Dean Smith (WA, Liberal Party) Share this | Hansard source

I also rise to speak this morning about the Excise Tariff Amendment (Tobacco) Bill 2016 and the Customs Tariff Amendment (Tobacco) Bill 2016, but I want to take a slightly different perspective—a slightly different angle.

Senator Jacinta Collins interjecting—

Just yesterday, Senator Collins would have seen on the Notice Paper that in the Senate was tabled the most recent report of the Australian Institute of Health and Welfare on Australia's health 2016. It was quite a revealing report on a number of levels—not least because it did point to the facts that Australians are getting healthier and living longer but that there still exist, for some Australians in our community, significant risks to their enjoyment of that health, and it pointed to what that path to longer living might look like for them.

There were a number of interesting things in that report that I would just like to share with the Senate this morning before turning briefly to the contents of these bills, because senators would know that other government senators have illuminated the motivation—illuminated the positive benefits for smokers from reducing their smoking and the positive benefits for the economy from this particular legislative initiative. But there are a number of things in the Australia's health 2016report that are worth sharing with the Senate this morning. One is—and I will come to it in a brief moment—what is happening around death rates in our country. There is also what is happening as to the increasing numbers of risk factors for healthy Australians; and there is important information about the incidence of smoking amongst Australians generally but also across core communities.

Importantly, in the report at chapter 4 people will see a specific discussion about tobacco smoking trends in our country—information that fewer Australians are smoking, and information about the positive changes that are happening to smoking patterns across the Australian community—and then, immediately following that, some revealing or even alarming information about the health behaviours and biomedical risks for Indigenous Australians which focuses very heavily on the issue of the incidence of smoking across Indigenous communities. That is especially alarming for a regional senator like myself from Western Australia who spends a considerable amount of time in the Kimberley region of Western Australia, which has a very high proportion of Indigenous Australians who live in very remote communities, as the incidence of smoking is a significant impairment to the benefits that they can enjoy from a healthy lifestyle and the benefits that they should be able to enjoy through greater longevity.

The institute's report, not surprisingly, starts by sharing with us this very important fact: that good health, of course, is important. It is important to each of us. It influences not just how we feel but how we go about our everyday lives and how we might be able to utilise those rich opportunities that come to us as Australians. The report says that the vast majority of Australians aged 15 and over report that their health is 'good' or better, and that this can mean different things to different people. Of course, the starting position of your health is a key determinant in whether or not you can expect to enjoy much greater improvements in your health or marginal improvements. The report goes on to say:

It is now widely accepted that health is much more than the presence or absence of disease.

Importantly, 'good' or better health:

… reflects genetic, lifestyle and environmental factors; cultural influences; socioeconomic conditions; and the availability and quality of health care programs and services.

I think that what makes the tabling yesterday in the Senate of the Australia's health 2016 report important is the fact that it provides a very timely examination of the health of Australians from a variety of perspectives, including the leading types of ill health that affect us as a nation, the specific risks and health inequalities that are faced by different types of communities across our vast and varied nation, and of course what level of services are currently being provided and what level of services it is necessary to provide to prevent illness.

What is revealing in this report, perhaps even refreshing—it is quite illuminating, because the report is quite honest and transparent—comes at the end of each chapter, where the report points to future work that needs to be done if this picture of Australia's health is to be accurate and if Australia's health is to continue to be well serviced and provided for. The report also provides a refreshing account of some of the topical issues that face Australians when discussing the healthiness of their current and future lives—importantly, a discussion around chronic disease, the very important issue of mental health, the use and abuse of illicit drugs in our community, health spending across various health services, end-of-life care and trends in hospital care. So it is quite an important and revealing report.

But I want to turn in the first instance to what the report has to say about the experiences of Australians when it comes to death. In 2013 nearly 147,700 deaths were registered in Australia—about 600 more than in 2012 and nearly 15,400 more than in 2003. Since 2003 the number has risen by an average of one per cent per year for males and 1.2 per cent for females. Despite an increase in the absolute number of deaths, there has been a long and continuing fall in death rates per 100,000 population. From 1907 to 2013 the age-standardised death rate for males and females fell by a staggering 71 per cent and 76 per cent, respectively.

This is an important point, because when we talk about the tremendous amount of public money and the tremendous amount of energy that goes into our health programs, our health services and our hospitals, we are fundamentally seeking to do two things: to give the living a better quality of life and to ensure that people live longer, and that much of our energy, much of our innovation and much of our public spending go into the very important task of keeping people alive. When we look at those results from 1907 to 2013 that reveal that the age-standardised death rate for males and females fell by 71 per cent and 76 per cent, respectively, we get a very powerful and positive sign of the success of everything this country does—and not just what the public health system does, with public health programs, but also what the voluntary system does and what the private sector does to ensure that Australians live longer and enjoy all the benefits bestowed on them.

Before coming to the specific issue of tobacco smoking, let me reflect briefly on what the report had to say about other death rates in our country. In 2013 children aged five to nine years and 10 to 14 years had the lowest rates of death, at nine and 10 per cent, respectively, per 100,000 population. The rate gradually increased from the ages of 15 to 19 years, to 32 per 100,000 population. By the age of 60 to 64 the rate was 613 per 100,000 population. The highest death rate was for people aged 85 and over—not surprising. Death rates have remained higher for males than for females in all age groups.

