Smoke-Free Environment Amendment Bill
Debate resumed from 17 November.
Ms SYLVIA HALE [3.05 p.m.]: The Greens believe that this bill is well overdue, but regret that it does not go far enough. We support the long-term goal of the legislation to eliminate smoking in enclosed spaces but we believe that a complete ban on smoking should be implemented as soon as possible. To that end, we will seek to amend the bill in Committee to prohibit smoking in enclosed public spaces from July 2005, not July 2007.
New South Wales is hardly leading the charge in this area. For example, in 2003 New York State banned smoking in indoor workplaces. In March this year the Irish Government implemented a similar ban. It is telling that the Irish Government had the courage to stand up to the pubs and the tobacco industry and recognise that indoor workplaces encompass bars, clubs and restaurants. Of that country's population, 25 per cent smoke—4 per cent more than in New South Wales. However, the Irish Government recognised the need to protect workers in all workplaces, including pubs and clubs.
By January this year smoking had been banned in pubs and bars in California, Connecticut, Delaware, Maine and New York State, as well as in 72 local government municipalities across the United States. El Paso, in George Bush's home State of Texas, banned smoking in bars in January 2002. In February this year the Texas Department of Health released a report analysing sales tax data for 12 years preceding and one year following the introduction of the ban. The study concluded:
... no statistically significant changes in restaurant and bar revenues occurred after the smoking ban took effect.
It noted that this was consistent with similar studies of the impact of smoking bans in other American cities. It appears that smokers do not stay away from bars in droves. Some may change their smoking habits, but most probably move outdoor, or even stop smoking.
A report published on 10 November this year by the United States Centre for Disease Control indicated that the 2003 ban in New York State had resulted in a dramatic decline in the number of airborne pollutants. Second-hand smoke, which contains more than 50 carcinogens, kills more than 38,000 non-smokers each year. The report found that within three months of the ban being introduced, pollution levels at the 20 public places monitored in western New York "dropped an average of 84% in the public places, which included bars, restaurants, bowling alleys, a pool hall and a bingo parlour". Significantly, since New York State banned smoking in indoor workplaces in 2003, bar revenues there have risen by 8.7 per cent.
In New South Wales a survey by NSW Health found that 23 per cent of people say they would go to bars and pubs more frequently if smoking were banned. The Government admits that smoking is a major health risk and puts a major burden on the health care system. The Minister noted in his second reading speech that 54,000 hospital admissions each year in New South Wales are tobacco-related—
The Hon. Dr Arthur Chesterfield-Evans: Tobacco-caused.
Ms SYLVIA HALE: Tobacco-caused, indeed—amounting to a cost to the health system of approximately $180 million annually. The Cancer Council, the Australian Medical Association and countless anti-smoking organisations have been lobbying for years for a total ban on indoor smoking. The evidence is irrefutable that smoking kills. The need to ban smoking to protect smokers and non-smokers alike from environmental smokers is well established. The Government admits that indoor smoking must be banned. By falling into line with other countries and other State governments, New South Wales is at last taking seriously the risks associated with indoor smoking. But the Government also seems determined to drag its feet for as long as it can.
Queensland, Tasmania, the Australian Capital Territory and the Northern Territory will all introduce full bans before New South Wales does. Community opinion in New South Wales is behind a ban, and all that remains is the legislation to enact it. The Cancer Council has found that approximately two-thirds of all people would support a ban on smoking in public places. By delaying the introduction of this bill until July 2007 the Government is capitulating to the pubs and clubs industry. And make no mistake about it, the staged approach being proposed by this bill will achieve very little until July 2007.
Arbitrary divisions, such as are proposed in the bill, with about 50 per cent of a room being smoke-free and that percentage being reduced over time to 25 per cent, will be impossible to implement. How on earth does one prevent people who are drinking alcohol from moving around a room? Bars are not like restaurants where people sit down and stay seated for the duration in either a smoking or a non-smoking area. In bars most people stand and move around freely as the night progresses and as, perhaps, other patrons take their fancy. Despite what the industry has been saying, this staged introduction will be impossible to implement.
Arbitrary lines about where smoking begins and where it ends will be unworkable. But even if it were possible to police, it simply takes us back 15 years to the back 10 smoking rows in an aircraft. Even if smokers can be made to sit in one place, within no time the entire space is smoke filled. The 50 per cent rule is meaningless in reducing the exposure of people to harm from environmental smoke. This bill allows those bars that are either opposed or indifferent to anti-smoking regulations to remain smoking venues until 1 July 2007. The delay is simply a face-saving exercise for the Government so that, in the face of overwhelming community support for a ban, it can be seen to be acting while at the same time giving its mates in the pubs industry a further 2½ years grace.
The Hon. Duncan Gay: The Government is your mate; you give it your preferences all the time.
Ms SYLVIA HALE: I do not think the Government would contemplate the Greens being its mates. Certainly the Greens do not contemplate that either. Any talk about this bill being a compromise is rubbish. The real compromise is allowing smokers to smoke outside or in their own homes. In fact, these days many smokers choose to smoke outside even when they are at home. The Cancer Council has for some years conducted an education campaign to highlight the dangers of environmental smoke, particularly for children, at home and in a car. This campaign is having an effect, and many people now step outside onto the veranda or into the garden to smoke, even when they are at home. Asking people to smoke outside is not the radical shock-horror stuff that the hotel industry would have us believe.
It would be nice to think that some bars will decide that trying to police an unworkable policy is not worth the hassle, and will simply ban smoking outright from 1 July next year. But that is unlikely. Lazy or unscrupulous operators will just keep the puffing going until mid-2007, making it difficult for establishments that were prepared to do the right thing to compete. Given the choice between the non-smoking pub on one corner versus the smoking pub on the other, many—though not all—smokers would probably choose the smoking pub. That is why a flat, across-the-board ban is the only way to ensure a level playing field.
One argument put by the industry is that smokers will be forced outdoors and that pushing people onto already crowded narrow footpaths or cramped inner-city streets may be dangerous. This may be true. It would be dangerous to overcrowd footpaths, and for this very reason steps must be taken to provide sufficient outdoor space for smokers. Indeed, with or without smokers, the dramatic increase in footpath cafes and outdoor eating has been a hallmark of urban gentrification in the past decade. But to talk about the dangers associated with overcrowded footpaths is to entirely miss the point. It is equally, if not more, dangerous for people to be crowded into smoke-filled rooms. I remind members of a point I have already made: there are 6,500 smoking-related deaths in New South Wales every year, more than 2,000 of which are from lung cancer alone.
The Greens note the absolute and total capitulation to Star City Casino. The exemption for the high rollers room at Star City Casino is an act of prostitution on the part of the Government, prostitution influenced by the casino's tax revenues. High rollers do not sit and gamble alone; they are wined, dined, primped and preened by a bevy of staff who are exposed to environmental smoke just like workers in any other bar or workplace. Star City might argue that it has to compete with high rollers rooms in other States and that big spenders will simply move to those other States if they are not permitted to smoke in New South Wales. This may or may not be true.
But should the Government be making policy in the interests of high rollers and Star City or in the interests of the workers who are exposed to the hazards and dangers of workplace smoke? Workers in the high rollers room are entitled to the same protection as workers anywhere else in this State. In conclusion, the Greens believe there is no justification for not introducing a full ban on smoking in indoor public areas from 1 July 2005. This will still give the industry seven months to undertake the necessary preparations. On health grounds, there is no justification for delaying a ban beyond this time. We must not forget that people will die as a result of the delay.
The Hon. Dr Arthur Chesterfield-Evans: 11,800 by the—
The DEPUTY-PRESIDENT (The Hon. Amanda Fazio): Order! I call the Hon. Dr Arthur Chesterfield-Evans to order.
Ms SYLVIA HALE: As the Hon. Dr Arthur Chesterfield-Evans says, 11,800 people. As the Premier has acknowledged, up to 97 bar staff die every year from the effects of passive smoking. The fact that somewhere between 190 and 260 workers will die needless, preventable deaths as a result of this Parliament's delay should rest heavy on the consciences of those members who do not support the Greens amendment to bring the ban forward to July next year.
The Hon. RICK COLLESS [3.19 p.m.]: I support the Smoke-free Environment Amendment Bill. Smoking and the expectation that workers should be able to enjoy a safe workplace free from toxic substances is a very vexed and complex issue to negotiate from the legislative perspective. To the Hon. Dr Arthur Chesterfield-Evans, who is a long-time and vocal opponent of smoking, the issue is black and white. However, to someone who is a long-time smoker, the issue is also black and white but for completely different reasons. I shall touch briefly on the arguments from both perspectives. In support of the smokers initially, the bill impinges on their personal freedoms and choice. As a former smoker, I enjoyed a beer and a smoke at the pub after cricket, football or golf on a Saturday afternoon with my team-mates. It is a very social thing to do to replay the highlights of the afternoon's game over a beer and a smoke.
The term "a smoke" has been written into Australian folklore. A beer and a smoke after cricket, after work or simply for no reason at all is just as important to many people as having a cup of black tea and a smoke in the bush, the cattle yards or the wool shed, or on a building site or the waterfront. It is the genesis of the very Australian expression "smoko time". This bill will disfranchise all those who enjoy one of the simple pleasures of life—being able to go to their local pub or club, as they have for many years, and enjoy a cold beer and a smoke after work or on Saturday afternoon. Many people in the community are critical of the increasing legislative control over their lives, and one often hears comments along the lines that "next the Government will tax fresh air and charge us to breathe".
I am concerned about the impact of this bill on the freedom of choice for people to smoke if they wish, but they should be considerate enough to allow those who wish not to smoke also not to smoke. This raises the other side of the argument, and it is a very powerful argument once someone has been impacted by the effects of smoking, and even more so by those impacted by the effects of passive smoking. I gave up smoking more than two years ago and, although I was never a heavy smoker, 18 months ago I needed a quadruple heart bypass operation. Until that time I was one of those with the attitude that it would never happen to me. My heart condition may not have been directly attributable to my smoking history as I have a congenital problem with high cholesterol as well.
Despite my "it will never happen to me" attitude, I was aware that I was in a very high-risk group, with a family history of heart disease, high cholesterol and smoking. I did not have a heart attack, but when I went to the doctor my condition was diagnosed as acute unstable angina, which felt more like indigestion than a risky situation with my heart. The doctor assessed that I was in immediate danger of a major heart attack, and a doctor remained in my company until I was admitted to St Vincent's Hospital and placed on the monitors, which I remained on until I went into surgery 36 hours later. As I was recovering in the intensive care unit at St Vincent's, the sister who brought me out of the anaesthetic said to me, "We can tell you blokes who are smokers as soon as we open you up. Please don't ever smoke again."
I was pleased to be able to tell her that I had at that stage already given up smoking some time previously, although I was now realising the folly of ever taking up smoking all those years ago. I pay tribute to the doctors, the nursing staff and all the staff in the heart unit at St Vincent's Hospital. They are fabulously skilled and caring people who obviously have saved many thousands of lives. This life-threatening experience has left me with a much different outlook on life, particularly with respect to smoking and heart disease. The cholesterol condition I have is not something I have control over, other than with medication. My levels were so high that one doctor told me that I could live on lettuce leaves and still have high cholesterol. So I may still have suffered from heart disease even if I had never smoked.
But being a smoker the risk of heart disease manifesting itself as a major heart attack is greatly increased, and if I had not had the bypass operation it is very likely that there may have been a casual vacancy in this House by now. It is these personal considerations that have convinced me that every opportunity must be taken to convince people that they should not smoke. While it basically comes back to a matter of individual choice whether they smoke, it is not that simple for those who work in smoke-filled environments. These people do not have the choice, other than to find a different career path, and that is certainly not an option for everyone. This lack of choice means that they are placed in a situation every day where their health is placed at risk—not a risk that will manifest itself immediately, but a risk that can creep up on them and attack, in many cases without warning.
My younger brother, who was also a smoker, recently thought that he also might have a heart problem. When he was speaking to his heart specialist the doctor drew an analogy that crystallises the risk to one's health of cigarette smoke. The doctor asked my brother whether, if he was about to go overseas and the airline he had booked with crashed one 747 each week before he was due to go, he would still fly with that airline. Of course, my brother said that he would not. The doctor then asked him why he was still smoking, as the risk was about the same. That is how many people die from smoking each week. It is for these very compelling health reasons, which have affected me and other members of my family, that I must support the Smoke-free Environment Amendment Bill.
