tag:theconversation.com,2011:/institutions/cancer-council-nsw-1082/articlesCancer Council NSW2019-01-21T18:42:02Ztag:theconversation.com,2011:article/1054842019-01-21T18:42:02Z2019-01-21T18:42:02ZWhat’s behind the increase in bowel cancer among younger Australians?<figure><img src="https://images.theconversation.com/files/245711/original/file-20181115-194509-4mwn4d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Bowel cancer was the second most commonly diagnosed cancer in Australia in 2017.</span> <span class="attribution"><span class="source">from shutterstock.com</span></span></figcaption></figure><p>Bowel cancer mostly affects people over the age of 50, but recent evidence suggests it’s on the rise among younger Australians. </p>
<p>Our study, published recently in <a href="http://cebp.aacrjournals.org/">Cancer Epidemiology, Biomarkers and Prevention</a>, found the incidence of bowel cancer, which includes colon and rectal cancer, has increased by up to 9% in people under 50 from the 1990s until now. </p>
<p>Our research examined all recorded cases of bowel cancer from the past 40 years in Australians aged 20 and over. Previous <a href="https://www.ncbi.nlm.nih.gov/pubmed/3818155">studies</a> assessing <a href="https://www.ncbi.nlm.nih.gov/pubmed/22520938">bowel cancer incidence</a> in <a href="https://www.ncbi.nlm.nih.gov/pubmed/25251195">young Australians</a> have also <a href="https://www.ncbi.nlm.nih.gov/pubmed/28791283">documented an increase</a> in the younger age group.</p>
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Read more:
<a href="https://theconversation.com/interactive-body-map-what-really-gives-you-cancer-52427">Interactive body map: what really gives you cancer?</a>
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<a href="https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=620&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=620&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=620&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=779&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=779&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245017/original/file-20181112-83589-1pw3fxa.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=779&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Bowel cancer includes cancer of the colon and rectum.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/File:Stomach_colon_rectum_diagram-en.svg">Wikimedia Commons</a></span>
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<p>This trend is also being seen internationally. A <a href="https://www.ncbi.nlm.nih.gov/pubmed/28376186">study from the United States</a> suggests an increase in bowel cancer incidence in people aged 54 and younger. The research shows rectal cancer incidence increased by 3.2% annually from 1974 to 2013 among those aged age 20-29.</p>
<p>Bowel cancers are predicted to be the <a href="https://bowel-cancer.canceraustralia.gov.au/statistics">third most commonly diagnosed</a> cancer in Australia this year. In 2018, Australians have a one in 13 chance of being diagnosed with bowel cancer by their 85th birthday.</p>
<p>Our study also found bowel cancer incidence is falling in older Australians. This is likely, in part, to reflect the efficacy of the <a href="http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/bowel-screening-1">National Bowel Cancer Screening Program</a>, targeted at those aged 50-74. Bowel cancer screening acts to reduce cancer incidence, by detecting and removing precancerous lesions, as well as reducing mortality by detecting existing cancers early.</p>
<p>This is important, as bowel cancer has a good cure rate if discovered early. In 2010 to 2014, a person diagnosed with bowel cancer had a nearly 70% <a href="https://bowel-cancer.canceraustralia.gov.au/statistics">chance of surviving</a> the next five years. Survival is more than 90% for people who have bowel cancer detected at an early stage. </p>
<p>That is why screening is so effective – and <a href="https://www.ncbi.nlm.nih.gov/pubmed/29253458">we have previously predicted</a> that if coverage rates in the National Bowel Screening Program can be increased to 60%, around 84,000 lives could be saved by 2040. This would represent an extraordinary success. In fact, bowel screening has potential to be one of the greatest public health successes ever achieved in Australia.</p>
<h2>Why the increase in young people?</h2>
<p>Our study wasn’t designed to identify why bowel cancer is increasing among young people. However, there are some factors that could underpin our findings. </p>
<p>The <a href="https://www.ncbi.nlm.nih.gov/pubmed/27060626">increase in obesity parallels</a> that of bowel cancer, and large population based studies have <a href="https://www.ncbi.nlm.nih.gov/pubmed/23591454">linked obesity</a> to increased cancer risk.</p>
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Read more:
<a href="https://theconversation.com/how-obesity-causes-cancer-and-may-make-screening-and-treatment-harder-73596">How obesity causes cancer, and may make screening and treatment harder</a>
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<p>Unhealthy lifestyle behaviours, such as increased intake of highly processed foods (including meats), have <a href="https://www.bmj.com/content/360/bmj.k322">also been associated</a> with increased bowel cancer risk. High quality studies are needed to explore this role further. </p>
<p>Alcohol is also <a href="https://www.ncbi.nlm.nih.gov/pubmed/19350627">thought to be a contributor</a> to increasing the risk of bowel cancer.</p>
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<a href="https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245714/original/file-20181115-194488-11fvppj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Alcohol is thought to contribute to an increased risk of bowel cancer.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
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<p>So, should we be lowering the screening age in Australia to people under the age of 50? </p>
<p>Evaluating a cancer screening program for the general population requires a careful analysis of the potential benefits, harms, and costs. </p>
<p>A recent <a href="https://www.ncbi.nlm.nih.gov/pubmed/30190276">Australian study</a> modelled the trade-offs of lowering the screening age to 45. It showed more cancers would potentially be detected. But there would also be more colonoscopy-related harms such as perforation (tearing) in an extremely small proportion of people who require further evaluation after screening. </p>
