Andrew Leigh (Fraser, Australian Labor Party, Shadow Assistant Treasurer) Share this | Link to this | Hansard source

A few years ago I received an email from a constituent about why we should support efforts to reduce smoking rates. The constituent wrote:

My great grandfather, grandfather, father and one of my uncles all died from smoking related conditions. Each of the latter three died 20 to 30 years before the life expectancy for their generation. My father's addiction contributed to two decades of poor health prior to his premature death, resulting in frequent periods where he was unable to work. My siblings and I grew up in poverty, the effects of which are still evident, and the taxpayer bore the cost of his many hospitalisations as well as the cumulative years of income support our family depended on in lieu of employment. I say this so you will understand my absence of sympathy for the 'principled' argument that tobacco companies have a right to make a profit from pushing legal drugs.

This legislation is a progressive health measure. While the national smoking rate is around 17 per cent, it remains considerably higher for disadvantaged groups. It is 26 per cent for people living in low socioeconomic areas, 34 per cent for Indigenous Australians and 38 per cent for the unemployed. Smokers in these groups also consume more cigarettes, around 15 to 20 per cent more cigarettes than the average smoker.

This bill also has particular benefits for regional Australia. Smoking rates in regional areas are twice as high as in the cities, and people in the bush have higher death rates from lung cancer, heart disease, asthma and chronic obstructive pulmonary disease. This bill will help nonsmokers. We know that smokers harm those around them, including children who inhale passive smoke and the one in six babies born to mothers who smoked while pregnant.

Smoking kills over 15,000 Australians every year. Put another way, for every hour that we spend debating this matter in the chamber, two Australians die of smoking related causes. On one estimate, smoking costs Australia $31 billion a year. It is responsible for 84 per cent of lung cancer cases in men and 77 per cent in women. We know the score when it comes to long-term smoking: the hacking cough, the breathlessness, the fatigue, the chest infections and the bloody phlegm.

We also know what happens when you stop smoking. Immediately you smell better and your hair and clothes are no longer infused with the stench of stale smoke. In a week, most of the nicotine has left your body and your sense of taste has improved. You gain much more enjoyment from a meal or a drink. One ex-smoker told me that she could finally enjoy herbal tea after she had quit smoking. A month later, better blood flow improves your skin and people will notice that you are looking healthier. Three months down the track, your lung function will have increased by 30 per cent and you will have your breath back. You will have so much air available and will finally be able to feel it reaching right into your lungs. Suddenly, walking and running are much easier. After one year without a cigarette your risk of heart attack has halved. You will also have noticeably more cash in your pocket. Ex-smokers describe quitting as the best thing you will ever do.

If tobacco were discovered today it would be unlikely that most developed countries would legalise it. Uniquely, smoking is harmful even in small doses. That makes it unlike other legal vices, which can be consumed in moderation. The occasional double whiskey or deep fried Mars bar will not kill you but, as the ad says, 'every cigarette brings cancer closer'.

The Excise Tariff Amendment (Tobacco) Bill 2014 and the Customs Tariff Amendment (Tobacco) Bill 2014 amend the Excise Tariff Act 1921 and the Customs Tariff Act 1995 to increase the rate of excise and excise equivalent Customs duty on tobacco for a series of four staged increases of 12.5 per cent, commencing on 1 December 2013. The bills also index the rate of excise and excise equivalent customs duty on tobacco to average weekly ordinary time earnings, instead of the consumer price index. The last CPI indexation occurred on 1 August 2013, and the first AWOTE indexation occurred on 1 March 2014, reflecting the unusual historical circumstances of the government being able to adjust excise rates and then come back to the parliament for ratification of those changes.

The measures implement policy that was announced by the former Labor government in the 2013-4 budget and then the 2013 economic statement. The former Labor government announced those policies in order to reduce smoking rates in Australia, to reduce the scourge of cancer to which I referred in my opening remarks. The effects in practical terms—so those listening to proceedings are aware of their effects—will be a 12.5 per cent increase on 1 September 2014, 1 September 2015 and 1 September 2016. The increase will mean an increase in excise from 36c to 40c per stick for cigarettes, and that per-stick excise applies to cigarettes with a tobacco content up to and including 0.8 grams per cigarette. In pack terms, that is $8.04 in excise in a pack of 20 cigarettes or $10.05 in a pack of 25 cigarettes. In international terms, if we look at excise tax as a share of the average price for the most popular brand of 20 cigarettes, the tax share according to a 2013 WHO report in Australia was 50 per cent, but in other countries it was higher: in France, 64 per cent; in the United Kingdom, 62 per cent; in Ireland, 60 per cent; and in New Zealand, 61 per cent. So, in international terms, Australia's tax regime will remain appropriate.

