Nigel Scullion (NT, Country Liberal Party, Minister for Indigenous Affairs) Share this | Hansard source

I rise in support of the Excise Tariff Amendment (Tobacco) Bill 2016 and the Customs Tariff Amendment (Tobacco) Bill 2016, and I have to say that this legislation is of special interest to me and to my portfolio of Indigenous Affairs. I have personally seen, as I am sure have many in the chamber, the devastating impact of smoking on far too many Aboriginal and Torres Strait Islander communities. So, through my portfolio we have three priorities: getting kids to school, getting adults to work and ensuring that communities are safer. But we are not going to achieve this when our First Australians die 10.6 years earlier, for males—9.5 years earlier for females—and, generally speaking, enjoy far poorer health outcomes.

That is why the coalition government is committed to closing the gap between Indigenous and non-Indigenous Australians across a whole range of measures. Madam Deputy President, I know you would be aware that the Closing the Gap measures started as a suite of health measures and have grown over time. Part of the motivation for those fundamental measures initially was to address the health gap. If you are not healthy it is very difficult to engage in education. If you are not healthy it is very difficult to engage in employment. If you are not healthy it is very difficult to engage in the sorts of opportunities that other Australians take for granted. So one of those Closing the Gap targets is to close the gap in life expectancy between Indigenous and non-Indigenous Australians by 2031.

Closing the gap is particularly challenging because it is not only about ensuring that Aboriginal and Torres Strait Islander people live longer; it is also a matter of ensuring that they catch up with the remainder of the medical miracles that constantly make those in the mainstream live longer. So it is a very challenging gap but obviously one that is absolutely fundamental to the Closing the Gap process. If we are going to achieve this, then if there is any lever that is available to us we need to ensure that we can pull that lever. This legislation is one of those levers.

The Australian Institute of Health and Welfare report titled Australia's health 2016, which was released just this week, reinforces why we need to tackle smoking rates. Let me share with the Senate some of the report's key findings. Between one-third and one-half of the health gap between Indigenous and non-Indigenous Australians is associated with differences in socioeconomic position. Only 39 per cent of Indigenous Australians rated their health as 'excellent' or 'very good' in 2012-13, a decrease from 44 per cent in 2008 and 43 per cent in 2004 and 2005. A further 37 per cent of Indigenous Australians reported their health as 'good', 17 per cent as 'fair' and seven per cent as 'poor' in 2012-13. By comparison, more than half of Australians more generally—56 per cent—rated their health as 'excellent' or 'very good', only 10.4 per cent as 'fair' and 4.4 per cent as 'poor'. There is a stark contrast.

Chronic diseases, such as cardiovascular disease and cancer, are responsible for a majority of the life expectancy gap. Certainly it has been my observation that, particularly in very remote areas and very remote communities, the nature of the environment is a factor in chronic disease. Whilst smoking is a part of that, if a person has rheumatic heart disease, which is one of the largest killers in our communities—and I have to commend those who are working very stridently at the moment, particularly Menzies, to try to provide some respite via a vaccination or other processes in that regard—it is like an accumulation of things that can go wrong in that person's life, an accumulation of things that are negatively affecting their body and how it works.

Rheumatic heart disease, congestive heart failure, various types of lung disease—a lot of them are caused by the circumstances in the community. There may be a house that people do not themselves own, so it is very difficult to know who is responsible for it. People are coming and going, visiting the house, and it is not the normal circumstance of a house that someone is actually responsible for; it is a circumstance where a lot of people are responsible. I suppose it is a little like the 'tragedy of the commons': you cannot identify someone who is particularly responsible for this house in the way that you can in many normal households.

So the circumstance is that some of these houses are, as we would say, a bit dirty. Having many fingers at child level moving around the place makes it a bit grubby. But we are now starting to understand that such an environment has a direct impact on health. And when we see that some of these chronic disease presentations—cardiovascular diseases particularly—are being impacted by that, we have to ensure that we start to look after that environment, and that goes to how we can better manage some of our tenancies in this area and how we can assist those families, because it just gets on top of them. They have lots of visitors, lots of people going through, and they just do not have the capacity to ensure that the house does not have such a negative impact on people's health.

