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House of Assembly - Fifty-Fourth Parliament, First Session (54-1)
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Motions

World No Tobacco Day

Mr PICTON (Kaurna) (10:39): I move:

That this house—

(a) acknowledges that 31 May is the UN World No Tobacco Day;

(b) recognises the thousands of South Australian families impacted by the damage caused by smoking every year;

(c) continues to support measures to reduce the smoking rate, especially those designed to prevent young people from becoming smokers; and

(d) notes the significant policy progress made to reduce South Australian smoking rates over the past decade, including smoke-free outdoor dining areas.

I rise to speak on the important matter of UN World No Tobacco Day, which is being held tomorrow. This is, of course, a very important day on which we acknowledge the harm that is caused by tobacco smoking. This is something where we have taken tremendous action over the past 30 to 40 years in South Australia and indeed across Australia and much of the Western world in terms of combating the dangerous health effects of tobacco smoking.

The latest South Australian data, for 2016-17, from the South Australian Health and Medical Research Institute shows us that smoking rates are now at the lowest ever level recorded for this state. However, there is still 14.9 per cent of South Australians aged 15 and over who are smoking. We know the significant health effects smoking has in terms of cancer, heart disease and a whole range of other health effects, which result in thousands of Australians dying each year from tobacco-related illnesses.

We must be doing everything we can as a parliament and as the government to ensure that we reduce that number even further to prevent many more people from being susceptible to tobacco-related diseases. The statistics also show that in 2016 there were still 12.3 per cent of young people aged 15 to 29 smoking, so there are obviously a significant number of people in the younger age demographic we need to target as well. While we have had great success in the past decade or so in reducing that rate, there is still much more that we can do to reduce it even further.

The devastating effects of smoking are of course felt not just by the individuals themselves but also by their loved ones. The loss of a family member to smoking and tobacco-related diseases is very heartbreaking, as is the knowledge particularly that this loss could have been prevented. Of course, we know that smoking impacts our health system more broadly. In particular we have increased pressure on our hospital system and the rest of our health system because of the pressures of tobacco-related disease. Also, all of those incidents and admissions to our hospitals would be preventable.

Prevention is better than cure in this regard. We must continue to do everything we can to take on the terribly addictive habit of smoking. This is something that I have long had an interest in. I spoke about in my maiden speech and have worked previously, before entering this house, in the area of tobacco-related disease. In particular I worked for a number of years on the introduction of tobacco plain packaging. We now see this across Australia, and also countries around the world are implementing this reform. It was a very difficult reform to implement but is one which was so important in reducing the ability of the last vestige of tobacco companies to advertise their products and create glamour associated with the brands of smoking.

I am also proud that over the course of the Labor government that we had in this state for 16 years we did so much to reduce smoking in this state, whether it was campaigns that we ran or the laws that we implemented to take further action in regard to tobacco smoking. We saw significant steps over that period of time in terms of limiting the areas of smoking, particularly in licensed venues. The most recent of those reforms were in terms of limiting smoking in outdoor dining areas; that has been implemented in this state. We also saw reforms such as limiting smoking in cars where children are present. Those reforms led the country as well. They were designed to prevent vulnerable people—children—from being susceptible to second-hand smoke in the confined space of a vehicle.

We believe that in those areas, such as a car, or a meal space in terms of a licensed venue, people should be free from second-hand smoke. It also sent the message that smoking is becoming less and less acceptable by community standards in our community. We must continue to progress this view. I think another area that needs to be progressed, that we have debated at length over the past couple of years in this parliament, is in relation to e-cigarettes. We had a select committee of the parliament that you, Mr Speaker, were a member of, as well as myself and the member for Hurtle Vale, the now member for Black, and the former member for Elder, in which we recommended a series of reforms that our state needs to implement into what is the largely unregulated field of e-cigarettes.