I move:

That all the words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House is of the opinion that:

(1) tobacco continues to be the world's leading preventable cause of death;

(2) in government, Labor implemented measures to reduce smoking, including plain packaging; and

(3) the National Party continue to accept donations from tobacco companies."

Mr Briggs interjecting—

I find it passing strange, Deputy Speaker Kelly, that the minister at the table is unacquainted with second reading amendments. I do encourage him to put the standing orders on his bedtime reading list.

Labor ceased accepting tobacco donations in 2004. We took a principled stance. Our view was that it was not appropriate for a serious political party to continue to take tobacco money. Since 1999, the Liberal Party has accepted more than $3 million in donations from big tobacco. I pay tribute to those Liberal MPs who spoke out against that practice. For example, Russell Broadbent, Mal Washer, Liberal candidate Bill Glasson and Liberal Premier Colin Barnett encouraged the Liberal Party to change their policy on donations. Eventually, the Liberal Party kicked the habit, as the former member for Gellibrand might have put it. There was a final whopping donation, as has been recorded by the 2012-13 AEC returns: in 2012-13 Philip Morris donated $107,040 to the Liberal and National parties, including $45,000 to the Liberal Party's federal branch and $25,000 to the National Party's federal arm. Philip Morris also made a donation of $6,100 to the Liberal Party division in the seat of Hindmarsh, where Steve Georganas, not supported by big tobacco money, was ultimately defeated; and $10,660 for the seat of Sturt, held by the Minister for Education. At the last election, members opposite in the seats of Sturt and Hindmarsh were assisted by big tobacco money. Big tobacco assisted the Liberal Party in Hindmarsh and Sturt in particular, but also across the board by virtue of the donation to the federal Liberal Party.

This is a coalition government, so it is absolutely worth recognising that the Liberal Party's coalition partner, the Nationals, has not kicked the habit. National Party Federal Director Scott Mitchell confirmed in February that the National Party would continue to take donations from big tobacco. Mr Mitchell said: 'Our position has been that it's a legal product; they're legitimate businesses'. Returns lodged with the Electoral Commission show that over $350,000 has been donated by big tobacco to the National Party.

It is a concern that we saw the government shutting down the Alcohol and Other Drugs Council of Australia, a body which played a vital role—until its pre-emptive closure—in combating the scourge of binge drinking and of substance abuse. Evidence-based policymaking ought to be the bedrock on which all parliamentarians in this place stand. But too often those on the other side of the House have been shutting down the voices of experts, whether it is the Climate Commission or the Alcohol and Other Drugs Council of Australia. There has been an attack on expert evidence, which I believe is regrettable.

I do commend Liberal Party members opposite for their decision to cease taking money from big tobacco—nine years too late, in my view, but it was a good decision by those opposite. I am sure they will be speaking about the principled decision that the Liberal Party has made, but I would encourage them to speak to their National Party colleagues and to encourage the National Party to follow other major political parties in Australia and take a principled stance and no longer accept money from big tobacco.

This bill enjoys bipartisan support. It will increase tobacco excise and is aimed at reducing the scourge of smoking. We on this side of the House are pleased to see the government legislating it. Reducing smoking rates is an issue that all members in this House are committed to. Nobody in this House wants to see young kids taking up smoking. But we need policies in our political parties that will back what we are doing here in the parliament. It is a vital issue of principle. It is an issue of conscience for the National Party, and I urge them to kick the habit.

Craig Kelly (Hughes, Liberal Party) Share this | Link to this | Hansard source

Is the amendment seconded?

Matt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Parliamentary Secretary for Foreign Affairs) Share this | Link to this | Hansard source

I second the amendment.

Craig Kelly (Hughes, Liberal Party) Share this | Link to this | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for Fraser has moved as an amendment that all words after ‘That’ be omitted with a view to substituting other words. If it suits the House, I will state the question in the form, 'that the amendment be agreed to.' The question now is that the amendment be agreed to.

