ACOSH Advocacy in Action - 1 October

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.

Review of the evidence says e-cigarettes not the answer for Australian smokers

ACOSH has welcomed the findings of a comprehensive review by the Australian National University (ANU) of the published scientific and medical evidence on the use of e-cigarettes and their impact on the uptake of smoking and smoking cessation.

The review was based on a systematic analysis of evidence from Australia and internationally, and was conducted by leading epidemiologists from the National Centre for Epidemiology and Population Health at ANU.

The major conclusions from the review included:

1. Among people in Australia aged 14 years and over in 2019, 11% had ever used e-cigarettes, most of whom (60%) reported using e-cigarettes once or twice only; 0.2% (equivalent to 412,000 people) reported current use (daily, weekly or monthly) and 1.1% (equivalent to 227,000 people) report daily use, according to the 2019 National Drug Strategy Household Survey. Use has increased significantly of the last 6 years.

2. A combined analysis of all data from studies examining the use of e-cigarettes by never smokers showed those who have used e-cigarettes were 3 times more likely as those who have not used e-cigarettes to try smoking traditional cigarettes and transition to regular smoking.

3. The limited available evidence indicates that former smokers who had used e-cigarettes were around twice as likely to relapse and resume current smoking as those who had not used e-cigarettes.

4. Overall, there is insufficient evidence that nicotine-delivering e-cigarettes are efficacious for smoking cessation, compared to no intervention, placebo existing nicotine-replacement therapy or other best-practice interventions. However, preliminary evidence highlights the potential for nicotine-delivering e-cigarettes to support cessation, and more reliable, large-scale evidence is needed.

See also
E-cigarettes ‘gateway’ to smoking for non-smokers – Australian National University

Vaping increases the chances of regular smoking threefold, Australian review finds – The Guardian


E-cigarettes to become available as prescription-only items in Australia from June 2021

“E-cigarettes will become available by mid-next year, but only with a doctor’s prescription, as determined by Australia’s drug regulator on Wednesday.

“The Therapeutic Goods Administration (TGA) announced its interim decision to reclassify nicotine as a prescription-only medication, meaning nicotine for use in e-cigarettes, and e-juice containing nicotine, would become prescription-only from June 2021.

“The decision is open for consultation until 6 November.

“An advisory committee to the TGA recommended retaining the current exemptions for tobacco, and certain smoking-cessation products such as patches and gums, which are available over-the-counter.

“Existing state and territory laws make the sale of nicotine containing e-cigarettes and e-juice illegal throughout Australia and its possession illegal everywhere but in South Australia.”

See also
RACGP welcomes TGA stance on e-cigarettes – RACGP

TGA vaping decision will protect young Australians – AMA media statement

‘They get young people into smoking’: Doctors hesitant to prescribe vaping – The Sydney Morning Herald



Statutory Review of the Western Australian Tobacco Products Control Act 2006

The Department of Health (DOH) is conducting a Statutory Review of the Western Australian Tobacco Products Control Act 2006 (the Act).

The review of the Act is being undertaken to ensure that tobacco control legislation in Western Australia remains contemporary, relevant and responsive to new and emerging issues in tobacco control.

A Discussion Paper has been prepared to facilitate the public consultation and is placed on the DOH’s Consultation Hub. You can participate in this consultation by completing an online questionnaire, or submissions can be made by email or post to the DOH.

The closing date for submissions is 5.00pm, Friday 6 November 2020.

Following the consultation, a report will be prepared by the Department of Health for consideration by the Minister for Health.


Growing evidence of harms highlight the need for science, not bogus health claims, to inform Australia’s policy on e-cigarettes

“Cancer Council, the National Heart Foundation of Australia and the Australian Council on Smoking and Health have urged Australians to ignore unsubstantiated claims about the benefits of e-cigarettes as mounting evidence points to their potential harms.

“Professor Sanchia Aranda, CEO of Cancer Council Australia explained, “Gathering the strong, reliable evidence about the potential benefits and harms of a product to inform policy takes time. As the evidence about e-cigarettes mounts so too does the slew of highly concerning potential effects. These include acute lung disease, increased markers of cardiovascular disease and carcinogenesis, toxicological risks and nicotine addiction through increasing use in young people.

