We intend to provide focused information to improve anti-tobacco messaging especially among marginalised populations and during respiratory pandemics.

Collaborating Organisations

University of Oxford, Lung Foundation Australia, WHO, SESLHD.

Key Funders

Nuffield Department of population Health Pump Priming Grant.

Project Type

Current project

Chief Investigators

A/Prof Freddy Sitas (CPHCE ), A/Prof Margo Barr, Dr Marianne Gale, (SESLHD), Mark Brooke (Lung Foundation Australia, Sarah Lewington (University of Oxford).

Project Rationale

The role tobacco and e-cigarette smoking plays in Lower Respiratory Tract Infections (LRTI-tuberculosis, pneumonia, influenza and other lung infections including COVID-19) has been underappreciated. COVID-19 and other respiratory viruses continue to pose ongoing worldwide threats. This association is a key factor in maintaining health inequities. Information on risk between tobacco and e-cigarette smoking and LRTI is based on small or inconclusive studies, leading to hesitancy around development of sound anti-smoking policies, as expressed by Lung Foundation Australia (LFA), which informs the Commonwealth Department of Health National Tobacco Strategy, and by World Health Organization (WHO), responsible for worldwide policy and practice development in tobacco control. They will guide these research outputs into implementable findings for Australia and worldwide to inform tobacco control programs, policy and practice, and streamline public health messaging.  

Project Aim/s

  1. Obtain robust results from the largest possible worldwide collaboration on the risks between smoking and LRTI and quantify the benefits of cessation
  2. Continue a 20-year collaboration with South Africa using 3.4m death records with tobacco smoking collected on death notifications to measure risks in relation to population, education, place and LRTI.
  3. Use these data to advocate the insertion of questions on smoking and vaping on death notification forms in Australia.

Project Design and Method

Federated meta-analyses of cohort and case-control studies. We have data on smoking and LRTI from Australian 45 and Up, UK Biobank and Million Women Study) to inform a collaborative meta-analysis using the 57 cohort studies of the Univ. of Oxford Richard Doll Consortium, 19 million participants.


Sitas F, Short G, Brooke M, Griffiths K. Smoking and vaping on death notification forms in Australia: Improving the reporting of preventable risk factors. Health Promot J Austr. 2023 Feb 15. doi: 10.1002/hpja.703.

Groenewald P, Pacella R, Sitas F, Awotiwon OF, Vellios N, Van Rensburg CJ, Manda S, Laubscher R, Nojilana B, Joubert JD, Labadarios D, Ayo-Yusuf L, Roomaney RA, Turawa EB, Neethling I, Abdelatif N, Pillay-van Wyk V, Bradshaw D. Estimating the changing disease burden attributable to smoking in South Africa for 2000, 2006 and 2012. S Afr Med J. 2022 Sep 30;112(8b):649-661. doi: 10.7196/SAMJ.2022.v112i8b.16492.


Freddy Sitas
02 90658007
F.Sitas @unsw.edu.au

Project lead centre


Project stream

Prevention and Management of Long Term Conditions