ACOSH Advocacy in Action - 6 August 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.

Time to phase out the sale of tobacco products

“Tobacco products are manufactured and promoted by a ruthless industry that knowingly sells a lethal product and opposes all effective measures to reduce the death, disease, misery and costs its products cause.

“Along with WA’s outstanding success in responding to the COVID-19 pandemic, now is an opportune time to plan for further action to create a tobacco-free WA and nationally by 2030 and save hundreds of thousands of lives in this century.

“There is now discussion internationally and in Australia about accelerating the decline in smoking by planning to phase out the commercial sale of cigarettes.

“The Australian Council on Smoking and Health recently commissioned a survey of 1000 West Australian adults to assess their attitudes to phasing out the sale of cigarettes and found encouraging levels of support.

“60% of those surveyed thought it would be a good thing if there came a time when it would no longer be legal to sell cigarettes in Australia, while only 14% thought it would be a bad thing.

“67% of survey respondents also thought that the next 10 years would be a fair timeframe in which to phase out the sale of cigarettes,” said Maurice Swanson, Chief Executive, Australian Council on Smoking and Health.



E‐cigarette use and cigarette smoking initiation among Australian women who have never smoked

“This study aimed to determine the association between lifetime e‐cigarette use and subsequent initiation of cigarette smoking among tobacco‐naïve Australian women aged 20–27.

“The mean (± SD) age of the study participants at baseline (third survey) was 22.5 (±1.7). Ever e‐cigarette use at baseline was positively associated with smoking initiation at follow up (adjusted odds ratio 3.71; 95% confidence interval 2.33, 5.93). History of depression, binge drinking and higher childhood adversity score were also risk factors for subsequent smoking initiation in the follow-up.

“This study identified a strong association between e‐cigarette use and subsequent initiation of smoking. Enforcing the existing restriction of sale and supply of e‐liquid containing nicotine is essential to prevent never smokers from nicotine addiction via e‐cigarettes.”



Is the Australian smoking population hardening?

“The observed trends in the prevalence of hardcore smokers (i.e., either stable or declining depending on the definition) suggest that the Australian smoking population is not hardening. These results do not support claims that remaining smokers are becoming hardcore.

“The hardening hypothesis proposes that as smoking rates decline, the remaining smokers will become hardcore and resistant to quitting. This group of highly resistant quitters will potentially require more individualistic approaches to cessation and harm reduction. The harm reduction approach (specifically e-cigarettes) has been proposed as an option to address hardened Australian smokers. We tested the hardening hypothesis by analysing the rates of hardcore smoking in the Australian smoking population between 2010-2016.

“The most inclusive definition of hardcore smoking (i.e., a smoker with no plan to quit) showed a significant decline in hardcore smoking between 2010 and 2016 (5.49% – 4.85%) In contrast, the prevalence of hardcore smoking using the most stringent definition (i.e., a current daily smoker of at least 15 cigarettes per day, aged 26 years or over, with no intention to quit, a lifetime consumption of at least 100 cigarettes, and no quit attempt in the past 12 months) did not change significantly between 2010 and 2016.”



Electronic cigarettes: A position statement from the Thoracic Society of Australia and New Zealand

“The TSANZ develops position statements where insufficient data exist to write formal clinical guidelines. In 2018, the TSANZ addressed the question of potential benefits and health impacts of electronic cigarettes (EC). The working party included groups focused on health impacts, smoking cessation, youth issues and priority populations. The 2018 report on the Public Health Consequences of E‐Cigarettes from the United States NASEM was accepted as reflective of evidence to mid‐2017. A search for papers subsequently published in peer‐reviewed journals was conducted in August 2018.

“A total of 3793 papers were identified and reviewed, with summaries and draft position statements developed and presented to TSANZ membership in April 2019. After feedback from members and external reviewers, a collection of position statements was finalized in December 2019.

“EC have adverse lung effects and harmful effects of long‐term use are unknown. EC are unsuitable consumer products for recreational use, part‐substitution for smoking or long‐term exclusive use by former smokers. Smokers who require support to quit smoking should be directed towards approved medication in conjunction with behavioural support as having the strongest evidence for efficacy and safety. No specific EC product can be recommended as effective and safe for smoking cessation. Smoking cessation claims in relation to EC should be assessed by established regulators.”



Smoke-free laws in the City of Melbourne now include e-cigarettes

On 28 July, the City of Melbourne councillors voted to include e-cigarettes in existing smoke-free areas of the CBD, effective from Thursday 6 August.

There are 11 designated smoke-free areas within the City of Melbourne including Bourke Street, Goldsbrough Lane, QV Melbourne, The Causeway, Howey Place, Equitable Place, Block Place, the Tan and Princes Park running tracks, Collins Way and Fulham Place.

ACOSH wrote to the Mayor and Councillors of the City of Melbourne in June to encourage their support for the motion, highlighting the importance of a precautionary approach to e-cigarettes in Australia.

Despite opposition from civil libertarians and vaping advocates, almost two-thirds of submissions to the council supported banning vaping in the non-smoking precincts.

See also
Vaping likely to be banned in Melbourne CBD’s smoke-free zones – The Age



Nicotine-filled pods addicting Aussie teenagers at alarming rates

“The whole point of the [disposable e-cigarette] is to suck these young kids into becoming smokers,” school principal and Deputy President of the Secondary Principals Council, Christine Del Gallo, told A Current Affair.

