births (registered) during the calendar year, according to the age of the mother, per 1,000 of the female estimated resident population of the same age at 30 June.

Fertility rates for female young people aged 15 to 19 years, age-specific rate, WA, 2006 to 2017

Source: Australian Bureau of Statistics, ABS.Stat: Fertility rates by age, by state for Western Australia

The rate of births to WA female young people aged 15 to 19 years has decreased steadily over the last 12 years.

In 2017, there were 162 births to young mothers under the age of 18 years across WA. This included, 23 births to mothers aged 15 years and under, 45 births to mothers aged 16 years and 94 births to mothers aged 17 years.8

The rate of births to WA female young people aged 15 to 19 years is slightly higher than the Australian fertility rates for these ages.

Fertility rates for female young people aged 15 to 19 years by age, age-specific rate, WA and Australia, 2017

WA

Australia

15 years

2.9

1.7

16 years

5.7

3.7

17 years

9.6

7.7

18 years

16.4

14.0

19 years

28.0

22.8

15 to 19 years

12.6

10.2

Source: Australian Bureau of Statistics, ABS.Stat: Fertility rates by age, by state

In WA, just over one third (37%) of all teenage pregnancies in 2017 were young mothers from remote and regional areas. With only 16.4 per cent and 9.2 per cent of the population of young people living in regional and remote areas respectively, the proportion of teenage births in these areas is disproportionately high.9

Number of births to mothers resident in WA by region* and age, number, WA, 2017

15 years and under

16 years

17 years

Total

Major cities

16

26

59

101

Regional

0

10

26

36

Remote

7

8

9

24

Unknown

0

1

0

1

Total

23

45

94

162

Source: Report collated by the Commissioner for Children and Young People from data prepared by the WA Department of Justice from the Registry of Births, Deaths and Marriages [unpublished]

* Region has been calculated from the mother’s resident postcode by the Commissioner for Children and Young People using the Australian Bureau of Statistics 1270.0.55.005 - Australian Statistical Geography Standard (ASGS): Volume 5 - Remoteness Structure, July 2016, Correspondence, 2017 Postcode to 2016 Remoteness Area. One record had no postcode recorded.  

Across Australia, teenage pregnancies are generally more common in remote and regional areas.10 Research suggests this may be influenced by lower access to health services and sexual health education, limited access to abortion, lower education levels and reduced employment opportunities.11,12

Aboriginal female young people are more likely to have a child while under the age of 18 years, than non-Aboriginal female young people.

Birth rates and Aboriginal status for women aged under 19 years who gave birth in WA, age-specific rate*, WA, 1994-2014

Aboriginal

Non-Aboriginal

Total

1994

151.4

20.3

26.0

1995

133.6

19.8

24.7

1996

125.9

19.6

24.4

1997

135.4

17.8

23.1

1998

130.6

18.8

24.0

1999

125.2

18.4

23.4

2000

122.6

17.2

22.2

2001

104.1

16.3

20.9

2002

101.0

16.4

20.9

2003

100.1

14.6

19.3

2004

97.8

15.3

19.9

2005

107.0

15.9

21.2

2006

105.0

16.4

21.5

2007

94.1

16.5

20.9

2008

93.4

16.3

20.7

2009

88.0

15.4

19.6

2010

81.4

14.1

18.0

2011

83.2

14.1

18.2

2012

77.6

13.9

17.6

2013

78.3

12.1

16.1

2014

68.1

10.5

13.9

Source: WA Department of Health, Mothers and Babies, Western Australia, Western Australia’s mothers and babies 2014

* Age-specific birth rate was calculated from the total number of births in one year per 1,000 women of the same age group.

Birth rates and Aboriginal status for young women aged under 19 years who gave birth in WA, age-specific rate, WA, 1994-2014

Source: WA Department of Health, Western Australia’s mothers and babies report: 2014

Birth rates for Aboriginal and non-Aboriginal young mothers aged 15 to 19 years in WA has been decreasing over the last 20 years. The birth rate for Aboriginal young mothers has more than halved from 151.4 to 68.1. Nevertheless, a significantly higher proportion of young Aboriginal women and girls in WA than non-Aboriginal women and girls are still having children as teenagers.

