Submission by the Australian
Taxpayers’ Alliance to the
Intergovernmental Committee on
Drug’s Draft National Tobacco
Strategy 2012 – 2018
Introduction
1. The following is a submission to the Intergovernmental Committee on Drug’s
draft National Tobacco Strategy 2012 – 2018 by the Australian Taxpayers’
Alliance.
2. The Australian Taxpayers’ Alliance (ATA) was launched on 1 May as a grassroots
activist organisations dedicated to protecting the rights of taxpayers against
undue governmental interference. The ATA presently counts over 25,000
members.
3. The Australian Taxpayers’ Alliance is dedicated to firmly opposing excessive
taxation, over-regulation, maladministration of taxpayer funds, and the everencroaching nanny state. For further information, please visit Australian
Taxpayers Alliance website
4. The Australian Taxpayers’ Alliance receives is NOT affiliated with and receives NO
funding from tobacco or associated industries.
Summary
5. The Australian Taxpayers’ Alliance expresses its unreserved opposition to the
proposed recommendations of the National Tobacco Strategy 2012: A Strategy to
improve the health of all Australians by reducing the prevalence of smoking and
its associated health, social and economic costs, and the inequalities it causes.
6. It is submitted that if enacted, these recommendations would violate accepted
standards of medical ethics, and shall unduly burden Australian taxpayers,
particularly low income earners, through further increases in taxation and
expenditure, and shall unfairly restrict the freedom of choice of Australian
consumers.
7. It is further submitted that these recommendations have no sound basis in
evidence, and shall not achieve any public health benefits or lead to a reduction
in smoking rates.
8. The ATA also wishes to note its concern that the Draft Report was not made more
widely available, and that there was no effort made to provide the document to
the public for discussion. Such an approach results in only the most vehement
vested interests submitting comments, with resulting poor governance outcomes.
9. The ATA furthermore wishes to note the extreme hypocrisy that all persons
and/or organisations who lodge comments are required to disclose whether they
receive tobacco funding as a way of smearing their integrity or the validity of their
arguments. The ATA firmly believes that prior to impugning someone’s motives,
their argument must be answered, and this does not seem to be the case in this
instance. Furthermore, the ATA wishes to express its concerns at the double
standard applied by the Intergovernmental Committee, and that neither taxpayer
funded tobacco-control activists, nor bodies sponsored by pharmaceutical
industry with a vested interest in promoting taxpayer subsidies of smoking
cession drugs, are required to disclose funding.
Overall aims and objectives
10. It is submitted that the entire basis of the National Tobacco Strategy as an article
of social engineering to remove individuals’ choice and manipulate their
behaviour is fundamentally flawed. The Australian Taxpayers’ Alliance recognises
the need for appropriate information and awareness of the harms associated
with the use of tobacco. However, as such harms are well established, persons
should be free to choose whether to use tobacco products and accept personal
responsibility for the consequences. The role of government ought not include
the micro-management of personal behaviour
11. It is further submitted that the stated aims of reducing smoking rates to 0% over
the long term discounts the fact that individuals can make the rational choice that
their personal enjoyment of tobacco products outweighs the health costs that
they may suffer as a result. The ATA strongly argues that government bureaucrats
ought not have the right to impose their value preferences on Australian
consumers without exception. As such, the inability of Australians to choose to
‘opt out ‘ of these health measures, and to exercise their own freedom of choice
in regards to their bodies, is gravely disturbing; the concept of “my body, my
choice” is a fundamental principle in all other areas of health policy, it ought
apply here also.
12. The Australian Taxpayers’ Alliance further notes its alarm that many of the
policies used initially to restrict citizens choice regarding tobacco are being used
to regulate other industries, such as alcohol and various foods and beverages.
There is no doubt whatsoever that the slippery slope argument once derided by
tobacco-control advocates has been conclusively proven. As such, if this draft is
enacted, empirical evidence from other campaigns suggests that its
recommendations shall be expanded to other industries.
Medical ethics & public health intervention
13. It is submitted that within the field of medical ethics, the principle of autonomy
has established itself as the guiding principle for any health intervention
14. We note the words of Feiring writing in the Journal of Medical Ethics as
expressing the core underpinnings of the field of medical ethics as it pertains to
public health intervention:
Given that respect for the autonomous choices of patients runs
deep in modern healthcare, there are strong reasons to value the
claim that competent and well-informed individuals are the best
interpreters of their own interest and that they should be free to
make choices others would regard as non-beneficial to them
(Feiring E, Lifestyle, responsibility and justice. Journal of Medical
Ethics 2008 34: 33–36.)
15. In determining when public health outcomes may justify over-riding the principle
of autonomy, two criteria are commonly used by proponents of intervention: 1)
That individuals lack the capacity to choose, and 2)That health care costs justify
the intrusion.
16. It is submitted that neither of these conditions ought be considered valid in this
case for the reasons articulated by Dr. Michael Keane, a member of the ATA
Board of Advisers and Adjunct Lecturer School of Public Health and Preventive
Medicine, Monash University:
What standard should be used when judging people’s competence to
autonomously choose to consume a product? Electing to do something that
may lead to a harmful outcome does not define a lack of understanding of
the consequences. (Keane, M. Public Health Interventions Need to Meet the
Same Standards of Medical Ethics as Individual Health Interventions.