<p>A lower screening age would also increase the number of colonoscopies to be performed in the overstretched public health system and therefore could have the unintended consequence of lengthening colonoscopy waiting times for people at high risk. </p>
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Read more:
<a href="https://theconversation.com/needless-procedures-when-is-a-colonoscopy-necessary-102576">Needless procedures: when is a colonoscopy necessary?</a>
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<h2>How to reduce bowel cancer risk</h2>
<p>One of the most common symptoms of bowel cancer is rectal bleeding. So if you notice blood when you go to the toilet, see your doctor to have it checked out.</p>
<p>A <a href="https://www.cancer.org.au/preventing-cancer/reduce-your-risk/eat-for-health.html">healthy lifestyle</a> including adequate exercise, avoiding smoking, limiting alcohol intake and eating well, remains most important to reducing cancer risk. </p>
<p>Aspirin <a href="https://www.cancer.org.au/health-professionals/clinical-guidelines/colorectal-cancer.html">may also lower risk</a> of cancer, but should be discussed with your doctor because of the potential for side effects including major bleeding.</p>
<p>Most importantly, we need to ensure eligible Australians participate in the current evidence-based screening program. Only <a href="https://www.aihw.gov.au/reports/cancer-screening/national-bowel-cancer-screening-program-2018/contents/summary">41% of the population</a> in the target 50-74 age range completed their poo tests in 2015-2016. The test is free, delivered by post and able to be self-administered.</p><img src="https://counter.theconversation.com/content/105484/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karen Canfell’s research team has received Commonwealth funding for a number of consulting projects including some of the work cited here. Her team performed work to support the 2017 NHMRC-approved Cancer Council Australia Clinical Practice Guidelines for the Prevention, Early Detection and Management of Colorectal Cancer; the modelled evaluation of screening from age 45 years referred to in this Conversation article formed part of that work.
Karen Canfell is co-principal investigator of an unrelated investigator-initiated trial of cytology and primary HPV screening in Australia (“Compass”), which is conducted and funded by the VCS Foundation, a government-funded health promotion charity. VCS has received equipment and a funding contribution for the Compass trial from Roche Molecular Systems and Ventana USA. However neither KC, nor her institution on her behalf (Cancer Council NSW) has received direct or indirect funding from industry for Compass Australia or NZ or any other project.
Karen Canfell is Director of Research at Cancer Council NSW and Chairs the Cancer Council Australia Cancer Screening and Immunisation Committee.</span></em></p><p class="fine-print"><em><span>Eleonora Feletto and Suzanne Mahady do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The rise in obesity parallels the increase in bowel cancer. Highly processed foods and alcohol could also play a role.Suzanne Mahady, Gastroenterologist & Clinical Epidemiologist, Senior Lecturer, Monash UniversityEleonora Feletto, Research fellow, Cancer Council NSWKaren Canfell, Adjunct professor, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/794102017-06-20T20:02:49Z2017-06-20T20:02:49ZTaxing sugary drinks would boost productivity, not just health<figure><img src="https://images.theconversation.com/files/174633/original/file-20170620-22151-8jzq1m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Taxing sugary drinks to tackle obesity would lead to a stronger economy, new research shows.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/success?src=pKXcpUSmADtmZ3Cx6g1iZw-1-8">from www.shutterstock.com</a></span></figcaption></figure><p>Many studies have looked at the potential benefits of a sugar tax in
terms of the <a href="https://theconversation.com/australian-sugary-drinks-tax-could-prevent-thousands-of-heart-attacks-and-strokes-and-save-1-600-lives-56439?sr=3">longer, healthier lives</a> and <a href="https://theconversation.com/a-sugary-drinks-tax-could-recoup-some-of-the-costs-of-obesity-while-preventing-it-69052?sr=5">reduced health expenditure</a> associated with tackling obesity.</p>
<p>But our new <a href="http://www.healthpolicyjrnl.com/article/S0168-8510(17)30094-5/abstract">study</a> goes one step further. It predicts that higher taxes on sugar-sweetened drinks will benefit the wider economy through increased economic productivity, by having more, healthier people in paid and unpaid work.</p>
<h2>Obesity delivers a double whammy</h2>
<p>A total of <a href="http://www.aihw.gov.au/overweight-and-obesity/">63% Australian adults and one in four children</a> are overweight or obese, making this both a health and an economic problem.</p>
<p>Obesity increases the risk of diseases including <a href="https://theconversation.com/how-obesity-causes-cancer-and-may-make-screening-and-treatment-harder-73596?sr=1">cancer</a>, <a href="https://theconversation.com/explainer-diabetes-and-obesity-the-biggest-epidemic-in-human-history-1474?sr=5">diabetes</a>, <a href="https://theconversation.com/australian-sugary-drinks-tax-could-prevent-thousands-of-heart-attacks-and-strokes-and-save-1-600-lives-56439?sr=1">heart disease and stroke</a>. Obesity has also been estimated to cost Australia about <a href="http://www.pwc.com.au/pdf/weighing-the-cost-of-obesity-final.pdf">A$8.6 billion</a> a year or <a href="https://www.mja.com.au/journal/2010/192/5/cost-overweight-and-obesity-australia">more</a>. Not only does obesity drive up <a href="http://www.pwc.com.au/pdf/weighing-the-cost-of-obesity-final.pdf">health-care costs</a>, by causing illness and premature death, it also reduces people’s ability to work and contribute to the economy.</p>
<p>Added sugar contributes energy to the diet, but no useful nutrients. Increasingly, health experts suggest we should be treating sugar, and in particular sugar in soft drinks, as we do tobacco or alcohol, by taxing it to reduce consumption and so reduce obesity rates.</p>
<p>Taxing sugar is not a new concept. In the 1700s, Scottish economist Adam Smith <a href="https://www.marxists.org/reference/archive/smith-adam/works/wealth-of-nations/book05/ch03-3.htm">wrote</a> in An Inquiry into the Nature and Causes of the Wealth of Nations:</p>
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<p>Sugar, rum, and tobacco, are commodities which are nowhere necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.</p>