That select committee produced a bill which the government introduced, which passed this house but was stalled in the other place. We have not seen those reforms implemented because that bill lapsed before the election. In my new role as the shadow minister for health, I have been calling upon the health minister to reintroduce that legislation. I hope that he will do that very rapidly because it is an important piece of legislation to ensure that there is regulation in place covering that field of e-cigarettes, firstly because we know that in that field, while some people claim they are perfectly healthy, there is a lot of evidence that that is not the case and that these products could potentially be dangerous for people.

Secondly, we know that there is currently a risk of people under the age of 18 being exposed to these products. There is currently no age limit restrictions upon their sale in South Australia, so we need to limit that. We need to limit the potential advertising of these products so as not to be a gateway back into smoking tobacco as well. We know that there are a number of tobacco companies that now have e-cigarette lines, and the risk, that they are promoting these e-cigarettes as a way of therefore promoting the glamour of smoking again, is a real and dangerous one and one that we should be seeking to prevent in South Australia. I think that those regulations are very important and I call upon the government to reintroduce the legislation as soon as possible in this house.

Another area that I will be calling upon the government to ensure that action is taken on, and something that was started under the previous government as well in my time as Corrections minister, is the implementation of a ban on smoking in our Corrections facilities. We have implemented this already in the Adelaide Remand Centre, but it is not currently in place in other Corrections facilities across South Australia, yet it is in place in most of the facilities across the country. We think that is something that the government needs to implement. We said that we would do so by the end of next year, and I hope that the government is working towards that goal and continuing to implement that goal and we certainly, together with the member for Elizabeth and I, will be seeking to make sure that the government is working towards that.

We know when we look at that 14.9 per cent of South Australians that do smoke still, a lot of them are in vulnerable population groups, whether it be prisoners or people who have been involved in the criminal justice system. People who have mental health issues are another significant segment of that 14.9 per cent. We know that the rate of smoking amongst Aboriginal people is a lot higher. We know that smoking amongst lower-income people is higher as well.

We must continue to strive towards reductions in terms of all of those high-risk groups where we do see higher rates of smoking. In a lot of those areas it is more difficult to implement measures to reduce the smoking rate, but it is very important that we continue to drive down that rate of smoking, because we know what damage it is going to cause, not only to those people themselves, not only to their families, but also to our health system and the community more broadly.

I hope that the government takes this message seriously on World No Tobacco Day. I hope that they will continue to take measures, those important measures that I have mentioned, that reduce the smoking rate in South Australia. We also know the importance of social media and advertising campaigns that really drive home that message continually to people and get home those messages about the importance of quitting. We hope that we do not see any reductions in those efforts across South Australia. I ask all members and the whole community to pay close attention to this World No Tobacco Day and let's all work together to try to drive down the rates of smoking even further in South Australia.

Dr HARVEY (Newland) (10:49): I am pleased to rise today to speak in support of the private member's motion moved by the member for Kaurna to acknowledge UN World No Tobacco Day, which is on 31 May each year. This day highlights the health risks associated with tobacco use, promotes effective policies to reduce tobacco consumption and supports smokers to quit. The focus for World No Tobacco Day this year is tobacco and heart disease, which is really to highlight the significant links between smoking and cardiovascular disease.

Smoking is responsible for the hospitalisation of almost 150,000 Australians each year, 15,000 deaths across the country and 1,140 fatalities in South Australia each year. Smoking is also estimated to cost the South Australian economy around $2.3 billion each year. Moreover, a 2016 report from the Australian Institute for Health and Welfare found that smoking was the leading risk factor contributing to death and disease in Australia, responsible for 80 per cent of the burden of lung cancer and 75 per cent of chronic obstructive pulmonary disease.

The Marshall Liberal government is committed to encouraging South Australians to make healthy choices, and not smoking is an example of a healthy choice. The government certainly supports investments in effective prevention strategies to reduce the total number of people who smoke and also to reduce the number of those who have the greatest risk of taking up the habit in the first place. Over recent decades, there has been a significant reduction in smoking rates in South Australia. Smoking rates have halved over the last 20 years and dropped by almost 5 per cent since 2013. Importantly, a significant drop has also been seen in the number of South Australian high school students who have ever smoked, and now 86 per cent of high school students are reported never to have smoked.