Andrew Southcott (Boothby, Liberal Party) Share this | Link to this | Hansard source

The previous speaker seemed to be channelling the former health minister and former Attorney-General, talking about 'kick the habit'. What he neglected to say is that, after the Labor Party publicly declared that they would stop taking donations from tobacco companies, they were caught out soliciting a donation from Philip Morris. That is the Labor Party: say one thing and do another.

The Excise Tariff Amendment (Tobacco) Bill 2014 is very simple. It involves increasing the tobacco excise by 12½ per cent per year over four years on 1 December each year—2013, 2014, 2015 and 2016. It also involves the indexation adjustment which happens on 1 March and 1 September being done at average weekly earnings rather than at the CPI. I think this is a welcome piece of legislation and it really does address what we need to look at in terms of further decreasing the smoking rates in our community.

When you look at Australia's track record on tobacco control over the last 30 years you see that we have been very successful. We have seen reductions in smoking rates amongst men and women of the order of 40 to 44 per cent. Very few countries in the OECD have seen such a dramatic fall in their smoking rates. It is not necessarily one way. If you look at Europe you see that smoking rates amongst women have increased. In countries like France and Germany smoking rates have increased amongst women; and, in countries like Greece, they have increased dramatically amongst women. There does need to be a concerted effort made to see these smoking rates come down.

The Preventative Health Taskforce of the previous government reported to the government, and one of their key recommendations in this area was to make tobacco products significantly more expensive. All of the evidence shows that if you increase the cost of tobacco you see fewer people take up smoking to begin with and you see a reduction in the amount people smoke. To quote from the government response to the Preventative Health Taskforce:

Price increases encourage existing smokers to quit and raise the barrier for people considering taking up smoking, especially young people.

All the evidence shows that. In terms of reducing the smoking rates further—and COAG has a goal of a 10 per cent smoking rate by 2018—this will be an important measure.

Going back a little bit, in 2008 a packet of 30 cigarettes cost $13.50 in Sydney, and that was quite a low price by international standards. I do recognise that different jurisdictions have city taxes and so on, but it was still a low price. Using the example of a pack of 25 Winfield cigarettes, which had a retail price of $18.80 before the 1 December 2013 increase, under this legislation the price will go up to $21.26 on 1 September this year, $23.43 on 1 September 2015 and $25.96 on 1 September 2016. This should have a significant impact on reducing smoking rates.

When the Preventative Health Taskforce were talking about increasing the price of a pack of cigarettes from $13.50 to $20, they thought that the excise increase on its own would reduce tobacco consumption by six per cent and the number of smokers by two to three per cent and that 87,000 Australians would give up smoking. This is something that has wide support in the community. A 2007 Australian Institute of Health and Welfare survey found that two-thirds of Australians support increasing the tax on tobacco to discourage smoking. So, in terms of all of Labor's tax grabs, this was a virtuous tax grab. They cannot resist their instinct to make a grab for cash and to increase taxes, but this was a virtuous one, and in opposition we suggested similar things.

I want to touch on the issue of illicit trade in tobacco, because it is an important public health issue. The Preventative Health Taskforce touched on this and recommended that the government 'develop and implement a coordinated national strategy to prevent the emergence of illicit trade' in tobacco in Australia. I think it is often the case that health bureaucrats dismiss this as being something that is raised by tobacco companies. It is not; it is a serious issue. The National Drug Strategy Household Survey estimated that illicit tobacco was smoked regularly by 4.6 per cent of smokers in 2010. A KPMG report had the percentage as high as 13 per cent.

If we look at tobacco detections, we see an increasing number of cigarettes being seized by the Australian Customs and Border Protection Service. In 2010-11, 82 million sticks were seized, which was potentially $135 million in duty evaded. In the next year, 141 million sticks were seized with a potential $125 million in duty evaded. In the most recent year that I have figures for, 2012-13, 200 million sticks were seized with a potential $151 million in duty evaded. So it is a serious issue and it needs attention. One of the suggestions that we had in opposition was to look at a track-and-trace scheme in the Australian context. Australia is generally seen as a country which has a fairly low rate of illicit and counterfeit tobacco, but I think it is important, as it is a significant public health measure, that we continue to make sure that that avenue, which is a way of having cheaper tobacco, is really cut out.

