Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action
The case for prevention
‘Tobacco has a catastrophic but preventable impact on the health of Australians’
(Quote from submission)
The case for action on tobacco is clear. Since 1950, when the dangers of smoking were recognised, almost one million Australians have died because they smoked.[1]
Trends in recent years have been encouraging,[2] but there is no room for complacency while the death toll from tobacco continues,[3, 4] thousands of young people each year start smoking,[5] non-smokers are exposed to second-hand smoke,[2] disadvantaged groups are disproportionately affected,[6-12] the overall cost of smoking to the economy is more than $30 billion each year,[13] and tobacco companies maintain efforts to promote sales of their lethal product.[14-16]
Australia has been among the global leaders in tobacco control – nationally, in the states and territories, and through the work of non-government organisations and researchers. At a time when the international commitment to tackling the tobacco problem has never been stronger,1 we have the opportunity to show the way to the rest of the world in terms of what can be achieved through a comprehensive, coordinated, evidence-based, long-term strategy that is conscious of the needs of the entire community.
We know what needs to be done. The strategies set out in this report are based on the best international evidence and research, together with advice from some of the world’s leading experts in tobacco control. We know what works in tobacco control; by contrast, we also know what does not work and should not be further pursued. We have also been assisted by some valuable insights from our consultations and submissions to the Taskforce. When implemented, this strategy will ensure that we have world’s best practice in tobacco control.
The target set by the Taskforce is that we should reduce daily smoking to under 10% by 2020. This will require a dramatic reduction in the numbers of children taking up smoking and in the percentage of smokers who try to quit,[17] but on the basis of evidence from Australia and internationally, we are confident that it is achievable. When we reach this target, we believe that smoking will continue to decline until rates are so low that it is no longer one of our most important health problems.
‘The target of further reducing the prevalence of smoking is achievable and can be advanced through collaboration with other key stakeholders’ (Quote from submission)
Achieving the target will require a strong commitment from all who can play a role in getting us there, and a special focus on working with and supporting disadvantaged groups and communities. Australia can also both be a role model for other countries and play a part in helping to implement similar policies, especially in low- and middle-income countries where tobacco promotion is rampant and tobacco control is in its infancy.
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Individuals can:
- Take action to stop smoking. The sooner a person quits, the more benefit they gain, not only from reduction of illness and early death but also in practical ways such as saving money and avoiding frequent breaks away from work. Individuals may need many attempts to quit for good but it is important to keep trying.(1) Those finding it difficult can:
- Call the Quitline for information and counselling advice
- Visit their GPs or ask their local pharmacist for help
- Consider using medications that help lessen the effects of withdrawal from nicotine[18]
- Give up smoking to increase the chances of having a healthy baby and to stop their children from taking up smoking.[19, 20]
- Establish good communication and relationships within the family. This makes it easier to discuss issues such as smoking – and quitting,[21] ensuring that young people know that smoking is addictive and that they should not experiment because of the health risks.
- Properly enforce smoke-free policies for staff, students and visitors alike.
- Use materials in the curriculum that incidentally increase understanding of the short and longer term effects of smoking.
- Include activities that raise awareness about smoking in drug education.
- Look for any evidence that retailers close to the school are selling cigarettes to students (and, if they are, ask the local council to take appropriate action).
- Be aware that students who are successful with their study and feel connected to their school are much less likely to take up smoking.[22]
- Discourage people from smoking near the entrances to buildings where they will be seen by (and cause difficulties for) quitters and ex-smokers when they enter and leave.
- Require anyone leaving the premises to smoke to do so in personal rather than company time.
- Not sell cigarettes from canteens or company shops.
- Offer bonuses to long-term employees who have quit and stayed smoke-free. Cash bonuses at one, three, six and 12 months after quitting could help individuals to maintain their resolve. A further bonus at five and 10 years after quitting could help employers retain valued staff.
Work carried out for the Taskforce shows that by simply implementing the two most important strategies recommended in this report (tax increases and extra media spend), we will see approximately one million fewer Australians smoking and will prevent the premature deaths of almost 300,000 Australians now alive just from the four most common diseases caused by smoking.[23]
The history of tobacco control shows the importance of adopting a comprehensive approach, as proposed in this strategy. Within that framework, measures such as removing all avenues for tobacco promotion, supporting disadvantaged groups and protecting non-smokers of all ages are emphasised as especial opportunities for early intervention.
The only significant opposition to this strategy will come from the tobacco industry, which in submissions disagreed with many of the major proposals in our Discussion Paper. We recognise that action designed to reduce smoking dramatically will always be opposed by tobacco companies, but also that the measures they most strongly oppose are those most likely to have the impacts we seek.
Implementing the strategy will require a comprehensive approach, strong leadership and support throughout the community. Surveys at all levels show very strong public support for both overall tobacco control and the specific approaches contained in this strategy.
Tobacco has been one of the great killers of the 20th century. Preventing the premature deaths of at least 300,000 Australians now alive is more than a noble target. This strategy shows how it can be done, ensuring that the Australian program is world’s best practice, and offering the opportunity for tobacco control to be one of the great public health success stories of the 21st century.
1 The international Framework Convention on Tobacco Control (FCTC) is the first treaty negotiated under the auspices of the World Health Organization (WHO). It was adopted by the World Health Assembly on 21 May 2003, and entered into force on 27 February 2005. See www.who.int/fctc/about/en/index.html for further details.