Tuesday, May 7, 2013

Australian tobacco labeling draws fire


Australia is leading the world having implemented aggressive laws limiting tobacco advertising and packaging of cigarettes. These are reportedly some of the toughest restrictions to date. Publicly accessible images show the impact of the limited marketing. The Australian Department of Health and Aging web site shows package labels.

Among the key elements of tobacco control are the increase in quit attempts and increase in use of evidence-based treatment to aid cessation and improve the effectiveness of treatment. A rigorous simulation analysis for the US shows that a combined effort across all three strategies could lead to the reduction in adult smoking that has previously been set as a national goal. (Levy DT, et al Am J Public Health 2010).

Among the effective strategies to increase quit attempts is the use of graphic labeling on cigarette packets and the media coverage of such initiatives. Analysis of data from Australia shows an increase in calls to the quit line for smokers following release of major media efforts and the implementation of package labeling restrictions.

Media efforts and restrictive tobacco labeling drive smokers towards quitting.

The graph below from Miller and colleagues shows calls to the Australian quit line before and after introduction of graphic cigarette package warnings. Repeated surveys in Australia show the substantial increase in calls to the quit line following major media events depicting the adverse consequences of smoking and announcing the implementation of package labeling restrictions. To try to counteract this, a number of cigar exporting countries, such as Cuba and the Dominican Republic, are now challenging the package labeling in Australia since it runs counter to their interests and marketing of cigars. It is reported in the New York Times that Australia represents a tiny fraction of the income for Cuba from cigars (which are only a fraction of their export income). Yet the legal challenge at the World Trade Organization is made against a public health strategy that is known to be highly effective.



The cost of cigarettes and tobacco consumption are amazingly well documented. Many reports from the US Surgeon General have summarized the impact of smoking on cancer, heart disease, chronic obstructive lung disease, and many other conditions. In addition to the impact on individual health, exposure to other people's smoke, or secondhand smoke, raises risk of many conditions and has substantial societal cost. Smoking increases workdays lost in the active workforce, and increasing disability days reported in the population, as well as lower quality of life.

Isn't it time we work to finally eliminate the number one cause of preventable more to morbidity and mortality?

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