In 2014, teenagers accounted for 17.8 per cent of Aboriginal women who gave birth. Of these 122 were 17 years and under, which represented 38 per cent of births to WA Aboriginal teenage mothers in that year.13

In 2017, two in every five (40%) teenage births across WA were to female Aboriginal young people. Further to this, four in five (83.3%) of the births within remote areas were to Aboriginal young mothers. This is in part because there are proportionally more Aboriginal young people living in remote areas than in the metropolitan area.

Number of births of mothers under 18 years of age by region* and Aboriginal status, number, WA, 2017

Aboriginal

Non-Aboriginal

Unknown

Total

Metropolitan

34

64

3

101

Regional

11

25

0

36

Remote

20

4

0

24

Unknown

0

1

0

1

Total

65

94

3

162

Source: Report collated by the Commissioner for Children and Young People from data prepared by the WA Department of Justice from the Registry of Births, Deaths and Marriages [unpublished]

* Region has been calculated from the mother’s resident postcode by the Commissioner for Children and Young People using the Australian Bureau of Statistics 1270.0.55.005 - Australian Statistical Geography Standard (ASGS): Volume 5 - Remoteness Structure, July 2016, Correspondence, 2017 Postcode to 2016 Remoteness Area. One record had no postcode recorded.

There are a number of factors that increase the likelihood that Aboriginal female young people will be teenage parents, these include living in remote and regional locations, greater likelihood of socioeconomic disadvantage, less access to health services and lower education levels.14,15

At the same time, research has found that some female Aboriginal young people felt that having children was an opportunity to transform their lives, with a strong desire to be a good parent.16,17

For more information on pregnancy care for young Aboriginal mothers refer to:

Reibel T and Morrison L 2014, Young Aboriginal Women’s Voices on Pregnancy Care, Telethon Kids Institute, The University of Western Australia.

While data and research often focuses on teenage mothers, male young people who become teenage fathers are also important. Similar to teenage mothers, evidence suggests that teenage fathers are more likely to come from socioeconomically disadvantaged backgrounds, single parent families and have lower education levels.18

Paternity rate for male young people aged 15 to 19 years, age-specific rate, WA, 2006-2017

15 years

16 years

17 years

18 years

19 years

2006

1.0

1.2

4.9

9.2

16.7

2007

0.7

2.2

5.0

10.0

15.5

2008

0.9

2.1

6.1

12.1

16.5

2009

0.8

2.9

4.7

10.6

16.5

2010

0.8

1.7

5.8

9.0

15.8

2011

0.7

1.7

5.7

9.6

15.2

2012

0.8

2.0

4.5

8.8

15.1

2013

1.0

2.4

4.8

9.2

13.0

2014

1.0

1.6

4.4

7.9

11.9

2015

0.7

1.7

4.3

8.2

11.6

2016

0.5

1.5

3.8

6.8

11.7

2017

0.6

2.4

3.2

6.2

12.0

Source: Australian Bureau of Statistics, ABS.Stat: Fertility rates by age, by state

* This data is not complete as it excludes births where paternity was not acknowledged or where the age of the father is not known.

Paternity rate for male young people aged 15 to 19 years, age-specific rate, WA, 2006-2017

Source: Australian Bureau of Statistics, ABS.Stat: Fertility rates by age, by state

Similar to rates of teenage pregnancy, the rate of WA male young people aged 15 to 19 years fathering children has steadily decreased since 2008.

Across WA, the number of registered births associated with teenage fathers has declined for male young people aged 15 years and under from 15 births in 2006 to nine births in 2017. However, for young male people aged 16 years, the number of births has doubled since 2006, from 19 to 37 in 2017.19

It should be noted that this data is not complete as it only includes births where paternity was acknowledged and the age of the father was recorded.

While it is often assumed that teenage mothers are no longer in a relationship with the father of their child, this is often not the case. Although there is no administrative data available, research suggests that teenage mothers can often be in an ongoing relationship with the father of their child.20,21 It is therefore important, where appropriate, to support teenage fathers (and fathers of children of teenage mothers) so that they can support the mother of their child and be a caring and responsible parent.22

The reduction in teenage birth rates has been linked not only to an increase in availability of effective forms of contraception, but also abortion accessibility across Australia.23,24 In WA, abortions performed before 20 weeks gestation are legal and non-surgical abortions have recently been introduced within Australia.25 Yet, data from the WA Department of Health highlights that the number of induced abortions have decreased by almost one-half from 2005 to 2015 for young women less than 19 years.

