In praise of Australia’s best minister for prevention

It isn’t often that an Australian minister visits the United States to acclaim, is hailed as a “global champion” and receives a major award to accompany assorted national and international awards already sitting on their shelves. The first anniversary of the introduction into the Parliament of Australia…

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Former health minister Nicola Roxon has won numerous awards for the plain packaging legislation. AAp/Tracey Nearmy

It isn’t often that an Australian minister visits the United States to acclaim, is hailed as a “global champion” and receives a major award to accompany assorted national and international awards already sitting on their shelves.

The first anniversary of the introduction into the Parliament of Australia’s historic plain packaging legislation is an appropriate time to recognise the achievements of former health minister, Attorney General Nicola Roxon.

Despite the well-deserved reputation of the health portfolio as a bed of nails, Roxon achieved international recognition as a leader who carefully and methodically took on the tobacco companies in the area closest to their hearts and promotional capacity, took everything that they could throw at her, and inspired others to do the same around the world.

Roxon will also be remembered as the minister who established Australia’s first National Preventive Health Agency, faced down the spirits industry over the alcopops tax, and provided a massive $872 million boost in prevention funding to the states and territories.

Australia’s plain packaging legislation is crucial both because it will help prevent children from starting to smoke and encourage adults to quit, and because the domino theory is nowhere more evident than in tobacco control. Once one country or state acts (whether on tobacco promotion, public education or passive smoking), others follow. As the former CEO of the Philip Morris company pointed out in 1985, “A sneeze in one country today causes international pneumonia tomorrow!”

Tobacco control advocates have long been familiar with the “scream test” – the louder tobacco companies scream, the more impact we know a measure will have. When the National Preventative Health Taskforce published a discussion paper in 2008 canvassing the full range of possible tobacco control measures, tobacco companies devoted 43 pages out of their 142-page response to arguments against plain packaging.

Nowhere is the domino effect more evident than in tobacco control. Bernard Rose

We knew from research evidence and the industry’s own documents that plain packaging would be effective: the screams could not have confirmed it more clearly.

The Taskforce’s final report duly recommended plain packaging as part of a comprehensive approach. But recommendations from expert committees often sit on shelves, especially if they entail taking on massive and ruthless global industries. We knew that Nicola Roxon supported prevention – she had established the Prevention Taskforce with strong terms of reference and filled it with known public health advocates – but we didn’t know whether she would be willing and able to follow through.

The clearest signal came with the media launch of the Taskforce report in September 2009, when in response to a question about action on prevention Roxon said, “We are killing people by not acting.”

She proceeded to pump up the federal government’s tobacco control efforts, with significantly increased funding and the first ever major program to address Indigenous smoking. But in 40 years of anti-tobacco campaigning, I cannot remember a more dramatic moment than a phone call from the federal health minister in April 2010 to say the government would be increasing the tax on tobacco by 25% – and introducing plain packaging.

The tobacco industry response was immediate and ferocious – and that was just the start. They have used every possible weapon, including advertising, lobbying, public relations, personal attacks, smears, campaigns through front organisations, vastly inflated estimates of the extent of the illicit market, distracting freedom-of-information (FOI) requests, legal challenges and international trade dispute mechanisms.

The tobacco industry’s nightmare of plain packaging is coming closer to reality. waferboard/Flickr

Throughout this, Nicola Roxon steadfastly and methodically took her legislation through the Parliament and drove action on plain packaging so that (subject to a favourable decision by the High Court), it will be implemented in Australia from December 2012. New Zealand and the United Kingdom (where the health minister publicly acknowledged Nicola Roxon’s influence) have made clear their intentions to take similar action, and other countries will then follow, as surely as lung cancer and heart disease follow smoking.

Roxon’s move from health minister to attorney general came at an opportune time, giving her added authority with which to resist the tobacco industry’s legal challenges – and to add legislation ensuring that tobacco smuggling cannot be used by tobacco companies and their allies to circumvent plain packaging.

Importantly, plain packaging was not introduced as one measure in isolation. It is part of a comprehensive approach that includes $100m for media campaigns, a ban on internet tobacco promotion, additional funding for quitlines and cessation supports, increased funding to states and territories for their programs, A$125m for programs on Indigenous smoking, including the Tackling Indigenous Smoking initiative, the 2010 budget’s 25% increase in tobacco excise, the 2012 reduction in tobacco duty-free allowances, increased penalties for tobacco smuggling and financial support for international action on smoking.

Small wonder that her shelves must be groaning under the weight of awards – a 2011 World Health Organisation Award, the Luther Terry Medal presented to the Department of Health and Ageing at the recent World Conference on Tobacco or Health in Singapore, the US Campaign for Tobacco Free Kids Global Champion Award, successive AMA/ACOSH/ASH tobacco scoreboard awards, and the prestigious Australian tobacco control award for individuals, the Nigel Gray Medal.

The recent announcement by the federal government of sponsorship for 12 national sports to promote anti-binge-drinking messages and eschew alcohol sponsorship is a consequence of the campaign Roxon fought to ensure that alcopops would be taxed at the same rate as other spirits-based drinks – despite furious opposition from the spirits industry.

