Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action
Summary Tables
Table of contents
- Key action area 1: Make tobacco products significantly more expensive
- Key action area 2: Increase the frequency, reach and intensity of social marketing campaigns
- Key action area 3: End all forms of advertising and promotion of tobacco products
- Key action area 4: Eliminate exposure to second-hand smoke in public places
- Key action area 5: Regulate manufacturing and further regulate packaging and supply of tobacco products
- Key action area 6: Ensure all smokers in contact with health services are encouraged and supported to quit, with particular efforts to reach pregnant women and those with chronic health problems
- Key action area 7: Work in partnership with Indigenous groups to boost efforts to reduce smoking and exposure to passive smoking among Indigenous Australians
- Key action area 8: Boost efforts to discourage smoking among people in other highly disadvantaged groups
- Key action area 9: Assist parents and educators to discourage use of tobacco and protect young people from second-hand smoke
- Key action area 10: Ensure that the public, media, politicians and other opinion leaders remain aware of the need for sustained and vigorous action to discourage tobacco use
- Key action area 11: Measure progress against and towards targets
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 1: Make tobacco products significantly more expensive | |||
| 1.1 Ensure that the average price of a packet of 30 cigarettes is at least $20 (in 2008 $ terms) within three years, with equivalent increases in the price of roll-your-own and other tobacco products. | Australian Government –Treasury; Australian Tax Office (ATO). | Year 1 onwards Continue to increase excise and customs duty each six months in line with CPI. Year 1 Amend Excise and Customs tariffs to add 7.5 cents per stick above CPI in Year 1, with equivalent increases for products dutied by weight. Year 2 Add a further 2.5 cents. Year 3 Add a further 7.5 cents. | Recommended retail price of leading brands. Prices actually paid by consumers. Immediate month-on-month change (pre- and post-increases) in smoking status among various income groups and in sales of tobacco products. Changes in quit attempts and reported number of cigarettes smoked daily. |
| 1.2 Develop and implement a coordinated national strategy to prevent the emergence of illicit trade in tobacco in. | A lead government agency (to be nominated by the Australian Government) with input from the ATO, ACBPS, AQIS, Australian Federal Police, state police, Australian and state Departments of Health. | Year 2 Nominate lead agency. Year 3 Report. Year 4 Legislative reforms if required. Year 5 Review and refinements to Strategy. | Percentage of smokers reporting purchase of tobacco or cigarettes outside licensed outlets. |
| 1.3 Contribute to the development and implementation of international agreements aiming to combat illicit trade in tobacco globally. | Lead agency (as above) and the intergovernmental group established by the Department of Health and Ageing to negotiate the FCTC protocol on illicit trade (the group currently comprising the Department of Health and Ageing, the ATO, Treasury, Attorney-Generals, Prime Minister and Cabinet, Department of Foreign Affairs). | Years 2–4 (and thereafter) | Australia plays a role in developing and implementing international agreements aiming to combat illicit trade in tobacco. |
| 1.4 Ban the retail sale of tobacco products via the internet. | Australian Government. | Year 2 or 3 | Legislation drafted and in force. |
| 1.5 End tax and duty free sales in Australia; abolish tax and duty concessions for all travellers entering Australia (specified limits for personal use); and participate in negotiations on international agreements concerning the application of limits to international travellers. | ATO and ACBPS. | Year 3 Amend Customs Regulations 1926 (Cth). | Number of cigarettes sold in Australia not subject to excise and customs duty. |
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 2: Increase the frequency, reach and intensity of social marketing campaigns | |||
| 2.1 Run effective social marketing campaigns at levels of reach demonstrated to reduce smoking. | Percentage of target audiences (including young and low SES smokers) who: Have seen advertising used in recent campaigns Can name themes covered in advertising (unprompted and prompted) Correctly identify health risks and other disadvantages of smoking See such disadvantages as salient and relevant to themself Agree that advertising contributed to their decision to quit or assisted with staying stopped Took action in the weeks during or following campaigns Number of Quitline calls in response to different creative material, program placement and advertising weight. Hits to cessation support websites over periods in which advertising is on air. | ||
| 2.1.1 Fund nationwide screening of most effective television advertisements, including those demonstrated to be most effective in state campaigns. | Department of Health and Ageing and state/territory agencies. | Year 1 | |
| 2.1.2 Provide long-term budget allocations at both federal and state levels to ensure commercially realistic funding for media campaigns (at least 700 TARPs per months until smoking prevalence reaches 9%). | Australian Government/ states and territories. | Years 2–5 (and thereafter) | |
