ACOSH Advocacy in Action - 26 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.

Invitation: 2020 Dr Bob Elphick Medal presentation

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

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 RSVP (with any dietary requirements) by Monday 30 November to Lucy Scott at


Select Committee on Tobacco Harm Reduction

ACOSH presented a joint submission with the Cancer Council Australia and National Heart Foundation of Australia in response to the Inquiry into Tobacco Harm Reduction (submission 194).

Professor Kingsley Faulkner, ACOSH President, and Maurice Swanson, ACOSH Chief Executive, presented to the Committee at the public hearing on Thursday 19 November via teleconference.
Read the transcript here and Maurice’s opening statement here.

See also
Joint submission by Emeritus Professor Simon Chapman AO PhD, Emeritus Professor Mike Daube AO and Professor Matthew Peters AM MD (submission 195)



Bombshell dropped in Senate Inquiry with NZ experts backpedalling on 95% safer estimate

“New evidence emerges, and thus good researchers adjust their modeling to account for e-cigs being more harmful than first thought. Modeling recommends prescription and not consumer model on basis of following the evidence. Good on @BlakelyTony and team!” said Dr Sarah White, Director Quit Victoria (via Twitter).

Submission by Professor Tony Blakely, University of Melbourne, and colleagues to the Select Committee on Tobacco Harm Reduction (submission 404)

“Our job as researchers is to provide the best evidence for policy makers – as above. We therefore cautiously make the following recommendations:

– A precautionary principle should be applied to any liberalization policy – we are not confident that net health gain will arise for a shift from the current Australian situation to something like the liberalized situation in NZ. Our recommendation on this may (appropriately) change as evidence and data improves.

– Serious consideration is still warranted for targeted policy or regulation:

– Controlled access to e-cigarettes for adult smokers seeking to quit is warrented (eg, through pharmacies or via doctors prescription).

– Conversley, unrestricted access to e-cigarettes for non-smoking adults or of youth is not justified”


ACOSH and Cancer Council Australia support interim decision by the TGA to reschedule nicotine

Cancer Council Australia and the Australian Council on Smoking and Health support the delegate’s interim decision of 23 September 2020 to amend the Poisons Standard and move nicotine for nontherapeutic human use (other than in tobacco prepared and packed for smoking) from Schedule 7 to Schedule 4.

The interim decision is consistent with the recommendations of the Advisory Committees on Medicines and Chemicals Scheduling in joint session (Joint ACMS-ACCS #25).

The proposed decision aims to remove uncertainty among some stakeholders about existing restrictions on access to nicotine in preparations for human use.

It will not change access to nicotine products as currently permitted by law.



Vaping decision closes loophole

“An interim decision to make nicotine for use in e-cigarettes available in Australia, but only with a doctor’s prescription, will help make vaping products harder to access, AMA President Dr Omar Khorshid said today.

“The Therapeutic Goods Administration (TGA) has proposed amendments to clarify that nicotine products for e-cigarettes can only be imported for use when prescribed by a doctor.

“Nicotine is a poison, and the AMA opposes all use of nicotine-containing vaping products,” Dr Khorshid said.

“Exposure to nicotine can harm adolescent brain development, and nicotine vaping products contain carcinogens including formaldehyde and solvents.

“The evidence that vaping is effective as a quit smoking aid is inconclusive, but there is plenty of evidence that it causes harm. Multiple studies show that vaping can lead to previous non-smokers taking up tobacco smoking, and that people using vaping as a quit aid are significantly more likely to still be vaping after a year than people using nicotine patches or other therapies.

“The proposed change will stop people accessing nicotine for any use without a prescription, and will ensure that patients see their doctor for advice on the most reliable and safe smoking cessation methods.

“While doctors can already prescribe nicotine for vaping, it is very rare – the TGA estimates that only about 10 doctors in Australia currently do so.”

See also
Submission by Australian Medical Association (AMA) to the Select Committee on Tobacco Harm Reduction (submission 183)



Philip Morris-sponsored articles in the Australian could breach tobacco advertising laws

“A series of Philip Morris-sponsored articles about vaping published on the website of The Australian newspaper may breach national tobacco advertising promotion laws, public health advocates have said.

“The chief executive of the Australian Council on Smoking and Health, Maurice Swanson, said he would ask the commonwealth health department whether the articles breached the Tobacco Advertising Prohibition Act 1992.

“ACOSH believes these sponsored articles are advertising and clearly breach Australia’s national tobacco advertising and promotion laws,” Swanson told Guardian Australia.

“They are part of a broader PR campaign by Philip Morris to undermine Australia’s cautionary approach to the regulation of heated tobacco products and e-cigarettes. Philip Morris is simply diversifying its range of nicotine products to ensure continuing addiction and maintain its profitability.”



Creating a market for IQOS: analysis of Philip Morris’ strategy to introduce heated tobacco products to the Australian consumer market

“To assess Philip Morris’ lobbying activities and corporate strategies, a case study approach was used by triangulating data from three sources: interviews with former Philip Morris employees, news articles reporting Philip Morris’ lobbying activities or plans for IQOS in Australia, and submissions to relevant government inquiries and reviews from 2015 to 2020.