Roxon fought to ensure that alcopops would be taxed at the same rate as other spirits-based drink. Katie Lips

She won that battle with the support of groups, such as the Australia Medical Association (AMA), which were at odds with her on other policy issues, but supported her stance on prevention – and after the undertaking that $50 million from the alcopops tax would go to programs aimed at reducing binge drinking.

Roxon also oversaw a range of initiatives drawing community attention to the rising tide of problems caused by obesity.

Nicola Roxon’s successes could not have been achieved without the backing of her cabinet colleagues, all-party parliamentary support (including important contributions from wonderful long-time advocates for prevention such as Liberal MP Dr Mal Washer), meticulous research, continuing advocacy from health organisations around the country and outstanding work in the Department of Health and Ageing.

It is also important to recognise that health ministers from both sides of politics have made important contributions to prevention – such as Neal Blewett’s early action on HIV/AIDS in the 1980s or Michael Wooldridge’s support for the first national tobacco campaign in the 1990s. At the state level, even in the last week Western Australia’s Kim Hames has led the way on obesity through support for a forceful and innovative media campaign.

There is never scope for complacency in tobacco control, and some of the major battles on alcohol and obesity are still ahead of us.

But as the tobacco industry’s nightmare of plain packaging comes ever closer to reality, Nicola Roxon’s historic initiatives mark her out as Australia’s best minister for prevention and the most influential we have had globally. To adapt her own phrase, by acting she will have saved tens of thousands of lives.

Join the conversation

20 Comments sorted by

  1. Marilyn Shepherd

    pensioner

    So what a pity that as AG on human rights she is one of the worst.

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    1. George Said

      Citizen

      In reply to Marilyn Shepherd

      You are right she has done nothing for human rights. At least she did not take us backwards as others did.

      She has done a great job in health issues and you cannot take that away from her. She has been internationally recognised for her contribution.

      Perhaps she will act on better human rights next.

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    2. Mark Harrigan

      Dr

      In reply to Marilyn Shepherd

      What's with the carping negativity? Not even an acknowledgement of the excellent work - just an attack without any evidence or back up?

      In what way is Roxon "one of the worst" AGs on human rights? Isn't the right to live a healthy life fairly fundamental? Hasn't Ms Roxon taken giant strides to make this happen? And you can't even acknowledge this?

      I find this sort of negative carping by the on-line commentariat a sad illustration of what is wrong with the mentality of many in Australia - just to focus on being a negative whinger.

      I say - well done to Ms Roxon (and all those who suported her and played a role) Fantastic Job - your work will savwe the lives of thousands, maybe tens of thousands - and protect the health of our nation. If that isn'a human right - what is??

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  2. Bruce Moon

    Bystander!

    Mike

    As you indicate "...plain packaging ...(subject to a favourable decision by the High Court), ...will be implemented in Australia from December 2012."

    As good as this may be, it is far from enough.

    In the major issue of juvenile tobacco take-up and addiction, plain paper packaging has long existed.

    From my own experience with youth, under 18's tend not to be the buyers of tobacco from 'registered' outlets. Rather, they buy from peers over 18. This 'arrangement' generally starts on…

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  3. Rosemary Stanton

    Nutritionist & Visiting Fellow at University of New South Wales

    A agree with you Mike. Nicola Roxon goes quietly about doing a lot of good. She was an impressive Minister for Health and has continued to push through this vital step to help reduce smoking rates further.

    On the obesity issue, however, the government seems to have dropped the ball. The food industry is calling the shots there and someone in authority needs to act. There's a lot of talking and everyone being nice to each other, but it doesn't seem to be leading us in the direction of cutting consumption of nutrient poor, energy dense foods.

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  4. Reinhard Dekter

    logged in via Facebook

    Nicola Roxon’s position is clearly that a) people are not responsible for making their own health choices and b) even if they were their choices would be wrong.

    How dare she insist that all Australians comply with her personal views on tobacco? And as this article makes clear, further interference in our diets and drinking habits is certain to follow.

    Freedoms we give up, even those freedoms that others view as a vice, always impact on all the other liberties we hold dear. Nicola Roxon has made it clear that she values her interests more than the liberty of an entire people. The support of her cabinet collegues in taking this step in the egregious violation of personal liberty implicates all of them as enemies of the people.

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    1. Rosemary Stanton

      Nutritionist & Visiting Fellow at University of New South Wales

      In reply to Reinhard Dekter

      Reinhard

      You obviously don't have to patch up the adverse health effects of those people whose health is ruined by tobacco, alcohol and junk food industries. These people pay huge sums to clever marketers to encourage the population (including kids) to buy their products. You seem to rate their their freedom to peddle their products more highly than the health of those they target.

      Nicola Roxon's view on tobacco are those of all those who work in the health arena.

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    2. Mark Harrigan

      Dr

      In reply to Reinhard Dekter

      There is no logic to your argument.

      Plain Paper packaging in no way removes the right of people to make their own health choices. It simply makes it much harder for the purveyors of a product known to cause death a lot harder.