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<p>Smith’s proposal to tax sugar was not aimed at improving health, as it is today. Now organisations like the <a href="http://www.who.int/mediacentre/news/releases/2016/curtail-sugary-drinks/en/">World Health Organisation</a>, the <a href="https://ama.com.au/ausmed/it%E2%80%99s-time-tax-sugary-drinks">Australian Medical Association</a> and many <a href="http://www.cancer.org.au/news/blog/prevention/australia-should-throw-its-weight-behind-a-sugar-tax.html">non-governmental organisations</a> are advocating a tax on drinks with added sugar, as part of wider efforts to tackle obesity.</p>
<h2>What we did and what we found</h2>
<p>Until our study, few worldwide had looked at the wider economic effects of taxing sugary drinks.</p>
<p>We modelled the Australian adult population as it was in 2010, in terms of consumption of sugar-sweetened drinks, body mass, obesity-related diseases, death rates, and the amount of paid or unpaid work people were likely to do. </p>
<p>We compared a scenario in which the prices of sugared drinks went up by 20%, compared to business-as-usual, and estimated what difference this would make for the number of obese people, the number of years lived, and for overall economic production.</p>
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<p><em>Further reading: <a href="https://theconversation.com/dietary-guidelines-dont-work-heres-how-to-fix-them-68803?sr=1">Dietary guidelines don’t work. Here’s how to fix them</a></em></p>
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<p>We used data from the <a href="http://www.abs.gov.au/australianhealthsurvey">2011-12 Australian Health Survey</a> and found that obese people aged 15-64 had a lower chance of being in a paid job, compared to people whose weight was normal. We assumed this was related to illness.</p>
<p>Of people in work, obese workers needed more sick leave, but only about an hour a year. </p>
<p>We also looked at unpaid work (like cooking, cleaning and caring, and volunteer work). We included gains due to more people surviving for longer due to lower body weight. We assumed that if work was not done as unpaid work, somebody would have to be hired to do it (so there would be a replacement cost).</p>
<p>Our results show that a 20% sugar tax would mean about 400,000 fewer people would be obese. Three-quarters of these would be in the workforce, so that about 300,000 fewer employed people would be obese.</p>
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<p><em>Further reading: <a href="https://theconversation.com/australian-sugary-drinks-tax-could-prevent-thousands-of-heart-attacks-and-strokes-and-save-1-600-lives-56439?sr=3">Australian sugary drinks tax could prevent thousands of heart attacks and strokes and save 1,600 lives</a></em></p>
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<p>Over the lifetime of the adult population of Australia in 2010, this would add about A$750 million to the formal, paid economy, due to more, healthier people producing more goods and services.</p>
<p>The gains in unpaid work were even larger at A$1.17 billion. Fewer obese people means more healthy people, who have a greater likelihood to do unpaid work, in the household or as volunteers.</p>
<p>These indirect economic benefits from increased employment in the workforce and from greater participation in unpaid work were larger than the savings in health care costs, which we estimated at about A$425 million over the lifetime of the adult population.</p>
<p>In all, the tax could deliver over A$2 billion in economic benefits in indirect economic benefits plus health care savings. And that does not even include the value of the gains in people’s quality of life and how long they lived.</p>
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<p><em>Further reading: <a href="https://theconversation.com/fat-nation-the-rise-and-fall-of-obesity-on-the-political-agenda-72875?sr=1">Fat nation: the rise and fall of obesity on the political agenda</a></em></p>
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<p>The exact size of the benefits depend on assumptions about what people would drink (and eat) if they drink fewer sugared drinks. In this study, we used <a href="http://onlinelibrary.wiley.com/doi/10.1002/hec.3070/abstract">Australian evidence</a> that found an increase only for diet drinks, which contain virtually no energy.</p>
<p><a href="https://theconversation.com/why-the-government-should-tax-unhealthy-foods-and-subsidise-nutritious-ones-72790">Other evidence</a> finds a sugar tax reduces the consumption of sugar and energy-rich foods, but may also lead to people eating fewer fruit and vegetables and more salt. This would reduce the health benefit, and that study suggests it would be even better to tax <em>all</em> sugar instead of only sugared drinks. </p>
<p>Nevertheless, <a href="https://grattan.edu.au/wp-content/uploads/2016/11/880-A-sugary-drinks-tax.pdf">the available evidence</a> shows health benefits of increased taxation of sugared drinks.</p>
<h2>What’s happening overseas?</h2>
<p>Studies in other countries have predicted similar effects of a sugar tax on the proportion of obese people. For example, a 20% tax is expected to reduce the number of obese people by about <a href="http://www.bmj.com/content/347/bmj.f6189">1.3% in the UK</a> and <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0105287">2-4% in South Africa</a>. </p>
<p>And <a href="https://grattan.edu.au/wp-content/uploads/2016/11/880-A-sugary-drinks-tax.pdf">an increasing number of countries</a>, including the UK, France, Denmark, Finland, Hungary and recently <a href="http://news.err.ee/588227/sester-expects-sugar-tax-to-bring-24-million-into-2018-state-budget">Estonia</a> and <a href="http://www.foreignbrief.com/daily-news/saudi-arabia-introduces-new-sugar-tobacco-taxes">Saudi Arabia</a>, have already announced or have implemented a tax on drinks with added sugar.</p>
<p>If Australia introduces a 20% tax on sugar-sweetened drinks, as many health advocates and economists have called for, that would not only improve health, our results predict it would also promote economic growth.</p>
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<p><em>The author of this article will be available for a live Q&A today 1-2pm. Please post your questions in the comments below.</em></p><img src="https://counter.theconversation.com/content/79410/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lennert Veerman receives funding from the National Health and Medical Research Council and the World Health Organisation.
