ACOSH Advocacy in Action - 23 July 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.

Dear subscribers to the ACOSH Advocacy in Action e-bulletin – Please keep safe during this challenging period for public health.

Graphic attached reproduced with the kind permission of AMA WA.

National Drug Strategy Household Survey 2019

The 2019 National Drug Strategy Household Survey report released last week showed that:

• In 2019, 11.0% of Australians smoked tobacco daily, down from 12.2% in 2016 and 24% in 1991.

• More smokers are opting for roll your-own cigarettes, both in combination with manufactured cigarettes (up from 26% in 2016 to 33% in 2019) and exclusively roll-your-own cigarettes (up from 10.7% in 2016 to 13.9% in 2019).

• People in their 40s and 50s were the most likely to smoke daily in 2019; this is different from 2001 when people in their 20s were the most likely age group to smoke daily.

• Use of e-cigarettes is increasing—between 2016 and 2019, lifetime use and current e-cigarette use increased for smokers and non smokers, as did frequency of use.

• 3 in 10 smokers do not plan on quitting— this proportion has not changed over the last decade.

• 2 in 5 smokers reduced the amount of tobacco smoked per day in the last 12 months.

See also
Remarkable decline in smoking in Australia continues – ACOSH Media Release

Aussie smoking rate falls, alcohol consumption stable, but use of some illicit drugs is up– Scimex



National Drug Strategy Household Survey finds e-cigarette use among non-smokers aged 18 to 24 years quadrupling in six years

“Between 2016 and 2019, use of e-cigarettes rose across most age groups, but the rise among young adults was particularly notable. Nearly two out of three current smokers and one in five non-smokers aged 18–24 reported having tried e-cigarettes.

“The director of centre operations at Melbourne University’s Centre for Behaviour Change, Dr Michelle Jongenelis, said the increased e-cigarette use among Australians was “very concerning”.

“Although marketed as a healthier alternative to traditional cigarettes, e-cigarettes are not harmless and there are significant health risks associated with their use,” she said. “Short-term consequences of use have been known for quite some time and data on the long-term health consequences of e-cigarette use are beginning to emerge, with studies linking vaping with cell death and increased risk of cardiovascular disease and cancer.”

“The increasing use of e-cigarettes among young adult non-smokers is especially worrying, Jongenelis said. Use among non-smokers aged 18 to 24 years rose from 5% in 2013 to 20% in 2019. Furthermore, 65% of adolescents and 39% of young adults report using e-cigarettes despite having never smoked.

“These concerning proportions are likely being driven by the vaping industry’s narrative that e-cigarettes are ‘harmless’,” Jongenelis said. “Increasing use among non-smoking youth also speaks to the vaping industry’s continued targeting of this population via youth-oriented marketing and the development of new youth-oriented e-juice flavours.”



Making it harder to import e-cigarettes is good news for our health, especially young people’s

“From next year, access to e-cigarettes and related products containing liquid nicotine will require a doctor’s prescription. This is to ensure liquid nicotine is handled like the poisonous, addictive substance it is and not promoted to young people. It’s good news for public health and bad news for the tobacco and e-cigarette industries.

“This restriction comes into effect from January 1 2021, six months later than originally proposed.

“It’s not a ban on importing e-cigarettes. But it will close loopholes between established prohibitions on the supply and sale of nicotine at the federal level, and state and territory laws restricting access to nicotine.

“Here’s the evidence to show why closing the loophole between health regulations, customs regulations and state and territory laws is good news for the nation’s health.”



US FDA does not rule that IQOS reduces tobacco-related harm, yet PMI still claims victory

“In July 2020, the U.S. Food and Drug Administration (FDA) approved IQOS, a heated tobacco product, as a “modified risk tobacco product.” Though the FDA agreed that the data submitted by Philip Morris International (PMI) showed that IQOS may reduce exposure to harmful substances, they conceded that IQOS does not reduce risk of disease and death when compared to cigarette smoking. Nevertheless, PMI has hailed the decision as a “milestone for public health”—a blatant misrepresentation of the FDA’s decision.

“Read more, including PMI’s own admission that IQOS is not proven to be a healthier alternative.”



US FDA action against Puff Bar and other disposable e-cigarettes is a positive step to protect kids, but not a substitute for a ban on all flavoured products

“The FDA today has taken a positive step to protect America’s kids by ordering ten companies that sell certain flavoured, disposable e-cigarettes, including Puff Bar, and some outrageously kid-friendly e-liquids to take their products off the market. This is a welcome, necessary and overdue step given the growing popularity of Puff Bar and other disposable e-cigarettes among kids – and growing sales of these products – since the FDA restricted the sale of some types of flavored e-cigarettes earlier this year. Disposable e-cigarettes like Puff Bar can deliver massive doses of highly addictive nicotine and are sold in an assortment of kid-friendly flavors, from banana ice to pink lemonade.

“While today’s action is a positive step, it  is not a substitute for a ban on all flavored e-cigarettes given the clear evidence that flavors have fueled skyrocketing youth use. Rather than playing whack-a-mole with a handful of egregious products only after they become popular with our nation’s kids, the FDA should clear the market of the thousands of flavored e-cigarettes that are still for sale. As long as some flavored e-cigarettes remain available, kids will migrate to them and we will not solve this youth addiction crisis.”



UK tobacco sales fell faster after plain packaging rules came into force

“Cigarette sales have decreased by about 20m a month after plain packaging rules and tougher taxes were introduced three years ago, researchers have found.

