Australia could become the first major nation to outlaw smoking, with a federal government-funded trial about to test the viability of electronic cigarettes as a safer, permanent replacement for tobacco.
Medical experts, cancer groups and anti-smoking lobbyists battled for decades to rid cigarettes from public spaces.
Why not get serious and just ban smoking
The federal government is banking on a $5.3 billion revenue gain from lifting tobacco excise over four years, which suggests the move will only marginally reduce smoking rates.
Naturally, the government promotes the health benefits of its tax. Citing the $35 billion annual cost of smoking-related disease, death and productivity losses, Prime Minister Kevin Rudd says it’s time to ”get serious” about an addiction that kills at least 15,000 Australians a year.
Only about one in six Australians smokes regularly, but tobacco kills more people than the combined death toll from road accidents, illicit drugs, alcohol, murder, AIDS, diabetes and skin cancer. Smoking is the single biggest preventable cause of our two biggest killers, cancer and heart disease. It is a factor in all of the seven deadliest diseases.
In Victoria, tobacco kills nearly six times as many people as alcohol, 11 times as many as road accidents and 18 times as many as illicit drugs.
Given the weight of research showing tobacco eventually kills one in two long-term smokers – half the deaths are in middle age – why should the tobacco industry be a legitimate business? This is a product that even kills babies: smoking is the leading preventable cause of SIDS.
These merchants of death lied for decades about the dangers. Their denials have been discredited, but they still plead an economic case for their business. If we accept that, we should accept the narco-corporations built on illicit trafficking. We don’t and for good reason, because no amount of profit can justify the harm their product does.
Nobody would regard it as ethical if a government allowed heroin or ice or other dangerous drugs to be sold while raking in billions from taxing the sales, in a nod to the need to limit the harm.
In any case, tobacco’s benefits are much smaller than its costs. The three companies that dominate our market have combined revenues of about $3 billion and employ little more than 2000 Australians. We once had a tobacco-growing sector, but it’s all imported now. Two of the companies also manufacture their products overseas.
Were tobacco banned, governments would lose about 3 per cent of their revenue, but spending shifts, as well as health and productivity gains, would eventually offset that.
The underlying reason is that the nicotine in cigarettes is highly addictive, so smokers are driven to cough up the money for their habit. This is why retailers should survive a ban on selling cigarettes: most if not all of the spending would be transferred to other goods and services.
With cigarettes selling at a rate of about 1000 a year for every Australian, this is a big drag on household budgets. In the Australian Bureau of Statistics’ Household Expenditure Survey, families of smokers were 2.5 times more likely to report severe financial stress. Another study found one in three Australian smokers reported the cost of their habit affected their ability to pay for essentials such as food and clothing.
This leads us to a troubling aspect of the tobacco excise: low-income earners are more likely to be smokers – whose voting preferences, incidentally, flow about 60 per cent Labor’s way. A 2010 Age/Nielsen survey found only Greens voters have a higher proportion of smokers as rates peak among 20-somethings. (It’s still weird how many of this anti-nuclear brigade suck in harmful radiation doses from cigarettes.)
Almost any smoking exposure is harmful. Children in smokers’ households are four times more likely to be admitted to hospital with respiratory illness. Smokers are 32 per cent more likely than non-smokers to end up in hospital and admissions last 40 per cent longer. The costs of absenteeism and non-productive time at work are about 70 per cent higher for smokers. They are three times as likely as non-smokers to die in what should be productive middle age. Surviving smokers retire earlier on average.
Smoking is a largely neglected factor in the chronic disadvantage of Aborigines and Torres Strait Islanders. Almost half of those over 14, including pregnant women, smoke daily. When their smoking rates are almost three times the national average and are falling much more slowly than for the rest of us, we should not be surprised that ”Closing the Gap” results are so disappointing.
The history of America’s Prohibition era justifies caution in banning a product that is widely desired. Still, only an extreme libertarian would advocate free trade in all harmful goods or services for which a demand exists. In contrast to the good cheer of social drinking, smoking is widely regarded as undesirable, unhealthy and antisocial. Also, the vast majority of smokers want to quit – unlike drinkers – which makes a carefully implemented ban more feasible.
Now that smoking has become socially unacceptable, this ought to embolden governments to do more to tackle supply as well as demand.
A ban on commercial sales would have to consider the power of addiction and be phased in with much practical support to wean people off the weed. Let’s be very clear: smoking should not be criminalized – smokers need all the help they can get to save their money and their lives – but the commercial sale of tobacco ought to be.
Cutting off easy access will especially help smokers who want to quit as well as the next generation: 90 per cent of smokers began as teenagers and the age of 18, when tobacco can be bought legally, marks a sharp jump in smoking rates.
We now have governments spending huge amounts on anti-smoking campaigns and healthcare, but also banking on most smokers’ physiological need for a fag outweighing the urging to quit. When smokers say they are dying for a fag, that’s literally true.
That is what makes tobacco excise rises both cruel budgeting and timid policy. In reality, however, it’s wishful thinking to hope for a total ban – if only because of constitutional obstacles – but when governments collect about two-thirds of the money from the sale of cigarettes, they have an obvious motive for being only half-serious about eradicating smoking.