American Journal of Bioethics. Volume 10, Number 3 2012 p37)
17. Dr. Keane further developed these thoughts in a submission to the Public
Consultation on Plain Packaging of Tobacco Products:
In order to justify such proposals, it would need to be
convincingly demonstrated that adult smokers do not have the
capacity to understand the adverse effects of smoking. This is
clearly not the case. Secondly, although some may believe the
argument that smoking is due to a nicotine addiction and
people, therefore, cannot make a voluntary decision, this is
factually inaccurate. While it may be difficult for persons to
cease smoking, it is a decision that rests with the individual. All
international psychiatric classifications come to the same
agreement. If it was not ultimately a voluntary behaviour it
would be classified as a psychotic condition. This is not the case.
18. As such, it is submitted that the argument that individuals lack the capacity to
choose, and as such there ought be governmental intervention, is invalid.
19. In examining the argument that the cost of health care ought over-ride autonomy,
it is firstly submitted that the evidence demonstrates that through a combination
of higher taxation and lower lifespan expenditure, smokers are not a net cost on
the Australian taxpayer. It is secondly submitted that even if that were not the
case, this line of argument is not ethically valid.
20. Numerous international studies have examined the cost to taxpayers of smokers
and demonstrated that smokers, on net¸ save taxpayers money. Obviously, it is
not the position of the Australian Taxpayers’ Alliance that smoking is a positive
due to the cost savings. However, the evidence (as listed by Christopher Snowdon)
does demonstrate that the premise underlying the argument that autonomy
ought be curtailed due to the cost of healthcare is factually inaccurate:

A more complete accounting of the health costs of smoking not
only increases the size of the costs, but also reallocates costs
and implies net financial benefits for some parties. Governments
save on the costs of old-age medical care, social security, and
nursing home care due to the earlier death of smokers. (This
result does not mean that it is desirable that people die early; it
means that in determining financial cost, if that is the
justification for a payment, a correct measure of the loss will
only be calculated if these effects are included.) Smoking has
apparently brought financial gain to both the federal and state
governments, especially when tobacco taxes are taken into
account. In general, smokers do not appear to currently impose
net financial costs on the rest of society. - The Proposed
Tobacco Settlement: Who Pays for the Health Costs of
Smoking? Gravelle, 1998

Net additional external costs borne by non-smokers worked out
to $244 million for Canada in 1986. However, smokers are
responsible for a much larger flow in the other direction. In the
pension area alone, non-smokers benefit from a transfer of $1.4
billion mainly because smokers tend to die before non-smokers
do if we use risk coefficients established by the medical
profession. Finally, the massive tax burden borne by smokers
alone means that they account for a further transfer of close to
$3.2 billion to the benefit of non-smokers. Smokers' burden on
society: Myth and reality in Canada, Raynauld, 1992

Despite the higher annual costs of the obese and smoking
cohorts, the healthy-living cohort incurs highest lifetime costs,
due to its higher life expectancy, as shown in Table 1.
Furthermore, the greatest differences in health-care costs are
not caused by smoking- and obesity-related diseases, but by the
other, unrelated, diseases that occur as life-years are gained
(Table 1). Therefore, successful prevention of obesity and
smoking would result in lower health-care costs in the short run
(assuming no costs of prevention), but in the long run they
would result in higher costs. Lifetime Medical Costs of Obesity:
Prevention No Cure for Increasing Health Expenditure, van Baal,
2008

The widespread belief that smokers do not pay their own way is
the result of repeated assertions that are totally lacking in
empirical support. There is simply no evidence that smokers
impose costs on others by making more use of medical care
than do nonsmokers. Social cost and the cigarette excise tax: A
misguided rationale for an inefficient and unfair policy, D. Lee,
1995

The proper goal of tobacco taxation policy should be to recoup
only the extra costs that smokers place on others (at most a
$1/pack tax on cigarettes) Risk perception, addiction, and costs
to others: An assessment of cigarette taxes and other antismoking policies, Menzel, 2005

On balance, most studies find that smokers cost the
government less in terms of health care outlays than the sum
of what they save the government in unclaimed retirement
benefits and pay the government in tobacco taxes at existing tax
rates. Confusing, misleading CDC figures on economic costs of
smoking, Entin, 2002

Although nonsmokers subsidize smokers' medical care and
group life insurance, smokers subsidize nonsmokers' pensions
and nursing home payments. On balance, smokers probably pay
their way at the current level of excise taxes on cigarettes; but
one may, nonetheless, wish to raise those taxes to reduce the
number of adolescent smokers. In contrast, drinkers do not pay
their way: current excise taxes on alcohol cover only about half
the costs imposed on others. The Taxes of Sin: Do Smokers and
Drinkers pay their way?, Manning, 1989

The results imply that lifetime expenditure is higher for
nonsmokers than for smokers because smokers' higher annual
utilization rates are overcompensated for by nonsmokers' higher
life expectancy. Population simulation, taking into account the
effects of past smoking on present population size and
composition, suggests that 1976 expenditure would have been
the same if no male born since 1876 had ever smoked. The male
population would have been larger, particularly at older ages,
increasing medical care expenditure, but this increase would
have been offset by lower annual medical care utilization rates.
