4. “Australia is the darkest market in
the world, and from a distance it’s
easy to get dispirited by that.”
5. A long history
• 1950 – Doll and Hill (BMJ), Wynder and
• 1962 – First report of Royal College of
Physicians of London
• 1964 – First report of US Surgeon General
• 1971 - First WHO report
• 1981 – Hirayama (BMJ) on passive
• And continuing streams of evidence
7. COMPREHENSIVE APPROACH
•No one magic bullet – but all recommended measures contribute, and
•Now strong evidence for all components of WHO-recommended approach
•Confirmed and reinforced by FCTC
•Australia – Federal system (national and state/territory governments)
•Progressive action over time
8. EARLY AND CONTINUING ADVOCACY
• Strong, cohesive coalitions
• Maintaining a high profile for the tobacco problem
• Emphasis on magnitude of problem, new evidence, need for action
• Exposing and opposing tobacco industry
• Innovative approaches
Professor Rob Moodie
(Chair, Alcohol c’ttee)
Professor Mike Daube
(Chair, Tobacco C’ttee)
Professor Paul Zimmet
Professor Leonie Segal
Dr Lyn Roberts (Chair, Obesity C’ttee)
Mr Shaun Larkin
Ms Kate Carnell
Dr Christine Connors
Dr Linda Selvey
The Taskforce was announced on 9 April 2008.
Develop targets and strategies for the nation.
27. TOBACCO CONTROL AUSTRALIA in 2008 – Over-simplified
summary (Note - mix of Federal and State activity)
Tobacco advertising bans since late 80s/early 90s
Health warnings since 1973, increasing strength every decade – 1973, 1987,
Continuing State legislation/action (leapfrog effect)
Bans on point-of-sale promotion
Strong measures to protect non-smokers – cars around kids, bars and
restaurants, other public places (including some beaches)
National and State media campaigns
Strong, cohesive advocacy organisations, individuals, coalitions – Cancer,
Heart, AMA, AMA, ASH, ACOSH, PHAA – and many others
Continuing new approaches to media and media coverage
Cessation support – NRT, Quitlines, etc
(Industry last 10 – 15 years – much lobbying and working through others but
staying below parapet )
• Many submissions
• Consulted widely – but Minister clear that we
did not need to consult with the tobacco
industry (FCTC Article 5.3)
• Tobacco industry submissions kindly offered
30. “BAT believes there is already a significant amount of regulation
on tobacco products and there may now be a risk of too
much, with unintended consequences of progressing further.”
BATA submission to Taskforce
“Australia has passed the limit of the ability of regulations on
tobacco advertising, marketing, sales and public smoking to
advance health objectives.”
Philip Morris submission to Taskforce
• Articles 11 and 13 (inc. guidelines)
Parties should consider adopting measures to restrict or prohibit the use of logos, colours,
brand images or promotional information on packaging other than brand names and
product names displayed in a standard colour and font style (plain packaging). This may
increase the noticeability and effectiveness of health warnings and messages, prevent the
package from detracting attention from them, and address industry package design
techniques that may suggest that some products are less harmful than others
Parties should consider adopting plain packaging requirements to eliminate the effects of
advertising or promotion on packaging. Packaging, individual cigarettes or other tobacco
products should carry no advertising or promotion, including design features that make