He is also a Senior Research Fellow at the University of Queensland.</span></em></p>The benefits of a sugar tax go beyond mere health savings when obesity rates drop. Our new research predicts wider economic benefits due to more, healthier people in work.Lennert Veerman, Senior health economist, Cancer Council NSWLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/727902017-02-14T19:10:04Z2017-02-14T19:10:04ZWhy the government should tax unhealthy foods and subsidise nutritious ones<figure><img src="https://images.theconversation.com/files/156278/original/image-20170209-8651-12sldxw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Would you eat more of this if you were subsidised to?</span> <span class="attribution"><span class="source">from www.shutterstock.com.au</span></span></figcaption></figure><p>In an <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002232">Australian study published today</a>, we show that if the government were to combine taxes and subsidies on a range of foods and beverages, it could substantially improve the health of Australians and potentially free up billions in health care spending.</p>
<p>In the past five years, <a href="https://grattan.edu.au/wp-content/uploads/2016/11/880-A-sugary-drinks-tax.pdf">no fewer than 13 countries</a> have announced new taxes on sugary drinks or unhealthy foods to address the enormous and growing burden of obesity and its associated chronic diseases.</p>
<p>So far, the Australian government has remained steadfastly quiet, so we thought we might help with some facts.</p>
<p>We spend <a href="http://www.pwc.com.au/publications/healthcare-obesity.html">A$4 billion every year</a> on health care associated with obesity in Australia. Successive federal governments have <a href="https://www.ncbi.nlm.nih.gov/pubmed/24102746">invested in programs</a> to motivate people to shape up and eat better, such as “<a href="http://www.healthyactive.gov.au/internet/healthyactive/publishing.nsf/Content/getmoving">Get Moving</a>” and “<a href="http://www.healthyactive.gov.au/internet/healthyactive/publishing.nsf/Content/2and5">Go for 2 and 5</a>”. But rising obesity rates suggest this is not enough. Especially in the face of powerful <a href="https://www.ncbi.nlm.nih.gov/pubmed/22561190">food industry marketing</a> and an environment where unhealthy foods are widely and cheaply available.</p>
<p>By tweaking the prices of foods and drinks, to make healthy options more affordable relative to the less healthy products, <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001353">we can influence</a> what people will buy.</p>
<h2>Will it work?</h2>
<p>There are precedents. In Australia we have raised the price of cigarettes and <a href="http://tobaccocontrol.bmj.com/content/12/suppl_2/ii59">smoking has gone down</a>, and we have raised the price of alcoholic drinks and <a href="https://www.ncbi.nlm.nih.gov/pubmed/20833425">consumption has gone down</a>. </p>
<p>Mexico’s <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002057">sales of unhealthy foods have fallen</a> a year after introducing an 8% tax on these foods, compared with no change in sales of un-taxed foods.</p>
<p>By taxing unhealthy food components (saturated fats, excess salt, sugars) and subsidising healthy foods (fruits and vegetables) we aim to tip the pricing structure in favour of choosing healthier options. It can also provide an incentive to processed food manufacturers to improve the nutritional profile of their products.</p>
<p>Eating foods high in saturated fats, salt and sugar can lead to high blood pressure and obesity, which <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00128-2/abstract">puts people at risk of diseases</a> such as heart disease, type 2 diabetes and cancer.</p>
<h2>How would Australia benefit?</h2>
<p>In our study we modelled the effects of adding a tax to foods based on saturated fat, salt and sugar content, adding a tax on sugar-sweetened beverages, and placing a subsidy on fruits and vegetables. The policies were designed to have less than a 1% impact on average household food and drink expenditure.</p>
<p>We found over the lifetime of our Australian population of 22 million (that’s how many there were at the start of our simulations in 2010), we would gain an estimated 470,000 disability-adjusted life years (DALYs; meaning an extra year of life in perfect health) with the combination of taxes and subsidy.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/156281/original/image-20170209-28716-12742qz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Taxing food and beverages high in sugar would have the greatest effect on our health and budget.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
</figcaption>
</figure>
<p>That is a gain of 2.1 years of healthy life for every 100 Australians alive in 2010. Few other public health interventions could deliver such health gains on average across the whole population.</p>
<p>Taxing sugar produced the largest benefits (270,000 DALYs) followed by the salt tax (130,000 DALYs), saturated fat tax (97,000 DALYs) and sugar-sweetened beverage tax (12,000 DALYs). The subsidy on fruits and vegetables provided additional health benefits (6000 DALYs) when added to the combination of taxes, but did not show a clear benefit when implemented on its own.</p>
<p>Our simulations suggested the combination of taxes and subsidy could avert A$3.4 billion in healthcare spending over the population’s lifetime. And the benefits would be even greater if the food industry responded by reformulating products to have healthier levels of fats, salt and sugars.</p>
<p>Simulation studies, such as ours, do have uncertainty. For example, we are reliant on other research estimating the responsiveness of the public to changes in food prices. But simulation modelling is the only way to explore what might happen to the population in the medium to long term with the policy choices we make today.</p>
<p>This study adds to a growing body of evidence showing large health benefits and cost-effectiveness of using taxes and regulations to influence consumption of healthy foods.</p>
<h2>What next?</h2>
<p>Many Australians want to lose weight, eat better and move more. And we want our children to grow into healthy adults.</p>