Abortion rate for young people aged 15 to 19 years, rate per 1,000, WA, 2005 to 2015

15 to 19 years

2005

21.2

2006

23.6

2007

22.9

2008

22.3

2009

21.3

2010

18.9

2011

18.0

2012

14.7

2013

13.8

2014

11.7

2015

9.1

Source: WA Department of Health, Reports on induced abortions in Western Australia, Induced Abortions in Western Australia, 2013-2015: Report of the WA Abortion Notification System

Abortion rate for young people aged 15 to 19 years, rate*, WA, 2005 to 2015

Source: WA Department of Health, Reports on induced abortions in Western Australia, Induced Abortions in Western Australia, 2013-2015: Report of the WA Abortion Notification System

* Rate per 1,000 women

The abortion rate for WA female young people has steadily decreased from 21.2 per 1,000 women aged 15 to 19 years in 2005 to 9.1 per 1,000 women aged 15 to 19 years in 2015. In 2015 there were only 20 abortions across the state for female young people aged under 15 years, this is a significant reduction from 37 in 2005.

Aboriginal female young people in WA aged 15 to 19 years are less likely to have an abortion when pregnant than non-Aboriginal female young people of the same age group.26

The combined reduction in teenage births as well as induced abortions suggests that young people are more effectively using the various contraception options available and that the increase in the quality and accessibility of sexual health education is having an impact.

Endnotes

  1. In keeping with the terminology used by the Australian Bureau of Statistics and other states, in assessing this measure ‘teen’ and ‘teenage’ are used to indicate persons aged under 19 years of age. Where this measure is highlighting births to mothers aged 17 years and under, that is specifically stated.
  2. Marino JL et al 2016, Teenage Mothers, Australian Family Physician, Vol 45, No 10.
  3. Department of Social Services 2016, Try Test Learn Fund: Young Parents Fact Sheet, Australian Government.
  4. Marino JL et al 2016, Teenage Mothers, Australian Family Physician, Vol 45, No 10.
  5. Gaudie J et al 2010, Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage, BMC Public Health, Vol 10, No 63.
  6. Australian Institute of Health and Welfare (AIHW) 2015, Teenage mothers in Australia in 2015, AIHW.
  7. Australian Institute of Health and Welfare (AIHW) 2012, A picture of Australia’s children 2012, Cat No PHE 167, AIHW, p. 50.
  8. Sourced from an unpublished custom report prepared by WA Department of Justice for the Commissioner for Children and Young People WA from the Registry of Births, Deaths and Marriages.
  9. Commissioner for Children and Young People WA 2019, Profile of Children and Young People in WA, Commissioner for Children and Young People.
  10. Hoffman H and Vidal S 2017, Supporting Teen Families: An Assessment of Youth Childbearing in Australia and Early Interventions to Improve Education Outcomes of Young Parents, Life Course centre: Institute for Social Science Research, The University of Queensland, p. 6.
  11. Hoffman H and Vidal S 2017, Supporting Teen Families: An Assessment of Youth Childbearing in Australia and Early Interventions to Improve Education Outcomes of Young Parents, Life Course centre: Institute for Social Science Research, The University of Queensland, p. 6.
  12. Australian Institute of Health and Welfare (AIHW) 2018, Teenage mothers in Australia in 2015, AIHW.
  13. WA Department of Health, Western Australia’s mothers and babies report: 2014, p. 36.
  14. Australian Institute of Health and Welfare (AIHW) 2018, Teenage mothers in Australia 2015, AIHW.
  15. Hoffman H and Vidal S 2017, Supporting Teen Families: An Assessment of Youth Childbearing in Australia and Early Interventions to Improve Education Outcomes of Young Parents, Life Course centre: Institute for Social Science Research, The University of Queensland, p. 7.
  16. Hoffman H and Vidal S 2017, Supporting Teen Families: An Assessment of Youth Childbearing in Australia and Early Interventions to Improve Education Outcomes of Young Parents, Life Course centre: Institute for Social Science Research, The University of Queensland.
  17. Larkins et al 2011, The transformative potential of young motherhood for disadvantaged Aboriginal and Torres Strait Islander women in Townsville, Australia, The Medical Journal of Australia, Vol 194, No 10.
  18. Olajide N et al 2019, The antecedents and consequences of adolescent fatherhood: A systematic review, Social Science & Medicine, Vol 232.
  19. Australian Bureau of Statistics, ABS.Stat: Fertility rates by age, by state, Paternity: births by state for Western Australia [website].
  20. Manning W and Cohen J 2015, Teenage Cohabitation, Marriage, and Childbearing, Population research and policy review, Vol 34, No 2.
  21. Kumar N et al 2018, Adolescent Mothers’ Relationships with their Mothers and their Babies’ Fathers during Pregnancy and Postpartum, Journal of Child and Family Studies, Vol 27.
  22. Wilkes L et al 2012, ‘I am going to be a dad’: experiences and expectations of adolescent and young adult expectant fathers, Journal of Clinical Nursing, Vol 21.
  23. Family Planning Victoria, Teenage Pregnancy [website].
  24. Marino JL and Sawyer S 2019, Monitoring the missing half: why reporting adolescent births is insufficient, The Medical Journal of Australia, Vol 210, No 5.
  25. de Moel-Mandel C and Shelley J 2017, The legal and non-legal barriers to abortion access in Australia: a review of the evidence, The European Journal of Contraception and Reproductive Healthcare, Vol 22, No 2.
  26. WA Department of Health 2018, Induced Abortions in Western Australia, 2013-2015, p. 28.
Young people in care

