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ACOSH Advocacy in Action - 10 December

Welcome to the final edition of the ACOSH Advocacy in Action e-bulletin for 2020. We aim to provide topical information on advocacy for tobacco control in Western Australia, Nationally and around the world. Please forward to others who may be interested. Thank you for your support.

The work of ACOSH is generously supported by Healthway and Lotterywest.

ACOSH expresses its best wishes to all subscribers for a happy and safe Christmas and prosperous New Year. 

Dr Denise Sullivan awarded the 2020 Dr Bob Elphick Medal

Dr Denise Sullivan has been named this year’s winner of the prestigious Dr Bob Elphick Medal.

The award was presented to Dr Sullivan by Dr James Williamson, Assistant Director General – Clinical Excellence, in Perth on Friday last week.

“Dr Denise Sullivan is one of the unsung heroes of tobacco control in WA – a critical figure in program and policy development here and nationally, for over 25 years,” said Dr Williamson.

“Denise’s first job in the Health Department was from 1995 as Coordinator of the Quit Campaign that had a reputation from 1985 for running television commercials that graphically portrayed the health consequences of smoking.

“Denise continued and developed this approach when she was recruited to the Cancer Council WA to establish and implement the ‘Target 15’ campaign at the Cancer Council WA, later known as the ‘Make Smoking History’ Campaign to reflect a broader agenda – and because the 15% prevalence target had been achieved.

“From this role, Denise also coordinated the publication of some outstanding reports on the effects of tobacco, and she also added to her academic credentials with a PhD in public health from UWA.”

Denise continued her commitment to tobacco control in WA when she returned to the Health Department in 2010 as Director of Chronic Disease Prevention, and more recently in her current position as Acting Assistant Director General.

“From this role she has overseen a wide range of tobacco control activities and programs, and has been a key figure in the development of much of the policy progress that we have seen over the years, as well as supporting and supporting many other staff in the Health Department and elsewhere who work on tobacco and related issues,” said Dr Williamson.

In accepting the Dr Bob Elphick award, Dr Sullivan said, “I feel very privileged to have started my career in health in tobacco control; the calibre of people and maturity of the campaigning were unrivalled then and continues to be an exemplar to other public health causes.”

The Elphick Medal is awarded annually in memory of Dr Bob Elphick, a pioneering chest physician who was President of the Australian Council on Smoking and Health from its inception in 1971 and remained a driving force in tobacco control and advocacy throughout his life.

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Push for vaping to become widespread continues

“The final Coalition party room of the year was dominated by a debate on vaping.

“The health minister, Greg Hunt, and the TGA are pushing to move to a prescription-only model by mid-2021, and senators Hollie Hughes and Matt Canavan have been dissenting from that position in a Senate inquiry into e-cigarettes.

“In the party room there were 10 contributions in favour of legalising vaping (and against the prescription-only model), including Hughes, Canavan, Trent Zimmerman, Tim Wilson, Perrin Davey, Barnaby Joyce, George Christensen and Eric Abetz.

“Hughes and Canavan put forward a compromise position that would allow people to seek a prescription from their doctor but preserve the ability to personally import vaping fluid. It sounds like that might be the direction of their inquiry report, due by 18 December.

“Andrew Hastie made a cautious contribution that noted the overlap in the US between the pro-vaping and pro-marijuana lobby. “Vaping is fine, but drugs are bad m’kay” seems to be the tenor of the contribution.

“Davey’s contribution was emotionally powerful – she recounted her father’s experience of cutting down from 30 cigarettes a day to two a day and vaping, which allowed him to have an operation doctors had previously refused.

“Hunt did not reply to the contributions – but Scott Morrison rounded out the debate by noting that both he and Hunt were listening and were sensitive to MPs’ and senators’ views.”

The Senate Committe Inquiry into Tobacco Harm Reduction is expected to provide a report by 18 December 2020.

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E-cigarettes and respiratory disease: from “no available evidence” to “significant concern”

“Three years after the NASEM report a much larger body of evidence from independent researchers is available for review, and additional scientific panels have been commissioned by international organizations and national governments to consider the evidence. These reviews have been broader in scope, covering other health effects, not just respiratory diseases, and generally conclude that e-cigarettes are not safe.

“These reviews include reports by or for the World Health Organization, the European Union, the Irish Government, the Government of the Netherlands, the Australian Government, and the Spanish Government.

“There is a growing global scientific consensus that e-cigarette use leads to increased risk of respiratory diseases.”

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Giving voice to anti-smoking campaign

“it is more than 40 years since an Australian marketing guru developed a novel anti-smoking television advertisement using kitchen sponges filled with tar to depict the deadly effects of cigarettes on the lungs.

“The ‘yuk factor’ was enough to have the advertisement banned briefly in the 1980s – after fierce lobbying by the tobacco industry – while it was slightly altered to satisfy regulators.

“… In the swings and roungabouts of shock-tactic Quit campaigns, West Australians are now seeing the latest instalment, Voice Box, featuring some of the most graphic images since the early 2000s.”

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North Metropolitan Health Service Smoke Free Mental Health Project highly commended in the 2020 ACHS Quality Improvement Awards

Congratulations to the North Metropolitan Health Service Smoke Free Mental Health Project which received a Highly Commended Certificate at the annual Australian Council of Healthcare Standards (ACHS) Quality Improvement Awards.

“To reduce the impact of smoking and mental health the NMHS MHPHDS Executive committed to creating a totally smoke-free health service, thereby removing the exemption for involuntary mental health inpatients as of 27 August 2019. Governance systems were established, led by a Steering Group chaired by the Director Public Health. The Project aimed to support Mental Health staff and patients through this transition, adopting a supportive approach by improving clinical staff knowledge, skills and confidence to manage nicotine dependence among patients using evidenced-based behavioural support interventions and pharmacological therapies such as Nicotine Replacement Therapy (NRT).”

