Public Health Amendment (Prevention of Sale of Smoking Products to under-age persons) Bill 2018
Ms ARMITAGE (Launceston) - Mr President, I first congratulate and commend the member for Windermere. He has put a lot of effort into it. Everyone agrees -
Mr Dean - You do that, then you go chonk. For goodness sake, I do not enjoy that sort of -
Ms ARMITAGE - Well, it is true, you have put a lot of work and effort into it. I accept your effort in endeavouring to do all you can to reduce the number of our population who want to either take up smoking, or alternatively, want to continue with the habit that kills approximately 560 Tasmanians each year. Of course, many smokers also want to quit, but they do have difficulty.
We should make no mistake, smoking does kill. Someone once said to me, 'I saw a sign the other day that said the maximum penalty for smoking was $1000, but that is not right. Surely the maximum penalty for smoking is death'. We are all aware of that.
We are further told the costs of smoking-related chronic obstructive pulmonary disease, lung cancer and heart disease costs Tasmania $600 million each year. You ask yourself why people smoke, and the answers are interesting. It seems there are no really persuasive reasons. The answers you will find are that it relieves stress, it becomes a pleasurable experience, it is peer pressure, it is encouraged by friends. For the young, smoking is a way of rebelling, showing youthful independence. Youth thinks that others are doing it so they will, too - probably, most importantly, because of the tobacco industry using clever marketing tactics which target teenagers.
But with smoking remaining as the leading preventable cause of death and disease in Australia, causing many types of cancer, heart disease, strokes, chest and lung illnesses and stomach ulcers, killing up to 15 500 people in Australia each year, you ask yourself: why is smoking still legal? Again, the answers are interesting. They range from, the governments enjoy the revenue to there would be a public outcry from smokers and non-smokers alike if it were banned, policing costs, illegal importation, anti-government intervention and underground sales. But the point in this debate is that smoking is still legal. Governments have not been brave enough to stamp it out. What should we do?
The history of countries trying to reduce smoking rates is interesting. It seems to have commenced when Richard Doll and A Bradford Hill, in 1950, published an article in the British Medical Journal that confirmed a link between smoking and lung cancer. In 1961, the American Lung Association, along with public health partners, wrote to President John F Kennedy, highlighting the increasing evidence of the health hazards of smoking and urging him to establish a commission to address the problem. This letter led to the publication of a landmark Surgeon General's report, 'Smoking and Health', in 1964. From that time until today, there has been a significant improvement in the reduction of smokers as a result of numerous reduction strategies. These include warnings on cigarette packets of the danger of smoking, graphic photos of smoking sufferers, separate smoking areas in public places, to no smoking in public places, nicotine gum being the first drug designed to help users quit smoking, articles on the harmful effects of second-hand smoke, smoke-free restaurants, smoke-free airlines, public buildings, nicotine being declared a drug, significant tax increases, the list goes on. Until 2020, in the USA, T21 laws were passed across the USA.
Throughout this time, the cigarette companies have continued with their fight to keep their profits. In 1968 Philip Morris introduced the Virginia Slims brand with its iconic, 'You've come a long way, baby' advertising campaign targeting women. In 1987, R J Reynolds Tobacco Company debuted the Joe Camel character in its US advertisements. This cartoon character is said to have hooked millions of children on Camel products.
In 1994, seven tobacco company executives testified before a congressional committee that they did not believe nicotine to be addictive. Fast forward to 2006 in the US and you have Judge Kessler releasing her final ruling in the US Department of Justice federal suit against the tobacco companies. She found that the tobacco industry had lied for 50 years and deceived the US public on health issues and marketing to children.
In summary, the history of the smoking debate in the USA highlights the fight between the health professionals and the cigarette companies, and it is testament to the saying that in the end the truth wins out. In Australia, the anti-smoking campaign was launched in 1997 and it was aimed at reducing smoking rates in Australia by 22 July 2020. We know that smoking reached a peak in 1964 and has been on the decline since that date, 57 years ago. Like the USA, we have introduced plain packaging, graphic photos on packets, bans on tobacco advertising, promotion campaigns, programs to reduce smoking and smoke-free areas, including enclosed public places, workplaces and shared areas.