At 30 June 2018 there were approximately 2,240 young people aged between ten and 17 years in care in WA, more than half (51.9%) of whom were Aboriginal.1

Family relationships, parenting and the environment that a young person grows up in informs their understanding of how to make responsible choices about alcohol, tobacco and other drug use and sexual activities.2,3 Children and young people in out-of-home care have generally experienced significant adverse events on an ongoing basis. These may include neglect, food scarcity and physical, sexual or emotional abuse. Furthermore, children and young people in the child protection system have often not had stable and positive adult support to provide advice and information on sex and sexual health.4 

These experiences increase the likelihood of these young people engaging in risk-taking behaviours, including risky level of alcohol, tobacco and other drug use and risky sexual activities.5,6,7 Furthermore, children and young people who have experienced high levels of childhood stress are more likely to experience poor health outcomes, including alcoholism, as adults.8

In a 2016 report research, Anglicare Victoria highlighted that children and young people in care are more likely than their peers in the broader community to smoke and use illicit drugs.9 Just under three in every ten (26.6%) young people in care reported ever having smoked cigarettes, in comparison to one in every twenty (5%) young people in the broader community.10 In addition, more than three in ten (33.3%) young people had used an illicit substance in the past 12 months in comparison to 17.6 per cent of the young people in the rest of the community.11

Studies have also shown that young people in care often have received limited formal sexual health education and are more likely to have experienced dysfunctional family relationships.12 This increases their risk of early sexual activity and consequently they have a higher risk of pregnancy and contracting sexually transmissible infections.13

Research shows that young women who have been in care have a higher risk of teenage pregnancy than other young women in Australia.14,15 There is also evidence to suggest that pregnant female young people with a care experience are more reluctant to use health services in the fear that their child may being take into the child protection system.16

Even though young people in care have higher risk profiles for sexually transmissible infections (early sexual initiation, risk-taking behavior, substance abuse), no data is available on the prevalence of sexually transmissible infections for young people in care.  

No data exists for WA young people in care regarding their alcohol, tobacco or drug use or their sexual health.