As I said, chronic diseases such as cardiovascular disease and cancer are responsible for a majority of the life expectancy gap. We in this place would all know about the strong association between cancer and smoking. I have to confess that I have been a smoker during my life, and if I have one or two beers there is certainly that tendency to want to go and, in the vernacular, 'bot a durry' from someone. I think even the most chronic smokers—speaking of which, good to see you, Senator O'Sullivan!—know themselves that they would like to not be smokers. And it is really interesting in communities: it is not as though communities are not absolutely aware that smoking is bad for you. If I am in a community in north-east Arnhem Land and I see someone light up in a tree, people will yell out—it is a wonderful way that they have got in north-east Arnhem Land—'Quit smoking!' They will say, 'No durries.' They will do it in a likely place, but each time, as they would say, it provides a little shame for someone who is lighting up. The whole community give a bit of a yell out in that regard.

So it is not as if people are not aware that smoking is bad for them. As I have heard from some other speakers this morning, it is, of course, the nature of addiction. The evidence is that nicotine is one of the most difficult drugs in your system to get rid of. It not only provides the circumstances where you are in a much more vulnerable demographic; also you are much more likely to develop cancer if you are a smoker. Obviously, there are a whole range of other issues. We still need to work very hard on exactly how we try to ensure that this is no longer cool in the community. There are demographics within a community that we can ensure are made aware in a way that appeals to them. It is that which this bill addresses. Whilst the smoking rate—that is, the daily and less-than-daily rate—for Indigenous Australians has declined somewhat, Indigenous Australians are still 2.6 times as likely to smoke daily as non-Indigenous Australians, whose rate is around 15 per cent.

In 2013, Indigenous mothers were 3.6 times as likely to smoke during pregnancy as non-Indigenous women. I have to say I despair sometimes because there are groups—sometimes very vulnerable groups—who do not have access to the same sort of constant education. If you go into any of the medical centres, for sure the walls are festooned with warnings about smoking during pregnancy and the negative effects it can have on your unborn child. But, given the numbers of people who still smoke when they are pregnant, clearly the message is not getting through to them. We need to do our very best to ensure that that is no longer the case.

We are not going to close the gap in life expectancy if we do not lower the rates of smoking among Aboriginal and Torres Strait Islander Australians. Of course, the smoking rates are on top of a number of other startling facts in terms of that difference. For example, in 2015, the immunisation rate for one- and two-year-old Indigenous children was much lower than the rate of all children. It was 89 per cent compared with 92 per cent for one-year-olds and 86 per cent compared with 89 per cent for two-year-olds. The immunisation rate for Indigenous five-year-olds was higher than the rate for all children—that is, 94 per cent compared with 93 per cent. This is a startling difference.

All of these statistics have a parallel. They are all connected and they are all contextualised around the actual gap that they create. If you cannot get immunisation processes right and if you cannot reduce the rates of smoking then life expectancy for our First Australians and the gap between the mainstream and our First Australians is going to close very slowly, if at all.

In 2012-13, after adjusting for the differences in the age structure, Indigenous adults living in non-remote areas were still more likely than non-Indigenous adults to not have undertaken the recommended level of physical activity in the past week. That is another 10 per cent difference.

Whether it is smoking or whether it is immunisation, all of these matters need to be dealt with to ensure that that headline of life expectancy is actually dealt with. That is why it has been so important to ensure that we have a whole-of-government approach. I have to say it is so much easier, now that my portfolio is under Prime Minister and Cabinet, to deal with some of the structural matters that we have done. We now have a cabinet subcommittee with all the other ministers who are responsible. In this case, it is the minister for health, but it is the same with Employment, Environment or whatever the area is. For the very first time, we can have a far more structured approach to those matters.

Obesity was also more common amongst Indigenous Australian adults aged 18 and over. Between 2012 and 2013, after adjusting for differences in age structure, Indigenous adults were 1.6 times more likely to be obese than non-Indigenous—that is, 43 per cent compared with only 27 per cent for non-Indigenous adults.

In 2012-13, a high proportion—26 per cent—of Indigenous Australians aged 15 and over reported that they had not drunk any alcohol in the previous 12 months. After adjusting for age differences, this was 1.6 times the non-Indigenous rate. In some areas, quite clearly there is no grey area of every now and again. Those people who are prepared to go down the road of abstinence do so quite proudly and often as a family. It sometimes cannot be done community by community or area by area. But this indicates that, to be absolutely successful at this and to ensure that we can be successful at this, we need to recognise that a family group and the peers within that family group can lead a better behaviour, a different behaviour and, in this case, a healthier behaviour than any other process might actually deliver.

