STRATEGIC DIRECTIONS FOR TOBACCO CONTROL IN NSW 2011-2016 Submission from NSMA Incorporated to the NSW Government re: Directions for Tobacco Control 2011 - 2016 Explanation: Below is the submission submitted by our President Mrs Margaret Hogge on behalf of the members of the NSMA. Submissions closed on 28th January, 2011. The text below is just the NSMA submission, other instructions and headings from the proforma document have been deleted. Questions raised by the Department of Health are in italics. Details of the person putting forward the submission Name: (Mrs) Margaret Hogge Mailing address: P.O. Box K860 , Haymarket NSW 1240 Postcode:2099 (home) Email address: nsma@nsma.org.au Organisation: Non-Smokers' Movement of Australia Incorporated (NSMA) What are your impressions of Part 3 of the discussion paper “A proposed approach to future tobacco control in NSW”? NSMA Inc. is generally in favour of the proposed approach to Tobacco Control, with the Working in Partnership principle, but only as long as all partners are in line with the major principles of reducing tobacco use, improving health, of increasing smokefree lives for everyone, of reducing inequity, and of ensuring a healthy future, especially for those whose rights to tobacco-free and smoke-free lives have been ignored, unnoticed, or forgotten over the past decades. We have a long way to go before these inequities are removed, but it need not take a long time if all partners are committed to the same principles and funding is provided to carry out the necessary changes. We challenge that the targets are too conservative, and propose that funding is provided to at least double the first target and add another target, i.e. to greatly reduce the proportion of children who smoke, triple the second, and add to the third by targeting the proportion of children living in smoke-free households and reducing that proportion by a substantial amount. Also, we must reduce the proportion of Aboriginal adults and children who smoke by far more than 1 percent per year. We are supposed to be aiming to Close the Gap. We need to change the attitude of all indigenous Australians, from tobacco being socially acceptable to it being totally unacceptable, a product which has killed off far too many indigenous Australians and led to huge loss of family life and culture. We agree that NSW has been among the world leaders in tobacco control but the lead has slipped badly, especially in regard to smokefree areas. This would be a good race to win. Are the Priority Areas identified in Part 4 appropriate? If not, what would you propose we change? Priority Area 1 - Continue social marketing campaigns to motivate smokers to quit. Priority Area 2 - Continue to provide evidence based cessation services to support smokers to quit. Priority Area 3 - Work in partnership with Aboriginal communities and peak bodies to reduce smoking and exposure to environmental tobacco smoke among Aboriginal people. Priority Area 4 - Strengthen efforts to reduce smoking among people in low socioeconomic and other groups with high smoking prevalence such as some culturally and linguistically diverse groups. Priority Area 5 - Eliminate the advertising and promotion of tobacco products and restrict the availability and supply of tobacco, especially to children. Priority Area 6 - Reduce exposure to environmental tobacco smoke in workplaces, public places and other settings. Priority Area 7 - Strengthen efforts to prevent uptake of smoking by young people. Priority Area 8 - Strengthen research, monitoring, evaluation and reporting of programs for tobacco control. We submit that the above priority order should be rearranged, with top priority going to Priority Area 6 (exposure to tobacco smoke), followed by Priority Area 7 (uptake by young people) and then Priority Areas 2, 3 and 5. Next, Priority Area 1 (quitting messages directed at smokers) should be reduced to Priority 6, followed finally by Areas 4 and 8. Are the proposed actions and implementation plans supporting each Priority Area appropriate? If not, what would you propose we change? Priority Area 1 - Continue social marketing campaigns to motivate smokers to quit. Actions (Additional to those proposed) 1. Regarding the content of social marketing campaigns, suggest collecting anecdotes from confirmed successful quitters, obtain real-life insights from them in order to build further campaigns. 2. Regarding EVALUATION of success/failure of campaigns, it is not appropriate for prime partner to evaluate results of own work. This must be undertaken by another, separate, peak body Priority Area 2 - Continue to provide evidence based cessation services to support smokers to quit. Actions (additional to those proposed) With only ten percent of smokers (approx 40,000 calls per year) having contacted Quitline at some stage (p.12), there is a need for other avenues of help, the most obvious being health professionals, who "see a large proportion of smokers each year" (p.11) and who must be co-opted into forming the main line of organised advice/support/follow-up for encouraging smokers to quit. New Zealand already has an ongoing campaign of this nature. An online QuittingSmoker program could prompt each health professional to follow-up and update the file of the person who smokes, with supportive quitting advice and prompt, persistent follow-up. Priority Area 3 - Work in partnership with Aboriginal communities and peak bodies to reduce smoking and exposure to environmental tobacco smoke among Aboriginal people. Actions (additional to those proposed) 1. Reduce smoking rates amongst Aboriginal and non-Aboriginal health professionals. Provide free therapies, reward tobacco-free workers. Strictly enforce smokefree workplace regulations. No paid smoking breaks. Smoking not allowed in uniform. Workers should only smoke in designated outdoor spaces and not in social groups at those spaces. 