Last week, federal Health minister Greg Hunt was at the National Press Club selling his vision of the Coalition’s health policy for the next three years.
Good on him. There was much good stuff in what he said.
Amongst his statements of priorities, however, was this:
Today, I want to announce that the Government will set a new target of reducing smoking rates below 10 per cent by 2025. This may be one of the most important things I ever have the privilege of being involved with. We’ve already committed $20 million to the education campaign but there is more to be done and we’ll develop that with the health preventable and mental health.
How that target is to be achieved, when the adult smoking rate has flat lined around the 14 per cent mark for more than five years, is the $64,000 question. More graphic product warnings? Still higher extortionate excise on tobacco products? More of the social marketing that allows governments to believe, like Tinker Bell, that they’re doing something but achieves nothing except enriching advertising agencies and media companies?
Perhaps the Minister should look at our Anglosphere counterparts, the United Kingdom and New Zealand. The UK last month released a Green Paper on preventive health that aims to make Britain smokefree by 2030. New Zealand has had, since 2011 and therefore under National and Labour governments, a Smokefree 2025 policy that has been aspirational while smoking rates, especially amongst Maori and Pacific Islanders have remained stubbornly high.
But both Britain and New Zealand’s anti-smoking strategies now have one thing in common. Both embrace nicotine vaping as a new but effective weapon in the armoury to mitigate if not eliminate the mortality and morbidity destruction of combustible tobacco in cigarettes.
From the UK Green Paper:
The government is committed to monitoring the safety, uptake, impact and effectiveness of e-cigarettes and to assess further innovative ways to deliver nicotine with less harm than smoking tobacco. There is a large amount of research now available to support e-cigarette use as a safer alternative to smoking and help people quit smoking, and we continue to monitor the evidence.
From the NZ Government’s position statement on vaping:
The Ministry of Health considers vaping products have the potential to make a contribution to the Smokefree 2025 goal and could disrupt the significant inequities that are present.
In the UK and NZ, politicians and even the wokest of health bureaucrats has accepted that their smoking-reduction targets will not be met without the contribution of nicotine vaping. In the UK, the acceptance and market penetration of vaping largely accounts for a significant drop in the smoking rate from around 20 to 14.7 per cent between 2011 and 2018 – and it’s likely that British vaping regulation will be further liberalised post-Brexit. In New Zealand, legislating to make nicotine vaping lawful is currently being completed, but already the government there has established websites and published other officially-backed public information about the stop-smoking potential of vaping.
Yet Australia refuses to join the party. Hunt himself repeatedly has declared that legalised nicotine vaping “will never happen on my watch”, and a promise to his party room to fund an independent review into the risks and benefits of vaping, made before the last election when the Coalition expected to lose and Hunt presumably thought he’d never have to deliver on it, has not so far commenced, nor looks like it will for at least two years.
Hunt’s immediate policy problem, however, is that the Australian adult smoking rate has reached bedrock. It includes smokers whose determination to get their nicotine fix is so entrenched that they’ll pay even the eye-watering tobacco taxes that are there to boost consolidated revenue, and whose coffin nail addiction therefore is crucial to the government’s delivering its commitment to return the Budget to surplus in 2020.
The so-called “Australian model” of tobacco control – ostracising smokers by severely restricting where one can smoke, punitive tobacco excise, plain packaging and social marketing – has reached its limits of effectiveness, and to reduce smoking rates further needs both fresh thinking and embracing major disruptions like legal nicotine vaping.
Australian public health pooh-bahs, and the politicians on both sides who listen to them and fear them, are so wedded to what they’ve done for decades that they lack such fresh thinking and refuse to accept this reality. As a result, Greg Hunt’s 10 per cent by 2025 target is destined to remain a throwaway line in a speech, unless he is willing to drop his wholesale opposition to legalised nicotine vaping.
Harvard-educated Hunt is no fool, and like any politician he likes to be on the ultimately winning side. Provided he consults more widely, keeps an open mind to emerging evidence, ignores influential public health types blinded by their own self-perceived brilliance, and can at least consider vaping’s disruptive potential to slashing smoking rates – as have Britain and New Zealand – there is yet a chance his aspirational 10 per cent goal is vaguely achievable.
It’s entirely up to him.
Terry Barnes is a policy consultant who formerly advised Howard government health ministers. He is also a Fellow of the UK Institute of Economic Affairs, and has never smoked or vaped.