In 2003 Hon Lik, a Beijing pharmacist, developed an electronic cigarette which attracted interest from industry. Decades before, Hon Lik had become a heavily-addicted smoker after authorities banished him to the countryside. All his attempts to quit smoking failed. Hon Lik knew that it was the nicotine in the cigarettes that had kept him smoking but it was the tar in cigarette smoke that would eventually kill him. A pharmacist and gifted technician, Hon Lik experimented for years before inventing a device that heated and aerosolised a nicotine-containing liquid into a vapour but without the dangerous toxins in cigarette smoke.
Less than a decade and a half later, e-cigarettes are now sold in dozens of countries. Groups of smokers who had managed to quit using e-cigarettes, despite failing to quit many times using a multitude of other approaches, formed small companies and became the early manufacturers and distributors of e-cigarettes. Today less than 20 per cent of e-cigarettes sold in the USA are made or sold by tobacco companies and no such devices available in Australia are currently made or sold by a tobacco company.
In Canberra just before Easter and after deliberating for a year, a House of Representatives committee launched their report on e-cigarettes. The majority supported the status quo that in effect continues the ban on nicotine-containing e-cigarettes in Australia.
However three of the eight members of the committee provided a minority report which concluded that the use of e-cigarettes by smokers who have tried and failed other ways of quitting ‘could save many thousands of lives’ and that they ‘should be available as a consumer good to Australians’. These dissenting members were the chair of the committee, the Liberal MP for North Sydney Trent Zimmerman, as well as the Liberal member for Goldstein Tim Wilson and the LNP member for Bowman Andrew Laming.
For decades Australia was an international leader in policies designed to curb deaths and other harms from tobacco. Australia was an early adopter and a rather muscular implementer of policies known as ‘tobacco control’. These effective policies include restricting or eliminating cigarette advertising; raising the price of cigarettes through tax increases; restricting the availability of cigarettes and areas where smoking is permitted; forcing tobacco companies to adopt plain packaging for cigarettes and linking telephone help-lines to aggressive anti-smoking media campaigns.
Year after year for decades, Australia’s smoking rates fell, with Australian smoking rates significantly below those in the UK and USA where tobacco control was relatively weak.
Cigarette smoking is still the most important cause of preventable death in Australia. Every year, 19,000 Australians die from a tobacco-related cause, more than deaths from all other drugs combined. Up to two out of every three smokers will die from a tobacco-related condition. Indeed the cost of tobacco to the Australian economy is greater than the costs resulting from all other drugs combined.
After the popularity of e-cigarettes became more widespread in 2010 in the UK and USA, public health experts noticed that the decline in smoking rates had speeded up. Meanwhile, Australia’s smoking rates had plateaued between 2013 and 2016. UK and US smoking rates were now, for the first time ever, lower than in Australia. In NSW, according to Ministry of Health figures, smoking rates for men actually increased 3.1 per cent from 2015 to 2016.
Australia began increasing its cigarette tax by 12.5 per cent per year starting in 2015 and which is to continue annually until 2021.
When this initiative started, Australia’s cigarette prices were already among the highest in the world. However, the increase in wages in Australia is now lower than it has been for decades and is not keeping pace with inflation. Smoking rates are higher in low-income populations so the increase in cigarette tax is adding to economic stress in disadvantaged groups.
Unlike countries Australia usually compares itself with – the UK, USA, New Zealand, Canada and the EU – Australia’s health establishment has remained vigorously opposed to e-cigarettes. Yet in many other countries, initial opposition melted away and slowly transformed into support. But now cracks are starting to appear here as well.
Is tobacco control still working in Australia when the fall in our smoking rates seems to have stalled? Is it fair to keep jacking up cigarette prices when they are now the highest in the world at a time when our poorer citizens are struggling? Is it right to continue the ban on e-cigarettes when they are clearly less risky than ordinary cigarettes and actually help many to quit when all other quitting strategies have failed?
During almost five decades of attending innumerable Alcoholics Anonymous meetings, I have lost many good friends from tobacco-related diseases. These were usually fine AA members who had managed to quit drinking alcohol and using other drugs, but had not yet managed to stop smoking.
Over the years I have continued to learn the importance of focussing on effective ways of reducing the immense harm that drugs can do. Naturally the ideal result for addicted people is no mood-altering drugs indefinitely. This includes stopping smoking as well as the cessation of all other drugs.
But while some people manage complete abstinence, other addicted drug users can never quite get there. Given this reality we should make it much easier for smokers to switch to e-cigarettes.
Australians should thank those brave dissenting MPs – Trent Zimmerman, Tim Wilson and Andrew Laming – for their valiant attempt to save smokers’ lives and prevent needless misery.
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