ACOSH Advocacy in Action - 12 November 2020


Welcome to the latest 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.


Select Committee on Tobacco Harm Reduction

On 6 October 2020, the Senate resolved to establish a Select Committee on Tobacco Harm Reduction.

The committee will inquire into tobacco harm reduction strategies, with particular reference to:

• The treatment of nicotine vaping products (electronic cigarettes and smokeless tobacco) in developed countries similar to Australia (such as the United Kingdom, New Zealand, the European Union and the United States), including but not limited to legislative and regulatory frameworks;

• The impact nicotine vaping products have had on smoking rates in these countries and the aggregate population health impacts of these changes in nicotine consumption;

• The established evidence on the effectiveness of e-cigarettes as a smoking cessation treatment;

• The established evidence on the uptake of e-cigarettes amongst non- smokers and the potential gateway effect onto traditional tobacco products;

• Evidence of the impact of legalising nicotine vaping products on youth smoking and vaping rates and measures that Australia could adopt to minimise youth smoking and vaping;

• Access to e-cigarette products under Australia’s current regulatory frameworks;

• Tobacco industry involvement in the selling and marketing of e-cigarettes; and

• Any other related matter.

Upcoming Public Hearings will take place on:
13 Nov 2020: Canberra
19 Nov 2020: Sydney

ACOSH presented a joint submission with the Cancer Council Australia and National Heart Foundation of Australia in response to the Inquiry.

Representatives from ACOSH will present to the Committee at the public hearing on Thursday 19 November via teleconference.


Inquiry into the Commonwealth Electoral Amendment (Banning Dirty Donations) Bill 2020

“The purpose of the amendments in the bill is to prevent certain industries from making political donations, specifically:

▪ property developers
▪ the tobacco industry
▪ the banking industry
▪ liquor and gambling businesses
▪ pharmaceuticals companies
▪ the mining industry and
▪ representative organisations for these industries.

“The bill also imposes a cumulative limit on donations from any source of $3,000 per election term.”

ACOSH provided a submission recommending that the Commonwealth Electoral Amendment Bill include a prohibition on direct and indirect donations from the tobacco industry.

This recommendation is consistent with the Australian Government’s obligations under Article 5.3 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC).


E-cigarettes can be ‘gateway’ to cigarettes for teens with no prior intention to smoke

“A new study, published on 9 Nov in the journal Pediatrics, finds that e-cigarette use is associated with a higher risk of cigarette smoking among adolescents who had no prior intention of taking up conventional smoking.

“Abstinence from e-cigarettes can protect teens from becoming future smokers and should be framed as a smoking prevention strategy by all concerned stakeholders,” says Dr. Owotomo. “Pediatricians are best positioned to educate patients and families on the clinical and psychosocial consequences of e-cigarette use and should support education campaigns and advocacy efforts geared to discourage adolescent e-cigarette use.”


Australian smokers’ experiences and perceptions of recessed and firm filter cigarettes

“▪ Past studies have documented how tobacco companies have modified cigarette filters and that such modifications increase the appeal and reassure smokers about harms.

▪ Using a mixed-method design, this is the first study to focus on smokers’ perceptions of cigarettes with recessed filters and firm filters.

▪ The current study found smokers perceive both these filter modifications may reduce harm and that firm filters increase appeal.

▪ These filter variants undermine the aims of plain packaging legislation and should be disallowed.”


Supporting smoking cessation during pregnancy

The WA rollout of the Safer Baby Bundle, an evidence-based and collaboratively designed eLearning resource by the Stillbirth CRE to support healthcare professionals in providing best-practice care in stillbirth prevention, was launched this week.

The Safer Baby Bundle provides evidence-based recommendations in five key risk areas including ‘supporting women to stop smoking’.

ACOSH in partnership with the Aboriginal Health Council of WA, Quitline Aboriginal Liaison Team, Cancer Council WA, Red Nose and Yarning it Up Don’t Smoke it Up, delivered the presentation ‘Connecting Communities: Maternal Smoking Cessation’ at the Safer Baby Bundle Masterclass on Tuesday 3 November.


