“The success in Australia is going to be the success of the world” … Margaret Chan, the head of the World Health Organisation. Photo: Simin Wang
Australia’s plain-pack laws are pivotal in the global battle to cut smoking, writes Amy Corderoy.
The troops are rallying. And as their tiny general takes the stage, the feeling of victory in the air is palpable.
Margaret Chan, the head of the World Health Organisation, will fight this battle to the death.
She addresses her enemy: ”You run a killing and intimidating industry, but not in a crush-proof box. The number and fortitude of your public health enemies will damage your health – tobacco industry.”
Advertisement: Story continues below <iframe src=”http://ad-apac.doubleclick.net/adi/onl.smh.news/national/health;cat=national;cat1=health;ctype=article;pos=3;sz=300×250;tile=3;ord=9.7210498E7?” width=’300′ height=’250′ scrolling=”no” marginheight=”0″ marginwidth=”0″ allowtransparency=”true” frameborder=”0″> < /iframe>
Her army, equipped with research papers and funding grants, gathered this week for the World Conference on Tobacco or Health.
And all their eyes are on Australia.
”The success in Australia is going to be the success of the world,” Chan tells the audience filling the vast ballroom of Singapore’s Suntec Convention Centre. ”It has to be a success because many countries are looking to Australia for leadership and inspiration.”
”Can we allow this to fail?” she asks.
”No,” the crowd mumbles.
”You are soft today, say it again!”
The stakes are high. Tobacco campaigners used to quote the shocking figure that in the 20th century tobacco killed 100 million people, more than all wars combined. Based on present smoking rates, in the 21st century 1 billion people will die from tobacco-related illnesses.
When federal laws requiring plain packaging for all tobacco products come into force in December, Australia will become the first country in the world to completely ban all tobacco advertising.
Public health advocates believe the legislation could be the beginning of the end for Big Tobacco – and that thought must also have crossed the mind of the industry.
There are now three separate court cases fighting the laws. In February last year, Philip Morris Asia bought Philip Morris Australia, allowing it four months later to launch a suit claiming the legislation violated a trade agreement with Hong Kong.
The company, along with British American Tobacco, Imperial Tobacco and JT International, have launched an action in the High Court claiming the move is unconstitutional.
And Ukraine, a country in which nearly half of 13-year-old boys and one in three 13-year-old girls have tried cigarettes, has begun proceedings against Australia under World Trade Organisation laws.
Anti-tobacco campaigners have long argued that sleek market-researched cigarette packets are the last method tobacco companies can use to promote their brand.
The director of the Public Health Advocacy Institute and a professor of health policy at Curtin University, Mike Daube, says he has no doubt the fight against tobacco is being won in developed countries. ”For the first 20 to 25 years I worked in tobacco, people would be saying: ‘You’ve failed, you’ve failed.’ Now they’re asking: ‘What’s the secret to your success?”’
This week Daube was awarded the equivalent of the Oscar of public health campaigning, the American Cancer Society’s Luther L Terry distinguished career award.
His personal success, and popularity, he can’t walk five metres around the conference centre without a wave hello or a friendly word, reflects Australia’s golden moment on the global stage.
The Department of Health and Ageing and Victorian researcher Melanie Wakefield were also recognised, meaning Australians took a third of the award’s prizes.
Daube believes that by 2025 only 5 per cent of Australians will smoke, down from 15 per cent now and 30 per cent in the late ’80s. ”We are definitely winning,” he says.
Daube argues the court challenges are to delay plain packaging, and they will not be able to stop its implementation. And as soon as there is a major victory a domino effect is likely, with Britain, New Zealand and some Nordic countries likely to follow.
All it takes is for countries to appoint health ministers willing to take on the fight. And it’s for that reason the tobacco industry will use everything it’s got to fight this to the bitter end, Daube says.
Perhaps unluckily for them, Jane Halton is no stranger to a fight. Before moving to health after the 2001 election, the secretary of the Department of Health and Ageing ran the Department of the Prime Minister and Cabinet, and survived brutal political scrutiny of her role in the ”children overboard” affair.
She says that in her 30-year career in the public service she has never seen anything like the tobacco industry’s response to plain packaging. ”It’s unprecedented.”
Since April 2010, her department has received 54 Freedom-Of-Information requests on the policy, 53 of which were from the tobacco industry. Unlike most requests, which are finely crafted to hone in on a particular document, they seem designed to cause the department as much trouble as possible.
”This is not a quest for information, this is a very deliberate action to actually drain my resources, there’s no two ways about it,” Halton says.