“Prof Anna Gilmore, director of the Tobacco Control Research Group (TCRG), said: “The underlying rate of decline in tobacco sales almost doubled after these policies were implemented.”

“The number of cigarettes sold in the UK was falling by about 12m a month before the measures were introduced in May 2017, according to the TCRG, which is based at the University of Bath.

“After the legislation took effect, sales began dropping off much more steeply. Monthly sales were almost 3.29bn individual cigarettes in May 2015, but fell to 3.16bn in April 2018.

“The UK was the second country in the world to implement plain packaging laws, Australia was the first, despite suggestions from the tobacco industry that this would increase sales of smuggled cigarettes.”

Related journal article
Longitudinal evaluation of the impact of standardised packaging and minimum excise tax on tobacco sales and industry revenue in the UK – Tobacco Control



The World Health Organization’s World No Tobacco Day 2020 Campaign exposes tobacco and related industry tactics to manipulate children and young people and hook a new generation of users

“Over the last decade, as the awareness of the harms of tobacco use has grown and global tobacco control efforts have intensified, the social acceptability of tobacco use has declined, directly impacting the sale of the most popular product the cigarette. To maintain its profitability, the multi-billion-dollar industry has aggressively started to look for newer markets in low- and middle income countries and also come up with innovative and creative ways to stay relevant and to keep its products on the market. Thus, it has been trying to reinvent itself by introducing a new portfolio of products, presenting itself as part of the solution to combat the tobacco epidemic, which it created in the first place. The strong marketing and promotional strategy of the tobacco industry has led to an increase in nicotine and tobacco product use among youth globally.”


Tobacco in Australia Facts & Issues: Coronaviruses and the COVID-19 pandemic

Read the Facts and Issues team’s latest update of the Smoking and Covid-19. This section is being updated monthly to report important developments in the research field as they become available. The current version is from 9th July 2020.


Evidence that an intervention weakens the relationship between adolescent electronic cigarette use and tobacco smoking: a 24-month prospective study

“The present research showed that never smoking 14-year olds who ever versus never used e-cigarettes were more likely to report having smoked at least once or more regularly 24 months later. These effects remained (although attenuated) when controlling for various predictors of smoking. The degree of attenuation was greater for regular smoking than for other smoking measures. This study adds to the growing number of US and UK studies showing that e-cigarette use in adolescents is reliably associated with subsequent smoking. The current results are comparable to those reported in a recent meta-analysis of nine such studies (OR=3.50, 95% CI 2.38 to 5.16) for ever smoking based on comparing never versus ever users of e-cigarettes.”

“The reviewed studies were generally over a period of 12 months (five of nine studies) with a maximum follow-up period of 18 months and focused on ever smoking. In contrast, the present study was over 24 months and showed effects for ever smoking, any recent tobacco smoking and regular cigarette smoking. Together, these studies suggest that it is unlikely that the high rates of dual use of e-cigarettes and smoking observed in the US and UK in cross-sectional surveys of adolescents are entirely attributable to cigarette users subsequently taking up e-cigarettes.”



Tobacco Tactics: Corporate Social Responsibility – Awards

“For decades, multinational tobacco companies have received awards for their corporate social responsibility (CSR). This broad category includes both human resources (HR) awards that recognise internal practices as well as external-facing practices, including sustainability, community development and supply chain management.

“Tobacco companies increase publicity for the awards they receive for CSR practices by highlighting them in their sustainability and annual reports and by garnering press attention. This tactic forms one part of the tobacco industry’s larger CSR strategy and helps mitigate the risk to companies’ reputation due to historic and current social transgressions. CSR is a public relations exercise that serves as a stand-in to making actual changes in company practices to improve social outcomes.”



Harm reduction and e-cigarettes: Distorting the approach

“Some supporters of electronic cigarettes have argued that they should be considered a form of harm reduction, analogous to that which has been successful with narcotics. In this viewpoint, we contend that this argument is based on highly selective use of the evidence, coupled with a fundamental misunderstanding of a comprehensive harm minimisation strategy. This includes not only harm reduction but also reduction in demand and supply — two elements that are explicitly rejected by many advocates of electronic cigarettes. We contend that, in the absence of all three elements, there is a danger that electronic cigarettes will delay the achievement of a tobacco-free world.”

Michael Moore, Martin McKee and Mike Daube Journal of Public Health Policy Vol. 37, No. 4 (December 2016), pp. 403-410



ACOSH Advocacy Action 1971 – 1999

ACOSH has published an online resource on advocacy strategies and achievements of ACOSH from its establishment in 1971 to 1999.

The resource aims to assist health professionals, students of public health and other health sciences, in public health advocacy by providing case studies on successful advocacy for tobacco control in WA and nationally.



Tweet of the Week



Tobacco Control News

Principals sound alarm as students take up vaping, become black market ‘dealers’ – The Sydney Morning Herald

Big Tobacco’s decisive defeat on plain packaging laws won’t stop its war against public health – The Conversation

AI health worker to quit tobacco – World Health Organization

The Changing Landscape: Tobacco and Marijuana Use Among Young Adults in California – UCLA Center for Health Policy Research

Flavored cigarette ban significantly reduced youth smoking, new study finds– Science Daily

Tobacco giant’s menthol-ban substitutes take 5% share of Irish market – The Irish Times