Andrew Leigh

In the debate over plain packaging of cigarettes, we had some procedural shenanigans this afternoon, with the Coalition calling two 'quorums' on every Labor speaker. In order to get the debate finished, Labor eventually withdrew several of our speakers, including yours truly.

But I rather liked my speech (which Huw Pohlner and Louise Crossman had put a lot of time into), so have pasted it below for your enjoyment.

Most importantly, the bill has now passed the House of Representatives.

Plain Packaging
24 August 2011

Australia has been a leader on action to reduce smoking in the past and we have a chance again this year to do much more to protect the health of all Australians. This is a chance to demonstrate that we are not a nation that just says ‘no’ to progressive ideas, not a nation that shies away from taking bold steps, from taking the lead where it is right and proper to do so.

Smoking kills over 15,000 Australians every year. Put another way, for every two speeches in this debate, an Australian dies from smoking-related causes.

On one estimate, smoking costs our society $31 billion a year. It is responsible for 84% of lung cancer cases in men and 77% in women. We know the score when it comes to long-term smoking. The hacking cough, easy 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. A month later, 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%. You’ve got your breath back, so much air available, and you can finally feel it reaching right into your lungs and 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’.

Because cigarettes are such an abnormal product, the government is aiming to take away one of the tobacco industry’s last avenues for promotion: an attractive pack design. Described as ‘the silent salesman’, cigarette companies have long relied on slick packets to communicate to consumers not merely the desirability of their product, but also to reach out to particular target groups, such as youth, women, or consumers wanting a milder product.

In marketing jargon, cigarettes are known as a ‘badge product’, because the packaging is frequently displayed to others. As one industry insider put it, ‘if you smoke, a cigarette pack is one of the few things you use regularly that makes a statement about you. A cigarette pack is the only thing you take out of your pocket 20 times a day and lay out for everyone to see. That’s a lot different than buying your soap powder in generic packaging.’

A friend of mine actually changed the brand of cigarette that she smoked when she moved from the outer suburbs to the inner city. She’d realised that the cigarettes she smoked didn’t cut it status-wise so changed to fit in. But when she’d visit home, she’d revert back to the old brand to fit in with that group.

Much like brands of clothing, mobile phones and personal accessories, cigarette companies compete for status and social preference. They seek to differentiate themselves through symbols, colour, language and style. In 2010, one company introduced a ‘slide pack’, which opened via a side panel rather than the flip top. Their sales shot up 25% over six months and a further 32.5% after a year. Spokespeople for the company explicitly attributed sales success to the packaging.

For many smokers, packaging is a truly decisive factor. In one study, one in two smokers were not able to distinguish in blind tests between similar cigarettes. As an industry magazine advised in 1999, ‘If your brand can no longer shout from billboards, let alone from the cinema screen or the pages of a glossy magazine … it can at least court smokers from the retailer’s shelf, or from wherever it is placed by those already wed to it’.

Although no country has yet implemented plain packaging, medical researchers have run a spate of laboratory experiments to see how people’s perceptions of cigarettes change as design elements are progressively removed from the pack. For example, a 2009 study by Daniella Germain and coauthors recruited Australian adolescents (smokers and non-smokers). The researchers then randomly showed them regular cigarette packages, plain packages, or something in between. As branding was removed, adolescents became less positive about the kinds of people who smoked that cigarette, and more negative about its taste.

A Canadian expert panel reviewed a batch of studies in 1995 and found that they almost universally converged on one conclusion: plain packaging would likely lead to fewer people, particularly teenagers and young adults, starting smoking and more smokers choosing to quit. A separate review of the evidence up to 2009 concluded that plain packaging would have benefits across three core areas: ‘increasing the effectiveness of health warnings, reducing false health beliefs about cigarettes, and reducing brand appeal especially among youth and young adults’.

The laboratory evidence accords with what the tobacco industry has found in its street surveys. One marketing report (released as part of the US tobacco settlement) mournfully noted: ‘when we offered them Marlboros at half price – in generic brown boxes – only 21% were interested, even though we assured them that each package was fresh, had been sealed at the factory and was identical (except for the different packaging) to what they normally bought at their local, tobacconist or cigarette machine.’

