Nursing Online – July 2010

Big, bad tobacco.

Recently the Federal Government announced what some have called the worlds toughest anti-tobacco initiatives. Tobacco is Australias single largest cause of premature death and disease, killing 15,000 people a year. The following are some online resources and background discussion papers on the tobacco debate.

WHO Tobacco Free Initiative

The World Health Organization’s Tobacco Free Initiative is engaged in a range of activities aimed at reducing the prevalence of tobacco consumption. It collaborates with an international network of scientists and health experts to promote research on various aspects of tobacco production and consumption and their impact on health and economics.

Policy recommendations are developed based on this research and in accordance with the provisions of the WHO Framework Convention on Tobacco Control (FCTC). These recommendations cover different aspects of tobacco control, including regulation and legislation in relation to cessation, second-hand tobacco smoke, smoking and children, smoking and gender, economics and trade.

Should Australia lift its ban on low nitrosamine smokeless tobacco products?
Coral E. Gartner and Wayne D. Hall, MJA 2008; 188 (1): 44-46

In Australia, 2.9 million people continue to smoke daily, and tobacco still accounts for 8% of disease burden. Tobacco harm-reduction strategies, such as the use of Swedish snus, have been suggested as a way to further reduce this disease burden. In Australia, the most dangerous tobacco products (cigarettes) are the least regulated, while oral tobacco products, including snus, cannot be sold legally.

Recent epidemiological modelling indicates that there are only small differences in life expectancy between smokers who quit and those who switch to snus. There is a case on public health and ethical grounds for allowing inveterate smokers who want to reduce their health risks to access snus.

At a minimum, the recent increase in tax on smokeless tobacco should be reversed, and the ban on the commercial importation and supply of low nitrosamine smokeless tobacco should be reconsidered in light of the epidemiological evidence on its potential to reduce tobacco-related disease in smokers.

On ciggies, Australia the world leader in public health reform
Becky Freeman and Professor Simon Chapman, Crikey, Friday, 30 April 2010

The Federal Government breathed new life into the smoking debate with the double-barrelled announcement that tobacco tax was jumping up by 25% effective at midnight and that tobacco would be sold in plain packaging from January 2012.

Tobacco taxes are a proven cornerstone of tobacco control policy and have a long track record of preventing young people from starting and inciting current smokers to quit. Plain packaging, however, is without international precedence and positions Australia as a global leader in public health reform.

Putting the accolades and triumphant high fives aside, what does plain packaging actually mean?

The case for the plain packaging of tobacco products
Becky Freeman, Simon Chapman & Matthew Rimmer

The Framework Convention on Tobacco Control (FCTC) requires nations that have ratified the convention to ban all tobacco advertising and promotion. In the face of these restrictions, tobacco packaging has become the key promotional vehicle for the tobacco industry to interest smokers and potential smokers in tobacco products. This paper reviews available research into the probable impact of mandatory plain packaging and internal tobacco industry statements about the importance of packs as promotional vehicles. It critiques legal objections raised by the industry about plain packaging violating laws and international trade agreements.

The research found that plain packaging of all tobacco products would remove a key remaining means for the industry to promote its products to billions of the world’s smokers and future smokers. Governments have required large surface areas of tobacco packs to be used exclusively for health warnings without legal impediment or need to compensate tobacco companies.