Asthmatics can’t buy flavoured puffer drugs, so why should e-cigarette choices be like a candy shop?

“Australia has about 2.7 million people with asthma, and some 464,000 with chronic obstructive pulmonary disease (COPD). Most of both groups use puffers for relief, sometimes in lifesaving attacks.

“But none of the asthma drugs which are inhaled come in flavours which might make them more palatable. And respiratory medicine colleagues tell me that many users do not enjoy the medicinal taste. So you’d imagine that the manufacturers of inhaled medicines would jump at the opportunity to have flavours available if this would encourage more people to use their puffers when needed.

“Here’s an example of someone enquiring to an on-line forum about whether puffer flavours are available. The advice back? “We still do not know the long-term consequences of inhaling concentrated flavourants, but I suspect that many are pretty bad for you… Also, many aromas (perfumes) are known to induce asthma attacks in people who are sensitive. So all-in-all probably not the best idea for people who are already at risk of reduced lung function.”

“People who use puffers are advised that it’s safe to use them 4-6 times a day maximum. Contrast this with the number of times that the average vaper fills their lungs with propylene glycol, nicotine and flavouring chemicals, all vaporised from the liquid that is heated by the metal coil heated by the e-cigarette battery,” said Emeritus Professor Simon Chapman AO.


New Zealand: New vaping laws take effect

New Zealand passed the Smokefree Environments and Regulated Products (Vaping) Amendment Act in August, with restrictions to be phased in over a 15-month period.

From 11 November 2020:
▪ the sale or supply of vaping products to under 18s is prohibited
▪ indoor vaping is prohibited at workplaces, restaurants and licensed premises
▪ vaping is prohibited at schools and early childhood centres (including outdoors)
▪ most advertising and sponsorship of vaping products is prohibited
▪ retailers cannot encourage the use of vaping products (with some exceptions).

“Professor Janet Hoek from the University of Otago, co-Director of ASPIRE 2025, and a member of the VEAG, notes New Zealand research has shown a significant rise in vaping use among youth (under 18-year-olds), which needs to be addressed.

“The Act will provide much-needed regulation around the aggressive marketing of vaping products to youth; we hope the forthcoming regulations will stop promotions used to recruit a new cohort of nicotine-dependent users”.

“The latest ASH Year 10 Data on e-cigarette use among New Zealand adolescents shows that prevalence of regular (at least monthly) and daily use of e-cigarettes approximately trebled between 2015 and 2019, with the greatest use among Maori students.”


Which Canadian province is doing the best at reducing smoking?

“The takeaway:
British Columbia is ahead of the other provinces but is not necessarily making better progress against tobacco use.▪ Individual and community efforts to reduce smoking have succeeded in Canada at a steady if slow pace for the past 20 years.

▪ British Columbia has maintained its lead for two decades. Other provinces are generally keeping pace with B.C., and some appear to be making progress more quickly than B.C. on some indicators.

▪ Falling smoking rates reflect changes in two sets of behaviours: the reduced number of people who start to smoke and an increased number of smokers who successfully quit. Success in some provinces can be attributed more to one of these than the other.
More refined statistical analysis is needed to compare inter-provincial progress.

▪ Demographic differences between the provinces may be responsible for some differences between provincial smoking, starting and quitting rates.”


Big Tobacco, Big Tax Avoidance

“As COVID-19 sweeps across the globe and ravages public finances, governments are looking for innovative ways to fund COVID-19 relief without adding pressure to already suffering economies. Meanwhile, Big Tobacco pays as little in profit-related taxes as possible while selling deadly products known to exacerbate the effects of COVID-19.

“In a new report, The Investigative Desk and the University of Bath, a partner in STOP, found that Big Tobacco uses five key methods to avoid taxes. Those taxes could be used to fund COVID-19 recovery or strengthen public health systems, but instead, they are enriching a nefarious and deadly industry.”


