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T21 - raising the minimum legal Sales age to 21 years

There is a bill before the Tasmanian Parliament to raise the age of tobacco sales to age 21 years.
There has been some opposition from retailer groups and criminal lawyers.
Information about the T21 can be found at the Minderoo T21 website.
Presentations made to the Legislative Council.

Major health organizations support T21

Media comments

Letter from leading Tasmanian Dr. Bryan Walpole

Big tobacco push

IT’S not hard to see where Robert Mallet gets his opinions from, maybe Big Tobacco (Letters, June 28)?

They have doggedly opposed every measure to reduce deadly tobacco consumption for 60 years.

His excuses border on pathetic, staff afraid to ask for ID indeed! And what has the drinking age to do with it?

Tobacco 21 legislation is successfully in place in more than 450 cities and countries, used in 27 US states and has become an evidence-based tobacco control measure in California and Singapore, so it’s important to follow suit and lift the age limit to 21 and reduce the likeliness of smoking addiction in future, because history tells us if they can get to 21 without smoking, they are far less likely to start, and will avoid having a shortened, painful life as customers of big tobacco.

Studies by Andrew Forrest’s Minderoo Foundation have found the majority of Aussies are in support of lifting the legal age for purchasing cigarettes, with more than seven in 10 in each state in favour, including 73 per cent of Tasmanians, so Mr Mallet is really going against the flow, because stopping smoking is the cheapest most effective health reform.

Australia has been a world leader in tobacco control and we Tasmanians should continue with policies to prevent vulnerable teenagers from taking up smoking, thus further driving down smoking rates to ultimately zero, to prevent thousands of premature deaths. Read the evidence, have some compassion, and get out of the way of sensible health reform.

Bryan G. Walpole, Sandy Bay

Letter to The Examiner
Professor David Hill AM

I spent a great deal of my career in behavioural research studying adult and adolescent patterns and predictors of smoking in populations.

The proposal to set the age at which it would be legal to purchase tobacco has merit.

Nobody, including me, can sure it will work to reduce the uptake of smoking, but it’s a testable hypothesis.

It’s ironic that Russell Zimmerman seems confident that it will work – otherwise why would he fear its commercial impact on tobacco sales?

I disagree totally with his view that any such initiative should be left to a federal agreement for all states to proceed in concert.

This is a classic tobacco industry strategy to delay progress. In the history of tobacco control, there are a number of examples of one state leading and others following.
It only takes two people to desist from smoking for one tobacco related death to be averted in the long term. Anything that reduces tobacco use saves Tasmanian lives. The possible benefits far outweigh the risks of it being ineffective.

Professor David Hill

Tasmanian Respiratory Physicians support the T21 Bill

Evidence shows that the vast majority (95 per cent) of smokers start smoking before age 21. Hence, it is appropriate to focus on this age group to reduce tobacco addiction.

We have all seen the devastating effect of tobacco-related lung disease up close because of our work as respiratory physicians in Tasmania.

The common conditions of chronic bronchitis and emphysema are usually a consequence of many years of smoking from an early age. They are associated with cough and breathlessness and a reduced lifespan.

They are frequent causes of admissions to our hospitals especially during the winter when infections are more common.

Lung cancer is also common and more likely to deprive people of quality and quantity of life.

These deadly disorders of the lungs persist, even in those who quit, because they reflect the cumulative exposure to tobacco products. There is no safe threshold level of smoking. The more one smokes and the longer one smokes, the greater the risks.

Quitting smoking is important, but the risk of lung cancer remains for the rest of a smoker’s life. There are many other cancers also associated with tobacco smoking, which present to our medical oncology colleagues (including cancers of the larynx, oesophagus, pancreas and bladder).

There are many common cardiovascular disorders which present to other medical colleagues, especially coronary artery disease, cerebrovascular disease and peripheral vascular disease.

These are also permanent diseases which can often be helped by interventions.

Tobacco smoking is a frequent cause of flare-ups of asthma, which affects about 11.2 per cent of Australians and 12.8 per cent of Tasmanians (Asthma Australia data 2019). There are also some rare conditions of the lungs caused directly by smoking, which can resolve with cessation of smoking (eg Respiratory Bronchiolitis-associated Interstitial Lung Disease and Langerhans Cell Histiocytosis).

Smoking rates have gradually fallen in Australia. About 14 per cent of the population are current smokers in 2019. The rates in Tasmania have been consistently higher.

Two suburbs in Hobart in 2019 had the highest current smoking rates (40 per cent and 35 per cent ) of any region in Australia.

Hence, it is appropriate for Tasmania to lead the way in new initiatives to reduce tobacco addiction.

The decline of smoking rates has followed the intensive efforts of numerous health organisations and Government campaigns to advise Australians about the health risks of smoking and to assist them to quit. Legislation to apply a tax on tobacco products has added additional pressure for smokers to quit. Legislation has proved very successful to protect those who choose not to smoke from being exposed to Environmental Tobacco Smoke.