Thus the results imply that smoking does not increase medical
care expenditure and, therefore, reducing smoking is unlikely to
decrease it. Does smoking increase medical care
expenditure? Leu, 1982

Results: Health care costs for smokers at a given age are as much
as 40 percent higher than those for nonsmokers, but in a
population in which no one smoked the costs would be 7
percent higher among men and 4 percent higher among
womenthan the costs in the current mixed population of
smokers and nonsmokers. Conclusions: If people stopped
smoking, there would be a savings in health care costs, but only
in the short term. Eventually, smoking cessation would lead to
increased health care costs. The Health Care Costs of Smoking,
Barendregt 1997

There was no difference in sickness absence between smokers
and non-smokers, however there was an increase in sickness
absence with increasing Body Mass Index (BMI) (correlation
coefficient 10.9 %-p=0.005) and perhaps surprisingly there was
an increase in sickness absence with increasing exercise
participation (correlation coefficient 7.7% p=0.045). Do smoking,
body mass and exercise affect sickness absence and job
satisfaction?, Critchley (2006)

The study found that although annual health-care costs are
highest for obese people earlier in life (until age 56 years), and
are highest for smokers at older ages, the ultimate lifetime costs
are highest for the healthy (nonsmoking, nonobese) people.
Does Preventing Obesity Lead to Reduced Health-Care Costs?,
McPherson, 2008
21. It is further noted that since many of these studies were conducted, tobacco
taxes have risen substantially and, therefore, the government's net profit from
smokers has increased further, meaning the net effect regarding public health
costs is even greater in terms of monies saved.
22. Even if the aforementioned studies were ignored, it is submitted that the costsavings line is morally and ethically invalid for the reasons articulated by Dr.
Keane in the previously cited piece in the Journal of Bioethics:
If the health care cost argument is accepted, then we have to
accept the ethical precedent that this sets. It would then be
ethically permissible to forcibly inflict medical treatment on a
legally competent adult against that person’s will as long as that
treatment would lower government expenditure.
23. It is submitted that such an argument is morally reprehensible and ought not be
the basis of government action.
24. For the reasons outlined, is submitted that the recommendations of the Draft
Report do not meet the necessary requirements for usurping established
principles in medical ethics and do not meet the requirement to usurp the
established concept of freedom and individual autonomy.
Priority Areas
25. It is submitted that in the event that the ethical and public policy points presented
above prove insufficient to overturn the recommendations, that the specific
action items in the eight priority areas listed are fundamentally flawed, and that
the recommendations are neither desirable nor feasible to attain.
Strengthen social marketing campaigns to discourage uptake of smoking, motivating
smokers to quit; prevent relapse; and reshape social norms about smoking
26. Actions 6.1.1 through 6.1.8 calls on further taxpayer expenditure on social
engineering campaigns, both directly by Australian governments and through
NGO’s.
27. The Australian Taxpayer’s Alliance strongly opposes the implementation of these
recommendations. Australian taxpayers already pay for considerable expenditure
on media campaigns, both directly and through NGO funding, and there is no
justification for the burden on taxpayers to be increased.
28. It is further submitted that Australians are well aware of harm that tobacco may
cause, and that that empirical evidence has demonstrated that the effectiveness
of such campaigns has diminished to the point of being statistically nil, a point
tacitly acknowledged in the report with the plateauing of a decline in smoker
numbers.
29. Furthermore, research conducted at the University of Missouri published in the
Journal of Medical Psychology in August 2011, has found that anti-smoking
campaigns are not only ineffective, but may backfire and retard smoking
cessation:
A combination of disturbing images and threatening messages to
prevent smoking is not effective and could potentially cause an
unexpected reaction. . . . Showing viewers a combination of
threatening and disgusting television public service
announcements (PSAs) caused viewers to experience the
beginnings of strong defensive reactions. The researchers found
that when viewers saw the PSAs with both threatening and
disgusting material, they tended to withdraw mental resources
from processing the messages while simultaneously reducing the
intensity of their emotional responses. Leshner says that these
types of images could possibly have a “boomerang effect,”
meaning the defensive reactions could be so strong that they
cause viewers to stop processing the messages in the PSAs.
30. The writings of Dr. Michael Siegel, a long-time tobacco control advocate
and Professor of Community Health Sciences at Boston University School
of Public Health who previously worked in the office of Smoking and
Health at the CDS Control researching tobacco advertising, prove
instructive:
The key problem with a defensive reaction is that the viewer no longer
attends to the message and processing of the message ends abruptly. In
addition, the message likely induces psychological reactance, a feeling of
threatened loss of freedom and control which is best relieved by ignoring or
dismissing the warning and smoking a cigarette. – For more information
please visit Tobacco Analysis BlogSpot website
31. As such, as there is no convincing evidence of these campaigns being effective,
despite their high cost to taxpayers, it is reiterated that these actions ought not
be taken.
Continue to Reduce the Affordability of Tobacco Products
32. Recommendations 6.2.1-6.2.10 revolve around increasing the burden on
taxpayers, combined with taxpayer subsidies for pharmaceutical companies.
33. Australia presently has a relatively high tax on tobacco and tobacco products
(Sijbren Cnossen, Excise Taxation in Australia, 2009), and one of the highest in the
Asia-Pacific Region.
34. Tobacco excise tax and customs duties generated approximately $7.4 billion in
government revenue during 2010-2011 (For more information please visit
Australian Government Budget website,)
35. Research by the Institute of Public Affairs has revealed that low income earners
are disproportionally hit by such taxes, paying three times more than higher
income demographics (Nanny State Taxes: Soaking The Poor in 2012). As such, it
is submitted that the attack on lower-income earners that these
recommendations for a regressive tax represent are unconscionable as a matter
of public policy fairness.
36. Furthermore, it is noted that, as demonstrated in the IPA report, increasing the
tobacco tax will often lead not to a reduction in smoking, but in dispensable
income that would otherwise be used to purchase other consumer products
being used to purchase tobacco, hurting the retail sector and the Australian
economy.