It is exacerbated by the fact that people who work in smoke-filled environments do not, in the vast majority of cases, have the choice as to whether they are exposed to the toxins contained in cigarette smoke. It is unfortunate that those who enjoy the simple pleasure of a beer and a smoke after work or on Saturday afternoon, or a smoke with their mug of tea at smoko time, will be displaced by this legislation. However, I believe that the benefits to the rest of the community and the safety of workers in those currently smoke-filled workplaces will greatly outweigh the losses incurred by the smokers. It is for those reasons that I support the bill.
The Hon. DAVID CLARKE [3.25 p.m.]: The Smoke-free Environment Amendment Bill is worthy of support. Its purpose is to phase out smoking in enclosed areas of hotels, clubs, casinos and nightclubs—all venues that are frequented by large numbers of people—by July 2007. It will accomplish this by means of a graduated phasing out commencing on 1 January 2005 and achieving completion by 1 July 2007. It is clear that medical science has established beyond all reasonable doubt that smoking constitutes a monumental threat to health in a multitude of ways. Smoke-related diseases and ailments are responsible for many thousands of deaths in Australia annually. Smoking is a major contributor to heart disease and many types of cancer, as well as other illnesses and diseases. Apart from death-causing health issues, smoking causes physical discomfort such as aggravation of asthma and eye irritations to many who may be in the vicinity of those engaged in its practice.
The restriction of smoking in enclosed places and premises frequented by the public has been a matter of contention and debate for some time. On one side are those who contend that such restrictions are an invasion of rights, an infringement of the right of smokers to indulge in the practice if they so wish. On the other side are those who point out that smokers who indulge in enclosed public locations interfere with the right of others to move freely in such areas without being subjected to health hazards and something which is physically uncomfortable to them. We are faced with a competing clash of rights, but to my mind the scales tilt very heavily to those who seek to move freely in enclosed public areas without being subjected to the threats to their health that derive from smoking.
I believe that this is the clear view of the overwhelming majority of the community. I believe also that the overwhelming majority would support the thrust of this bill. Employees who work in clubs and hotels are particularly at risk from continued smoking in these premises. We have an obligation to these employees to ensure that they are not subjected to the detrimental effects of smoking. Could anyone reasonably or in good conscience suggest otherwise? Additionally, we have a responsibility to members of the public, many of whom are children, who visit such premises. They are entitled to similar protection. Some concern has been expressed that this bill does not have sufficient clarity in some aspects. Time will tell on that matter.
The clubs industry was entitled to expect greater consultation from the Government than it received when it came to the preparation of this bill. However, the clubs, which represent hundreds of thousands of members, have come to expect nothing more than off-handed and contemptuous treatment from the Government. The way the Government is bleeding New South Wales clubs with ever-escalating taxes, for example, is testament to its contempt of clubs and their members. However, that is a matter that club members will deal with effectively at the next State election, because that is when they will sort out this Government in a decisive and permanent way. I believe that the bill should be supported because it goes to the important issues of public health and saving lives. Accordingly, it is in the best interests of the people of New South Wales that the bill should be passed.
The Hon. DAVID OLDFIELD [3.30 p.m.]: My views on smoking are reasonably well known. I am not a smoker. I have been a smoker. I am sorry that I was and I hate to think of the damage I did to my body in my youth in particular as a smoker. But peer pressure and the concept of these things appearing to be trendy or cool sometimes push one into becoming a smoker, as they did with me. Honourable members may remember that I had passed by the House the Public Health Amendment (Juvenile Smoking) Bill, a private member's bill, which gave police power to confiscate cigarettes from children under 18 years.
It had been a clear anomaly for some time that children under 18 could not purchase cigarettes but could smoke them. That is ridiculous. Realistically, it should be illegal for children under 18 to smoke, as it is illegal for them to drink when under 18. My bill at least went in the right direction of giving police, amongst other things, power to confiscate cigarettes from children under 18 in exactly the same way as existing laws allow them to confiscate alcohol from children under 18. Smokers absorb a disproportionate amount of the Health budget. The Hon. David Clarke has already referred to the health problems, and I am sure that the Hon. Dr Arthur Chesterfield-Evans will be particular in his remarks about the health implications for smokers.
There is no such thing as a good cigarette. One of the best advertisements I have seen against smoking had the message, "Every cigarette is doing you damage". There is not a single, solitary redeeming feature in smoking, and as far as I am concerned it is the equivalent of a self-inflicted wound. People should not smoke. I do not like smoking. However, in a pragmatic position, I recognise that people have certain rights in society. One of them is to hurt themselves. We recognise the fact that people do smoke. Given that, I am slightly disappointed that the Government did not engage in the possibility of allowing for separate smoking in enclosed lounges, separately ventilated, possibly staffed by people who smoke, et cetera. That might have better recognised the rights of those who smoke to continue to smoke in a hotel. In general I support the bill. It would be a better world if no-one smoked. I hope that one day we can reach that situation. In the meantime we have to recognise that people have a right to hurt themselves; but at the same time those people should recognise that they do not have a right to soak up our Health budget in the course of hurting themselves.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS [3.33 p.m.]: In speaking on the Smoke-free Environment Amendment Bill I am sadly about 25 years late, but we have to make do with what we have. Tobacco was brought back from the New World, North America, by Walter Raleigh. He was beheaded for treason. Sadly, this was not the reason: they got the punishment right but seemed confused about the crime. Tobacco had been used by native Americans in peace pipes in small doses at ceremonial occasions. Raleigh was smoking in the south of England in a pub called the Virginia Ash Hotel when a woman, believing him to be on fire, tipped a bucket of water over his head. Would that we could all respond in the same way. Smoking took off—presumably because it was addictive. In 1604 King James I of England delivered his "Counter-blaste" to tobacco:
Smoking is a custom loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs, and in the black, stinking fume thereof nearest resembling the horrible Stygian smoke of the pit that is bottomless.
It is interesting that King James had a number of the medical effects correct. He linked smoking to a religious evil. For many years the church was strongly against tobacco as a defilement of the body and it took a strong moral stand. As the world became more secular the tobacco industry carefully and cleverly used the ploy of associating people who were against smoking with some sort of religious nuts. Throughout the entire history of smoking—certainly since the 1950s—the industry has been totally cynical and ruthless. It has been happy to kill people in order to make its profits. The morality displayed by the asbestos industry has the same sort of approach.
Be that as it may, the per capita consumption of tobacco was relatively small and mainly confined to men, who retired after supper away from women. They wore smoking jackets so that when they took the jackets off and returned they would not smell so bad. In a sense it was a male bonding ritual. Duke invented the cigarette-rolling machine in 1898. Smoking was recognised as harmful and the Juvenile Smoking Suppression Acts were introduced in the Australian States in the period from 1906 to 1912. But it was the First World War that made the sales of tobacco really take off. Soldiers spent time in their trenches before they came out to relatively certain death: 75 per cent of soldiers killed in the First World War were killed by artillery rather than small arms. When the soldiers leapt out of their trenches they were blown to smithereens. The masculine bonding in the smoking ritual enabled the smoking industry to link masculinity and friendship with smoking, which was extremely important in tobacco marketing campaigns following the First World War.
I think that the saying "third time lucky" had its origins from this time. The light from somebody lighting a cigarette would attract the attention of the enemy. Lighting a second cigarette gave the enemy time to pick up a rifle and by the time the third fellow was having his cigarette lit he could be shot—yet another smoking-caused disease. Smoking in public became acceptable after the First World War and gathered ground in the 1920s. In the 1980s I was interested to see a newspaper article about a man who was the oldest prisoner in this State. He had been imprisoned for shooting a man who had had the temerity to smoke in a restaurant, a crime that had occurred, from memory, in 1924.
Reverend the Hon. Dr Gordon Moyes: I remember him well. I used to visit him in gaol.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS: Perhaps you could name him.
The DEPUTY-PRESIDENT (The Hon. Amanda Fazio): Order! I remind members that interjections are disorderly at all times. The Hon. Dr Arthur Chesterfield-Evans should ignore them and continue his speech.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS: Women's liberation encouraged the view that women had the same right to smoke as men or soldiers had. "Blow some smoke my way, soldier" was part of the marketing of cigarettes to women. Wars were very good for per capita consumption of tobacco: there was again a huge rise in tobacco consumption during the Second World War. The tobacco industry lobbied hard to make sure that tobacco was included in the Marshall Plan aid that rebuilt Europe. People in Europe previously did not smoke because they had no money but once they had an increase in income the industry wanted them to be addicted to American tobacco. It has been the strategy of the tobacco industry ever since to target countries with rising disposable incomes for immense marketing campaigns. So the mistakes made by the First World are being perpetuated into developing countries in sequence as they develop—very cynical but very effective.
Smoking was seen to be relatively harmless. In fact, outrageous claims were made that it was good for you and did no harm. But the seminal article by Richard Doll, in the British Medical Journal of November 1950—54 years ago—entitled "The Aetiology of Carcinoma of the Lung", clearly linked tobacco smoking with lung cancer. In the 1950s a series of articles linked smoking with various diseases, basically utilising the new statistical techniques that Doll and his colleagues were using.
In 1961 the Royal College of Physicians expressed concern that for 10 years successive governments had failed for 10 years to legislate against smoking, and that resulted in its seminal report on the effects of smoking in 1962. Across the Atlantic the American Surgeon General asked the tobacco industry to vet all scientists examining the effects of smoking, and his 1964 report was a damning indictment. Even scientists approved by the tobacco industry found that tobacco was the cause of myriad diseases. Since that time the tobacco industry has played politics, despite the known harmful effects of tobacco being sufficient to warrant action. For 40 years governments have done as little as possible while industry has continued to lobby and health forces have ineptly undertaken further research.
Earlier this year I gave a speech on smoking. I visited the Medline web site and found 102,000 articles on the effects of smoking on health. The research done in the 1950s was certainly sufficient to justify political action, yet as late as 1985 John Dollison from the Tobacco Institute still argued that "smoking causes disease" was a hypothesis. There is no end to the lies of the tobacco industry and, quite frankly, the behaviour of the clubs and pubs industry has been a disgrace in this and every other country. Any action that they regard as damaging to their patronage they have steadfastly resisted, and the Australian Hotels Association [AHA] is amongst the worst. The tobacco industry has been in bed with the AHA, subsidising it and, effectively, being a front for a small clique who do not give a fig for public health or the welfare of their patrons; it cares only about a potential loss of patronage. It is nothing but a disgrace, and the lack of action by both sides of this House over the last 40 years is also a disgrace. I have attended many breakfast functions at which some film or football star has launched a minimal no-smoking campaign, yet relevant Ministers congratulate themselves on these pathetic gestures but basically take no substantial action. In 1978 the Roper report, which was commissioned by the tobacco industry, concluded:
[The non-smokers' rights movement represents] the most dangerous development to the viability of the tobacco industry that has yet occurred … The issue, as we see it, is no longer what the smoker does to himself, but what he does to others.
That was a very prescient remark. It showed that in America the driving force for reducing smoking was the passive smoker. As a doctor I find that ironic because the passive smoker receives only a small dose compared to the smoker. Smokers see themselves at fault for continuing to smoke and poisoning themselves, but no-one actually cares about them. As a doctor I find that offensive, but it should be noted that the political push came from people who did not like the smoke. It was all right for smokers to poison themselves but it was not all right for them to poison non-smokers. The Hon. Rick Colless painted this issue as an argument between smokers and non-smokers. That was the model I started with when I became interested in the tobacco issue in 1980, but I later realised that the issue is between the tobacco industry and the people.
This is a war between money and people, not smokers and non-smokers. It is ironic that non-smokers are criticised for trying to help people quit smoking because, apparently, it is impolite to try to improve someone's health. A similar situation arose with a former Attorney General. It is very difficult to raise health issues with people who have alcohol problems. Both groups regard it as personal criticism. I believe the industry has been instrumental in promoting this by its catchcry, "Leave me alone." Indeed, Benson and Hedges ran a campaign here in Australia called "I know" and people who tried to help smokers were told, "I know", meaning "It is my right to poison myself"—without using the term "poison", of course.