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    3. Gil Hardwick

      Anthropologist

      In reply to Rosemary Stanton

      Yes, I agree with you Mike, and Mark and Rosemary. One thing we thend to neglect, however, is the flow of cash out of often tight household budgets toward cigarettes, alcohol and junk food.

      While I am adverse to the point of nagging about cigarettes and junk food, and to a greater extent oillicit drugs (as the #1 priority in this country), I remain somewhat more sanguine about alcohol especially in moderation.

      Alcopops are the equivalent of junk food, whereas good beer and fine wine in particular…

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    4. John Anderson

      Admin

      In reply to Mark Harrigan

      Mark, care to comment?

      According to the Tobacco Control Industry, The Children™ are attracted by the “glitzy” cigarette packaging, risking them becoming one of those “perverse, terrible” smokers. So, the cigarette packs must be hidden from display, lest The Children™ become overwhelmed with the desire to smoke. Now the TCI wants to remove all the “seductive, tempting colours” on the packs to further “save” The children™ – plain packaging draped with medical pornography.

      Yet here we have The…

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    5. Mark Harrigan

      Dr

      In reply to John Anderson

      No, there's no logic to your arguments either. Just mindless unsupported rhetoric in defence of the tobacco industry propaganda. Coupled with unsupported assertions linking marijuana with tobacco - an utter fruphy in relation to this matter

      And anyone who references fox news as asource of information is not only follishly ignorant they are also totally unaware of just how silly they are being. No doubt you are unaware that Fox Viewers are the most ill informed of any audience

      http://www.skepticalscience.com/pics/2012toon09.jpg

      Smoking kills - those who smoke and those nearby. It also costs - those who smoke and the general public.

      Grow up.

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    6. John Anderson

      Admin

      In reply to Mark Harrigan

      A raw nerve, Mark? Ease up or you’ll blow an antismoking gasket :)

      That’s right, Mark. It’s all just tobacco industry propaganda. Of course it is; how could I have been so blind! Only the moralistic proclamations of medicos and the Tobacco Control Industry are “truth”……. apparently. Let’s get one thing straight. I’m not interested in the tobacco industry. You can trash it all you want. My interest is in the damage that “society-fixer” fanatics/zealots can do in their social-engineering ventures…

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  5. John Anderson

    Admin

    Daube has been with the current antismoking crusade since the early days in the 1970s. He’s made a comfortable career out of antismoking. It’s, therefore, not surprising that he writes regular articles singing the praises of the Tobacco Control Industry.

    When it comes to the TCI, there is no shortage - in fact, there's a deluge - of self-adulation, self-approbation, and, of course, numerous award functions where the fanatics/zealots can further massage each other's massive egos.

    There have…

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  6. John Anderson

    Admin

    Daube: “Tobacco control advocates have long been familiar with the “scream test” – the louder tobacco companies scream, the more impact we know a measure will have.”

    There’s also a Tobacco Control Industry “scream test”, or, rather “screech test”. Question any of their pathological lying or ill-considered “programs”, question their ill-gotten, obscene amounts of funding, question the damage they wreak, and watch the zealots come screeching as they viciously attempt to protect the comfortable lifestyle to which they have become accustomed and their unfettered access to political power.

    The sanctimonious screeching continues – “How dare anyone question our benevolent, wonderful work! The only ones that would stoop to question very important people like us are shills of the [evil] tobacco industry, or [evil] tobacco industry apologists, or [evil] tobacco “addicts.””

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    1. Rosemary Stanton

      Nutritionist & Visiting Fellow at University of New South Wales

      In reply to John Anderson

      John

      Are you for real? It's hard to believe anyone is as bitter as you sound.

      Having spent time helping with anti-smoking campaigns in the 1970s (no payment by the way), we met in someone's home to plan campaigns, researched material in university libraries and were motivated by a desire to save lives. It wasn't easy and success has been slow.

      I don't know any public health people who receive 'obscene amounts of funding'. But I am aware of obscene amounts of money being spent by the tobacco industry in their marketing campaigns.

      The anti-smoking campaigns have not been easy and every step has required commitment and bravery from various health ministers. Nicola Roxon has taken a thoroughly worthwhile step. Your criticism of her is beyond my understanding. Have you seen people dying of emphysema or lung cancer?

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    2. John Anderson

      Admin

      In reply to Rosemary Stanton

      Dear Rosemary, thank you for your reply. At least you didn’t accuse me of being a tobacco industry shill. You sound like a caring person. But I doubt that you’re familiar with the considerable history of anti-smoking/tobacco or dangerous zealotry. Many of the great catastrophes have been pre-fixed as attempts to “save lives” or “save the world”. Consider eugenics of early last century – which was physician-led, by the way, and was also anti-tobacco/alcohol. It was predicated on the promise that it…

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    3. Mark Harrigan

      Dr

      In reply to John Anderson

      Unbelievable. Tastes like Fruit and goes Crunch to boot.

      Not even the tobacco industry advocates wear this sort of tinfoil hat.

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