After months of negotiations the claim is often withdrawn or modified, which can begin the costly process all over again. Halton says every line of redaction is appealed. The requests often involve calling back hundreds of files from archives and thousands of documents.
”They might ask for all documents pertaining to a particular topic for a 10-year period,” she says.
One FOI request from British American Tobacco alone cost her department $643,000 to process.
Halton, who describes Chan as a personal friend, seems comfortable on the world stage. But the second-generation career public servant (her father, Charles Halton, ran the Department of Transport under Gough Whitlam), is probably not used to the role of bureaucrat-as-hero she has been bestowed in Singapore.
She says the department is aware of the intense international interest focused on plain packaging and just why the tobacco industry is so worried about it.
”It’s not that hard to work out that the techniques that we have been using, which have had a demonstrated effect in our country, can and will be picked up by other countries,” Halton says. ”Ultimately there is a logical end point to that, which is why tobacco companies are fighting so hard.”
Australia is committed to achieving a smoking rate of 10 per cent and is one of several countries that are on the cutting edge in terms of their low smoking rates.
”I would be delighted if the rate of smoking in Australia was zero. I’m not sure ultimately what the final number will be, I don’t have a crystal ball,” Halton says.
She says developing new anti-smoking measures is as important today as it ever was. ”There is a new generation coming forward every year who are the potential customers of Big Tobacco,” she says.
And that is what keeps the battle going. For every adult that quits there is a teenager waiting to take their place. For every developed country that implements anti-tobacco measures there is a developing country with an emerging market ready to be tapped.
In the Solomon Islands, more than 41 per cent of the population smoke. In Nauru, it’s almost 53 per cent. Chinese men alone smoke one-third of the world’s cigarettes.
On a typically sweltering day 10 years ago on Singapore’s Orchard Road, a glamorous young woman paused for a moment, gazing in a shop window. She reached into her designer bag and pulled out a white tipped ”mild seven light” cigarette.
Joanna Koh was 18 when she started smoking, on her breaks at work. ”I liked the sense of relaxation and fun, we were young and we could do whatever we wanted,” she says.
In Singapore, Koh is the perfect example of what anti-tobacco campaigners fear most. Young, educated women who are fashion conscious and now have money to burn on the deadly habit. The difference is Joanna eventually quit and has joined a Singapore government campaign to convince other young people to do the same.
Singapore reached a historic low smoking rate of 12.6 per cent in 2004, before creeping back up to 14.3 per cent in 2010, and in that time the number of female smokers increased more rapidly than male smokers.
While the overall number of women smokers is still low (a little more than 4 per cent compared with almost 25 per cent among men), it will take only a small increase in women picking up the habit to have a massive public health impact.
”We are very concerned about young women smoking primarily because the industry is targeting women,” says Susan Mercado, the team leader of the Tobacco Free Initiative in the WHO’s western Pacific regional office. Her job is to help the 37 countries in the region, including Australia, to implement the Framework Convention on Tobacco Control, the bible of tobacco control. Mercado says increasing prosperity is a double-edged sword for women, as they become a bigger target for the tobacco industry.
”They know that women in this day and age, especially in Asia, they have got jobs, they are independent, and they see women as their new market, they are very aggressive,” she says.
Mercado says tobacco marketing links smoking with freedom and independence, and cigarettes and their packets are often brightly coloured or decorated with popular characters such as Hello Kitty.
”The cigarette packet is becoming a battleground now and the tobacco industry doesn’t want to let go of that,” she says. ”Plain packaging for us is a cutting-edge intervention – I think it’s inspiring a lot of countries to go above and beyond what they are already doing.”
Mercado says as the tobacco industry has lost credibility in its fight with public health advocates, it has shifted its tactics. ”The industry is moving towards trade and litigation and away from our area of comfort, which is public health,” she says.
The WHO is now being forced to take on the role of legal defender, to add lawyers and trade experts to its panels of doctors and health professionals, with the backing of rich philanthropists such as the Bill and Melinda Gates Foundation and Bloomberg Philanthropies. The latter this week announced $US220 million ($211.5 million) to go to anti-tobacco campaigns, bringing its total contribution to more than $US600 million.
Amy Corderoy attended the World Conference on Tobacco or Health courtesy of the Singapore Health Promotion Board.
Read more: http://www.smh.com.au/national/health/fight-may-cost-big-tobacco-a-packet-20120323-1vp5d.html#ixzz1q8ciSUvS