The Collins and Lapsley paper "Counting the cost: Estimates of the social costs of Drug Abuse in Australia 1998-99" from the Commonwealth Department of Health estimated that the cost of smoking to the Australian economy was $21 billion, of which $5.1 billion was lost productivity. However, $52 million of that amount was the result of fires caused by discarded cigarette butts—but that statistic does not take into account the latest bushfires. I interviewed Sir Richard Doll on radio when he visited Australia in 1983. When he published his paper in 1950 tobacco was considered a legitimate business. People did not realise that tobacco was harmful and, therefore, the selling of cigarettes was regarded as a legitimate sales business. Leaders of the tobacco industry expressed concern to him because they realised that their product was dangerous. They asked for his advice on how to fix the problem. Richard Doll told them that it was not his expertise. He was an expert in epidemiology; he examined the harmful effects. He told them that it was difficult to remove certain substances because it was the burning organic substances that produced the harmful chemicals.
I believe that the tobacco industry undertook a large amount of research in the 1950s endeavouring to make its product safe, but could not do so. It was left with two choices: to get out of the business or lie and cheat to avoid being regulated out of the business. The industry took the latter option. Doll commented on the difference in the calibre of people he dealt with more recently from those with whom he dealt in the 1950s. Rather than politicise the issue, he saw his role as giving indisputable scientific facts. He regarded the implementation of his findings as someone else's job. Sadly, most of the medical profession, whose members were happily making a fortune from treating tobacco-caused disease, also regarded it as someone else's problem.
One could count on one hand the number of political activists in Australia who were dedicated to working on tobacco control. And those who were unpaid numbered nil! Those who became politically active basically lost their jobs. Personally I found tobacco unpleasant and I regarded it as offensive that I could not go to a pub without having to put up with cigarette smoke. However, I accepted the smoke, in the same way as others one accepts bad weather. When I started in medicine I found it absurd that so much time and effort was spent treating tobacco-caused disease. Every ward I visited accommodated patients suffering from tobacco-caused diseases. In some medical wards I found many people with chronic emphysema, on oxygen support, fighting for their last breath.
Reverend the Hon. Fred Nile: And still smoking.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS: Yes, and ducking out to the toilet for a smoke. In the head and neck cancer wards I never saw mouth cancer or cancer of the larynx in a non-smoker. If non-smokers have had those types of cancers, I have not seen them, and I have seen many cancers. In urology wards I saw people who had little tumours growing like mushrooms in their bladders that were the result of tar passing into their urine. In orthopaedic wards I saw tough bikies whose bones would not heal. Years later I read an article in a paper that confirmed what I had deduced at that time: the effect of smoking on blood supply reduces bone union, even in young people. I saw spontaneous rib fractures caused by depletion of calcium resulting from changes in the pH levels because of an increase in carbon dioxide in the blood and respiratory failure. Of course, the cough fractures associated with that are well known.
In intensive care wards I saw people suffering heart and lung failure and other complications. I amputated the legs of vascular patients whose arterial reconstruction surgery had failed. I observed the cleaning of arteries, which were lined with a combination of fat, almost like butter. The fat is shelled out, like sludge out of a pipe, and sometimes it is calcified, almost like stalagtites, so that the opening of the artery becomes blocked. It goes on and on. Every doctor who has worked in surgery has seen this damage, but for some reason the message never seems to get through.
Last week the Premier talked about his meeting with asbestos victims. He said that he was going to do something for them. Well, where has he been all these years? There are smokers in their thousands who suffer like the victims of asbestos suffer. When I lived at Newtown my house was on a gentle slope. My neighbour, who was a smoker, could only walk as far as his letterbox. To get to Newtown to do his shopping he walked very slowly down to Parramatta Road, caught a bus to Grace Bros at Broadway, caught another bus up to Newtown, did his shopping and then wheeled his trolley downhill to home. He could only walk downhill. But you would not even notice him. If you walked down his street, you would merely see him sitting on his front verandah, breathing heavily.
Last week Liz Kernohan died. I attended her funeral in Camden. Everyone said her death was a shock. She was a heavy smoker and she died at, I think, 63 years of age. I confess, I was not surprised. One of the eulogies was delivered by John Fahey, who said that he was surprised to hear of Liz's death. That seemed odd to me. I would not have thought he would have been surprised. He is missing a lung from lung cancer. Nick Greiner, who also spoke at the service, gave his condolences for another smoking-caused death.
A few cases in particular motivated me to join the anti-smoking movement. At Port Kembla I amputated legs and observed people surviving on ventilators. Although there was a huge shortage of doctors in the area, the excellent surgeon Vernon Allen James, who died recently, practised there. I spoke about him on the adjournment debate in this Chamber on Tuesday night. When I assisted him with his patients I wondered whether the tobacco industry had it in for all of us—we looked after the late stage, hopeless cases while the tobacco companies hooked the children on tobacco. A couple of cases in particular brought home the message to me.
When I was working at North Shore hospital a young fellow, from memory 39 years old, was admitted with cancer at the back of his tongue. At the time there was a visiting professor from Glasgow who performed a clever new operation that involved taking a piece of skin from the shoulder and digging the muscle flap in under the flesh, so that when the tongue was taken out, this super flap of skin, nourished from the pectoral muscle, would fill the gap in the bottom of the mouth. After supposedly having all the cancer removed, the patient underwent this elaborate reconstruction to the bottom of his mouth. The visiting specialist from Glasgow completed the operation but later the flap died, and the young man had a nasty piece of dead flesh going up into his mouth.
A person with cancer of the mouth cannot move his mouth so that when he eats, small pieces of food remain in the mouth and rot. This patient had rotting food and a rotting graft in his mouth. He was put in a private room because the smell that emanated from him was too bad for others in the ward. The pathology showed that the excision was incomplete, and the man was going to die. His wife was 31 and he had an 18-month-old baby. Doctors see this type of case every day, and people here laugh when I talk seriously about the effects of tobacco.
The case that finally got me going, though, was when I was working at North Shore, this time in the coronary intensive care unit when a businessman was admitted after suffering a major heart attack. He was 51 years old, very well-dressed, very intelligent, smoked Benson and Hedges. He had been occupied with his business and thought, like the Hon. Rick Colless, that it could not happen to him. A major heart attack causes a flail segment, which means as the muscular part of the heart contracts the scarred part balloons the other way. The heart is pumping on one side and ballooning out the other, and, therefore, has little output. His angiogram showed a major blockage of the coronary vessels, as might be expected. What was unusual about that day was that I had some spare time and I was able to talk to the man, his wife and his two daughters, who were perhaps aged 14 and 12. I saw what a good family they were.
The next morning we went off to theatre at 8 o'clock. We operated, but it did not go very well. The area of muscle damage was too great. He was put on a balloon pump to try to assist his heart after the operation. I was trying to titrate all the different pressor drugs, that is, heart-stimulating drugs, to keep him going. At about 3 o’clock the next morning his heart stopped. We could not keep it going any longer. So we pumped his chest. I rang the consultant. He said, "Mate, open him up, try and pump his heart internally and I'll come in." So I opened his chest with wire cutters, put the gloves on, and pumped his heart in my hands. I said, "Get the relatives." The boss came in, started pumping the heart and asked me to describe what had happened. I went through it bit by bit with all the drugs I had given and what had happened. He said, "You did the right thing, mate." He put the heart down, pulled the sheet over the man's head and said, "You go talk to the relatives."
I went outside into the corridor, the lights were low. The man's wife and his two daughters were there, tears streaming down their faces. They said to me, "Why did this happen?" I said, "It's just one of those things." Then I thought: It isn't one of those things; it's Benson and Hedges cigarettes; that's why your husband is dead, and for some reason I'm not allowed to say so. I went to bed for the remaining two hours of the night, worked the next day, and finished around seven. I had agreed to take my girlfriend out. I said, "I don't want to go out, I'd rather go to bed, I'm exhausted." She said, "We never go out. You're always tired. Come, we'll go to the movies." We went to the movies in George Street. Outside and in the foyer all the kids, from 12 upwards, were smoking, because it was so glamorous to smoke. We sat down, and when the Marlboro Man rode onto the screen I thought: I'm going to stop this if it kills me.
I rang Brian McBride from the Non Smokers' Movement of Australia, who had tried to get the smoking prohibition enforced on buses. Theoretically the ban, which had been introduced by Pat Hills, was in existence but it had never been enforced, particularly on private buses. Brian McBride was vilified as a nut when he tried to enforce the ban. I joined the Non Smokers' Movement and through its meetings I met the people from BUGA UP. I would like to diverge a little to talk about the health effects of tobacco in a systematic fashion. Rarely are the effects talked about in a systematic fashion. When looking for quotes about tobacco, I found this piece from the Bloomsbury Book of Quotations. The words by Tobias Venner, 1577 to 1660, Via Recta ad Vitam Longam, read:
Tobacco drieth the brain, dimmeth the sight, vitiateth the smell, hurteth the stomach, destroyeth the concoction, disturbeth the humours and spirits, corrupteth the breath, induceth the trembling of the limbs, exsiccateth the windpipe, lungs and liver, annoyeth the milt, scorcheth the heart, and causeth the blood to be adjusted.
To understand the effects on health of tobacco one must first realise that a smoker is basically inhaling the product of combustion, which has a combination of poisons. If you think of the elements of tobacco smoke in their simplest form and then analyse their effects, you will have some idea of the number of diseases that are caused by tobacco. Think of the five elements: hot gases, particles, tars, carbon monoxide—which is a gas, but I will mention it separately—and nicotine. As this combination goes into the body it produces what I call input cancers. You get an increased incidence of carcinoma of the lip, the tongue, the pharynx, the larynx and the lung as the tar is inhaled. You get an increased incidence of carcinoma of the oesophagus and the stomach as a direct result of the inhalation then swallowing of these toxic substances.
The particles then get trapped in the lungs, and the lungs become markedly effected from the tar, hot gases and particles, which then predispose us to infection by damaging the cilia, which move through the mucus and move foreign material out of the lungs. The cilia become damaged and the foreign material stays in the lung, pooling there, leading to infection and tissue damage. That leads to emphysema and chronic obstructive airway disease, or chronic obstructive lung disease as it sometimes called. So, we have marked lung effects.
The toxic products travel from the lungs into the blood. So, there is a systemic effect as the toxic products of tobacco move through the body via the circulation. There is a reduction in the oxygen carrying capacity and there is a direct toxic effect on the arteries of the carbon monoxide as the cells lining the arteries are poisoned. As those cells are damaged the platelets condense in order to try to repair them, and that leads to plaque forming on the walls of the arteries.
Carbon dioxide also affects free radicals, which are polar molecules that act as detergents to keep the fat in solution. So the fat becomes less soluble in the blood. Clotting is affected and this leads to a greater tendency to thrombosis. If that were not enough, the nicotine contracts the walls of the arteries so that the hole in the middle of an artery, the lumen, becomes smaller. This increases blood pressure so the heart has a reduced blood supply through the coronary arteries and an increased load through the contracted arteries through which blood is pumped. Naturally, that has a huge effect on the heart. So blood vessels and arteries are affected. Every part of the circulatory system is affected.
There can be clotting or bleeding in the brain. Arteries to the brain can be blocked. There can be blockages of arteries to the heart, which causes coronaries. There is reduced flow to the kidneys. There is reduced flow to the intestine, which can give intestinal angina. There is reduced flow to the skin, which causes premature ageing. There is reduced flow to the uterus, which causes small babies. There is reduced flow to the penis, which causes impotence. I must say, impotence is a valuable side effect because there is nothing like the threat of impotence to middle-aged men to awaken their interest in trying to quit. Poor circulation to the legs leads to amputations—which are so conspicuous in vascular wards.
There are malignant effects as nicotine passes through the body. Tar flows through blood and the incidence of leukaemia is greatly increased. Principally, the tar passes from the body in urine but it also comes out in all secretions. We can smell smokers because tar is coming out in their perspiration. There is an increased incidence of cancer of the breast because tar comes out in breast milk. There is an increase in cancer of the pancreas because tar comes out in intestinal secretions. There is increased incidence of cancer of the cervix because tar comes out in cervical secretions. There is an increased incidence of cancer of the urinary tract and bladder because tar comes out in urine. There is an increased incidence of cancer of the prostate because tar comes out in prostatic secretions. There is a huge range of diseases: input cancers, going around cancers, arterial effects and output cancers, if I could put it that way. If one were to ask in relation to a particular disease whether one would more likely contract the disease if one were a smoker, generally the answer would be yes.