37. It is further submitted that any increase in tobacco taxes will cause a shift to illicit
tobacco, sourced either via counterfeiting or smuggling.
38. Recent increases in the tobacco excise has already caused a sharp increase in the
illicit trade in tobacco products from an estimated 12.3% of the legal
Tobacco market in 2009 to 15.9% in 2010 (Deloitte, Illicit trade of tobacco in
Australia – June 2011 Update, June 2011, p 3).
39. Although the draft report notes the problem of illicit tobacco, its premise that
only 1.5% of smokers use unbranded tobacco is faulty, as it does not factor in the
fact that many persons do so unknowingly, do not report their use of it, or
purchase branded tobacco from overseas. It is further submitted that the
comments regarding tobacco smuggling in the report may only lip service to the
issue, and shall do nothing to reduce its prevalence.
40. It is submitted that there can be no health benefits from a policy which shall lead
to persons switching from a regulated tobacco product to an unregulated
counterfeit one. According to the World Health Organization Framework
Convention on Tobacco Control, there are an estimated 600 billion counterfeited
and smuggled cigarettes crossing national borders each year ( For more
information please visit Science 2.0 website)
41. In 2009, the UK government reported the loss of 2 billion pounds in tax revenue
through illegal cigarette smuggling (For more information Please visit Telegraph
website).
42. The inferior quality of counterfeit cigarettes will lead to a worsening of health
outcomes if taxation is increased: a 2003 report by the BBC noted that
counterfeit cigarettes contain 75% more tar, 28% more nicotine and about 63%
more carbon monoxide than genuine cigarettes
43. Furthermore, smuggling is a serious crime, with severe consequences. In its
2009/10 Annual Report, The Australian Customs and Border Protection Service
also recognised the growing involvement of organised crime in tobacco smuggling
stating: “Transnational organised crime is growing in its reach and sophistication.
The high profits associated with illicit drug, precursor and tobacco trafficking
ensure that these commodities will continue to attract organised crime
involvement.” Beyond the revenue risk, the report explained, tobacco smuggling
“poses public health risks and the majority of criminal entities involved are
experienced, highly organised and extensively networked.”
44. The Australian Crime Commission has made similar comments in its report,
Organised Crime in Australia 2011 at page 18:
Organised crime networks have been linked to the importation of
counterfeit cigarettes and loose tobacco. Significant government
revenue is avoided through the activities of groups involved in illicit
tobacco importation and illicit growing, curing, manufacture and sale
of tobacco products. The successful interdiction of illicit tobacco
products at the border, the high illicit profits and increases in the
excise duty on tobacco products are likely to increasingly attract
organised crime groups to the illicit tobacco market.
45. The ATA is concerned that for all the lip service paid to tobacco smuggling, the
draft report does not place sufficient emphasis upon the negative impact of
tobacco smuggling, or the fact that people die as a result of the illegal cigarette
trade, just as they do as a result of drug and human trafficking (For more
information Please visit Reporting Project website).
46. In the 1990’s, the smuggling of cigarettes in Berlin caused “a surge in ganglandstyle executions and turf wars that made Berlin streets more dangerous than at
any time since World War II”: “Turf battles between the Vietnamese gangs that
control street-level sales have been blamed for the deaths of 40 Vietnamese, 15 in
Berlin alone. These killings are the latest episode in a bloody gang war over
Berlin's lucrative trade in smuggled cigarettes.” In the Balkans, “high-profile
killings connected to illicit tobacco networks have claimed journalists,
intelligence officers, politicians and the criminals themselves”. In 2009, police
just outside Washington DC arrested 14 members of a contraband cigarette ring
for attempting to murder their competition.
47. Furthermore, the shift from legal to illicit tobacco shall create significant
opportunities for illegal and terrorist organisations to benefit. A 2003 report by
the US-based non-partisan Cato Institute concludes that “a wide range of
terrorist groups are known to use the proceeds from cigarette smuggling to fund
their operation. For example, counterfeit cigarette tax stamps were found in an
apartment used by members of the Egyptian Jihad cell that carried out the 1993
bombing of the World Trade Center.”
48. In 2008, a U.S. House of Representatives Homeland Security Committee report
concluded that “Law enforcement officials in New York State [alone!] estimate
that well-organized cigarette smuggling networks generate between $200,000$300,000 per week. A large percentage of the money is believed to be sent back to
the Middle East, where it directly or indirectly finances groups such as Hezbollah,
Hamas, and al-Qaeda.” Examples of terrorism being financed by tobacco
smuggling are numerous. In 2001, Aref Ahmed was convicted of smuggling
tobacco to finance the infamous “Lackawanna Six” Islamic-terror cell’s
attendance at al-Qaeda’s al Farooq training camp in Afghanistan. In 2002, 26
Hezbollah terrorist cell agents in North Carolina were convicted for selling $7
million worth of bootleg tobacco, planning to use the funds to buy advanced
aircraft analysis and design software, blasting equipment, ultrasonic dog
repellents, munitions and other military hardware. At least $1.5 million dollars in
tobacco smuggling proceeds was directly forwarded to Hezbollah by Mohamad
Hammoud, along with laptops, night-vision goggles, stun guns, blasting
equipment, and more. Finally, in 2010, Hazam Ali Ahmed pled guilty for raising
approximately half a million dollars through tobacco smuggling, while an FBI Joint
Terrorism Task Force wiretap caught Ahmed recruiting for al-Qaeda and
discussing blowing up a shopping centre.