| 2.1.3 Fund development of a suite of effective materials covering a range of health issues including dramatic treatments. | Australian Government/ states and territories. | Years 2–5 (and thereafter) | |
| 2.1.4 Place media to ensure maximum reach with smokers including young smokers and smokers from disadvantaged groups. | National Prevention Agency (NPA)* and states and territories working with NGOs. * or appropriate national agency | Years 2–5 (and thereafter) | |
| 2.2 Choose messages most likely to reduce prevalence in socially disadvantaged groups and provide extra reach to these groups through the skewing of placement to television programs most likely to be watched by low SES groups, and by targeting radio, outdoor and other local advertising to low SES neighbourhoods. | Australian Government/states and territories/NGOs. | Years 1–5 (and thereafter) | Percentage of targets who have seen recent advertising. Number of Quitline calls and web-hits from people with disadvantaged postcodes, with and without extra advertising. |
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 3: End all forms of advertising and promotion of tobacco products | |||
| 3.1 Legislate to eliminate all remaining forms of promotion, including advertising of price specials, public relations activities, payments to retailers and proprietors of hospitality venues, promotion through packaging and as far as feasible through new and emerging forms of media. | Australian Government. | Year 1 Review legislation and policies. Year 2 Amend legislation. Year 3 Introduce restrictions. Year 4 onwards Proactively enforce legislation and prosecute as deterrent to breaches. | Percentage of young people aware of tobacco promotion in media, sport or popular entertainment. |
| 3.2 Regulate to require mandatory reporting of amounts spent on any form of promotion – on payments to public relations companies or any other third parties, as well as details of any other promotional expenditure. | Australian Government. | Year 2 | System established or not. |
| 3.3 Amend legislation to ensure that tobacco is out-of-sight in retail outlets in all jurisdictions. | All state and territory governments. All states and territories to implement. | Year 1 Year 2 (by end of 2011) | Percentage of teenagers and adults aware of tobacco advertising at point of sale. Percentage of stores where stock is visible. |
| 3.4 Eliminate promotion of tobacco products through design of packaging. | |||
| 3.4.1 Amend Tobacco Advertising Prohibition Act 1992 to require that no tobacco product may be sold except in packaging of a shape, size, material and colour prescribed by the government, with no additional design features. | Australian Government. | Year 1 or 2 | Market weighted percentage of brands that comply with plain packaging regulations. Percentage of teenagers and adults with false beliefs about particular brands (smoother, less tar etc) and extent of positive appraisal of cigarette packaging and brand identities. |
| 3.4.2 Undertake research to establish optimal colours, pack sizes and fonts that would be prescribed. | Department of Health and Ageing. | Years 2 and 3 Commission work. | |
| 3.4.3 Amend Trade Practices CPIS (Tobacco) Regulations 2004 to specify exact requirements for plain packaging. | Australian Government. Department of Health and Ageing and Australian Competition & Consumer Commission. | Year 3 | |
| 3.4.4 Commence new arrangements. | Years 4–5 | ||
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 4: Eliminate exposure to second-hand smoke in public places | |||
| 4.1 Amend legislation and departmental policies to ensure that smoking is prohibited in any public places where the public, particularly children, are likely to be exposed. | All state and territory governments. | Year 1 Legislate and introduce policies. Year 3 Restrictions in force in line with best practice in all jurisdictions. | Percentage of Australian population living in jurisdictions not covered by legislation in each area. |
| 4.2 Legislate to ensure that children are not exposed to tobacco smoke when travelling as passengers in cars. | All state and territory governments. Enforcement – state and territory governments. | Year 1 Legislate Year 2 onwards: Enforce | Percentage of smokers with children who report sometimes or often smoking in cars. Percentage of people detected smoking in cars in observational studies. |
| 4.3 Tighten and enforce legislation to protect against exposure to second-hand smoke in workplaces (including outdoor areas in restaurants and hotels, near the entrances to buildings and air-conditioning intake points, and in workplace vehicles). | All state and territory governments and local councils where applicable. | Year 1 Review legislation and policies. Year 2 Amend legislation. Year 4 Restrictions in force in line with best practice in all jurisdictions. | Percentage of adults reporting exposure to second-hand smoke in their place of work. Measures on air-monitoring studies. |
| 4.4 Introduce and enforce legislation, and encourage adoption of policies that restrict smoking outdoors where people gather or move in close proximity. | All state and territory governments. | Year 1 Review legislation. Year 2 Amend legislation. Year 4 Additional restrictions appropriate to local practice in force in all jurisdictions. | Percentage of adults reporting exposure to second-hand smoke in their day-to-day life. |