The WHO Framework Convention on Tobacco Control explicitly recognises illicit tobacco as a public health concern. As I said before, the tobacco companies raise this issue, and I think that is one of the reasons that illicit tobacco gets dismissed. The previous government focused a lot on plain packaging, but they really missed the boat on illicit tobacco. The WHO Framework Convention Tobacco Control was signed during the period of the Howard government, and there are a number of parts of that framework that look at implementing a track-and-trace regime for tobacco products and strengthening the legislation against illicit trade in tobacco—and I think that is something that does need more attention. Article 15 and article 20 of the WHO framework recommend a track-and-trace scheme—something that the previous government in their six years were inactive on.

The draft protocol to eliminate illicit trade in tobacco products, published by the WHO, states that the obligations of each party to the FCTC 'shall not be performed by or delegated to the tobacco industry'. In other words, if you have a track-and-trace scheme it needs to be a neutral scheme. Unfortunately, the previous government, with their plain packaging, decided that the alphanumeric code markings could be used by tobacco companies on a voluntary basis. In opposition, when we considered plain packaging, we called on the government to look at a neutral track-and-trace system for tobacco products—a scheme that could be managed by the Australian Customs and Border Protection Service in conjunction with the Australian Taxation Office. When the House of Representatives Standing Committee on Health and Ageing looked at the plain packaging bills, they noted that there were 'a range of sophisticated anti-counterfeiting measures which could be adopted'.

In welcoming this bill, there are two points to be made. The first point is that an increase in the price of tobacco will have an impact on reducing our smoking rates and reducing the amount of tobacco that is consumed in Australia—and that will benefit our health in the long term. The second point to make is that illicit tobacco is a serious public health issue and the government really need to look at how they can best address this. Legislation is not by itself enough. Many countries that have strong records, similar to Australia—low-smoking countries—have implemented track-and-trace systems, and I think this is something that the government needs to act on.

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Link to this | Hansard source

It is a pleasure to follow the member for Boothby, someone who has been championing prevention for his entire career. I acknowledge his former profession as a doctor and I also acknowledge the contribution that he has made to prevention during his time here in the parliament.

I rise to speak on the Excise Tariff Amendment (Tobacco) Bill 2014 and the Customs Tariff Amendment (Tobacco) Bill 2014, which amend the Excise Tariff Act and the Customs Tariff Act. Both of these bills increase the rates of excise and excise equivalent Customs duty on tobacco through a series of four-staged increases of 12.5 per cent commencing on 1 December 2013 and index the rates of excise and excise equivalent Customs duty on tobacco to average weekly ordinary time earnings instead of the CPI. The last CPI indexation occurred on 1 August 2013 and the first average weekly ordinary time earnings indexation occurs on 1 March 2014. The previous Labor government announced these measures as part of the 2013-14 budget and the 2013-14 economic statement. These measures continue to implement Labor's world-leading approach to tobacco control and measures to reduce tobacco consumption.

World-wide tobacco continues to be the leading preventable cause of death, killing approximately six million people each year—a staggering number—including 600,000 deaths from second-hand smoke; all of which is preventable. According to current projections, tobacco will kill one billion people in this century. In Australia over 15,000 people die each year from smoking related illness, and in 2003 tobacco smoking accounted for nearly eight per cent of the entire total burden of disease. We know tobacco smoking is a major risk factor in coronary heart disease, stroke, peripheral vascular disease and numerous cancers, including mouth, lung, oesophagus, larynx, kidney, pancreas, bladder, stomach and cervical cancer. The health problems linked to passive smoking or second-hand smoke are just as serious: asthma in children, lower respiratory tract infections, lung cancer and coronary heart disease.

In recognition of the devastating impact of tobacco consumption on health, the previous Labor government made significant efforts to reduce tobacco consumption, which included the world's first tobacco plain packaging legislation. The objectives of plain packaging tobacco included: reducing the attractiveness and appeal of tobacco products to consumers, particularly young people—in other words, to remove the last form of advertising the tobacco companies had, particularly when marketing to young people; increasing the noticeability and effectiveness of mandated health warnings; reducing the ability of retail packaging of tobacco products to mislead consumers about the harms smoking; and contributing to efforts to reduce smoking rates in combination with a broader suite of tobacco control measures.