When I joined the non-smokers movement, which I think was in 1981, I met Brian McBride. We used to hold meetings. The members of the movement were almost his cheer squad. He used to write numerous letters. I remember one time reading one of the letters and saying, "They are going to do something in September, are they?" He said, "We are just refiling the old letters. That one is 10 years old." When you write to politicians you get fobbed off with promises that a committee will inquire into your problem, and the years go by. Promises from politicians are not worth the paper they are written on.
When I was holding forth about this very thing at a party while I was working at Royal North Shore Hospital I recall a chap, Stuart White, saying, "That sounds like a very Liberal opinion." I said, "I don't know about Liberal." He said, "Yes, we are a broad church. Why don't you join the Liberal Party and get something done?" I said, "I might as well do something. I had better go and tell the politicians." All I can say is the Liberal Party was of no use. I recall saying to one old fellow, "Do you know that smoking causes $6 billion worth of damage to the Australian economy?" He said, " Yes, but they gave us $30,000 last year." I said, "That is only $30,000; smoking is causing $6 billion worth of damage to the Australian economy." He said, "Yes, but that is our $30,000." I said, "Is $30,000 the going price of the Liberal Party?" He said, "You won't get anywhere with an attitude like that, sonny." He was right; I did not get anywhere in the Liberal Party. I spoke to John Fahey when he was Minister for Industrial Relations and asked him to do something about smoking. Interestingly, he did nothing about smoking, at either a policy or a personal level. Of course, we know what effect smoking had on Mr Fahey.
I made one fatal mistake, and it was probably the worst mistake I will ever make in politics: I took Fred Cole from BUGA UP to the Young Liberals conference. Unfortunately, I let Fred become the after-hours speaker. Fred was a sort of a hippie in his approach, and was not the best spokesperson. Nick Greiner, who was at the conference, formed the impression that people who were against smoking were hippies, and he went on to do immense harm with British American Tobacco. I joined the Australian Democrats because it was the only party at the time that did not take tobacco money and had a sensible tobacco policy. It took me some years to do that.
After 1960, tobacco became a political battle. The medical system's way of treating tobacco-caused disease is almost foolish in the sense that there does not have to be any tobacco-caused diseases. We have the cure: Stop smoking! We cannot cure the disease at the end stage, but we can spend a fortune on it. Tobacco is fundamentally a political problem, but the political system does not want to know about it. The medical profession is cleaning up, in an inefficient, expensive and not very successful way, a problem that should have been solved by the political system acting in the interests of constituents.
The system should have taken on the tobacco industry and the riffraff of the clubs and pubs industry who support the tobacco industry. Politicians should have taken them on in the interests of stopping disease and public health. If vested interests will not do the right thing for the good of the public, it behoves those who supposedly represent the people to take the necessary action. Bob Carr, in his overweening vanity, has claimed credit for things he has not done. He has been extremely slow in getting to this point. I congratulate Mr Frank Sartor because he is the only Government member who has had the guts to put this issue on the table and drive it through. It is no credit to this Government; it is a credit to Frank Sartor.
As I said, the research was done slowly and with difficulty because, of course, the exact ingredients were not known. The industry has always kept them secret. The research was done again when the industry decided it would co-operate. As long as there were no regulations, they would do the research again. It was revealed at the World Conference on Tobacco or Health in Chicago in August 2000 that the tobacco companies had known in the 1960s what was rediscovered by reputable researchers in the 1980s.
The tobacco industry documents were obtained through the American legal discovery process. An eminent scientist on the stage at the plenary session was asked how he felt about spending his working life researching a question that had already been researched and the answer to which had been documented years before he started his work. He looked extremely deflated and gave a dispirited answer. He knew he had inadvertently been part of the process of the tobacco industry duping the public and delaying so that those responsible could avoid taking the action that they should have taken 20 years previously.
If they had looked at the donut and not the hole, if they had looked at the existing research data rather pursued tiny bits of data they did not have, they could have come to that conclusion. If they had had access to the tobacco industry data, the answer would have been evident. That is how we have reached this point. Delaying the ban until the middle of 2007 is another part of that process, and some of my amendments are designed to expedite change.
I suggest a tobacco control policy with five elements. The first element is price. People generally care far more about their money than about their health. We assume that a cut will heal, and that evil things will not happen to us. The second element is a smoke-free environment that sets non-smoking as the social norm. The third element is education. People should know about the harmful effects of tobacco. The fourth element is a ban on marketing. We must stop the tobacco industry telling lies. That goes further than advertising; it also involves marketing, which is a broader concept. Of course, any measure must be constantly assessed to ensure that it is effective, because there are different ways to impart a message.
The tobacco companies initially used advertising and then they used the sponsorship loophole, which was good for another 12 years. They are now using various other techniques involving peer groups and paying peer role models to smoke at bars and so on. The fifth element of the policy is to prosecute tobacco executives. Some have suggested that special laws should be enacted to allow the prosecution of tobacco executives. In the early 1980s BUGA UP said we did not need special laws because the executives could be prosecuted under the Trade Practices Act. We could simply ask whether they had sold goods they knew to be inherently faulty, and the answer would have to be Yes! Yes! Yes!
The law is adequate if we have the courage to prosecute the guilty. It is sad that we have one law for the rich and one for the poor. All the penalties we legislate in this place relate to crimes committed by the poor. If someone were to kill one person, he would go to gaol for a long time. However, someone who produces something that kills thousands is given an export award. It is not good enough. The parallel with asbestos is patently obvious. It is interesting that we are talking about introducing legislation dealing with asbestos but nothing is being done about tobacco.
In 1983, Seattle Professor William Weis examined the price sensitivity of tobacco. He found that a 10 per cent rise in the price of tobacco produced a 4.5 per cent fall in adult tobacco consumption, and a far greater fall in children's tobacco consumption. There was a 24 per cent fall in children's consumption and about a 22 per cent fall in uptake. Therefore, a 10 per cent price rise produced a 45 per cent increase in the consumption of tobacco by children.
A price rise was obviously a positive move. David Sweanor of the Canadian Non-Smokers' Rights Association pointed this out to me in 1983. In 1984 I obtained the material he produced for the Canadian Government and lodged a submission. I then arranged for the Australian Council on Smoking and Health and the Anti-Cancer Council of Victoria to make submissions in 1984, 1985 and 1986. Of course, at that stage the excise component of the price of tobacco in Australia was only about 50 per cent. Denmark was displaying world's best practice with an 86 per cent excise. We have managed to get it to about 80 per cent over the years. "Ashes to Ashes: America's Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris" by Richard Kluger states:
Seattle University economist William L. Weis reported in 1983 that smokers devoted 6 percent of their workday to the ritual, took 50 percent more sick days, and made 50 percent greater use of the health-care system than non-smokers. If they hired only the latter instead, Weis added, employers would shave their personnel costs by 20 percent, their insurance premiums by 30 percent, their office maintenance by 50 percent, and their disability outlays by 70 percent, for a claimed total savings of as much as $4,600 per worker per year.
A similar study of 42,000 households by the United States Public Health Service showed that smokers lost 27 per cent more work hours than non-smokers. It is certainly a general rule that smokers take more sick leave than non-smokers. Warren Buffett, the famous investment guru, knows a dollar when he sees one. He commented:
I'll tell you why I like the cigarette business. It costs a penny to make. Sell it for a dollar. It's addictive. And there's a fantastic brand loyalty.
It is obvious that the relationship between money and tobacco has always been very strong. The history of the BUGA UP group has never been appropriately recorded, so I will do so now. Bill Snow, Rick Bolzan and Geoff Coleman came up with the name in 1978. It may have been Bill Snow and Rick Bolzan who painted the first billboards. Bill had a friend who was sick—thanks to tobacco—and when he drove past a billboard advertising Marlboro cigarettes at White Bay he was offended that tobacco companies were pushing a product that was obviously so harmful. He wrote the word "cancer" across it.
Some time later the three men got together and decided to sell the concept of satirising the tobacco industry on its billboards, which were ubiquitous at the time. They wanted a concept that was naughty and satirical and would capture the Australian idea of standing up to evil bullyboys. Billboard Utilising Graffitists Against Unhealthy Promotions was born and they signed their work BUGA UP. On the occasional blank billboard they wrote the acronym and the expansion so that people would know the reason for the campaign.
BUGA UP was an unstructured organisation. I hesitate to use the word "anarchist" because that means "communist", "anti-capitalist" and is against everything we all stand for—property rights and so on. However, it had no hierarchical structure. One must make a personal decision to spray paint on a billboard, because it is an illegal act. One cannot be ordered to do that because that would constitute criminal conspiracy, and people are not willing to commit a crime for which there is no personal benefit unless they have searched their soul. BUGA UP was seen as an anti-smoking group, but it was not; its members were against the concept of tobacco advertising.
Some of us were anti-smoking—there is no doubt about that—and some were not. In a sense, there were two factions: the conservative faction, which thought it would just get rid of tobacco advertising and then relax; and the other faction—the more progressive faction perhaps—which was more prescient and wanted more responsibility in advertising. It said that if an industry has so much power over people's behaviour that it can get people to do something as totally irrational as to light something and suck the smoke into their lungs, it needs to be regulated with some degree of social responsibility.
Around that time the advertising industry, which was getting some criticism for tobacco advertising, worked out self-regulatory codes, which were various degrees of farce, and there was a lot of debate about that. A book called Advertising Regulation was written by Blakeney and Barnes from the University of New South Wales. I was there with the non-smokers movement writing letters to the Ministers, and I was getting fatuous, ridiculous fobbing-off replies. The Government was clearly going to do nothing. I had been in the Liberal Party, and it was clearly going to do nothing. The Labor Party was not doing any better. Both parties were on the take from the tobacco industry, and I could see that the only people who were making a difference were the people from BUGA UP.
So for me it was an easy choice: was I going to be a wimp who made a lot of money out of cardiac surgery or would I go and help the people who were actually doing some good? It was not really a matter of personal courage, it was a matter of my being too cowardly to do nothing. I could not have lived with my conscience if I had done nothing, so I started spraying billboards, for which I was eventually arrested. Being arrested did some good, in the sense that doctors being arrested for being a part of BUGA UP gave the campaign far more publicity because it could not really be said that we were total riffraff who could not get a job—which of course was, and still is, the standard putdown line against anybody trying to change anything in any sort of illegal fashion.
The Australian Consumers Association tried to take on the advertising regulatory system in the Trade Practices Tribunal and it nearly went broke in the endeavour; it got almost no publicity in the mainstream media, which is incredible considering the significance the case had. Interestingly, because the Australian Consumers Association could not suggest an industry-supported advertising regulation scheme which was self funding, it failed; and the advertising regulation system as it was—which was something of a farce—succeeded because it was better than nothing. Some people argue that it was not better than nothing because they were paying some percentage of their revenues into this so-called regulatory system. Eventually, when the political pressure came off, that whole regulatory system was simply abolished at the stroke of a pen—barely noticed some years later.
Because BUGA UP raised the profile of tobacco advertising and how monstrous it was, advertising bans were attempted by the South Australian Government in 1982 and by the Western Australian Government, more conspicuously, in 1983. The sports lobby stopped this. There was the threat that there would be no sport on weekends if there was no tobacco money to sponsor it, and the sports lobby—which was, of course, addicted to the tobacco money—lobbied against that, and the Western Australian bill was defeated.
The answer was to impose an extra tobacco tax, which we had discovered was a good thing because it increased the price, and the Victorian Tobacco Act added an extra excise to the cost of cigarettes in Victoria and used some of the money to replace the sponsorships, some for health promotion, and some to pay to little clubs and groups, particularly the ethnic clubs that had been taking tobacco money to try to lessen the amount of smoking in ethnic groups. The tobacco industry managed to stop this very successful model from spreading to New South Wales, Queensland and the Northern Territory. They said to Treasury, "Hey, you don't like hypothecated money, do you? You don't like taxes being specifically allocated to health promotion when you have lots of other things you would like to use it for."
