Doctor and activist


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Category: Tobacco/Vaping

22/05/2025

Tobacco Tax Rises

22 May 2025
I started it, but look what has happened now.

In 1983 I attended the 5th World Conference on Smoking and Health in Winnipeg, Canada. It was all about the health effects of smoking. There were no activist or political sessions and Stan Glantz of American for Non-Smokers Rights called an evening meeting for those interested. I gave a paper on BUGA UP, which was the only paper that had to be given again because the room was too small for the audience.

I met a very significant figure, William Weis of Seattle who had a paper on the price sensitivity of tobacco. He said that if the price of cigarettes went up 10%, total consumption would go down 4.5%, so if the rise was tax, the government would make money. He also said that young people were more price-sensitive than adults, so consumption by those under 18 would go down 12% and uptake by young people would also go down by 12%.

Thus tobacco tax was a good revenue measure and good for public health.
I came home and wrote to the health minister without effect, but I also wrote to the Anti-Cancer Council of Victoria (ACCV) and ACOSH, (Australian Council on Smoking and Health) who were in WA. They were the most active bodies on tobacco in Australia at that time.

Australian tax was low by international standards at that time, being 50%. Only the US was lower among developed countries at 36%. Denmark had the world’s highest at 85%.

The Australian tobacco growers were supported by the TISP (Tobacco Industry Support Program), which subsidised them as they could not compete on price with developing countries such as Zimbabwe. The Australian tobacco manufacturing industry, mainly British American Tobacco- AMATIL and Rothmans bought just over 50% of their tobacco from the Australian growers, who were mainly in Queensland, with about 20% in Victoria and about 3% in NSW. They did this although it was more expensive because the farmers were useful as a lobby group, and the tobacco was only about 1% of the final price anyway.

The ACCV took up the excise case and started to lobby the Federal government for the 1984 budget. At that time there were both Federal and state taxes.

The campaign against tobacco in Australia differed from those in other countries largely because of the existence of BUGA UP, which had first become active in 1979. In most countries, the health lobby had been beavering away for years with little success, as the tobacco industry simply funded political parties on the deal that they could say what they liked about tobacco, but not legislate against it till the next election, when they would offer the same deal. 

The smokers were said to know the risks and were supposedly happy to take them. The Non-Smokers Rights Movements, who did not like the smoke, were the forefront of activism around the world, but the industry painted the battle as one between smokers and nonsmokers and asked for tolerance and understanding. This naturally translated into non-smokers putting up with the smoke. 

Great store was placed on the medical evidence of a Japanese professor, Takeshi Hirayama, who published a paper in the BMJ in 1981 showing that wives of smoking men had a higher incidence of lung cancer than wives of non-smokers. Naturally the tobacco industry denied all this, and governments, paid to dither, did nothing except talk. The Non-Smokers Rights groups did make it a political issue and tried to use product liability cases to advance their cause. 

In Australia, Geoff Coleman a still unknown activist and one of the three founders of BUGA UP reframed the debate, saying it was not a battle between smokers and non-smokers; Tobacco was a rogue industry, happy to kill people to make its profits, and buying the advertising industry and the politicians as part of this business model. The advertising industry similarly was happy to say anything that its clients wanted without regard for the consequences of the consumption changes that they achieved. Hence the BUGA UP acronym, Billboard Utilising Graffitists Against Unhealthy Promotions. Cigarette billboards were about half of all outdoor advertising at that time and by far the most prolific at points of sale, so that general stores were chiefly recognisable because they were covered in tobacco ads. The key BUGA UP concept was that anyone could paint (reface) a billboard and sign it BUGA UP, so there would be a unifying concept from a public point of view without any formal structure. BUGA UP also wanted to tap into the Australian larrikin image and to use humour to satirise the absurd imagery of the tobacco ads. There were also street protests and disruptions of tobacco promotions, which were happening in shopping centres, pubs and music venues as well as all the sports sponsorships. BUGA UP activists were arrested for graffiti vandalism or staying on premises against orders to leave, and the court cases were played for publicity, and to contrast that some people were being arrested for doing good, while the industries were getting away with doing bad.

It must be mentioned that when tobacco advertising was banned from TV, the industry had switched to sponsorship, which meant that rather than paying the Telecaster directly, they paid the sport. This had two advantages; it was cheaper in terms of the amount of time that the brand was on TV, and it also gave them a political ally if there was any attempt to ban the sponsorships. They gave money to basically anyone who would take it, supporting cultural events and ethnic clubs to build the lobby, so while BUGA UP was winning the PR battle against the industry, it was getting its allies in order. This played out in Western Australia where the government tried to ban tobacco sponsorship in 1984 and was defeated. In Victoria the health forces were more successful with the Victorian Tobacco Act or 1987 raising tobacco excise to do three things; replace the tobacco sponsorships of just about everything with health promotion messages, have some grants for organisations that would promote health and fund some medical research. All the political opposition was bought out except the Tobacco industry itself. Health promotion foundations were created in Victoria, SA and WA, but the industry managed to get other State treasuries to stop the further spread of them by saying that they created the precedent of hypothecated taxes, which would reduce Treasury control over where money was spent.

Excise taxes were later rationalised so as only to be collected Federally after a High Court case ruled that States could not collect such a tax.  (Ha v NSW in 1997, Ha was a tobacco wholesaler).

The rise of vapes is another story. As World Conferences on Tobacco and Health, (Later changed to Tobacco or Health) went on, the tobacco industry used to run parallel conferences in the same cities with tame doctors are produce a book of proceedings of these with summaries that took a very anodyne view of the tobacco problem, to encourage the idea that legislation was not really needed, edited by people such as Robert Tollison. These books were then sent free to public libraries, some of them mistaking them for proceedings of the world conference as the dates were similar. The tobacco industry also wanted to medicalise the whole issue of quitting, so that addiction was a medical problem to be treated by gradually reducing nicotine doses in lozenges or patches. Their conferences were often subsidised and created a market and a rationale for practitioners in Quit Clinics. 