Australia is now recognised as a world leader in tobacco control, and around the world we are seeing a number of other countries, including New Zealand, Ireland and Scotland, following suit with plain packaging laws of their own. Results from behavioural research on the implementation of plain packaging indicate that those who are smoking from plain packs as compared with branded-pack smokers perceived that their cigarettes were of a lower quality, perceived that their cigarettes were less satisfying than a year ago, were more likely to have thought about quitting at least once a day in the past week and rated quitting as a higher priority in their lives. These results certainly suggest that plain packaging is meeting the original objectives that I outlined earlier.

Plain packaging was not the only measure we took to reduce tobacco consumption. This bill in fact goes to the heart of that matter. Increasing tobacco prices through effective taxation is one of the most effective measures that can be taken to reduce premature death and disease due to smoking. Price increases on tobacco products reduce cigarette consumption, increase attempts to quit and reduce smoking prevalence. We know it is an effective measure that works, and it has been working increasingly across the world.

This measure increases the percentage of excise tax on the retail price of a mainstream pack of 20 cigarettes from around 49 per cent to 62 per cent by 1 September 2016. After the first rise of 12.5 per cent on 1 December last year, the Treasury had estimated the number of Australians aged 18 and over who smoke would decrease by around 60,000. In fact, when tobacco excise was last increased under Labor in April 2010, a post-implementation review conducted two years later by Treasury showed a decrease in consumption of tobacco by 11 per cent, as compared to consumption immediately prior to the increase. In the coming years, further estimates by Treasury suggest that as excise increases tobacco consumption will decrease by as much as a further seven per cent by September 2016.

Modelling aside, and despite what we are still seeing from big tobacco as recently as today, we do know that taxation measures on tobacco control are already working. It is certainly one of the most effective measures in making the decision that people need to make to quit and in making the uptake of cigarette smoking less attractive, particularly to young people. For example, in the State of preventative health 2013report, the Australian National Preventive Health Agency outlined that there had been relatively large drop in smoking prevalence in the most disadvantaged areas between 2007-08 and 2011-12, and the National Prevention Health Taskforce reported that cost is a major trigger to quit smoking among smokers of lower socioeconomic status, who often bear the largest part of the burden of disease for smoking-related illnesses. Further, a study of Victorian smokers by the Cancer Council Victoria showed that after the April 2010 excise increases heavy smokers reduced consumption dramatically.

Labor's announcements of tobacco excise increases over the coming four years, and the government's commitment in these bills to implement that decision, will contribute to achieving the Council of Australian Governments' targets for smoking. It is a very important measure and, again, a measure the complements all of the measures that are across the suite of trying to reduce rates of smoking and uptake of smoking in Australia.

In addition to the measures that I have already mentioned, Labor's tobacco control package included investment of more than $135 million in anti-smoking social marketing campaigns—important campaigns to start targeting those population groups, particularly groups of young men aged 18 to 25, that have been more difficult to get the message to with regard to smoking. It is very important to try and work with them using methods that they would understand and hear to make sure that they actually understand what smoking is doing.

Labor also introduced updated and expanded graphic health warnings on tobacco products. I particularly reflect on my own experience internationally. I was asked to represent the then Minister for Health and Ageing, Nicola Roxon, in Moscow at the WHO precursor to the noncommunicable diseases convention, which was to be held in New York later in that year. One of the topics I was asked to speak on was plain packaging. Being in Moscow, a city that has very high smoking rates, and presenting before an international audience, I remember the complete silence in the room when I displayed the plain packaging tobacco pack that has the eye on it. Most people will be familiar with that particular one. They found it absolutely fantastic that Australia had gone this far, but it was incredibly confronting for those countries that had only just started on the pathway of tobacco reform, many of which had, in the first instance, only just started to introduce taxes on tobacco and introduce these price measures. Labor and the Australian people should be justifiably proud. In tackling the issue in the way that we have, we are in fact influencing the world and the world's rate of smoking.