2. The shockingly high 51.8% rate of pregnant smokers must be reduced dramatically. Provide incentives for pregnant women to lead smokefree lives and to not allow smoking indoors and near themselves and family, especially after childbirth. 3. Also, provide maximum incentives and protection possible for those adults and children whose lives are already tobacco-free and smokefree. 4. Call on Aboriginal leaders to promote the very real benefits of living healthy lives free from the stranglehold of tobacco. Tobacco needs to become UNCOMMON and UNACCEPTABLE amongst our indigenous communities in order for elders to live full, rich, healthy lives well beyond the current norms and to pass on culture and traditions to all Australians. Priority Area 4 - Strengthen efforts to reduce smoking among people in low socioeconomic and other groups with high smoking prevalence. Actions (additional to those proposed) 1. Another shockingly high smoking statistic (72%) amongst the prisoner population is reinforced and almost institutionalised due to prisoners still being allowed to smoke indoors in cells. Smoke from 72% of the population of any residential property is totally unacceptable in any section of the community. Non-smoking (and even smoking) prisoners, staff and visitors are all entitled to at least smokefree indoors. Some authorities seem to consider that, because the cells are regarded as prisoners' home, that smoking should be allowed. Prisoners, however, are not allowed alcohol (another legally available product) and nor can they come and go at will. Prison is not home - it is a place of detention. Besides, the majority of households are now smokefree, with residents going outside to smoke, so this does not reflect the population as a whole. Smoking rates amongst prison officers are also high, reflecting a tacit acceptance of tobacco as part of prison culture and currency. This situation must change dramatically, with quitting advice and non-tobacco therapies being made very widely and freely available, for both inmates and staff, and with all indoor areas being declared smokefree. Smoking should only be allowed outdoors, at Designated Area/spaces well-distanced from building openings. Non-Smoking staff and inmates have been subjected to the poisons in tobacco smoke on a far greater level than any other workplace and should undergo regular and thorough heart/lung examinations and must gain immediate protection from secondhand smoke. They should not be forced to wear full-face masks (as is one case currently) in order to protect their own health. Alternative, non-tobacco therapies should be made available, if requested, to all workers and inmates at no cost. Quitting smoking (or cutting down) whilst in prison will benefit inmates greatly when released, as it will be less difficult to find employment, will save much-needed income, will make life at home with families less unhealthy and it will be less likely for their own children to take up smoking. 2. Corrective Services Employees, through their Unions or elected representatives, must be involved in developing and implementing policies, projects and initiatives regarding Tobacco Control. 3. Similar restrictions must be enforced in all residential institutions. As emphasised previously, there ARE alternative, non-tobacco therapies available which can be offered in order to protect everybody's right to clean air, especially indoors. Priority Area 5 - Eliminate the advertising and promotion of tobacco products and restrict the availability and supply of tobacco, especially to children. Actions (Additional to the proposed) 1. Strengthen legislation so that other suppliers(non-retail), such as friends and family can be prosecuted heavily for supplying tobacco to minors - it's not difficult to work out that a huge percentage of young people are supplied by their friends and family. The chilling statement "the younger the take-up, the less likely to be able to quit" is surely serious enough to prompt strong and swift action to crack down on this deadly but familiar supply-chain. Of course it should not be difficult to work out that supply would occur in settings where minors are relatively unsupervised, during school travel-times, at entertainment venues, etc. Successful prosecutions must be heavily publicised as deterrents. 2. Media stories (print, television and internet) about tobacco are almost always accompanied by positive graphics/film of tobacco use, e.g. smoker "enjoying" a ciggie at an outdoor cafe. It is far preferable for all aspects of the media to use negative tobacco graphics such as graphic warning, similar to those on cigarette packets. Media should be warned that showing general tobacco use in a positive light is tantamount to advertising, and will no longer be tolerated. De-normalise smoking in everybody's eyes, especially children's. 3. Ban internet sales. 4. Ban tobacco vending machines. 5. Ban children and minors from entering all areas where smoking is allowed, similar to gambling area bans. 6. Ban tobacco sales on all NSW government property, so that there is no tacit approval of tobacco as a source of rental income, etc, and so that the Government is not part of the tobacco supply-chain. Priority Area 6 - Strengthen efforts to reduce exposure to environmental tobacco smoke in workplaces, public places and other settings. Additional Actions INDOORS 1. So-called "unenclosed" areas of pubs and clubs. The 75%/25% definition of "enclosed" in the NSW Smokefree Environment Act 2000 must either be examined by health experts and declared officially safe for workers and patrons of pubs and clubs (with reference to the statement that there is no safe level of exposure to secondhand tobacco smoke), or must be repealed. A new definition must be worked out with regard to the health and safety of workers and patrons, and with no reference to an economic bottom line for the "hospitality" industry. Premises which then claim to fall within the new, re-defined outdoor/unenclosed category must then pay for and undergo rigorous and routine inspection prior to allowing smoking in those areas. As previously pointed out, children would not be allowed in smoking-allowed areas. 