PHAA CEO, Adjunct Professor Terry Slevin
Health Minister Mark Butler’s National Press Club address on 2 May 2023 was a watershed moment when it comes to public health in Australia.
He announced a wide-ranging package of measures to tackle the public health scourge of tobacco and vaping. It included a detailed set of measures as part of the National Tobacco Strategy 2023-2030. Tobacco Control advocates were cock-a-hoop. And none are blind to the importance of its implementation and the roles to be played by many arms of government, including States and Territories. Similarly, the legislative process is still ongoing. The Public Health (Tobacco and Other Products) Legislation 2023 is open for consultation and industry forces will do their best to derail it.
But the implications of these efforts have the potential to go well beyond tobacco and vaping – as important they are as public health issues.
Comprehensive policy packages essential for public health challenges
My argument is this: The federal government has demonstrated it both understands and is committed to the notion that no single measure, but rather a raft of them all steering a policy issue in a clear direction, will generate meaningful, lasting public health benefit.
Rather than clambering for one public health measure at a time and facing the challenge of a commercial interest pushing back, with arguments like “how will this really move the dial” the total package of actions instead cuts through with unambiguous intent.
In the case of tobacco and vaping they included:
- Stopping the import of non-prescription vapes
- Increasing the minimum quality standards for vapes including by restricting flavours, colours, and other ingredients
- Requiring pharmaceutical-like packaging
- Reducing the allowed nicotine concentrations and volumes
- Banning all single use, disposable vapes
- Extending and increasing Tackling Indigenous Smoking program funding
- Funding for programs to support smokers and vapers to quit
- Funding a community wide tobacco and vaping mass media program
- Funding a lung cancer screening program
- Working with states and territories to close vape sales in retail settings
- Making it easier to get an e-cigarette prescription for legitimate therapeutic use.
- Updating the Tobacco Control legislation to make it contemporary (it’s more than 30 years old)
- Increasing the tobacco excise by 5%
But not everyone is focused on tobacco control. So how is this relevant beyond that issue?
Comprehensive measures surpass any one intervention
The case I’ve been putting to anyone who will listen is that this approach cuts a pathway through the public health policy bush for others to follow.
Rather than sweating the detail and heavy resistance of a single measure, important as they may be, like promoting a sugary drinks tax, or a time specific gambling advertising ban on TV, or putting controls on the minimum price of alcohol, our challenge is to think “comprehensive”.
Many of the small incremental steps we take in public health are fought tooth and nail by commercial interests who fear a hit to their bottom line. A common challenge thrown at us by industry players (and repeated by policy makers and politicians) is that “it won’t shift the dial”. Many public health measures proposed in isolation struggle to prove the change will make a substantial difference.
But when we unite them as a complementary, cohesive set of measures, they are far more likely to reduce the use of and harm from commercially promoted products like unhealthy food, alcohol, or gambling.
So, what’s your patch? Obesity? Alcohol? Illicit drugs? Injury prevention? Gambling?
Whatever it is, now’s the time to bring together the strongest possible raft of measures that will, according to the best available evidence, seriously move the dial.
Obesity as one example
Following that comprehensive tobacco and vaping package, consider what a similar package could look like for tackling obesity and associated disease:
- Advertising and marketing controls on unhealthy products
- Funding for ongoing effective campaigns
- Sugary drinks tax
- Initiatives to improve access to affordable healthy food
- Food reformulation labelling and regulation
- Improved physical activity infrastructure like cycleways and public transport through an activity transport initiative
- Mandatory and strengthened Health Star rating system
- Enact the National Obesity Strategy
- Clinical guidelines to assist people experiencing obesity
Put all these (and more) measures together, and now we’re getting somewhere.
Then add comprehensive packages for gambling and alcohol related harms, and we’re beginning to fit even more puzzle pieces together for a whole-system shift toward better health in Australia.
The gauntlet is on the table.
It’s up to you
It’s down to us in the public health world to collate the arguments, evidence, policies, recommendations, and ideas to tackle the big public health challenges – in a manner that governments can implement. The National Preventive Health Strategy provides us with some important guidance. And remember, this government is a little over one year old. We need to find a means to ensure we’re constructively working with them.
Of course, there remains the underpinning obstacles of social determinants. Income security, housing, discrimination, racism, the bigger equity issues that we need to solve for a fairer, healthier, and better society for everyone. We each have a responsibility to talk about, support, and reinforce measures that address these.
Like supporting the Voice to Parliament, joining the ACOSS Raise the Rate Campaign, amplifying and contributing to the Raise the Age campaign, demanding an increase in the age of criminal responsibility to at least 14 years old in every state and territory. Like challenging the inequity of the proposed stage three tax cuts by supporting the No Thanx to Tax Cuts campaign.
Challenges and threats in communicable disease control, in climate and health, and much more remain enormous mountains to climb.
But before us there are chronic diseases contributing to an enormous burden, which the public health community needs to take a direct lead in preventing. These are our core strengths and competencies. It’s territory others will not take up.
Our time is here and now. Together, let’s follow the “comprehensive strategy” path cut through the bush by the tobacco and vaping package, and into a better future for every person in Australia!
Featured image: Liam Hunter/Unsplash
Icon image credits:
Research paper icon created by Freepik – Flaticon
Three-person team icon created by Freepik – Flaticon
Four hand teamwork icon created by Smashicons – Flaticon
No tobacco icons created by BZZRINCANTATION – Flaticon
No e-cigarette icon created by Freepik – Flaticon
Note: First bullet point list updated 6/6/23.