The other measures that Labor introduced were the comprehensive advertising restrictions under the Tobacco Advertising Prohibition Act 1992, including internet advertising in Australia; a really important health measure of listing of nicotine replacement therapies on the Pharmaceutical Benefits Scheme, something long advocated for by those in the medical community and certainly by Quit; and the extended listings of smoking cessation drugs. We also saw under Labor the largest ever investment in support for Aboriginal and Torres Strait Islander communities to reduce their smoking rates, including $14.5 million for the Indigenous Tobacco Control Initiative, which funded innovative tobacco control projects in 18 Indigenous communities. This is an initiative which I must admit is not sitting within the health portfolio anymore, and I have some concerns about what may be happening with that project. There was also $100.6 million for the tackling smoking measure and $35.6 million for the healthy lifestyle measure to support Regional Tackling Smoking and Healthy Lifestyle program teams in 57 regions around Australia. Through Medicare Local networks, not-for-profit organisations and through medical organisations, we need to be able to look at those communities where we have not been as successful in getting smoking rates down and introduce initiatives specifically trying to assist those communities and those people to reduce smoking.

These measures were all included as endorsed strategies for reducing tobacco consumption under the World Health Organization Framework Convention on Tobacco Control. That convention is a treaty to address the health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke worldwide, a very important convention that has set the framework for all of the measures introduced in Australia and the measures that are progressively being introduced internationally.

As I have said, Labor made significant efforts to reduce tobacco consumption and the harms associated with it. I have high hopes that these efforts will not be wasted, and it is great to see the Liberal Party make the decision to no longer accept tobacco donations. That has long been an issue and I am very pleased to see that the Liberal Party have finally made that very important decision. I do have to point out that, unfortunately, the National Party have stated that they will continue to take tobacco donations. In this day and age, when we have so much research linking tobacco consumption to such poor health outcomes, and the big numbers of people in Australia and worldwide that are dying from tobacco related illness, it leaves me wondering how any political party would willingly accept financial donations from a company associated with such a product, frankly. I have said in this place before that I think it is untenable when you have an Assistant Minister for Health who is meant to be responsible for prevention accepting that her party will continue to accept tobacco donations. It is something that is untenable and I certainly hope very much that the National Party reflects upon the very difficult position in which they have placed that Assistant Minister for Health. I have had other things to say about her, but they have placed her in a difficult position.

Unlike this government, Labor does put health as a priority. It was a priority for us when we were in government and it remains absolutely a priority for us now. We support the measures in this bill, no less than the World Bank and the World Health Organization supported Labor's position on tobacco control. It was Labor who committed to the most comprehensive suite of tobacco reform measures in order to reduce tobacco consumption in Australia, and the increase in tobacco excise over the next three years will continue this tobacco control legacy. I am pleased to see on the list of speakers that the former Minister for Health, the member for Sydney, will also contribute to this debate. I want to particularly pay tribute to both her and, before her, Nicola Roxon for staring down industry and many people on tobacco control initiatives. It took some tough negotiations and tough leadership to get those through and I think that is a legacy that Labor is truly and justly proud of.

David Gillespie (Lyne, National Party) Share this | Link to this | Hansard source

I rise to speak in favour of the Excise Tariff Amendment (Tobacco) Bill 2014 and the Customs Tariff Amendment (Tobacco) Bill 2014. The excise and excise equivalent in customs duty on tobacco will rise as a consequence of this in four staged increases of 12.5 per cent. The first of these has occurred. It will also index the rates of excise and excise equivalent customs duty against average weekly ordinary time earnings rather than CPI. The net effect of these rises over four years will amount to $6.5 billion over the forward estimates. That will include $560 million of GST, which will be payable to the states, which incidentally bear the brunt, directly and indirectly, of running public hospitals. Against the cost of an average pack of 25 cigarettes, the first increase puts the cost up for consumers by $1.86, the second $4.02 and the third $6.56. We should not shrink from these increases in cost to the consumer because it is the government, at least in this country, that bears the responsibility for managing the health of those same consumers either directly or indirectly. If health were the sole responsibility of citizens of this nation, I could see why they would object. But we are all beneficiaries of a wonderful health system that is paid for by the government. So it is well within the remit of any government that is responsible for funding such a scheme to enact measures that will lead to a reduction in the health burden.