2. Lift the exemption for smoking on stage - there is no need to use real tobacco on stage - actors, other workers, and audience must be protected from smoking tobacco and from secondhand smoke. Actors simulate with alcohol, with killing, with babies and with sex - they can easily simulate the act of smoking. 3. High-roller rooms in casinos must be declared smokefree, to protect workers and patrons. The ridiculous face-off between Australian States must end, with New South Wales taking the lead, for the health and safety of workers and patrons. 4. Extend Smoking in Cars legislation to ban smoking in cars where members of vulnerable groups are passengers - especially disabled people and frail-aged. Smoking in cars is potentially dangerous to all drivers and passengers, and butt-tossing can cause bushfires. 5.Smokefree Homes Smoking within the Home - In the matter of secondhand smoke in the home, nobody should smoke at home where children, frail aged or disabled people are present. In any instance of smoking where children are present, a smoker should be prosecuted for child abuse. Spanking a child is regarded as child abuse. moking near a child, with the possibility of triggering life-threatening conditions such as Sudden Infant Death Syndrome and asthma, must also be designated as child abuse. "Child abuse doesn't have to mean broken bones and black and blue marks. Young growing tissues are far more vulnerable to carcinogens than those of adults. Knowingly subjecting children to respiratory tract diseases is child abuse." Dr William Cahan, Sloan Kettering Cancer Center , USA , 1993 Smokedrift/invasion and smoke seepage from neighbours. These are growing health and social problems, calling for strong and positive support, assistance and legislation from Government Government should assist home-dwellers in protecting themselves and their families from secondhand smoke invasion from neighbours. Nobody should be forced to barricade themselves into their homes to protect themselves from neighbours' smoke. They have every right to expect clean water to flow from their taps - similarly they have every right to breathe clean, smokefree air in their homes. People should only be allowed to smoke where their smoke does not affect others, indoors and outdoors. Governments should support anyone who brings a complaint of invasion/assault from tobacco smoke from neighbours. We already have government protection from invasion/assault from excessive noise. The same should apply to the poisons in tobacco smoke. Regarding Smoke Seepage "Tobacco smoke travels from its point of generation in a building to all other areas of the building. It has been shown to move through light fixtures, through ceiling crawl spaces, and into and out of doorways. Once exposed, building occupants are at risk for the irritant, allergic and acute and chronic cardiopulmonary and carcinogenic adverse health effects which are known to be associated with environmental tobacco smoke (ETS) exposure", California Chief of Occupational Health and Safety, 1993. Researchers Winickoff, Gottlieb and Mello in a recent article in New England Journal of Medicine (NEJM) dated 17 June 2010, have advised the USA government that, due to the nature of smoke seepage, and also, in order to protect the most vulnerable members of the community, multi-unit Public Housing should be declared smokefree. We call on NSW Public Housing to declare all multi-unit housing complexes smokefree, especially to protect all children, disabled and frail-aged residents from the potentially deadly effects of smoke-seepage within buildings. Smokers have the option to move well away from the building or to use alternative (non-tobacco) methods of nicotine delivery. Unit- dwellers, realtors, landlords, tenants, Strata Managers and all who live or work around multi-unit housing must be informed of the nature, dangers, and capabilities of secondhand smoke and how it can invade and seep into homes, causing grave damage to health and a high degree of stress. 6. Smokefree Residential Institutions. See Priority 4, regarding Prisons and other Residential Institutions. Smokefree OUTDOORS 7. Smokefree Outdoor Dining. Research from Stanford University in California in 2007 shows that secondhand smoke in crowded outdoor settings can be as bad as indoors. Workers are subjected to unlimited smoke for many hours and non-smoking diners (including children) are also faced with the well-known toxins. Queensland's restaurants and cafes have traded successfully for several years with smoking bans wherever food is served. NSW can follow their successful lead. Children should not see smoking (especially in relaxed settings) as a normal way of life - we need to de-normalise smoking in their eyes. Non-smokers (the majority) hugely resent that smoking patrons of establishments with outdoor areas have "hi-jacked" those areas by fouling the air with tobacco poisons. It is not discriminatory to ban smoking in an area - smokers would be welcome, simply not their smoke. 8. Smokefree Public Transport Waiting Areas - Bus, Boat, Airport, Ferry, Train, Tram and Taxi waiting areas and Vehicle and bicycle Parking Areas should all be declared smokefree, within at least a 10 metre zone. There should be at least 10metre buffer zones around all areas. Public transport users often wait long periods for their smokefree and environmentally-friendly transport. They are "doing the right thing" by using public transport. People who wish to smoke should find an area well-distanced from all others. Governments should not feel the need to provide butt-bins at every waiting area - smokers should dispose of their butts safely and thoughtfully, in personal ashtrays. 