Interestingly, the model was picked up by the Californians; they recognised that it was the best model in the world. They have done immensely good and innovative things with their advertising and now they have the greatest decrease in tobacco use in the world. Dileep Bal was the fellow who ran that model, and he delivered a very impressive paper at the World Conference on Tobacco and Health in Paris in 1994. He had assumed that because he did some really progressive anti-tobacco advertising he would lose his job at the end of his term, which I think was two years. He thought he may as well go down in a blaze of glory and run some really good advertisements. He did that and there was a dramatic decline in smoking in California, so dramatic that his contract was renewed. He came to Australia basically because I had urged some of the people here to bring him out as a spokesperson. I will tell about that a little later.
From 1982 I was spraying billboards and I was arrested for that early in 1983. I went to the World Conference on Tobacco and Health in Winnipeg, Canada, in 1983 and BUGA UP was seen there as the most innovative tobacco control initiative in the world. Australia was riding high as the number one country in the world for tobacco control. I cannot remember from exactly when, but from about 1984 to 1998 I edited the non-smokers movement magazine, which was initially called the Clean Air Clarion and later became the Non-smokers News. I ran a radio program, initially with Freddie Cole, at 2SERFM, from 1983 to 1997. Puff Off was modestly called Australia's leading radio program on smoking; it was the only radio program in the world dedicated to the politics of smoking. But I did not want to make extravagant claims. I had hopes that there would be other smoking and health radio programs in Australia that I could be better than, but that never eventuated either.
The main driver of tobacco control in America was the tort law relating to non-smokers being exposed to tobacco smoke. The main driver in Australia, I believe, was a small group of activists centred around BUGA UP but, at the same time, there were some people who had sued, particularly under workers compensation legislation, and the first of these was Roy Bishop, who in about 1983 sued the Surveyor General and the Commonwealth of Australia for his exposure to passive smoking in the workplace in Canberra. He eventually won a minor victory in 1985 and was supposedly given a smoke-free workplace; in practice he was sent to Coventry. He sued the Surveyor General again and won another settlement, I think in 1987.
The other highly significant legal case here was Leisel Scholom v New South Wales Department of Health. Leisel Scholom was a psychologist with the New South Wales Department Of Health and she was exposed to an immense amount of smoke because psychiatric patients, of course, have a very high incidence of smoking. She was sensitive to smoke and she tried to get a smoke-free workplace—which theoretically she had but which, in practice, she did not have—and she eventually went on to develop emphysema. She sued the Department of Health. The department could hardly argue that it did not know that smoking was harmful, and she won the first victory in a common law court in the world on the basis of passive smoking.
It has been a fight the whole way. In 1991 we had got rid of tobacco advertising for many years but Winfield had got into bed with the New South Wales Rugby League and were expanding their activities immensely in tobacco sponsorship—that is where a body accepts tobacco sponsorship in such a way that the tobacco industry supposedly sponsors that body when in reality it is advertising its product. That body effectively prostitutes itself to the tobacco industry to allow that advertising. The only difference between sponsorship and advertising is who gets paid.
The non-smokers movement tried to take on Channel 10, but it was found that an association could not lay a charge, so Brian McBride—the hero from the buses—sued Channel 10 over the Winfield Cup sponsorship. I think it was the 1988 Winfield Cup, but I could be wrong. At that time the Winfield spectacular consisted of a huge Winfield flag carried by men and women who also carried an Australian flag as they played the Winfield theme—the Tchaikovsky piece of music, which became known as the Winfield theme—and someone in a helicopter took a photograph of the whole spectacle. Unfortunately, the lawyer defending Channel 10 was Jim Spigelman. Since that case I have been unable to think about the man with warmth.
There were complaints about the painting under the goalposts and on the A-frames on each side. We put the case that the entire football match was an advertisement because there was practically no time during the entire game that the Winfield A-frames along the side or the perimeter fences, or the goalposts, were not visible. He said, "No, an advertisement must be very short. Which bit do you want?" We chose the Winfield spectacular to give us victory, because one could hardly say it was incidental or accidental exposure of the cigarette brand name. The audience could scarcely see the helicopter shot. We won the case. Interestingly, it cost about $1 million and was in the courts for nearly five years.
We laid the information in the Local Court, and it went to the District Court to be judged by a jury of four. Then it went to the Supreme Court, where the decision was overturned. The lawyer had shown the jury a cigarette packet, which no doubt had, according to him, impaired their judgment! Presumably they could not understand what they had seen! The matter then went to the High Court, where the Supreme Court decision was overturned and the jury's verdict was upheld. The whole process took about five years. Channel 10 was fined $10,000, which was less than it had cost us to lay the information five years previously. If you think the law gives justice, think again! Justice delivered the right decision in the end, but the delay gave the tobacco industry more years in which to advertise in Australia.
The disunity of the tobacco and health lobbyists was extremely depressing. Many egos were involved. The public servants who worked in the public health area could not complain because they would lose their jobs. So the best of them were, in a sense, condemned to stay at a fairly low level or remain silent. Some people were good activists but they could not do anything. The treatment lobby, which was the entire health system, was large, and its lack of effectiveness was unbelievably depressing. If ever the story is written by the tobacco lobby it will not make pleasant reading. It would include a chapter called something like "Naïve health lobby defeated easily—another 25 years of sales achieved." One could expect similar headlines.
We tried to raise the issue in Australia. For some years I used to wake up each morning and wonder how I could get tobacco on the front page. I used to have great contempt for people working in the health area because they used to say, "We haven't got any resources." I said, "Have you got a phone? Have you got a library? Have you got a brain?" That is all one really needs to get publicity for a good cause. Find an issue, repackage it for one's local audience, and put it out there. But they all said, "There's nothing we can do." It was extraordinarily effete. Perhaps they could have invented a name. Indeed, BUGA UP invented a name. When it needed an expert to say something, it simply opened the phone book, put a finger on any name, and used that name. We made more accurate health claims that the tobacco industry, whose claims were nonsense. Indeed, some of the industry's secret documents have been found to refer to the success of bogus experts travelling around the world.
While we were successful with workers compensation suits, they were mainly made by public servants because they were the only people secure enough in their jobs to sue their employer over passive smoking. We spent 20 years trying to find a plaintiff from the hospitality industry who would sue their employer. Hospitality workers were all too scared of losing their jobs. They were dying of tobacco-caused diseases and being exposed to massive doses of tobacco smoke, but they were too scared to sue. That was until the case of the woman, Marlene Sharp, who developed cancer of the larynx from working at Port Kembla RSL and the Port Kembla Hotel. That happened years later, in 2001. It simply shows the security, or lack thereof, of jobs in certain industries in Australia.
The Department of Health had rotating staff. The section dealing with tobacco control would often rotate managers, who would use the same old boring and unsuccessful techniques. And the Government could then say, "We've spent some money on this. We've done something completely unimaginative." It was as if the tobacco control section was a management training unit for people who were, hopefully, on the way up in the health system. Australia had a brief flowering in the Quit for Life campaign in the early 1980s, which was piloted on the North Coast. Indeed, it was world's best practice at that time. That died, perhaps because the Quit for Life campaign was successful.
The Victorian Anti-Cancer Council, under Nigel Gray, managed to get expenditure for tobacco control and made its own advertisements. At one stage in the 1970s it spent 15 per cent of its budget on anti-smoking advertisements. But these were isolated events. Mostly, the cancer council is a research-funding exercise. Although tobacco causes about one-third of all cancers, the cancer council expends only a tiny fraction of its funding on fighting tobacco. If the cancer council's job is to cut the incidence of cancer, we would assume it would allocate funds to where it would get the most cancer reduction per dollar—which for about 40 years has been the fight against tobacco. Why does the Cancer Council not do that? I believe that generally it is captive to the research community, and it gives money to cancer research rather than bring research to fruition in terms of public policy. That is sad. If the Cancer Council wants to get bang for its buck, that is what it should be doing.
That very same lack of application led Garfield Mahood, who ran the Non-Smokers' Rights Association in Canada, to attack the Canadian Cancer Society strongly, charging it with not doing enough—and I charge cancer councils generally with not doing enough. Certainly, that significantly changed the behaviour of the Canadian Cancer Society and, needless to say, it caused a considerable ruckus in the tobacco and health forces.
Some 25 per cent of heart disease is caused by tobacco but, sadly, the Heart Foundation is mainly interested in blood pressure and lipids. I do not believe that the Heart Foundation has pulled its weight in terms of tobacco control. Australia has lost its lead in tobacco control. We know that Ireland has gone smoke free, and Norway and many other countries are leading Australia in this regard. The venality of the pub and club industries has been set back even further because smokers drink more than non-smokers and gamblers gamble much more than non-smokers. The gambling lobby knows that gamblers stop gambling while they go outside to smoke. It has psychology reports on the danger of reduced gambling revenue when people stop smoking because clubs and pubs have smoke-free indoor areas.
Recently I saw a paper from a consultant psychologist on how to keep people gambling if non-smoking regulations are introduced. The gambling lobby is concerned about this. Delaying the introduction of smoke-free pubs and clubs until 2007 will mean that the gambling lobby, and indeed the Government, will give the maintenance of gambling profits a higher priority than people's health—47 years after smoking was shown to cause lung cancer.
The implementation of smoke-free areas has been desultory. I note that the person in WorkCover who was active in implementing smoke-free areas has been transferred, which is odd to say the least. Indeed, when the Smoke-Free Environment Act was enacted with great fanfare—it was significant legislation in 2000—clubs and pubs had 12 months in which to go smoke free or the legislation would be imposed on them. However, four years down the track that still has not happened.
Last year we had the pathetic—indeed, it was disgraceful—"Share the Air" campaign. The idea that we can share the air was rejected in the 1980s. It is like having a swimming pool with a urinating end and a non-urinating end, and expecting non-urinaters to swim up the other end. Fluids have flows, and similarly it is ridiculous to talk about smoke-free areas. We should be talking about smoke-free volumes. The Share the Air concept, which means we all share the smoke, is absurd. It is disgraceful that since 2000 the health department has issued leaflets on the Share the Air campaign. It simply shows the power of the tobacco lobby and its proxies, the hotel industry, on these committees. Why we put these people on these committees when we know that their only objective is to delay progress I do not know. It is a question of whether the Government has the courage to do the right thing or it does not. The fact that it does not, despite the overwhelming public support for a number of years, is a sad indictment of the political process. Never has so much information on a subject been assembled for so little political effect.
Despite the Government's general lack of interest and lack of implementation, because of massive public support smoke-free areas are to a large extent self-policing. What will happen in the future? There has to be some concern that the Carr Government has allowed the bill to be possibly reversed. The fact that the final cut-off date is not until after the next election is very worrying. I think that the Carr Government will fall because of its poor financial policies in terms of the maintenance of public infrastructure. The question then is whether the Liberals will water the legislation down or simply not implement it. It would be nice to hear from the Liberals that they intend to strengthen the bill or bring forward its implementation. But talk is cheap in all of this. Perhaps Mr Carr thinks that if he does not bring it in before the election any hassles that might happen will not have happened before the election and he will still get the money from the clubs and pubs lobby.
The Hon. Don Harwin: He will not be here in 2007.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS: That may be so. If the Government wants to know what to do perhaps it should be guided by the Bal editorial. As I said, the expert from California who wrote an editorial in the Medical Journal of Australia came over to speak to Craig Knowles. He spoke to the media before he spoke to Craig Knowles and Craig Knowles refused to see him, which was a very foolish decision. Bal pointed out in his editorial that between 1998 and 2001 United States tobacco consumption fell by 34 per cent. In California, which had spent a large amount on tobacco control advertisements, it fell by 60 per cent—almost double the national average. Between 1988 and 1997 the prevalence of smoking in young people had fallen from 11.2 per cent to 5.9 per cent, a 47 per cent fall, which was far in excess of what had been achieved in the rest of America. California had spent $1US billion over five years in tobacco control.
New South Wales in 2001 spent less than $2 million. Bal recommended that $50 million per year as a minimum be spent on quit campaigns in New South Wales. Having a New South Wales surgeon-general would be money well spent. In the United States the Surgeon-General is highly prestigious but has a relatively small office in terms of resources. The United States Surgeon-General looks at the overall health status of the United States and what needs to be done. In practical terms it is a lobby for public health. Again, it looks at the overall picture of health in the country. In a sense it is a small factor lobbying for prevention against treatment-based individual services, which are a bottomless pit. This could be a modestly funded post—perhaps associated with the school of public health—and have a much better effect on resources provision within the health system by looking at disease patterns from year to year and depoliticising such initiatives.
