• Subject Name : Nursing

Standard Packing of Tobacco and Its Products

Plain packaging of tobacco and its products is one of the initiatives that has been suggested and implemented by the World Health Organization so that the use, trade and selling are reduced. This is expected to affect the consumption of tobacco and tobacco products. To adhere to this Australia is one of the first countries which accepted and implemented the same as a national public health policy. Tobacco consumption is associated with various types of cancers and other non-communicable diseases which have arisen in the recent decade as the communicable diseases have reduced in number. Standard or plain packaging of the tobacco and related products is a policy change that is taken as a progressive health policy in Australia. The present paper aims to discuss the background of the policy and its importance to the public. Also, to discuss the policy concerning politics and power and its effect.

On a broader term, non-communicable diseases are the ones which cannot be transmitted from an affected person to one who is not affected by the means of touch and other things. There are many diseases which are considered as non-communicable in the present context of the policy analysis non-communicable disease which is the result of tobacco use is considered. According to a report by the World Health Organization, almost 38 million people die every year due to non-communicable diseases. Of this, a two-thirds is linked to the use of tobacco and its products. According to the recent facts given by the World Health Organization, it is seen that the use of tobacco has more than 50% mortality (World Health Organization, 2019).

The forms in which tobacco users are either smoking or smokeless tobacco. When a person smokes it not only affects him but also affects people around him. How a person who is not a smoker is affected is called second-hand smoking and it is seen that almost 1.2 million people are affected by this. When tobacco use is considered it mostly consists of the smoking population as it is easier to identify and it is the most prevalent in higher economic countries. Smoking status is the one that is mostly asked the people who are surveyed consist of the frequency of smoking which included commercial cigarettes, roll-your-own cigarettes, cigar and pipes. It excludes chewing tobacco and electronic cigarettes. In the year 2017-18, it was estimated that there were 2.6 million adults who correspond to daily smokers (Australian Bureau of Statistics, 2018). The trend of smoking has been variant over the years as the proportion of people who are smokers have reduced from 23.8% in 1995 to 14.5% in 2015. Meanwhile, the percentage of people who have never smoked has increased from 49.4% in 2008 to 55.7% in 2018.

Tobacco is a leading contributor to the cancer burden that is 22% in Australia (Australian Institute of Health and Welfare, 2020). The use of tobacco has shown a downward trend in the recent decade which can be attributed to strict policy regulations. In the present public health policy to reduce the consumption of tobacco former senator, Steve Fielding introduced plain packaging curbing branding from cigarette pack (Greenland, 2016). It warranted 58 submissions for the inquiry into the bill but in 2010 the governor-general prorogued the 42nd parliament and dissolved the House of Representatives (Moodie et al., 2019). From the policy, it can be seen that it did not have a different political agenda but it was only to make the nation a healthy one. Tobacco sale and use are legal in Australia but it has strict legislation to regulate the use so that the sale and consumption can be kept in check (Bonfrer et al., 2019). Implementation of this policy along with others that have been made for reduction of sugar content by sugar lobbying and others have always faced strong opposition from the industry that might lose its profit (Crosbie et al., 2018; Colchero et al., 2016).

The public health policy aimed at reducing the consumption of tobacco and its products employing plain packaging (Freeman, 2019). Australia is a known global leader in control of tobacco for decades due to the strong advocacy that is seen and bi-partisan support in the parliament has resulted in strong legislations and low prevalence of smoking. National Preventative Health Taskforce which was commissioned by the Federal government of Australia which consisted of health researchers and advocated (Freeman, 2019). The task force aimed to explore the harmful effects of tobacco, alcohol and obesity. The report aimed to reduce the prevalence of smoking by 7% and one policy that was formulated for the same was standard packaging or plain packaging of the packages. In the older packaging, it was seen that branding product was prevalent and the proportion of the package containing the health warning was reduced and not consistent in the packaging (Noar et al., 2016). In the recent policy, the changes that have been made are that the packaging of the tobacco should be plain and uniform, there should not be any branding in terms of name or even brand logos and there should not be any inserts or onserts.

Use of tobacco is one of the leading causes of preventable deaths which are related to the lifestyle of the people. Due to the direct as well as indirect health consequences which are well established the control of tobacco is a public health issue (Riley et al., 2017). The proportion of people who get into the habit can be because they did not understand the health consequences due to less health literacy. It is seen that when the knowledge about the health and disease increase in population prevalence of smoking reduces. Tobacco use has been associated strongly with many types of cancers depending on the use: for example, smoking with lung cancer, chewing tobacco with head and neck cancer and even second-hand smoking is associated with breathing problems (Riley et al., 2017). Females who are pregnant when exposed to smoking directly or indirectly are associated with problems in the fetus as well as there can be pre-term labour (Gould et al., 2020). The policy is supported by the federal governments as well as the international bodies which work against the tobacco.