Despite these recent successes, there still remains much more work to do to see further reductions in smoking rates, particularly amongst high prevalence groups. These measures should include strong mass media campaign strategies encouraging smokers to quit; robust legislation around the sale, marketing and use of tobacco products; and smoking cessation support services such as the Quitline counselling service, a service that is run by Cancer Council SA and funded by the state government.

The government has a number of policies designed to continue to see reductions in smoking rates and to reduce the negative health effects of smoking in general, in particular passive smoking. A focus on the creation of smoke-free public areas to protect nonsmokers from passive smoking will reduce the visibility to children, so that children do not see people smoking as often, and assist recent quitters to sustain their efforts, which will ultimately help to reduce the rates of tobacco-related disease and the associated impacts on the health system as a whole.

The government will also undertake a review of the effectiveness and scope of current legislation restricting smoking in outdoor dining areas to address any loopholes that may exist in the current legislation. The government will also implement plans to make all South Australian prisons smoke free by 2019 and this will, of course, be undertaken ensuring that there is appropriate support for both prisoners and staff.

The government will also work with other jurisdictions to ensure that tobacco control legislation in South Australia and nationally is properly enforced. Tobacco control is an important part of the government's broader agenda and plans for preventative health care to reduce pressure on our hospitals and health systems, which will ultimately improve the health outcomes for all South Australians.

Mr BROCK (Frome) (10:54): I also rise to speak to the motion put forward by the member for Kaurna. Every year on 31 May, the World Health Organisation and partners mark World No Tobacco Day, highlighting the health and other risks associated with tobacco use and advocating for effective policies to reduce tobacco consumption.

World No Tobacco Day 2018 will focus on the impact tobacco has on the cardiovascular health of people worldwide. It will highlight the links between the use of tobacco products and heart and other cardiovascular diseases, increase awareness within the broader public of the impact tobacco use and exposure to second-hand smoke has on these health issues, and provide opportunities for the public, governments and others to make commitments to promote heart health by protecting people from the use of tobacco products.

Tobacco use is an important risk factor in the development of coronary heart disease and strokes as well as cardiovascular disease (CVD). Despite the known harms of tobacco to heart health and the availability of solutions to reduce related death and disease, knowledge among large sections of the public that tobacco is one of the leading causes of CVD is very low. Tobacco use is one of the largest causes of preventable, non-communicable diseases including cancers, heart and lung disease.

The legislation of plain packaging for tobacco products entails restricting or prohibiting the use of logos, colours, brand images or any other promotional information other than brand and product names displayed in a standard colour and font, thus preventing the display and temptation to people and making it more difficult to tempt people to take up smoking. Previously, the packaging of various brands of tobacco was one of the main reasons that many people started to take up smoking. This was seen a long time ago in commercials in cinemas, etc., especially commercials like the 'Marlborough Man' advertisements, which made it look as though this was the great new thing to do.

Tobacco also diverts valuable household income. It has been proven that plain packaging reduces the attractiveness of tobacco products, restricts tobacco advertising and promotion, limits misleading labelling and increases the effectiveness of health warnings. I have known many people who actually spend more money on tobacco and cigarettes than they do on feeding their own children. Over and over again we have seen how industry, fuelled by its deep pockets, has been able to develop new strategies in an attempt to protect profits generated from its deadly products. In the case of plain packaging, that has been the target of a massive tobacco industry misinformation campaign dating as far back as 1993.

CVD kills more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 12 per cent of all heart disease deaths. Tobacco use is the second leading cause of CVD after high blood pressure. The global tobacco epidemic kills more than seven million people each year, of which close to 900,000 are nonsmokers who are dying from breathing second-hand smoke. Nearly 80 per cent of the more than one billion smokers worldwide live in low and middle-income countries, where the burden of tobacco-related illness and death is heaviest.