The technology of the quitting devices kept being ‘improved’ until they were a whole new drug delivery device, ready for a new market. Some companies that were ahead of the tobacco industry in their technologies were bought by the industry, who were taking advantage of the new social media market that could reach young people without older demographics being aware of what was happening. Some of the medical folk, obsessed by the carcinogenesis of tobacco, and influenced by harm minimisation strategies from hard drugs and AIDS advocated vapes as a quit aid, which immensely helped the tobacco industry in avoiding having to prove that vaping chemicals were safe; they just had to be better than cigarettes, an easy bar to clear.

At a political level, the last Federal Health Minister to take tobacco seriously was Nicola Roxon in the Gillard government. After this there were some Liberals, perhaps helped by vaping associated party donations, who felt that vaping should be encouraged, and certainly not regulated against. So instead of working hard to get the remaining lower demographic of smokers to quit, and linking vaping to smoking as other undesirable health behaviour, there was no real action, except on tobacco excise. This continued to be raised, so that the price was far too high for the poorer demographic who continued to smoke, so there was a huge margin of profit for chop chop, tobacco leaves from the farm, or for imported smuggled cigarettes. 

The social marketing of vaping products had gone on unabated and medical research was trickling in showing that as many young people started vaping and went to smoking as ever managed to use vapes to quit. There were a few cases of deaths from vaping and scientific evidence that the cilia, the tiny hairs that move to mucus up the bronchi to clean out the lungs were adversely affected, but the industry has naturally ignored these and have reversed the onus of proof politically. Now they do not have to prove it is harmless, the medical profession will again have to prove it is harmful and get this through the political process. Last time this took 50 years; from smoking being linked to lung cancer in 1950, to a ban on indoor smoking in NSW in 2000.

Now with no action except excise rises since the election of the Abbott government in 2013, Labor is trying a prohibition approach that is unlikely to succeed. The vaping industry marketing is significantly controlled by tobacco and vapes are largely distributed by organised crime. An article in the SMH stated that there were 60 tobacconists for every McDonalds (SMH 19/5/25). Many recent stories of firebombing of tobacconists emphasise the criminals’ power. The challenge to stamp out vaping by medical evidence and the marketing of such evidence is now a huge challenge that I no longer have either the expertise nor the energy to tackle. Here is an update from the SMH.


The tobacco tax is a disaster playing out on our streets and in our budget
By Shane Wright
SMH May 19, 2025
The tax and policing approach to tobacco across this country is becoming a social, economic and legal disaster.
This disaster is playing out in our streets – from more than 120 arson attacks across Melbourne that have claimed at least one life to dodgy looking tobacco shops in Newtown and small “farms” in rural areas with unusual-looking cash crops, it’s clear to anyone that the current system is failing.
Not only is criminal activity becoming the norm, hundreds of thousands of ordinary people are being dragged into breaking the law every time they light up a cheap ciggie.
America launched a war on drugs, and it failed. What’s going on in this country at present is eerily similar.
Not only have ever-more expensive cigarettes created market opportunities for organised crime, but they’ve also provided smokers with products that could be worse for their health than legal products.
That’s the human side of ever-increasing excise rates being used to tax smoking out of existence. There’s also the economic side.
Treasurer Jim Chalmers is dealing with what is now a $43 billion hole in tobacco excise since 2020 that affects the provision of services, welfare and infrastructure to the entire community.
That’s due to governments of both political persuasions overestimating just how much revenue their assault on tobacco would reap for the budget bottom line. And, as revenue has fallen, governments have spent more money on trying to make up for the cash shortfall.
The situation is so out of hand that in his pre-election budget, Chalmers pumped an extra $156.7 million over the next two years into increased efforts to police the illicit tobacco trade. That was in March.
In January last year, the government announced an extra $188.5 million over four years for Border Force to work with the states in a “co-ordinated effort to tackle all aspects of illicit tobacco”.
That extra policing was partly paid for by another increase in tobacco excise, worth 5 per cent a year for three years, that began on September 1, 2023. At the time, it was estimated it would garner an extra $3.3 billion in excise revenue.
But it’s clear that it did not. In the two years since that excise increase was announced, excise collections for 2023-24 and 2024-25 have been downgraded by $9.3 billion.
Apart from the extra resources pumped into state health departments, the country now has its own version of Eliot Ness in the form of Erin Dale, a senior Border Force official who is the nation’s “Illicit Tobacco and E-cigarette Commissioner”.
Public health advocates in this country have led the way in trying to reduce tobacco consumption. From ending television commercials to sports sponsorship and plain packaging, they’ve made huge strides in making cigarettes as unattractive as possible to potential new smokers.
Price – through tax – has been another key element to their strategy. But somewhere along the line, the key economic concept of substitution has been ignored.
In this case, the substitution is whether people switch to chemist-only vaping products or get their fix via the black economy. And guess what? Australians have done both.
Given the way smokers are more likely to be lower-income earners, every large lift in excise disproportionately affects those least able to afford it. The assumption was that these people would give up.
Instead, the economy came up with another solution – a thriving, illegal but cheap market.
Public health officials, police and politicians have to come up with another way to deal with the explosion in illicit tobacco. The starting point has to be an acknowledgment that there is a cohort of people who will continue to smoke, no matter the health impacts.
And this approach has to cut the cord between federal governments and higher excise as an easy way to repair the budget. Tobacco excise is just a sign of the problems for the budget that are coming as petrol- and diesel-powered vehicles give way to electric ones.
At the end of The Untouchables, Ness is asked what he was going to do if Prohibition came to an end.
“I think I’ll have a drink,” he replies.
We don’t want a situation where people just light up and do irreparable damage to themselves and their loved ones. But we can’t continue with a series of policies that are not working.

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26/02/2025

Vale Marg White

26 February 2025

Marjorie Irene White (just call me Marg) died on 18 December 2024. She was the doyen and major organiser of the Melbourne activists of MOP UP (Movement Opposed to the Promotion of Unhealthy Products) and later BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions). The difference between the two groups was that MOP UP confined itself to legal activities, and BUGA UP did not.