36. Why Plain Packaging?
• Not a magic bullet
• Not in isolation – next step in comprehensive approach
• Research evidence – impacts of packaging on children, young
people, adults, smokers, non-smokers
• Primary focus long-term – children and young people
• Removes last form of direct tobacco advertising
• Industry’s own research
• Sends out important signal
• Supports rest of program
• FCTC and international implications
• Industry opposition – passes the Scream Test
39. 1 Make tobacco products significantly more expensive
2. Increase the frequency, reach and intensity of social marketing campaigns
3. End all forms of advertising and promotion of tobacco products
4. Eliminate exposure to second hand smoke in public places
5. Regulate manufacturing and further regulate packaging and
supply of tobacco products
6. Ensure all smokers in contact with health services are encouraged and supported to quit
7. Work in partnership with Indigenous groups to boost effort to reduce smoking and exposure to tobacco among Indigenous Australians
8. Boost efforts to discourage smoking in other highly disadvantaged groups
9. Assist parents and educators to discourage tobacco use and protect young people from second hand smoke
10. Ensure the public, media, politicians and other opinion leaders remain aware of the need for sustained and vigorous action to
discourage tobacco use
11. Ensure implementation and measure progress against and towards targets
Infrastructure recommendations also included: Establish a National Preventive Health Agency
Tobacco – Comprehensive approach
40. PACKAGING - ACTION PROPOSED
• REQUIRE ALL TOBACCO PRODUCTS TO BE SOLD IN PLAIN
PACKAGING, THE EXACT APPEARANCE OF WHICH (PRECISE
COLOUR, PAPER FINISH, SHAPE OF PACK, ETC.) COULD BE
PRESCRIBED IN REGULATIONS UNDER THE TRADE PRACTICES
• COMMISSION RESEARCH TO DETERMINE EXACTLY HOW
PACKS SHOULD BE DESIGNED TO MINIMISE APPEAL TO
42. Action On Tobacco After Report
Current/further action at national and state levels, including dealing with
• loopholes in ad ban legislation (e.g. internet advertising);
•Further bans on any display at point of sale;
•further protection for non-smokers;
•Funding for media campaigns;
•specific education and support for disadvantaged groups;
•Tackling Indigenous Smoking Initiative;
•Cessation supports (e.g. NRT, Quitline)
•But plain packaging? Heavy industry campaigning
•And a ‘phone call
45. INDUSTRY APPROACH
• INSTANT AND CONTINUING ATTACK
• MOST FEROCIOUS I HAVE SEEN IN 44 YEARS
• BEST INDICATOR OF CONCERN – COMPANIES
THEMSELVES GO PUBLIC
46. THE RESEARCH
• Meticulous – all aspects of the pack, design, colour,
• Primarily from Melanie Wakefield and colleagues
• Essentially not challenged
• Minister’s only mistake – “olive brown”
47. THE POLITICS
• Minority Government – needed support of Independents in Lower House
• Majority in Senate, with strong support from Greens
• Opposition oppositional….Opposing everything
48. Massive industry campaigns
• Media – press, radio, TV
• Public relations – direct, indirect
• Social media
• Dirty tricks
• Industry spend unknown – certainly tens of
49. Industry Arguments
• It won’t work
• It will put us out of business
• End to freedom
• International agreements
• It’s never been done before
• And so on……..
64. Health Coalition
• Government, Minister, Minister’s office
• Major health groups and experts working nationally as cohesive
• Cancer Councils, Heart Foundation, Australian Medical Association,
QUIT campaigns, ASH, ACOSH, Public Health Association, and other
• Prominent experts, health/medical leaders
• Media, media, media - Proactive, reactive
• Responding to industry campaigns, exposing industry tactics,
research, reports, surveys, advertisements…
• Active support from politicians of all parties
• Lobbying, lobbying, lobbying – all parties, all members
65. • WORK BY GOVERNMENT
• STRONG, DETERMINED MINISTER
• SYMPATHETIC MPs FROM ALL PARTIES
• MORE INNOVATIVE ADVOCACY (e.g. plain packaging professors)
• PUBLIC AND MEDIA SUPPORT
67. • Need for all-party support
• Many good supporters from all sides
• Another ‘phone call – and a robust Australian
68. ......Liberal MP Mal Washer ...... who spent 26 years as a medical practitioner before
moving into federal politics, gave a blunt assessment of the tobacco industry's
''All this talk of chop chop and crime gangs sounds like bullshit to me. The
tobacco industry is jumping up and down because they're worried about their
businesses. I support these reforms unequivocally and whatever my party
decides to do, I don't give a shit,'' Dr Washer said.