Endnotes

  1. Department of Communities 2019, 2017-18 Annual Report, Child Protection Activity Performance Report 2017-2018, WA Government.
  2. Potter M and Font S 2019, Parenting influences on adolescent sexual risk-taking: Differences by child welfare placement status, Children and Youth Services Review, Vol 96, p. 135.
  3. Ibid, p. 134.
  4. Mendes P 2009, Improving outcomes for teenage pregnancy and early parenthood for young people in out-of-home care, Youth Studies Australia, Vol 28 No 4, p. 13
  5. Research in practice 2016, Risk-taking adolescents and child protection, Research in practice.
  6. Potter M and Font S 2019, Parenting influences on adolescent sexual risk-taking: Differences by child welfare placement status, Children and Youth Services Review, Vol 96.
  7. Somers C et al 2016, Adolescent Girls in Out-of-Home Care: Associations Between Substance Use and Sexual Risk Behavior, Journal of Child & Adolescent Substance Abuse, Vol 25, No 5.
  8. Franke H 2014, Toxic Stress: Effects, Prevention and Treatment, Children, Vol 1 No 3.
  9. Kandasamy N et al 2016, Children in Care Report Card, Anglicare Victoria.
  10. Ibid.
  11. Ibid.
  12. Mendes P 2009, Improving outcomes for teenage pregnancy and early parenthood for young people in out-of-home care, Youth Studies Australia, Vol 28 No 4, p. 13.
  13. Ibid.
  14. Ibid.
  15. Create Foundation 2018, Create position paper: Young people leaving care as parents, Create Foundation.
  16. Ibid.
Young people with disability

The Australian Bureau of Statistics Disability, Ageing and Carers data collection reports that approximately 23,700 WA children and young people (7.5%) aged five to 14 years have a reported disability.1,2

Young people living with disability often experience a range of adverse individual and environmental issues, including experiences of discrimination, bullying and exclusion.3 Some disabilities can also make it difficult for young people to communicate, develop supportive social relationships and self-regulate their behaviour.4 These difficulties can all increase the risk of young people with disability using alcohol or illicit drugs to cope.

At the same time, young people with disability have the right to explore their gender and sexuality, have relationships based on consent, respect and safety and, where possible, control decisions which affect their sexual health and relationships.5

There is very little information about substance use or sexual activities and sexual health of young people with disabilities.

Research from the United States suggests that young people with disabilities are less likely to smoke, use drugs or drink alcohol at risky levels. However, they also note that young people with emotional disturbances and learning disabilities were more likely to report smoking, drinking and drug use.6

All children and young people, regardless of the range of their abilities, must be seen as active and valued citizens who have the right to participate in community life to its full extent. This includes having access to information and resources to make informed choices about alcohol and drugs and their sexuality and sexual and reproductive health.7 Many young people with disability are frequently denied sexual health support and planning due to discrimination, health services being ill-equipped and educated on ability to assist young people with disability and therefore may increase the risk of mistreatment and abuse.8

For information and resource on sexuality and sexual health of people with disability refer to the SECCA website.

No data exists on the consumption of alcohol, tobacco or other drugs, or the sexual health of WA young people with disability.

Endnotes

  1. ABS uses the following definition of disability: ‘In the context of health experience, the International Classification of Functioning, Disability and Health (ICFDH) defines disability as an umbrella term for impairments, activity limitations and participation restrictions… In this survey, a person has a disability if they report they have a limitation, restriction or impairment, which has lasted, or is likely to last, for at least six months and restricts everyday activities.’ Australian Bureau of Statistics 2016, Disability, Ageing and Carers, Australia, 2015, Glossary.
  2. Estimate is to be to be used with caution as it has a relative standard error of between 25 and 50 per cent. Australian Bureau of Statistics 2016, Disability, Ageing and Carers, Australia, 2015: Western Australia, Table 1.1 Persons with disability, by age and sex, 2012 and 2015 estimate, and Table 1.3 Persons with disability, by age and sex, 2012 and 2015, proportion of persons.
  3. National People with Disabilities and Carer Council 2012, SHUT OUT: The Experience of People with Disabilities and their Families in Australia: National Disability Strategy Consultation Report, Australian Government.
  4. Dix K et al 2013, KidsMatter and young children with disability: Evaluation Report, Flinders Research Centre for Student Wellbeing & Prevention of Violence, Shannon Research Press, p. 15.
  5. Shine SA 2019, Disability and Sexuality, Shine SA [website].
  6. National Center for Special Education Research 2008, Substance Use Among Young Adults With Disabilities, U.S. Department of Education, p. 11
  7. Sexual Health and Family Planning Australia (SH&FPA) 2013, Improving Sexual and Reproductive Health for People with Disability, SH&FPA Disability Special Interest Group.
  8. Family Planning NSW 2013, Taking Action on reproductive and sexual health and rights of people with disability: 2014-2018, Family Planning NSW, p. 15.
Policy implications

Most young people in WA engage in positive healthy behaviours, while also participating in normal experimentation with substances and sexual activity as part of the transition to adulthood. However, some young people engage in risky behaviours such as the misuse of alcohol or other drugs and engaging in unsafe sexual activity. Providing young people with information and support to increase their understanding of the risks involved and how these behaviours can have long-lasting impacts on their health and wellbeing, can enable them to make healthier choices.

