Cigarettes in Australia have never been subjected to prohibition. Advances in manufacturing, marketing and advertising of cigarettes, starting over a century ago, saw cigarette smoking steadily increase for half a century. Soon after World War II, a majority of Australian men smoked, although smoking rates among women never reached such high levels.
After World War II, shocking research about the dangers of smoking began to appear. First a trickle of research, then a flood. Now we know that up to two of every three long-term smokers will die from a smoking-related condition.
Smoking is still the biggest public health burden in Australia and internationally. About 21,000 Australians and globally 8 million people die from a smoking-related condition every year. About a third of these deaths occur in people of working age.
Governments responded very slowly to the growing body of evidence showing a huge toll of deaths and diseases caused by smoking. Cigarette companies lied, denied and obfuscated appallingly about the health problems caused by smoking. Not even their own internal research confirming these findings stopped them. Their toxic behaviour has not been forgotten and complicates the task of developing a rational tobacco policy in Australia.
Over the last few decades Australian governments have stepped up their responses to our biggest long-term threat to public health by reducing the availability of cigarettes and the demand for smoking. But cigarettes are still available legally for sale to adults in Australia from over 20,000 outlets. Cigarettes are now more expensive in Australia than any other country, with the 9th increase in cigarette taxes in 10 years occurring tomorrow, 1 September.
The biggest debate in tobacco policy in Australia today is over vaping.
Vaping was developed in 2003 to provide nicotine without the tars and other toxic products of burning tobacco. According to the recent National Drug Strategy Household Survey, the estimated number of Australians vaping increased from 240,000 in 2016 to 520,000 in 2019. Almost 3 million Australians still smoke cigarettes, although fortunately few young Australians smoke these days. Unfortunately, very few Australians over 40 are quitting smoking. In the UK and USA, where vaping has been popular for the last 6-7 years, the fall in smoking rates has accelerated and their smoking rates are now declining much faster than in Australia.
Vaping is not harmless, but there is compelling evidence that it is considerably less risky than smoking. It is the most popular and so far the most effective aid for quitting smoking. As it happens, cigarette companies do not sell any vaping products in Australia and probably sell less than 20% of vaping products globally.
However current Australian policy makes it hard for smokers to switch from cigarettes to lower-risk vaping. Like a majority of health organisations in Australia, federal Health Minister Greg Hunt is strongly opposed to vaping. This is despite the fact that a majority of the Coalition party room (but not the ALP) supports vaping as a pragmatic harm-reduction response to a major health burden. On 19 June 2020, Minister Hunt announced increased restrictions on nicotine liquid for vaping to commence on 1 July. But Hunt was pressured to delay the date of implementation by six months and to engage in consultations.
The matter is likely to come to a head soon. Pauline Hanson’s One Nation Senator Malcolm Roberts has announced an intention to move a Disallowance Motion in the Senate over vaping. This is likely to precipitate a heated debate, publicly exposing divisions over this issue in the federal parliament.
The growing debate about vaping in Australia reflects a battle between those who support tobacco prohibition and those who support tobacco harm-reduction. Strident opponents of vaping argue that whenever nicotine is readily available, young people will start with vaping and end up smoking cigarettes. However, the evidence worldwide is precisely the opposite: when vaping increases, smoking decreases and when vaping is increasingly restricted, smoking increases.
For many years, new harm-reduction interventions for drugs have often been fiercely resisted. This is what happened when methadone treatment was introduced for heroin users; needle syringe programs were instituted to slow the spread of HIV; Medically Supervised Injecting Centres were established to reduce drug overdose deaths; and pill testing was proposed to decrease drug-related deaths at youth music events. With the exception of pill testing, all of these interventions have been adopted and proved to be extremely successful.
Among western democracies, Australia is alone in its hostility to vaping. On 4 August a sensible bill legalising vaping was supported in the New Zealand parliament by the governing Labor and New Zealand First parties, as well as the National and Greens parties in opposition.
A parliamentary debate here about vaping would be an important debate at any time, but it is a particularly important debate when the COVID pandemic is straining our healthcare system and Australians are experiencing the worst economic downturn in almost a century.
Many Australians support vaping because they see current policy as an unwarranted attack on the freedom of smokers to reduce their health risks and help them quit. Others, focused on reducing government taxing and spending, support the idea of smokers being able to take more responsibility for quitting without the need for government-paid assistance. Many of these are ideologically-driven prohibitionists.
Those politicians and commentators whose main focus is on social justice are troubled by the higher smoking rates of the disadvantaged. As a matter of fact, Australian electorates with the highest rates of lung cancer are held by the Nationals and the ALP.
Vaping is one of a growing range of reduced risk options for smokers. So even if the vaping debate is resolved, other debates in the future are likely.
Australian vapers have been galvanised by Heath Minister Hunt’s vehement anti-vaping announcements and increasingly many unhappy vapers are making their views known to their MPs. So, watch this space. There will be some fireworks soon.
Emeritus Professor of History & Politics at Griffith University, Ross Fitzgerald is the author of 42 books, most recently a memoir, ‘Fifty Years Sober: An Alcoholic’s Journey’, published by Hybrid in Melbourne.
FACEBOOK, AUGUST 31, 2020
Professor Ross Fitzgerald AM