Q. Professor Chapman, you were one of the strongest supporters of the introduction of plain packaging legislation in Australia. The objectives of the legislation were to reduce the attractiveness and appeal of tobacco products to consumers, particularly young people, increase the noticeability and effectiveness of graphic health warnings, reduce the ability of the retail packaging of tobacco products to mislead consumers about the harms of smoking, and, in the long term, contribute to the reduction of smoking rates. Two years after the law has been enforced, are you happy with its impact? Assuming you are, could you please explain why?

A. Very happy. A highly chemically engineered, addictive product which is forecast to kill 1 billion people this century on average ten years early is now being packaged in a way commensurate with its unparalleled status as the most deadly consumer product ever marketed. My only regret is that the gangrene pictorial warning does not yet incorporate a scratch-and-sniff tab impregnated with putrescence or cadavarine which would allow smokers additionally unforgettable insight into the world of smoking that will await many of them.

 

Q. There has been much debate about the lack of hard data on the development of the tobacco market and smoking in Australia since plain packaging became mandatory. On which evidence do you base your findings?

A. Tobacco companies of course know exactly the impact it is causing in Australia and likely to cause when it spreads internationally. They know this impact day by day, suburb by suburb, shop by shop and brand by brand because they have instant sales data and can map this to both proximal and distal factors intended to both promote and reduce smoking. The industry’s apoplexy about plain packs is all we need to know about whether plain packaging is biting. In a nearly 40-year career, I have never seen the industry attack any policy – including tax – with the venom and aggression that we are seeing with plain packs.

 

Q. Even two years after its implementation, the relevance of the introduction of plain packaging is difficult to evaluate. Judging from the hype that emerged around its introduction and the great expectations about the potential impact of this unprecedented, drastic measure by the tobacco control community, as well as the fierce opposition from the tobacco industry, one would have expected an immediate, obvious effect of the legislation. Today, in the absence of reliable, unequivocal data, it appears that the public health community, not unlike the tobacco industry, rejoices at every set of data that seems to prove their point, while at the same time they excuse any other findings claiming plain packaging legislation was merely part of a comprehensive package of tobacco control activities and that it was still too early to look at its effectiveness. Could you please comment on this discrepancy? What do you think, is plain packaging already a success in its own right or just an “experiment”, as the then health minister Nicola Roxon termed it when it was implemented? When would be the right time to assess the effectiveness of the legislation in your opinion?

A. I am unaware of anyone with any experience or credibility in tobacco control who forecast “an immediate, obvious effect” from plain packaging. This is so obviously and deliberately an industry straw-man game. No Australian born after 1 July 1993 (so now aged up to 21) has ever seen a local tobacco advertisement or sponsored event. They have grown up understanding that, unique among all consumer products, tobacco is the only product subject to a total advertising ban. Similarly, those born after December 2012 will now grow up never seeing a product with 60-plus carcinogens packaged in beguiling livery, reflecting the best efforts of your industry to keep smokers’ minds off that reality. Measures like advertising bans, graphic health warnings, smoke-free policies, plain packaging and all other elements of comprehensive tobacco control have worked synergistically to get both adult and children’s smoking prevalence to today’s record lows. Australia today has the world’s lowest smoking prevalence, with only 12.8 percent smoking daily. It is a template that if replicated will save hundreds of millions of lives this century.

 

Q. Asked about the effectiveness of plain packaging, the tobacco industry, as would have been expected, basically said it had no effect whatsoever and argued that it was rather the series of significant tax hikes that impacted on cigarette sales. What is your opinion on that? Was the introduction of plain packaging a necessary measure or would tax hikes alone have done the trick?

A. On the same day that the Australian government announced plain packaging, it introduced an overnight 25 percent hike in tobacco tax (1 May 2010). Treasury modellers predicted a 6 percent fall in consumption, but an 11 percent fall occurred. In August 2011, we witnessed BATA’s David Crow acknowledging this decimating impact to a Senate committee but almost begging the government to continue it rather than progress plain packaging. What should that tell us?

 

Q. Recent population health surveys from several Australian states indicate that smoking prevalence among adults has gone up. A New South Wales population health survey showed that in 2013 16.4 percent of adults smoked, up from 14.7 percent in 2011. The latest figures from Queensland reveal that for 25- to 34-year-olds, 28 percent of men smoke, compared with 19.8 percent in 2012, and for women it has risen 4 percent to 17 percent. In South Australia smoking rates were up from 16.7 percent to 19.4 percent. The New South Wales Health of Young People Report reveals an upward trend since 2011 for smokers aged between 16 and 24. Apparently, plain packaging has not deterred these people from taking up smoking. Could you please comment on these figures?