Quit programs are extremely important. They need to be in the media, as suggested by Bal, but personal quit programs have a huge potential and have been used in the United Kingdom. I spent 10 years at Sydney Water, and I was asked to do something about asbestos and other hazards. I said, "The work force here is ageing. It is getting a lot of tobacco-caused disease. Tobacco is causing far more disease than any other single factor in Sydney Water." I was a voice in the wilderness for some time but I finally managed to achieve some success because the antidiscrimination laws said that people could not be made to retire on the grounds of age. The ageing work force was somewhat unfit so we introduced a regime of fitness testing.
Part of that regime was counselling in alcohol and tobacco use to try to get a fitter work force, which included going smoke free, which it was claimed we could not do. But by taking a personal interest in the people, testing them all individually, counselling them individually and then having sessions based in every workplace we got a very high quit rate and a huge cut in the consumption of tobacco in the blue-collar work force in Sydney Water. I am very proud of that work and I think a good number of lives were saved by it. In one case a man stepping up and down on a box got a sore bottom. We discovered that was buttock claudication and he had an aortic bypass. His condition would never have been picked up had he not had that fitness test at work. We were able to conduct the tests for $40 a head in the tearooms. That is the model that ought to be used for quit programs in a workplace-based situation.
Another patient I saw was an overweight man with bad lung function and very high blood pressure who smoked 50 cigarettes a day. I rang St Vincent's Hospital and said, "I have a man here who is at very high risk of a heart attack. He has all these symptoms. What can you do?" The response was, "Book him in. Which bed is he in?" I said, "He is not in a bed yet. He has not had his heart attack yet." The reply was, "Oh, we cannot admit him if he has not had his heart attack. When he has it give us a call and we will do everything possible." It says a lot about the way health resources are allocated in terms of quitting. Mind you, it took an awful lot of talking even to get the man to agree to quit. There were no facilities that I could send him to for ongoing counselling and for the exercise program he needed. We could have saved that man's life. I do not know whether he is still alive but he was at very high risk.
I have circulated some amendments to the bill. I believe it must be implemented much more quickly, before 2007. In the Roper report of 1978, which I quoted earlier, the tobacco industry said that it expected the whole world to go smoke free by the mid-1980s. The tobacco industry must be laughing: it has got 20 years since then and it looks like getting more than 20 years. Yet people are claiming that the legislation has been rushed and there has not been time for discussion. Their answer is to talk forever. They do not care about the people who die. Because of the extra delay from the end of this year to the middle of 2007 the number of tobacco-caused deaths in New South Wales, at 13 people a day, will be 11,800. In that time the tobacco industry will succeed in hooking plenty more people. Its main means of hooking kids is to wait until they go to the discos. As people grow up they are allowed to drink, smoke and have sex. Drinking and smoking are part of the growing up ritual. Role models are paid to smoke and encourage people to smoke in these venues. This is having an immense effect on the next generation. It is tragic but history shows that it is always people in the 20 to 24 age group who have the highest smoking rates. If the younger ones are still the ones smoking it must mean that they have been recently recruited. Later they have their own personal struggle as they try to quit. There should be faster implementation of the bill; 2007 reflects a very slow pace, an apologetic pace, and shows the lack of leadership and courage of the Carr Government.
Local councils should be given the opportunity to introduce the requirements more quickly. In the United States one of the first councils that went smoke free was a tiny little town in the middle of nowhere in California. Little towns have councils that are not affected by the tobacco industry. The bigger the government the more big lobbies can affect them; the smaller the government the less. All the small towns in the United States went smoke free first, then the cities started to fall and the States fell later. Some years ago Ted Mack tried to control advertising through North Sydney Council. Philip Morris or one of the other tobacco companies took North Sydney Council to court and he was stopped. In a survey carried out at the time of a North Sydney Council election in 1991 about 72 per cent of people wanted smoke-free restaurants but the industry would not allow that to be introduced through local government. If local councils could introduce smoke-free areas—the tobacco lobby is less powerful in councils—we could get action.
My amendment suggests that legislation should form the bottom line, but that local councils have the power to move more quickly if they so wish. The entertainment industry has held the view that turnover will decline if smokers no longer visit pubs. Statistics show the opposite. Ms Sylvia Hale quoted some extremely good statistics, which demonstrate that the main reason people do not go to restaurants and bars is that they cannot afford it and, second, that they do not like the smoke. Many non-smokers would again frequent those places if they did not have to put up with smoke. I believe they would exceed the number of smokers who would leave, although many have become used to smoking outside.
Smoke-free environments have led to a reduction in the level of smoking. The Federal public service went smoke free in 1987 in response to the Roy Bishop case—again workers compensation law influenced the then head of the public service, Peter Wilenski, who later became the Australian Ambassador to the United Nations. An examination by Borland, Chapman and others, of the number of cigarettes smoked both before and after the introduction of the smoke-free policy in the Australian Federal Public Service showed up to a 25 per cent decrease in consumption by heavy smokers during work hours and resulted in a large number of smokers quitting. Introduction of the legislation will mean that fewer smokers will smoke and the remainder will smoke outside.
Gambling problems have increased because gambling has become the financial mainstay of our pubs and clubs, far more than alcohol sales, and that is more sensitive to cigarettes. The excellent work undertaken with respect to the Crown Casino in Victoria should be replicated at the national level. The money saved from these smoke-free initiatives will far exceed any money that a few Asians put into casinos. Another amendment seeks to tighten the definition of "outdoor space". Some weeks ago I ate at a restaurant in Leichhardt, delighting in the fact that even in that locality restaurants are smoke free. We were given a table in what was supposedly a smoke-free courtyard area, which had a roof. It was between two terrace houses, so it had walls on three sides. The fourth, and supposedly open, side had a solid railing and a large window, which was closed by a blind that totally restricted air flow. Nearby at a large table of 35 to 40 people, three or four people lit up, but the restaurateur said they were permitted to do so because the area was regarded as outside space.
Certain people have sought to make the definition of "outside space" elastic. Indeed, the group that is defining the term in the Australian Capital Territory has had some pretty weird definitions. Basically, any area that is substantially enclosed and that restricts airflow should be defined as indoor space. For example, the pub at Woolwich has glass walls on all sides, with overlapping umbrellas that effectively form a roof. It is extremely unpleasant when people smoke in this area because it is effectively a closed area. We must be very careful about definitions because elements within the tobacco industry, and probably the hotel industry, will try to redefine the word "outdoors" to circumvent the legislation, as they have sought to do with every smoking control measure since 1950. They will not stop now, and it is up to the Government to show some spine.
I congratulate Frank Sartor. I do not congratulate the Carr Government because it has been very desultory. However, I believe the bill does not go far enough. Australia should lead the world. In the early 1980s we led the way, but we have slipped behind, and it is time that the legislation was tightened. It is being implemented so slowly that the chance of something going wrong is high. Indeed, implementation and enforcement have been so poor that we cannot accept victory as a certainty, although there is a chance. We can say that this is a significant day, but we must be vigilant and tighten up the legislation before it is passed.
The Hon. JOHN TINGLE [4.54 p.m.]: I do not normally feel that banning something is necessarily the solution to a problem. But having been the victim of pointless, counterproductive and discriminatory bans in my sporting life, I still have to say that I think this is different. Although we live in an age of prohibitive legislation, where most of the laws we pass tell somebody they cannot do something, I repeat that I believe this is different. I believe the jury is back on the dangers, particularly to other people, of passive smoking and it is time that we took the sort of action this bill envisages.
I have to say that I have a vested personal interest in this. I have lost to smoking seven people very close to me, including my father. I have had other friends who had very unhappy episodes with lung cancer, cancer of the oesophagus, cancer of the larynx, cancer of the tongue, strokes, heart disease and other disabling events simply because they smoked—and I will not say they smoked too much; I will say simply because they smoked. In discussing this bill the Hon. Robyn Parker said that smoking was a matter of choice, and so it is, in the beginning. But that choice very quickly disappears because nicotine is so addictive. It is not very long before the smoker has no further choice but to keep on smoking.
It gets the smoker in a grip. There is probably nothing we can do—and I think the Hon. Dr Arthur Chesterfield-Evans has suggested this—to help the addicts give it up because they are in the grip of it and they are powerless. They, of course, cannot do very much to help themselves. However, I believe we can do something to try to protect other people who may inhale passive smoke or people who are at the stage of starting to smoke. Maybe we can even dissuade people who still have enough willpower to be able to give it up. But that is not the main factor.
The main factor is that we have to protect the general, non-smoking society from the inroads of the smoke they inhale and which is imposed upon them. I must say that I have a great deal of sympathy with the feeling of the Hon. Dr Arthur Chesterfield-Evans that this is still moving too slowly. I wonder how many people will be adversely affected, how many people will die and how many people will take up the dreaded weed before we bring this law in. I believe we need to move swiftly and decisively. I believe this bill addresses all those issues and I support it.
The Hon. JON JENKINS [4.57 p.m.]: I speak very briefly on this bill. When I was a young man I was in a motor vehicle accident, and most honourable members can see the result of that. During my 18-month stay in hospital—I was obviously very badly injured—I became addicted to morphine as a painkiller. For those of you who do not know, morphine is just heroin. It is the medical name for heroin.
The Hon. Dr Arthur Chesterfield-Evans: No, it is not.
The Hon. JON JENKINS: It works on the same opiate receptors; it is addictive to an equivalent degree. During my recovery period I took up smoking also. In terms of addiction there is no equivalence between the two. Nicotine is far more addictive than an opiate. People who smoke are the real victims. They are the ones who are addicted to an extraordinarily powerful drug. As well as all these punishments, restrictions and other efforts to encourage people to effectively give up smoking permanently, I believe some measure should be included in the legislation to help them because they are the real victims.
The Hon. Dr PETER WONG [4.58 p.m.]: First, I agree with the Hon. Dr Arthur Chesterfield-Evans that heroin is not morphine. Heroin is much more addictive than morphine. I strongly support the Smoke-free Environment Amendment Bill, which seeks to amend the Smoke-free Environment Act 2000 in order to phase out smoking in enclosed public places and licensed premises. I want to recap some facts that were referred to by previous speakers, in particular, the Hon. Dr Arthur Chesterfield-Evans. According to information from the Cancer Council of New South Wales, in 2001, 21.2 per cent of Australian adult males and 18 per cent of Australian women smoked. More importantly, statistics show that the smoking population peaks at 33 per cent for 17-year-old boys and 30 per cent for 17-year-old girls. Medical practitioners and most members would be aware that women are catching up in the tobacco-smoking statistics. That is not good for our society.
As has been stated by many experts, smoking can cause numerous cancers, including cancer of the lung, mouth and pharynx, oesophagus, larynx, bladder, kidney, pancreas, stomach, cervix, vulva, penis and anus. Further, it has severe side effects on the cardiovascular system, causing stroke, emphysema, hypertension, peptic ulcer, eye cataracts, back pain and impotence. Almost any condition you wish to name is on the list. The Cancer Council has highlighted the dangers of passive smoking of both side stream and mainstream smoke. The Commonwealth Government has issued a fact sheet highlighting the danger of smoking in our society. It states:
Smokers don't only put themselves at risk of serious health problems—people around them can also be exposed to much potential danger. The smoke exhaled by someone else or emitted by the tip of a burning cigarette is called environmental tobacco smoke, and breathing it in is known as passive smoking.
The fact sheet continues, in part:
Children of parents who smoke are likely to:
_ inhale about the same amount of nicotine as if they were actively smoking 60 to 150 cigarettes a year;
_ have more serious lung infections, such as croup, bronchitis and pneumonia;
_ have reduced lung function;
_ suffer more asthma attacks.
For adults, smoking increases the risk of developing lung cancer and cardiovascular illnesses. In summary, they are the dangers of smoking tobacco and passive smoking. As the Hon. Dr Arthur Chesterfield-Evans said in his contribution, the amendments in the bill should have gone further and with a tighter time frame. Nevertheless, they are a step in the right direction. At the same time, I am concerned that private casino gaming areas will be granted an exemption from the provisions of this bill. I will speak about that exemption later. I congratulate the Cancer Council of New South Wales, in particular, Dr Penman, who has been persistent in bringing about these long and overdue changes. At a meeting with Dr Penman about 12 months ago I suggested that apart from campaigning actively for legislation he should lobby the Minister for Science and Medical Research. I also congratulate the Minister on banning smoking in public places. As a medical practitioner who knows only too well the effects of smoking on people, I am pleased to see the introduction of this legislation.
