Paris Lord – PHAA
Editor’s note: this Intouch post is longer than usual, but is worth your time, particularly if you can remember how ubiquitous smoking and its advertising was in Australia, and the efforts it took to counter that.
It’s New Year’s Day 1992. Ascot race course, Perth. New outfits, smart suits. Lots of sponsors’ advertisements. But something has changed.
“Suddenly the Winfield Cup becomes the Quit Cup,” Addy Carroll AM recalled.
“Gone were the scantily clad young women offering free cigarettes to punters, plus the Committee and members’ lounges were designated smoke-free.
“These measures made us quite unpopular. And that’s an understatement.”
Measures like phasing out smoking, and tobacco advertising and promotion at public events – which Addy, Shirley Frizzell and others helped enact – were among the actions to tackle smoking across Western Australia in the 1980s and 1990s.
Addy and Shirley shared their reflections at a ceremony in November 2021 at which they received the 2021 Bob Elphick Award from the Australian Council on Smoking and Health for their decades of efforts.
Addy Carroll on the early years of Healthway
Carroll told the audience that much of Western Australia’s tobacco control history was played out in the early years of Healthway, the WA Government’s Health Promotion Agency.
“And with Healthway celebrating its 30th anniversary, it has been interesting to reflect on our involvement, and in particular our roles in tobacco control,” she said.
“My career in tobacco began in 1984, when the Smoking and Health Project, which later became the Quit Campaign, was established.
“In that year, I jumped at the opportunity to be seconded from my tertiary teaching position to become its Schools and Youth Coordinator.
“This was tobacco control on steroids. A well-funded, comprehensive program with a dynamic team producing advertisements, running campaigns, events and promotions, research, lobbying, preparing education programs. It had it all, and I loved it.”
Addy recalled the efforts by the tobacco industry in the late 1980s and early 90s to stop the passage of what became WA’s Tobacco Control Act. These included stirring up opposition among sport, art, and racing organisations which the industry sponsored, as well as the media and billboard industries.
“It claimed that these groups would face ruin, despite provision in the Bill to replace sponsorship and advertising revenue over a three-year phase-out period,” Addy said.
These funds were to be administered by a new Health Promotion Foundation, an entity of which Addy initially thought no one in their right mind would become Director.
“Somehow it became me,” she said.
In early 1992, Addy was seconded to work with the late Harry Sorensen, who was the newly-appointed chair of the Foundation’s board which became Healthway.
Addy said Harry was “an inspired choice” as the retired, respected banker was involved with many community organisations.
Their first three years focussed on phasing out outdoor tobacco advertising and sponsorship and replacing it with government funding.
“Amid predictions that the advertising industry and sport would face financial ruin without tobacco backing, we found that the total value of replacement over three years amounted to only $4.5 million – around 10% of our total budget of $44 million during this time. A clear windfall for public health and the many organisations which received support.
“However, partnering organisations which had previously promoted tobacco was a challenge for us, and a shock for them.
“Health promotion sponsorship was a new concept, but guided by the Health Promotion Development and Evaluation Program at the UWA, it was found to be effective.
“Not only in raising awareness of health messages leading to behaviour change, it became a lever to introduce smoke-free policies in all of the organisations we funded.”
Addy said they took an incremental approach starting with indoor areas, and gradually expanded to outdoor events.
“In 1994 when the compère announced that the Opera in the Park was completely smoke-free and there was spontaneous applause from the 25,000-strong audience, I think I shed a small tear.
“Attitudes to smoking were definitely changing.”
When Addy and Shirley retired in 2002, surveys showed 95% of the community supported Healthway events being smoke-free.
Shirley Frizzell on program implementation, and its challenges
Shirley Frizzell said she was very humbled and honored to receive the award with Addy.
Shirley said the late Harry Sorensen was a key player in tobacco control. Shirley met Harry in 1983, when she was education coordinator at the WA Division of the Heart Foundation, and Harry was heavily involved with Rotary WA.
Rotary helped fund and distribute education materials about heart health and smoking, of which Shirley was the primary author. The materials were sent to every school in WA, and later, schools across Australia.
As with Addy, Shirley was seconded from her lecturing position at Curtin University to establish Healthway in 1991.
As Healthway’s Director of Health Promotion Programs and Research, Shirley said it was a privilege to fund many excellent health programs and health promotion research grants.