To put things in perspective, smoking is the single largest preventable cause of death and disease, both worldwide and here in Australia. We could run through a litany of diseases, though the ones that spring to mind are cancers, and lung cancer in particular. But the end organ damage of the horrible habit of smoking goes well beyond cancer of the lung. Smoking increases the risk of many other cancers: throat cancer, cervical cancer—even bowel cancer has a doubling in the risk if one smokes—along with cancers of the bladder, kidneys and oesophagus. But the things that really lead to major morbidity and death are heart disease—coronary heart disease in particular—and damage to the peripheral arteries of our bodies. One sees people with gangrene of their toes and feet; amputees; people with longstanding and slowly creeping emphysema, where patients slowly suffocate because they smoke the essence of their lungs away; or people spending their life attached to oxygen bottles, or wheezing and coughing their way through winter, interspersed with three or four hospitalisations.

It is not just the smoker who suffers from smoking, unfortunately. Their families suffer. In particular, they suffer from the scourge of passive smoking. Initially that was thought to be drawing a long bow, but now there is overwhelming evidence that passive smoking does cause damage to those who inhale. Imagine young children with two smoking parents in a small house: they would be getting the hazards of smoking from a very early age, particularly if their parents are heavily addicted smokers.

We know that increasing the cost prevents early uptake, and I will mention some figures later for young smokers. Also, if the cost is prohibitive, not only does that reduce the lure of smoking to young teenagers and those even younger, but also it puts a brake on even the most voracious physical addiction because of the sheer cost. So, even though it is an excise and a revenue-raising exercise, which everyone realises, it is a very powerful health improvement vehicle. It is preventive, and it reduces and limits harm. If you halve the amount you smoke, your lung cancer risk reduces, and similarly with other cancers. The greater the volume of nicotine you put between your lips and inhale into your lungs, the greater the risk of emphysema and bronchitis, and the same applies to all those other diseases I have mentioned.

We know that these benefits will occur because we have statistics to back that up. Overall, in 2001, 27.2 per cent of the Australian populace was smoking. With the increase in costs, that has dropped down to 20 per cent. Amongst females, as opposed to overall, a 21 per cent incidence dropped to a 16 per cent incidence. If you look into it in more detail, amongst the more socially disadvantaged the effect is just as great or greater. Amongst Aboriginals and Torres Strait Islanders, for instance, the overall smoking incidence was 49 per cent. In 15- to 17-year-olds, those who are enticed by the social prop that cigarettes are or by the social acceptance of smoking with their friends would stop and think if the cost were prohibitive. But by the time people are 15 years old up to five per cent of males and one in 10 females are already smoking regularly. Amongst another very vulnerable group of youths, young teenage mothers, the incidence is 35 per cent. Amongst those with chronic mental illness it is about 32 per cent. So, as we can see, the scourge of smoking and the ravages that it causes affects those who are most vulnerable, and also those who will then turn to the health system to salvage their problems later on in life.

So, what is better than solving problems? It is preventing them. An increase in costs will cause some social disharmony amongst those who are unfortunately addicted to smoking and get pleasure from it. I understand that; everyone understands that. But if, as I mentioned earlier, you then turn to the state to fix your problems, when you get your peripheral vascular disease or emphysema or asthma and you want your asthma puffer drugs on the PBS and you want to be able to see the doctor and get your antibiotics to fix up your pneumonia, well, the government is saying: we think this is not a good thing, and if we can add this to the suite of manoeuvres that will reduce this burden on society then well and good.

The cost of smoking does not work alone as a prevention. It is coupled with smoking cessation manoeuvres. One only has to think of the Quitline which we have seen ads for on TV, or nicotine replacement therapies that are also advertised on TV—both of these are funded by the Medicare system. With these increases we expect to see, over the forward estimates, a 60,000 nominal reduction in active smokers. That does not account for people who have reduced the volume of their smoking, which will also add a benefit. And if you look at the cost of Medicare, one or two hospitalisations with this could be $20,000 or $30,000 at least to a public hospital budget.

One thinks of all the presentations to general practitioners with all the various complaints—high blood pressure, chronic heart disease, chronic asthma, chronic bronchitis—and all those visits to oncologists treating not just your lung cancer but your cervical cancer, bowel cancer and bladder cancer, let alone the unsightly ageing effects of smoking. If teenagers were aware of the dermatological impact of smoking on their good looks, they would think twice, but what will make them think twice even sooner is if the cost is $25 as opposed to $20. It sounds hard, but it seems quite logical to me.

