Why is the tobacco industry continuing to call the shots?

27 April 2023

Originally posted by Croakey Health Media on 26 April 2023: https://www.croakey.org/why-is-the-tobacco-industry-continuing-to-call-the-shots/?fbclid=IwAR2CFLsUtQ-Lp1PHiotcdixF3_Pw55MHrq8kat-daDPhb6mwOvS2TDYpDOw&mibextid=kdkkhi

Introduction by Croakey: Australia is being urged by leading tobacco control researchers to follow in Aotearoa/New Zealand’s footsteps and phase out the retail supply of tobacco products.

Australia’s tobacco control programs and policies to date have aimed to minimise demand for tobacco products – by encouraging smoking cessation or discouraging uptake of smoking – rather than reduce supply, and this has greatly “benefited the tobacco industry”, according to PhD candidate Andrew Perusco, Associate Professor Raglan Maddox and Professor Coral Gartner.

Endgame policies, such as those in Aotearoa/New Zealand’s Smokefree Aotearoa 2025 Action Plan, aim to “actively address the key driver of the tobacco epidemic – the tobacco industry”, Perusco, Maddox and Gartner write below.

Their article includes highlights from Perusco’s presentation to the Australasian Professional Society on Alcohol and other Drugs on 18 April 2023, and answers common questions raised during his presentations.

Andrew Perusco, Raglan Maddox and Coral Gartner write:

Corporations actively influence public perceptions using a variety of tools including marketing, communications, and the way they socialise and frame their products and impacts. This is not always in the best interest of the public and public health.

For example, despite knowing about the harms of tobacco smoking since the mid-1950s, cigarette manufacturers not only survived the 20th Century but have thrived, fuelling death and disease. The global tobacco market is valued at US$267 billion in 2023, yet it kills over 20,000 Australians per year and over 8.2 million people globally.

Given smoking’s massive health toll and that most people who smoke are addicted to nicotine, it is unsurprising that most people who smoke wish they’d never started, and want to quit. Yet commercial tobacco products remain widely available in general retail outlets. This regulatory leniency serves to legitimise a product that kills when used as intended.

Rather than addressing this anomaly, most tobacco control programs and policies have focused on demand reduction measures such as discouraging individuals from starting smoking or encouraging quitting – mass media campaigns, health warnings, tax excise increases.

Importantly, this imbalance does not meet societal expectations, with the public and people who smoke supporting approaches to phase out commercial tobacco.

This policy focus on demand rather than supply reduction measures has benefited the tobacco industry and is a testament to its influence.

While many health-harming industries, such as the asbestos industry, have been pushed to extinction in Australia, the tobacco industry has so far avoided this outcome.

The case of asbestos

Asbestos importation, manufacture, and supply across Australia has been strictly regulated, and there are stringent procedures for handling asbestos within existing infrastructure.

All commercial use of asbestos-related products was phased out between 1984 and 2003. These regulations have helped to limit exposure to asbestos across Australia.

Purported narratives

We witness diverse framings and purported narratives every day, but the public may not be explicitly aware of the potential commercial conflicts of interests of those advancing these narratives.

Tobacco industry framings evolved over time, from questioning the science on tobacco harms and promoting tobacco use as a symbol of masculinity and also female emancipation, to a matter of personal or ‘individual choice’. These framings contradict tobacco industry investment in engineering a highly addictive product that they market heavily.

More recently, the tobacco industry promotes ‘reduced risk’ products such as e-cigarettes and its framing purports itself to be ‘transformed’ and therefore a credible player with a role in efforts to reduce the burden placed on communities as a result of commercial tobacco.

Research suggests that this assertion is a myth, mirroring the framings of the past, and is straight out of the tobacco industry playbook – the tobacco industry continues to profit handsomely from commercial tobacco products and actively resists regulation.

Tobacco endgame policies seek to rapidly end the tobacco epidemic – phasing out retail supply is one policy option. In 2012, when Australia implemented tobacco plain packaging and enhanced graphic health warnings, it was considered a tobacco control world leader.

However, Aotearoa/New Zealand now owns this mantle, legislating The Smokefree Aotearoa 2025 Action Plan to end the tobacco epidemic.

Modelling of the action plan’s key policies – including banning sale to people born after 2008, mandating a very low nicotine standard for tobacco products, reducing tobacco retail availability by at least 90 percent, building on the leadership, engagement and Māori governance of tobacco control – suggests that smoking rates will fall dramatically over the next few years, coming close to achieving the New Zealand Government target of less than five percent daily smoking by 2025 for both Māori and non-Māori people.

The endgame

Endgame policies and regulation can actively address the key driver of the tobacco epidemic: the tobacco industry.

If we are to end the tobacco epidemic, we must move to viewing the tobacco industry and the retail sale of commercial tobacco products as illegitimate.

After all, how many more generations of Australians must die unnecessarily from tobacco-related disease for no other purpose than the generation of corporate profits?

About the authors and disclaimer

Andrew Perusco and Associate Professor Raglan Maddox (Bagumani (Modewa) Clan, Papua New Guinea) are at the National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, ANU.

Professor Coral Gartner is at the University of Queensland. All authors are affiliated with the NHMRC Centre of Research Excellence in Achieving the Tobacco Endgame.

Andrew Perusco’s Sir Roland Wilson PhD scholarship is funded by the Australian Government Department of Health and Aged Care and the Sir Roland Wilson Foundation. Professor Gartner is supported by an ARC Future Fellowship.

This paper represents the views of the authors and does not necessarily reflect the views or the position of the Australian Government Department of Health and Aged Care, the Sir Roland Wilson Foundation, NHMRC or ARC.

Andrew Perusco’s PhD research explores why Australia hasn’t adopted tobacco endgame polices so far, and what might precipitate adoption. He has presented on the focus of his research at several forums.