9. Smokefree Parks, Sporting Fields, and all spectator Areas Sport, active play and smoking simply do not mix. o child should see smoking as a normal part of sport or play. 10. Smokefree zones around Children's Care Centres, Schools, Play Centres, and Services. Schools and child-care centres carry high concentrations of children, for at least thirty hours each week. All such centres should have a 10 metre smokefree zone around their borders, not only to protect from the smoke but also to de-normalise smoking in children's eyes. Similarly, hospitals and medical centres should also have 10 metre smokefree zones completely surrounding their borders. 11. Smokefree Publicly-sponsored Events and Events held on Public Land (e.g. markets/concerts/festivals/ChristmasCarols) All should be declared smokefree, with a simple clause included in contracts. Short announcements, combined with the usual sun-safe messages are sufficient - "This is a smoke-free event". There is no reason to apologise for an "inconvenience" - tobacco smoke has caused an "inconvenience" for years. Smokers should be directed to use a restricted number of Designated Outdoor Smoking Spaces, well-distanced from crowded areas and, preferably, out of sight of children. Such spaces would control and restrict the spread of the smoke and its poisons. 12. Smokefree Beaches, Waterways and Jetties Smoking along all waterways and at jetties (within 10 metres) should be totally banned. The ban should not be limited to patrolled areas. Poisonous cigarette butts cause untold damage to our marine life. 13. Smokefree Workplace Policy - smoking in the grounds of many NSW Health properties is still rife, despite No-Smoking signs at all entrances. Security staff must be authorised to enforce bans and impose heavy fines. Smoking is totally out of place on Health properties - patients should be offered alternative therapies and staff should leave the grounds if they wish to smoke. Priority Area 7 - Strengthen efforts to prevent uptake of smoking by young people. Actions(additional) See comments on Priority 4. At any Designated Outdoor Smoking Space where smoking is allowed, it should be situated, as much as possible, out of sight of children, in order to de-normalise smoking in children's eyes. Priority Area 8 - Strengthen research, monitoring, evaluation and reporting of programs for tobacco control. Actions. The NSMA concurs. Do you anticipate there might be a role for your organisation that is not currently identified? Please describe the nature and extent of this potential role. NSMA Inc. would expect to continue in its role as an activist organisation, involved in all aspects of reducing smoking and thus reducing the amount of toxic air contaminant which continues to poison the clean air to which every body is entitled. We assist many individuals and organisations to gain their clean-air rights in the workplace, in schools, hospitals, public and private transport, waiting areas, at large public events, outdoors at dining areas, and in the home. We welcome involvement in discussion on all aspects of tobacco control, but especially in the areas of smokefree legislation and child protection. Are there any other comments you would like to make regarding the discussion paper? Subject: Smoke-free New South Wales Everybody has the Right to breathe Clean Air, free from the Poisons in Secondhand Tobacco Smoke Our organisation was formed over 30 years ago, in 1977, to fight for every body's basic right to breathe clean air, free from the poisons in tobacco smoke. On behalf of the Non-Smokers' Movement of Australia Inc (NSMA), I must comment that Tobacco Control reforms in NSW are well overdue. We were very relieved and pleased when recent reforms regarding smoking in cars with children and putting tobacco out of sight were enacted. As you would be aware, we had been calling for such reforms, and many more, for a very long time. We now call on the NSW Government to further strengthen smoke-free policy in the interests of the health of all residents and visitors, and especially for children, frail-aged people, and people with disabilities. We are constantly reminded of the following statement from NSW Health: "There is no safe level of exposure to ETS/SHS (secondhand smoke)." So we call on you again, as our primary health legislation body, to accept responsibility for protecting every member of our community from the well-known poisons in secondhand smoke. Tobacco products are unsafe, have no useful purpose and are universally harmful. The harm which they cause is totally preventable. All Australian Governments agree that, if tobacco were introduced today, it would be banned. Many Local Councils and Shires have enacted far-reaching regulations regarding smokefree outdoors, in order to protect residents' and workers' and visitors' rights to clean, smokefree air (at beaches, public transport waiting areas, outdoor dining and children's playgrounds and sports grounds), and we commend them. This has, however been piecemeal, never uniform, has led to confusion, is unfair, and is time-consuming and expensive to enforce and, frankly, has led to an embarrassing mishmash situation between the different well-meaning communities. We need uniform legislation to protect the rights of everybody in the State of NSW. Clean water, clean air - every body's inalienable rights. Our Governments protect our right to clean water in our taps - we have every right expect our Governments to protect our right