| 4.5 Protect residents from exposure to smoke-drift in multi-unit developments. | All state and territory governments. | Year 2 Review policies and explore options. Years 3 and 4 Legislate. By Year 5 Legislation in force all jurisdictions. | Percentage of adults reporting exposure to second-hand smoke in their place of residence. |
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 5: Regulate manufacturing and further regulate packaging and supply of tobacco products | |||
| 5.1 Tighten and enforce legislation to eliminate sales to minors and any form of promotion of tobacco at retail level. | |||
| 5.1.1 Require all tobacco retailers be licensed. | All state and territory governments. | Year 1 Amend legislation. Year 2 All retailers in Australia to be licensed. | Percentage of tobacco retailers in Australia who are subject to licensing regulations. |
| 5.1.2 Legislate to preclude sales through vending machines, internet, at hospitality and other social venues. | All state and territory governments. | Year 1 Review legislation. Year 2 Amend legislation. Year 3 Best practice provisions operating in all jurisdictions. | Percentage of young people aware of tobacco products sold through entertainment venues, the internet etc. |
| 5.1.3 Review and if necessary legislate to put the onus of proving age on retailers and to increase the penalties for breaches. | |||
| 5.1.4 Ensure licence fees are high enough to provide funds for education on the legislation, compliance monitoring and prosecution. | All state and territory governments. | Year 1 Review budgets for compliance monitoring and enforcement. Year 2 Amend legislation to increase licence fees accordingly. Year 3 Optimal budget for compliance monitoring and enforcement in all jurisdiction. | Percentage of revenues for enforcement programs in jurisdictions from licence fees. |
| 5.2 Improve consumer product information related to tobacco products. | |||
| 5.2.1 Mandate standard plain packaging of all tobacco products to ensure that design features of the pack in no way reduce the prominence or impact of prescribed government warnings – refer to 3.4. | |||
5.2.2 Substantially increase the size of required front-of-pack warnings, prohibit misleading labelling, brand names and product characteristics, and ban products such as specially designed covers that would reduce efficacy of warnings.
| Department of Health and Ageing. Department of Health and Ageing. Australian Competition and Consumer Commission. Australian Government. | Year 1 Year 1 Year 2 Year 3, Year 6 and every three years | Percentage of smokers able to recall each of the mandated warnings and able to demonstrate understanding of: Magnitude of risk Severity of illnesses and consequences for quality of life Tractability of conditions (curability, survival rates and times) Percentage of smokers endorsing false health information or inaccurate beliefs. |
| 5.2.3 Automatically review and upgrade warnings on tobacco packages at least every three years, with the Chief Medical Officer to have the capacity to require amendments in between. | Australian Health Protection Committee (AHPC) or other appropriate group. | Year 3 Amend Trade Practices Act to require such reviews and give the CMO this power. | |
| 5.2.4 Link the process of regularly reviewing mandated consumer product information to a process that would provide more timely warning to Australian consumers of new and emerging health risks through mechanisms such as alerts in the media and notices at point of sale. | Year 1 Develop proposal. Year 2 Consider proposal and budget requirements. Year 3 System operating. | Average time from release of meta-analyses, major studies or major reports to issuing of public statement. | |
| 5.3 Ensure compliance with new regulations regarding reduced fire-risk cigarettes. | |||
| 5.3.1 Introduce reduced fire-risk cigarettes in the market. | Minister for Consumer Affairs. | From March to September 2010 | Market-weighted percentage of cigarette brands sold that are compliant with the standard for reduced fire-risk. Number of fires known to be started by discarded cigarettes. |
| 5.4 Regulate tobacco design, contents, emissions and labelling. | | | |
| 5.4.1 Establish or nominate a body with the power to regulate the contents and performance of tobacco products and any alternative nicotine delivery devices that may come onto the market in Australia, and with responsibility for specifying the exact wording of any public disclosures about contents and performance. | Department of Health and Ageing. Australian Government. Nominated body. | Year 2 Develop proposal. Year 3 Amend necessary legislation to establish body (or give powers to an existing body). Year 4 Commence. | Body established/nominated or not. |
| 5.4.2 Specify the form and content of reporting required for all tobacco products, and the exact wording required for disclosures to consumers. | | Year 3 | Reporting procedures in place or not. |
| 5.4.3 Consider prohibiting the use of filter ventilation in Australian cigarettes. | Nominated body. | Year 3 | Market-weighted percentage of brands using filter ventilation. Market-weighted percentage of brands using targeted additives. Market-weighted averages for targeted emissions. |
| 5.4.4 Consider banning all additives that enhance palatability or addictiveness. | Nominated body. | Year 3 | |
