In the decade of 2000 – 2010, there have been a few commendable success stories in the field of Australian Public Health system like Tobacco control, Infectious disease control, Cardiovascular disease prevention, cancer prevention, motor vehicle safety and so on. Among these, I would like to present the work on tobacco control and Cardiovascular Disease Prevention and try to comment on a few of the techniques or methods used towards success in these areas.
Tobacco Control
Smoking has been identified as a major cause of cardio vascular diseases, lung cancer and several other high risk diseases.[1] In 1945, smoking rate was first published and showed 75% in the statistics. Since then, there has been a consistent downfall of the number of smokers in Australia. There have been various campaigns from the 1970s that the State and Territories have carried out to reduce the smoking rate in Australia.
Since its inception in 1971, Australian Council on Smoking and Health has dedicated its work towards tobacco control. From the initial statistics showing 75% of adult smokers in Australia in 1945 to 14.9% in 2010 and in later years, there has been a lot of work done towards decreasing these numbers and a lot has been done, from health warnings like “Smoking is a Health Hazard”[2] on the cigarette packets in 1972 to introduction of Federal law banning cigarette advertising on TV and radio in 1975, prohibition of smoking in all domestic aircrafts in 1986, fine of $5000 on sales of tobacco to under 18 year olds and increased tobacco tax in 1990, Point of Sale Advertising regulations under Tobacco Act 1990 restricting advertising and prohibiting tobacco advertising in view public places in 1991, Federal government deciding to implement graphic warning covering about 30% on the front and 90% on the back of the cigarette packets in 2004, all healthcare facilities going smoke – free in 2008 and the banning of tobacco advertisement on internet and 25% increase on the tobacco excise in 2010.[3]
One of the most visible changes brought about in tobacco control is the cigarette packets designs. Dark brown packaging with images of smoking-related hazards have replaced colourful packets with Brand logos, brand promotional graphics and text since 1st of December 2012[4], making Australia to be the only country by far to have a plain packaging cigarette packs rule. Every cigarette company can choose from about 15-20 pre decided health warnings like ‘Smoking causes peripheral vascular disease’, ‘Tobacco smoke is toxic’, ‘Smoking harms unborn babies’ etc that they have to display on the packaging along with the image. This has proved to reduce the number of smokers as branded packaging was rated as considerably more appealing and associated with style and sophistication of the smoker. Research has proved that cigarette packaging has always been targeted to attract young adults and women [5]. Adding health warnings made the packets less appealing to smokers and removing the description and the graphics and adding images of smoking related hazards lead the customers to consider the pack to be even lesser appealing. From a long time, the cigarette packets have been the main source of tobacco marketing. “Tobacco tax increases have been identified as the most effective single intervention to reduce demand for tobacco” [6]. Due to the higher taxes, the prices of individual packs of cigarettes went up, making them heavier on the pockets of the consumers. And if looked back in time, the price hikes have, if not always, most of the times, reduced the demand of a product. The same thing happened with cigarettes, due to high prices, most of the people reduced smoking and ultimately quit because it was hard for them to afford smoking anymore. It was also seen that quitting activity increased considerably around the period of the tax increase in 2010, which suggests a direct relation between increased prices and decreased smoking [7].