The strategies have steadily worked. The National Drug Strategy Household Survey estimated that in 2019, 11.6 per cent of adults smoked daily, a reduction from 12.8 per cent in 2016 and 25 per cent in 1991. We are told that in Tasmania we have the second highest rate of daily smokers in Australia, 17.9 per cent. These rates have decreased significantly over the last decade, but I accept there is still work to do.
They also question whether the member's bill is the right vehicle at this time of the journey of reducing the rates of smoking. The Tasmanian Tobacco Control Plan is dated 2017‑21. Through its Healthy Tasmania Five Year Strategic Plan, the Government has set a target to reduce the Tasmanian smoking rate to 10 per cent by 2020. Admittedly, that ambitious target has not been achieved, but the target was to be reduced to 5 per cent by 2025.
The strategies to be used target suppliers of tobacco, together with education and marketing to help people quit. In his foreward to Tasmania's plan, the then secretary of the Department stated:
The Tobacco Control Plan 2017-21 is accordingly a plan for action by all sectors and levels of government. It highlights the opportunities for working in existing and new partnerships in recognition of the substantial evidence that health prevention action is more effective when it is integrated and comprehensive. The Tobacco Control Plan recommends actions based on the best available evidence that can be taken over the next five years. These actions have been informed by the national and international evidence base for reducing tobacco related harm. They were developed by the Tobacco Control Coalition through a series of consultations and workshops held during 2016, in collaboration with a number of additional stakeholders who also had expertise in health and tobacco control.
Under the subheading 'Priorities for Action', there were four key areas for action, which include the age group targeted by the member's bill - that is, prevent smoking uptake and de‑normalise tobacco use and reduce smoking by high prevalence groups. Importantly, for each area identified, recommendations are to be drawn from the latest state, national and international evidence.
At this stage, I believe we should let the process already underway proceed without this Chamber legislating outside what has been prioritised by the experts who developed our Tobacco Control Plan. What gives me some comfort in the plan is that evidence is to be drawn not only from state and national evidence, but also from international evidence. Therefore, there is every opportunity to look at what has happened with T21 in the USA and, if appropriate, bring the debate back to parliament. It would appear at this stage that our experts have not looked at or completed their analysis of that legislation. I believe it pertinent to wait for that to occur before I could possibly vote on the member's bill.
The member mentions many medical people and medical associations are in favour of this bill. I accept that it would be accurate. Of course, any medical person and most people would agree smoking is injurious to health. I also do not doubt the Menzies Institute's facts and figures. Many people would support anything to stop smoking. It is a scourge on our society and I, along with most members in this House, detest smoking and would be very pleased if it did not exist in our society. Do I support legislation or ways of preventing people taking up smoking, or making it more difficult for young people? Well, of course, the answer is yes, on emotion.
Mr Dean - Listen, do that. Obviously you will vote for it.
Ms ARMITAGE - On emotion, I, too, would support anything that stops people smoking. But we are legislators who must pass workable bills that will become law.
As I said, many doctors that I have spoken to support this bill. Many have lobbied me to support this bill. But they are people of medicine. They are not legislators, and cannot be expected to look into the workings of the bill if it becomes law. I am concerned with the practical application of the proposal. I find this bill confusing, so I can only imagine the difficulty for people having to enforce it.
An example is clause 4, Section 3 amended (Interpretation). I note in (a), for the first 12 months, it refers to 'a person who has attained the age of 18, but not 19'; and (b), the next 12 months, 'a person who has attained the age of 18, but not 20'; and (c) after a period referred to in (b), 'a person who has attained the age of 18, but not 21, years …'.
Let us remember here that sellers of cigarettes in businesses, particularly hotels, are likely to be young assistants who need to understand this legislation. I understand it comes in over three years, but it is confusing.
A question for the member, in your summing up: we have a 20-year-old tourist who comes over in year 3 of the bill, goes to a hotel, buys a beer and asks for a packet of cigarettes. Do we make it widely known, tourism-wise, that if you are under 21 and you are coming to Tasmania, you had best bring your own? What do you propose for this?
You mentioned to me at one stage, when I had asked you previously, that I could move an amendment. I recall you saying that, but I am just wondering what you actually propose in this situation for tourists or visitors coming to the state. Will it be widely known to tourists? Will there be something out there?