When the government brings in costs like this, there will be, undoubtedly, some complaints from people who, as I mentioned, are addicted to it, but we cannot resile from making hard decisions that in the long run will benefit the whole community. I commend these changes to you, Mr Deputy Speaker. They are common sense. They are a financial burden on the addicts, but the addicts will hopefully get a better outcome because they will not be in hospital as much. They will not be buying as many asthma puffers. They will not be taking as many blood pressure pills. They will not have to deal with the stack of cards that can be dealt them when they get a malignant disease. I commend these amendments and the associated legislation to the House because overall the nation will be better off.

Amanda Rishworth (Kingston, Australian Labor Party, Shadow Parliamentary Secretary for Health) Share this | Link to this | Hansard source

I rise to speak on the Excise Tariff Amendment (Tobacco) Bill 2014 and the Customs Tariff Amendment (Tobacco) Bill 2014. I think it is very important that we have in this place a debate about prevention and particularly about the prevention of tobacco related diseases, because it is estimated that over 15,000 people die each year from smoking related illness. It is really important to recognise that the suffering that goes along with that, not just through the deaths and through the suffering of families but also in the diseases themselves, such as cancer and cardiovascular diseases that are exacerbated by tobacco, is preventable. We can try and prevent some of this suffering by really focusing on prevention.

I am very pleased about the focus that we in the previous government had on prevention. I have to say that I was very, very proud to stand in this parliament and pass legislation that led to plain packaging. That saw a world-leading tobacco control measure brought in here in Australia. I have to take this opportunity to note that it was not welcomed by every member of this House. I remember the fierce debate that ensued, but we are now seeing the early benefits of this.

As to some of the benefits, researchers at the University of Sydney found, as published in the Medical Journal of Australia, that calls to the stop smoking Quitline rose by 78 per cent following the appearance of plain packaging. While they found it difficult to distinguish whether it was the olive-green package or the big new anti-tobacco advertising, we did see a lot more people looking at taking that important step. Indeed, research by Cancer Council Victoria's Professor Melanie Wakefield, published in the British Medical Journal in July 2013, found that plain packs reduce the appeal of smoking and increase smokers' thoughts about quitting.

I remember that in that debate the then health minister, Nicola Roxon, made a very strong argument that we needed to reduce the appeal for young people of taking up smoking. We are now seeing the evidence coming through that indeed there is less appeal in taking up smoking with the plain packaging that was brought in. So I am very proud, and I would like to join the shadow minister for health in commending both Nicola Roxon and the member for Sydney for pursuing this landmark reform. It is something that I think we will reflect on in many years to come as having an effect in reducing tobacco related illness.

Of course, there is no silver bullet for reducing tobacco related illness. Part of the package is an increase in tobacco excise but also an increase in antismoking social-marketing campaigns, which was also part of the package brought in by the previous government.

Importantly, I think one issue did get missed a little bit in the public discussion but was not lost on electors in my electorate, and that was the listing of nicotine replacement therapies on the Pharmaceutical Benefits Scheme. I remember very clearly a number of people coming up to me in the shopping centres. One lady in particular at Seaford shopping centre said, 'Now that it's been listed and now that they are subsidised, I've been able to afford to get nicotine patches.' She was a cleaner at the Seaford shopping centre, and for the first time she was able to attempt quitting. One thing we know is that tobacco addiction is significant. Nicotine addiction is significant. So making this accessible to people who had not been able to access it before actually made a difference to people's lives out there in the community. I certainly very much supported that move, and I think it will continue to make a difference.

Also, I must recognise the investment that the former government made in support for Aboriginal and Torres Strait Islander communities to reduce their smoking rates. We see much higher smoking rates in Aboriginal and Torres Strait Islander communities. Indeed, the $14.5 million Indigenous Tobacco Control Initiative, which funded innovative tobacco control projects in 18 Indigenous communities, was an important contribution in reducing smoking rates.

So there is a wide range of evidence—and I realise that I have limited time here—that there is no silver bullet, but some of the things that Labor in government put in place are starting to make a difference. I am pleased to see that the coalition, despite a lot of argument while in opposition, are now coming to the party. I hope that this will continue. I hope that this is not the only step in tobacco control and preventative measures when it comes to smoking related illness. I hope that this is just the start and that they will pursue and continue the things that Labor did in government.

Bruce Scott (Maranoa, Deputy-Speaker) Share this | Link to this | Hansard source

Order! Debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour, and the honourable member will have leave to continue her remarks when the debate is resumed.