Tasmania has led the way with some of this legislation, including the first state to pass laws to protect children from ETS within motor vehicles. The rate of decline is slowing, and it is unlikely that a continuation of the same measures will lead to substantial future improvements, given that smoking rates are higher in young adults compared with older adults (that is, the ones who became addicted before all these measures came into place).

The proposed legislation will be the first in Australia but it is not without precedent in similar democracies, so it is not a complete leap of faith.

This equivalent legislation has been introduced in other countries successfully and we can learn from those efforts.

Even in modern democracies, there are restrictions sometimes placed on us, even as adults, for our own benefit and for the benefit of the general community, such as compulsory wearing of seat-belts when driving. No-one disputes that this measure saves lives and reduces health costs. Most drivers conform and it becomes a way of life.

Tobacco addiction produces illness and suffering for many Tasmanians, which in turn affects their family and friends.

As the respiratory physicians of Tasmania, we see that suffering first hand and every day we go to work. We sympathise with the plight of smokers and we do our best to treat their illnesses and to help them quit if they are still smoking.

Most people we meet regret they ever started smoking, but too often it is too late for them to prevent serious illness.

We believe that the time has come for us as a caring community in Tasmania to make a bold move and to assist our young adults by increasing the legal age to purchase tobacco products to age 21 years.

We recommend that you support the Bill that will enable this.

  • James Markos, Launceston respiratory physician on behalf of fellow Tasmanian physicians Emma Ball, Collin Chia, Nick Harkness, Greg Haug, Robert Hewer, Josie Larby, George Mabeza, Hugh Mestitz, Gaurie Palnitkar, Scott Parkes and David Stock. This letter was sent to political representatives on August 1 opposing the Tobacco Bill being debated in Tasmanian Parliament this week.

Executive officer Robert Mallett is attempting to recruit more young customers because many current customers of his businesses are lying in ramped ambulances outside our public hospitals.

The tone of Mr Mallet’s comments indicates a complete indifference to the suffering of those with lung cancer, like Jason Trewin who recorded TV ads in May supporting the T21 proposal. Jason died in June.

Tobacco kills more than 500 Tasmanians every year, more than alcohol, car crashes, suicides, homicides and illicit drugs combined. Seventy per cent of acute admissions to the Royal Hobart Hospital are smokers.

Smoking does not kill people immediately - it causes chronic obstructive pulmonary disease, blindness, diabetes, gangrene, deafness, cancers, heart disease and stroke, which may leave the smoker alive - but with significant health deficits.

Tobacco smoke is linked to SIDS, which can kill babies, and meningococcal disease, which can kill both babies and adolescents.

Smoking does not kill people immediately - it causes chronic obstructive pulmonary disease, blindness, diabetes, gangrene, deafness, cancers, heart disease and stroke, which may leave the smoker alive - but with significant health deficits.

Furthermore, we know that the flu is exacerbated by smoking, and such patients are more likely to die. We are in the midst of a flu season.

In direct response to Mr Mallett:

First, Mr Mallett asserts loss of 18-24-year-old tobacco customers will “hurt” small retailer business and cost jobs.

This is an astonishing claim given that we know only one per cent of Tasmanian smokers who buy from small retailers are aged 18-24. As there are fewer than 700 licensed retailers in Tasmania, they have only one young customer each.

If they only have one young customer and it is a “large chunk” of their business, they must be on a path to bankruptcy.

Furthermore, existing young smokers will be able to continue to buy after this legislation is passed. The current 70,500 smokers are not affected by the bill. It is only new smokers who will be saved from this lethal product.

We also know from 2016 research work completed by the Department of Health that giving up selling tobacco has no effect on the economics of small business in Tasmania.

Many small retailers have stopped selling because they do not like to be involved in contributing to the death of friends and neighbours.

Second, the age of 18 is not always recognised as adulthood. For example, Newstart is not available until a young person reaches the age of 22 years.

In cases such as voting or the drinking age a person can always change their mind or desist. In the case of tobacco, we know that 90 per cent or more of smokers are addicted before the age of 18 years.

Nicotine is more addictive than heroin.

Neurologists tell us that the human brain is not fully developed until the age of 25 years, and younger people are not able to make rational choices about addictive substances before that age.

Third, urging more “enforcement” of tobacco sales to minors is a tobacco industry ploy that is irrelevant in Tasmania, because we have 98 per cent compliance from retailers. Our Health Department enforcement officers do a splendid job.

These words regarding enforcement are from Imperial Tobacco’s submission to the government. Imperial Tobacco is well known for its “Project 16”, a program designed to addict children and teenagers.

Few retailers in this state sell to children, and the penalties are already huge at around $19,800 for a first offence.

Mr Mallet is echoing the smoky voice of big tobacco.

Fourth, there is massive public support with the polls showing 70 per cent or more Tasmanians support the minimum legal sales age of 21 years.

The proposal does not punish smokers, nor young people.

This legislation is aimed squarely at what former Liberal health minister Peter McKay MLC described as the “peddlers of death”, the tobacco industry and those who sell the product.

Finally, I am advised that Minderoo have offered to assist with the costs of education of Tasmanian retailers, the public, and implementation of this legislation, so Mr Mallet’s insults are misplaced.