Mr Dean - Of course you understand the laws if you go to a state. If you go to a different state, different laws apply. Different countries apply different laws.
Ms ARMITAGE - I would have to disagree with you there. I do not think I would actually look up all the laws that pertain to a state when I go to visit there. You assume in Australia that most laws would be the same. But I will not debate that with you, I am not here to debate.
The other issue I have is that a 20-year-old person going to a hotel bar cannot be sold cigarettes. It is the assistant, often young, who sells the cigarettes. If you look at these people, they are not old. They will be given a significant fine. My understanding is that it is 120 penalty units for the first offence; second offence, 240 penalty units; and subsequently, 360 penalty units. However, if a person standing next to them, on the face of it, gifts the cigarettes to them, buys it for them, and gives it to them, does not actually hand over money -
Mr Dean - No, buys it for them. They would be committing an offence.
Ms ARMITAGE - Exactly, does not hand over money in view of anyone, faces no fine unless they are caught exchanging money for that purpose, it would need to be proven. Would the police follow or chase this up, or are they busy enough chasing up the sale of illicit drugs?
Mr Dean - No, they would not, because most people comply with the law; 90 per cent of people comply with the laws.
Ms ARMITAGE - As I said, I support preventing young people, or all people, taking up smoking. It is a horrible, insidious habit. However, I find too many problems with the bill before us to make it workable. I would love to support it, because I understand where you are coming from. It would be really good to be able to support it, but with the legislation before us, I am sorry, I do not see it practical or workable. I cannot support it.
Mr WILLIE (Elwick) - Mr President, just a short contribution from me. I certainly respect the member for Windermere's intent. I, too, have an interest in young people. I could not let this opportunity pass without talking about education outcomes in our state.
Arguably, improving education outcomes is a long-term project, but it is the biggest lever the state Government has to influence workforce participation, productivity, wages and health outcomes. We know social determinants of health include income, education, conditions of employment, power and social supports.
If you look at our current education system, it is not serving Tasmanian young people well, and it is not serving their health outcomes well. We have one of the most unequal education systems in the developed world, and that is across the country.
If you look at our funding model, it is deeply unequal. For example, if you look at the funding growth from the Tasmanian Government for two private schools, since 2014-15 that has grown by 27.5 per cent per student. At the same time, Tasmanian Government funding for public school students has increased by 5 per cent per student.
I represent an electorate that has pockets of disadvantage, and I suspect there are very high smoking rates in some suburbs in my electorate. There would only be one or two schools that would be above the national average when it comes to the Index Of Community Socio-educational Advantage. Most of my schools would be well under that national average, and a lot of the parents would be in the bottom quartile. In fact, in a school I taught at - you can look this up on the My School website - I think a large majority of the school population was in the bottom quartile.
Our attainment rates as a state have gone backwards for the third year in a row, and are at 58 per cent. Retention rates dropped in 2020 to 73.9 per cent, compared to the national average of 82.1 per cent. We have had a debate regarding NAPLAN in this Chamber, and NAPLAN figures over the past decade show Tasmania has gone backwards in half of the indicators assessed across grades 3, 5, 7 and 9.
If I look at what that means in my electorate, I looked at the unemployment rate. The most up-to-date figure I could get by municipality was 8.4 per cent, and that was in the September quarter in 2020.
Where I am getting to is that smoking is a symptom of disadvantage. If we are serious about this health issue, or any other health issue, as a parliament we should demand of the Government serious improvement and serious intervention in our education outcomes. Until we do that, we are going to have these bandaid solutions for a whole range of problems. That is where my focus is as a member of the parliament.
I want to see those indicators improve, because the by-product will be that smoking rates will improve, and that is where we should all be focused.
I welcome the Education minister being ambitious with some targets, but I have heard him be ambitious around targets before. Just recently in March, he announced that all young people in year 7 will meet the expected reading standard, or above the national minimum standard, by 2030. What he is proposing is a significant change in practice. There was no dollar figure attached to how he was going to implement that. There was no mention of that in the Premier's Address.
Arguably, this is our greatest challenge as a state. It is arguably the biggest lever we could pull to improve Tasmanians' lives, to improve their health outcomes. I just wanted to make that point, Mr President.