49. Australia’s close proximity to South East Asia, where tobacco smuggling is
particularly rife, combined with the rapid increase in online-based cigarette
smugglers (where cartons can be bought for under $20AUD), make it guaranteed
that if these recommendations are enacted, the sale of illicit tobacco will
increase, leading to worsening outcomes for all.
50. The Australian Taxpayers’ Alliance further submits that taxpayer subsidies to
pharmaceutical multi-nationals constitute an invalid use of taxpayer funds. If
persons choose to consume tobacco-cessession products, then they – and not the
taxpayer – ought be financially liable for their decision.
Bolster and build on existing programs and partnerships to
reduce smoking rates among Aboriginal and Torres Strait
Islander people
51. It is submitted that the racist paternalism as detailed in this report to the Aboriginal
and Torres Strait Islander community, with the underlying theme that indigenous
Australians are unable to choose for themselves how to act, is a morally abhorrent
legacy of generations of post-colonial racism in Australia.
52. Recommendations 6.3.1-6.3.11 are premised on nothing short of blatant racism, and
the mindset that indigenous Australians can’t look after themselves. The Australian
Taxpayers’ Alliance rejects this notion, and believes that indigenous Australians
should and should not be singled out for demeaning programs on the basis of their
race.
Strengthen efforts to reduce smoking among people in disadvantaged populations with
high smoking prevalence
53. Recommendations 6.4.1-6.4.11 involve further expenditure by Australian taxpayers,
and the funnelling of funds to NGO’s. The Australian Taxpayers’ Alliance strongly
submits that taxpayers should not be forced to foot the bill for even more services,
and even more funding to NGO’s. It is submitted that if NGO’s wish to take part in
welfare delivery services to reduce smoking then they ought pay for it themselves,
rather than forcing taxpayers to foot the bill.
54. The ATA also notes that the draft report provides no definition of disadvantage, nor
that when discussing disadvantage, examines the root issues underlying it. As such, it
is submitted that it is imperative for the Intergovernmental Committee to identify on
what basis such “disadvantaged” persons are unable to assert their right to cease
smoking. Such baseless condescension in the Draft Report is accepted without critical
appraisal of what the concept actually implies.
55. It is further submitted that persons in lower socio-economic groups are not mentally
disadvantaged, as implied in the Draft Report, and the patronising attitude of the
Draft Report is an insult to hundreds of thousands of Australians.
56. It is further submitted that recommendation 6.4.6 – to ensure mental health services
and drug treatment agencies are smoke free – can cause serious problems and ought
not be acted upon:
"Many prior studies have found an association of ceasing smoking and
suicide (Leistikow & Shipley 1999). In addition, a recent review cited some
evidence that smoking cessation could precipitate a clinical depression
(Hughes 2006) and, thus, might lead to increased suicide." - John R.
Hughes, University of Vermont, Burlington, VT. For more information
please visit National Center for Biotechnology Information website
"Nicotine has some positive effects on symptoms of psychiatric
disorders… several studies have shown that some symptoms of
psychiatric disorders may be exacerbated by nicotine withdrawal.
Therefore, attempts to quit smoking pose additional problems to
patients with mental health problems." Fagerstrom K and Aubin HJ.
Management of smoking cessation in patients with psychiatric disorders.
Current Medical Research and Opinion. 2009;25:511-8
57. It is noted that in the UK a survey showed that 90% of staff members in mental
health care service providers were opposed to a total smoking ban due to the effects
that this would cause (For more information Please visit Psych Minded website).
Eliminate remaining advertising, promotion, and sponsorship
of tobacco products
58. Recommendations 6.5.1-6.5.11 deal with further regulations on the sale of tobacco.
The Australian Taxpayers’ Alliance submits that these are immoral, shall hurt
businesses, and will do nothing to reduce smoking rates.
59. Recommendations 6.5.1-6.5.4 revolve around the passing of the Plain Packaging
legislation. The Australian Taxpayers’ Alliance is strongly opposed to plain packaging
legislation in that it is a) blatant theft of intellectual property, b)potentially
unconstitutional, and c)a violation of our international obligations, and d) that there
is no impartial evidence whatsoever it will reduce smoking rates.
60. The Australian Taxpayers’ Alliance endorses the submission by the Property Rights
Alliance in February 2010 to the Senate Standing Committee on Community Affairs
as representative of its position on plain packaging and states its belief that this
policy ought be reversed.
61. It is noted that even prior to the passing of plain packaging legislation, Australia
already has some of the most draconian restrictions on tobacco products in the
world. These include prohibition on tobacco advertising & sponsorship, display bans,
and graphic health warnings occupying 30% of the front of a cigarette pack, and 90%
of the back of the pack. To increase this to cover 75% of the front of the packet, as
well as 90% of the back, is unsubstantiated by any empirical evidence, and is
opposed by the ATA.
62. It is submitted that the evidence that increasing such warnings will reduce smoking
rates is simply non-existent. Indeed, almost no scientific studies support the
hypothesis that graphic warning labels will cause smokers to quit, and a wide range
of evidence suggests that this intervention is unlikely to be effective.
63. A 2012 study published in published in Tobacco Control, entitled “The emotional
impact of European tobacco-warning images”, offers a qualitative examination of the
emotional impact of graphic cigarette warning labels. Volunteers were shown 35
different graphic cigarette warning labels developed by the European Commission
and rated their emotional reactions. The study found that very few of the warnings
(only 4 of the 35) elicited strong emotional reactions, and among youth, the
messages were even less effective. A significant number of images (17%) elicited
positive responses.