to breathe clean air. Some may say that the battles for clean air rights are almost over but we must point out that, due to greed, ignorance, addiction and complacency, there are still more than 3 million Australians who smoke and expel the poisons in tobacco smoke. Tobacco kills more Australians than any other single product. Children continue to take up smoking at an alarming rate, with very few restrictions. Even worse than that, innocent victims are forced to breathe in the poisons in secondhand smoke from those 3 million smokers - children, disabled people and the frail-aged are the silent and helpless victims and their rights are far more valid than those of people who claim a right to smoke anywhere because they are using a so-called legal product. Chainsaws, cars and guns are also legally available products but are subject to sensible restrictions. Along with many others at the NSW Stakeholder Forum about Tobacco Control on 14 December, we also regard it as UNCONSCIONABLE that secondhand smoke is a factor in 96% of the 21,000 admissions of children with respiratory problems to NSW hospitals in one year. We call on the NSW Government and all of Australia's Governments, to protect all Australians from this totally preventable epidemic. Right to breathe Clean Air: The message, of everybody's basic human right to breathe clean air, must be emphasised in the face of opposition from smokers who are, after all, in the grip of a highly addictive substance (nicotine). Opposition comes not only from smokers, but also from Big Tobacco and its lengthy chain of dealers, from the so-called "Hospitality" Industry and the Gambling Industry and many who feed off them, including political parties and governments dependent on sponsorship and taxation from tobacco - particularly odious methods of revenue-raising. Smokers' Rights: We continually remind non-smokers and people who smoke that, despite the fact that tobacco is currently a restricted but legally available product, smokers' rights to use it stop at their own bodies (at their lips). Smokers have no right to impose the poisons and stink of tobacco smoke on others, indoors or outdoors. Discrimination: Discrimination occurs in all places where smoking is allowed. Those who cannot, or who will not (to protect themselves) enter premises or outdoor areas where smoking is allowed are being discriminated against not only by the smokers but also by the owners of the premises and by the governments which allow smoking in those places. Smokers are not being discriminated against - they would all be welcome to use such places, simply not to smoke there. "If the behaviour of one person causes unreasonable disadvantage to another then that behaviour must be curbed or some way found to minimise or prevent its impact. When testing for reasonableness, it seems to me that total exclusion weighs far more heavily than the pleasure gained from the smoking of a cigarette." Judge G. Innes Disability Discrimination Case,1997 Francey & Meeuweissen v. Hilton Civil Liberties: Smokers may have the right to use a legally available product, but not where their smoking adversely affects others. Nanny State: In the words of the President of UK's Royal college of Paediatrics and Child Health, in 2009, when discussing smoking in cars with children -"This is legitimate Nanny-State territory". We remind the NSW Government that, with children exposed daily to the poisons in tobacco smoke, this is legitimate Nanny State territory, and that all governments have a special responsibility to protect those who cannot protect themselves. We don't hear the cry of "Nanny State !" when vehicle fuel emissions are restricted or when building workers are told to wear helmets and hearing protection, and safety vests. No - it's mostly where deadly drugs of addiction, such as tobacco and alcohol are involved, and where those drugs of addiction are peddled legally. The NSW Government has a responsibility to protect those who cannot protect themselves. The majority of smoking law reform has been driven by complaints from the loudest and strongest. Governments must look at the pressing need for those reforms in the past, and provide the same or stronger protection for those who cannot help themselves, namely: the unborn, infants and children, physically and intellectually disabled, frail-aged, prisoners, non-English speakers, in all aspects of their lives. Financial Impact/Benefit: It is difficult to estimate the financial benefits of smokefree policies except to say that such benefits will far outweigh the estimated costs of legislation, signage, monitoring and enforcement, as the impact will be long-term and far-reaching, viz. cleaner air, healthier community, less places for smoking and thus reduced smoking rates, less visibility of smoking, less stink and less cigarette butts and packets in streets, doorways, parks, beaches, waiting areas, and waterways. Most people don't smoke and they greatly resent that their access to clean air outdoors is currently blatantly denied them by smokers. Smokers have become accustomed to restrictions and should only smoke in designated spaces. Any adverse impact which may occur as a result of smoking bans must be regarded as a community cost of health reforms which will, in the short and long term, save lives, not only through lessened exposure to tobacco smoke but also through reduced smoking rates. No smoke-free reforms should ever be delayed in case of perceived adverse economic impact. Advice from Big Tobacco about potentially adverse economic effects should certainly be taken into account - they are, quite naturally, gravely concerned about the effect on their profit margins Duty of Care /Workplace Health and Safety: Proprietors and Governments are reminded that they owe a legal duty of care to clients, patrons