“Professor Aranda explained that much of the misinformation surrounding e-cigarettes came from unsubstantiated claims by organisations and individuals with vested interests.

“E-cigarette lobbyists often find alternative studies with results that suit their commercial interests. We also hear anecdotes and unfounded claims, positioned as evidence. Independent evidence reviews are crucial to informing public health policy on e-cigarettes.”


ARA ends relationship with Australian Retail Vaping Industry Association

“The Australian Retailers Association has announced the dissolution of vaping body, the Australian Retail Vaping Industry Association (ARVIA).

“ARA CEO Paul Zahra said the decision by the ARA Council in August to immediately dissolve ARVIA reflected a new direction the ARA was taking on the issue of tobacco and nicotine.

“Whilst the ARA recognises the rights of Australian consumers to purchase and use tobacco and vaping products, we don’t believe advocacy for these products and services is an appropriate focus for ARA resources, or the right alignment with our brand moving forwards,” said Mr Zahra.

“The ARA jointly established ARVIA in 2019 as a mechanism for supporting the legalisation of nicotine vaping products within Australia.”



‘The last line of marketing’: Covert tobacco marketing tactics as revealed by former tobacco industry employees

“In countries with bans on tobacco advertising and promotion, tobacco companies have focused their promotional expenditure on business-to-business relationship marketing activities aimed at retailers.

“However, evidence of such activities has been obtained through secondary sources only, including surveys and interviews with tobacco retailers and analyses of tobacco industry documents.

“To understand the breadth of promotional strategies employed in the retail sector to enhance tobacco sales, 10 semi-structured interviews were conducted with a sample of key informants who formerly worked for tobacco companies operating in Australia.

“Participants described tobacco retail marketing and promotion strategies that were categorised into three primary themes:

“(1) the provision of financial incentives, such as price promotions, cash payments and rebates;

“(2) the provision of experiential incentives, such as all-expenses paid vacations, exclusive parties and events, and

“(3) targeted marketing and education, which enabled retailers to market to consumers on behalf of tobacco companies.

“Such strategies had the ultimate objective of increasing market share and driving sales. For countries to comprehensively restrict all tobacco marketing, legislation must be introduced to outlaw these activities in tobacco advertising and promotion legislation.”

Related media
Big tobacco giving retailers cash and international trips to promote products, study finds – The Guardian

Whistleblowers tell how tobacco industry exploits loopholes – Financial Review



Cancer Council WA marks 70 year anniversary with provocative reminder

“We have used the 70 year anniversary of the landmark paper that linked smoking to lung cancer, to remind West Australians how tobacco companies have denied and undermined the truth about tobacco for decades.

“Our CEO Ashley Reid said a provocative full page advertisement was placed in The West Australian newspaper to illustrate how tobacco companies still treat Australians.

“Seventy years ago today, the British Medical Journal published the landmark paper, ‘Smoking and Carcinoma of the Lung’ by Sir Richard Doll and Sir Austin Bradford Hill which established conclusively that smoking was linked to lung cancer,” Mr Reid said.

“Australian Council on Smoking and Health Chief Executive Maurice Swanson said there is an incorrect growing public sentiment that smoking is no longer an issue and that tobacco companies have gone away.

“Tobacco companies are actually on the resurgence and have never been so active,” Mr Swanson said

“Despite advertising bans since the early 1990s, they are still promoting their products through retail outlets, PR, lobbying, and social media.

“The business model for tobacco companies has always been to addict people to nicotine, and now, as always, they are out looking for new market opportunities.

“Tobacco is the only consumer product available in Australia that kills some two thirds of its regular consumers when used as intended.”



COVID-19 has offered us an unexpected opportunity to help more people quit smoking

“Smokers are worried. A respiratory disease is running rampant across the globe and people with unhealthy lifestyle habits appear to be especially vulnerable.

“We know smokers hospitalised with COVID-19 are more likely to become severely unwell and die than non-smokers with the disease.

“At any point in time, most smokers want to quit. But COVID-19 provides the impetus to do it sooner rather than later.

“In our new study, we surveyed 1,204 adult smokers across Australia and the United Kingdom. We found the proportion intending to quit within the next two weeks almost tripled from around 10% of smokers before COVID-19 to 29% in April.”