He said smoking killed about 19,000 Australians each year, and governments had a
moral responsibility to implement any measure that could stop young people from
taking up the habit
The Age, May 22, 2011
77. Percentage of ever-smokers who have quit
Australians 14 and over, 1991―2013
AIHW National Drug Strategy Household Survey, Tobacco Tables, Table 1
78. Tobacco plain packaging report released
by Australian government
• Plain packaging
25% of the decline
Dec 2012 to Sept
• These effects are
likely to grow over
82. And industry claims of doom and disaster? - 1
PP would be rejected by Australian courts as being unconstitutional, with huge consequential costs for
the Federal Government.
Outcome: The High Court rejected the industry's arguments, awarding costs to the Australian
There would be significant problems for retailers in identifying the newly packaged brands, with
consequent delays in serving customers.
Outcome: Peer-reviewed research shows no such problems.
There would be a shift in sales of tobacco products from small retail outlets to supermarkets.
Outcome: Peer-reviewed research and independent data show that there has been no such shift.
Smokers would cover up the plain packs with newly purchased special covers.
Outcome: Peer-reviewed research shows minimal use of any such covers.
There would be a massive increase in the illicit tobacco trade.
Outcome: Government reports and peer-reviewed studies show no such increase.
83. Doom and disaster - 2
There would be an increase in counterfeiting of the new plain packs.
Outcome: Independent reports and Customs statements show no such increase, and evidence
from British American Tobacco to the Chantler review in the UK confirmed no increase.
There would be a substantial drop in prices.
Outcome: Industry financial data show no such drop; indeed, because of the introduction of plain
packaging, tobacco companies have reportedly aggressively increased prices.
There would be a shift to low-cost Asian brands of cigarettes.
Outcome: Peer-reviewed research shows no such shift.
Tobacco sales would increase (although the rationale for this claim was never clearly articulated).
Outcome: Official data and industry data show a decline in sales.
There would be in-store crime, as shop staff would take so long to identify specific brands that
they would not be able to observe shoplifting.
Outcome: There is no evidence for this having occurred.
84. And Now.....
• Industry litigation – but so far losing all cases
• Australia, Ireland, UK, France, Hungary, Uruguay, Norway have legislated
• At least 14 further countries on the way
• Governments (both sides) committed to substantial regular annual tax
• Strong and increasing public and bipartisan political support
• Continuing developments from tax to smoke-free
86. Tobacco taxation
• 25% increase in 2010
• 12.5% increase in each of 2013 to 2020
• Increases the price*
of Winfield Blue 25 packs from $12.95 in
2010 to $42.50 in 2019
• Especially effective policy to tip lower SES smokers towards
*In current dollar prices
88. So what have we learned? What
made it happen?
1. Magnitude of problem – and continuing new ways of presenting the evidence.
2. Constant and continuing advocacy over decades from health organisations and
3. Comprehensive approach
4. Work as coalitions - consensus is crucial
5. Recognise that it doesn’t all happen at once
6. Evidence-based recommendations and meticulous science
7. Seize the hour; be open to opportunity when it arises (good Minister; good
timing; all-party support); make the case, encourage – and work at it!
8. Recognise that it is a battle with tough, ruthless opposition.
9. Play to your strengths (magnitude of problem, protecting children, evidence,
credibility, international support (especially WHO); identify and expose the
opposition; and campaign hard and professionally.
10. Plain packaging has generated a new sense of excitement globally – and shown
that we can win battles that would once have seemed impossible.
89. What else have we learned - 1?
• Success is popular
• Strong and increasing public support
• Prime Minister Turnbull – “One of the big public health successes…..”
97. “Australia is the darkest market in
the world, and from a distance it’s
easy to get dispirited by that.”
Study of over 200,000 individuals who joined the 45 and Up Study from 2006–2009 with no history of cancer (other than melanoma and non-melanoma skin cancer), heart disease, stroke, or thrombosis. Current and past smokers compared to never-smokers.
Once the Alliance of Australian Retailers was discovered to be funded by the tobacco industry, these ads were produced by partnering public health organisations (PHAA, VicHealth, Heart Foundation, Cancer Council, ACOSH) to educate the public on the truth about Big Tobacco.
Two ways in which prevalence is declining.
The first is by adult smokers quitting. Out of all those who have ever-smoked