and employees within their jurisdictions and premises. All are aware of the dangers and that there is no safe level of tobacco smoke. Any person/s who suffers due to exposure to the well-known toxins is entitled to sue those proprietors and/or governments for breach of that duty of care as well as for breach of workplace health and safety law which states that known dangers must be removed from the workplace. International Treaty: Australia and NSW are party to the International Framework Convention on Tobacco Control (FCTC). Australia played a leading role in the negotiations and claims to be a strong supporter of the Convention. The second key obligation under the treaty commits our governments to the following action: Recognising that "scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability", Governments shall take measures "providing protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places, and, as appropriate, other public places." Legislation and Enforcement: Regarding signage: All signage should be clear and unambiguous Policing new regulations is, of course, a matter of community education. With smoking rates dropping in the community, and with a heightened sense of our basic right to clean air, many non-smokers will, with the knowledge that government aims to protect the community's health, speak up when they see breaches of regulations. Governments should, of course, provide strong deterrents in the form of fines in cases of breaches of the regulations. With the backing of smoking ban and some simple signage, both children and adults will be able to speak out confidently to defend their right to clean, smokefree air. Smokefree Lives, INDOORS and OUTDOORS Over the past decade many members of the community, especially children, have lived, worked and played in smokefree conditions indoors and, when they approach the "great outdoors" they are immediately assaulted, at every doorway, every outdoor seating area, outdoor dining, at picnic areas, at so-called outdoor areas of pubs and clubs, and even at entrances to kindergartens, schools, and medical centres, by tobacco smoke from people indulging in their killer drug of choice and then tossing their butts away. Tobacco products kill and harm not only smokers but also innocent bystanders. If they were using syringes for delivery of their drug of choice, there would be a huge outcry. Governments protect other amenities in the environment - they carry out noise abatement, pest control, food hygiene, fight chemical pollution. Governments have the right and the responsibility to protect the community from the effects of tobacco smoke, for the sake of improved public health as well as for improved amenity. IF YOU CAN SMELL THE TOBACCO SMOKE, THE POISONS ARE GOING INTO YOUR LUNGS (AND YOUR FAMILY'S LUNGS) (Thoracic Surgeon, NSW, 2009) Smoke-free New South Wales: Basic steps towards a truly smokefree and tobacco-free New South Wales 1. Commit to an end date for tobacco sales, preferably 31 May (World No Tobacco Day) 2017. By that date, sales must be restricted to prescriptions for licensed users only. 2. Confirm that everybody has the right to breathe clean air, free from the poisons in tobacco smoke. 3. Declare tobacco smoke a Toxic Air Contaminant Government can thus provide a strong tool for developing far-reaching legislation and legal rights to gain everybody's right to clean, smokefree air in all aspects of their lives. 4. Declare all tobacco products unsafe. 5. Protect unborn and babies (especially in indigenous communities) by doing everything possible to prevent women from smoking while pregnant and while caring for babies 6. Smokefree Homes - In the matter of secondhand smoke in the home, nobody should smoke at home where children, frail aged or disabled people are present. In any instance of smoking where children are present, a smoker should be prosecuted for child abuse. Spanking a child is regarded as child abuse. Smoking near a child, with the possibility of triggering life-threatening conditions such as Sudden Infant Death Syndrome and asthma, must also be designated as child abuse. "Child abuse doesn't have to mean broken bones and black and blue marks. Young growing tissues are far more vulnerable to carcinogens than those of adults. Knowingly subjecting children to respiratory tract diseases is child abuse." Dr William Cahan, Sloan Kettering Cancer Center , USA , 1993 Smoke drift/invasion and smoke seepage from neighbours These are growing health and social problems, calling for strong and positive support, assistance and legislation from Government Government should assist home-dwellers in protecting themselves and their families from secondhand smoke invasion from neighbours. Nobody should be forced to barricade themselves into their homes to protect themselves from neighbours' smoke. They have every right to expect clean water to flow from their taps -similarly they have every right to breathe clean, smokefree air in their homes. People should only be allowed to smoke where their smoke does not affect others, indoors and outdoors. Governments should support anyone who brings a complaint of invasion/assault from tobacco smoke from neighbours. We already have protection from invasion/assault from excessive noise. The same should apply to the poisons in tobacco smoke. Regarding Smoke Seepage. "Tobacco smoke travels from its point of generation in a building to all other areas of the building. It has been shown to move through light fixtures, through ceiling crawl spaces, and into and out of doorways. Once exposed, building occupants are at risk for the irritant, allergic and acute and chronic cardiopulmonary and carcinogenic adverse health effects which are known to be associated with environmental tobacco smoke (ETS) exposure", California Chief of Occupational Health and Safety, 1993. Researchers Winickoff, Gottlieb and Mello in a recent article in New England Journal of Medicine (NEJM) dated 17 June 2010, have advised the USA government that, due to the nature of smoke seepage, and also, in order to protect the most vulnerable members of the community, multi-unit Public Housing should be declared smokefree. We call on NSW Public Housing to declare all multi-unit housing complexes smokefree, especially to protect all children, disabled and frail-aged residents from the potentially deadly effects of smoke-seepage within buildings. Smokers have the option to move well away from the building or to use alternative (non-tobacco) methods of nicotine delivery. 