Alcohol, tobacco and other drugs

The rates of alcohol, tobacco and other drug use by young people aged 12 to 17 years has declined steadily over the past thirty years in WA. Furthermore, the proportion of young people that reported never having consumed alcohol, tobacco and other drugs has increased.

However, there are still a significant number of young people drinking alcohol, smoking and taking other drugs at risky levels. For example, for those WA young people who are drinking regularly, there has been an increase in the proportion drinking at risky levels on a single occasion.1 Additionally, while drug use overall has decreased over time, the higher quality and lower cost of some drugs (methamphetamine) means those who use illicit drugs are at greater risk of harm.

Research suggests that young people living in remote and regional locations, LGBTI young people and young people in care are more likely to use alcohol, tobacco and other drugs at risky levels. Preventative policies and programs should be targeted to these groups. There also needs to be a concerted effort to improve services and supports for young people who are using alcohol and other drugs at risky levels.  

Of particular concern was one in three WA young people who had consumed alcohol reported sourcing alcohol from their parents. Further to this, studies highlighted that parental drinking behaviour influenced the likelihood of young people in their care consuming alcohol. Public health campaigns promoting key messages and harm minimisation strategies are critical, for example, the Alcohol. Think Again campaign which targets parents.

A multifaceted approach is required, which recognises the important role individuals, parents and carers, institutions and communities play in reducing alcohol and drug-related harm. Some key policy priorities should be:

  • Strategies that address the broader culture of alcohol consumption in Australia. Programs should be delivered to involve and educate parents and the wider community recognising that social influence, particularly from parents and peers, has a significant impact on young people’s behaviours. Provide a supportive environment for parents’ behavioural change, reinforced in external environments such as schools, sporting clubs and the media.
  • Compulsory culturally appropriate education on alcohol, smoking and drugs in schools. Promoting protective behaviours and a positive school culture is a key component of this approach. School-based alcohol, smoking and drug education programs should aim to modify behaviour, not just increase knowledge and competence.
  • Listening to young people’s experiences with alcohol, tobacco and drugs is critical to developing effective policy. Young people should be an integral part of the ongoing development and implementation of strategies to reduce alcohol and drug-related harm.
  • Policymakers and educators should consider the unique developmental period of the middle years (nine to 14 year-olds) as the stage to commence age-appropriate school-based alcohol, smoking and drug education programs.
  • Reduce the availability of cheap and discounted alcohol, through means such as volumetric taxation and/or introduction of a minimum floor price.
  • Consider legislation to restrict the advertising and promotion of alcohol, particularly advertising to which children and young people are exposed (e.g. billboard and sport advertising).
  • Provision of more alcohol-free events for children, young people and families.
  • Providing accessible, holistic, culturally appropriate family-focused treatment services that assess and meet the needs of children and young people living with parents who have an alcohol or drug dependency.2

For further information on young people and alcohol refer to the following:

Commissioner for Children and Young People WA 2018, Policy Brief: Alcohol and the role of parents, Commissioner for Children and Young People WA

Commissioner for Children and Young People WA 2011, Issues Paper: Young people and alcohol, Commissioner for Children and Young People WA

Sexual health

It is important for young people to grow and develop in a supportive social environment. Strong relationships with parents, peers and the school community all assist in establishing a supportive social environment for young people throughout their sexual development. 

Across Australia, two in every three young people aged 15 to 17 years of age have reported experiencing some form of sexual activity (deep kissing, genital touching, oral sex or penetrative sex). Of young people engaging in sexual activities, more than half are at risk of contracting a sexually transmissible infection due to unsafe sexual practices. Research has also highlighted that young people aged 15 to 17 years across Australia have limited knowledge of STI transmission.3

Improving the knowledge and understanding of young people about sexual health is critical and should be a focus of policy and sexual health education within all schools. Research clearly shows that educating young people about sex and sexual health does not encourage young people to engage in sexual activities earlier.4

Policy and programs also need to recognise and support the diversity of young people’s sexual identities and experiences.

