31 August 2021

Falling support for ban on cigarette sales

Political Respiratory Smoking

Even with a ban, tobacco products are unlikely to completely disappear.

More than half the population still supports banning cigarette sales within the next 10 years, but enthusiasm appears to be waning.

A 2019 survey of about 2700 Victorian adults found that 52% of people – including 30% of current smokers – thought phasing out the retail sale of cigarettes entirely by 2030 would be “fair”.

According to the research letter, which was published today in the MJA, people who had never smoked were more likely to support the call for tougher measures.

Although the data is consistent with contemporaneous research conducted in Western Australia, it differs markedly to the results of a similar Victorian survey conducted in 2009.

At that time, amid a federally funded anti-tobacco campaign and not long after a ban on smoking in pubs, nightclubs and other public spaces had rolled out across all states and territories, roughly three-quarters of Victorians supported phasing out cigarette sales.

“A major tobacco control media campaign, new graphic health warnings, and new smoke-free laws may have increased awareness of tobacco control in 2009, and the phrasing of the question (2009: ‘will no longer be available’, 2019: ‘it will no longer be legal’ to sell cigarettes) may also have influenced the willingness of respondents to approve the goal,” the authors wrote in the MJA.

Maurice Swanson, CEO of the Australian Council on Smoking and Health and a co-author of the research letter, told The Medical Republic that more funding for public health campaigns would be vital to re-piquing public interest.

“The federal government has not run a decently funded National Tobacco campaign since 2013, and when you look at the evidence for the most effective things to drive down the prevalence of smoking, number one is tax and number two is sustained, realistic funding for mass media campaigns,” he said.

As for what “phasing out” cigarettes may look like in practical terms, Mr Swanson said it was most likely that retailers like bottle shops would be prohibited from selling tobacco products first, followed by petrol stations and supermarket chains.

Eventually, according to Mr Swanson, tobacco products may only be available at pharmacies.

“One of the interesting things about pharmacists is that in Australia they already sell approved nicotine replacement therapy products,” he said.

“From the first of October, they will be selling liquid nicotine and e-cigarettes under the under the guidance of the TGA’s product standard 110.

“While not every pharmacist would be happy with selling traditional cigarettes, we’re talking about 10 years hence, and we’re talking about a completely different social environment in relation to nicotine.”

Professor Gillian Gould, a GP and health equity researcher currently studying smoking cessation initiatives, told TMR that from a global perspective, Australia banning the retail sale of cigarettes may not necessarily be a positive step.

“If cigarettes were phased out in high income countries, it’s still not necessarily going to be a solution for the low to middle income countries,” she said.

“What would happen, I think, is that the big tobacco companies would then push their efforts more into countries where there are less legal protections for consumers.”

She does, however, believe that a “carefully mapped out” plan to reduce the availability of cigarettes is urgently needed.

“If [phasing out cigarettes is] the way we’re going to go as a country, then the longer we delay it, the more people are dying and more babies are being born with low birth weight, which has lifelong repercussions,” Professor Gould said.

MJA 2021, online 30 August