Impact of three annual tobacco tax rises on tobacco sales in remote Australian Aboriginal community stores

“Background There is strong evidence from many settings that tobacco tax rises which increase prices reduce tobacco consumption, but only limited evidence from Indigenous settings.

“Methods We analysed 3 years (2016–2018) of weekly sales data from 32 stores in remote Aboriginal communities. We used interrupted time series analysis to estimate the immediate impact of the price rice following annual 12.5% tobacco tax rises on sales on (A) stick equivalents of tobacco and (B) fruit and vegetables (kg) per $A1000 of grocery sales, and on the trend in sales between price rises.

“Results We detected 5.8% and 8.2% immediate declines in tobacco sales following the price rises associated with annual 12.5% tax rises in 2016 and 2018, and a non-significant decline (1.6%) following the 2017 tax rise. Decreased sales were mainly driven by declines in mainstream and premium factory-made cigarettes. Fruit and vegetable sales did not change at the time of tobacco price rises.

“Conclusion For the first time, we demonstrated evidence of price-sensitivity and the immediate impact of price rises from tobacco tax rises on tobacco sales in remote Aboriginal communities. We acknowledge that Australia already has very high tobacco taxation and prices, but recommend further increases to the taxation of roll-your-own (RYO) tobacco to prevent smokers and industry using cheaper RYO cigarettes to undermine this impact of high tobacco taxes and prices.”



Fact or Fiction? Debunking the myths around e-cigarettes

“In Australia, data from the National Drug Strategy Household Survey indicates a significant increase in use of the devices over the last six years.

“Concerningly, it isn’t just adult smokers using e-cigarettes: rates of use have also increased significantly among non-smokers and adolescents.

“E-cigarettes have clearly made their way into Australian society. So, what’s the problem?

“Well, consumers have a right to know about the products they are buying. Be it cereal, yoghurt, bread, or alcohol (just to name a few), we need to be adequately informed about what we are consuming.

“Unfortunately, misinformation about e-cigarettes is widespread. It’s time to set the record straight.

“So, let’s debunk the myths about e-cigarettes and separate fact from industry-written fiction.”



Make Smoking History marks 20 year anniversary with graphic new campaign

A new, confronting advertising campaign was launched last week to mark the 20th anniversary of Make Smoking History.

“In our latest campaign, they share what lays ahead for smokers who have to have their voice box removed because of cancer. They describe a laryngectomy as one of the most life-changing operations a person can have.

“There are many things that can never be the same again; the way you talk, breathe, smell and taste. Things you take for granted like screaming for your footy team are no longer possible. Almost 80% of cancers of the voice box (larynx) are caused by smoking.

“The surgical footage in the commercials is highly graphic because, as we continue to hear from people who smoke, using shocking images is one of the most urgent and effective reminders of the need to quit.”



Webinar: PHAIWA Advocacy Boot Camp Series #1

This free lunchtime Advocacy Boot Camp on Wednesday 14 October will showcase advocacy activities that aim to reduce tobacco related harms. This session gives you an opportunity to hear key insights from decades of advocacy activities of the Australian Council on Smoking and Health and findings from cutting edge research into e-cigarettes. All participants will join Emeritus Professor Mike Daube AO as he facilitates a lively discussion to draw out priorities going forward.




Tweet of the Week

“Should cigarettes be available just about everywhere (corner stores, supermarkets, service stations, newsagents)?

“Answer: No!

“We phased out lead petrol, lead paint and asbestos…it’s time to phase out cigarettes,” said Dr Sarah White, Director of Quit Victoria.



Tobacco Control News

Menthol e-cigarette sales rise following 2020 FDA guidance – Tobacco Control

Accurate labels like ‘aerosol’ or ‘chemicals’ increase perceived risks of e-cigarette use – Science Daily

STOP COVID-19 Monitoring Brief: The tobacco industry, its interests and allies  – Stopping Tobacco Organizations and Products

Menthol Cigarettes: Tobacco Industry Interests and Interference – University of Bath Tobacco Tactics

FDA Does Not Rule that IQOS Reduces Tobacco-Related Harm – Stopping Tobacco Organizations and Products