Excising the Habit

My op-ed in today's Canberra Times looks at the impact of tobacco excise on reducing lung cancer deaths.
Coughers to cough up for coffers or excise the habit, Canberra Times, 2 August 2013

One of the most poignant emails I’ve received from a constituent read as follows:

‘My great-grandfather, grandfather, father and one of my uncles all died from smoking-related conditions. Each of the latter three died 20-30 years before the life expectancy for their generation. My father’s addiction contributed to two decades of poor health prior to his premature death, resulting in frequent periods where he was unable to work.

‘My siblings and I grew up in poverty, the effects of which are still evident, and the taxpayer bore the cost of his many hospitalisations as well as the cumulative years of income support our family depended on in lieu of employment. I say this so that you will understand my absence of sympathy for the “principle argument”, that tobacco companies have a right to make a profit from pushing legal drugs.’

I thought of this constituent with the announcement that the government will increase the excise on tobacco by 12.5 per cent each year over the next four years, with some of the money to be spent on building new cancer treatment facilities.

Few taxes are popular, but tobacco excise has been one of Australia’s most effective health policies. Since 1977, the share of adults who smoke daily has fallen from 37 per cent to 16 per cent.

One reason that tobacco excise is so effective is that higher prices particularly impact the behaviour of younger smokers – discouraging them from taking up smoking, or providing a stronger incentive to kick the habit.

We know the score when it comes to long-term smoking. The hacking cough, breathlessness, fatigue, chest infections and bloody phlegm.

We also know what happens when you stop smoking. Immediately, you smell better and your hair and clothes are no longer infused with the stench of stale smoke. In a week, most of the nicotine has left your body and your sense of taste has improved.  You gain so much more enjoyment from a meal or drink. An ex-smoker tells me she could finally drink herbal tea.

Medicos tell us that a month after quitting, better blood flow has improved your skin. People notice that you’re looking healthier. Three months down the track, your lung function has increased by 30 per cent. Suddenly walking and running become much easier.  One year without a cigarette and your risk of heart attack has halved. You’ve also got noticeably more cash in your pocket. Ex-smokers describe quitting smoking as the best thing you’ll ever do.

If tobacco had been discovered today, it’s unlikely that most developed countries would legalise it. Uniquely, smoking is harmful even in small doses. This makes it unlike other legal vices, which can be consumed in moderation. The occasional double whiskey or deep-fried Mars Bar won’t kill you – but as the ad says ‘every cigarette brings cancer closer’.

No other legal product – when consumed as directed – ends up killing half of its users. Smoking kills over 15,000 Australians every year, or about one person every half hour. It is responsible for the vast majority of lung cancer cases.

Increasing tobacco excise is a progressive health measure. The smoking rate is considerably higher for disadvantaged groups: 24 per cent among people living in disadvantaged areas, 47 per cent among Indigenous Australians, and 38 per cent among the unemployed. Smokers in these groups also consume up to a fifth more cigarettes than the average smoker.

Reducing smoking will help non-smokers. We know that smokers harm those around them—children who inhale passive smoke, or the one-in-six babies born to mothers who smoked while pregnant.

Tobacco excise isn’t the only way of reducing smoking. Last week, I launched the inaugural State of Preventive Health report on behalf of Health Minister Tanya Plibersek. The report notes the importance of social marketing campaigns in encouraging smokers to quit, and plain packaging in helping make cigarettes less ‘cool’. But it also notes that price matters, and that taxation has helped play a role in helping people kick the habit.

Increasing tobacco excise won’t be uniformly popular. But this is a rare instance in which raising a tax has a social benefit – not a social cost.

Labor stopped taking tobacco donations nearly a decade ago, because we believed it was wrong in principle. Let’s hope the Coalition – which still accepts money from big tobacco – can kick the habit. Then perhaps they will support a measure that will raise revenue and save lives.

Andrew Leigh is the federal member for Fraser, and his website is www.andrewleigh.com.

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