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Vape liquid dangers revealed in new study

“More than one in five electronic cigarette liquid mixtures contain nicotine, despite it being illegal in Australia, and people who vape are being exposed to an array of harmful chemicals that could be acutely toxic.

“They are they findings from a Curtin University study which is the most comprehensive examination of the composition and toxicity of e-liquids supplied or manufactured in Australia.

“The study, jointly funded by the Lung Foundation Australia and the Minderoo Foundation, found that 21 per cent of the liquid mixtures contained in e-cigarettes contain nicotine. It is illegal to sell nicotine-containing e-cigarettes in Australia.

“In addition, 62 per cent of the e-liquids tested by researchers contained at least one chemical at a concentration above the acute inhalation toxicity limits.

“The researchers used an “ageing” method on the e-cigarette liquid to replicate the aerosol inhaled by the user during the ­vaping process, and also tested the aged liquid for chemical compounds. They found that 65 per cent of the aged liquid contained between one and four chemicals at levels that were potentially acutely toxic. These four chemicals were benzaldehyde, menthol, 2-chlorophenol and benzyl alcohol.”

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Charlotte’s accessible web: how West Australian children and adolescents can access e‐cigarettes online

“This is the first Australian audit of its kind and highlights significant concerns in the online retail of e‐cigarettes in Australia. Children and adolescents who wish to purchase e‐cigarettes in Australia face few obstacles and the plethora of promotional strategies used by retailers is disturbing. These issues are plausibly attributable to poor industry self‐regulation, as well as gaps in state and federal legislation relating to e‐cigarettes, though it should be noted that the Australian Therapeutic Goods Administration is currently exploring regulatory options which could significantly dampen access through online retailers.”
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Tasmanian research examining safety of e-cigarettes and its consequences amid COVID-19

“Vaping is no safer than tobacco cigarettes, according to a Tasmanian researcher, who’s concerned the devices are being marketed as a smoking cessation tool, despite known health impacts.

“Whether newly introduced electronic smoking devices are a safe alternative to help someone stop smoking and the wider implications amid COVID-19 will be the focus of new research.

Dr Sohal, head of the University of Tasmania’s Respiratory Translational Research Group, said e-cigarettes were increasingly being marketed towards young people to become long-term users.

“They [tobacco companies] are promoting it as a smoking cessation tool, but actually it’s not a smoking cessation policy. It’s basically a policy to have more users,” he said.

“Because nicotine is a drug – once you are hooked onto it, you’ve got a long-term customer. And it’s very much targeted to the young people.

“In work we have done so far, we tested some of the samples available from tobacco shops in Launceston, which goes into these electronic gadgets and they’re quite toxic.”

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New training and resources for maternity health professionals

“More pregnant women and their partners will be supported to stop smoking with new Australian-first resources designed for their treating health professionals. The resources – clinical guidelines and an online training package – have been developed by Quit and Alfred Health to help GPs, obstetricians, midwives and pharmacists have a simple conversation and provide best practice care so pregnant women and their partners may lead healthier lives for themselves and their babies.

“The clinical guidelines include information from The Royal Women’s Hospital in Melbourne on how to use nicotine replacement therapy during pregnancy. The guidelines support the Safer Baby Bundle national stillbirth prevention program, and have been endorsed by RANZCOG, the Australian College of Midwives and the Stillbirth CRE, and are recognised as an Accepted Clinical Resource by the RACGP.

“Quit and Alfred Health, in consultation with Safer Care Victoria and maternity clinicians, have also developed smoking cessation brief advice online training, which can be completed in an hour. See the resources and a short video at quit.org.au/maternity.”

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Tweet of the week

“Interesting that Altria (Philip Morris USA, major Juul shareholder, etc.) acknowledge “today’s youth vaping epidemic”. Will they now stop exposing young people to e-cigarette and tobacco marketing?

“Trust and credibility” and these companies don’t belong in the same sentence,” said Emeritus Professor Mike Daube.

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From the archives: History in the Making – The first 10 years of the Make Smoking History Campaign

“In May 2000, our Target 15 – Make Smoking History program was publicly launched. An astonishing amount has been achieved by the program since then, and the campaign has had a great impact on the Western Australian community as well as achieving national and international recognition.

“In 2000, almost one in four adults were smokers and the prevalence of smoking in Western Australia had barely changed for the best part of a decade. Mike Daube, as Chief Executive Officer of Cancer Council Western Australia, saw the need for a renewed effort in tobacco control in the State.

“Health Minister John Day agreed, and Target 15 – Make Smoking History was born, jointly funded by the Cancer Council and the Department of Health, Western Australia. Target 15 referred to the goal of reducing the prevalence of adult smoking to 15% by 2010 and we are well within range. These significant reductions in smoking prevalence mean that in years to come, there will be many Western Australian lives saved, and families spared the appalling tragedy of having loved ones die from tobacco use.”

Read more on the Make Smoking History campaign in its 10th Anniversary Book (published in 2010).

This year Make Smoking History celebrated its 20th anniversary.

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Tobacco Control News

Smoking and COVID-19: What we know so far – Elsevier Public Health Emergency Collection. Respir Med.

Is the tobacco ‘footfall’ argument justified for tobacco purchases in New Zealand convenience stores? – Tobacco Control

Smokefree law and tobacco tax increases followed by big drops in heart attacks in Thailand – Professor Stanton Glantz Blog

WHO launches year-long campaign to help 100 million people quit tobacco – World Health Organization

The Sin Tax: How the Tobacco Industry’s Heated-Tobacco Health Offensive is Sapping State Revenues – Organised Crime and Corruption Reporting Project