Australia is highly unlikely to hit its draft target of less than 5 per cent of the population smoking by 2030 unless it takes significant steps to reduce supply including by curtailing retail sales, experts have warned.
Writing in the Medical Journal of Australia, they say control efforts have been too focused on measures that dampen demand, and have called on the federal and state governments to set an end date for tobacco sales through general retail outlets.
About 14 per cent of Australians over the age of 14 are smokers. Of them, 11 per cent smoke daily, according to the 2019 National Drug Strategy Household Survey. That is down from 25 per cent in 1991.
The 2030 target was stated in the Draft National Preventive Health Strategy released this year and the experts, from Queensland, Darwin, Canberra and New Zealand, say it will not be achieved through industry self-regulation or other voluntary approaches.
A decade ago, Australia was a world leader in efforts to combat smoking, introducing plain packaging for cigarettes, graphic images and media campaigns.
But since then, it has focused mainly on increasing the tax on cigarettes by 12.5 per cent annually ( from 2013 -2020) , says lead author, Associate Professor Coral Gartner, School of Public Health, University of Queensland.
In 2013, the tax on a single cigarette was 35.4¢. By 2020, it was $1.10.
“While these are important strategies, they put a lot of pressure on the individual to quit, without changing the wider environmental context,” Professor Gartner says. “You might be trying to quit smoking and every time you go to a convenience store, a petrol station or a supermarket, you know the products are right there waiting for you.
“We’re talking about shifting focus to the environment, so it supports people quitting, and we’re talking about ending retail sales. Phasing out tobacco retailing is gaining traction as the natural next step in controlling the tobacco pandemic and setting an end date is important and is long overdue.”
A date would help to end the conflict between public health goals to reduce sales and the fiduciary obligations of commercial retailing businesses to maximise profits through sales.
The experts lay out a plan for the new approach. Retailers would have to be consulted and where necessary, supported to change their business models.
These businesses are already likely to be under pressure because smokers who are quitting or dying from tobacco-related diseases are not being replaced by younger smokers.
“Products that rely on new young people taking up smoking, are not suited for a profitable enterprise,” says Professor Gartner.
As these products are too harmful and addictive to be sold as general consumer goods, their historic exemption under the poisons standard should be reversed.
And as tobacco is regulated by both federal and state laws and there are jurisdictional differences, the phasing out of smoking nationally should be coordinated by the national cabinet, which is dealing with the COVID-19 pandemic.
Many novel strategies for reducing retail sales are being explored around the world. One is having pharmacies supply cigarettes over the counter, as doctors might baulk at prescribing them.
Another is radically cutting the amount of nicotine in cigarettes, so they are no longer rewarding, or cutting the profit margin of selling them. Financial incentives for smokers have been trialled and found to be effective in low-income populations.
Smoking remains the leading preventable cause of death in Australia, claiming more than 20,000 lives a year.
Just before the pandemic, a Victorian survey found 64 per cent of adults, including some smokers, thought it was fair to implement a phase-out of smoking within the next 10 years.
Internationally there has already been action. The Netherlands legislated for supermarkets to stop selling cigarettes from 2024. Balanga City Council in the Philippines ended sales in 2016, and the city councils of Beverley Hills and Manhattan Beach in the US ended sales from January 1, 2021.
Professor Gartner says “this is not about making tobacco illicit, it’s about reducing profit for maintaining sales.”
Extracted from AFR