Like the first vultures of some satanic winter, gruesome tobacco pack graphic warnings have been sighted in shops, in anticipation of their mandatory introduction on 1 March. Tobacco companies fought these like they fought all three generations of health warnings since they first appeared in 1973. But this time the desecration of their personality-extending designer crafted boxes is complete because pictures are worth a thousand words. The photo of the smoker’s gangrenous foot that will grace packs was supplied to me by surgeon Professor John Fletcher of Westmead Hospital, whose work too often involves sawing off the rotting feet and legs of smokers whose peripheral circulation has packed up after years of addiction-driven lung basting. As the BUGA UP graffiti used to say: ‘When only the best will do you in.’
Over the years, colleagues have sent me a collection of photos of some of the more visible consequences that can await the one in two long-term smokers who die from a smoking caused disease. I supplied some of the worst of these to the federal Health Department who tested their impact with smokers. When smokers were shown photos of mouth and throat cancer, and the gangrenous foot, many were incredulous. They’d never seen this. But when half your mouth is missing from cancer, it’s a rare smoker who feels up to their usual round of social interaction. Somehow Marlboro Country seems a little different to the promises in the ads.
The tobacco industry has called the warnings ‘anti-smoking pornography’. They ought to know, having spent years trying to keep the brown paper wrapping around health risks and minimize public awareness and acceptance of the harms of smoking. The true obscenity in smoking lies in the years of denial from the industry about the harm its products cause, the total absence of any contrition for the misery it causes and its on-going efforts to thwart effective tobacco control.
Tobacco industry corporate responsibility reports are full of anodyne blather about fully informed adult consumers taking the known risks of smoking with their eyes wide open. But before the ink dried on these efforts, British American Tobacco was funding a campaign through tobacco retailers to have smokers protest about the new picture warnings. The companies argued it would take over two years to change their pack print runs, when they can wheel out the smallest test marketing exercise of a new pack at will.
Canada, Brazil, Thailand and Singapore have had the warnings for some years. Singapore has the
lowest rate of smoking in the world. In British Columbia, where the government also banned smoking in pubs and bars, daily smoking is now down to 12 per cent and as low as 6 per cent among the university educated. In Australia, 17.4 per cent of people smoke daily and if the slope of the downward trend continues at the rate it has been moving south in the past six years, we may well be looking at the end of smoking in Australia well before 2020. With every national survey, tens of thousands join the ex-smoking population and smoking grows ever more marginalized. The idea that we have somehow hit rock bottom and are now looking at dedicated smokers is belied by recent data that shows 75 per cent of smokers say they intend to quit.
In spite of this promise, Australian states – with the exception of Tasmania and Queensland – are dragging their feet on ending the ‘half pregnant’ restrictions on public smoking which see every worker protected except those most exposed: bar and casino staff. This month a disconsolate Frank Sartor, NSW’s Minister Assisting the Minister for Health (Cancer), was told to announce the farcical NSW Cabinet decision that the so-called pub smoking ban due in July 2007 will see smoking still allowed in any room that is up to 75 per cent enclosed. The same rules are to apply in Victoria, South Australia, the ACT and Western Australia.
Sartor, who has been rock solid on cancer control, was rolled in a Cabinet headed by a former health minister, fresh the same week from the premiers’ conference with an announcement of greater commitment to tackling chronic disease like cancer through prevention. The shameless NSW government is awash with gaming and hotel lobby money. The myopia in that industry is staggering.
The hospitality industry looks at its present customers and sees many smokers. But it can’t see past its own nose when it comes to understanding the future. Hard data from tax receipts in New Zealand, New York and California — to name three where smokefree pubs have been implemented — show continuing sales growth after the bans; something not hard to predict here when 84 per cent of the population doesn’t smoke and when legions stay away because of the foul and unhealthy environments inside pubs.
The Iemma Cabinet, along with those in several other states, are in desperate need of a spinal transplant. Public health historians will record its venal capitulation to the hospitality industry’s last grab at the smoking dollar and its contempt for bar staff’s occupational health rights.