7. Legislate that children may not enter any smoking-allowed areas, indoors or outdoors (similar to not being allowed in gambling areas). Nobody can say how much tobacco smoke will trigger life-threatening asthma, Sudden Infant Death Syndrome (SIDS), heart and lung conditions. The safest option is to keep all smoking well-distanced from every body and at the same time help prevent further uptake of the use of this deadly and highly addictive substance. Rather than designating that areas such as children's' playground equipment should have a smokefree zone around it, the government should turn the concept around to recognise our basic rights to smokefree air, and should designate all areas to be smokefree with the exception of a limited number of designated outdoor smoking areas/ spaces. Dr. Andrew Penman , CEO of Cancer Council says, "We are recommending to the government that outdoor smoking needs to move…to the assumption that smoking is prohibited from all outdoor areas unless otherwise stated." 8. Smokefree Public Transport Waiting Areas- Bus, Boat, Airport, Ferry, Train, Tram and Taxi waiting areas and Vehicle and bicycle Parking Areas should all be declared smokefree, within at least a 10 metre zone. There should be at least 10metre buffer zones around all areas. Public transport users often wait long periods for their smokefree and environmentally-friendly transport. Many of them are children. They are "doing the right thing" by using public transport. People who wish to smoke should find an area well-distanced from all others. Governments should not feel the need to provide butt-bins at every waiting area - smokers should dispose of their butts safely and thoughtfully, in personal ashtrays. 9. Smokefree zones around Children's Care Centres, Schools, Play -Centres, and Services. Schools and child-care centres carry high concentrations of children, for at least thirty hours each week. All such centres should have a 10 metre smokefree zone around their borders, not only to protect from the smoke but also to de-normalise smoking in children's eyes. Similarly, hospitals and medical centres should also have 10 metre smokefree zones completely surrounding their borders. 10. Smokefree Alfresco Dining and Drinking-Cafes and Restaurants, Pubs and Clubs These areas are used for long periods, with people of all ages sitting in close proximity to each other. The impact from tobacco smoke in such circumstances can be as bad as indoors. Children and employees should not be allowed near such spaces. Smoking should only be allowed in Designated Outdoor Smoking Areas/Spaces, well-distanced from building openings. Also, children should not see smoking in relaxed dining settings as a normal part of life - we need to de-normalise smoking in children's eyes. There is nothing normal about smoking. 11. Smokefree Parks, Sporting Fields, and all spectator Areas Sport, active play and smoking simply do not mix. No child should see smoking as a normal part of sport or play. 12. Smokefree Publicly-sponsored Events and Events held on Public Land (e.g. markets / concerts/festivals/Christmas carols) All should be declared smokefree, with a simple clause included in contracts. Short announcements, combined with the usual sun-safe messages are sufficient - "This is a smoke-free event" There is no reason to apologise for an "inconvenience" -tobacco smoke has caused an "inconvenience" for years. Smokers should be directed to use a restricted number of Designated Outdoor Smoking Spaces, well-distanced from crowded areas and, preferably, out of sight of children. Such spaces would control and restrict the spread of the smoke and its poisons. 13. Smokefree Beaches, Waterways and Jetties Smoking along all waterways and at jetties (within 10 metres) should be totally banned. The ban should not be limited to patrolled areas. Poisonous cigarette butts cause untold damage to our marine life. 14. Designated Outdoor Smoking Areas/Spaces All potentially crowded public spaces, such as central business districts, markets, concerts, festivals, and sporting arenas, should have a limited number of Designated Outdoor Smoking Areas/spaces. Designating such spaces should not be regarded as condoning smoking, but as a means to restrict and contain both the tobacco smoke and cigarette butts. When placed at a distance from thoroughfares and building openings they also serve to take smoking out of sight of children, therefore de-normalising smoking in their eyes. There is nothing normal about smoking. Non-smokers should not be forced to find smokefree spaces. Smokers should search out a space where their secondhand smoke does not affect others. 15. Ban smoking in all vehicles Ban smoking in all vehicles, especially those carrying children, disabled people, frail-aged, and other dependants, and to help prevent smoking distractions. Drivers must fully concentrate on driving, not be distracted by the multiple actions of opening a packet, lighting a cigarette, ashing, stubbing out, and carefully disposing of it. Prevent bushfires (lit by tossed butts). 