Statewide and Mental Health Services, Policy Development Unit
Submission to the Building on our Strengths discussion paper
Over the past decade, there has been a rapid increase in the number of countries and states that have implemented legislative change that bans or restricts smoking in public places. Restricting people’s capacity to smoke in public settings has multiple effects. Most immediately, it protects non-smokers from the harmful health effects of exposure to second hand smoke. Smoking bans help provide a supportive environment for people who want to quit smoking. Lastly, banning smoking in public spaces ultimately ‘de-normalises’ what is ultimately harmful behaviour that costs the State in significant ways.
Statewide and Mental Health Services Policy Development Unit (SMHS PDU) supports the efforts to strengthen legislative controls to reduce the harms from tobacco smoking and suggest that the proposal include vital research into the impacts on smoking behaviour of these legislative changes.
From a public health perspective, most smoking bans to this point have been implemented due to legislation concerned with reducing employee exposure to passive smoke. Therefore, most of the studies evaluating the effect of smoking bans on outcomes measure exposure to passive smoke and health, rather than smoking behaviour itself as an outcome measure. To this point, surprisingly little attention was given to active smoking behaviour. What we can conclude from the existing literature is that the effect of smoking bans on smoking prevalence are inconclusive with smoking prevalence declining slightly in most of the population based studies.
The broadest systematic analysis of the legislative efforts to ban smoking in public spaces – through the Cochrane Review – has established that legislative bans reduced exposure to second hand smoke. The review finds inconsistent evidence of a reduction in cigarette consumption, but in studies where declines in prevalence were recorded, consumption levels also fell. While several country-based studies did show improvements in smoking trends, the question of active smoking merits further investigation.[1]
SMHS PDU understands that there is a raft of activities aimed at reducing the levels of harm and overall smoking rates in line with evidence that effective smoking policies usually comprise multi-component efforts to tackle smoking cessation as well as the public health objective of reducing exposure to environmental tobacco smoke. Measure such as increased media awareness, telephone smoking cessation help lines, online interventions and smoking cessation support services to ensure awareness, comprehension and support of those affected by it are on the Tobacco coalition’s agenda. However, the comprehensive approach would not be clear to the general public. The inclusion of such information would significantly help support the Building on Our Strengths proposal to highlight that the issue is being dealt with on a number of fronts.
The effectiveness of legislative efforts proposed will depend on successful enforcement of the smoking ban legislation is necessary to ensure high level of compliance for its successful implementation. The implementation of such a broad range of legislative interventions will have potentially significant resource implications for those agencies given responsibility of enforcement.
However, these challenges should not deter the positive legislative proposals found in the Building on Our Strengths discussion paper. The measures outlined in the paper echo many of the population-based approaches that are identified in the Tasmanian Alcohol Action Framework, and are being highlighted in the formation of an Alcohol, Tobacco and other Drugs Promotion, Prevention and Early Intervention Framework. The willingness to utilise legislative mechanisms to influence behavioural change to reduce harms felt by the Tasmanian community is to be applauded.
Our feedback in the requested feedback template format is attached.
Statewide and Mental Health Services (SMHS)
Policy Development Unit (PDU)
Contact Person: Sylvia Engels
Manager, PDU, SMHS, DHHS
GPO Box 125, HOBART 7001
Proposal Number / Proposal / Support / Do not Support / ReasonsPlease √
1 / Ban smoking in all outdoor dining areas. /
2 / Remove the 3 metres exemption permitting patrons to smoke at tables within 3 metres of an entrance/exit to an eating establishment. / / The exemption is an anomaly from a public health perspective. The status of an individual as a patron or otherwise of an establishment does not diminish the potential harms from their actions.
Consideration should be given to how this action will impact upon the safety and amenity of the urban environment (e.g. lighting, litter, footpath space, role of alcohol etc).
3 / Ban smoking in all pedestrian malls, bus malls and covered bus shelters. / / Consideration will need to be given to the implications for enforcement, e.g. who will be responsible, resourcing, sanctions, processing fines etc.
4 / Ban smoking within enclosed children’s playgrounds or within 10 metres of any children’s playground equipment in unenclosed areas. /
5 / 5.1 Ban smoking in all outdoor sporting stadia and cultural venues, OR / / Please indicate whether you do or do not support a ban or restriction on smoking in outdoor sporting stadia. If restrictions are your preference, then please indicate which of the options is your preference.
A more precise definition of ‘cultural venue’ is required. It is unclear if this would include temporary structures.
5.2 Further restrict smoking in all outdoor sporting stadia and cultural venues by:
5.2.1 Prohibiting smoking within 10 metres of any seating area in the stadium or cultural venue, OR
5.2.2 Prohibiting smoking in all seating areas of the stadium or cultural venue, OR
5.2.3 Prohibiting smoking in all areas of the stadium or cultural venue except for designated smoking areas
6 / Ban smoking within 20 metres of the competition area at all sporting events where children are participating.
. / / Consideration will need to be given to the implications for enforcement.
7 / Ban smoking at all public swimming pool complexes. /
8 / Ban cigarette vending machines. / / .
9 / 9.1 Ban specialist tobacconists’ displays: / / Please indicate which of the proposals you do or do not support. You may choose several options.
Our preference is to remove sales from ‘general’ outlets and limit sales only to specialist tobacconists. Subsequently, the number of specialist licences of this sort should be capped.
Ultimately, the goal must be to limit the ‘casual’ exposure of Tasmanians to tobacco products, and that settings such as ‘corner stores’ or supermarkets are inappropriate for the sale of what is a harmful substance.
Longitudinal studies consistently suggest that exposure to tobacco advertising and promotion is associated with the likelihood that adolescents will start to smoke. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and smoking behaviours observed, as well as the theoretical plausibility regarding the impact of advertising, the Cochrane Collaboration concluded that tobacco advertising and promotion increases the likelihood that adolescents will start to smoke.[2]
9.2 Cap the number of specialist tobacconist to remain at the existing level: /
9.3 Phase out specialist tobacconists: /
9.4 Introduce a new category of specialist tobacco licensing. /
10 / Remove tobacco and tobacco products from reward schemes. /
11 / Ban tobacco sales at all temporary events such as music, sport or art festivals or where the majority of patrons are likely to be under 18. /
12 / Enable confiscation of tobacco and tobacco products in the possession of a child. / If you support this proposal, indicate who you think would be most suited to be given authority to confiscate tobacco from a child.
Given that this responsibility would inevitably fall to Tasmania Police, we would defer to their response to the issue of enforcement of this goal. The implications on their daily activity are potentially profound.
There is also a ‘rights’ issue. Perhaps harmony should exist between the legislation currently in place for alcohol.
Other / There is an opportunity for the discussion paper to explore the issue of Government taking a lead and imposing smoke free environments across all State Government buildings and workplaces. In addition, SMHS PDU understands that there is embryonic work to look at (banning) smoking in supported residential facilities, as such supports the continued exploration of this matter.
Statewide and Mental Health Services (SMHS)
Policy Development Unit (PDU)
Contact Person: Sylvia Engels
Manager, PDU, SMHS, DHHS
GPO Box 125, HOBART 7001
[1]Callinan JE, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database of Systematic Reviews 2010, Issue 4. Art. No.: CD005992. DOI: 10.1002/14651858.CD005992.pub2.
[2]Lovato C, Linn G, Stead LF, Best A. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD003439. DOI: 10.1002/14651858.CD003439