Marg was born in 1930 in Macksville, the only child of Frank and Irene Macrae. Frank was a farmer, who took Marg everywhere he went, so she developed a handy range of practical skills and good self confidence Her mother was a schoolteacher and she helped her mother and acquired a love of teaching.

They moved to Kendal in 1937 and she was somewhat protected from the Depression as her father could grow food and her mother’s teaching job remained. Later Kendal, a town of only 600 people, was where the troop trains stopped on their way to northern Australia and Papua New Guinea. She was a popular youngster as she took treats to the troops. Frank bought a small weekender at Bonny Hills where the family spent holidays. He later retired there.

She was very musical and a good student, topping NSW in geography and going on to Uni in Armidale and then Sydney Uni where she did a BA and Dip Ed and specialised in early childhood education, believing that lessons learned early were the most important. She met her future husband, David Ogilvie White, who had got into medical school at 16, but was more interested in playing chess. She pushed him to do more work and actually pass. They married in 1954 and went to ANU in Canberra where she met Bob Hawke and Hazel, resulting in a lifelong friendship. Consistent with her idea that everyone should reach their full potential she encouraged Hazel to get a degree when Bob was not keen on this. They remained great friends, with Bob and Hazel staying with them in Melbourne. David’s career blossomed and he rose in the academic ranks becoming Professor of Virology and head of Infectious Diseases at Melbourne University.

She became involved with MOP UP (Movement Opposed to the Promotion of Unhealthy Products) and had quite a large corps of medical students who were keen to help. Some of their stunts were very effective. MOP UP made a graveyard with satiric names based on tobacco brands and handed out leaflets outside the Marlboro Australian Tennis. The sponsorship was dropped in 1985. The Royal Philharmonic Orchestra was met with a group of protesters in black tie outfits playing mock instruments as ‘The Royal Carcinogenic Orchestra.’ They also dropped their Benson and Hedges sponsorship. MOP UP continued street theatre and leafleting while BUGA UP refaced cigarette billboards, and occasionally alcohol or offensively sexist ones. Marg quietly worked as an organiser, but not merely of the activists, keeping in contact with the political and medical establishments, writing letters and encouraging progressive initiatives.

She was happy to contribute directly to the BUGA UP campaign; standing at a tram stop in a houndstooth tweed suit, complete with cape, she would reface the cigarette ad on an arriving tram, then stand back, spray can under her cape looking like the super-respectable middle aged schoolteacher that she was. If you were getting on or off the tram or blinked you would have missed it.

At that time the tobacco industry used ‘shop panels’, cigarette ads about 50x90cm stuck on each side of the doors of convenience stores with two-sided tape. They stuck well enough, but could be prised off easily with either a claw hammer or small jemmy. Marg went out with an activist one night to clean up the shop panels which her companion removed and stacked in the backseat of her car. There were few security guards and no CCTV cameras in the mid 1980s, but they were spotted and hailed. Her companion ran off and she drove away, but the Police had been alerted, so she was chased with Police lights flashing and sirens blaring. She pulled over and the officer who came to car window was flabbergasted to see a respectable grey-haired woman. ‘What are you doing?’ he asked. ‘I am just on my way to pick up my daughter from the ballet’ answered Marg calmly. ‘Oh, sorry lady’, said the Policeman. The story goes that he got a hard time back at the station and was told, ‘Yes, that was her; that is the exact description’. Meanwhile Marg hurried home and put the shop panels under the house in case the police returned. They never did.

Marg was a philanthropist and gave money to the Melbourne Symphony Orchestra and the Australian Ballet, as well as the Australian Conservation Foundation. She was an environmentalist and fought for causes she believed in, successfully funding an expensive QC to stop a canal development at Laurieton in NSW near the family weekender at Bonny Hills. The success of that case became a template for similar residents’ actions.

She was active in many roles in the Australian Democrats and became President of the Victorian division when they were a significant force in Australian politics. At home, she nursed her husband who had liver failure, probably occupationally acquired.

Her greatest achievement is probably the Victorian Tobacco Act of 1987. The Western Australian government had tried to ban tobacco advertising in 1983, but were beaten by sports associations that complained that they would founder without tobacco money. So the Victorian Tobacco Act sought to increase tobacco tax and use the money to buy out the sponsorships of sports, cultural events and all the other entities that had been bought by tobacco, as well as funding medical research and doing health promotion to take up the empty billboards among other initiatives. It was the first Health Promotion Foundation in the world, and the legislation passed by one vote. Nigel Gray, doyen of the Establishment and head of the Anti-Cancer Council of Victoria said that the legislation would never have passed without the public support generated by the activist groups, of which Marg was a critically important member.

She is survived by three daughters and two grandchildren.
Marjorie Irene White (just call me Marg) died on 18 December 2024. She was the doyen and major organiser of the Melbourne activists of MOP UP (Movement Opposed to the Promotion of Unhealthy Products) and later BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions). The difference between the two groups was that MOP UP confined itself to legal activities, and BUGA UP did not.

Marg was born in 1930 in Macksville, the only child of Frank and Irene Macrae. Frank was a farmer, who took Marg everywhere he went, so she developed a handy range of practical skills and good self confidence Her mother was a schoolteacher and she helped her mother and acquired a love of teaching.

They moved to Kendal in 1937 and she was somewhat protected from the Depression as her father could grow food and her mother’s teaching job remained. Later Kendal, a town of only 600 people, was where the troop trains stopped on their way to northern Australia and Papua New Guinea. She was a popular youngster as she took treats to the troops. Frank bought a small weekender at Bonny Hills where the family spent holidays. He later retired there.

She was very musical and a good student, topping NSW in geography and going on to Uni in Armidale and then Sydney Uni where she did a BA and Dip Ed and specialised in early childhood education, believing that lessons learned early were the most important. She met her future husband, David Ogilvie White, who had got into medical school at 16, but was more interested in playing chess. She pushed him to do more work and actually pass. They married in 1954 and went to ANU in Canberra where she met Bob Hawke and Hazel, resulting in a lifelong friendship. Consistent with her idea that everyone should reach their full potential she encouraged Hazel to get a degree when Bob was not keen on this. They remained great friends, with Bob and Hazel staying with them in Melbourne. David’s career blossomed and he rose in the academic ranks becoming Professor of Virology and head of Infectious Diseases at Melbourne University.