| 5.4.5 Specify any further modifications required, restrictions on additives or upper limits for emissions. | Nominated body. | Year 4 onwards | |
| 5.5 Investigate the feasibility of legal action by governments and others against tobacco companies to recover health and other costs. | | | |
| 5.5.1 Investigate the legal implications of continuing sales of tobacco products and principles that should guide future regulation. | Australian, state and territory governments. | Year 2 | Investigations under way or not. If the industry is found to be liable for costs, whether action is in place to recover. Whether or not fines, fees or surcharges are in place to ensure that the costs of addressing harm caused by tobacco have been established. |
| 5.5.2 Investigate possible mechanisms for recovery of costs. | |||
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 6: Ensure all smokers in contact with health services are encouraged and supported to quit, with particular efforts to reach pregnant women and those with chronic health problems | |||
| 6.1 Ensure all state- or territory-funded healthcare services (general, maternity and psychiatric) are smoke-free, protecting staff, patients and visitors from exposure to second-hand smoke both indoors and on facility grounds. | State and territory ministers and governments. | Depending on current status in jurisdictions, Years 1–2 | Absence or presence of state-wide policies. |
| 6.2 Ensure all patients are routinely asked about their smoking status and supported to quit, both while being treated and post-discharge. | | | |
| 6.2.1 Include requirement in hospital accreditation procedures. | Hospital associations and accrediting organisations. | Year 1 Develop guidelines. Year 2 Implement. | Included or not. |
| 6.2.2 Include a requirement in service funding agreements and performance contracts with senior staff. | State and territory Health Departments. | Year 1 onwards | Percentage of institutions in each jurisdiction that are subject to funding agreements. Percentage of staff for whom action on tobacco is included in performance contracts. |
| 6.2.3 Provide training in institutional or health-service procedures for assessment and referral. | State and territory governments. | Year 2 onwards | Percentage of institutions in each jurisdiction that have established systems and percentage of staff that have undergone training. |
| 6.2.4 Provide training in smoking cessation counselling in pre-service training and continuing professional education for all health workers. | Australian Government. Lead training provider institutions and professional associations in medical, nursing and allied health fields. | Year 2 onwards | Number of health professionals that have undergone training. |
| 6.3 Improve the quality and use of pharmacotherapies and services demonstrated to assist with smoking cessation. | National Prescribers Service, pharmaceutical companies, health professionals, pharmacists and Quitline counsellors. | Year 1 onwards | Percentage of people using pharmacotherapies who receive behavioural information, support or counselling. |
| 6.4 Increase availability of Quitline service. | |||
| 6.4.1 Ensure that Quitlines are resourced to respond to projected demand from media campaigns. | Department of Health and Ageing. | Year 1 Assess the likely increase in demand, additional resources required and optimal arrangements for service provision. Year 2 onwards Upgraded service operating nationwide. | Missed call rates in each state and territories. |
| 6.4.2 Fund the development and delivery of interactive smoking cessation services using approaches such as internet, mobile phone and web-enabled mobile devices. | NPA. Nominated agencies. | Year 2 Preparatory work. Year 3 Web 2.0 Quitline services operating nationwide. | Whether programs are in place. |
| 6.4.3 Establish special Quitline counselling services for pregnant women, including call-back services and feedback to treating obstetricians/GPs/midwives. | NPA. Nominated agencies. | Years 2 and 3 From end of Year 3 Expectant and New Parent Quitline operating nationwide and promoted to all major obstetric care providers. | Number of callers using Expectant and New Parent Quitline, caller satisfaction levels, quit attempts and quit rates in evaluation samples. |
| 6.4.4 Establish a group of counsellors within one or more Quitlines who would deal specifically with people needing to use interpreter services. | NPA. Nominated agencies. | Year 2 Preparatory work. Year 3 Quitline via interpreter operating nationwide and promoted through national non-English language media. | Number of callers using Non-English Quitline, caller satisfaction levels, quit attempts and quit rates in evaluation samples. |
| 6.4.5 Establish a group of counsellors within one or more Quitlines who would deal specifically with people receiving specialist treatment for chronic health conditions (asthma, diabetes, arthritis, CVD etc), mental illness, providing call-back services and feedback to treating health professionals. | NPA. Nominated agencies. | Year 2 Preparatory work. Year 3 Chronic Care. Quitline operating nationally and promoted with all major relevant providers. | Number of callers using Chronic Care Quitline, caller satisfaction levels, quit attempts and quit rates in evaluation samples. |
| 6.5 Ensure that NRT is affordable for all those for whom it is clinically appropriate. | |||