<p>But we need policies that will support people to sustain their behaviour changes. Over recent decades, Australians have become far more responsible around smoking, drinking and driving, safe sex and sun exposure, because the environment has been changed to make those healthier choices easier. </p>
<p>Australia knows how to support people in taking personal responsibility, and we can do it for the biggest health problem we are currently facing - unhealthy diets. We need policies in place to address the environment that fuels the obesity epidemic.</p>
<p>The <a href="https://www.mja.com.au/journal/2017/206/3/national-health-summit-obesity-calls-australia-take-action-stem-pandemic">Medical Colleges of Australia</a> have taken the government to task for inaction on obesity, and called for a six-point action plan – including a sugary drinks tax. Our study adds impetus to this call. And while this is implemented, we need research and planning around a wider system of taxes and subsidies.</p><img src="https://counter.theconversation.com/content/72790/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Linda Cobiac has received funding from the National Health and Medical Research Council, the Health Research Council of New Zealand, VicHealth, the Queensland Government, the Richmond Group of Charities (UK) and Department for Environment, Food and Rural Affairs (UK)</span></em></p><p class="fine-print"><em><span>Lennert Veerman has received funding from the National Health and Medical Research Council, the Australian Research Council, the Cancer Council Victoria, the World Bank, and various universities and governmental sources.</span></em></p><p class="fine-print"><em><span>Tony Blakely has received funding from the Health Research Council of New Zealand, New Zealand Ministry of Business, Innovation and Employment and the New Zealand Ministry of Health.</span></em></p>By tweaking the prices of foods and drinks, to make healthy options more affordable relative to the less healthy products, we can influence what people will buy.Linda Cobiac, Senior Research Fellow, The University of MelbourneLennert Veerman, Senior health economist, Cancer Council NSWTony Blakely, Professor of Epidemiology, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/197192013-10-31T23:31:50Z2013-10-31T23:31:50ZSugary drinks tax could swell coffers, shrink waistlines<figure><img src="https://images.theconversation.com/files/34149/original/h366mtcw-1383187805.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A 20% tax on sugar drinks could change the habits of young Australians, which would benefit future generations.</span> <span class="attribution"><span class="source">Shutterstock / Creativa</span></span></figcaption></figure><p>A study published in the journal of the British Medical Association, BMJ, today says a tax on sugary drinks could cut the number of obese adults in the United Kingdom by 180,000. Similar Australian projections predict an even bigger impact.</p>
<p>The BMJ study shows people aged from 16 to 29 years would be most affected, and the tax would raise up to £276 million (AU$442 million) annually, which could be invested in the health sector.</p>
<p>Lennert Veerman, senior research fellow in population health at the University of Queensland, is in the process of doing a similar projection with Australian data. </p>
<p>He has found that if such a tax were implemented here, the number of Australians with obesity would drop by 110,000, a 2.6% drop in the nation’s obesity rate. This is twice the impact expected in the United Kingdom according to the BMJ study.</p>
<p>Veerman said that one reason for the difference is “unique consumption” of sugary drinks in the two countries; people in the United Kingdom consume less sugary drinks per person than Australia.</p>
<p>Another reason is that we are reliant on very old data; Australia’s last national nutrition survey was conducted in 1995. The survey collects data on what and how much people consume.</p>
<p>Veerman also noted that such studies tend to underestimate true effects because people under-report how much they indulge in unhealthy habits.</p>
<p>Nutritional clinical affiliate at the University of Sydney, Suzie Ferrie said a tax on sugary drinks would greatly benefit society. </p>
<p>Ferrie said “patterns of consumption” show young people under the age of 30 drink more soft drinks than older people, so the potential for change would be great because this age group is when habits really become entrenched.</p>
<p>“Changing youth drinking habits to healthier options could carry on to future generations,” she said.</p>
<p>But the chances of having such a tax implemented are low.</p>
<p>“Not many countries have managed to successfully implement these taxes,” said research fellow at Deakin population health, Gary Sacks.</p>
<p>The problem is that all governments have faced opposition from the private sector. In France, Sacks pointed out, “the food industry threatened to close down some of their factories”. </p>
<p>Despite full-page ads in Mexican papers opposing the measure, the government has just implemented a tax of one peso (A$0.08) per litre of soft drink and a 5% excise on high-calorie packaged food. </p>
<p>It is also too early to understand the full effect of the tax on the obesity rates in these countries because most laws have only been in effect for a couple of years. So, there is still only a limited amount of data to analyse.</p>
<p>However, when Denmark put a tax on fatty foods, consumption dropped by 15%, which was consistent with the modelling, Sacks said. </p>
<p>In an accompanying editorial in the BMJ, assistant professor of population medicine at Harvard Pilgrim Healthcare, Jason P Block suggests the only way we can truly find out what the impact of such a tax would be is by implementing it and reviewing the results.</p>
<p>But Ferrie suggested a pilot study would be adequate to collected data. </p>
<p>A new national nutrition survey to update from the one in 1995 may be a better way help calculate the results of such measures. It would be very expensive, but useful for many public health initiatives.</p>
<p>“We’re really suffering now because we still use old data,” Ferrie said. “I think the investment is worth it.”</p><img src="https://counter.theconversation.com/content/19719/count.gif" alt="The Conversation" width="1" height="1" />