She became involved with MOP UP (Movement Opposed to the Promotion of Unhealthy Products) and had quite a large corps of medical students who were keen to help. Some of their stunts were very effective. MOP UP made a graveyard with satiric names based on tobacco brands and handed out leaflets outside the Marlboro Australian Tennis. The sponsorship was dropped in 1985. The Royal Philharmonic Orchestra was met with a group of protesters in black tie outfits playing mock instruments as ‘The Royal Carcinogenic Orchestra.’ They also dropped their Benson and Hedges sponsorship. MOP UP continued street theatre and leafleting while BUGA UP refaced cigarette billboards, and occasionally alcohol or offensively sexist ones. Marg quietly worked as an organiser, but not merely of the activists, keeping in contact with the political and medical establishments, writing letters and encouraging progressive initiatives.

She was happy to contribute directly to the BUGA UP campaign; standing at a tram stop in a houndstooth tweed suit, complete with cape, she would reface the cigarette ad on an arriving tram, then stand back, spray can under her cape looking like the super-respectable middle aged schoolteacher that she was. If you were getting on or off the tram or blinked you would have missed it.

At that time the tobacco industry used ‘shop panels’, cigarette ads about 50x90cm stuck on each side of the doors of convenience stores with two-sided tape. They stuck well enough, but could be prised off easily with either a claw hammer or small jemmy. Marg went out with an activist one night to clean up the shop panels which her companion removed and stacked in the backseat of her car. There were few security guards and no CCTV cameras in the mid 1980s, but they were spotted and hailed. Her companion ran off and she drove away, but the Police had been alerted, so she was chased with Police lights flashing and sirens blaring. She pulled over and the officer who came to car window was flabbergasted to see a respectable grey-haired woman. ‘What are you doing?’ he asked. ‘I am just on my way to pick up my daughter from the ballet’ answered Marg calmly. ‘Oh, sorry lady’, said the Policeman. The story goes that he got a hard time back at the station and was told, ‘Yes, that was her; that is the exact description’. Meanwhile Marg hurried home and put the shop panels under the house in case the police returned. They never did.

Marg was a philanthropist and gave money to the Melbourne Symphony Orchestra and the Australian Ballet, as well as the Australian Conservation Foundation. She was an environmentalist and fought for causes she believed in, successfully funding an expensive QC to stop a canal development at Laurieton in NSW near the family weekender at Bonny Hills. The success of that case became a template for similar residents’ actions.

She was active in many roles in the Australian Democrats and became President of the Victorian division when they were a significant force in Australian politics. At home, she nursed her husband who had liver failure, probably occupationally acquired.

Her greatest achievement is probably the Victorian Tobacco Act of 1987. The Western Australian government had tried to ban tobacco advertising in 1983, but were beaten by sports associations that complained that they would founder without tobacco money. So the Victorian Tobacco Act sought to increase tobacco tax and use the money to buy out the sponsorships of sports, cultural events and all the other entities that had been bought by tobacco, as well as funding medical research and doing health promotion to take up the empty billboards among other initiatives. It was the first Health Promotion Foundation in the world, and the legislation passed by one vote. Nigel Gray, doyen of the Establishment and head of the Anti-Cancer Council of Victoria said that the legislation would never have passed without the public support generated by the activist groups, of which Marg was a critically important member.

She is survived by three daughters and two grandchildren.

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28/12/2022

Please Write Submission re Vaping by 16 January

28 December 2022

Vaping is now own by tobacco companies who are following exactly the same path as they did with tobacco. They managed to get out of having to prove it was safe because a few naive doctors, still fight the tobacco wars said it was ‘better than tobacco’, an incredibly low bar to clear- not really a bar at all.

Then they said it could be used to quit, and a handful of doctors who made a living from Quit clinics when 99% of people quitting just do so, supported this. Now it is being marketed in new ways to that the adds are not visible to those who are likely to oppose vaping and the habit is growing hugely, with the Industry also using peer-to-peer marketing to evade and futures regulations or prohibitions.

Vaping is now more of a gateway to smoking than a path from it, and that suits the Industry just fine.

It is likely that the solvents will be harmful in the long term, so the precauti0onaly principle would mean that it should be banned until it is proven safe, which is frankly unlikely.

In London there is now a coffee shop that advertises Vaping and Coffee’ which assumes that indoor vaping is not smoking and will be tolerated by non-vapers. Presumably they will resists vaping controls indoors until passive vaping is shown to be harmful and tat might take 30 or 40 years- a total tobacco epidemic re-run. So please write a submission to the inquiry.

 

smh.com.au

Now here’s a deadline: We have until January 16 to help stop toxic vaping

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23/11/2022

British American Tobacco launches new Campaign to legitimise Vaping.

23 November 2022

Almost all the vaping products are owned by tobacco companies, and the marketing is almost a re-run of their tobacco campaigns. i.e:

1. Assume that it is here to stay, and hence legitimate and unstoppable.
2. Suggest that ‘courtesy and consideration’ is all that is needed.
3. Fight regulation as much as possible.

Naturally they are keen to say that any attempt to restrict nicotine is doomed to failure as it is already totally available on the Black Market.

It might be noted that when there were different regulations in Canada from the US for tobacco labelling, cigarettes were smuggled through the Indian reservations, and all labelling that used to allow the source of the cigarettes to be identified was removed from the packaging, which showed what contempt the tobacco industry had for regulations that lessened their sales.

We might expect that similar things are happening in sales of vaping products and liquids. Naturally as they talk about how hopeless it is to regulate vaping products they want to hark back to the failure of alcohol prohibition in the 1930s, which led to Al Capone and his gangsters.