“Philip Morris has actively lobbied Australian policy-makers to overturn bans on nicotine-containing products. Information obtained from key informants and Philip Morris’ government submissions indicates that the company’s goal is for heated tobacco products in Australia to be regulated in a new product category, exempt from tobacco control laws. Informants revealed that Philip Morris was also working to establish a network of upmarket pubs, clubs and bars where they could sell IQOS once legalisation was achieved.

“Philip Morris has strongly lobbied the Australian government to legalise heated tobacco products, while simultaneously making plans to sell IQOS at young adult-friendly premises such as bars, clubs and pubs if its proposed legislative changes are made. This case study provides valuable insights for other countries where Philip Morris may be replicating similar strategies to weaken tobacco control legislation.”



Why do West Aussies vape?

“The popularity of vaping is on the rise, but one of its main appeals may come as a surprise.

“Long gone are the days of hazy bars and smoking sections on airplanes. And while cigarette use in Australia has been in steady decline since 1994, the popularity of vaping is exploding, especially among young people.

“Conventional cigarettes create smoke by burning tobacco. E-cigarettes create a vapor from nicotine-containing liquid, which is then inhaled.

“A survey conducted in 2019 for the Australian Institute of Health and Welfare found that the use of e-cigarettes and other vaping products among young people aged 18–24 had quadrupled since 2016.

“Kahlia McCausland is a Research Officer at the Collaboration for Evidence, Research and Impact in Public Health at Curtin University. She is doing her Ph.D. on vaping.

“She says that, as well as being much cheaper than cigarettes, the colorful vaping devices and sweet or fruity flavors are particularly attractive for young people.”



Health groups urge Crown Melbourne to become a smoke-free workplace

“Leading health groups Quit, Cancer Council Victoria and the Heart Foundation have urged Crown Melbourne to permanently ban indoor smoking in the VIP ‘high roller’ gaming rooms, after casino workers expressed concerns about their health and safety due to coronavirus.

“Last night, the casino decided to temporarily suspend indoor smoking until December 6, in response to complaints from casino workers worried about contracting COVID-19 from patrons removing their masks and smoking cigarettes and cigars in VIP gaming rooms.

“Around 1,000 casino workers are exposed to deadly, secondhand tobacco smoke in their workplace.

“It has been conclusively shown that secondhand smoke increases the risk of cancer and cardiac issues among non-smokers. The casino is the last enclosed workplace in Victoria to still expose workers to secondhand smoke.

“Quit director Dr Sarah White said staff at Crown Melbourne are entitled to be in a workplace with appropriate health and safety standards.”

See also
Casino workers win suspension of indoor smoking, call on Crown to make it permanent – United Workers Union




Results from the US National Youth Tobacco Survey

“In fall 2020, FDA and CDC released findings from the 2020 National Youth Tobacco Survey showing that 1.8 million fewer U.S. youth are currently using e-cigarettes compared to last year. However, youth e-cigarette use has increased dramatically since 2011, and 3.6 million youth still currently use e-cigarettes.

“Moreover, the data shows an alarming increase in the number of youth who use disposable e-cigarettes and more than 8 out of 10 youth e-cigarette users report use of flavored products. In addition, almost 40 percent of high school users are using an e-cigarette on 20 or more days out of the month and almost a quarter of them use e-cigarettes every day, indicating a strong dependence on nicotine among youth.”

See also
Tobacco Product Use Among Adults — United States, 2019 – Centres for Disease Control and Prevention

CDC Report Shows Rise in E-Cigarette Use Does Not Result in Decreases in Adult Smoking – Truth Initiative


An update on evidence linking teen vaping to cigarette smoking

“Earlier this spring, we provided a review of studies into the relationship between young people using e-cigarettes and their subsequent use of tobacco. This post reports on four more large studies which support the general conclusion that young e-cigarette users are three to four times more likely to become tobacco cigarette smokers.

“All four studies provide systematic reviews of previous evidence. The most recently published of these studies provides a a new analysis of longitudinal data from the Population Assessment of Tobacco and Health (PATH) survey in the United States. Two others are meta-analyses commissioned by government health agencies – one from Ireland and Australia. One other, from the European Union, reviewed previous studies, meta-analyses, and e-cigarette components particularly attractive to young people.”



The rise of electronic nicotine delivery systems and the emergence of electronic-cigarette-driven disease

“In 2019, the United States experienced the emergence of the vaping-associated lung injury (VALI) epidemic. Vaping is now known to result in the development and progression of severe lung disease in the young and healthy. Lack of regulation on electronic cigarettes in the United States has resulted in over 2,000 patients and 68 deaths. We examine the clinical representation of VALI and the delve into the scientific evidence of how deadly exposure to electronic cigarettes can be. E-cigarette vapor is shown to affect numerous cellular processes, cellular metabolism, and cause DNA damage (which has implications for cancer).