A study published in the journal of the British Medical Association, BMJ, today says a tax on sugary drinks could cut the number of obese adults in the United Kingdom by 180,000. Similar Australian projections…Daniel Horsley, EditorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/172262013-08-19T20:32:37Z2013-08-19T20:32:37ZTotal cancer death rate drops but progress slow on ‘forgotten cancers’<figure><img src="https://images.theconversation.com/files/29521/original/fscwydc4-1376892858.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A lot of cancer researchers shy away from researching cancers where they can't see a clear research path going forward 10 or 15 years, the author of the report said.</span> <span class="attribution"><span class="source">Pan American Health Organization-PAHO / World Health</span></span></figcaption></figure><p>Australia’s mortality rate for all cancers has dropped 28% in 20 years, new figures show, but progress has been slow in the fight against thyroid and pancreatic cancer, while the death rate from liver cancer has skyrocketed.</p>
<p>Cancer Council NSW released the data today, saying the results highlighted overall successes in cancer research but also the struggle to fund and execute research on ‘forgotten cancers’ that must share the limelight with more high profile diseases, such as breast cancer.</p>
<p>The data is drawn from Cancer Council’s State of Cancer Control report, to be released in full next month.</p>
<p>The researchers compared the mortality rate from various cancers in 1987 with the expected cancer death rate in 2007 and the actual cancer death rate in 2007.</p>
<p>The figured show that between 1987 and 2007:</p>
<ul>
<li>The mortality rate for all cancers dropped by 7287 people, or 28%</li>
<li>The mortality rate for pancreatic and thyroid cancers dropped by just 6%</li>
<li>The mortality rate for liver cancer rose 70%</li>
<li>The mortality rate for oesophagus cancer dropped by just 9%</li>
</ul>
<p>“The big picture good news is that there are almost 8000 people alive and walking around today who, if this was 1987, would be dead from cancer,” said Associate Professor Freddy Sitas, author of the report and Director of Cancer Council NSW’s Cancer Research Division.</p>
<p>“Then you have these other cancers, like thyroid and pancreatic, where we haven’t seen much change at all or the mortality rate has gone up, like liver cancer.”</p>
<p>The slow rate of progress in some cancers was partly explained by a lack of research, he said.</p>
<p>For pancreatic cancer, for example, diagnosis is usually associated with really serious illness, leaving a small pool of patients willing to participate in research.</p>
<p>“They often have other priorities in their lives,” said Associate Professor Sitas.</p>
<p>Thyroid cancer, despite being one of the <a href="http://www.aihw.gov.au/cancer/">10 most commonly diagnosed cancers in Australia</a>, is still, in fact, reasonably rare, resulting in fewer patients for research, said Associate Professor Sitas.</p>
<p>“For these cancers, researchers need to collaborate across different hospitals and cities, which makes scientific coordination and paperwork quite complicated. Researchers tend to avoid these cancers,” he said.</p>
<p>The increase in the mortality rate for liver cancer may partly be explained by migration patterns, he said.</p>
<p>“We know that certain migrant groups had higher rates of liver cancer than others – for example, people from Italy, Southeast Asia and some Middle Eastern countries. These groups may possibly have higher rates of Hepatitis B and C, which is a contributor to liver cancer,” he said.</p>
<p>The data was released ahead of Cancer Council’s fund raising drive, <a href="http://daffodilday.com.au/">Daffodil Day</a>, on Friday.</p>
<p>“We have seen remarkable changes in survival from cancers like breast cancer because of a lot of money is being poured into research in that area. We want to see money poured into these other cancers so we can see the same progress there,” said Associate Professor Sitas.</p>
<p>“A lot of researchers shy away from these cancers because they can’t see a clear research path going forward 10 or 15 years, which is what it normally takes for an embryonic idea to bear real fruit. Take, for example, <a href="http://www.cancer.org.au/about-cancer/types-of-cancer/cancer-of-unknown-primary.html">Cancer of Unknown Primary</a>. Which smart researcher is going to look at this rare and difficult cancer with a poor prognosis, unless there is a clear 10 year funding stream?”</p>
<p>Bruce Armstrong, Professor of Public Health at University of Sydney said Cancer Council NSW “has been very good at identifying important cancers that cancer researchers have neglected, and funded excellent, broadly based and collaborative research programs in a number, including pancreas cancer, oesophagus cancer, brain cancer and liver cancer.” </p>
<p>“Cancer of the pancreas is the most of important of these. It is a highly fatal cancer and is rated by the <a href="http://www.aihw.gov.au/cancer/">Australian Institute of Health and Welfare</a> as Australia’s sixth most important cancer in terms of its contribution to Australia’s total burden of disease (measured in disability adjusted life years lost each year because of disease and injury),” said Professor Armstrong.</p>
<p>“While cancer of the liver doesn’t rate so highly at eighteenth, it has added importance because its incidence rate has trebled and its mortality rate more than doubled in Australia in the past 30 years; although both may have recently stopped rising.”</p>
<p>Liver cancer is almost completely preventable, being caused mainly by the preventable diseases hepatitis B and C viruses, and alcohol excess, he said. </p>
<p>“Thyroid cancer is important to those who get it, particularly the rarer but much more likely to be fatal <a href="http://en.wikipedia.org/wiki/Follicular_thyroid_cancer">follicular</a> and <a href="http://en.wikipedia.org/wiki/Anaplastic_thyroid_cancer">anaplastic</a> cancers; however it contributes only 0.4% of the annual burden of cancer in Australia.”</p><img src="https://counter.theconversation.com/content/17226/count.gif" alt="The Conversation" width="1" height="1" />
