E-cig ar­gu­ment a smoke­screen

The West Australian - - OPINION - Mau­rice Swan­son

The de­bate on elec­tronic cig­a­rettes took a turn for the worse this week, when raw num­bers were used to sug­gest that cur­rent in­ter­ven­tions to re­duce smok­ing may not be work­ing — and there­fore e-cig­a­rettes need to be part of the so­lu­tion.

There was no sci­en­tific merit to ei­ther of these claims. To use them to­gether to push an ev­i­dence-free bar­row on e-cig­a­rettes is not only flawed but danger­ous.

Yes, re­li­able es­ti­mates show the to­tal num­ber of smok­ers in Aus­tralia in­creased by 21,000 be­tween 2013 and 2016. But that is ex­plained mainly, and eas­ily, by mi­gra­tion.

Ac­cord­ing to the Aus­tralian Bureau of Statistics, Aus­tralia’s net pop­u­la­tion grew by 589,000 from mi­gra­tion be­tween 2013 and 2015. On that ba­sis, a growth in to­tal smoker num­bers of 21,000 is re­mark­ably low, at only 3.5 per cent of that pop­u­la­tion growth.

Smok­ing take-up among other Aus­tralians, and par­tic­u­larly in younger age groups, is at an all-time low, thanks to decades of ef­fec­tive to­bacco con­trol pol­icy. Claims that to­bacco tax and plain pack­ag­ing are “not work­ing” are sim­ply wrong.

This is pop­u­la­tion health 101, and it is the rea­son that per­cent­ages, rather than ag­gre­gate or to­tal fig­ures, are used to eval­u­ate the ef­fec­tive­ness of in­ter­ven­tions.

At a time when other na­tions with poor to­bacco con­trol poli­cies and ter­ri­ble to­bacco health harms are look­ing to Aus­tralia’s suc­cess for guid­ance, not to recog­nise these facts and prin­ci­ples of science is not just wrong, but also po­ten­tially danger­ous.

Smok­ing preva­lence in Aus­tralia has more than halved in the past 25 years. This is a re­mark­able achievement in the face of un­re­lent­ing op­po­si­tion from to­bacco com­pa­nies, who now sup­port e-cig­a­rettes un­der the guise of pub­lic health pol­icy. This is just an­other du­bi­ous at­tempt to cast them­selves as part of the so­lu­tion to a prob­lem they cre­ated — and one that will rack up 1 bil­lion global deaths this cen­tury since the mass-mar­ket­ing of cig­a­rettes be­gan a cen­tury ago.

One quar­ter of all re­duced preva­lence from 2012 to 2014 can be at­trib­uted to plain pack­ag­ing alone. This is ex­tra­or­di­nary, given that plain pack­ag­ing was in­tended to pre­vent peo­ple start­ing smok­ing, rather than to en­cour­age peo­ple to quit.

Yes, the de­cline in Aus­tralia’s smok­ing preva­lence has since slowed in rel­a­tive terms — but this is af­ter what was the great­est rel­a­tive de­crease on record, be­tween 2010 and 2013. The slow­ing down also co­in­cides with a big fall in Fed­eral govern­ment fund­ing for hard-hit­ting, mass me­dia ad­ver­tis­ing cam­paigns em­pha­sis­ing the harms of smok­ing.

We don’t hear any­thing from the e-cig­a­rette en­trepreneurs about the out­stand­ing suc­cess of Aus­tralia’s me­dia cam­paigns, go­ing back to the late 1990s with the Ev­ery Cig­a­rette is Do­ing You Dam­age ini­tia­tive. But why would we, when it’s dif­fi­cult to sep­a­rate e-cig­a­rette en­trepreneurs from the to­bacco in­dus­try?

The ev­i­dence in favour of e-cig­a­rettes does not stack up when the po­ten­tial risks and ben­e­fits to the whole pop­u­la­tion are as­sessed. Aus­tralia’s Ther­a­peu­tic Goods Ad­min­is­tra­tion and Na­tional Health and Med­i­cal Re­search Coun­cil, and the Aus­tralian Med­i­cal As­so­ci­a­tion, have all come to this con­clu­sion based on the cur­rent ev­i­dence.

This is Aus­tralia, af­ter all, where we are blessed to have strong and in­de­pen­dent health au­thor­i­ties to ad­vise govern­ment on poli­cies. Aus­tralia is also the na­tion where a phe­nom­e­nal 98 per cent of teenagers do not smoke — an unimag­in­able per­cent­age a gen­er­a­tion ago. This is an achievement we will pro­tect fiercely, in the face of stud­ies show­ing young peo­ple ini­tially ex­posed to nico­tine from e-cig­a­rettes are more than three times as likely as those who do not use e-cig­a­rettes to be­come to­bacco smok­ers.

There are also stud­ies that show e-cig­a­rettes may have a ben­e­fit. We need to look at all the ev­i­dence and would sup­port the avail­abil­ity of e-cig­a­rettes un­der ap­pro­pri­ate con­trols if such ev­i­dence were con­clu­sive. But it isn’t, es­pe­cially in the Aus­tralian con­text.

The World Health Or­gan­i­sa­tion has warned that coun­tries with a good record in to­bacco con­trol — and yes, that’s us — need to be par­tic­u­larly cau­tious about the risks of e-cig­a­rettes. And these risks are not only about the gate­way to smok­ing.

Does any par­ent want their kids in­hal­ing toxic vapour laced with highly ad­dic­tive nico­tine di­rectly into their lungs, from prod­ucts bla­tantly de­signed to ap­peal to youth — with fruit and en­ergy drink flavours, and gim­micky mar­ket­ing?

Let’s con­tinue to do what works to get Aus­tralia’s smok­ing rate down below 10 per cent in the next five years. Revving up our mass me­dia cam­paigns is the miss­ing piece, as the ev­i­dence shows.

Smok­ers are pay­ing their to­bacco tax. We would only need a frac­tion of that rev­enue to fund ef­fec­tive cam­paigns that would prompt peo­ple to quit in even big­ger num­bers. We just need to see through the to­bacco in­dus­try’s smoke­screen.

A phe­nom­e­nal 98 per cent of Aus­tralian teenagers do not smoke

Il­lus­tra­tion: Don Lind­say

Newspapers in English

Newspapers from Australia

© PressReader. All rights reserved.