Imagine that cigarettes did not exist. Now imagine that some plucky upstart − let’s call them Philip Morris −invented them and went to the regulators for approval to sell their product in the Australian market. You can hear the laughter coming out of the offices of Product Safety Australia as these new inventors explain that they want to commercialise a product that has the perverse combination of being both highly addictive and highly deadly. Even a product as loathsome as asbestos − completely banned in Australia in 2003 − only shares one of these characteristics.
Yet this is not the world we live in. We live in a world in which the mass-commercialisation of cigarettes in the early 20th century rapidly outpaced our understanding of their health consequences. We live in a world in which 15,500 Australians die every year from smoking-related diseases, more than road accidents, murders, alcohol and other drugs combined. We live in a world in which every year three foreign companies are allowed to take a combined profit of over $500 million from the Australian market while leaving us with a combined social cost of over $31 billion.
With this Gordian knot tied, the Government seems content to pull as hard as it can on one end as the considerable might of the tobacco industry pulls on the other. The Governments bans cigarette advertising on television and radio; the tobacco industry increases its print media advertising. The Government bans cigarette advertising in print media; the tobacco industry increases its sponsorship of sporting events. The Government mandates graphic health warnings on cigarette packets; the tobacco industry adjusts the attractiveness of their packaging designs. The Government mandates plain packaging; the tobacco industry hires a battalion of silks and runs to the High Court.
This relentless tug of war persists as three million Australians continue to smoke and 70,000 young people are recruited into the ranks every year. No matter how hard the Government pulls we can be sure that smoking will remain one of the leading preventable causes of death and disease in Australia for generations to come.
There is of course another way to untie a Gordian knot: by cutting it. The Government could mandate that cigarettes can only be sold to a person who is over 18 years of age and was born before the year 2000. This would gradually phase-out cigarettes in Australia by forever prohibiting their sale to the next generation − those who are currently 12 years old or younger. It would not be a crime to smoke but there would be heavy penalties for any vendor caught selling cigarettes to someone born after 2000.
This proposal balances the rights of existing smokers and the need to protect children born in this century from the pernicious effects of tobacco addiction. When this idea was raised by a group of oncologists in Singapore in 2010, over 70% of people surveyed supported the plan including 60% of smokers. It seems that even if we smoke ourselves, we can all agree on the need to prevent our kids from joining our ranks. Even British American Tobacco is on the record as saying that “we do not want children to smoke and we actively support programmes to prevent and reduce under-age smoking”.
Many of us will be still be concerned that such a prohibition – like with alcohol in America in the 1920s – will lead to a proliferation of the black market. However, the aim here is not to criminalise cigarettes but to drastically reduce their consumption by as yet unaddicted future generations. A teenager would inevitably still be able to source a packet or two of cigarettes from the black market or an older sibling, but they would be much less likely to form or sustain a ‘packet a day’ addiction lasting many years without easy access. If we are trying to reduce cigarette-related deaths by 90%, gradually withdrawing their sale from our petrol stations, supermarkets and 7-Elevens is a sure-fire way to get us there.
Many of us will also be worried about the effect this will have on the tobacco industry and retailers. However, the gradual nature of the proposal means that the tobacco companies and retailers will have decades to exit the industry and devote their productive resources elsewhere. Naturally, money not spent on cigarettes will be spent in other parts of the economy such as clothing and entertainment. Moreover, in contrast to recent proposals to “licence” smokers or set a daily limit on the amount of cigarettes they can purchase, the phase-out proposal has the advantage of imposing minimal regulatory costs. It will merely require vendors to check whether the birthdate on a customer’s ID starts with the number two.
Finally, what about those words that sit permanently perched at the tip of any tobacco company’s tongue – what about the “nanny-state”? By that measure, the Government should get out of the way and allow companies to start selling heroin, cocaine and other highly addictive and highly deadly drugs at everyday retail outlets. After all, they are consumed by people exercising free-will and their commercialisation would create thousands of jobs.
Fortunately, most of us accept that such profits fall into the category of “ill-gotten gains” and demand that our Government prohibit the creation of such unscrupulous markets. Yet, despite knowing cigarettes to be a product that will kill half of its long-term users, we are somehow happy to carve out an exception for tobacco companies.
Ultimately, it is very difficult to come up with a good reason that justifies the premature deaths of 15,500 Australians every year. After many decades of heaving, we should now accept that this Gordian knot has been pulled as tight as it will go. It is time for the Government to pick up a knife and cut the problem in half. The phase-out proposal ensures that currents smokers will be unaffected while future generations will be protected.