Australia’s mortality rate for all cancers has dropped 28% in 20 years, new figures show, but progress has been slow in the fight against thyroid and pancreatic cancer, while the death rate from liver…Sunanda Creagh, Senior EditorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/161702013-07-22T03:17:22Z2013-07-22T03:17:22ZNearly two thirds of men over 45 report erectile dysfunction: study<figure><img src="https://images.theconversation.com/files/27675/original/f3z682p2-1374116016.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Two thirds of Australian men aged 45 and over are at risk of suffering from erectile dysfunction</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Almost two thirds of men aged 45 and over have reported experiencing erectile dysfunction, a new <a href="https://www.mja.com.au/journal/2013/199/2/risk-factors-erectile-dysfunction-cohort-108-477-australian-men">study</a> has shown.</p>
<p>The study, published in the <a href="https://www.mja.com.au/journal/2013/199/2/risk-factors-erectile-dysfunction-cohort-108-477-australian-men">Medical Journal of Australia</a>, examined data on health, socio-demographic and lifestyle factors on 108,477 men aged 45 and over living in NSW who took part in the <a href="https://www.saxinstitute.org.au/our-work/45-up-study/">45 and Up Study</a> between 2006 and 2010.</p>
<p>They found that 61% of men surveyed had been affected by erectile dysfunction.</p>
<p>Study co-author David Smith, Associate Professor in Epidemiology and Research Fellow at the Cancer Council NSW, said prostate cancer treatment is known to increase the likelihood of erectile dysfunction but that some men undergoing cancer treatment may not be fully aware of the risks.</p>
<p>“Some men are unaware, or they may miss the quick sentence or two about the complications of erectile function as they’re so focused on getting the cancer treated,” he said.</p>
<p>“And many men may neglect their erectile health until they’re well enough to think about it, and often by that stage the issues have compounded themselves and they’re unlikely to get an erection again,” he said.</p>
<p>In the 101, 674 men studied who reported no prior diagnosis of prostate cancer, 39.31% had no erectile dysfunction, 25.14% had mild erectile dysfunction, 18.79% had moderate erectile dysfunction and 16.77% had complete erectile dysfunction.</p>
<p>The researchers found that the odds of experiencing erectile dysfunction increased by 11.3% each year over the age of 45, and almost all men aged 75 and over reported moderate or severe erectile dysfunction. </p>
<p>“Overall, the risk of moderate/complete ED was higher among men with low socioeconomic status, high body mass index, those who were sedentary, current smokers and those with diseases including diabetes, heart disease, and depression/anxiety, compared with men without these risk factors. Moderate alcohol consumption was associated with a significantly reduced risk of ED in men aged 45–54 years, but not in older men,” the study found.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/27587/original/hkgwwvqj-1374037923.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/27587/original/hkgwwvqj-1374037923.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=521&fit=crop&dpr=1 600w, https://images.theconversation.com/files/27587/original/hkgwwvqj-1374037923.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=521&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/27587/original/hkgwwvqj-1374037923.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=521&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/27587/original/hkgwwvqj-1374037923.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=654&fit=crop&dpr=1 754w, https://images.theconversation.com/files/27587/original/hkgwwvqj-1374037923.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=654&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/27587/original/hkgwwvqj-1374037923.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=654&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Men who experience erectile dysfunction should see their doctor, the experts said.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Professor Rob McLachlan, deputy director of Endocrinology at the Monash Medical Centre, said that the study confirms and expands previous understandings of risk factors, including socioeconomic status.</p>
<p>“A lot of these chronic disease and lifestyle issues are more challenging in men with reduced access or literacy of health. Erectile function is nature’s blood vessel test, so everything that affects blood vessels adversely also affects erections,” he said.</p>
<p>Health and lifestyle-related preventative measures for erectile dysfunction are the same for overall health, such as increased physical activity, not smoking, moderate drinking, and lowering your body mass index. </p>
<p>Men who experience erectile dysfunction should see their doctor.</p>
<p>Men with severe erectile dysfunction are 60% more likely to be hospitalised for coronary heart disease and twice as likely to die prematurely than men with no erectile problems, <a href="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001372">a previous study</a> has found.</p>
<p>Even minor erectile problems could be an indicator of future heart risks.</p>
<p>“This is clearly something that’s not done over the internet or a 1800 number. For the hundreds of thousands of men that this is a daily concern, they need help and it should be obtained through their doctor who can tackle these issues, and provide verified medications,” said Professor Smith. </p>
<p>“Men obviously want to do these things anonymously or privately but we need to make sure they feel that that’s not necessary. This is such a common problem, so we have to demystify it,” said Professor McLachlan.</p><img src="https://counter.theconversation.com/content/16170/count.gif" alt="The Conversation" width="1" height="1" />
