Tackling Australia’s No. 1 
preventive health issue:  TOBACCO  

A guide from ASH Australia for MPs and candidates

Ten policies for a tobacco-free Australia

ASH is seeking commitment from major party leaders to ten policies for a tobacco-free Australia, to meet our FCTC treaty obligations (the first 9 were also recommended in 2009 by the National Preventative Health Taskforce report):

1.   Further tobacco tax increase by 2012 to increase price of average pack of 30 to $20;

2.   Set a minimum floor price of $15 for a pack of 25;

3.   Abolish duty-free tobacco sales and raise up to $200m pa in extra revenue;

4.   Increase frequency, reach and intensity of counter-tobacco social marketing campaigns - with particular emphasis on social disadvantage and high-needs targets;

5.   End all forms of tobacco advertising and promotion, including a ban on internet sales;

6.   Eliminate tobacco promotion in package design by honouring federal government commitment to mandate plain packaging by July 2012 (see our  factsheet for MPs);

7.   Strengthen smokefree places laws by ending exemptions in high roller gaming rooms;

8.   Substantially improve content regulation and mandatory consumer information;

9.   Increase availability of quitline services and evidence-based cessation aids; and

10. End organisational donations to political parties and candidates, cap individual donations and electoral expenditure by parties and candidates.  

Tobacco – still our No. 1 preventable health and No. 1 drug problem

• Tobacco kills around 15,000 Australians a year – more than the combined death toll from road accidents, alcohol, illicit drugs, all homicide, HIV, diabetes, skin cancer - and more.  Tobacco smoking is the biggest single preventable cause of both cancer and heart disease – our two leading causes of early death; and is linked with the seven diseases causing most deaths.   See evidence from   ABS    AIHW   National Drug Strategy 
  

• Tobacco is responsible for more than $31b a year in costs to the Australian community. Collins and Lapsley report 2008 for National Drug Strategy 

  Tobacco is responsible each year  for:

  • Around 15,000 deaths, including 36 a year aged under 15.

  • 56% of total drug abuse costs - more than alcohol and all other drugs combined.  

  • Over $15b in workplace costs - twice as much as alcohol and all other drugs combined.

  • Over 750,000 hospital bed days - around 8% of them occupied by children under 15.

  • Over $600m hospital costs.

• Around 19% of adults still smoke at least weekly - around 3 million Australians.  
  See AIHW - Table 4.1, p.19

Australian children at risk

• 36 Australian babies and children under 15 years old die each year from involuntary (in utero  and secondhand) intake of tobacco smoke.    Collins & Lapsley (2008) above 

• Over 60,000 hospital bed days a year occupied by children as a result of tobacco exposure.   Collins & Lapsley (2008) above

• Tobacco smoke is now the leading preventable cause of SIDS deaths.  2007 research review 

• Over 140,000 (9% of) Australian schoolchildren smoke at least weekly – 18% of 17-year-olds; and children have ready access to cigarettes: 23% of schoolchildren aged 12-17 (and 29% of 16-year-olds) are supplied illegally by shops. 
  2005 secondary schools survey

Smoking costs Australia a staggering $31bn a year

Real social costs of smoking are conservatively estimated to be as high as $31b a year (see above). And who pays?

• Business and Governments – in health care costs, absenteeism, and lost productivity.

• Smokers – half of all long-term smokers will eventually be killed by tobacco – losing an average of 10 years; and half of these will die during productive middle age, losing 20-25 years of life.   Doll R et al (June 2004), "Mortality in relation to smoking: 50 years' observations on male British doctors" in BMJ  2004;328:1519 (26 June), doi:10.1136/bmj.38142.554479.AE

• Non-smokers – babies born to smoking mothers have lower birth weights and an increased risk of SIDS and respiratory diseases. In addition, substantial costs can be incurred where people are exposed to tobacco smoke in workplaces and public places.   
  Collins & Lapsley, above

Australians want better tobacco control

Opinion polls consistently show health at or near the top of the list of Federal election issues – with cancer and heart disease the No. 1 and No. 2 disease concerns. As the electorate knows, tobacco is the biggest preventable factor in both these diseases.  