| 6.5.1 Investigate options for provision including through the Quitline and through the PBS. | Department of Health and Ageing. To be determined. Australian Government. | Year 1 Develop proposal. Year 2 Submit proposal to the Pharmaceutical Benefits Advisory Committee or direct to the Australian Government. Year 3 Consider proposals and implement preferred arrangements. | Number of prescriptions and proportion of prescriptions that are concessional. |
| 6.5.2 Ensure availability of NRT and Quitline services for patients and clients of all state and territory health services. | State and territory governments. | Year 1 onwards NRT available through pharmacies of all public hospitals. Year 2 Voucher scheme operating for clients of all other state-funded human services. | Percentage of public hospitals in each state and territory that routinely provide NRT. |
| 6.6 Explore whether financial incentives might be effective in helping people to quit or stay non-smokers. | |||
| 6.6.1 Consider exempting from Fringe Benefits Tax employers who cover the costs of cessation therapies or who provide financial incentives to quit. | Preventative Health Taskforce. Australian Government. Australian and state governments. | From Year 1 Exploratory research. Year 2 or 3 Implementation to follow if appropriate. | Whether or not pilot projects have been funded and evaluated. |
| 6.6.2 Trial incentive program for young Indigenous children to stay smoke-free, remain at school etc. | |||
| 6.6.3 Trial projects that use incentive payments to help people to retain their resolve to stay stopped after quitting. | |||
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 7: Work in partnership with Indigenous groups to boost efforts to reduce smoking and exposure to passive smoking among Indigenous Australians | |||
| 7.1 Establish multi-component community-based tobacco control projects that are locally developed and delivered. | Project sites to be determined through a transparent process. Projects to be developed and led by local Indigenous communities. Organisation(s) with main responsibility for the projects depends on the location and nature of the projects, but may include local Indigenous health services, state/territory National Aboriginal Community Controlled Health Organisation (NACCHO) affiliates, or regionally based associations of Indigenous health services. Projects may involve partnerships with Indigenous organisations from other sectors. | Year 1 Project sites chosen. Years 1–4 Projects funded. Year 4 Evaluation. | Percentage of Indigenous people aware of project activities. Changes in knowledge and attitudes in targeted compared to non-targeted communities. Percentage of community events and meetings that are smoke-free. Changes in wholesale orders of tobacco products in targeted communities. |
| 7.2 Enhance social marketing campaigns for Indigenous smokers ensuring a ‘twin track’ approach of using existing effective mainstream campaigns complemented by Indigenous-specific campaign elements. | | | |
| 7.2.1 Identify and run existing mainstream tobacco control campaigns that have demonstrated an effect in terms of awareness, impact and relevance to Indigenous people. | Australian, state and territory governments. NPA. NGOs and Quit campaigns. NACCHO and other Indigenous organisations. | Year 1 Year 2 onwards | Percentage of Indigenous smokers surveyed who: Have seen advertising used in recent campaigns Can name themes covered in advertising (unprompted and prompted) Correctly identify health risks and other disadvantages of smoking See such disadvantages as salient and relevant to themself Agree that advertising contributed to their decision to quit or assisted with staying stopped Took action in the weeks during or following campaigns |
| 7.2.2 Identify existing campaign material that could be adapted to include greater representation of Indigenous people and include relevant themes and calls to action. | |||
| 7.2.3 Develop new Indigenous-specific campaign material using radio and complemented by local print and/or outdoor campaigns. | |||
| 7.2.4 Link social marketing campaigns to community projects and activities of health workers. | |||
| 7.2.5 Enhance qualitative research efforts to examine the impact of campaigns and future campaign directions. | |||
| 7.3 Provide training to Aboriginal and Torres Strait Islander health workers to improve skills in the provision of smoking cessation advice and in developing community-based tobacco control programs. | Strengthen delivery of tobacco control information within Aboriginal Health Workers (AHW) training and on-the-job – NACCHO state and territory affiliates, and RTOs providing AHW training. Delivery of brief intervention packages (e.g. Smokecheck, Quit) – state/territory government departments, NGOs (e.g. Quit Victoria). | Year 1 Revision of training packages. Year 1 and ongoing Delivery. Years 1 and 2 Roll out delivery of existing packages (with adaptation where necessary), and evaluation. Years 3 and 4 Revision of packages where necessary. Ongoing delivery and support to AHWs. | Project evaluation. |
| 7.4 Improve training in the provision of smoking cessation advice of other health professionals working in Aboriginal and Torres Strait Islander health services. | Developing and delivering TC programs – (e.g. CEITC ‘Talking Up Good Air’ kit). Up-to-date information through existing training available to GPs and RNs (e.g. through Divisions of GPs). | Years 1 and 2 Intensively during and ongoing. Years 3 and 4 Less intensive delivery and support activities. Year 1 and ongoing | Project evaluation. |
