What's next for tobacco control? A smoke-free generation

Each year 60,000 Australians and millions throughout the world die from cigarette smoking. One billion people are projected to die of tobacco-related disease by 2050. This is a national and international scandal.

The tobacco-free generation is a key “endgame” reform, recognised internationally as part of a suite of measures to finally eliminate tobacco smoking. If legislation currently before the Tasmanian parliament passes, the state could be the first in the world to prohibit the sale of tobacco to people born after 2000.

Before we get into the detail of the proposal, let’s take a closer look at the problem.

Nicotine is a highly addictive drug which is usually obtained through inhaling the smoke of slow-burning tobacco leaves, plus many additives. According to the United States Surgeon General, modern tobacco products are more toxic and addictive than ever, due to cigarette engineering by the tobacco industry, and more likely to cause cancer now than in the last century.

The addiction begins for most smokers as children and teenagers, but breaking the addiction is hard. Two thirds of these victims will die prematurely of disease related to their smoking habit, and the average life lost will be over ten years.

Smokers die of heart disease, stroke, chronic obstructive airways disease, asthma and many cancers, above all, lung cancer. Lung cancer is almost exclusively caused by tobacco smoking and has a survival rate of less than 15%.

Why are smokers “victims”? Because they were targeted when young, at a stage when their brains were immature and especially vulnerable to nicotine. This is the core business plan of the tobacco industry, with a constant need for new addicts; they need to get their targets hooked very young.

The industry uses any tactic available to promote their product, and fights any attempt to constrain them. In the affluent West, including Australia, they use money to influence political parties directly, cozying up to individual politicians, in some instances to the point of corruption.

In developing countries, they shamelessly use tactics already outlawed in developed countries, and engage in intimidating legal actions. They finance “front organisations”, who then regurgitate industry mantras about “freedom of choice”, “nanny state”, or freedom of commerce for their “legal” but lethal product.

So, having set the scene, what is the tobacco-free generation legislation all about, and why Tasmania?

Tasmania has smoking rates 50% higher than elsewhere in Australia. Tasmania has widespread multigenerational poverty and social disadvantage, exactly the type of community especially susceptible to drug addiction in general, and tobacco-smoking in particular.

This leads to another twist or two in the cycle of deprivation: through the cost of the cigarettes, the high incidence of mental illness it initiates, long-term poor health in smokers and in babies born to smoking mothers.

Most anti-tobacco legislation has addressed the demand side of the problem:

• increasing the price
• banning advertising
• displaying images that shock
• using unattractive colours on the packaging.

All of these measures work to some extent, as do mass media campaigns and cessation support services, but mainly in middle class people. More is needed.

The tobacco-free generation is a supply side measure, but implements it in a way that is gradual, does not entrap or criminalise those already addicted, and is highly practical because the machinery to limit sales to young people under 18 is already in place and works well.

The onus is on the retailer not to sell or supply. Retailer compliance with the current law is 98% in Tasmania due to strong enforcement.

In practical terms what the tobacco-free generation legislation would do if passed by Parliament is to roll forward, from January 2018, the age that a young person can be sold cigarettes, so that anyone born in the 21st century will never get to an age at which it is legal.

At first that sounds startling, but we do know that hardly anyone takes up smoking in their 20s or beyond. Most addicted smokers would like to give up and regret starting. The tobacco-free generation is a very popular measure, in the general population, among smokers and young people.

The age at which young people started their addiction has risen gradually since the 1990s. The age at which smokers start tends to lag behind the “legal” age by about two years. This is because kids get their smokes from friends slightly older than themselves, less often from parents or shops.

Thus the older the age of legal sale, the older the new smokers; so if we can roll the age forward, there will be fewer smoking friends and fewer new smokers, and ultimately just no new smokers. That is what we hope for, and this is what we think is achievable. This of course is why the tobacco companies are screaming blue murder.

The tobacco-free generation is a cry from the heart from people who have had enough. Those backing the amendment include many Tasmanian health professionals and advocates who are fed up with the tobacco companies and their greed, and the complacency of some politicians in the face of so much avoidable suffering.

Haydn Walters receives funding from the NHMRC. He is affiliated with Smoke Free Tasmania.

Julia Walters is affiliated with SmokeFree Tasmania

Kathryn Barnsley received research assistance fees for drafting the cabinet submission, first draft of the Bill and second reading speech for the tobacco-free generation Bill. She is convenor of Smoke Free Tasmania, a member of the Tasmanian Tobacco Coalition and has done anti-tobacco work for Cancer Council Australia and Tasmania.