The 2007 National Drug Strategy Household Survey of almost 25,000 Australians aged 12 and over showed very strong and increasing public support for measures to reduce problems caused by smoking. Support for these measures has increased again since last survey and now shows:  

• 90.1% support stricter enforcement of laws against illegal tobacco sales to minors; 

• 87.5% support stricter penalties for sale to minors; 

• 82% support banning smoking in the workplace; 

• 77% support banning smoking in pubs and clubs;

• 73.6% want bans on retail display of tobacco products; 

• 71.6% support implementation of a licensing scheme for tobacco retailers;  

• 68.6% support increasing tax on tobacco to contribute to treatment costs; 67.1% support increasing this tax to pay for health education; and 65.7% to discourage smoking; and  

• 66.4% want it made harder to buy tobacco in shops.  

See  AIHW - Table 4.1, p.41     

In addition, a survey of 400 Australians by the University of WA in August 2007 showed:

• 94% support full information about cigarette ingredients being made available to the public;
• 75% support anti-smoking advertisements to be screened before movies that promote smoking; and
• 78% support an end to tobacco company donations to political parties.

See  AMA/ACOSH media release 16/10/07/doc/WEEN-77ZV3Y 

Anti-smoking campaigns SAVE money – and they work!

• Evidence shows that effective smoking reduction programs can cut tobacco’s death-and disease toll, and can also yield clear economic benefits in the short to medium term.

• Example: The National Tobacco Campaign was identified in a Commonwealth Health Department report as the most cost-effective intervention to reduce cancer deaths and disabilities, saving $2 for every $1 spent over 40 years. Based on evaluation of the NTC’s first stage, where spending of $8.95m over six months led to cost savings of nearly $40m, the report concluded that an effective campaign would pay for itself four times over.   See www.quitnow.info.au/hotspot/sof.html

• The NTC contributed to the first reduction in adult smoking prevalence in almost 10 years. Some US states have reduced daily smoking rates below 15%. We can do likewise – but only with sustainable funding for a comprehensive strategy.  

• Further investment in tobacco control will curb increasing PBS costs and help government efforts to ensure the viability of Australia’s health financing programs. See Hurley et al 2004 study  

Better tobacco control can improve social equity

June 2004 macroeconomic study by Junor et al, commissioned by Cancer Council NSW, showed tobacco prevention does not “penalise the poor”. In fact, tobacco use hits poorest families hardest and well-designed tobacco control strategies - including increased tobacco taxes - can benefit them most of all.  See Junor et al study 2004 for Cancer Council NSW 

Australia's international responsibility

Worldwide, tobacco causes over five million preventable deaths a year. Unless urgent action is taken, one billion will die in the 21st century.

Australia is bound by ratification of the WHO Framework Convention on Tobacco Control to take comprehensive action against the global tobacco epidemic. The treaty, ratified by over 160 countries, represents an historic opportunity for global action. See summary of  Governments' responsibilities to the FCTC    

Why act now?

• To meet national smoking reduction targets.  Australia must raise tobacco taxes or smoking rate fall will falter. A 2009 study warns that quit rates will need to double for the Australian smoking rate to fall to 10% by 2020. At present quit and initiation rates, the daily smoking rate will fall from the present 17% only to around 14%. The University of Queensland study in Tobacco Control  journal points to the need to raise tobacco taxes to drive smoking rates down.  See abstract  and  accepted manuscript 

• To fulfil Australia's treaty commitments. The Framework Convention for Tobacco Control (above) has been ratified by Australia and represents an historic opportunity for a whole-of-government approach - federal, state, territory and local - to curbing the tobacco epidemic in Australia, the Pacific region and globally.   

• To support preventive health aims and save money.  See recommendations of the  National Preventative Health Taskforce report (2009); also a Treasury report on Australia’s Demographic Challenges - warning that with an ageing population, low retention rates and rising health care costs, rebalancing towards preventive medicine is critical and represents “value for money”.     See Treasury report

Page last updated on 3/8/10