In 2014, lung cancer was the leading cause of cancer deaths in Australia, and it is estimated that it will remain the most common cause of death from cancer in 2018. In 2014, the age-standardised mortality rate was 31 deaths per 100,000 people (40 for males and 23 for females). The mortality rate of lung cancer will generally increase with age for both males and females. In 2017, it is estimated that the risk of an individual dying from lung cancer by their 85th birthday will be one in 23 (one in 18 males and one in 29 females).

The number of deaths from lung cancer increased from 2,883 in 1968 to 8,251 in 2014. Over the same period the age standardisation mortality rate increased from 32 deaths per 100,000 in 1968 to a high of 43 per 100,000 in 1989, before decreasing to 31 deaths per 100,000 in 2014. The decrease in mortality largely has been seen in males, while age standardisation rates for lung cancer in females has been lower than in most males. The age standardisation has increased in females to 23 per 100,000.

From a personal point of view, my first exposure to smoking was in my early days. Both my parents were smokers, my dad being a heavier smoker than my mother. However, I can vividly remember travelling in our car with both parents smoking. Bear in mind that in those days there were no air conditioners in cars and the windows were always up. At that point, because of the movies, etc., and the portrayal of men smoking, it appeared to me that this was the thing to do. How wrong I was.

My first attempt at having a smoke was at the local football game while I was working on the scoreboard. I was 14 years of age and my mates lit up an Alpine cigarette, which was in a green packet. They beckoned me to have a puff with them, saying how great it was. Well, I coughed, spluttered, turned green and looked similar to the Alpine packet, and that was my last attempt at smoking.

As my dad got older his lungs were deteriorating, and he was then getting emphysema and at times had to have an oxygen bottle for breathing. When he was told of the damage that had been caused to his lungs over the many years, and was finally accepting the truth, he was advised to give up smoking. However, my dad being very stubborn, asked, 'Will it make any difference to me?' and when the doctor answered, 'No it won't,' he then stated, 'Well, I may as well have some sort of enjoyment until my dying days.'

This was very traumatic because seeing my dad go through that, and seeing other people's loss of lifestyle, etc., and the impact on the family, is just one of those things I will never forget. Whilst there may have been some enjoyment for him, it certainly was not enjoyable for his family to watch him, especially his grandchildren. I strongly urge people to look at the facts and the dramatic photos of the lung cancers and the affected lungs and give it up. I commend this motion to the house.

Mr PATTERSON (Morphett) (11:02): The motion before us asks the house to acknowledge UN World No Tobacco Day, the focus of which this year concentrates on the impact that tobacco has on the cardiovascular health of people. Smoking is a major cause of heart disease. Smokers are up to four times more likely to die from coronary heart disease than are nonsmokers. Unfortunately, knowledge amongst large sections of the public that tobacco is one of the leading causes of cardiovascular disease is low. While many people know that a diet high in saturated fat leads to atherosclerosis, or hardening of the arteries, rarely do they consider that smoking will play a leading role, along with diet, in causing cardiovascular disease.

It is not just tobacco users who are directly affected but also second-hand smokers, with estimates that tobacco use and second-hand smoke exposure contribute to about 12 per cent of deaths from heart disease. Overall, smoking is responsible for an estimated 15,000 deaths in Australia each year; approximately 1,150 of those deaths are in South Australia. Close to two in three long-term smokers will die prematurely due to smoking, and, additionally, it is estimated that $2.4 billion is lost to the state's economy each year in health costs and loss of productivity related to smoking.

Therefore, the Marshall Liberal government supports and will seek to implement policies that encourage and enable individuals and communities to make healthy choices. As part of this, the government also supports investment in effective prevention strategies to help reduce the number of South Australians who smoke or who are at risk of becoming smokers. This will have an effect on reducing pressure on hospitals and also health services and will result in better outcomes for all South Australians.

A key consideration of this is to reduce the effects of second-hand smoking, and so the member for Kaurna will be pleased to hear that we will move to protect both prisoners and staff from the harms of passive smoking, as the government will ensure that all South Australian prisons are smoke free by the end of 2019. Appropriate support will be provided for both prisoners and staff as this important preventative health measure is implemented. At the same time, the Marshall Liberal government also has a focus on the creation of smoke-free public areas designed to protect nonsmokers from passive smoking. It will also help to reduce the visibility of smoking to children, and will assist recent quitters to sustain their efforts.