Independent research has repeatedly affirmed the effects and dangers of passive smoking. For pregnant women who find themselves in an enclosed environment full of smoke, the effect of passive smoking increases the risk of sudden infant death syndrome. According to the Minister, tobacco-related illnesses currently account for 54,000 hospital admissions and cost government an estimated $180 million dollars per year. Balancing the rights of smokers as opposed to the rights of non-smokers is not as difficult as many would have us believe. True, smokers have the right to light up a cigarette. After all, it is a product they have worked and paid for. However, their right to a cigarette should cease at a time when their actions will be harmful to others.
I commend the phasing out of smoking in bar rooms, gaming machine rooms and recreation rooms in licensed premises between 1 January 2005 and 1 July 2007, with a total ban in place after this time. The implementation of such changes is the first of many initiatives that need to be taken. As costs associated with tobacco-related illnesses continue to increase, it would be wise to invest in a campaign that warns people of the changes and encourages smokers to quit. While we can bring about changes in the law, we cannot expect to change public attitudes without a coherent and constructive campaign that warns of the dangers and costs associated with this addictive habit. By implementing changes that provide for a smoke-free friendly environment, the onus is placed on the smoker to quit. For all the non-smokers and those who support this action, raising awareness of the dangers posed through passive smoking is a responsibility we should all share.
It is not a question of seeking scapegoats, nor should one be seen to impede the individual rights of smokers. As the Hon. John Tingle said, the rights of smokers cease when their actions are deemed harmful to others. In making it more difficult to smoke in public places, I am sure that many smokers will, in the long term, carefully consider the restrictions and the dangers posed and decide smoking no longer warrants the associated risks. While I strongly support the bill, I am concerned that smoking will continue to be permitted in the so-called high-rollers private casino gaming areas. If the purpose of the bill is to amend Acts that phase out smoking in all enclosed public places, surely we cannot allow, as the Minister put it, a minor exemption for certain sections of the private gaming or high-rollers rooms at Star City Casino. The employees in these so-called high-rollers rooms are entitled to the same smoke-free working environment that every other establishment in New South Wales will provide.
I constantly hear arguments that by banning smoking in these high-rollers gaming areas, or non-public gaming areas, we will encourage the big spenders at our casinos to travel interstate, where they can smoke their cigarettes and puff away on their cigars. By smoking they may alleviate their growing anxieties, but in the process they endanger the wellbeing of card dealers, croupiers and other staff. While I acknowledge that the casino exemption will be reviewed every 12 months, I remind honourable members that we represent the interests of all the people of New South Wales equally. Unless high-rollers gaming areas have a robotic system that can deal cards, handle cash and deliver drinks, I do not believe that such an exemption is warranted. Given the costs associated with smoking, I find it difficult to accept that the benefits reaped from allowing high-rollers gaming areas an exemption outweigh the long-term costs associated with smoking, passive or otherwise.
While speaking against smoking in support of this bill, I want to make a brief comment on marijuana smoking. Marijuana smoking has been proved to be as harmful as tobacco smoking. Apart from the physical ailments it produces, it can do enormous psychological harm, such as causing depression, psychosis and other mental illnesses. Marijuana smoking is seen as a trendy, beneficial and socially acceptable activity. It would be appropriate for the Government, while tightening the tobacco-smoking laws, to prevent the harmful effects of marijuana smoking through education, media campaigns and other means.
Reverend the Hon. Fred Nile: What about medical benefits?
The Hon. Dr PETER WONG: I note the interjection by Reverend the Hon. Fred Nile. As a medical treatment it should be considered in the same way as heroin and opium. Morphine can be used for medical illnesses, especially terminal illnesses. However, it must be administered under strict control. Marijuana has some definite beneficial effects in the treatment of nausea and the relief of pain. But it is debatable how beneficial it is. It is seen as a recreational and social drug. I do not believe any member of the House, especially those who are healthy, holistic human beings, should advocate the banning of tobacco and support the smoking of marijuana. I commend the bill to the House.
Reverend the Hon. Dr GORDON MOYES [5.09 p.m.]: I acknowledge the rather expert contributions of our doctors—Dr Wong, Dr Jenkins and Dr Chesterfield-Evans. What can a mere Doctor of Divinity, Doctor of Laws and Doctor of Literature say in the light of all that expert evidence? I acknowledge the lifelong work of the Hon. Dr Arthur Chesterfield-Evans and Reverend the Hon. Fred Nile. The Hon. Dr Arthur Chesterfield-Evans' speech, I believe, was his magnum opus on this subject, and I was pleased to be in attendance to hear it and that it has been recorded for posterity. I remember interviewing the Hon. Dr Arthur Chesterfield-Evans about the work of BUGA UP in the early 1980s on my 2GB radio program. I believed that BUGA UP was drawing the attention of the public to a very important issue.
The Smoke-free Environment Act prohibits smoking in an enclosed public place but contains certain exemptions in relation to a hotel, club, nightclub or casino. The purpose of the bill is to phase out those exemptions by 1 July 2007. There have already been a number of references to what effect that will have on the number of deaths caused by tobacco. Depending on what evidence one accepts, there are either 12, 13 or 14 deaths every single day as a result of tobacco-related diseases, and the Government is proposing that for the next 950 days we turn a blind eye to such. Therefore, 14,000 dead people is the cost of this legislation. The Greens and the Australian Democrats have both foreshadowed amendments to bring forward that date, and I will be very happy to support those amendments.
Smoking will continue to be permitted in private gaming rooms of casinos after that date, but this exemption will be regularly reviewed by the Minister for Health. As though that might improve the situation! The exemption safeguards the casino's income and the payment of levies to the Government but it does nothing to safeguard the health of workers who have to work in smoke-filled environments. Casino workers now know what their lives and suffering are worth. Their lives, and the suffering that might be caused by passive smoking, is the amount of the levy paid to the Government by the casino! I commend this bill in general terms save for the provisions that deal with the removal of the right of a person to be compensated by the Crown for any loss that a person may have suffered by the matters specified in proposed section 21A and the casino exemption provisions. I will deal with my concerns about the compensation provisions later. In his second reading speech the Minister stated:
Several compelling reasons shape the decision to bring in further smoking bans … A plethora of eminent research bodies and health bodies have affirmed that passive smoking causes harm … There have been 20 successful Australian prosecutions for passive smoking in the workplace.
Some of these were referred to by my colleague Reverend the Hon. Fred Nile in his speech, which outlined the battle he has had for more than 20 years to restrict smoking in public places. The Minister continued:
Tobacco-related illnesses account for 54,000 hospital admissions annually at a cost of $180 million per annum or $500,000 per day …
The initiatives in the bill will serve to curb the adverse health effects suffered by many people who work in areas where people frequently smoke. They will also be a welcome relief to those who frequent areas where people habitually smoke. I welcome those initiatives, although I remain deeply concerned for those who must continue to work in smoke-filled casinos. The health effects of active smoking are well documented. Passive smoking is a phenomenon that has been closely considered as a source of adverse health effects arguably only in the past decade or so. For example, in 1986, the National Health and Medical Research Council examined the issue of passive smoking and found sufficient evidence of an adverse effect on health to recommend that policies and practices be introduced to reduce exposure to passive smoking. This bill is 20 years after that report. This report is one of the many well-resourced reports on passive smoking published in the past couple of decades.
A report entitled "The Health Effects of Passive Smoking", which was published by the council in 1997—10 years after the report I just referred to—found that "the scientific evidence reviewed has found positive associations between passive smoking and the following diseases: asthma in children, lower respiratory illnesses and, lung cancer, major coronary events and other illnesses." It found also:
On the basis of 48 studies of the relationship between passive smoking and asthma, children exposed to environmental tobacco smoke are estimated to be about 1.4 times as likely to suffer from asthma symptoms as children who are not exposed. Passive smoking also aggravates pre-existing asthma in children. It is estimated that in Australia about 8% of childhood asthma—or 46,500 Australian children—is attributable to passive smoking.
That is mainly from their parents. The report continued:
The effect is most marked in children of mothers who smoke heavily (more than 10 cigarettes/day). It is likely that there is an effect on asthma due to lower levels of smoking but this has not been included in the burden of illness estimates.
The report continued further:
On the basis of 25 studies, it is estimated that the risk of lower respiratory illnesses (such as croup, bronchitis, bronchiolitis and pneumonia) is about 60% higher in children exposed to environmental tobacco smoke during the first eighteen months of life … In addition, a number of studies have reported a positive association with lower respiratory illness in older children, but the conservative assumption was made that the effect ended at 18 months of age. On this basis, it is estimated that about 13% of lower respiratory illness in Australian children under 18 months of age is due to passive smoking.
This is due to inhaling air from smoking parents. In relation to lung cancer, the report found:
Estimating the risk of lung cancer in people exposed to environmental tobacco smoke is complicated by differences in the way studies have been conducted and what they have measured. On the basis of 34 studies, it is estimated that there is an increase in risk of about 30% in never-smokers who live with a smoker compared with never-smokers living with a non-smoker …
On the basis of 16 studies, it is estimated that the risk of heart attack or death from coronary heart disease is about 24 per cent higher in never-smokers who live with a smoker compared with unexposed never-smokers. Over many years in my work among prisoners I found that almost all prisoners would light up when I began to talk to them. In my work over many years counselling psychiatric patients I found that people suffering from anxiety, depression, schizophrenia and a whole range of other mental illnesses almost inevitably light up when you start to talk to them. I was constantly exposed to passive smoking. I believe years of this have contributed to two heart attacks and five bypasses I have suffered, given that I am a never-smoker.
The report emphasised that the above estimates of burden of illness relate only to exposure at home and include only illnesses in never-smokers. The scientific proof and evidence on this matter is quite overwhelming. For those reasons we would embrace any moves that will increase the prohibition on smoking in public places. As pronounced by Stan Glatz in the Independent in 2001:
I'm a great believer in civil liberties, but I don't believe anyone has the right to poison someone else. A cigarette is a little toxic waste dump on fire.
The bill progressively narrows the exemptions that licensed premises can seek and under which they can operate from 1 January 2005 until 30 June 2007. On 1 July all areas in licensed premises, except casino private gaming areas, are to be smoke free. I note that this date is after the next State election. It seems to be a tacit indication that the Government expects reaction from the casinos, the pubs, the clubs and others, and expects the Coalition will then have to deal with it, when Premier Brogden—or will it be Premier O'Farrell—is in charge.
It is being denied that it will be Premier O'Farrell. I do not have a vote on that matter, so I cannot say. However, I am a bit of a prophet. I note that the person concerned has definitely lost weight, has shaved off his beard and is looking more handsome and telegenic. That is a true sign of a run for leadership.
Honourable members can be assured that the report that is to be presented on 1 January each year for examination by the Minister for Health will have been written in a haze of smoke. There is also a significant issue relating to the retrospectivity of the compensation provision, which should not be upheld. The bill abrogates the right of a person to be compensated by or on behalf of the Crown for loss arising directly or indirectly from any proposed section 21A matter that occurred before the bill's commencement. Of course, sometimes lung cancer and other forms of cancer take some time to develop. I am also concerned, as the committee has emphasised, that the bill will have the effect of rendering any such claims ineffective. As a result of its concerns, the committee has referred to the Parliament the question of whether the retrospective operation of the bill trespasses unduly on personal rights and liberties.
Reverend the Hon. Fred Nile has made this issue a personal crusade. It has dragged on for 20 years. People say that the clubs, pubs, casinos and other venues must have time to implement the necessary changes. I was recently in Ireland and I read that the Irish pubs, which traditionally have been smoke filled, became no-smoking areas almost overnight. I was interested to see while experiencing the life and music in local pubs in Ireland that no-one smoked. How long does it take to read a sign that reads "No smoking"? The Irish discovered that it can be read quickly.
