There are no silver bullets, magic tricks or secret hacks to solving complex public health problems. Taking on the global tobacco industry and reducing the devastating consequences of smoking has taken decades of incremental reforms.
Author
Becky Freeman
Associate Professor, School of Public Health, University of Sydney
Most of these reforms have focused on making smoking less attractive, to reduce the appeal of and demand for tobacco products. Countries that are serious about reducing tobacco use have all increased the price through high taxes, placed graphic health warnings on packs, adopted bans on all forms of tobacco advertising, and generally made smoking socially unacceptable through indoor smoking bans and emotive campaigns about the dangers of smoking.
Last week, the United Kingdom took an important step in shifting the dial on tobacco control, to not only focus on reducing the appeal and demand for products, but to totally rethink how tobacco products are supplied.
Under the new law, the legal age for cigarette sales (currently 18) will increase by a year each year from 2027. This means people born from 2009 will never be able to legally buy cigarettes in the UK. But what does this mean for Australia and the rest of the world?
A smoke-free generation
While some jurisdictions require tobacco retailers to have a license to sell cigarettes, and most countries put a minimum age on legal sales of all tobacco products, the UK looks set to be the first country in the world to phase out who can legally be sold tobacco products.
The focus of the UK law is not to criminalise smoking, but to end the sale of a highly addictive and uniquely dangerous product to future generations. Penalties for defying the law will include on-the-spot fines for retailers.
Aotearoa New Zealand was poised to be the first country to implement this same type of law in July 2024. However, when a change of government occurred in the 2023 election, the legislation was repealed as part of a coalition negotiation. The law was dropped alongside other public health measures that were set to reduce the number of tobacco retail outlets and a plan to reduce nicotine in cigarettes.
Undue tobacco industry interference and influence is viewed by public health experts as the primary factor in overturning these laws. Just as when Australia became the first country to implement tobacco plain packaging laws in 2012, the UK will need to be vigilant in pushing back against these same powerful commercial interests.
What's happening in Australia now?
At the end of last year, a much-needed package of tobacco control reforms was passed in Australia. These include refreshing the now dated graphic health warnings on tobacco packages, requiring the tobacco industry to report its sales data and marketing activities, and revamping the tobacco advertising laws to capture new forms of digital marketing and vaping products.
These measures are all wholly welcome by the health sector and will be rolled out over the coming months.
While this suite of new reforms does not address the supply of tobacco products, the National Tobacco Strategy 2023-2030 has a goal to reduce daily smoking prevalence to 5% or less by 2030. Current daily smoking in Australia is at 10.6%, and provided we continue to innovate and adopt progressive policies we can reach this target. Of course, we should not be content to stop at 5%, but must embrace a goal of being a smoke-free country.
One of the key priority areas to reach this goal is to "strengthen regulation to reduce the supply, availability and accessibility of tobacco products". Specifically, the National Tobacco Strategy will "consider the feasibility of raising the minimum age of purchase of tobacco products and monitor international developments on this matter".
There is a clear government mandate to keep in step with international best-practice in tobacco control. This is the key reason the tobacco industry opposes innovative law reforms so strongly, even in relatively small countries like New Zealand.
When a public health measure is successfully adopted and proven effective in one nation, it has a habit of spreading quite quickly to others. As an example, plain packaging laws are now commonplace after surviving multiple tobacco industry legal challenges in Australia. So we may soon see similar age-restrictive laws introduced in Australia and other countries.
A public health priority
Australia is currently debating legislation that will place further restrictions on how vaping products are sold. In these proposed laws, we have an opportunity to protect young people from lifelong addiction.
If passed, these laws will also set a powerful precedent that harmful and addictive products should not be sold as consumer goods in the same shops that sell everyday household groceries like bread, fruit and milk.
When it comes to smoking, future generations will look back and shake their heads that we ever allowed a product that kills 20,500 Australians a year to be so casually available, anywhere and any time.
Becky Freeman is an Expert Advisor to the Cancer Council Tobacco Issues Committee and a member of the Cancer Institute Vaping Communications Advisory Panel. These are unpaid roles. She has received relevant competitive grants that include a focus on e-cigarettes/vaping from the NHMRC, MRFF, NSW Health, the Ian Potter Foundation, VicHealth, and Healthway WA; relevant research contracts from the Cancer Institute NSW and the Cancer Council NSW; relevant personal/consulting fees from the World Health Organization, the Hong Kong Special Administrative Region Department of Health, BMJ Tobacco Control, the Heart Foundation NSW, the US FDA, the NHMRC e-cigarette working committee, NSW Health, and Cancer Council NSW; and relevant travel expenses from the Oceania Tobacco Control Conference and the Australia Public Health Association preventive health conference.
