ACOSH Advocacy in Action - 21 May 2021

Welcome to the latest edition of the ACOSH Advocacy in Action e-bulletin for 2021.
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.
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The work of ACOSH is generously supported by Healthway and Lotterywest.

Update on TGA Standard for Vaporiser Nicotine consultation

From 1 October 2021, consumers will require a doctor’s prescription to legally access any nicotine e-cigarettes and liquid nicotine in Australia. This aligns with current domestic restrictions under State and Territory law that prohibit the supply and use of nicotine containing e-cigarettes in Australia without a valid medical prescription.

In February 2021, the Therapeutic Goods Administration (TGA) asked for feedback on a proposed standard for nicotine vaping products, including product safety and quality standards, to apply to unapproved nicotine vaping products.

No e-cigarette product has been approved by the TGA to assist with smoking cessation.

The ACOSH and Cancer Council Australia joint submission  highlighted many concerns regarding the proposed standard for unapproved nicotine vaping products, including how the proposal in effect provides minimum standards to facilitate a new legal business sector in Australia based on the promotion of addictive products for which there is no evidence of population health benefit.

In response to the 103 submissions received in its consulation, the TGA announced this week that:

“The standard includes updated labelling requirements for nicotine concentration (including requiring nicotine concentration to be specified in mg/mL and warning statements to be provided), the prohibition of three additional ingredients with established inhalation risks, record keeping requirements for sponsors, a limit of nicotine concentration of 100 mg/mL in products and a requirement for actual nicotine concentration/content of a product to be within +/- 10% of what it says on the label. The standard has also been expanded to cover ARTG-listed ‘Export Only’ products.”

“Although the standard does not restrict the flavours of nicotine vaping products (other than those containing prohibited ingredients) or container sizes, it is important to remember that these factors, and others, are restricted by the person’s prescription. This allows the prescribing health professional and patient to work together to make sure that the right product is supplied to support nicotine and smoking cessation.”

ACOSH remains concerned that failure to adequately communicate the harms of vaping products to prescribers could lead to increased use and increased levels of nicotine addiction, and failed cessation attempts due to dual use of nicotine vaporisers and smoked tobacco products.

ACOSH is also concerned that the regulatory controls and safeguards put in place by all levels of government in Australia will continue to be extensively undermined by the illegal importation of vaporiser nicotine and e-cigarettes online.

ACOSH strongly supports the reintroduction of the Customs (Prohibited Imports) Regulation to address this issue that were withdrawn by the federal government in June 2020.


City of Vincent Council passes unanimously a motion for options to change planning framework to exclude new tobacconists and cigar bars

“Let’s be really clear on this – tobacco is no ordinary commodity, the tobacco industry is insidious. It kills 15,500 Australians every year.

“It is an industry that actively manufactures and promotes a product that kills two out of every three people that use it exactly as the manufacturer intends you to.

“It is a global industry that has manipulated and obfuscated the evidence of health impacts for 70 plus years. It is an industry that has no social license and it is entirely appropriate (indeed imperative) for governments at all levels to minimise, exclude and marginalise the industry (not individual smokers) for the deaths it has already caused and will continue to do so as long as it is allowed to continue.

“It is an industry that targets children and adolescents. It is an industry that exploits low and middle income countries. It is an industry that has fought scientists and attacked governments through the courts for acting in the public interest including our own.

“Other industries have certainly learnt from tobacco about strategies to sew doubt about scientific evidence and delay regulatory reforms that protect our health and the environment. But tobacco really is in a class of its own. We must do everything we can to ensure that this industry doesn’t recruit new consumers and minimise tobacco promotion that makes it harder for existing smokers to quit,” said Cr Jonathan Hallett.

See also
Notice of Motion – Cr Jonathan Hallett – Planning Framework Review Regarding Tobacco Outlets


Smokers swallow menthol cigarettes as less harmful, but Cancer Council warns it’s a smokescreen

“Smokers incorrectly believe menthol cigarettes are less damaging than non-menthol cigarettes, according to Cancer Council Victoria research published today in the International Journal of Environmental Research and Public Health and funded by the National Health and Medical Research Council.

“Of the sample of 999 Australian 18–69-year-old weekly smokers recruited for the study, three-quarters had at least some experience of smoking menthol cigarettes and a quarter currently smoked menthol cigarettes at least once a week.