Older folk will remember that as the tobacco control movement grew stronger in the late 1970s we were attacked as ‘wowsers’ and ‘killjoys’, with the implication that we were stopping people having a good time, which was what smoking was all about. It is the same tactic again. We want to stop all the happy vapers.

The tobacco industry used the fact that some doctors think that vaping can help people QUIT to allow them to sell their product without having to prove it was safe. They only had to prove it was less dangerous than tobacco- a very very low bar.

Now vaping is used more as a gateway to smoking than a path from it, and often if there is nicotine in the vape it can be used alternately as a substitute. So presumably will be a move to push vaping in smoke-free areas. Then vaping will be the ideal product for the tobacco industry, being used everywhere, helping consumption, and keeping some people smoking at other times. Just like the good old days.

Health interests have to keep the government onside, but also demand some serious anti-vaping campaigns.

Vaping uses solvents, which dissolve fats. If this is the case, it is like upmarket petrol sniffing, as it will dissolves cell membranes, especially in the brain, which has the highest blood supply of any fatty tissue in the body. This is likely to lead to gradually progressive dementia. Naturally this may take years to manifest, and even longer to be identified and scientifically proven, given that a highly sceptical Industry that will criticise the research; in short a re-run of the tobacco wars.

If we look at the history of tobacco, it was used in relatively small quantities until the invention of the cigarette rolling machine by Duke in 1898. It was massively marketed during and after WW1 from 1914. It was shown to cause lung cancer in 1950. Advertising bans started in the mid 1970s, but full sponsorship bans and smoke-free indoor air did not come until 2000. The tobacco epidemic lasted a full century; so watch out for a vaping re-run with a dementia epidemic in older folk. Unlikely? No;. quite possible. So will the tobacco industry prove it is is safe. They can’t, don’t want to; now don’t have to, and have put out this BS new organisation.

www.theaustralian.com.au/the-oz/news/big-tobacco-company-behind-vaping-overhaul/news-story/1078baf2358e5ba3d96c6235aac49610

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16/11/2022

BUGA UP Nostalgia

16 November 2022

BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) was most active fro m 1979-1985, and had a big effect on tobacco and smoking. It was also a high point in the demand for advertising to be responsible for the consequences of its use of its products.

In the end, the advertisers accepted a ban on tobacco to keep the threat of stronger regulation at bay. They cut back on sexism a bit and the movement to regulate them died down. So alcohol, gambling annd junk food ads have survived.

Here is a link to some of the TV programs from that time and a little after.

www.youtube.com/user/BUGAUPTube

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15/11/2022

Submission to Inquiry into Online Gambling

11 November 2022

Dr Arthur Chesterfield-Evans

The Internet Problem

The issue of online Gambling is similar to many problems in that online gambling involves an area of activity that is largely beyond the direct control of the Australian Parliaments, or indeed any single Parliament.  The internet was designed to be anarchic, and so it is.

Programs to deal with gambling regulation are thus ineffective, but the limited terms of reference of this inquiry suggests that governments are not thinking in terms of what they can do at a systemic and global level and are turning instead to a focus on the individual.

Need for an Industry focus rather than an Individual Focus

It must be noted that where creating public health problems benefits an Industry, the response must be against that Industry.  Concentrating on individuals while the Industry markets to the world is a very inefficient strategy.  To use a historical example, the Tobacco Industry marketed with ubiquitous ads, sponsorships, product placements and many other techniques, yet wanted medical professionals and school education to be the only techniques used against them, framing the issue as personal choice (and responsibility) and ‘smokers v. non-smokers’ requiring courtesy (and no criticism and restrictions).

This is the situation that the Gambling Industry is in now. They demand to be able to market to the world, but want all harm minimisation programs directed at individuals.  They know that this is a winning strategy for them.

What the Federal Government Can Do

While it is true that the Australian Federal government has no effective jurisdiction over the internet, and does not licence or control the Hotels, Clubs and Casinos with their poker machines, it has control over Australian media advertising laws and also allocates grants to States.  The Federal government could ban all Gambling advertising on electronic media in Australia, and lessen grants to States in proportion to their revenue from Gambling. This would stop the States getting any benefit from gambling revenue, which they rely on quite highly.  Western Australia, which is missing out on Gambling revenue would certainly support this.

The ban on tobacco advertising and sponsorship has set a precedent for action on public health issues, and there was censorship of certain opinions that were antithetical to a national COVID strategy, so the idea of a ban on Gambling advertising is not new or radical.  VicHealth also replaced tobacco advertising with ads for healthy lifestyles and anti-Gambling advertising could replace ads for Gambling. The protest group, BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) in the 1980s used satire of tobacco advertising to sharpen the focus on the Tobacco Industry’s absurd imagery and callous disregard for the lives of their customers.  They won hearts for their Robin Hood approach to the entrenched power of the Tobacco Industry and set the world standard for action against tobacco, because compared to their actions, everything else became ‘moderate’.  But less recognised than their billboard campaign  was the re-framing of the debate from ‘smokers v non-smokers’ and ‘personal choice’, to a ‘Tobacco Industry campaign to make a profit even though it kills people’.  This reframing in the public mind allowed governments to stand up to the Tobacco Industry and forced political parties to eschew their donations (at least publicly).. 

Gambling Industry Strategy

The Gambling Industry’s ads are very clever, appearing to take the loser’s side to identify with (usually) him and dangle the prospect of a win, though of course this is statistically impossible in the medium term. They are perverting the idea of ‘mateship’ to a group Gambling session with a cheery comparison of who they are backing as they watch sport.  This would be very vulnerable to a satiric response, based on a commiseration as to which mug lost the most and a final comment that ‘gamblers are losers’.

Laissez-faire v. Health

The Federal government is responsible for the health of Australians and with an increasing percentage of health problems being related to lifestyle choices, the government cannot simply ‘leave health to the market’.  ‘The market’ will sell anything that makes money irrespective of whether it has good health outcomes or not, so leaving the national wellbeing to ‘the market’ is a highly flawed strategy as the government in the end picks up the tab for all problems. The Federal government should unashamedly promote sales and practices that are good for health and discourage things that are not.

