Tobacco is the second highest cause of death in the world, responsible for five million adult deaths a year. Although Australia has one of the lowest smoking rates in the OECD, with almost 18 per cent of people aged 15 years and over smoking every day in 2007 it is still the largest avoidable risk to health in the nation. It contributes 7.8 per cent of the national burden of disease: more than high blood pressure, overweight and obesity, physical inactivity and high blood cholesterol. Smoking also increases the risk of blindness from macular degeneration by a factor of four.
A range of important health promotion, regulatory and fiscal measures brought down the overall rate of smoking in Australia from 31 per cent in 1986 to 19 per cent in 2007. But the major impact was in cities and things are worse in the bush. Smoking rates increase with remoteness: from 17.6 per cent in major cities to 27.3 per cent in remote areas. Overall, people who live in rural and remote areas are 1.24 times more likely to be daily smokers than those living in major cities.
There are two national targets in place: to reduce the smoking rate to 10 per cent of the population by 2018; and, by the same date, to halve the Indigenous smoking rate. These targets will not be met unless there are targeted and successful anti-smoking efforts in rural and remote areas.
The Government’s substantial and unprecedented support for smoking cessation activity is acknowledged and very welcome. Health promotion work in country areas must be fit for purpose and not merely the backwash from national campaigns. The work being undertaken to reduce smoking rates among Aboriginal and Torres Strait Islander populations, particularly in rural and remote communities, provides a good example of what is needed.
There must be no reservation or stinting in national efforts to reduce rates of smoking still further and to stop new uptake of the habit. In a legal tug-of-war between public health for all Australians and intellectual property rights for the tobacco industry, people in rural and remote areas will stand up for good health.
The law must not be such an ass as to back the wrong horse.