Tammy Tyrrell (Tasmania, Jacqui Lambie Network) Share this | Hansard source

The Public Health (Tobacco and Other Products) Bill 2023 is designed to consolidate existing tobacco control legislation into a single act. It's designed to introduce new tobacco regulations to discourage smoking. It's designed to stop people from vaping. But basically it's designed this way to do one thing: stop 20,000 Australians from dying. That's how many people are dying from tobacco-use-related conditions every single year. Those are the stakes, so it's worth unpicking a few of the things that this bill does in order to reduce those tobacco deaths.

Pushing up the price of a pack of ciggies is a really good way of stopping people from getting started smoking, and that's not a bad thing. If it can stop people from developing a lifelong addiction that they regret ever developing, then that's a good thing. But price increases are a blunt tool, and they're a harmful one in their own way.

When you're addicted to something, you pay for it, even if you give up everything else. You don't see many heroin addicts with gym memberships, do you? When you're addicted to something, your brain is dependent on it. You will put your everyday essentials to one side in order to keep yourself functioning, and you feel like you can't function without the thing you think you need. The things you give up to feed your addiction are the things that hurt the ones around you. You hear about it with people who are addicted to pokies, who won't give up pokies but will give up socialising. They will give up shopping. They will give up everything in their life that gets in the way of what they can't live without. This is what you're dealing with.

If the price of a smoke goes up by so much that the only people buying them are the ones who are addicted to them, then the ones who pay the toll are the ones who feel like they've got no choice. They are who this bill tries to help. There is a link between tobacco consumption and poverty. Lower income households are particularly vulnerable to the opportunity cost of expenditure on tobacco products. Tobacco may replace food and other essential goods and services for the family. The health impact of tobacco consumption also puts pressure on family budgets and reduces the income-generating potential of family members. That's not me saying it either; that's from the Department of the Prime Minister and Cabinet in 2015.

Making tobacco more expensive will definitely drive smoking down amongst poor people, to some extent, but it will have no effect on rich people, because they wouldn't notice a price increase, would they? So this is really about targeting one socioeconomic group over another. We need strategies that apply to other socioeconomic groups too. Rich people aren't price sensitive.

To date, we haven't really come up with much as an alternative. It's why we need to think creatively. We don't seem to be doing that. We seem to be just amping up the current restrictions and regulations, in the hope that, if we make them strong enough, they'll work even better. That's not how these things work.

It's true that nobody likes paying more than they need to; that's as true for ramen noodles as it is for real estate. And, if you're skint and you're struggling to keep up with the cost of smokes, it's sensible to look around for what else you can do to service your addiction. It's no surprise, then, that, as we've ramped up taxes on tobacco, we've seen a jump in the consumption of illicit tobacco. You have two products that both feed the meter of your addiction. One's cheap; one's not. Guess which one people go for. Illicit tobacco is cheap because it isn't taxed. A pack of cigarettes taxed properly could be $50 or $60. A pack of illicit cigarettes could go for nothing like that—for $15.

Also, every time the tobacco tax rate goes up, the profitability of the illegal black market goes up along with it, because if the price of legal cigarettes goes up by $2 because of tax, then the price of illegal cigarettes can go up by $2 as well, and they're still cheaper than the legal kind. But that extra $2 in tobacco tax isn't going to the government; it's going to organised crime. Nearly one in four cigarettes sold in Australia is from the black market, costing taxpayers more than $4 billion a year. Every time the excise goes up, poor Australians are pushed into funding organised crime.

It doesn't just fuel the black market, either. Stores that don't sell illicit tobacco are paying the price of doing the right thing. People who would come in and buy a basket of bread, milk and eggs are going somewhere else because that's where you buy illicit tobacco. That lost revenue is worth billions every single year.

You see, this is the one thing that we all seem to forget: what got you here won't necessarily get you there. We've had tremendous success in reducing the rate of smoking in Australia. It's a mistake to assume that the more you ramp up what we're doing, the further the rate will fall. You might feel a million times better going to bed at 10 pm instead of 11 pm every night, but you can't assume that you'll feel even better still by going to bed at 9 pm or 8 pm or 7 pm. Things don't work that way.