“I saw it as my role to actively work with organisations to come to us for funding in areas that were a priority for Healthway, and to ensure we were putting the money where it was most needed.”
These included commencing funding in 1995 of the Smarter Than Smoking Program which filled a gap by directly targeting children and youth.
“This campaign involved mass media, teacher resources, sponsorships, competitions, smart school grants, Aboriginal resources and much more,” Shirley explained.
“This program was funded for a total of 18 years for over $8m.”
While not all the successes in reducing youth smoking rates in WA were attributable to the Smarter Than Smoking program, between 1984 and 2005 rates of youth smoking fell significantly, and WA achieved Australia’s lowest youth smoking rate.
But not all of their projects worked successfully, Shirley recollected.
“I remember convincing a wary Education committee and Board, that it would be good to target a difficult to reach target group, construction workers,” she said.
“We gave a small grant to an off shoot of the CFMEU to look at the health effects of smoking and how to quit as part of their safety program.
“As was usual, I visited a course once they had started, and the instructor proudly showed me his newly acquired polo shirt with QUIT emblazoned across the pocket. I was about to congratulate him, until he mentioned the pocket was the perfect size in which to store his pack of cigarettes.”
Healthway funded numerous research grant applications in the tobacco control area. One particular benefit, Shirley said, was the demise of the tobacco industry-funded research in universities.
“In 1992, it became a condition of Healthway research funding to universities that they could not accept grants from tobacco companies. This effectively halted tobacco industry-funded research to four WA universities.
“[In the past year], Healthway has just advertised a targeted round of research grants on ‘the impact of harmful industry marketing on children and young people’.
“I was pleased to read in the guidelines that further stipulations apply to any applicants or organisations receiving any support from harmful industries.”
One of Healthway’s successes was achieving smoke-free areas in major venues across WA.
Shirley is an avid West Coast Eagles supporter, and in the early days she and husband Peter would attend most games at Subiaco Oval, and “endure the pain” of having seats near two chain smokers.
Healthway negotiated with the Western Australia Football Club to make Subiaco Oval smoke-free. Signs appeared to inform patrons that the venue would be changing, and Shirley kept her head down amid vocal complaints from smokers near her seats.
“One particular day I was presenting a Healthway award in the middle of the oval,” she said.
“Needless to say, my cover was blown and I wasn’t very popular by some seated around me. I may have even heard a boo or two when coming back to my seat. That was in 2001.”
How far has tobacco control come?
“In 1983, three in 10 people were regular smokers,” Shirley said.
“Today it is less than one in 10. And as Addy mentioned, there is almost universal support for smoke-free areas at venues and events.”
Powerful pair thank many partners in the tobacco control fight
Shirley and Addy acknowledged the many people and organisations whose work contributed to them receiving the Elphick award.
“You are equally worthy of the recognition. This award is for you,” Shirley said.
“These include the many health organisations such as the Heart Foundation, AMA, ACOSH, Cancer WA, Health Department whose lobbying efforts ensured the establishment of Healthway and who continued to support us in many ways.
“All our Board and committee members who set the scene and framed our programmes.
“The Healthway staff members and sponsorship officers who were in the front line, and it is great to see some of those who were involved right from the beginning have now taken up leadership roles in the organization – Julia Knapton, Sue-Ellen Morphett.
“All of the grant and sponsorship recipients who embraced the smoke-free and other health messages. Thank you. The research teams which added to our knowledge in the health promotion area.
“And while we are reluctant to mention individuals as we will no doubt leave some out, we acknowledge people like Deborah Fisher now Protter and Maurice Swanson who were involved in the first Quit campaign in WA, D’Arcy Holman, Rob Donovan, Billie Giles Corti, Jo Clarkson, Michael Rosenberg and the rest of the team at The Health Promotion Evaluation Program at UWA, who provided evaluation and direction.
“Bruce Armstrong for his guidance on our research program, Lisa Wood for her strategic planning work, Noni Walker for her work on the leadership program and of course Mike Daube, our mentor, strategic advisor and “go-to” person when we were in sticky situations.
“And lastly, John Carroll and Peter Frizzell for their ongoing support. And of course, ACOSH and the Elphick family.”
Image: Addy Carroll AM (left), Shirley Frizzell, and the Hon Roger Cook MLA, Deputy Premier of Western Australia and Minister for Health. Courtesy ACOSH.