| 7.5 Place specialist Tobacco Control Workers in Indigenous community health organisations to build capacity at the local health service level to develop and deliver tobacco control activities. | Specialist Tobacco Control Workers should ideally be placed within each Indigenous health service, or within a group of regionally associated Indigenous health services (to be determined with input from the Indigenous community-controlled health sector). State/territory-wide Tobacco Control Workers should also be based at NACCHO state/territory affiliates to support the service-level Tobacco Control Workers. | Year 1 Process to determine placement of these workers. Years 1–4 Workers to be placed. Year 4 Evaluation of impact. | Number of workers in position. |
| 7.6 Provide incentives to encourage NGOs to employ Indigenous workers. | Australian and state and Territory governments to provide incentives to NGOs (e.g. Cancer Councils, Heart Foundation, Quit). | Year 1 and ongoing | Number of Indigenous workers employed in NGOs. |
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 8: Boost efforts to discourage smoking among people in other highly disadvantaged groups | |||
| 8.1 Boost efforts to discourage smoking in highly disadvantaged neighbourhoods. | |||
| 8.1.1 Target surveillance and enforcement of sales to minors legislation in disadvantaged areas. | State and territory governments and local councils. | Year 1 onwards | Percentage of staff time and funding for education and compliance monitoring spent in low SES areas. Response and referral rates of health professionals. Number of calls to Quitlines (hits on website) from people giving their address indicating low SES postcodes. |
| 8.1.2 Target promotion aimed at encouraging GPs and other health professionals to refer to Quitlines to practices located in disadvantaged areas. | NPA or appropriate body, divisions of general practice and other local health agencies. | Year 2 onwards | |
| 8.1.3 Place the majority of any poster/outdoor or mobile advertising in highly disadvantaged neighbourhoods. | Quit campaigns. | Year 1 onwards | |
| 8.2 Ensure access to information, treatment and services for those with common mental health problems. | |||
| 8.2.1 Intervene more vigorously to prevent smoking uptake in young people at risk of developing mental health problems. | NPA in consultation with mental health agencies, advocacy groups. Other relevant government and non-government organisations. | Year 2 Develop proposals. Year 3 Assess and implement. | Whether discussions have been held and whether initiatives have been commenced. |
| 8.2.2 Educate GPs and other health professionals that people with common mental health problems can succeed in quitting and benefit from greater control of withdrawal symptoms. | NPA, National Prescribing Service, agencies involved in GP training. | Year 1 Develop proposals in consultation with mental health agencies and advocacy groups. Year 2 onwards: Assess and implement. | Responses in studies of health professionals. |
| 8.2.3 Ensure that the most clinically suitable pharmacotherapy to aid smoking cessation is affordable for all those with mental health problems. | Department of Health and Ageing. | Year 1 Investigate options for provision including through the Quitline and PBS. | Whether or not any person suffering mental health problems is able to receive or purchase at an affordable price the therapy their psychiatrist believes to be most appropriate. |
| 8.2.4 Train all staff working on Quitlines about common mental health problems and how to support people living with such problems to quit successfully. | Quitlines. | Year 1 Develop plans and programs. Year 2 onwards Run ongoing professional development. | Whether or not training has occurred (and percentage of staff trained) in each state and territory. |
| 8.2.5 Include information on quitting and common mental health problems in Quitbooks, internet and other educational materials. | Quit campaigns. | Ongoing | Whether information is included or not. |
| 8.3 Support cessation among those using mental health services. | |||
| 8.3.1 Educate mental health professionals about the importance of quitting and the importance of not discouraging quit attempts in clients. | NPA. | Ongoing | Responses in studies of health professionals. |
8.3.2 Include in healthcare agreements requirements that child, adolescent and adult mental health services and drug treatment agencies:
| State/territory governments. | Year 2 | Requirement included or not. Percentage of facilities in each jurisdiction subject to and in compliance with agreements. |
| 8.3.3 Support these processes by commissioning the production of national information packages for clinicians and facility managers. | Department of Health and Ageing. | Ongoing | |
| 8.3.4 Run a rolling program to train all staff in such services over a three-year period. | State and territory governments. | Ongoing | Number and percentage of professional staff in each jurisdiction who have undertaken training. |
| 8.4 Encourage cessation in those with mental health problems outside institutional settings. | |||