64. It is submitted that the following conclusion of this study, although based upon a
European sample, has considerable salience in Australia: "If the aim of the European
anti-tobacco campaign, based on aversive warning images, is to prompt negative
attitudes towards smoking and predispose smokers to quit smoking by activating the
defensive-avoidance motivational system, our results question the effectiveness of
most of the proposed images. ... Considering that young people are currently one of
the main marketing targets of tobacco firms in the world, the proposed tobaccowarning images might be particularly ineffective for this target population unless
more arousing unpleasant pictures are used. ... the present results suggest that the
warning images proposed by the European Commission for tobacco packages might
have limited effectiveness in reducing tobacco consumption in the general population
because most of the proposed images were evaluated as [only] moderately
unpleasant and arousing. Because such images may not be capable of inducing
negative attitudes and avoidance behaviors, the question of their effectiveness
remains open." (Munoz MA, et al.The emotional impact of European tobaccowarning images. Tobacco Control 2011 For more information please visit Tobacco
Control website)
65. A 2011 report by the UK Based National Centre for Social Research in conjunction
with the Institute for Social Marketing at the University of Sterling examined, through
two waves of surveys, the impact of new graphic health warnings. The findings were:
a) There was no observed effect of the graphic warning labels on cigarette smoking
prevalence.
b) There was no observed effect of the warning labels on cigarette consumption.
c) There was no observed effect of the warning labels on smoking reduction
(measured as forgoing cigarettes due to the warning labels).
66. In the United States, it is noted that the US Food and Drug Administration, a
supporter of graphic health warnings, conceded in August 2011, in its Regulatory
Impact Policy, that graphic warning labels will have very little impact, and perhaps no
impact at all, on cigarette smoking. This analysis predicts that the graphic warning
labels will only reduce smoking prevalence by 0.088 percentage points (less than 0.1
percentage points). Importantly, the 95% confidence interval for the effect includes
zero, meaning that it is not statistically different from zero (Federal Register /Vol. 76,
No. 120 /Wednesday, June 22, 2011).
67. It must be stressed that the US Food and Drug Administration further concedes its
scientific evaluation concludes that the predicted effect of the graphic warning labels
is not statistically different from zero: "FDA has had access to very small data sets, so
our effectiveness estimates are in general not statistically distinguishable from zero;
we therefore cannot reject, in a statistical sense, the possibility that the rule will not
change the U.S. smoking rate. Therefore, the appropriate lower bound on benefits is
zero." (Federal Register 76 at 36776)
68. The words of tobacco control advocate Dr. Michael Siegel on the FDA data are
telling:
The analysis is based on a comparison of smoking rates in the U.S. and
Canada before and after the implementation of graphic warning labels in
Canada. The analysis compares smoking rates after accounting for the
effect of cigarette tax changes, and attributes all unaccounted for
differences to the Canadian warning labels... In this case, there was no
observed significant effect of the graphic warning labels on smoking
prevalence in Canada, once the tax increase was accounted for.
Were this a scientific paper instead of a regulatory impact analysis, the
paper would be forced to conclude that there was no significant effect of
the graphic warning labels in Canada on cigarette smoking prevalence over
an 8-year follow-up period. In fact, if you delete the year 2001 from the
analysis, the observed difference in unexplained smoking rates between the
U.S. and Canada is -0.23 percentage points, indicating that after the initial
year of the warning labels, this intervention actually increased smoking
prevalence in Canada by 0.23 percentage points...Most significant, but
shocking, of all, if the analysis is restricted to the period 1994-2008 (not
including 2009), then the results show that the graphic warning labels in
Canada increased smoking prevalence by 0.066 percentage points. Thus,
had the same analysis been conducted one year ago, before 2009
prevalence data were available, the very same report would have been
forced to conclude that the proposed regulation is predicted to increase
smoking rates and cost the U.S. billions of dollars.
The FDA's own analysis demonstrates no statistically significant impact of
the graphic cigarette warning labels on smoking prevalence in Canada. This
evidence - presented by the FDA itself - supports my earlier conclusion that
the proposed graphic warning labels in the U.S. will likely have a minimal
impact on cigarette smoking, and that this miminal effect will occur due to
the immediate shock value of the warning change, not to any sustained
effect of the warnings. For more information please visit Tobacco Analysis
Blogspot website
69. It is submitted that recommendation 6.5.4, that tobacco companies may need to
report regularly on promotional activities, has no science or evidence behind it, and
can only be seen as a capricious undue burden on a legal business.
70. Recommendation 6.5.6, which is based upon the argument that sight of a product
constitutes advertising imposes a burden to retailers (for instance struggling to
locate products during peak hours without holding up sales), without any
justification. Indeed, international evidence has demonstrated such bans to be
ineffective at reducing smoking.
71. The ATA submits the evidence of what occurred in two international examples of
smoking display bans: Canada and Iceland.
72. As noted in The Grocer journal: “The Icelandic ban, introduced in 2001, has failed to
achieve its aim of reducing smoking rates in the country’s under 18s. In fact smoking
prevalence among 15-19-year-olds actually increased from 14.4% to 17.5% in the
year that the ban was introduced, official figures from Statistics Iceland reveal.
In 2002, smoking prevalence among this age group was the highest it had been for
five years at 17.%. Today at 15.2% it still remains higher than it had been before the
ban” (http://www.thegrocer.co.uk/articles.aspx?page=articles&ID=194143). In
conjunction with this, any overall decline in smoking rates in Iceland is exceeded by
that over the same period of time in other countries where no display ban took
place.