New York City Housing Authority Secondhand Smoke Policy Needs More Time & Effort to Show How Well It Works

“One year into a smoking ban in buildings run by the nation’s largest public housing authority, tenant exposure to secondhand smoke in hallways, stairwells, and apartments has not declined, a new study shows.

“Among the explanations for this, investigators say, are delays in promotion and enforcement, including putting up signage and training building managers, and reluctance among nonsmokers to report violations. They also cite lack of smoking cessation services as a possible factor.”


Childhood Smoking, Adult Cessation, and Cardiovascular Mortality: Prospective Study of 390,000 US Adults

“Overall, current smokers in this contemporary US population had nearly 3 times the risk of premature cardiovascular mortality compared with never smokers. The risk was higher among those who had begun smoking in childhood (<15 years), and highest of all for those who had begun before age 10 years. However, quitting at any age was associated with a substantially lower risk than continuing to smoke, with the greatest risk reduction among those who quit before age 40 years.

“Age at starting to smoke is an important, but underappreciated, determinant of adult cardiovascular mortality, and this study indicates that the ≈5 million US smokers who began before age 15 years are at especially high risk of premature death from cardiovascular disease if they do not quit. If the associations between smoking and cardiovascular mortality are largely causal, then smoking is a cause of more than two-thirds of all premature deaths from cardiovascular disease among smokers who began before age 15 years. However, smoking cessation substantially reduced the excess risk of cardiovascular death, with those who quit before age 40 years (preferably well before age 40 years) avoiding >90% of the excess cardiovascular risk, as well as avoiding substantial excess risks of death from other tobacco‐associated diseases.”


Illicit Tobacco Trade not exacerbated by tobacco tax increases in low & middle-income countries, research shows

“If cigarettes are more expensive, people quit, smoke less, or don’t start. Unsurprisingly, the tobacco industry opposes excise tax increases to protect their revenue and profits. One of the most common arguments they use is that increases in tax will result in illicit trade. The main issue in illicit trade is tax evasion, which includes counterfeiting, and smuggling.

“Illicit tobacco trade is a problem that deserves attention, especially in low-and-middle-income countries (LMICs) where cheaper and more accessible illicit tobacco products perpetuate inequalities in health.

“Governments should be extremely cautious when lobbied by the tobacco industry about these issues.

“In a newly published BMJ Tobacco Control supplement on illicit trade, a team of researchers investigated illicit trade before and after tax increases.”


Save the date: 2020 Dr Bob Elphick Medal presentation

The 2020 Dr Bob Elphick Medal presentation will be held on Friday 4 December, 7:30 am at the Matilda Bay Restaurant. 

The medal commemorates the exceptional achievements of former ACOSH President, Dr Bob Elphick, and is awarded annually to a person or organisation that has made an outstanding contribution to tobacco control in Western Australia or Nationally.

Please save the date and visit the ACOSH website for more information on this initiative.


From the archives: The end of tobacco advertising in magazines

Advertising of tobacco products in Australia has been progressively restricted since the 1970s, with cigarette advertising bans on radio and television in place since 1976.

In 1989, the Australian Government introduced the Tobacco Products Advertisements (Prohibition) Act 1989, which prohibited the advertising of tobacco products in all newspapers and magazines, effective from December 1990.

The banning of newspaper and magazine ads for cigarettes in December 1990 signalled the end of the last mainstream advertising medium available to cigarette companies.


Tweet of the week


Tobacco Control News

If e-cigs are effective cessation aids, when will an e-cig company submit the needed evidence for FDA approval? – Stanton Glantz blog

North Korea Tells Its People to Stop Smoking. But What About Kim Jong-un? – The New York Times

Children exposed to tobacco smoke at home have worse heart function as adults – American Heart Association

Bar Atmospherics and Smoking: A Qualitative Analysis of New Zealand Young Adult Smokers – Nicotine & Tobacco Research

Switching stories: user testimonials on continue to contradict JUUL’s switch ≠ cessation narrative – Tobacco Control