Encouraging good personal decisions

Any reasonable management textbook will say that the best way to manage things is to have good decisions made at the lowest possible level within the organisation. Yet gambling advertising uses distractions and dreams of riches that are statistically extremely unlikely to encourage people to gamble, and thus not use their money wisely. If the ads said ‘Do not contribute to superannuation’, ‘Do not save’, Do not worry if you do not have enough money to feed your kids’, there would be a huge outcry.  Yet this is the outcome with a large percentage of gambling money received being from people who cannot really afford it.  The social problems created take an immense amount of effort from government and NGO charitable organisations to try to rectify them. Often they cannot.  This problem is entirely created because of bad decisions on gambling made by people who the Gambling Industry has conned.  It is exactly like people taking up smoking. It was portrayed as a bit of harmless pleasure, but when people were hooked, it did them immense harm.  Gambling is the same.

Need for Gambling Research

One the other problems of Gambling is that the research is funded by the industry, so its scope and nature are controlled.  The amount of harm that it does is poorly quantified, so that there is little evidence for those opposing Gambling to use in political debate. The lack of evidence and the lack of debate suits the Gambling Industry fine- they are more than happy to continue and extend the status quo.  Given that the Federal government is a major player in cleaning up the social problems created by the Gambling, it should insist that there be well funded research on the social consequences of Gambling, and the nature of this research should not be determined by the Gambling Industry.  The Gambling Industry in Australia is extremely large by world standards, perhaps the largest in the world apart from little enclaves like Monaco or Macau where the money is retained by the State and the social problems are either ignored or assumed to be manifest elsewhere.  The social indices of distress are very high in Las Vegas.  It might be said that the Gambling Industry in Australia is like the gun lobby in the US; it is almost unchallengeable.  This must change, and the Federal government must initiate the change.

Off-line Gambling

It is interesting that the Clubs lobby is under challenge at a state level.  The origin of this is uncertain.  There has always been a lobby against Gambling, and this may have been helped by the rapid rise in the inflation rate which is straining the family budget, particularly of disadvantaged people, who are the ones most affected by Gambling losses.  It is also no doubt helped by the revelations that the Casinos have happily laundered money for organised crime, by-passing their regulatory systems, and being perceived by organised crime as an easier target than foreign jurisdictions.  The public also notice that the Casino boards were well stacked with ex-politicians, who were presumed to be there to smooth the political pathway of the Casinos in their dealing with regulation or (even) enforcement. It might be noted that despite the huge amounts of money being laundered and the findings that the Casinos were not fit to have licences, their share prices have only suffered modestly, showing that everyone knows that eventually their licence will be restored and it will be ‘business as usual’. The public is also well aware that the charade, ‘’I had no idea what was happening’ from the politically connected people at the top, merely leads to a resignation or two, but there is no penalty on the individuals.  An aboriginal youth can go to gaol for petty theft, but laundering billions for organised crime merely leads a Casino director to a sojourn in the yacht club.  While the major political parties have been very reluctant to upset the Hotel and Club industry, as evidenced by the 20 year delay in introducing smoke-free indoor air legislation, the rise of the Teal candidates threatening once safe seats, has pressured the major political parties to take a more ethical stance, and also  blunted the financial advantage that support  from the pubs and clubs lobby gives to their campaigns. 

Online v. Off-line Gambling

But the final possibility for the pressure on the Clubs and Hotels may have come from the Online Gambling lobby. If it is assumed that people who want to gamble will use what is available, there is a real possibility that the lack of poker machines availability in pubs and clubs may lead to an increase in online Gambling.  Supporters of the pubs and clubs are quick to point out that the clubs are non-profit and spend their monies enlarging their premises and providing facilities in Australia, as well as paying at least some tax to State governments. If there were a change towards online Gambling this money would go overseas.  This overlooks the social context of gambling. Playing a poker machine is quite different  from going online, so there is unlikely to be a direct transfer, even if the online experience is made more similar.

Need for Federal Government Action on all Gambling

The lesson for the Federal government, however, is that Gambling must be discouraged at both the pub and club level, and online at the same time. Both have similarly detrimental financial consequences for the players and punters, though the industries are distinct. From the public’s point of view, it is worrying that the terms of reference of this inquiry neglect that issue of Gambling in pubs, clubs and the TAB, as it suggests that these influences have restricted the terms of reference.  The regulation of the internet is also a wider problem, which usually comes into focus with the issues of inflammatory hate speech, medical disinformation, defamation or an aspect of pornography.  Gambling for money should be in a similar category to these and discussed in a similar context.

Recommendations:

  1. The Federal Government should recognise that the Gambling Industry and its power is the reason that Australia has a worse Gambling problem than almost any other developed country and the the Gambling Industry has a hold on Australian politics as strong as the Gun lobby in the USA, and with a detrimental effect that could be of similar magnitude.
  2. The Federal government should take an unequivocal stand that Gambling is harmful in that it encourages poor financial decision-making which puts a strain on the whole welfare system, Federal, State and NGO.
  3. The Federal government should recognise that all forms of Gambling need to be discouraged, pubs, clubs, TAB, on-course and online and this needs to be an unequivocal campaign, similar to Quit or for the necessity for vaccination.
  4. The campaign against Gambling needs to be in schools and have both a mathematical component as part of statistics, and a more practical part looking at online Gambling, and the social institutions which encourage Gambling.
  5. The campaign against Gambling must involve electronic media advertising bans on TV and all advertising and sponsorship.  It must involve active ads against Gambling as well as merely bans on pro-Gambling ads.  It should use satire and be prolonged.
  6. The control of online Gambling should be seen in the context of minimising the harm of the ubiquitous internet, and research on how to lessen Gambling should be pursued with endeavours to lessen other social harms such as child sexual exploitation, bullying, vaccine disinformation, tobacco and vaping advertising and disinformation, hate speech, video games that promote violence and defamation.
  7. The Federal government should fund Gambling research so that the social consequences can be quantified and rational decisions made about the cost-benefit to society.  Gambling research should not be neglected, limited, financed and controlled by the Gambling Industry as is currently the case.
  8. There must be support for people who have a gambling problem. Such services need to be publicised, and destigmatised, as happened for those with mental illness.  However, individual services must not be a substitute for a more systemic industry-focussed approach.
  9. There needs to be  a national register of addicted gamblers to allow better exclusion from gambling facilities. If this were comprehensive, it could be used to prevent addicts losing money online with a caveat emptor for those who took the bets from registered addicts.  The credit card companies could be recruited not to allow Gambling to such addicts and not to honour Gambling debts incurred by registered addicts.
  10. The Federal government should consider family support for addicted gamblers in the same way that child support is available for at risk families.