“Professor Melanie Wakefield, Head of the Behavioural Science Division at Cancer Council Victoria, said the findings were particularly concerning as menthol cigarettes can make it easier for young people to become addicted to cigarette smoking, and can make it harder for current smokers to quit.

“We found that current menthol smokers were up to nine times more likely to report that menthol rather than non-menthol cigarettes create favourable sensory experiences when they are smoked, including feeling smooth, being soothing on the throat, having a fresh taste and feeling clean. Menthol smokers incorrectly believed cigarettes with these favourable sensations are less damaging than cigarettes with more unpleasant sensory experiences.

“This is worrying; although young people have been raised with the knowledge that smoking is bad for them, anything that makes smoking seem less harmful to a young demographic, and that makes it harder for current smokers to quit, is cause for concern.”


Smoking and health 2021 – new report from the Royal College of Physicians

“Almost 60 years after the Royal College of Physicians (RCP) report Smoking and Health, researchers from the University of Bath’s Tobacco Control Research Group (TCRG) have contributed to a new report which reviews the UK’s progress in reducing smoking prevalence, and which sets out comprehensive recommendations for England’s forthcoming National Tobacco Control Plan. Prof Anna Gilmore, Director of TCRG, is a member of the RCP’s Tobacco Advisory Group which has published the report.

“The UK Government has set out an ambition for England to be smoke free by 2030. While smoking rates have declined, modelling in the RCP report suggests that under current tobacco control policies, a smoking prevalence of less than 5% won’t be achieved until after 2050. The report identifies a number of areas where action should be taken to address this, from reforming tax policy and eradicating media promotion of smoking, to raising the legal age of sale for tobacco products, and silencing the voice of the tobacco industry.”


Proven tobacco control tools are key to a healthy recovery

“It sometimes feels like a whole new era began in early 2020 when COVID-19 started spreading.

“Our old ways of doing things – business, travel, even social interaction – suddenly changed as the world struggled to contain a novel coronavirus.

“But as talk of “flattening the curve” shifted to “the new normal”, it became clear that despite the unprecedented nature of this pandemic, the same public health challenges remain.

“Cancer and other noncommunicable diseases (NCDs) are still the world’s leading causes of death and disability, only now they’re also making people more vulnerable to COVID-19. The COVID-19 pandemic is hitting marginalised communities the hardest just as NCDs do, underscoring the same inequities. And eight million people died last year due to tobacco use, while the tobacco industry encourages people to keep smoking despite a pandemic of respiratory illness.

“As we work to overcome this new challenge, we can’t forget our existing public health toolkit. We need to double down on prevention, making use of legal and regulatory measures we already know are effective. That includes the landmark treaty that has been saving lives for more than 15 years: the WHO Framework Convention on Tobacco Control (FCTC).”


Ian Irvine, the Foundation for a Smoke-Free World and the CD Howe Institute – undisclosed funding by commercial interests is a public health problem

“Over the past months Canadians have heard the views on vaping regulations of Concordia University economist Ian Irvine.

“Recently the Globe and Mail’s business editor gave space to his opinion that taxes on vaping products should not be so high as to discourage people from using them and that governments should do more to encourage smokers who don’t quit to switch to the companies’ new forms of nicotine products.

“Two weeks earlier, the CD Howe Institute had published his longer report on the same theme.

“This was not the first or the only time that the CD Howe Institute had promoted Mr. Irvine’s views on vaping products. At the end of March, they hosted his letter to the federal health minister, encouraging her not to see youth vaping as a crisis, but rather as a driver of lower youth cigarette smoking.

“… At no time did the CD Howe Institute acknowledge that Mr. Irvine was working on a contract funded by the Foundation for a Smoke-Free World (FSFW), the most recent in a history of tobacco industry efforts to align public and regulatory opinion with their business interests.”



Hospital staff perspectives on the provision of smoking cessation care: a qualitative description study

“This study explored the perspectives of clinical and non-clinical staff on the provision of smoking cessation care across metropolitan, regional and rural hospitals. The views of hospital staff in metropolitan mental health acute inpatient settings were congruent with those from rural and regional generalist hospitals. The key themes deriving from this study were associated with clinical setting, knowledge, consistency and appropriateness. These indicated that while hospital staff discussed barriers for providing smoking cessation care in clinical settings, they had a sense of responsibility to support quitting, and empathised with the difficulties experienced by patients who smoke.