The argument in favour of the policy was the one given by the public health researchers and the policymakers so that the branding is reduced and the health warning is increased. As per the report given by the task force, it was seen that the industry of tobacco is a multi-million dollar business (Lauchs & Keane, 2017). The industries invest millions of dollars for branding and advertisement so that it can reach more and bigger crowd. It was estimated that in 2012, British American Tobacco in Australia had spent more than AUD 4.5 million for the campaign against tobacco plain packaging (Wilkinson, 2019). The health groups which consist of healthcare professionals and legal scholars are the stakeholders along with people living in the communities are the one supporting the policy as the use of tobacco has strong implication to the health.

The main argument against the policy is the one presented by the tobacco industry. They argue that they will lose revenues and many jobs will be lost as a result of the closing of the industries. The opposition was mainly given by British American Tobacco, Philip Morris International and Imperial Tobacco and they did it by press releases, campaigns and comments in media and parliamentary submissions (Crosbie et al., 2018). They mainly gave four arguments against standard packaging: firstly they said it would not work, it would increase illicit trade of tobacco, create problems for people in retail and it would violate domestic and international treaties (Crosbie et al., 2018).

In the society that has more power, the implementation of the policy is difficult as they are the ones who might be reaping the benefits from the tobacco industry. It is generally seen that people with more power have more money and they can still afford the commodity even if the taxations are increased (Gostin & Wiley, 2016). The people with less power are the one who suffers the negative impact of the policy implementation as they usually are underprivileged. It is difficult to reach them in terms that policy is good for them and the taxation will have more effect on the people with less power. The policy is a public health and it will require the help of healthcare professionals to implement the policy (Gostin & Wiley, 2016). Conversely, it will affect the healthcare professional as the disease burden might reduce.

In conclusion, tobacco is one such product which has the highest level of addiction and has health implications. To reduce the profound implication multiple measures have been taken at international as well as national level. Standard packaging is one such policy to reduce branding to reduce the consumption of tobacco. The public health workers and policymakers along with the population are the stakeholders and the associated health implications are the ones who form an argument for the policy. Meanwhile, the producers of tobacco are the ones against the policy. Healthcare professionals play a vital role in the promotion of the policy as well as the success of the policy will impact them as it will reduce the health burden.

References for Australian Public Policy

Australian Bureau of Statistics. (2018). 4364.0. 55.001-National Health Survey: first results, 2017–18. https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Smoking~85.

Australian Institute of Health and Welfare (2020). Alcohol, tobacco & other drugs in Australia. https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/tobacco.

Bonfrer, A., Chintagunta, P. K., Roberts, J. H., & Corkindale, D. (2019). Assessing the sales impact of plain packaging regulation for cigarettes: Evidence from Australia. Marketing Science. https://doi.org/10.1287/mksc.2019.1164.

Colchero, M. A., Popkin, B. M., Rivera, J. A., & Ng, S. W. (2016). Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: Observational study. BMJ, 352, h6704. https://doi.org/10.1136/bmj.h6704.

Crosbie, E., Thomson, G., Freeman, B., & Bialous, S. (2018). Advancing progressive health policy to reduce NCDs amidst international commercial opposition: Tobacco standardised packaging in Australia. Global public health13(12), 1753-1766. https://doi.org/10.1080/17441692.2018.1443485.

Freeman, B. (2019). Australia’s tobacco plain packaging. In Global Health Leadership (pp. 1-13). Springer. https://doi.org/10.1007/978-3-319-95633-6_1.

Gostin, L. O., & Wiley, L. F. (2016). Public health law: power, duty, restraint. Univ of California Press.

Gould, G. S., Havard, A., Lim, L. L., & Kumar, R. (2020). Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting. International Journal of Environmental Research and Public Health17(6), 2034. https://doi.org/10.3390/ijerph17062034.

Greenland, S. J. (2016). The Australian experience following plain packaging: The impact on tobacco branding. Addiction111(12), 2248-2258. https://doi.org/10.1111/add.13536.

Lauchs, M., & Keane, R. (2017). An analysis of the Australian illicit tobacco market. Journal of Financial Crime. https://doi.org/10.1108/JFC-10-2015-0056.

Moodie, C., Hoek, J., Scheffels, J., Gallopel-Morvan, K., & Lindorff, K. (2019). Plain packaging: legislative differences in Australia, France, the UK, New Zealand and Norway, and options for strengthening regulations. Tobacco Control28(5), 485-492. http://dx.doi.org/10.1136/tobaccocontrol-2018-054483.

Noar, S. M., Francis, D. B., Bridges, C., Sontag, J. M., Ribisl, K. M., & Brewer, N. T. (2016). The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies. Social Science & Medicine, 164, 118–129. https://doi.org/10.1016/j.socscimed.2016.06.011.

Riley, K. E., Ulrich, M. R., Hamann, H. A., & Ostroff, J. S. (2017). Decreasing smoking but increasing stigma? Anti-tobacco campaigns, public health, and cancer care. AMA Journal of Ethics19(5), 475. https://doi.org/10.1001/journalofethics.2017.19.5.msoc1-1705.

Wilkinson, G. (2019). Tobacco plain packaging, human rights and the object and purpose of international trade mark protection. In The Object and Purpose of Intellectual Property. Edward Elgar Publishing.

World Health Organization. (2019). Tobacco. https://www.who.int/news-room/fact-sheets/detail/tobacco.

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