| 8.4.1 Encourage GPs, maternal and child health nurses, other health professionals and services such as Kidsline, Mensline and the BeyondBlue information line to ask people about smoking status/extent of tobacco use and to refer smokers to Quitline. | Australian Government /state and territory governments . | Year 1 Improve staff training. Year 2 Commence promotion. | Number of referrals from each service. |
| 8.4.2 Fund Quit courses for people with mental illness in non-threatening community settings. | State and territory governments. | Year 1 Evaluate South Australian project. Year 2 onwards Adapt as appropriate in other states and territories. | Number of people attending such courses and quit rates in samples evaluated. |
| 8.5 Ensure all state-funded human services agencies and correctional facilities (adult and juvenile) are smoke-free and provide appropriate cessation supports. | State and territory governments. | Years 1 and 2 Planning. Year 3 All facilities completely smoke-free in all states and territories. | Percentage of facilities in each jurisdiction covered by and compliant with policies. |
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 9: Assist parents and educators to discourage use of tobacco and protect young people from second-hand smoke | |||
| 9.1 Convey the message that parents can help – by quitting smoking; making homes smoke-free; choosing appropriate films, videos and games; and by making it clear that they do not want their children to smoke for the sake of their health. | Quit campaigns and prevention programs (Smarter than Smoking etc). Parents, carers, teachers. | Ongoing Ongoing | Track the percentage of parents of young people under 18 who: Ever smoke indoors Have tried to or succeeded in quitting Track the percentage of young people aged 12–15 and 16–17 years reporting: Being aware of the seductive depictions of smoking in films, television, video games etc That parents set clear rules about not smoking at home Know their parents would strongly disapprove of them smoking |
| 9.2 Cover the medical, social, environmental and economic aspects of tobacco in the school curriculum. | Education systems. | Ongoing | Percentage of young people aged 12–15 and 16–17 years reporting: Remembering a lesson at school concerning smoking |
| 9.3 Encourage schools to enforce smoke-free policies (grounds as well as buildings) for all members of the school community consistently, both indoors and in grounds. | Schools. | Ongoing | Percentage of young people aged 12–15 and 16–17 years reporting schools enforcing smoke-free policies. |
| 9.4 Encourage universities and other institutions of higher education to adopt smoke-free policies, including outdoors on campus. | Universities and other institutions of higher education. | Ongoing | Percentage of administrators reporting enforcement of smoke-free policies in schools and institutions of higher education. |
| 9.5 Make smoking a ‘classifiable element’ in movies and video games. | Australian Government. | Year 2 | Exposure of Australian teenagers (concentrating on those aged 14–15 years) to portrayals of smoking in movies (both at the cinema and on DVD): Desk-top study of the percentage of films (PG, M and MA) screening in Hoyts and Village cinemas in Australia with positive portrayals of smoking Survey of which films the average 14–15-year-old sees each year |
| 9.5.1 Designate tobacco use as a ‘classifiable element’, to be taken into account by the Classification Board when rating films. | |||
| 9.5.2 Produce guidance notes to the Board and to television licensees based on the literature on the impact of portrayals of smoking on young people. | |||
| 9.5.3 Fund a project to raise awareness among people working in the Australian film, television and entertainment industries of the damaging effects of seductive portrayals of smoking in popular entertainment viewed by children. | |||
| 9.5.4 Include training to decode depictions of smoking in movies in drug education in schools. | |||
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 10: Ensure that the public, media, politicians and other opinion leaders remain aware of the need for sustained and vigorous action to discourage tobacco use | |||
| 10.1 Ensure the public is constantly alerted to information about tobacco and its impact arising from new research findings. | NPA, Cancer Councils, Heart Foundation, Diabetes Australia, medical, nursing, pharmacy and other health professional associations and other health-oriented NGOs. | Year 1 onwards | Track volume of media stories about: Health effects of smoking Need for tobacco control measures and percentage that is supportive. Track levels of public support for tobacco control measures. |
| 10.2 Ensure that politicians and other opinion leaders are aware of international developments in tobacco control; including guidelines developed to assist countries comply with international obligations under the FCTC, and research on the efficacy of TC interventions. | |||
| 10.3 Ensure greater awareness that selling tobacco products is incompatible with principles of corporate social responsibility. | |||
| 10.3.1 Seek to make the percentage of revenue generated from tobacco products an agreed component of CSR award programs (e.g. Australian Business Awards; Telstra Business Awards and Australasian Reporting Awards). | Preventative Health Taskforce. Prime Minister’s Community Business Partnership. | Year 1 Year 3 | Number and percentage of business awards programs where guidelines incorporate a requirement to report revenue generated from tobacco and where high levels of revenue preclude high CSR scores. |