  • Kathryn Barnsley is the convener of SmokeFree Tasmania

The Examiner - August 19 2019

Tobacco industry and the black market

CONCEIVABLY Premier Will Hodgman is indeed wise to fear that a black market could be created by T21.

Possibly he has confidential advice from law enforcement sources that this is possible, given experience of tobacco industry involvement in smuggling overseas.

The tobacco industry and their partners are saying that there will be a black market and smuggling if T21, raising the sales age of tobacco to 21, is introduced.

The tobacco industry has been involved in smuggling in Asia, Europe and Canada.

This has been well documented in the research literature.

Rowell et al said, “Despite historical involvement in the illicit trade, and recent evidence of complicity, TTCs (Trans-national tobacco companies) continue to use the threat of illicit tobacco to argue against key tobacco control policies”.

In 2013 CBC Canada reported that:

“A Reynolds subsidiary, Northern Brands International Inc, has been fined $75 million after pleading guilty under the criminal code to one count of conspiracy for helping others sell contraband cigarettes.

Canadian tobacco manufacturer JTI-Macdonald Corp has been fined $150 million after pleading guilty under the Excise Act to helping people sell and possess contraband tobacco.

The governments had previously reached deals with two other tobacco manufacturers, Imperial Tobacco Canada Ltd and Rothmans Benson and Hedges cigarette makers have been hit with a total of $1.7 billion in fines and settlements.”

However, it is unlikely that teenagers will get on a plane to Melbourne get cigarettes along with their Crispy Crème Donuts.

As there are 670 plus retail outlets in Tasmania and over 74,000 smokers, Tasmania will remain awash with available tobacco.

It will not be hard for smokers to obtain cigarettes after T21 is implemented, however, the US experience is that the uptake age of smoking decreases considerably with these laws.

It will save lives.

Dr Kathryn Barnsley, Kingston.

Tobacco Free Generation

Here is a narrated Powerpoint by Professor Jon Berrick that describes the background and rationale of the TFG.

FACT SHEET

The Public Health Amendment (Tobacco Free Generation) Bill 2014 is a Private Members Bill gradually phasing out the sale of tobacco products in Tasmania.

  • The Amendment WILL:
    • Stop the sale of tobacco products to anyone born since the year 2000, the tobacco free generation.
    • Prevent the supply of tobacco products by licensed tobacco sellers, or their agents, to members of the tobacco free generation.
    • Provide (with penalty) that members of the tobacco free generations must not give false identification to tobacco sellers.
    • NOT prevent members of the tobacco free generation from smoking, or attempting to purchase tobacco products.
    • NOT penalise any member of the tobacco free generation for smoking.
    • NOT prevent friends and family from giving tobacco products, such as a few cigarettes to members of the tobacco free generation, however, they must not SELL tobacco products to them.
    • NOT prevent “botting” of cigarettes by members of the tobacco free generation. They would be able to scrounge or borrow cigarettes, and would not be penalised.
  • NOT have any effect on a smoker aged over 18 years at present, or when the amendment comes into law.

In effect, the Amendment gradually raises the age for tobacco products to be sold to a person, from 18 years to 21 years, then again to 25 years. It signals: no acceptable age for tobacco use, and no rite-of-passage to such an age.

The Amendment:
• Provides for reviews of the legislation, which must then be tabled in Parliament, when the tobacco free generation reach the age of 21 years, in 2021 and again in 2025.

SmokeFree Tasmania is involved in campaigning for the Tobacco Free Generation proposal which would see the end of tobacco sales to persons born since the year 2000, as first proposed and published in the Journal Tobacco Control by Professor Jon Berrick et al.

In 2012 a motion was carried unanimously in the Legislative Council in Tasmania supporting the tobacco free generation proposal and other tobacco control measures.

In November 2014 an amendment was tabled in the Tasmanian Legislative Council by Hon Ivan Dean MLC to propose a Tobacco Free Generation. The amendment is titled Public Health Amendment (Tobacco Free Generation) Bill 2014

If you want to provide feedback or ideas about the amendment to Hon. Ivan Dean at Parliament House in Hobart - contact him here - or write to:
Hon. Ivan Dean, Parliament House, Hobart, TAS. 7000. Or telephone: (03) 6212 2300

For more on the Fact Sheet and Clause Notes about the amendment - click at the bottom of the page

See the FAQ page for more detail about this proposal.

See the Media Page for coverage of this issue in international and Tasmanian news sites.

The British Medical Journal Tobacco Control blog has more details on the process to date.

The TFG proposal was referred to the Acting Children’s Commissioner, Elizabeth Daly in 2013. Pictured at a consultation meeting (l to r) Jeanette Banks, Dr. Harley Stanton (SFT), Elizabeth Daly, Prof Jon Berrick, Kathryn Barnsley (SFT)

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Jon Berrick visited Launceston in 2012 and met with Respiratory Physicians Dr. Collin Chia (Left ) and Dr. James Markos (2nd left) , Kathryn Barnsley (centre) Prof Berrick and Dr. Harley Stanton (right)

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