The Hon. HENRY TSANG [Parliamentary Secretary] [5.26 p.m.], in reply: I thank honourable members for their contributions to the debate and their support of the bill, which is a very significant step in the Government's planned commitment to protect the New South Wales public from the dangers of environmental tobacco smoke. It establishes a phased-in timetable that begins in January 2005 and culminates in smoking bans in all enclosed areas of licensed premises by July 2007.
The Government has taken a collaborative approach to this important public health initiative. In order to maximise compliance with the smoking bans, the hospitality industry has been consulted throughout the development of the bans. The Department of Health has undertaken to work closely and co-operatively with operators to enforce the restrictions, especially in the early stages. Public opinion has also been actively sought, and the results of surveys show that support has been steadily growing as the earlier restrictions have come into effect.
An honourable member asked why we are not implementing the ban immediately. By banning smoking in progressive phases, both industry and patrons have come to accept and understand the benefits of a smoke-free environment. The careful timing of the implementation of the bans has been essential to the process of changing community and industry attitudes to smoking in enclosed public spaces. It has allowed people to accept the changes gradually and has led to a high degree of compliance, even when the bans were voluntary. Since the announcement that the Government was proceeding to total smoking bans in enclosed areas of licensed premises, a great deal of support has been expressed by members of the public. Patrons, entertainers and staff who have experienced discomfort and illness from environmental tobacco smoke have applauded the bans.
The Hon. Robyn Parker asked whether the ban would be bad for business. The answer was supplied by the Hon. Don Harwin. Overseas experience has shown that smoking bans increase the amenity of recreational venues leading to increased patronage and employment opportunities. This is in addition to the enormous public health benefits delivered by decreasing exposure to tobacco smoke.
A question was asked also about the definition of enclosed space. The Government is committed to developing a clear, workable definition of enclosed space. Proposed definitions have already been put forward by Clubs New South Wales and the Australian Hotels Association, supporters of the New Zealand model for defining outdoor areas, and now by the Australian Democrats. It is important that the definition that is finally settled on has broad support across the industry and from health groups. Should the bill be passed—and I am sure that it will be—it is the Government's intention to begin extensive consultation with peak bodies, design experts, proprietors and health professionals.
An honourable member also asked why high-roller clients of Star City should be exempt. The exemption for the international private gaming area of Star City Casino has been granted to maintain parity with its interstate competitors in Queensland and Victoria. It is important to note that the private gaming area of the casino comprises less than 10 per cent of the overall casino floor space and it is not open to the general public. This exemption will be subject to review every 12 months and it does not absolve Star City Casino from its responsibilities under the Occupational Health and Safety Act. I again thank honourable members for their contributions and I commend the bill to the House.
Motion agreed to.
Bill read a second time.
Clause 1 agreed to.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS [5.28 p.m.]: I move:
No. 1 Page 2, clause 2 (1), line 5. Omit "3 January". Insert instead "1 January".
This amendment will move the commencement date from 3 January to 1 January. My reason for moving the amendment is that generally people make a New Year's resolution on New Year's Eve. I realise 3 January is a Monday, but if people resolve to give up smoking on New Year's Eve, they will stop smoking on 1 January, not 3 January.
The Hon. HENRY TSANG [Parliamentary Secretary] [5.29 p.m.]: The amendment will move the implementation date of the first phase of the smoking ban from Monday 3 January 2005 to New Year's Eve 2005. Given the difficulties that would be involved in enforcing a smoking ban in the middle of the busiest night of the year, resulting in significant disruption in licensed premises on New Year's Eve, the Government opposes the amendment.
Ms SYLVIA HALE [5.31 p.m.]: I move Greens amendment No. 1:
No. 1 Page 2, clause 2 (1). Omit "2 July 2007". Insert instead "4 July 2005".
The purpose of this amendment is, essentially, to do away with the staged introduction of a ban over the next 2½ years and instead introduce a full ban on smoking in indoor public areas from Monday 4 July next year. A number of pubs and bars in New South Wales have already gone smoke free. They include: Bonnie Doon Golf Club at Pagewood, Oatlands Golf Club, Bowral Golf Club, Orange Ex-Services Country Club, Orange Emus Rugby Club, Clovelly Hotel, Cronulla Golf Club, Penrith Panthers nightclub, Cromer Golf Club, the Royal Motor Yacht Club at Toronto, Dubbo RSL Memorial Club, the Royal Motor Yacht Club at Port Hacking, the Duke of Wellington Hotel in New Lambton, the Basement at Circular Quay, Five Islands Brewery in Wollongong, the Tilbury Hotel in Woolloomooloo, Katoomba Golf Club, Woolooware Golf Club, the Mosman Rowing Club, Paddy's Irish Bar at the New Albury Hotel, and the Newstead Bowling Club in Orange.
In all, those establishments total 22 and are the venues listed as smoke free on the web site of the New South Wales Cancer Council. I have identified them for two reasons: first, because they deserve recognition and should be congratulated on their courage and willingness to stand out against the tide of misinformation being peddled by the Australian Hotels Association and some sectors of the industry; and, second, because the list demonstrates that the sky does not fall in when smoking is banned. Many of the venues are highly successful business enterprises that attract large numbers of clients.
As I said in my speech to the second reading debate, on health grounds alone any delay in introducing a total ban on smoking cannot be justified. The delay will result in needless avoidable deaths. There is no justification whatsoever for postponing the ban any longer. For this reason, and for the reasons that have been more than adequately outlined by the Hon. Dr Arthur Chesterfield-Evans and Reverend the Hon. Dr Gordon Moyes it is incumbent upon all members of this Chamber who genuinely are concerned about the health, well-being and lives of workers in the club and hotel industry or in any enclosed space, that this ban should be implemented at the earliest opportunity rather than delayed for a further 2½ years.
Reverend the Hon. FRED NILE [5.34 p.m.]: The Christian Democratic Party supports this amendment. If this bill had suddenly come out of the blue and—Shock! Horror!—no one knew anything about it, a later date could perhaps be argued. But because we have been debating this issue for many years—in fact the debate started in the 1900s—and because over the past four years there has been regular consultation with clubs and hotels over implementing this legislation, it is obvious that everybody has had sufficient warning. There is no surprise, and I believe that clubs and hotels could redesign their premises to meet the deadline.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS [5.34 p.m.]: I have a timetable for phasing in the restrictions modelled on the Government's deadline, but I must admit I rather admire this cutting of the Gordian knot, as it were. I am a little discouraged, however, that someone has taken a more radical position than I in this regard. This legislation was expected by the tobacco industry in the mid-eighties—of course, it should have been in the mid-sixties—and the idea that any more time is needed is a nonsense. I support the amendment.
The Hon. HENRY TSANG [Parliamentary Secretary] [5.35 p.m.]: The amendment introduces complete smoking bans in licensed premises from July 2005. If adopted, this amendment will prevent pubs and clubs from having time to do the necessary design and construction work to expand outdoor areas and build extensions. It will prevent the bans from being effectively communicated to patrons. It will force a major cultural change on the New South Wales community without adequate consultation or time to adjust.
A major advertising campaign is planned to coincide with the phased introduction of the bans. This advertising campaign in pubs relies on the industry to spread the message among their patrons. The industry co-operated fully in advertising and promoting the original Shared Air Agreement in 2000. Industry co-operation cannot be provided within the timetable proposed by the Greens and other honourable members. A complete indoor smoking ban also represents a major cultural change for many patrons of pubs and clubs. The tradition of having a cigarette with one's beer is still very strong in some sections of the community, especially in regional New South Wales.
The Government strongly supports this cultural change occurring for reasons set out in my second reading speech. However, it is unrealistic to expect this cultural change to occur by July next year. The Government's timetable for phasing in bans between January 2005 and July 2007 is a realistic proposal mirrored by similar timetables in other States. I urge members to oppose this amendment.
Question—That the amendment be agreed to—put.
The Committee divided.
Reverend Dr Moyes
Question resolved in the negative.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS [5.46 p.m.]: I move Democrats amendment No. 2:
No. 2 Page 2, clause 2 (2), line 7. Omit "2 July 2007". Insert instead "1 January 2006".
Basically, this amendment brings the final date back to 1 January 2006, which is before the election. There will still be adequate time for the phase-in, which will happen over six months. There is no reason for the phase-in to not take place until 2007. Once again the Government is kowtowing to the hotels lobby, which will ask for extensions forever. This way the final phase-in will be well clear of the election; there will not be a danger of anything happening around election time. In other words, the amendment is truncating the phase-in by six months, from July 2007 to January 2006. I believe that is perfectly reasonable. That is a much longer phase-in period than was provided in Ireland. Consistency with the other States is not important; any inconsistency will have a minimal effect across the border. The idea that we will put our foot out as far as he who goes slowest is absurd. I commend the amendment to the Committee.
Reverend the Hon. FRED NILE [5.47 p.m.]: The Christian Democratic Party supports the amendment in principle. It completely negates the Government's arguments. Amending the date to 2006 will still provide sufficient time for the adjustment or change in culture that the Government is worried about.
The Hon. HENRY TSANG [Parliamentary Secretary] [5.48 p.m.]: The Democrats amendment is similar to, though less draconian than, Greens amendment No. 1, and therefore the Government opposes it.
Question—That the amendment be agreed to—put.
The Committee divided.
|Reverend Dr Moyes|
Question resolved in the negative.
Clause 2 agreed to.
Clauses 3 and 4 agreed to.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS [5.56 p.m.], by leave: I move Australian Democrats amendments Nos 3 and 4 in globo:
No. 3 Page 3, schedule 1 , line 5. Omit all the words on that line. Insert instead:
Omit the definitions of enclosed and exempt premises. Insert instead:
enclosed has the meaning given by section 4A.
No. 4 Page 3, schedule 1. Insert after line 6:
 Section 4A
Insert after section 4:
4A Meaning of "enclosed"
(1) In this Act, enclosed in relation to a public place means:
(2) For the purposes of subsection (1), a wall includes anything that prevents the free flow of air.
(a) having a ceiling, roof or other covering that substantially covers the place (whether permanently or temporarily) and having walls that substantially surround the place (whether permanently or temporarily), or
(b) having a construction that causes smoke to remain in the place.
These amendments define "enclosed". There has been a tradition, for want of a better term, to subvert smoking bans by exempting outdoors courtyards and so on that have three sides surrounded by a wall.
There may be a roof and, on the fourth side, a railing or a half wall up to the height of a railing. The addition of an occlusive blind, made from plastic or canvas, effectively turns an outdoor space into a room. Recently I went to a restaurant in Leichhardt that was at the back of a terrace house. It had a roof and walls on each side and it was effectively completely closed off but could be claimed to be an outdoors space, and thus smoking would be permitted. Having a roof might seem critical, but sometimes the new square umbrellas can be linked to effectively form a roof with only a tiny space between them. The airflow is extremely low. Effectively, it is an indoor space. Anyone there would experience a large amount of smoke pollution. Sections of the hotel or entertainment industry want to define such areas as "outdoor areas" so that smoking is permitted there. The bill is deficient because it does not define "enclosed space". I commend the amendments to the Committee to deal with a major loophole.
The Hon. HENRY TSANG [Parliamentary Secretary] [5.59 p.m.]: The amendments relate to the definition of "enclosed space" in licensed premises. As I said in my reply to the second reading debate, the Government is committed to develop a clear, workable definition of "enclosed space". Proposed definitions have already been put forward by ClubsNSW, the Australian Hotels Association, supporters of the New Zealand model, and now the Australian Democrats. It is important that the definition finally settled upon has broad support across industry and health groups. Should the bill be passed, the Government intends to begin extensive consultation with peak bodies, design experts, proprietors, and, most important, health professionals. These amendments would short-circuit the processes set out in the definition before any consultation has occurred. Therefore the Government opposes them.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS [6.00 p.m.]: I must answer the Government's pathetic response. Basically, it either has smoke-free areas or it does not. Consensus will not be reached on this. The interests of the tobacco industry, the backward lobbyists on the Australian Hotels Association, and the clubs will never agree to smoke-free areas. They are trying to find loopholes in the legislation. The Government must take a strong stand. The amendments provide that if the area is effectively an indoor area, it cannot be called an outdoor area. It is a very clear definition. This will merely be another time-wasting exercise by the industry. The Government should grasp the nettle and support the amendments.
Question—That the amendments be agreed to—put.
The Committee divided.
Reverend Dr Moyes
Question resolved in the negative.
Progress reported and leave granted to sit again.