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Jan 8, 2014

Australians still smoke 21 billion cigarettes a year. Why?

A report has found the government's campaign against the cigarette may have stalled. Smoking rates have levelled off after years of falling. Will the new, ugly plain packs have an effect?

Cathy Alexander — Freelance journalist and PhD candidate in politics at the University of Melbourne

Cathy Alexander

Freelance journalist and PhD candidate in politics at the University of Melbourne

Australia has implemented some of the world’s boldest measures to reduce smoking. There’s just one problem: they seem to have stopped working.

A global study out today has found that after decades of declining, Australia’s rate of smoking has plateaued, and even increased slightly among women. There are almost 3 million smokers in Australia and between them they puff on 21 billion — yes, billion — cigarettes a year.

That’s the most recent data available, and it goes up to the end of 2012. As to whether the world’s first laws mandating the plain packaging of cigarettes have worked (they started in December 2012), those who have the data won’t release it. It’s a public policy secret. More on that later.

Today’s study, by the Institute for Health Metrics and Evaluation at the University of Washington, found global smoking rates have greatly decreased since 1980 (there’s some excellent interactive graphics in the report). But because there are so many more people than there were in 1980, more people smoke (there are now almost 1 billion). Smoking is very much in vogue in places like Indonesia and East Timor, where more than half the men smoke. Tobacco led to the deaths of 5.7 million people worldwide in 2012.

Australia gets a pretty good rap in the report, published in the Journal of the American Medical Association. The rate of smoking among men in 2012 — 18% — is well below the global average of 31%, and has been one of the fastest declines in the world.

Some 15% of Australian women smoke, compared with a global average of 6% (this gap reflects the cultural antipathy towards women smoking in many countries rather than a particular problem here). The rate of Australian women smoking has declined steadily over decades.

The report synthesises various research papers into smoking in Australia, including Australian Bureau of Statistics data. It found the Australian most likely to smoke is a man in his 30s, and the average smoker has 7000 fags per annum.

The big drop in people smoking is a medium-term success story, but since 2009 the rate of smoking in Australia has levelled off. This graph from the report shows the rate of change is now approaching zero:

Rate of change in the prevalence of smoking among Australians; women are pink, men green (standardised for age)

And here’s the graph showing the prevalence of smoking in Australia:

Australia has been at the forefront of efforts to reduce smoking: hiking up the excise, restricting advertising and where people can smoke, and bombarding citizens with quit campaigns. So what’s going on?

Alan Lopez, professor of public health at the University of Melbourne and one of the study’s authors, says the plateauing smoking rate is concerning. “It’s something to watch acutely,” he told Crikey from the United States.

He says Australia has bold tobacco control measures and strong public policy. “It ought to be having a greater effect than it currently is,” he said. When asked why it wasn’t, he responded: “It’s a very good question.”

Lopez notes  the plateauing of smoking rates is also a trend elsewhere. The Australian result could just be “a bump”, or it could be that the anti-tobacco campaign had run up against the brick wall of rusted-on smokers. “It’s getting harder and harder to chop away at that hardcore group of smokers,” he said.

It may be that the mandating of ugly olive-green plain packaging for cigarettes — with graphic warnings and no trademark — from December 2012 is driving down smoking rates again. Today’s report cuts out before those laws started, and there’s no more recent data available. While the government and the tobacco industry have data on cigarette sales, both claim “commercial in-confidence” in not releasing it.

Simon Chapman, professor of public health at the University of Sydney (and an anti-tobacco campaigner), called on the government to release the information: “The government now has 12 months of data, why is the government withholding data?”

British American Tobacco Australia spokesman Scott McIntyre told Crikey: “After a year of implementation the plain packaging experiment is not working and has had no impact on legal tobacco volumes.”

McIntyre claimed legal tobacco sales “remain stable”, but would not provide figures. He claimed smokers were switching to cheaper legal products and the black market. However, the fact that the tobacco lobby challenged the plain packaging laws in the High Court (it lost) indicates the industry may have had good reason to fear the laws.