“Findings highlighted opportunities for education and training around best-practice tobacco dependence treatment (combined behavioural intervention and pharmacotherapy), communication skills and greater awareness of existing resources to support hospital staff to confidently address smoking cessation with patients. As this study focuses on the perspectives of hospital staff exclusively, our results shed light on the specific barriers of sustainable implementation of smoking cessation care in hospital settings.”



Phasing out smoking: The Tobacco-Free Generation policy

“The NZ Government has published a discussion document outlining an Action Plan for achieving the Smokefree Aotearoa 2025 goal and invited submissions. This blog is one of a series examining key aspects of the plan to help inform the debate and submissions. Here we examine the ‘Tobacco-free generation’ policy (TFG), which provides a mechanism to protect future generations from tobacco harm and, over time, to phase out tobacco sales entirely.”

By Jude Ball, Jon Berrick, Richard Edwards, Janet Hoek, Frederieke Petrovic-van der Deen.



World Health Organization: Quit tobacco to be a winner

“The saying goes that “quitters never win,” but in the case of tobacco, quitters are the real winners.

“When the news came out that smokers were more likely to develop severe disease with COVID-19 compared to non-smokers, it triggered millions of smokers to want to quit tobacco. But without adequate support, quitting can be incredibly challenging.

“The nicotine found in tobacco is highly addictive and creates dependence. The behavioural and emotional ties to tobacco use – like having a cigarette with your coffee,  craving tobacco, feelings of sadness or stress  – make it hard to kick the habit.

“With professional support and cessation services, tobacco users double their chances of quitting successfully.

“Currently, over 70% of the 1.3 billion tobacco users worldwide lack access to the tools they need to quit successfully. This gap in access to cessation services is only further exacerbated in the last year as the health workforce has been mobilized to handle the pandemic.

“That’s why WHO launched a year-long campaign for World No Tobacco Day’s   – “Commit to Quit” theme. The campaign aims to empower 100 million tobacco users to make a quit attempt by creating networks of support and increasing access to services proven to help tobacco users quit successfully.”

See also
‘Commit’ to Keeping the Industry Out of Tobacco Control Legislation –



E-cigs double risk of relapse among former smokers

“Most of the discussion of the effects of e-cigarette use on smoking has focused on their gateway effect among youth (they are) and whether e-cigs help smokers quit (as consumer products they do not). There has been much less attention to how e-cigarettes affect the risk of relapse among former smokers.

“But now there are studies of relapse. Laura Barufaldi and her colleagues at the National Cancer Institute of Brazil recently published Risk of smoking relapse with the use of electronic cigarettes: A systematic review with meta-analysis of longitudinal studies that identified six relevant studies from the US, UK and France, three of which have quantitative results. They found that risk of relapse is doubled among former smokers who use e-cigarettes than among non-users (relative risk 2.03; 95% CI 1.39-2.96),” said Professor Stanton Glantz.



#georgetalks Smoking in the time of COVID: challenges and opportunities in Australia and the United Kingdom

“The George Institute for Global Health invites you to a #GeorgeTalks on ‘Smoking in the time of COVID: Challenges and opportunities in Australia and the United Kingdom’ to mark World No Tobacco Day 2021.

“The event will be held on Thursday 3 June 2021, 6pm-7pm (Sydney AEDT) / 9am-10am (London BST). The event will be a hybrid event online (via Zoom) and in-person (over canapes in Sydney, Australia).

“In marking World No Tobacco Day 2021, we will be convening an expert panel to discuss the impact of the COVID pandemic on smokers in Australia and the United Kingdom. We will discuss the opportunities, challenges and emerging evidence on effective strategies that can support smokers to quit during this window, with long-term benefits for the burden of preventable death and disease.”



Tweet of the week

“NZ Trade Minister withdraws from international conference in Japan after being informed it’s sponsored by BigTobacco @InsidePMI Wonderful to see principled gvt like this,” said Emeritus Professor Simon Chapman AO.


Tobacco control news

STOP Welcomes the Withdrawal of the Tobacco Industry from the “Future of Asia” International Conference –

Why does British Columbia lag behind when it comes to taking cigarettes out of pharmacies? – Physicians for a Smoke-Free Canada

South East Asian Region – Tobacco Tactics, University of Bath

Secondhand tobacco exposure in utero linked to decreased lung function in children – American Thoracic Society

E-Cigarettes and myocardial Infarction: a systemic review and meta-analysis – European Journal of Preventive Cardiology