Plain packaging works: Australia shows fastest decline in smoking rates in over 20 years

Latest research results from Australia on its standardised packaging of tobacco products are very encouraging. Official data from its latest national survey show the fastest decline in smoking rates in over 20 years with an 11 per cent relative reduction in the prevalence of smoking.

Customs and excise data in the same survey show a fall of 3.4 per cent in tobacco sales by volume in the first year of the legislation. This led to a Financial Times report in June declaring "Australians are consuming less tobacco than at any time since records began in 1959". Ireland needs similar headlines year-on-year if the Government's policy to make Ireland tobacco free by 2025 is to be achieved.

This will not be easy. But Ireland has been taking the right steps. The interventions scientifically shown to be effective in reducing tobacco use are well established and enshrined in the legally binding Framework Convention for Tobacco Control treaty which Ireland and 145 other countries have ratified. Ireland has proven to be a champion for the treaty and it has also been incorporated into the Government’s tobacco-free Ireland plan. While price increases through taxation are regarded as most significant, there are many other viable interventions aimed at reducing demand for tobacco. These include smoke-free laws, advertising bans, restriction of access to cigarettes for, and advertising aimed at, children, the banning of advertising at point of sale and smoking cessation services.

Ireland has taken the lead in a number of these initiatives – most notably smoke-free legislation banning smoking in the workplace including pubs, clubs, and restaurants. This intervention, introduced by Micheál Martin as minister for health, marked its 10th anniversary last March and has forever changed the culture of smoking in Ireland.

The landmark legislation has been replicated all over the world, reducing heart attacks, strokes and respiratory disease by limiting the public’s exposure to secondhand smoke. It has also resulted in some 1,250 fewer deaths annually in Ireland from heart disease, stroke and COPD every year since it was introduced.

Mortality

Our research at the TobaccoFree Research Institute has shown the smoke-free law also reduced inequalities in health which very few other interventions except price increases have succeeded in doing. Among the many tobacco control interventions, it alone has been shown to reduce inequalities in mortality from these diseases between the well-off and the more disadvantaged in Ireland. This is a remarkable finding, particularly during the recession.

Ireland is taking a fresh and highly significant leadership role in deciding to introduce standardised tobacco packaging. It is the first country in the northern hemisphere to do this, although other countries (most notably Britain) are also considering its introduction. It also supports the EU Tobacco Products Directive which must be incorporated into Irish law by 2016. The Government and former minister for health James Reilly are to be congratulated on this bold and hugely important initiative which will play an enormous part in reducing tobacco addiction and consequent illness, disability and death.

Dr Reilly consistently declared his determination to rid our children of the scourge of tobacco addiction, knowing the vast majority of smokers start before the end of their teenage years. In that regard, this initiative will make a very significant contribution. All research to date shows packaging is central in attracting children to tobacco. When stripped of their alluring colours and logos and replaced with textual graphic and health warnings, the packages will transform the relationship between teenagers and tobacco. It will also prevent the industry from making untrue evocations through descriptors such as “mild” or “light”.

The tobacco industry are opposed to this legislation. They argue it is a waste of time and will make no difference to smoking prevalence. They also perpetuate the notion that it will ruin trade, cause a loss of jobs, and increase illicit trade. The industry had challenged the Australian law, making similar statements regarding that law. However, the figures released in the Financial Times expose the real reason behind tobacco industry opposition: the law works!

Minister for Health Leo Varadkar has lent his support to the Bill and it appears Dr Reilly will still have a role in tobacco control as Minister for Children. Still, it has been reported that the Bill has gone to the EU, as is required practice, and that it will be delayed by Europe. It is difficult to see why this is assumed and why is it reported as seemingly inevitable.

Tobacco control

Nationally and internationally, the Irish Government, and Dr Reilly’s role in particular, in furthering tobacco control, is recognised. He was a recipient of the prestigious WHO World No Tobacco Day award, particularly for his role in shepherding the Tobacco Products Directive through the EU council of ministers.

The tobacco industry may feel the removal of Dr Reilly as minister for health may help it achieve its aims – specifically, to use tactics to oppose, stop or delay any tobacco control initiative which could save lives, increase health and free our children from tobacco addiction.

It is widely recognised that the tobacco industry operates in this fashion. Their jobs and their industry depend on people smoking and living in active tobacco addiction even if the end point is years of disability and the premature death of half the people who use their product.

Dr Reilly hasn’t gone away and neither has the Public Health (Standardised Packaging of Tobacco) Bill 2014.

The Government needs the Bill to achieve its admirable objective of a tobacco-free Ireland by 2025.

Prof Luke Clancy is director general of the TobaccoFree Research Institute Ireland