Reducing exposure to tobacco smoking will contribute to the reducing rates of tobacco-related disease and, therefore, the reducing health service costs associated with those diseases. As part of this work, the government will undertake a review of the effectiveness and scope of the current legislation restricting smoking in outdoor dining areas. This review will address any loopholes in the existing legislation. One such public area in the electorate of Morphett is the popular Moseley Square in the tourism precinct of Glenelg, where a ban on smoking has been in place since September 2013.

Those who have frequented Moseley Square will notice, especially in the summer months, that there are a lot of children playing either in the fountain or on other attractions, and congregating in groups. Because of this, passive smoking is one area that we need to continue to try to eliminate, especially for these young people. While fines are in place for those caught smoking in this smoke-free zone, to a large extent it is self-regulating and has seen both residents and visitors alike enjoy the benefits of clean sea air.

Initially, this trial was run for 12 months. Based on feedback from businesses, police officers and positive community feedback, including a survey where results showed that over 95 per cent of people who took part in that survey voted in support to continue this area as a nonsmoking zone, I then moved in 2014 that the Holdfast Bay council enact the Moseley Square smoking exclusion zone into parliament regulations.

By reducing the visibility of smoking to children in not only this public place but others like it, the effect will be that children further denormalise smoking, reducing the number who take up the habit in their youth. In fact, figures show that more people are choosing not to smoke now than over the last 10 years. However, this figure remains at approximately one in eight young people who are smoking, and so it is a figure that we need to continue to reduce.

In summary, if World Tobacco Day helps to reduce the number of people taking up the habit while at the same time encouraging those who currently smoke to quit, that can only have a positive effect on the health and wellbeing of South Australia.

Mr PEDERICK (Hammond) (11:07): I rise to support the motion:

That this house—

(a) acknowledges that 31 May is the UN World Tobacco Day;

(b) recognises the thousands of South Australian families impacted by the damage caused by smoking every year;

(c) continues to support measures to reduce the smoking rate, especially those designed to prevent young people from becoming smokers; and

(d) notes the significant policy progress made to reduce South Australian smoking rates over the past decade, including smoke-free outdoor dining areas.

As already stated, the global theme for World No Tobacco Day this year is tobacco and heart disease. Obviously, this highlights the fact that smoking is a major cause of heart disease and smokers are up to four times more likely to die from coronary heart disease than nonsmokers.

Smoking is responsible for an estimated 15,000 deaths in Australia each year, and approximately 1,140 deaths per year in South Australia. As catastrophic as our road toll is, at somewhere around 100 deaths per year in recent times, compared with this figure of 11 times more it shows the impact on the individual directly, obviously, and the loss to their families as well. Close to two in three long-term smokers will die prematurely due to smoking. It is estimated that close to $2.4 billion is lost to the state's economy each year in health costs and lost productivity related to smoking.

The Marshall Liberal government supports and will be implementing policies that encourage and enable individuals and communities to make healthy choices. As part of this, we on this side of the house also support investment in effective prevention strategies to reduce the number of South Australians who smoke or who are at risk of becoming smokers. Despite the decline in smoking in South Australia, evidence shows that driving further reductions, particularly among high-prevalence groups, requires a continuous effort.

Efforts focus on a strong mass media campaign with a strategy encouraging smokers to quit, and robust legislation around the sale, marketing and use of tobacco products. Quite frankly, I am not sure how people can afford to smoke. I think it is about $35 a packet or, as someone calculated recently, about a $1.04 a cigarette. I do not care what salary you are on; it is expensive for a habit. Obviously, there is a legislative framework around the pricing for that very reason. There is quite a high taxation regime around the sale of tobacco and cigarettes. Part of the continuous effort is about having smoking cessation support services such as the Quitline counselling service.

