An Australian perspective on tobacco control in the 21st Century

Neil Francey, Barrister at Law, Whitsunday Chambers

E Haydn Walters, University of Tasmania; The Alfred, Melbourne; and Royal Hobart Hospital

and Adrian Reynolds, Southern Mental Health and Statewide Services Tasmanian Health Organisation; and School of Medicine, University of Tasmania

The Australian experience in recent years is that tobacco control measures should be viewed according to their integrated effectiveness in denormalising smoking and reducing smoking prevalence

The tobacco industry has long sought to retard tobacco control measures, dating from a meeting of US tobacco companies in December 1953 and a meeting of US and UK tobacco companies in June 1977 (see Professor Robert Proctor’s  comprehensive history of the tobacco industry Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition).

Over time these efforts have moved from disputing that smoking causes various diseases to questioning whether tobacco control proposals are practical, workable and effective.  These industry tactics have, amongst other things, sought to:

  • impede restrictions on advertising and promotion of tobacco products;
  • resist the imposition of increased tax/excise on tobacco products;
  • hinder the introduction and extension of smoke free areas.

In Australia these efforts have most recently been directed to rejecting both plain packaging and a tobacco free generation proposal (legislation barring the sale of tobacco products to persons born on or after 1 January 2000).

The industry’s opposition seems to involve now conceding that smoking is harmful, but dissecting individual tobacco control measures and attacking the contribution they may make to achieving the overall objective of reducing the prevalence of smoking.

It is instructive therefore to put tobacco control measures in perspective so they may be considered in a sensible, practical and rational manner, the current suite of effective tobacco control measures being:

  1. Education programs, to inhibit the uptake of smoking.
  2. Restrictions on advertising and promotion, to neutralise the ‘glamorisation of smoking’ (eg plain packaging).
  3. Imposition of tax/excise/licence fees, which results in a price increase, thereby providing a disincentive to purchase.
  4. Reduced access by increasing the legal age to purchase cigarettes (now up to 21 in some US states), and the current proposal for any person born on or after 1 January 2000 as part of Tobacco Free Generation legislation in the Australian state of Tasmania.
  5. Introduction and extension of smoke free areas, which restrict opportunities for smoking.

All of these measures contribute to what may be called the ‘integrated effectiveness of tobacco control measures’ and/or the ‘denormalisation of smoking’ (by counteracting specific tobacco industry objectives of providing ‘smoker reassurance’ and preserving the ‘social acceptability’ of smoking).

Accordingly, and in order to rebut the tobacco industry’s tactic of dissecting these measures, and introducing ‘red herrings’ of unlawful sales of tobacco products (something which falls within enforcement of the existing law) and the controversial subject of e-cigarettes (potentially a form of preserving the ‘social acceptability’ of smoking – albeit in the form of a different nicotine delivery device), the Australian experience suggests that any proposed tobacco control measure be considered for the contribution it may make to the overall objectives of tobacco control and not as one to be viewed in isolation.

Finally, these efforts by the tobacco industry may be seen anywhere as an attack on “state sovereignty”, that is attempting to undermine and pervert the decision making process of Parliaments and Governments to act in the best interests of their constituents.