About the Author

Dr Arthur Chesterfield-Evans is medical doctor, who trained in surgery and became a tobacco-control advocate, then an Australian Democrat MLC in the NSW Upper House. He is currently working as a GP.

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10/11/2022

Vaping- A WHO Guide

10 November 2022
The World Health Organisation is trying to lessen vaping, which is now reaching epidemic proportions in young people. The attached article clarifies the tobacco Industry’s gobbledygook, though it is fairly soft on their rapacious marketing.

Social media has allowed the tobacco industry to target children and young people without adults noticing, which is different from the tobacco marketing days, when everyone saw the same ads.

The Industry claims that since vaping is less harmful than smoking, it should be legal, and most importantly that they should not have to prove it is safe. They have achieved this latter, and now because this has allowed them to achieve high sales they have made it hard to ban. They also use a lot of kids marketing to kids, as happens with illicit drugs, to make it harder again.
Of course not very many people use vaping to quit, and it now seems that vaping is a gateway to smoking, and a way of not quitting. But do not expect the Industry to do anything except maximise their profits.
The health interests are ponderously getting their resources together, for a battle that will take a generation or two, if tobacco, asbestos, lead etc are any guide.
www.facebook.com/groups/GlobalTobacco/?multi_permalinks=5906974112658360&notif_id=1668001224984823&notif_t=group_activity&ref

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13/04/2022

Belated Federal Govt. Action on Vaping

13 April 2022
The Federal government has made statements to try to lessen vaping especially in children. Health Minister, Greg Hunt has made statements and asked for State help on the issue. This is only days before the Federal government goes into ‘Caretaker’ mode before the election, so can have no real effect. Hunt himself is retiring at the election. Perhaps he is doing his best, but he has been undermined by a determined ‘pro-vaping’ group within the Liberal government, which includes Trent Zimmerman, MP for North Sydney. (One might wonder whether the vaping groups are funding the major parties, as they have significant tobacco company ownership. Presumably this will come out eventually- too late to be relevant)
Vaping has been increasing due to the same sort of marketing that launched tobacco, making it exciting, sexy and rebellious. With the internet, social marketing and ‘social influencers able to be paid and target certain groups, this can happen much more under the radar than in former times. As my son commented recently, ‘People believe what their algorithm feeds them’. Older folk who are not fed the ads do not notice what is happening. But now even student correspondents are complaining that there is so much vaping that the school toilets are polluted.
As one Professor of Medicine commented on Radio National Life matters today, ‘We should not be comparing vaping to smoking, we should be comparing it to breathing fresh air’. Exactly.
There were two articles in the SMH this week, ‘Federal bid to stop children vaping’ by Dana Daniel on 7/4/22 and on 9/4/22 (below).
We can only hope that the vaping members lose their seats and that the new Labor government takes a much more active stance. It is late to act on this, but better late than never.

Greg Hunt urges state governments to stop vapes being sold to children

By Dana Daniel April 9 2022

Health Minister Greg Hunt has written to his state counterparts urging them to halt the illicit sale of e-cigarettes to children, but state health ministers want the federal government to stop them at the border.
Community concern is growing about e-cigarettes in schools as increasing numbers of teenagers take up vaping – despite state laws making it illegal to sell the devices to under-18s, regardless of whether they contain nicotine.
“I ask that you take active steps to enforce these laws by taking action against retailers contravening your laws, for example by selling NVPs to school children,” Mr Hunt wrote in the letter, seen by The Sydney Morning Herald and The Age.
Under Commonwealth law, it has been illegal to import liquid nicotine, unless prescribed by a GP as a smoking cessation aid, for the past six months.
But e-cigarettes and vape juices containing nicotine remain widely available through a black market both online and in retail stores and schools are grappling with an escalating problem.
Mr Hunt’s letter dated March 18 linked to a report in The Age about a five-year-old boy who was hospitalised with breathing difficulties after vaping with his brother and a seven-year-old classmate at school.
In that case, the vape was not alleged to have been sold to a child by a retailer, with the child’s father telling the ABC it belonged to another student’s mother.
Victorian Health Minister Martin Foley hit back on Friday, telling the Age and Herald: “We need more action from the Commonwealth to strengthen e-cigarette regulation at a national level – and we encourage the Morrison Government to get on with it.”
A spokeswoman for NSW Health Minister Brad Hazzard, who is recovering from COVID-19, said a national approach was needed to tackle vaping, which the state had formally requested “on multiple occasions, including during feedback on the new National Tobacco Strategy”.
“The federal government previously tried to get a uniform approach on e-cigarettes, but was met with opposition from supporters of vaping,” the spokeswoman said.
Mr Hazzard had already asked NSW Health to “step up its compliance action” before receiving Mr Hunt’s letter.
“Hopefully, it will be possible for federal compliance to be stepped up to minimise the importation of illegal vaping products.”
The federal health department is finalising the National Tobacco Strategy, a draft of which recommends new restrictions on “the marketing, availability and use of all e-cigarette components in Australia, regardless of their nicotine content”.
Australian Border Force Commissioner Michael Outram told a Senate estimates hearing in February that the ABF had not committed any additional resourcing to the detection and seizure of nicotine vaping products since the ban on importation without a prescription began last October.