Not surprisingly, the tobacco industry has reacted vehemently to plain packaging legislation, arguing that it will lead them to cut prices. From an economic standpoint, it is hard to see why this should occur. Price wars are generally a reaction to a temporary change in market conditions (such as the entry of a highly-leveraged competitor) – not to long-run changes in the market environment. The industry has also claimed that plain packaging will boost the illegal market, a strange claim given that many black market cigarettes are already sold in plain packages.

I have mentioned brand appeal. But the ways in which cigarette manufacturers choose to differentiate their products have also led some smokers to misconstrue the impacts of their actions on their own health. Looking at just one brand, one type of cigarettes with a gold logo on the pack was perceived to be much less impactful on smokers’ health and much easier to quit than the same cigarettes in a pack with a red logo. Researchers in that and another similar study found that ‘removing colours from packs, as well as terms such as ‘smooth’, ‘gold’ and ‘silver’ would significantly reduce false beliefs’.

This is why the government has chosen to legislate that all cigarette packaging will be uniformly olive coloured. Research has shown that this colour has the lowest appeal to smokers. I trust Australia’s olive-growers won’t be offended.

As for increasing the effectiveness of health warnings, the existing research is very clear. Health warnings on plain packs have been found in trials to be seen as more serious than the same warnings on branded packs. Brand imagery diffuses the impact of health warnings.

Branding also, quite simply, distracts the eye. Two UK researchers, Marcus Munafo and Linda Bauld, had a group of 43 respondents - non-smokers, light smokers and daily smokers - look at both plain and branded cigarette packets. All packs featured health warnings. Using eye-tracking technology, the researchers measured the number of times each participant viewed the top of the pack, which contained the brand information, and the bottom half of the pack, containing the health warning. They found that non-smokers and light smokers paid more attention to the health warnings on plain packs than on those emblazoned with logos, brand names and designs. Frequent smokers recorded no significant difference, indicating that they may have become conditioned to ignore the warnings.

This legislation will strengthen the effectiveness of health warnings; they will be the only colour and imagery on cigarette packs, and they will be larger and more dominant than ever before. The research findings from the UK support the idea that it is the future smokers of Australia in particular who will be most impacted by these changes and who may make different choices to what they otherwise would have.

Earlier this year, I received an email from a constituent about why we should support efforts reduce smoking rates. The constituent wrote:

‘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.’

This bill is a progressive health measure. While the national smoking rate is 17%, it remains considerably higher for disadvantaged groups: 26% among people living in low socioeconomic areas, 34% among Indigenous Australians, and 38% among the unemployed. Smokers in these groups also consume 15-20% more cigarettes than the average smoker.

This bill will also have particular benefits for regional Australia. Smoking rates in regional areas are twice as high as in the cities, and people in the bush have higher death rates from lung cancer, heart disease, asthma and chronic obstructive pulmonary disease.

And this bill 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.

This plain packaging bill – combined with the 25% excise increase announced in April 2010, and record investment in anti-smoking social marketing campaigns - we aim to reduce the national smoking rate to 10% by 2018.

I spoke at the start of this speech about Australia as a leader of nations. We are rightly proud that ours was one of the first nations to give the vote to women, to use income-contingent loans to expand universities, and to choose skilled migrants using a points system. We were among the first in the world to put in place a minimum wage, an old age pension, and unemployment and sickness benefits. Australia was a world leader in these areas, and our society is better for it.

When this legislation is passed, Australia will have the world’s toughest tobacco advertising laws. We will be the only signatory to the WHO Framework Convention on Tobacco Control to have implemented this key recommendation to emerge from the 2009 Conference of the Parties. On this issue, this is where Australia should be: at the head of the pack, leading the way. It has been nearly twenty years since the Hawke-Keating government passed the Tobacco Advertising Prohibition Act and it is time that another Australian government continued their work in protecting the health of all Australians from the debilitating effects of nicotine addiction.