Claims that tougher laws on cigarettes are leading to a black market boom are interesting. The tobacco industry hired KPMG to investigate. Consultants collected 12,000 empty cigarette packs from streets and bins (sounds like a fun job) to compile a new report last October. The industry spun it as a significant increase in sales of illegal cigarettes, but the data actually shows sales have been pretty stable at 12-13% (illicit consumption as a proportion of total consumption) since 2010. According to KPMG, illegal tobacco comes mainly in the form of illegally imported cigarettes, especially from South Korea, at an average $8.60 a packet. Sales of black-market chop chop (loose tobacco) are down.

Smoking rates might also fall due to a 12.5% increase in the excise from last month (it’s too early to tell). The former Labor government announced the excise would rise by 12.5% a year for four years from 2013. The Coalition criticised the move at the time but seem happy to keep the revenue.

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16 thoughts on “Australians still smoke 21 billion cigarettes a year. Why?

  1. Peter Evans

    “He claimed smokers were switching to cheaper legal products”. I banged on for ages that this was the real reason the tobacco industry was opposed to plain packaging, but I do not recall the main stream media ever making the point.

  2. Cathy Alexander

    Peter, BATA told me this included switching to cheaper brands that they offer. But presumably they make a lower margin, so would prefer people to stick with the more expensive cigs?

    And it may be that the big companies have a lower share of cheaper legal ciggies.

  3. Shaniq'ua Shardonn'ay

    Maybe the government needs to look more at how to help people give up smoking rather than sticking to the punishment options. There is nothing sadder than seeing the homeless in melbourne fishing through bins for butts.

  4. klewso

    Shaniq’ua, do something (like was done with asbestos?) and interrupt a steady and increasing flow of tax dollars?

    Besides – going on the bank of scientific shingles for hire defence team, employed as many of them were then – isn’t “tobacco:disease” just another Leftist conspiracy, like climate change?

  5. Rohan

    From my observations it seems that smokers are increasingly falling into two groups:

    Young people (~ age 10-25) for whom long-term health is a hazy concept.

    Poor buggers who copped the addictive gene(s) and find it desperately hard to quit.

    It’s hard to see how a significant drop could be achieved within these demographics.

  6. sparky

    All public health interventions eventually lose steam, it’s not a lurking disease or bug this is human behaviour. I would think it prudent to wait a little more time (5 yrs) to see how the last one of PP Packaging goes.

  7. Richard Farmer

    Some of us actually think that nicotine is a wonderful drug that we enjoy

  8. rhwombat

    Richard Farmer. Endogenous is fine. Defending profit driven addiction is analogous to defending slavery.

  9. Gavin Moodie

    If the tobacco industry really were worried that plain packaging would reduce brand loyalty and thus increased brand switching it would have been far smarter to have been honest about this in its public campaign opposing plain packaging.

  10. Steve777

    The challenge seems to be to stop young people from taking up smoking. As a general rule, adults don’t take up smoking, children do. I have never heard of anyone taking up smoking when they were 40 or 25. Nearly all smokers start either while they are still at school or shortly thereafter. But if someone has not started smoking by the time they’re old enough to vote, the Tobacco industry has probably lost them.

    So the key to further reductions would seem to be to take away any ‘glamour’ and allure that smoking has for young people. In that we seem to have been partly successful – fewer young people take it up. But you see 15 year-olds practicing smoking. It must still seem delightfully wicked, rebellious or ‘cool’ to them. Telling young people that it’s naughty or that something bad will happen to them when they’re very old (say 40) won’t cut it, although if smoking caused acne they probably would not take it up.

    Smoking is a filthy habit, it stinks, the smoke gets into your hair and clothes (the smoker’s and those nearby), causes nicotine stains on fingers and teeth and causes bad breath. Who would want to kiss a smoker. Maybe this could be given emphasis in anti smoking campaigns directed at the young.