In 2012-13, Indigenous Australians aged 15 and over were 1.1 times as likely as non-Indigenous Australians to exceed the national alcohol guidelines for single-occasion risk—that is, 50 per cent and 44 per cent respectively. Amongst prison entrants, the use of methamphetamine was more common amongst non-Indigenous entrants than Indigenous entrants—54 per cent and 38 per cent respectively. Whilst we have a scourge that you would expect for those populations that have had difficulty in dealing with some other health issues that I have outlined, quite clearly there are some exceptions to that, and we need to drill into those demographics to find out why they have been more resilient. I have to say, though, that I have been nothing short of petrified when I have seen the scourge of ice and the vulnerability of my community, particularly in remote communities. Yet there seems to have been a line put down that, while there are some substances that are semitolerated in the community, methamphetamine and its associated drugs are not. They have put a hard line down. People are as frightened as I am. I am delighted that these substances have not simply raged through these communities like a bushfire, as we were all so worried they would. Again, we need to tap into the leadership that can provide that sort of inoculation against those sorts of scourges. We need to ask the advice of that leadership about how we may improve the messaging, whether it is around obesity, whether it is around levels of exercise or whether it is around levels of smoking. They have shown leadership in a way that works, and we need to look very carefully at that leadership and how we might apply that particularly to smoking.

I was just an hour ago at a meeting with Julie Tongs from Winnunga Nimmityjah Aboriginal Health Service here in Canberra. We were talking about a number of these issues. When talking to Aboriginal health services, it seems if someone is smoking it is generally an indicator—there are obviously other indicators—that they are suffering other poor health symptoms. I have yet to understand a little more about that, but it is still an issue to be highlighted. If you can get people into an Aboriginal medical service, invariably as part of a health check, whatever the presentation is, someone will ask you if you are a smoker. If you are, someone will invariably say to you, 'This is having an impact on your life, it is having an impact on your family and it is having an impact on your capacity to help your family out by providing leadership by being a nonsmoker yourself.' I would like to commend the AMSs not only for the education systems that they run but also for the very strong message that they provide.

Wherever I go around the country, and I have been to over 150 communities on over 200 occasions, I always see there is a culture of smoking in communities. These bills will increase tobacco excise, which is charged on domestic production, and equivalent customs duty, which is charged on imports, by way of four annual increases of 12.5 per cent a year from 2017 to 2020. In addition, the AWOTE—average weekly ordinary time earnings—based indexation of tobacco excise rates will continue. The next biannual indexation of tobacco excise will occur on 1 March 2017.

The increase in excise and duty will move Australia towards the World Health Organization's recommendation that excise should comprise 70 per cent of the price of a cigarette. The World Health Organization have been around a very long time, and they understand that the price of cigarettes has a direct correlation to your capacity to make a decision to no longer be a smoker. It also has a direct correlation to how many cigarettes you get access to at any particular time. We have not reached a 70 per cent excise level, but I think we have certainly made a very serious move towards it. Each year smoking kills an estimated 15,000 Australians and costs Australia $31.5 billion in social costs—including health and economic costs. Increasing the price of cigarettes via taxation is one of the most effective ways of reducing tobacco consumption and preventing the uptake of smoking.

The government announced in the budget that it will strengthen the penalties for illicit tobacco offences and provide an additional $7.7 million for the tobacco strike team to combat illicit tobacco activity. This is in recognition of the fact that there is no point saying, 'We are going to put an excise on it and we are going to make it more expensive,' without recognising it increases the attractiveness of criminal behaviour. We acknowledge that whatever you do there is a consequence. When you have a consequence, you have to be a sophisticated enough government to react to that. Australia has a strong legislative and regulatory framework to control illicit trade in tobacco products. The Australian Taxation Office and the Australian Border Force will continue to have a strong ongoing role in monitoring and enforcement activity against illicit tobacco. Again, that is a sophisticated approach, and it has to be. Every time we introduce legislation we know there is going to be a consequence and we have to be across that.

These bills are an important plank in helping to turn that culture and lower smoking rates, particularly in communities. We need to pull every lever against smoking, which is at 2.6 times the non-Indigenous rates. I commend these bills to the Senate.