| 10.3.2 Seek amendment of ASXCGC Best Practice Recommendations. | |||
| Key action areas | Staged implementation | Measurement | Responsibility |
|---|---|---|---|
| Key action area 11: Measure progress against and towards targets | |||
| 11.1 Establish a National Tobacco Strategy Steering Committee, | Australian Government | Year 1 | Committee established |
| 11.2 Include a question on smoking among Australians aged 18 years and over in the Australian Census. | Department of Health and Ageing. ABS. | Year 1 Submit question to ABS for consideration of inclusion in 2011 and subsequent census. | Question in 2011, 2016 and 2021 census. |
| 11.3 Establish a mechanism to collect reliable data on prevalence in 2011 in Queensland, Tasmania, the Australian Capital Territory and Northern Territory. | Governments of Queensland, Tasmania, Australian Capital Territory and Northern Territory. | Year 1 onwards | Surveys established or questions included in existing surveys. |
| 11.4 Include in future reports of ASSAD surveys the proportion (and number) of teenagers who have ever smoked more than 100 cigarettes. | Centre for Behavioural Research in Cancer. | Year 1 Include in report of 2008 survey. | Section included in report. |
| 11.5 Report on trends in the proportion of smokers and recent smokers who have attempted to quit in the previous three and 12 months, and the proportion who intend to quit in the next three months. | Department of Health and Ageing to request co-ordinators of Australian arm of International Tobacco Control study to provide triennial reports. | Year 1 onwards Year 2 onwards | Reports produced and available. |
| 11.6 Report on trends over time in prevalence of smoking and numbers of cigarettes smoked for persons in all various SES groups, both in reports on detailed findings of the National Drug Strategy Household Survey, and in reports of the Australian School Students’ Smoking, Alcohol and Drug Survey. | Department of Health and Ageing to request. AIHW and Centre for Behavioural Research in Cancer. | Year 1 onwards Year 2 onwards | Inclusion of items in reports of 2010, 2013, 2016 and 2019 National Drug Strategy Household surveys. |
| 11.7 Increase sample sizes of the NATSHI Health and Social Surveys to provide reliable indications of changes over time in each state and in the Northern Territory. This should be done in preference to trying to include sufficient Indigenous people in annual state population surveys. | Department of Health and Ageing to request. ABS. | Year 1 onwards | Inclusions in future NATSHI Health and Social surveys. |
| 11.8 Use state population surveys to over-sample each year within two or three state health department regions with a high proportion of Indigenous residents, so that reliable estimates of prevalence of Indigenous smoking at a regional level become available on a three-yearly basis. | State Departments of Health. | Year 1 onwards | |
| 11.9 Analyse percentage changes in the prevalence of Indigenous smoking compared with percentage changes in previous periods, and compared with absolute and percentage changes in the non-Indigenous population. | Department of Health and Ageing to commission a suitable research group. | Year 1 | Report commissioned, produced and available. |
| 11.10 Extend the ASSAD survey to more remote areas of Australia and to Indigenous schools to ensure the inclusion of greater numbers of Indigenous children. | Department of Health and Ageing and Centre for Behavioural Research in Cancer. | Year 1 onwards | Incorporated in 2011 and future surveys. |
| 11.11 Establish a panel of Indigenous people who are currently smokers to enable the monitoring of intentions and attempts to quit, amounts smoked and the prevalence of smoking indoors and around others. The panel could also be used to monitor the impact of tobacco control policies among Indigenous people. | Department of Health and Ageing to commission a suitable research group. | Year 1 onwards | Panels established and regular surveys undertaken to provide data on the reach and efficacy of programs by monitoring, for instance, the use of NRT and other medications, perceptions of advice from healthcare providers, adoption of smoke-free homes and smoking around children. |
| 11.12 Report on trends over time, by SES, in the proportion of Australians aged 14 years and over exposed to second-hand smoke at work and indoors at home. | Department of Health and Ageing to request research agency and AIHW. | Year 1 onwards | Inclusion of this data in reports on the 2010, 2013, 2016 and 2019 surveys. |
| 11.13 Report on long-term trends in the percentage of students (smokers and non-smokers) who have one or more parents who smoke, and who live in homes that are smoke-free. | Department of Health and Ageing to request research agency and AIHW. | Year 1 onwards | Inclusion of this data in reports on the 2010, 2013, 2016 and 2019 surveys. |
| 11.14 Report for each state and territory, for women living in areas of varying levels of social disadvantage, and for Indigenous and non-Indigenous women, the proportion of pregnant women who report smoking at early and late stages of pregnancy. | Perinatal Statistics Units. | Year 1 onwards | Inclusion of this data in regular reports. |