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25/03/2022

Vaping- the beginnings of a disease description

25/3/22

It seems that the tobacco industry has won the first major vaping battle.  They have succeeded in getting their new product legal, and now they do not have to prove it is safe, the medical world has to prove it unsafe. Progressive elements of the medical profession are describing the diseases caused by vaping.  Its progressive practitioners are also aware of the political aspects of vaping’s progress, though their power in this area is not great.

After my last article on vaping Anne Jones, who used to run ASH (Action on Smoking and Health,) sent me a significant lecture by Prof Andy Bush, from the Brompton Hospital.  (Brompton is probably the most prestigious hospital for respiratory diseases in Britain). 

The 45 minute lecture is quite medical/technical and as such quite hard going, but it is interesting in that it combines very detailed medical aspects with an astute analysis of the political and economic significance of vaping.  As a student I was subjected to endless lectures on the harm of tobacco without any consideration of the political aspects of its political cause or prevention.  As Prof Bush himself says, ‘Fool me once, shame on you.  Fool me twice, shame on me’.

He points out the similarities between smoking and vaping, but also the differences.  There is something of a nightmare of acronyms, so I will help where I can.

Currently vaping is being marketed using the same symbols of success as was used before tobacco had any restrictions  on it, freedom, rebellion and glamour.  The difference is that it now uses social media to market to CYPs (Children and Young People). BAT has spent a Billion pounds on social influencers.  Although vaping is supposedly allowed to help people get off tobacco, the marketing to kids is to those who do not smoke anyway, so clearly it either a gateway drug to smoking or an entirely separate habit to be fostered and developed. 

He points out that the tobacco industry has taken over the major vaping brands.  VUSE is owned by RJR, who were R.J.Reynolds Tobacco.  VYPE is owned by BAT, British-American Tobacco.  BLU is now owned by Imperial Tobacco, and JUUL is now significantly owned by Altria, the new name for Philip Morris.

If that were not enough, one brand Puffit2 is owned by a company called Discreet Vape Company and the vaping device looks like a Ventolin inhaler!  Philip Morris purchased Vectura, a British pharmaceutical company that manufactures respiratory drug delivery devices, in September 2021. 

ENDS (Electronic Nicotine Delivery Systems) (= vaping devices) deliver chemicals.  Prof Bush points out these chemicals have no information publicly available about their nature and properties. 18 flavours have carcinogenic, tobacco-specific components and there are bacterial and fungal contaminants in a high percentage of vaping products.  These contaminants may have their own ability to generate allergic lung diseases, which are similar to emphysema.   In one case the nicotine was at 120% of the level stated on the pack.

Passive vaping is similar to passive smoking in that the non-vapers get similar levels of nicotine in their urine to passive smokers. 

Vaping is not a gateway to smoking cessation and may even be a gateway to smoking. A study which compared nicotine replacement therapy to vaping showed that while 9% of nicotine replacement patients were off cigarettes after 6 months as opposed to 18% of people using vaping, 80% of the people who had used vaping were still vaping a year later (Hajek et al, NEJM 2019).  If Buprion was used with nicotine replacement the quit rate was 25% at 6 months and 20% in a year.  Varenicycline achieved 27% (Borelli and O’Connor NEJM 2019).  Interestingly, if you pay people to quit, it is a better investment than the drugs!

Vaping has risen rapidly amongst American teens and is currently at 28% and the prevalence of smoking has stopped declining since the vaping rise started. 

Prof Bush’s lecture states that the acute toxicity of vaping is actually worse than cigarettes. Researchers always do an immense amount of work, and doctors struggle to keep abreast of it.  The effect has been measured on foetal lungs, levels of all kinds of proteins, cytokines, chemokines, enzymes, Cell functions, lung pathology, oxygenation levels and from many areas including broncho-alveolar lavage (BAL), (i.e. washing from lungs).  Rat models have also been used to look at emphysema (poor little guys).  It increases their alveolar (lung air sac) size and causes a fall in transcutaneous oxygen levels. This may be due to a lipoid pneumonia due to lipid (fats) being leached out of the lungs.  The negative effects of e-cigarette vapour condensate on macrophages (the cells that fight infection) were similar with or without nicotine in the condensate. The condensate was also more toxic than the e-Cigarette liquid!   (Scott, Thorax 2018).

Vaping has been shown to increase bacterial adherence to epithelial cells which increases susceptibility to infection.  It also considerably worsens the effect of COVID infection.

There are case histories of a 16 year old previously healthy boy who was admitted urgently to an Emergency Dept with a lung disease so serious that he ended up on ECMO (Extra-Corporeal Membrane Oxygen- the artificial lung).  He had only used OTC (Over the Counter) vaping products.

Prof Bush describes a new disease that has been called EVADI (E-cigarette Vaping Acute Lung Injury), though it would not be medicine if they were not arguing over the new name which some want to call EVALD (E-cigarette Vaping Acute Lung Disease).

Bush finally asks that the recommendations of FIRS, (Forum of International Respiratory Societies) be implemented:

  1. ENDS (Electronic Nicotine Delivery Systems) should be considered as tobacco products and taxed and regulated as such.
  2. Sales to CYPs (Children and Young People = minors) must be prohibited and this must be enforced.
  3. All advertising and promotion should be regulated and made inaccessible to CYPs.
  4. Flavourings increase rates of youth initiation, so should be banned in ENDS
  5. Vaping should be prohibited in indoor locations, public parks, and places where children and youths are present.
  6. While their health risks are increasingly recognised, more research is needed
  7. Routine surveillance and surveys concerning combustible and electronic cigarette use should be carried out.

Prof Bush makes the point that they also need plain packaging and health warnings like tobacco products and says, ‘There is no chemical model that shows inhaling hot chemicals is a good idea.  You show me the proof that it is harmless.’

We all need to lobby on this.  Here is the video of the lecture: https://www.youtube.com/watch?app=desktop&v=yhdiIuz0ec4&fbclid=IwAR2ETBxTR8LD87Nmng54uo_w2xZ6vI7kRmYBqITPOv36R0

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