We should be proud of what we've done so far. We should be proud that we led the world on plain packaging. But, once you've done plain packaging, you can't make packaging more plain. Once you make tobacco too expensive for people to afford to begin smoking in the first place, then the effect of lifting tobacco taxes any further is zero. You've squeezed the juice from that fruit.

Every 10 per cent reduction in the rate of smoking is harder than the 10 per cent reduction before it. It takes new measures, rather than just more aggressive versions of the same measures, to break the back of tobacco deaths—and here is where I think we need to have some sympathy for the poor old smoker looking for a way to get off this train. If they're feeling the pinch from the cost of living, and the price of their addiction is going up, vaping might look like a tempting alternative. The UK's Institute of Psychiatry, Psychology & Neuroscience was recently commissioned by the British government's Department of Health and Social Care to do the most comprehensive review of the evidence around the risks of vaping that has ever been done. The lead author of the review summarised its conclusions like this: 'Smoking is uniquely deadly and will kill one in two regular sustained smokers. Two-thirds of adult smokers would really benefit from switching to vaping. They don't because they don't know that vaping is less harmful.' This is not from a tobacco lobbyist; this is from a professor of tobacco harm reduction at the King's College of London.

The evidence is overwhelmingly in favour of encouraging smokers to move to vaping. Getting smokers to switch to vaping would save lives—that is what the evidence suggests. The goal should be to get smokers to switch, and to get non-smokers to not take up smoking or vaping in the meantime.

The public conversation has been focused on the use of vaping as a gateway to smoking, and, if that's what is actually happening, it's a genuine cause for alarm. The question is: is it actually happening, and, if it is, what's causing it? Once you know what's causing it, you can start to figure out what to do about it. So first: is it happening? A major review and meta-analysis funded by the Australian government department of health found that never-smokers who used e-cigarettes had about three times the odds of smoking initiation compared with non-e-cigarette users.

However, we don't know if the people who go from vapes to ciggies are going to ciggies because they use vapes, or if they would have gone straight to ciggies if they didn't have vapes to go through. We just don't know, and we don't have an easy way of knowing. Even the studies that look at this question admit that, while you might be more likely to go from vaping to smoking than if you never started vaping at all, a person who starts on vapes is less likely to become a smoker than a person who starts on cigarettes. I think that's an important thing to note. The government's own evidence says this. If you start smoking cigarettes instead of vaping, you are more likely to become addicted to cigarettes. So, if we want to reduce the rate of smoking, we should be trying to encourage people to do things that divert them away from smoking.

The New Zealand Ministry of Health stated this year:

Despite some experimentation with vaping products amongst never smokers, vaping products are attracting very few people who have never smoked into regular vaping, including young people.

All the measures in the world to make smoking less appealing to people are going to fail unless they also include ways to help people to quit smoking. You can make it hard, but you are dealing with an addiction. If you don't help the addiction get broken, you won't break it. I think we're being ideological in how we get people off smoking, and I think that ideological fervour is driving us to make bad decisions.

A 2022 Cochrane review, which is considered to be the gold standard of scientific reviews, considered 77 different studies and found high-certainty evidence that nicotine e-cigarettes are more effective than traditional gums and patches in helping people quit smoking. We shouldn't be surprised about that, though. The head of the Therapeutic Goods Administration in Australia says that smoking is worse than vaping. He said it to the Senate. He doesn't say vaping is good; he just says it's better than smoking. Cutting back the number of cigarettes you smoke is good, even if you're only going from a pack a day to half a pack. Any reduction is a good thing. So I think making it easier for people to reduce their smoking dependence is a good thing and should be supported.

A report published in medical journal the Lancetin September this year found:

Growing evidence suggests that e-cigarettes can be a catalyst for smoking cessation. Current findings indicate that this may be true even within unstructured and unguided use.

In other words, you don't need to have a doctor supervising your use of a vape product to get a medical benefit from using it if you're using it to come off cigarettes. But our current regulations say you need a doctor's approval to do it. Doctors can't prescribe e-cigarettes unless you're trying to quit smoking. You won't be able to access a vape unless you're attempting to quit smoking. In other words, if you want to vape, you have to start with cigarettes. That's what this policy would do. It makes it so that the only way a nonsmoker can vape legally is to start smoking first. That's our public health initiative to reduce tobacco usage. 'You want vapes? No worries. All you've got to do is smoke these cigarettes.' Authorised by the Australian government, Canberra.