73. It is also shown that smoking display bans in Canada cannot plausibly be claimed to
have been caused by display bans, and that there is no difference in a reduction in
smoking between provinces which have instituted display bans, and those that have
not. This also seems to be the experience to date in Australia, showing that smoking
display bans do not reduce the incidence and uptake of smoking
74. Recommendation 6.5.7, to restrict the advertising products on the internet, is
unenforceable, and an undue burden on governmental resources through
attempting to censor and regulate the internet in a manner that will achieve nothing
due to the nature of the online world, but burden taxpayers as the government uses
funds to attempt to partake in this futile task.
75. The ATA expresses significant concerns also regarding the implementation of 6.5.10
which seeks to prevent tobacco companies from being represented in public health
debate. It is submitted that not only is this an unnecessary violation of free speech,
and essentially scientific censorship; indeed, it is beyond credulity to think that only
vehement tobacco control activists ought to be given a place in public discourse. The
hypocrisy is gravely disturbing due to its lack of applicability to taxpayer-funded
tobacco control NGO’s, and also pharmaceutical multi-national corporations.
76. Numerous tobacco control NGO’s receive taxpayer funds in Australia, which are then
used to lobby the government for further tobacco control. This creation of what is
effectively government-controlled ‘sock puppets’ is an unconscionable misuse of
taxpayer funds, and it is the position of the Australian Taxpayers’ Alliance that any
group that receives taxpayer funding should not then use said funding to lobby the
government.
77. It is submitted that all relevant parties read the UK report “Sock Puppets: How the
Government Lobbies Itself and Why” by the Institute of Economic Affairs, published
in June 2012. The ATA strongly endorses its conclusions that include “banning
government departments from using taxpayer’s money to engage in advertising
campaigns, the abolition of unrestricted grants to charities and the creation of a new
category of non-profit organisation, for organisations which receive substantial funds
from statutory sources” (For more information Please visit Institute of Economic
Affairs, UK website) .
78. It is also noted that corporations involved in the sale, distribution, and marketing of
tobacco cessation products have a vested interest in the policy debate, and that this
ought be factored into any consideration of their views on public health policies.
79. Recommendation 6.5.11, the “monitoring” of smoking in movies, is akin to artistic
censorship, and is strongly opposed by the Taxpayers’ Alliance.
Consider further regulation of the contents, product
disclosure, and supply of tobacco products and non
therapeutic nicotine delivery systems
80. Recommendations 6.6.1-6.6.8, which seek to regulate product disclosure, are also
fundamentally flawed for a number of reasons.
81. Recommendation 6.6.1, which commissions research to inform the development of
further regulatory policies on the disclosure of tobacco product ingredients, is
unobjectionable on the proviso that the research is conducted by an independent
and objective body, and not through a tobacco-control NGO.
82. It must be noted, however, that the evidence currently shows such research would
be a waste of taxpayer dollars: The impact of disclosure of tobacco ingredients
(which are freely available) was summed up by Dr. Michael Siegel as follows:
This is a complete waste of time and resources. Is this the appropriate
approach to dealing with a product that we already know is killing
thousands of Americans each year? Study the additives to make sure the
companies aren't adding anything "harmful" to the tobacco? God forbid if
cigarettes don't deliver pure tobacco.
There is also nothing new here. We already have a complete list of the
cigarette additives and a list of the more than 4,000 known chemicals in
tobacco smoke. Has that helped us to develop a safer cigarette? Frankly,
this is complete stupidity. Actually, it's not stupidity. It's a political stunt,
designed to make people feel like health groups and politicians are doing
something, when they're really not. For more information please visit
Tobacco Analysis Blogspot website
83. It is further noted that the “additives” added to tobacco are, in general,
approved for – and commonly used in – foods and beverages and are
considered “safe”.
84. It is also submitted that if companies were to “remove” additives from
tobacco, it may convey the impression that such cigarettes are “safer”,
leading to worsening health outcomes. Furthermore, as Dr. Siegel notes:
There is scientific plausibility behind the notion that mandating noadditive cigarettes could result in a more hazardous product. Such
a mandate would almost certainly result in higher use of fluecured, rather than burley tobacco in cigarettes because burley
tobacco produces unpalatable smoke unless flavorings or
sweeteners are used. Thus, such a mandate would cause tobacco
manufacturers to shift towards higher amounts of flue-cured
tobacco. However, there is scientific evidence that flue-cured
tobacco yields higher levels of benzo[a]pyrene and tar than burley
tobacco. Since tar and benzo[a]pyrene are associated with cancer
risk, it is at least plausible that the FCTC working group's
recommendation would increase the global burden of cancer,
which is not exactly a health- or science-based policy objective.
85. Recommendation 6.6.2, which commissions research on the effect of flavourings in
making tobacco products palatable, is also misguided. There can be no doubt that
some tobacco flavourings enhance the smoking experience for some persons
(otherwise they wouldn’t exist). To investigate this, however, is a waste of taxpayer
money as this ultimately is not an issue of science, but of policy and ultimately,
politics.
86. It is noted that there is no evidence in existence that flavoured cigarettes are any
more harmful than other cigarettes. Secondly, there is no evidence that flavoured
cigarettes are any more addictive or harder to quit smoking than other cigarettes.
Indeed, these assertions have not even been made. Furthermore, there is strong
evidence that young persons are far less likely to smoke flavoured cigarettes than the
non-flavoured cigarettes on the market hence an objection based on smoking
initiative and uptake is invalid. As such, this recommendation has no basis in health
but rather is simply a political agenda being pushed.