“E-cigarette use is associated with a higher risk of developing crippling lung conditions such as chronic obstructive pulmonary disease (COPD), which would develop several years from now, increasing the already existent smoking-related burden. The role of vaping and virus susceptibility is yet to be determined; however, vaping can increase the virulence and inflammatory potential of several lung pathogens and is also linked to an increased risk of pneumonia.

“As it has emerged for cigarette smoking, great caution should also be given to vaping in relation to SARS-CoV-2 infection and the COVID-19 pandemic. Sadly, e-cigarettes are continually promoted and perceived as a safer alternative to cigarette smoking. E-cigarettes and their modifiable nature are harmful, as the lungs are not designed for the chronic inhalation of e-cigarette vapor. It is of interest that e-cigarettes have been shown to be of no help with smoking cessation. A true danger lies in vaping, which, if ignored, will lead to disastrous future costs.”



Dutch to ban cigarette sales in supermarkets from 2024

“The Netherlands will ban the sale of cigarettes and other tobacco products in supermarkets from 2024 in a drive to get more people to give up smoking, the government said on Friday.

“Together with a ban on cigarette vending machines from 2022, the supermarket ban will remove around 11,000 of the current 16,000 tobacco vending points in the country, the government said.

“Supermarkets currently make up 55% of all tobacco sales in the Netherlands.

“This will prevent a lot of unnecessary deaths and medical suffering,” deputy health minister Paul Blokhuis said of the supermarket move in a statement.”



‘I’m killing myself, but I’m saving the planet’: rolling tobacco smokers’ perceptions of rolling papers

“There is a perception among Roll-Your-Own (RYO) smokers that rolling tobacco is more natural, and therefore safer, than factory-made cigarettes. Participants suggested that natural papers may reduce the harms of smoking, consistent with the view of a manager of a rolling papers manufacturer who stated that ‘a new generation of adult smokers considers natural rolling papers to be less harmful to their health’.

“Just as cigarettes with descriptors such as natural or organic are associated with reduced harm the same may be true for rolling papers using these terms and, as such, regulators may feel it beneficial to ban these on RYO papers, as they have done on RYO packs across much of Europe, as a result of the Tobacco Products Directive.”



Tweetable Influence: The Tobacco Industry’s Attempt to Engage in COP8

“The tobacco industry’s attempts to influence the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), a global health treaty that aims to reduce tobacco use and diminish tobacco industry influence in public policy, are well documented.

“According to leaked company documents, Philip Morris International (PMI) created a corporate affairs strategy outlining how it intended to influence the FCTC by promoting industry-friendly messaging around the treaty’s Conference of the Parties (COP)—an annual meeting where delegates convene to decide on tobacco control measures. And in 2017, Reuters exposed another PMI campaign to subvert the FCTC, once again by targeting the COP.

“To better understand the tobacco industry’s tactics and identify its allies, researchers examined the Twitter conversations that occurred around the most recent COP (COP8) that was held in October 2018. They set out to identify the most common topics and from whom those messages were coming.”



Carpe covid: using COVID-19 to communicate about harms of tobacco products

“Many of us in the field of tobacco control have asked how the COVID-19 pandemic can be used as an opportunity to motivate people to quit using tobacco products. A paper by Grummon et al (this issue) is, to my knowledge, the first published attempt to empirically answer this question.

“Emerging research consistently demonstrates that smoking makes COVID-19 outcomes worse, although the relationship between smoking and COVID-19 infection is unclear. A recent study showed cross-sectional association between youth and young adult e-cigarette use and COVID-19.

“Thus, more research is needed on how to best inform tobacco users about the increased risk of COVID-19. Grummon et al1 answer this call by evaluating messages that inform smokers and e-cigarette users (vapers) how smoking or vaping may increase the severity of COVID-19.”



Tweet of the week

“Um, #Canada you’re so great and you’re a signatory to @FCTCofficial —Article 5.3 calls on governments to NOT partner with tobacco companies even for good causes #DoBetter” said Dr Ruth Malone, University of California, San Francisco.

Philip Morris and the Government of Canada collaborate on COVID-19 vaccine development – Tobacco Control Blog



From the archives: supporting smoke-free workplaces

In 1986, ACOSH developed a smoking in the workplace manual in conjunction with the ACT office of the National Heart Foundation to assist workplaces in the negotiation and implementation of smoke-free policies. The Manual was produced for occupational health nurses, Commonwealth, State and Local Government officers, hospitals, and other interested organisations.

Then ACOSH Director Dr Ruth Shean also published in peer-reviewed journals on the theoretical and practical considerations for implementing smoke-free workplace policies.



Tobacco Control News

GPs willing to prescribe e-cigarettes to aid the quitting process – NewsGP

Nicotine e-vaping and cardiovascular consequences: a case series and literature review – European Heart Journal Case Reports

Controversial from creation to disbanding, via e-cigarettes and alcohol: an obituary of Public Health England – BMJ

Turkey’s smoking ban ‘sound decision’ amid virus, experts say – Daily Sabah

New Global Index Shows Aggressive Tobacco Industry Lobbying in 2019 and Exploitation of COVID-19 Pandemic in 2020 –

The Risks of Another Epidemic: Teenage Vaping – The New York Times