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Alex Wodak's avatar

Alan Gor is right to remind us that the paramount aim of Australia’s response to cigarettes, tobacco and vapes should be reducing smoking-related deaths & disease. That can only be achieved by reducing smoking. As smoking is still the most important cause of preventable deaths in Australia as it28 is worldwide, health policymakers should try to reduce smoking as quickly as possible but also while taking care to minimise adverse unintended consequences of policy. The primary aim of Australia’s response to smoking should not be to harm tobacco companies. But it would be easy to draw the conclusion listening to advocates for conventional tobacco control that maximising damage to tobacco companies, or better still completely eradicating them, is really their paramount concern. Harm minimisation hasn’t been mentioned as a key principle in Australian tobacco control for more than a decade and a half even though it is explicitly endorsed in Australia’s National Drug Strategy and Article 1 (d) of the Framework Convention on Tobacco Control which Australia has signed and approved.

It’s a fair assumption that Australia’s cigarette excise has been and will be decided after building a computer model of cigarette sales vs retail cigarette prices. The British American Tobacco company submission to the recent Senate inquiry included a description of a computer model of Australian cigarette sales vs retail cigarette prices which was claimed to be astonishingly accurate. It would be naive to imagine that political factors won’t be taken into account. Victoria will have its next state elections on 28 November. The Victorian Labor government is well behind in the polls and seems likely to lose office. Crime and violence has been identified as the second most important issue for Victorian voters at present. Most Victorian voters will be well aware that sky high cigarette excise and the quasi prohibition of vapes has resulted in a booming and violent illegal market for cigarettes, tobacco and vapes. It would be very surprising if the Labor Federal Treasurer did not also take this into account.

The international tobacco industry has been extraordinarily profitable for about 100 years. Tobacco company shares have been among the best performing shares for much of the last 100 years. The industry employs about 100 million people to make and sell about five trillion cigarettes every year. Much of the tobacco is grown in very poor countries. The US tobacco industry lost a number of important legal cases and decided to settle with 46 states and some territories in the 1998 Master Settlement Agreement. This required several major US tobacco companies to reimburse the plaintiffs for the estimated cost of health care for people with smoking-related conditions according to the smoking rate in the smokers’ state at that time. It is well worth reading an account of this important legal case (https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agreement). Some US states chose to securitise their future income assuming that the decline in smoking rates would continue at about the same rate. However, the decline in US smoking rates accelerated after vapes and some other safer nicotine products started coming on the market. The accelerated decline in smoking rates meant that income from the 1998 Master Settlement Agreement also decreased so that states which had heavily securitised their future income now had a growing shortfall in funding. Not surprisingly, the states which most heavily securitised their future earnings are also the same states most opposed to vaping!

For the last decade and a half, Australia’s tobacco control extremism has been matched by only one side of this conflict being presented to the public by governments, mainstream media and the health establishment. This is now slowly starting to break down. The One Nation party has advocated a 75% decrease in cigarette excise. There has been speculation that the Liberal party will recommend an 80% reduction. Coverage critical or skeptical of Australia’s extremist tobacco control now appears quite frequently in mainstream media. The NSW Legislative Council report on the ‘Illegal Tobacco Trade’ (Report #68) is the first Australian parliamentary report to accept the strong case for tobacco harm reduction. Australia’s per capita cigarette consumption peaked in 1960 while prevalence peaked in the mid 1970s. This was well before Australia started rapidly increasing cigarette excise, restricting smoking in public places and requiring graphic health warnings on cigarette packaging. It now seems inevitable that cigarette excise will be cut but it is hard to predict by how much and when this will occur. The quasi prohibition of vaping may continue for some time but its future survival now seems shaky. The reputations of the Australian supporters of conventional tobacco control is likely to start declining.

One of the lessons of this debacle is the importance of keeping an open mind and open debate among experts with different perspectives.

Ruth's avatar

Surely the key issue is not how to recover the legal cigarette market, but how to accelerate the decline of smoking? If smokers are turning to illicit cigarettes because legal products are unaffordable, the most appropriate response is not cheaper legal cigarettes but affordable, regulated lower-risk alternatives such as vaping products and nicotine pouches. Australia could adopt a harm reduction framework where s risk-proportionate approach would keep cigarettes relatively expensive while making safer alternatives more accessible and attractive to adult smokers. The real measure of success would not be increased legal cigarette sales, but faster reductions in smoking, smoking-related disease, and illicit tobacco use. The goal should be to help current smokers leave cigarettes behind altogether, rather than bring them back to legal cigarettes. Or is Australia do far down the wrong track that it has no options to allow a change of direction?

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