Category: Health

Plain packaging: a failed policy export

We all know plain packaging is incredibly unappealing to look at, but statistics are consistently showing that it is also completely useless – and may even have effects that go against its intended outcome of reducing smoking. 

First, some background. Since December 2012, all companies selling tobacco products in Australia have been required to remove any branding or logos on packaging under the Tobacco Plain Packaging Act 2011. This has meant that all products from all brands have same appearance – drab dark brown (or Pantone 448 C, “the ugliest colour in the world”). The drab packaging compliments enlarged pictures of a child dying from cancer, somebody’s rotten teeth, a gangrenous foot, or some other visceral and confronting medical image designed to scare people into giving up the habit.

Australia was the first country to implement standardised tobacco packaging laws, and has inspired at least 15 other countries … Read the rest

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Hashtag Big Public Health

Those following me on social media may have noticed the hashtag that I have started- #bigpublichealth. Some have asked what does this mean and why have I done it.

Good questions. Below is my explanation.

We are forever hearing about big tobacco, big food, big pharma, big sugar and just to round it out big banks. These terms are used derisively to imply that the size of these amorphous groups is of itself a problem and that due to size, their influence is considerable.

There is some credence to this view. The lobbying power of the pharmaceutical industry is significant, especially on the USA. Allegations have surfaced about the behaviour of the sugar industry in paying researchers. The food industry, of course wants to protect its position. The tobacco industry has negligible power these days.

However, not one of these groups has the express backing of governments. Not one of … Read the rest

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The case for pill testing

Over the New Year’s period two party goers have fatally overdosed at music festivals around the country, renewing the debate about pill testing which has become a contentious issue in New South Wales.

New South Wales Premier Gladys Berejiklian has taken a firm stance against pill testing in the wake of the two fatal overdoses and over 700 requiring drug related medical treatment at Defqon1 late last year.

Berejiklian has since softened her stance on pill testing after the deaths over New Year’s and is now open to considering the possibility of pill testing at future music festivals in the state. It is still unclear, however, if public money will be used to supply pill testing services or venue operators will be permitted to operate their own pill testing services privately, or with cooperation from outside institutions.

The current response to drugs in music festivals in both New South Wales … Read the rest

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Sex, cars and e-cigarettes

It is interesting to apply current thinking to decisions taken years ago. Whilst our greater knowledge today can make previous behaviours and thinking seem odd or plain wrong, there are also instances when applying todays approach would have stopped progress.

In the 1960’s it became apparent that seatbelts reduced harm from use of motor vehicles. Whilst the vast majority of users, got from A to B safely, there were (and still are) vehicle collisions causing death or serious injury.

Wearing seatbelts was not subjected to randomised double blind placebo trials. It was not felt that use of a seatbelt required a doctor’s prescription. Use of seatbelts did not make using vehicles harm free. We did not know if there may be long term harms from use.

Yet not only was this form of harm reduction recommended, it was made compulsory.

In the 1980’s we saw the advent of HIV/AIDS. It … Read the rest

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High tobacco taxes linked to crime spike

Another convenience store worker has been attacked in what has become an increasingly common occurrence. Criminals, lured by the sky-high value of cigarettes due to the government’s Tobacco Excise, are robbing local shops to get their hands on them. It has become “tobacco first then cash” according to Jeff Rogut, chief executive of the Australasian Association of Convenience Stores. Tobacconists in Queensland have also expressed concerns for the safety of themselves and their stores, with one man’s shop being hit twice in a week by thieves targeting cigarettes. New Zealand has faced the same crisis, with aggravated robberies soaring by 87% between 2016 and 2017 and then-acting Prime Minister Winston Peters criticising high tobacco taxes in his country for much of that rise.

This hardly comes as a shock. History shows that aggressively taxing a product is a surefire way to create a black market and contribute to increased … Read the rest

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WTO plain packaging verdict is an assault on liberty

The World Trade Organisation’s (WTO) recent decision to validate Australia’s tobacco plain packaging laws is a colossal setback for liberty. The plain packaging laws which were implemented in 2012, ban logos, stylised images, brands and coloured cigarette packaging in favour of a generic packet with brand names printed in small standardised fonts. The WTO concluded, without considering significant evidence of their ineffectiveness, that Australia’s plain packaging law contributed to improving public health by reducing the use of and exposure to tobacco products and rejected claims that alternative measures would be equally useful. As a result, they declared that the law was still consistent with global trade rules.

The decision to uphold plain packaging laws is an assault on the principles of liberty. Free market capitalism, personal liberty, the ownership of private property and the enjoyment of limited government are being curtailed as a result of the panel’s decision. Strong and … Read the rest

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My Health Record: it’s worse than you think

There have been many critiques of the Federal government’s rollout of the My Health Record, based on many different grounds. There are the threats of hackers abusing the lax security of government databases, there are concerns over abusive spouses accessing details by logging into their spouses’ accounts, there are questions over the access private companies will have to sensitive records, and there are worries regarding access creep – more and more people getting access to this information.

The government has been on the back foot since the opt out period has started and has scrambled to assuage the fears of the public. No health minister would want a large program like this to fall flat and give the opposition a free kick going into the next federal election, which could be held as early as August 4th. All of these criticisms are valid and any one of them provides good Read the rest

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A sugar tax won’t fix the damage done by ‘public health’

A recent TV Program has again raised the issue of a sugar tax. All the usual public health suspects were of course in favour. They also bemoaned the influence of industry whilst complaining that they themselves do not get enough funding and lack clout.

It is difficult to know where to start. Public health is generously funded by government and is not particularly accountable.

Let us be crystal clear. It was not the food industry that introduced low fat dietary guidelines in the absence of any evidence in the early 1980’s. It was not big pharma or big sugar or big food. It was public health.  Whilst pretending to be small and powerless, the reality is that public health leverages the power of big government.

This has been evidenced by trials of doctors such as Garry Fettke in Tasmania and Tim Noakes in South Africa where complaints by elements in … Read the rest

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Tobacco harm reduction and vaping: beyond a binary approach

In the Orwell classic Animal farm there was a binary notion that the animals lived by – “four legs good, two legs bad”. This eventually morphed into “four legs good, two legs better” as the pigs who became the lead animals began walking on two legs like the evil farmer they had replaced.

Binary thinking has a role in areas like engineering where unless a bridge or building is a certain strength it may fall down. However human biology is not quite as amenable to this approach. Notwithstanding that we are all similar, no two people (even identical twins) are exactly the same.

In seeking to treat or help people in medicine we need a variety of options. No antidepressant or antihypertensive works for everyone. Different approaches are required and we must tailor what is best to the individual. The more options we have the greater the number we can … Read the rest

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