16. Smokefree Indoors, including Residential Institutions No exceptions. With the knowledge that there is no safe level of tobacco smoke, all governments must ensure that exemptions in so-called "special circumstances" are removed. Residential institutions, such as psychiatric centres, hostels and prisons, if they continue to allow smoking indoors, continue to breach basic workplace safety regulations and their basic duty of care, towards smoking and non-smoking residents, as well as to all smoking and non-smoking employees and visitors. All other workplaces are designated smokefree, for health and safety reasons. Even smokers are entitled to smokefree indoors at their place of residence. We are advised that, following the promotion of the message "Car and home, smokefree zone" the majority of smokers in general don't smoke indoors at home, for the health and comfort of others. The wide range of alternative nicotine therapies should be accessed if designated outdoor smoking area/spaces cannot be used, due to physical disability or sensitive security concerns. Residents of such institutions should only be allowed to smoke in a limited number of Designated Outdoor Smoking Areas/spaces, strategically placed to prevent tobacco smoke from drifting inside buildings. 17. Criminal Prosecution for Suppliers of Tobacco to Minors. Vigorous criminal Prosecution of Suppliers of tobacco products to minors (including parents and friends). Such measures are under consideration in several countries, in efforts to stop early take-up by children and potential long-term addiction. The message "Every cigarette is doing you harm" is especially important where young people experience peer pressure to use abundantly available tobacco and alcohol. Suppliers (including friends and family) of these otherwise legally available drugs must be forced to recognise the seriousness of their actions in supplying to minors and must face the legal consequences, with heavy criminal penalties and full publicity. 18. Rigorous testing of all quitting therapies, including non-drug therapies. Subsidies and effective follow-up assistance. 19. Licence/prescription to purchase tobacco: Adults only, fee-paying photo-licence scheme, replacing tax revenues and providing frequent opt-out with possible refunds for proven quitting attempts. Such a scheme, provided by a Government fully committed to reducing take-up and reducing smoking rates, is well worth immediate consideration. Full public consultation, (national and international), should generate a successful scheme. The concept of a prescription/licence scheme for smokers has been promulgated for several years and should now be under serious discussion, with national and international input, and preparation for a series of pilot programs in the near future. 20. Call on Australia 's Federal Government to remove duty-free status from all tobacco products. 21. Support significant and relatively frequent price increases on tobacco products. 22. Ban tobacco industry and tobacco-friendly industry donations/sponsorship of political parties. No tobacco control legislation can be impartially developed in an atmosphere of financial influence from party contributors. We are intensely aware of the confidentially evolved "75/25 " standard for so-called unenclosed areas of pubs and clubs, where an area which is up to 75% enclosed is designated as unenclosed or "outdoors" for the purposes of defining smoking allowed areas. We continue to challenge this definition. This is unfinished business and can no longer be swept under the political funding "rug". 23. Tobacco Sales only from licensed retailers - minors prohibited from selling or handling tobacco products. No tobacco vending machines. 24. All tobacco products out of sight, wherever they are sold, to de-normalise smoking in children's eyes, as well as to reduce the visual impact of tobacco products on those attempting to quit. .Specialist tobacconist stores should not be open to view generally, nor visible to children. Currently they continue to operate selling a wide range of items which are attractive to children. 25. Allow only plain-paper packaging for all tobacco products. Brand Packaging is another form of advertising, appealing mostly to young people. 26. Media News coverage of all tobacco-related stories should be accompanied by graphic warnings depicting dangers of smoking. The majority of news items about tobacco continue to depict people "enjoying" tobacco products, thereby constituting a form of unpaid advertising - children see these images often and must regard smoking as a "normal' everyday pastime. 27. Films/Television shows depicting smoking - to be accompanied by adult rating, and prefaced with warnings. 28. All internet sales to be banned, and potential blackmarket /smuggling activities to be heavily attacked. Funding to be supplied from tax/licensing revenues. 29. Reducing financial support of Big Tobacco. Ban government and quasi-government investment (e.g. superannuation fund) in all aspects of the tobacco industry - all tobacco investment to be separated from other industries. Tobacco's financial links should be completely and openly exhibited to allow public scrutiny and deliberate withdrawal from unintentional funding of the production, packaging and marketing of its deadly products. 30. Death Certificates should indicate whether the death is attributable in whole or in part to tobacco use or to the effects of secondhand smoke. Conclusion We are convinced that, with commitment to an end-date, and with co-ordinated, tough measures, you can, and we can, truly achieve a Smokefree New South Wales by 31 May 2017, with smoking damage reduced to very minimal and manageable levels. We are happy to discuss these points further, especially in public forum. Yours sincerely, (Mrs) Margaret Hogge , President NSMA Incorporated. Phone 0419 257 605 |
|
||||