“With many of the younger ones, the 12, 13-year-olds, it’s not registering these are nicotine filled devices, which will make them addicted to nicotine and the process of inhaling and exhaling a substance.”

“Ms Del Gallo said because the disposable e-cigarette pods are so small, it’s easy for kids to vape in school or even in class without detection.

“While the products are illegal to sell in Australia, A Current Affair producer Mat showed it is hardly difficult to purchase them from corners stores.”



Driving Addiction: F1 and Tobacco Advertising

“The report, titled Driving Addiction: F1 and Tobacco Advertising, is the initiative of industry monitor Formula Money and the tobacco industry watchdog STOP.

“In its pages, the report noted that in F1’s 70 year history, its teams and events have garnered $US4.4 billion in advertising and sponsorship from the tobacco giants.

“Many countries that host an F1 race banned tobacco advertising well over a decade ago. That forced teams sponsored by tobacco companies to either cover or change the livery on their cars.

“Tobacco advertising was banned at the Australian Grand Prix way back in 2007 and the sport totally phased it out by 2011.

“However, the new report says some $US100 million was poured into F1 racing in 2019 alone. The highest figure since the ban was imposed in 2011.

“The spending, by tobacco giants Philip Morris and British American Tobacco on the F1 Ferrari and McLaren teams, is this year expected to rise to $US115 million, the report noted.”

ACOSH has signed an open letter, coordinated by the Global Center for Good Governance on behalf of Stopping Tobacco Organizations and Products (STOP), to the President of the F1 governing body FIA [Federation Internationale de l’Automobile] demanding that the FIA put an end to all tobacco advertising and sponsorship in Formula.



WHO statement on heated tobacco products and the US FDA decision regarding IQOS

“On 7 July 2020, the US FDA authorized the marketing of a heated tobacco product, the IQOS Tobacco Heating System, under the Federal Food, Drug and Cosmetic Act. This Act requires pre-market authorization of new tobacco products before they can be placed on the US market.

“The US FDA statement noted that, “Even with this action, these products are not safe nor “FDA approved“. The exposure modification orders also do not permit the company to make any other modified risk claims or any express or implied statements that convey or could mislead consumers into believing that the products are endorsed or approved by the FDA, or that the FDA deems the products to be safe for use by consumers.

“Given that health may be affected by exposure to additional toxins when using HTPs, claims that HTPS reduce exposure to harmful chemicals relative to conventional cigarettes may be misleading.

“Moreover, the relevant orders grant a temporary market authorization within the US and are based on factors specific to the US, which is not a Party to the WHO Framework Convention on Tobacco Control (WHO FCTC).

“All tobacco products pose risks to health and WHO urges full implementation of the WHO FCTC. Rigorous implementation will support quit attempts and reduce initiation by non-users of tobacco products, especially the young.”



Cigarette smoking and risk of intracranial brain aneurysms in middle-aged women

“The purpose of this study was to assess the relationship between first-hand cigarette smoking and an incidental diagnosis of an UIA [unruptured intracranial aneurysm] females aged between 30 and 60 years using a multicentre matched case-control analysis.

“From 545 eligible patients, 113 aneurysm patients were matched to 113 controls. The most common reason for imaging was due to chronic headaches in 62.5% of cases and 44.3% of controls. A positive smoking history was encountered in 57.5% of cases and in 37.2% of controls. A multivariable analysis demonstrated a significant association between positive smoking history (OR 3.7, 95%CI 1.61 to 8.50), hypertension (OR 3.16, 95% CI 1.17 to 8.52) and both factors combined with a diagnosis of an incidental UIA (OR 6.9, 95% CI 2.49 to 19.24).

“Women aged between 30 and 60 years with a positive smoking history have a four-fold increased risk for having an UIA, and a seven-fold increased risk if they have underlying chronic hypertension. These findings indicate that women aged between 30 and 60 years with a positive smoking history might benefit from a screening recommendation.”



Knowledge, Attitudes, and Perceptions of Young Adults About Electronic Nicotine Delivery Systems in the United States

“The purpose of this integrative review is to explore existing literature on young adults’ knowledge, attitudes, values, and perceptions about e-cigarettes, as well as the social norms they experience.

“Seventy-one full-text studies were assessed for inclusion criteria; 15 articles were included, coded, and analyzed for quality and thematic content. Current e-cigarette users represented just 3% to 35% of study participants. Three themes arose from a synthesis of the literature: “Is it bad for me?,” “I just like it,” and “Is it cool or not?”

“Young adults are not armed with the accurate knowledge to make informed choices about using e-cigarettes. E-cigarette users are understudied and tend to value appearance and physical sensation over health. Social norms related to e-cigarette use are linked to perception of identity and the current technology-focused culture.”



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.


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

“An ever-desperate vaping lobby lamely spinning there are now >500k vaping in Australia (based on 1 or more vape in a year). Many (incl me) have had a puff out of curiosity. But by that criterion I’m a vaping Aston Martin driver too, as I once drove one!” said Emeritus Professor Simon Chapman AO (@SimonChapman6)


Tobacco Control News

Juul submits application to FDA to keep selling e-cigarettes – Reuters

When will Canada get on the same page about the risks of vaping? – The Globe and Mail

The double-edged relationship between COVID-19 stress and
smoking: Implications for smoking cessation
– Tob Induc Dis.

Health of Former Cigarette Smokers Aged 65 and Over: United States, 2018 – Centers for Disease Control and Prevention