A. Your question conspicuously avoids the rhino in the living room: national data from a 24,000-strong national sample which shows the lowest ever smoking prevalence post-plain packs (12.8 percent daily), that younger people are delaying the take-up of smoking – the age at which 14- to 24-year-olds smoked their first full cigarette increased from 14.2 in 1995 to 15.9 years in 2013 – and that smokers reduced the average number of cigarettes smoked per week by 13.5 percent, from 111 cigarettes in 2010 to 96 in 2013.

The New South Wales and South Australian state data you cite are not statistically significant, and if they were in the opposite direction we would not be able to claim that rates were decreasing. The website for the New South Wales data states clearly that 2010 and 2012 data are not comparable (“In 2012 mobile phones were included in the survey methods for the first time and this increased the number of younger people and males in the survey sample. Both of these groups have relatively higher smoking rates, leading to a higher overall reported rate of current smoking. The 2012 prevalence estimate reflects an improvement in the representativeness of the survey sample. The rate for 2013 has stabilised.”) If the tobacco industry really believed these cherry-picked figures signified an increase in smoking in Australia, it would be voluntarily introducing plain packs as fast as it could.

Your industry is so amusing in the way that it regularly flip-flops between strenuously arguing plain packs have no effect on prevalence or sales and then megaphoning factoids like the infamous one circulated by the industry-sponsored Institute of Public Affairs that plain packs would work so well that $3 billion a year would be ordered by the courts for compensation. When we drilled down into this, the factoid was based on an assumption of a 30 percent fall each year in consumption. Would it be too much to ask you to make up your mind? Is it a policy that won’t work, or the most damaging policy ever introduced anywhere?

 

Q. As it looks, it is the lack of reliable, hard data that makes it so difficult to assess the impact of plain packaging. What would be a suitable solution to this problem? In a contribution to abc.net.au in July 2013, you call for publicly available data on tobacco-tax receipts and projections in Australia – would this be a good way out of the dilemma? And would this also be a solution favoured by the public health community?

A. Since I wrote that, the Australian Bureau of Statistics has released data showing a decrease in chain volume of tobacco sales of 6.3 percent from the March 2013 to the September 2014 quarters.

 

Q. Australia’s plain packaging legislation is currently facing a landmark challenge at the World Trade Organization (WTO) that was filed by five countries, among them cigar-producing nations Cuba, the Dominican Republic and Honduras, which say that brandless packaging is an assault to their trading rights, threatening their trademarks and local economies. In your book you are quite confident that it is highly unlikely Australia will lose the case – why?

A. “Landmark” is your word. A sad collection of minnow nations all with pathetic tobacco control, high smoking rates and high corruption indeces are leading this tawdry exercise. There has been a massive amount of legal scholarship published by extremely senior people on the prospects of the WTO challenge succeeding. All give its success about the same probability as a three-legged horse winning the Grand National or Kentucky Derby. Five tobacco transnationals were humiliated 6–1 in the Australian High Court, another result that all but industry consultants predicted.

 

Q. Several countries in the world, among them European Union member states, have already made efforts to follow Australia’s example (see Tobacco Reporter December 2014). Under EU law, restricting the use of brands is problematic, since it infringes intellectual property rights, and national and international trademark law, as well as articles contained in the Charter of Fundamental Rights of the European Union and even the European Convention on Human Rights. The outcome of the WTO case left aside, what makes you so sure that the domino effect we have seen with other tobacco control measures will occur in this case, too?

A. Some 77 nations have “infringed the intellectual property rights” of your industry by requiring graphic health warnings and thereby appropriating large areas of this “intellectual property”. Not a cent has been paid in compensation anywhere. There is not one component of comprehensive tobacco control that has been first adopted by one country and which has not then rapidly dominoed globally.

 

Q. Tobacco (and plain packaging) has also been a hot topic in the Trans-Pacific Partnership (TPP) talks. TPP is a proposed regional free-trade agreement. As of 2014 12 countries throughout the Asia-Pacific region, among them the United States, have participated in negotiations on the TPP. The trade agreement also contains investor-state dispute settlements (ISDS) clauses which enable foreign corporations to sue a host country for laws or policies, or even court decisions, they find inconvenient and objectionable. In how far could TPP put an end to Australia’s plain pack “experience” and prevent the “global plain-pack domino spectacle”, as you put it?

A. Australia’s Trade Minister Andrew Robb has now twice taken the trouble to state publicly that Australia will not allow the TPP to jeopardise plain packaging. There are many products on which different governments impose strong restrictions or even outright bans for health or cultural reasons. Examples include Islamic nations (with severe restrictions on alcohol sales), firearms, asbestos, exotic and endangered fauna, and pornography. I somehow don’t like the prospects of transnational liquor companies deciding that they could force Saudi Arabia to allow liquor, or publishers to sell Penthouse openly from cafés and newsstands in Mecca. No firearms company has taken Australia to any court or tribunal for its heinous action in 1996 of banning civilian ownership of semi-automatic rifles and pump-action shotguns, weapons favoured by gunmen who almost weekly wreak havoc in the USA.