Tasmanian Respiratory physicians encourage politicians to pass Tobacco Bill

Evidence shows that the vast majority (95 per cent) of smokers start smoking before age 21. Hence, it is appropriate to focus on this age group to reduce tobacco addiction.

We have all seen the devastating effect of tobacco-related lung disease up close because of our work as respiratory physicians in Tasmania.

The common conditions of chronic bronchitis and emphysema are usually a consequence of many years of smoking from an early age.

They are associated with cough and breathlessness and a reduced lifespan.

They are frequent causes of admissions to our hospitals especially during the winter when infections are more common.

Lung cancer is also common and more likely to deprive people of quality and quantity of life.

These deadly disorders of the lungs persist, even in those who quit, because they reflect the cumulative exposure to tobacco products. There is no safe threshold level of smoking. The more one smokes and the longer one smokes, the greater the risks.

Quitting smoking is important, but the risk of lung cancer remains for the rest of a smoker's life. There are many other cancers also associated with tobacco smoking, which present to our medical oncology colleagues (including cancers of the larynx, oesophagus, pancreas and bladder).

There are many common cardiovascular disorders which present to other medical colleagues, especially coronary artery disease, cerebrovascular disease and peripheral vascular disease.

These are also permanent diseases which can often be helped by interventions.

Tobacco smoking is a frequent cause of flare-ups of asthma, which affects about 11.2 per cent of Australians and 12.8 per cent of Tasmanians (Asthma Australia data 2019). There are also some rare conditions of the lungs caused directly by smoking, which can resolve with cessation of smoking (eg Respiratory Bronchiolitis-associated Interstitial Lung Disease and Langerhans Cell Histiocytosis).

Smoking rates have gradually fallen in Australia. About 14 per cent of the population are current smokers in 2019. The rates in Tasmania have been consistently higher.

Two suburbs in Hobart in 2019 had the highest current smoking rates (40 per cent and 35 per cent ) of any region in Australia.

Hence, it is appropriate for Tasmania to lead the way in new initiatives to reduce tobacco addiction.

The decline of smoking rates has followed the intensive efforts of numerous health organisations and Government campaigns to advise Australians about the health risks of smoking and to assist them to quit. Legislation to apply a tax on tobacco products has added additional pressure for smokers to quit. Legislation has proved very successful to protect those who choose not to smoke from being exposed to Environmental Tobacco Smoke.

Tasmania has led the way with some of this legislation, including the first state to pass laws to protect children from ETS within motor vehicles. The rate of decline is slowing, and it is unlikely that a continuation of the same measures will lead to substantial future improvements, given that smoking rates are higher in young adults compared with older adults (that is, the ones who became addicted before all these measures came into place).

The proposed legislation will be the first in Australia but it is not without precedent in similar democracies, so it is not a complete leap of faith.

This equivalent legislation has been introduced in other countries successfully and we can learn from those efforts.

Even in modern democracies, there are restrictions sometimes placed on us, even as adults, for our own benefit and for the benefit of the general community, such as compulsory wearing of seat-belts when driving. No-one disputes that this measure saves lives and reduces health costs. Most drivers conform and it becomes a way of life.

Tobacco addiction produces illness and suffering for many Tasmanians, which in turn affects their family and friends.

As the respiratory physicians of Tasmania, we see that suffering first hand and every day we go to work. We sympathise with the plight of smokers and we do our best to treat their illnesses and to help them quit if they are still smoking.

Most people we meet regret they ever started smoking, but too often it is too late for them to prevent serious illness.

We believe that the time has come for us as a caring community in Tasmania to make a bold move and to assist our young adults by increasing the legal age to purchase tobacco products to age 21 years.

We recommend that you support the Bill that will enable this.