Sexual health includes not only safe sex practices to reduce the risk of sexually transmissible infections (STIs), but should also include appropriate access to information and services that are inclusive and culturally safe and address healthy relationships, sexual coercion and consent.

The rates of births to WA female young people 17 years and under has decreased steadily over the last 12 years. However, factors such as limited access to high quality and culturally safe health care services, poor sexual health education, poverty and living in remote and regional areas increase the likelihood of risky behaviours which could lead to becoming a teenage parent.

Some key policy priorities to improve young people’s sexual health knowledge and practice should include:

  • Compulsory diverse and inclusive (gender, age, cultural and linguistic backgrounds, socio-economic status, sexual orientation, disability and geographic location) sexual health education should be available in high schools.5 The WA Department of Education’s, Growing and Developing Healthy Relationships program provides guides and learning tools.
  • Policymakers and educators should also consider the unique developmental period of the middle years (nine to 14 year-olds) as the stage to commence age-appropriate school-based sexual health education programs.6
  • Recognising that parents and communities are critical influences on children and young people’s knowledge and understanding of sexual health issues, culturally appropriate resources for parents and communities should be widely disseminated. For example, the WA Department of Health publishes the Talk soon. Talk often guide to help parents talk to their children about sex.
  • Improving access to sexual health services, particularly for young people in regional and remote areas. This may include outreach sexual health education, programs and clinical services.
  • Encouraging the use of condoms during sexual activity is critical.7 Free or low cost condoms should be available and accessible across the whole state.
  • Promoting safe sex behaviours including understanding consensual sex and the importance of regular STI testing.
  • Young people should be an integral part of the ongoing development and implementation of strategies and programs pertaining to their sexual health education and support.

Young people experiencing vulnerability, in particular young people in care and in the youth justice system are at an increased risk of engaging in unsafe sexual activities. Yet, they have often had less access to sexual health education and services. Sexual health education and access to condoms and sexual health services should be prioritised for these groups.

All children and young people are different, and while membership of one of any groups is influential (e.g. LGBTI, Aboriginal or living in a remote location etc.), there are many other factors which influence a young person’s identity and experiences. Thus, policy and programs need to not only recognise the heightened risk for different groups, but also be person-centred and focused on the needs and circumstances of the individual.

Data gaps

There is limited data on the prevalence of consumption of alcohol, tobacco or other drugs, or the sexual health of WA children and young people.

The 2014 Australian Secondary Students’ Alcohol and Drug (ASSAD) survey was the most recent survey establishing an estimate of WA prevalence of alcohol and other drug consumption. The 2017 results of this survey are available for national prevalence but jurisdictional data has not yet been made available. Further to this, WA data does not provide specific details on young people’s use of illicit or non-prescribed drug use in metropolitan, regional or remote WA.

No data is available on alcohol consumption or other drug use for Aboriginal children and young people in WA. In light of the 2019 WA State Coroner’s report, Inquest into the deaths of: Thirteen children and young persons in the Kimberley region, Western Australia, which highlighted that a majority of the children and young people that had committed suicide had experienced the effects of alcohol abuse, and seven of the cases (four of which were children) had been consuming significant amounts of alcohol in the lead up to their deaths. Further to this, in three of the cases, marijuana was detected in the blood of the young people post-death.8

Multiple inquiries have highlighted the need for further programs and services to support Aboriginal children and young people. To inform planning and implementation of these recommendations it is essential that data is collected and reported on the prevalence of alcohol and other drug issues for Aboriginal children and young people in WA. 

The Australian Study of Health and Relationships (ASHR) survey is conducted every ten years and provides a snapshot of the sexual health and wellbeing of the Australian population.9 However, this data is often too old to be relevant and is not available to the general public. The National Survey of Australian Secondary Students and Sexual Health is a survey that is conducted every five years that collects the sexual attitudes, knowledge and experiences of high school students in Years 10 to 12 across Australia. Although this study is completed more frequently, the study only includes attitudes, knowledge and experiences of young people in Years 10-12, specifically those that attend high schools. Considering that the age of initiation for sexual activity can be quite early for many young people, it is essential to understand their experiences and knowledge in this area.