That's not all. We're also banning the consumption of nicotine-free vapes. These could contain none of the harmful chemicals. These are products that have no poisons that require regulation by the TGA. They have no active or controlled substances inside them. These could genuinely save people's lives. But we're banning them too, and the only reason we're banning them is that, if we let them be sold, we couldn't ban other vapes. So we are banning adults who can legally buy cigarettes from every petrol station in Australia from buying a nicotine-free, less hazardous alternative if they want to try and quit smoking, and we are doing this because we want to reduce smoking!

I support the goal of reducing our rates of smoking. It means helping people quit. I support doing that. I think we should be sensible, not ideological, about how we do it, though. Professor Nicholas Zwar, who chaired the expert advisory group that compiled the RACGP's smoking cessation guidelines, says that vaping can help people quit. I don't smoke. I'm actually reformed. I don't vape. I just think that there are a lot of people in this debate who have fixed and firm ideological views about what other people should and should not be allowed to do, and it's those views that are, ironically, sabotaging us from achieving success. There is solid and peer-reviewed research that says that e-cigarettes can be a tool to help people quit smoking and reduce the rate of unnecessary death and disease that comes from smoking.

If you're serious about preventing the harm from tobacco, you will be focused on doing whatever you can do to prevent it. That means making access to e-cigarettes legal and making e-cigarettes at least as available as cigarettes are. Hiding a safer alternative to cigarettes behind a doctor's prescription but allowing anybody with an ID to buy cigarettes without a prescription is going to make people buy more cigarettes.

Think about the benefits of a regulated legal access scheme. You could regulate what's in vapes. There'd be no more stories about supposedly nicotine-free vapes being tested and found to contain nicotine or any other hidden nasties. You could regulate the price of vapes through taxation. You could apply an excise to vapes sold in a retail environment or reduce the excise for people with a valid prescription. The excise would mean there was no cheap option to get your nicotine fix. You could raise money to support anti-smoking campaigns or fund the health system instead of funding the profits of organised crime gangs, which is what the prohibition model we are pursuing will do. You could license retailers so you know who's selling vapes and how many they're selling. This would give us real-time data on what's being sold and in what quantity. This would help researchers measure the effectiveness of antismoking campaigns and prevent retailers from selling under the counter. It would also mean that anybody found to be selling under the counter would face charges and fines. You could restrict access based on a person's age. There's no penalty in a prohibition model for selling a vape to an underage person, because you're not supposed to sell them—full stop. Young people won't ever be carded in an environment where they're trying to buy an illegal product. You could reduce the marketing appeal of them. You could regulate what products could be imported if you provided importers with a legal channel to import their products. You could insist that they conformed to the plain-packaging guidelines. We can't do that when everything that is captured is seized.

People worry that a regulated retail access model will send a message that e-cigarettes are safe. For the record: they are not safe; they are simply less dangerous than cigarettes. That's not just my view. The United States government Centres for Disease Control and Prevention says they are. But I don't agree with the argument that being sold means being safe. Cigarettes are legal and regulated. I do not think that anybody gets the impression that they are safe because of that. Alcohol is legal and regulated as well. You can legally buy a gun in Australia. Does that mean we're sending a pro-gun message? We can have legal products in Australia that don't make their way into the hands of kids. It doesn't follow that regulating a product makes it available for kids.

To stop tobacco, the Labor Party is making it harder to access alternatives to tobacco. How? With bans. Is there a single example in history of banning a drug being successful in stopping people from using that drug? Cocaine is banned. Cannabis is banned. Ecstasy, speed, ketamine and crystal meth are banned. Bans don't work. We know this. But we keep trying to impose bans because we have ministers wanting to look tough to win votes. Ironically, looking tough is easy; actually reducing deaths from smoking is hard. We can't do that by doing more of what we're doing. We should support ways to reduce unnecessary harm from tobacco. Instead, we're banning them.