87. Somewhat counterintuitively, it is also noted that a new study out of the FDA's
Center for Tobacco Products reported that the risk of lung cancer death is
significantly and substantially lower among menthol cigarette smokers than among
non-menthol smokers (Rostron B. Lung cancer mortality risk for U.S. menthol
cigarette smokers. Nicotine & Tobacco Research 2012. March 1, 2012)
88. The Australian Taxpayers’ Alliance endorses recommendation 6.6.5 for further
research on electronic cigarettes and other next generation tobacco delivery
systems, however, this is made with the proviso that the research be genuinely
independent and not by a vested tobacco-control interest group. The health benefits
of smokeless tobacco, e-cigarettes, snus, and so forth in comparison to cigarette
products have been demonstrated in international academic literature, as have their
use in smoking cessation (For more information please visit 7thSpace website) , and
as such the Australian Taxpayers’ Alliance is supportive of further research on their
applicability in Australia.
89. The Australian Taxpayers’ Alliance strongly notes its objections to 6.6.8 which seeks
to limit the number of tobacco outlets in the community as a recommendation that
shall do nothing to reduce smoking rates, but place a burden on businesses reducing
profitability, thus hurting not just the overall economy but local communities.
Reduce exceptions to smoke free workplaces, public places
and other settings
90. The Australian Taxpayers’ Alliance is strongly opposed to all smoking bans as an
ineffective manner to reduce smoking, and as a violation of property rights.
91. The ATA reiterates the fundamental principle that private property is at the heart of
any western society, and smoking bans in private property strongly goes against
this principle.
92. It is further noted that smoking bans simply do not work to reduce smoking, as
shown by numerous studies:



A study published in earlier this year in Addiction found that the
Italian smoking ban had no lasting effect on smoking prevalence and
quit rates, concluding: “The impact of the Italian smoke-free policy on
smoking and inequalities in smoking was short-term. Smoke-free
policies may not achieve the secondary effect of reducing smoking
prevalence in the long-term, and they may have limited effects on
inequalities in smoking.” (Impact of the 2005 smoke-free policy in
Italy on prevalence, cessation and intensity of smoking in the overall
population and by educational group. Federico B et al. Addiction. 8
May 2012)
A paper published in 2012 in PLoS “has found that Scotland's smoking
ban had no effect on the country's smoking rate in the long
term.” (Impact of Scottish Smoke-Free Legislation on Smoking Quit
Attempts and Prevalence. MaKay et al. PLoS. 2012 For more
information please visit PLOS one website)
The International Journal of Nursing Studies found that there was no
change in the number of nurses smoking in France after smoking was
banned in the workplace. (Three-year follow-up of attitudes and
smoking behaviour among hospital nurses following enactment of
France's national smoke-free workplace law. Fathalla et al.
International Journal of Nursing Studies. 18 February 2012.
93.
It is further submitted that empirical evidence from studies on the effects of
smoke-free legislation internationally has demonstrated that it has had no
impact on overall health outcomes.
94.
The most comprehensive study of the effect of smoking bans on heart
attacks was commissioned in 2011 by the RAND Corporation, Center for
Studying Health System Change, University of Wisconsin, and Stanford
University, which examined the relationship between smoking bans and
heart attack admissions and mortality trends in the entire nation, using
national data (Journal of Policy Analysis and Management. Study citation:
Shetty KD, DeLeire T, White C, Bhattacharya J. Changes in U.S.
hospitalization and mortality rates following smoking bans. Journal of Policy
Analysis and Management 2011; 30(1):6-28.) The key conclusion of the
study is that: "In contrast with smaller regional studies, we find that
smoking bans are not associated with statistically significant short-term
declines in mortality or hospital admissions for myocardial infarction or
other diseases. . . An analysis simulating smaller studies using subsamples
reveals that large short-term increases in myocardial infarction incidence
following a smoking ban are as common as the large decreases reported in
the published literature."
95.
Recommendation 6.7.4 which looks at restricting in homes and in cars is a further
violation of private property rights that is opposed by the Taxpayers’ Alliance. The
ATA specifically notes arguments used to support the banning of smoking in
vehicles is based on a thoroughly debunked report that smoking in cars is 23 times
more dangerous than indoors. This claim has been comprehensively refuted in a
report in the Canadian Medical Association Journal by Ross MAcKenzie and Becky
Freeman from the University of Sydney, which states plainly that “there is no
evidence to support the fact that smoking in cars is 23 times more toxic than in
other indoor environments.” (For more information please visit adafad organisation
website)
96.
The ATA also strongly opposes other recommendations to extend smoking bans to
outside areas or to “restrict smoking outdoors where people gather” and in multiperson dwellings as having no basis in evidence in regards to health outcomes.
97.
The ATA also notes its opposition to taxpayer funds being used to “support
employees and employers” to quit smoking.
Provide greater access to a range of evidence based cessation
services to support smokers to quit
98.
The Australian Taxpayers’ Alliance supports persons having the right to choose
smoking cessation programs, and concedes the necessity of such programs at this
present state. However, it is submitted that such programs are already adequately
funded by the taxpayer, and there is no justification to increase their funding above
present levels.
Conclusion
99.
The Australian Taxpayers’ Alliance strongly opposes the recommendations of the
Draft Report as reducing freedom of choice, hurting taxpayers through both
increases in taxation and public expenditure, and doing little to reduce the rates of
smoking
100. The Australian Taxpayers’ Alliance submits that the Draft National Tobacco Strategy
2012-2018 ought be rejected in its entirety.
Timothy Andrews
Executive Director
Australian Taxpayers’ Alliance