Almost two thirds of men aged 45 and over have reported experiencing erectile dysfunction, a new study has shown. The study, published in the Medical Journal of Australia, examined data on health, socio-demographic…Zoe Ferguson, Editor, The ConversationLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/54932012-02-21T23:36:53Z2012-02-21T23:36:53ZSmoke-free outdoor laws herald better community health<figure><img src="https://images.theconversation.com/files/7917/original/hfwsw6d6-1329808039.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New South Wales' smoke-free outdoors legislation will be one of the most comprehensive in Australia.</span> <span class="attribution"><span class="source">Jess J/Flickr</span></span></figcaption></figure><p>The <a href="http://www.health.nsw.gov.au/news/2012/20120221_00.html">NSW government will introduce</a> a smoke-free outdoors law this year, making it the sixth state or territory to have some variation of this kind of legislation. The announcement shows that community health and common sense can override the vested interests and powerful lobbying of Big Tobacco. </p>
<p>While New South Wales has been late in introducing these laws compared with other states, the legislation will be one of the most comprehensive. </p>
<p>NSW Health Minister Jillian Skinner said the legislation – covering smoke-free children’s playgrounds, sporting fields when sports are being played, and covered bus shelters and taxi ranks – will be introduced in the spring session of parliament. The bans for smoking in commercial outdoor dining areas will come into effect in 2015. </p>
<p>Legislating for smoke-free outdoor areas is an important advance in reducing society’s entanglement with tobacco. As we have come to understand more about cancer, tobacco and the effects of second-hand smoke, there’s been a gradual shift in how society has viewed smoking. We have gone from a cigarette love affair in the 20th century, where Australia resembled a scene out of the heavy-smoking television show <a href="http://www.tv.com/shows/mad-men/">Mad Men</a>, to viewing it as a potentially deadly habit with no benefits. </p>
<p>Thirty years ago, smoking in the workplace or on public transport was fine. Now, we wouldn’t even consider it. </p>
<p>The change in New South Wales started at the grassroots level. Some local councils took the initiative (even before smoke-free laws were introduced in other states) to go smoke-free in outdoor areas, such as parks and bus shelters, demonstrating its feasibility. Similar moves have been <a href="http://www.theage.com.au/victoria/calls-for-more-smoking-bans-in-victoria-20120221-1tlap.html">made in Victoria by local councils</a> that have banned smoking in public places, such as playgrounds and outdoor eating areas.</p>
<p>Following the example set by local councils, some New South Wales café owners decided to ban smoking in alfresco dining areas, prioritising the health of their customers. In fact, a survey commissioned by the Cancer Council NSW showed eight out of ten café and restaurant <a href="http://www.canceraction.com.au/wp-content/uploads/2010/12/Ipsos-Eureka_Smoking-restrictions-in-alfresco-dining-areas_21.11.10.pdf">owners believed</a> that the smoke-free dining decision should not be left to councils, but should be legislated by state government. </p>
<p>The rest of the community also wants this type of legislation; a <a href="http://svc013.wic047p.server-web.com/html/aboutus/media/mediareleases/march03_2011_NSW_show_appetite_for_smokingban.html">Newspoll survey</a> conducted in New South Wales in February 2011 found four out of five people support smoke-free outdoor dining and more than nine out of ten adults believe playgrounds should be smoke-free. </p>
<p>So the New South Wales government is merely reflecting community sentiment with its announcement about the legislation, and there are strong grounds for other governments to do the same.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/7915/original/db5bvgvg-1329806293.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/7915/original/db5bvgvg-1329806293.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/7915/original/db5bvgvg-1329806293.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/7915/original/db5bvgvg-1329806293.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/7915/original/db5bvgvg-1329806293.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/7915/original/db5bvgvg-1329806293.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/7915/original/db5bvgvg-1329806293.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">For those wanting to give smoking up, it’s much more difficult to quit when surrounded by smokers.</span>
<span class="attribution"><span class="source">lanier/Flickr</span></span>
</figcaption>
</figure>
<p>No doubt there will be the usual cries about the nanny state from those with a vested interest in perpetuating tobacco use. But let’s consider some of facts.</p>
<p>Smoking is a known carcinogen that, to put it bluntly, kills. Breathing second-hand smoke is not just an unpleasant experience, it can also lead to serious life-threatening health problems, including cancer, heart disease and asthma. So it makes sense to not expose our kids to second-hand smoke when, for instance, they’re playing in parks or playgrounds. </p>
<p>And for those wanting to give smoking up, it’s that much more difficult to quit when surrounded by smokers in playgrounds or while enjoying an alfresco meal. </p>
<p>Businesses can be reassured that the announcement will be good for them; the 2008 New South Wales population health survey showed that for every person who objects to smoke-free dining, seven people favour the move. This means smoke-free dining is good for health, good for dining and good for business. </p>
<p>Soon smoke-free outdoor areas will be a normal part of life. Cigarettes will be out of sight and hopefully out of mind. Kids can play in a smoke-free environment and meals can be enjoyed without a side order of smoke. And that’s a cause for celebration.</p><img src="https://counter.theconversation.com/content/5493/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrew Penman is the CEO of Cancer Council NSW, which advocates for smoke-free outdoor areas. </span></em></p>The NSW government will introduce a smoke-free outdoors law this year, making it the sixth state or territory to have some variation of this kind of legislation. The announcement shows that community health…Andrew Penman, CEO, Cancer Council NSWLicensed as Creative Commons – attribution, no derivatives.