So I thought this was a very important starting point for discussion not just about increasing taxes on tobacco but also about what we are doing to discourage people from smoking. We know about the side effects of smoking, the cumulative effects and its cost, not just to our healthcare system but also in terms of the distress it causes to families as a result of the illnesses arising from tobacco use.

Moving through the report, its second most revealing aspect—and I mean revealing in a constructive sense—is what it has to say about risk factors and about what we as a community are doing to reduce those risk factors. The report says that many chronic diseases share common lifestyle risk factors that are largely preventable—for example, tobacco smoking, excessive alcohol consumption and excessive body weight. According to the results of the Australian Burden of Disease Study in 2011, a large proportion of the burden of disease experienced by the population—31 per cent, or almost a third of the community—could be prevented by reducing exposure to modifiable risk factors. The five risk factors that caused the most burden were tobacco use, high body mass, high alcohol use, physical inactivity and high blood pressure.

Importantly, the report goes on to talk specifically about smoking rates in Australia and whether or not we have had a positive or a negative experience regarding smoking rates. I am pleased to share with the Senate that on page 16 of the report it says that smoking rates in our country are continuing to fall. It says that smoking rates in Australia are still falling, continuing a long-term downward trend over the past 50 years that the OECD has described as 'remarkable progress'. The OECD has described the downward fall in smoking rates in our country as a remarkable success.

In 2013, 13 per cent of people aged 14 or older smoked daily, compared with 15 per cent in 2010 and 24 per cent in 1991. That is worth reflecting on: in 1991, 24 per cent of people aged 14 or over smoked daily, and in 2013 just 13 per cent of people smoked daily. This was one of the lowest smoking rates in the world. The OECD average daily smoking rate for people aged 15 and older was 20 per cent.

We can be confident that those legislative and other measures that governments—this government, previous governments—have been putting in place to reduce the incidence of smoking in our community have been successful. I think it is important to note that that success has come by not infringing on people's absolute liberty to smoke. If people want to smoke, that is their business. I am not a smoker; people in my family have previously been smokers. I think it is a powerful endorsement of the sorts of things that the community, supported by government, are doing that are leading to very tangible benefits in reducing the incidence of smoking in our community.

I could go on to talk about the positive benefits that are being achieved as a result of reductions in drinking levels et cetera, but that is not the purpose of my contribution today. I want to turn specifically to the issue of tobacco smoking and what the Australian Institute of Health and Welfare report had to say in regard to that. It has some positive news for those of us who care about the public health impost that happens as a result of an increase in smoking rates. Refreshingly, the report talks about the fact that fewer Australians are now smoking. It says:

Fewer people, both proportionally and absolutely, are smoking daily and more people have never smoked, compared with 20 years ago.

The report says:

As I have shared with you previously, in 1991 it was a staggering 21 per cent. Importantly, when we think about the impact of smoking on young people in our community, the report was positive. It says:

That is a very positive outcome. It goes on to say:

Fewer people are being exposed to tobacco smoking, more people are delaying the uptake of smoking and smokers are smoking fewer cigarettes.

Children being exposed to tobacco smoke in their home in 1995 was 31 per cent. Now, it is staggeringly low at 3.7 per cent. It goes on to say:

That has to be a positive outcome. Smokers smoked fewer cigarettes per week in 2013 than in 2001. In 2013, smokers smoked up to 96 cigarettes per week; in 2001, it was 113. The report goes on to say:

I am sure we are all pleased to hear that—

from 15% in 2009 to 12% in 2013.

So there is still some work to be done in regard to the incidence of smoking by pregnant women in our community.

I think it is also interesting to be reminded that, for different parts of our population, the incidence of smoking is very variant. It is valuable to look at these statistics before I move to the detail of the bill. The likelihood of being a daily smoker is two times as high in remote or very remote areas; three times as high in the lowest socio-economic areas compared with the highest socio-economic areas; 1.7 times as high for unemployed people compared with people who are employed; 1.9 times as high for homosexual or bisexual people compared with heterosexual people—I did not know that; it is rather revealing; 2.7 times as high for single people with dependent children compared with couples with dependent children; and, finally, 5.7 times as high for prison entrants compared with the general population. People may not be surprised to hear that the likelihood of a being a daily smoker is 2.6 times as high for Aboriginal and Torres Strait Islander Australians compared with non-Indigenous Australians.

As we have heard from previous coalition senators, the merits of the government's proposed reforms to the Excise Tariff Amendment (Tobacco) Bill 2016 and the Customs Tariff Amendment (Tobacco) Bill 2016 stand undisputed. They are positive and necessary reforms, from both a budget repair perspective and a public health perspective. I think the contributions of Senator Reynolds, Senator Paterson and Senator Hume were particularly revealing about the merits of the government's legislative initiative.

Senator Fawcett is now in the chamber and about to make a contribution, so I might draw my contribution to an end now.