The Marshall Liberal government has a focus on the creation of smoke-free public areas that are designed to protect nonsmokers from passive smoking, reducing the visibility of smoking to children and assisting recent quitters to sustain their efforts. Reducing exposure to tobacco smoking will contribute to reducing rates of tobacco-related disease and reducing health service costs associated with those diseases.

Having grown up in an earlier time, I know it was quite prevalent to have cigarette smoking in bars. I think one of the initial cases was where a barperson took action against their employer about the risk—not just the risk—of contracting cancer in the workplace, so it is significant. For those of us who have been here a little while on this earth, it is how things were in the early days. I can remember when you were out socially there were a lot more people smoking. At work, if you had someone assisting on a farm, they might have been a smoker. Certainly, in the shearing teams I operated in smoking was quite prevalent. As part of the work, we will undertake a review of the effectiveness and scope of current legislation restricting smoking in outdoor dining areas. This review will address any loopholes in the existing legislation.

In regard to prisoners—and I acknowledge that I have Mobilong Prison in my electorate at Murray Bridge—to protect both prisoners and staff from the harms of passive smoking the government will also ensure that all South Australian prisons are smoke free by the end of 2019. So if there are any smokers out there who are keen to break the law, you might want to look at that because you will not be able to have a cigarette when you are inside. Appropriate support will be provided for both prisoners and staff as this important preventative health measure is implemented. I am sure that it will take some work, some counselling and other measures to make sure that gets through.

There will also be robust and consistent enforcement, which will be important to ensure that the effectiveness of tobacco control legislation in South Australia is maintained. This is in combination with strategies at the national level. The Marshall Liberal government does have a strong commitment to initiatives targeting preventative health care, such as tobacco control, which will reduce the pressure on hospitals and health services and will result in better health outcomes for all South Australians. Certainly in my lifetime I have noticed a marked difference in smoking rates wherever you are. In a social setting, we have seen hotels adjust, with more outdoor areas, beer gardens and, even with that, they might have separate smoking areas as well.

Let's face it: smoking is legal, it is highly taxed, but it is a severe health risk, which, as I have indicated, has a massive impost of multiple billions of dollars per year on the South Australian budget. It has to be managed through a health system that—quite frankly, we inherited it—is flat out. It has so much effect on not just the people in South Australia who are directly affected and die from smoking, the over 1,100 who lose their lives, but also the families who are missing out on that loved one who has gone too early.

In some of the advertising campaigns, especially those on television, there is a lady who has to work out how she is going to tell her children that basically she has a death sentence. It is the same for a man who suddenly realises that he has let it go too long and has to tell his wife and family that it is too late and that he should have given it up long before. I think those programs are very effective, as is the advertising on cigarette packets. It is not that I look at cigarette packets very often, but you can see some quite grotesque pictures of what your lungs or heart could look like if you keep up the habit of smoking.

Some people are lucky, but only a few can smoke all their lives. I had a grandfather who died at 86, and he smoked roll-your-own, but I think they are very rare. I do not think it was smoking that killed him in the end. There are a few, but they are very much a minority in that category. As I said in the speech, two out of three people who smoke die prematurely, and that is backed up by statistics. The more we can do to make sure that we do not have those poor outcomes the better, not just for the families, whose lives are significantly impacted, but also for the health system and everyone else who is impacted by the poor choice of smoking cigarettes.

Mr PICTON (Kaurna) (11:17): I thank all the members for their contributions to this debate. As I said in my opening remarks, hopefully this is something about which we continue to see more action taken and we continue to see the government leading what was a strong agenda under the previous government to take more action. I hope we see that in a number of areas I have outlined, in particular e-cigarettes, where we are looking forward to the minister reintroducing the reforms and that bill into the parliament, but also in terms of smoking in our Corrections facilities. Hopefully, we will be seeing action on that as well.

I hope that all the community can note this day, pay attention to this day and encourage as many people as possible who are still smoking to give up and lead a healthier life not just for them but for the entire community.

Motion carried.

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