Both of these studies relate to Australian research and therefore data relating to sexual understandings and experiences of WA young people is unable to be specifically explored. This information is critical for the planning/service delivery/education programs that specifically relate to the sexual health needs of WA young people.

LGBTI status, unlike other demographic characteristics, is not readily identifiable through existing data collection methods (such as coronial records, surveys, administrative data collected by services).10 The lack of data on the prevalence of alcohol and other drug use and sexual health issues for LGBTI children and young people makes it difficult to effectively improve services and supports for them.

There is no data publicly available on the prevalence of alcohol and other drug use and sexual health issues among young people in out-of-home care, even though it is well known these young people are vulnerable and at high risk of risky behaviours such as alcohol and drug use and unsafe sexual activities.

The limited data being collected and reported regarding alcohol and other drug use and sexual health of WA young people from refugee and migrant background is of concern. With refugee young people potentially dealing with trauma, conflict and settlement issues, the use of alcohol and other drugs can become a way of coping. In addition, with migration comes breakdowns in families, disconnection from peers, and inconsistencies in education, which mean that sexual health education may not be a primary focus in many of these families’ lives.

Living with disability can also contribute to mental health difficulties due to a range of adverse individual and environmental issues associated with disability, which can increase the risk of using substances to cope. At the same time, young people with disability have the right to explore their gender and sexuality, have relationships based on consent, respect and safety and, where possible, control decisions which affect their sexual health and relationships. Data is currently not available for this cohort pertaining to both alcohol and drug use and sexual health attitudes and experiences. All children and young people, regardless of the range of their abilities, must be seen as active and valued citizens who have the right to participate in community life to its full extent and without such data it makes it difficult to effectively improve services and supports for this cohort.

The Commissioner’s Speaking Out Survey, scheduled for release in early 2020, will provide some further data on the experiences and views of WA’s children and young people regarding their healthy behaviours.

Endnotes

  1. Mental Health Commission (MHC) [undated], Alcohol trends in Western Australia: Australian school students alcohol and drug survey, MHC.
  2. Commissioner for Children and Young People WA 2011, Speaking out about wellbeing: children and young people speak out about alcohol and drugs, Commissioner for Children and Young People WA.
  3. Mitchell A et al 2014, 5th National Survey of Australian Secondary Students and Sexual Health 2013, Australian Research Centre in Sex, Health and Society, La Trobe University, p. v.
  4. UNESCO 2009, International Technical Guidance on Sexuality Education: An evidence-informed approach for schools, teachers and health educators, Volume 1: the rationality for sexuality education, UNESCO, p. 8.
  5. Skinner R and Hickey M 2003, Current priorities for adolescent sexual and reproductive health in Australia, The Medical Journal of Australia, Vol 179 No 3.
  6. UNESCO 2009, International Technical Guidance on Sexuality Education: An evidence-informed approach for schools, teachers and health educators, Volume 1: the rationality for sexuality education, UNESCO, p. 8.
  7. Department of Health 2019, Perspectives on working with young people: A youth health issue in focus: young people, sex and pregnancy [website].
  8. WA State Coroner 2019, Inquest into the deaths of: Thirteen children and young persons in the Kimberley region, Western Australia, WA Government, p. 10.
  9. Australian Study of Health and Relationships (ASHR) 2014, Sex in Australia 2 - Summary, The University of NSW, The University of Sydney, University of Sussex and La Trobe University.
  10. Rosenstreich G 2013, LGBTI People Mental Health and Suicide, Revised 2nd Edition, National LGBTI Health Alliance, p. 6
Further resources

For further information on the healthy behaviours of young people refer to the following resources:

Endnotes

  1. Australian Research Alliance for Children and Youth (ARACY) 2018, ARACY Report Card 2018: The Wellbeing of Young Australians, ARACY, p. 30.
  2. Australian Institute of Health and Welfare (AIHW) 2016, Australia’s health 2016 – Chapter 5.4 Health of young Australians, Australia’s health series no 15, Cat no AUS 199, AIHW.