”E-cigarettes” are battery-powered devices that simulate the effects of smoking by heating a nicotine liquid into vapour, which the user then inhales and exhales.
While the gadgets have been hailed as a safer substitute for cigarettes, there is no comprehensive scientific research into the health risks of inhaling vapour.
The Sun-Herald can reveal that as part of its anti-smoking reform agenda, the previous Labor government committed more than $1 million to a pioneering study that, by 2015, will determine whether or not e-cigarettes could be utilized to phase out traditional cigarettes altogether.
But while Labor took on ”big tobacco” in the High Court to introduce world-first plain packaging laws and vowed to ban all political donations from tobacco companies, it is uncertain if the Coalition is equally committed.
Coral Gartner, who will shortly lead the trial of 1600 smokers at the University of Queensland’s center for clinical research, said: ”These types of products have the potential to be beneficial to public health if they are used to completely replace the traditional cigarette. It would be a shame not to explore how they could be used to maximize public health while trying to minimize potential unwanted effects such as making smoking appear glamorous.”
Some e-cigarette ”tanks” resemble actual cigarettes but many are ornate, pipe-like vessels available in numerous shapes and sizes.
The tanks, e-liquids and other accessories can be legally bought in Australia but users are forced to order their nicotine from overseas because it remains classified as a ”dangerous poison” that can only be sold under licence.
While the conventional smoker’s sole accessory is a $2 lighter, the e-cig brigade can spend a fortune assembling the perfect kit. E-liquids aside, there are a range of fancy extras such as e-cigarette desktop holders and luxury ”drip tips” – the mouthpieces attached to the top of device.
For the real enthusiast, such as Damian Duncan, nothing is more important than the e-cigarette device. He has splashed out on the ”Cadillac” of tanks – the Wizard Evolved DA20. It was custom-built in Romania and set him back $1000.
”When you consider I was spending almost $300 a week on cigarettes, I view it as a good investment,” he said.
E-cigarettes have been successfully launched overseas, with celebrities such as Katy Perry and Leonardo DiCaprio pictured puffing away on their own tanks.
With US sales set to exceed $1 billion by the end of the year, cigarette company Philip Morris USA is about to muscle in with its own e-cigarette brand, MarkTen.
As usage increases, health implications remain hazy. In May, the French government triggered outrage among its nation’s 1 million e-cigarette users by banning the devices in public spaces.
That ruling appeared justified a fortnight ago when a study claimed to have found previously undetected carcinogenic chemicals in e-cigarette vapours, ”sometimes at levels even higher than in traditional cigarettes”.
In March, a US study of 12 e-cigarette brands found that while certain carcinogens and toxicants were present, levels were between nine and 450 times lower than in cigarette smoke.
Australian Medical Association president Steve Hambleton said Australia was the global leader in tobacco control and should not let its guard down.
”Plain packaging is having real impact now, as is the pricing strategy. The end for tobacco is coming,” he said.
While Dr Hambleton described nicotine replacement therapy as a ”positive measure” in helping people quit, he warned that the unregulated e-cigarette industry was becoming ”a recruiting tool” for the next generation of smokers.
While e-cigarette manufacturers frequently refer to their products as a quit-smoking aid, many have adopted the same marketing techniques tobacco companies once used to glamorise their brands.
The internet is awash with ”handcrafted” e-juice liquids for sale, with hundreds of novelty flavours. At least three Australian online suppliers have emerged in the past month. Fantazia states: ”We wanted to find the prettiest, most girly vaping products out there! If it has bling, glitter or pretty colours, if it’s glamorous, stylish, cute or cool then we want it for the store and for ourselves, too.”
A NSW Health spokeswoman said it would continue to monitor international evidence ”as it developed”.
Smoke without fire and ire
A nicotine-laced fog pours from Damian Duncan’s mouth as he lounges inside his local pub. At first it appears he’s flouting the law, smoking in a public bar. But these are no ordinary gaspers. ‘‘This is smoke without fire,’’ he says. ‘‘It has saved my life.’’
Electronic cigarettes are a smoke-free substitute for the real thing. They don’t fall under tobacco legislation because they don’t contain any. Some can contain nicotine, some are flavoured. Until lawmakers decide exactly what they are, users can happily puff away in public, despite concerns about long-term use and passive risk.
While not completely odourless, the vapour from an e-cigarette smells nothing like tobacco and disappears within seconds of being exhaled. But is it a genuine saviour for smokers, or an equally addictive lesser of two evils?
Kevin and Jo Husband, from Campbelltown, tried patches, lozenges and even $1000 hypnotherapy without success.
‘‘No doubt about it, this is the miracle cure,’’ Mr Husband said. ‘‘I’ve not had a cigarette since November last year.’’ He added that while detractors would no doubt ‘‘scoff’’ at the fact he was still consuming nicotine, ‘‘at least I’m no longer pumping the other 4000 chemicals and carcinogens into my blood stream. I feel great.’’
Another e-cig convert, Andrew Washbourne said he had been a ‘‘40-a-day’’ slave to tobacco since he was 11: ‘‘I would rather go hungry and buy smokes than food.’’ He feels like a new man: ‘‘I can actually walk up the stairs again.’’