Wednesday, 28 March 2018
Standing Committee on Health, Aged Care and Sport; Report
On behalf of the Standing Committee on Health, Aged Care and Sport, I present the committee's report, incorporating dissenting reports, on the inquiry into the use and marketing of electronic cigarettes and personal vaporisers, together with the minutes of proceedings.
Report made a parliamentary paper in accordance with standing order 39(e).
by leave—Approximately 2.4 million Australians smoke cigarettes daily, and it has been estimated that two out of every three smokers will die prematurely due to their smoking. Given these stark figures, reducing the number of Australians who smoke is one of the nation's most important public health objectives. This committee has spent close to a year examining whether e-cigarettes could assist in meeting that objective. The Standing Committee on Health, Aged Care and Sport has a long history of delivering consensus and bipartisan reports. On this occasion, that has not been possible and I find myself in the unusual position as chair of co-authoring a dissenting report. The committee has been presented with starkly conflicting views during this inquiry, and I respect those committee members who have formed different judgements to my own. I do, however, disagree with the conclusions reached by the majority of my colleagues. The majority on the committee made five recommendations, including two-yearly reviews of the evidence, an international gathering of experts, a national approach to non-nicotine e-cigarettes, including greater regulation of colours and flavourings, and a continuation of the Therapeutic Goods Administration's role in classifying nicotine. I present a dissenting report, along with my colleague the member for Goldstein. The member for Bowman has also submitted a dissenting report, which concurs with our conclusions.
Australia has been a global leader in developing tobacco control policies. This approach has been very successful. Between 1991 and 2013, the proportion of Australians smoking daily dropped from 24 per cent to 12.8 per cent. If recent years, however, progress has stalled, with the daily smoking rate only dropping from 12.8 per cent to 12.2 per cent between 2013 and 2016. It is highly unlikely Australia will reach its 2018 target of reducing smoking to 10 per cent of the population. In these circumstances, a new approach is needed for those smokers who have been unable to quit smoking using the assistance currently available. We need another weapon in the arsenal. That's why our dissenting report recommends that e-cigarettes containing nicotine should be made legal. We know that nicotine is highly addictive. Quitting is hard and many smokers have unsuccessfully tried repeatedly. Based on the evidence presented to the committee, e-cigarettes may be an answer for many of these people. While the evidence base regarding e-cigarettes is still emerging, there are clear indications that e-cigarettes are significantly less harmful to human health than smoking tobacco cigarettes. If long-term smokers who have been unable to quit smoking tobacco cigarettes switched to e-cigarettes, thousands of lives could be saved. One medical researcher whom the committee met in New Zealand put the choice starkly. As she said, if a patient has earnestly tried existing ways of quitting but failed, then, knowing the consequences of that patient continuing to smoke, how could a medical practitioner morally and ethically not recommend they consider e-cigarettes?
Despite the potential health gains, Australia's public health community has been resistant to the idea of making e-cigarettes legally available. This stands in contrast to many of their counterparts in the United Kingdom and New Zealand who gave evidence to the committee. Many members of our health community are concerned that legally available nicotine e-cigarettes may, by extension, make smoking attractive to young people. This is what is referred to as the 'gateway effect'. In those countries where nicotine e-cigarettes are legally available, however, there has not been an increase in youth smoking. In fact, smoking rates among young people continue to fall in jurisdictions where e-cigarettes are available. If e-cigarettes are made legal, we need the right regulatory environment, particularly one that recognises the need to prevent young people from taking up vaping. Restrictions should be imposed to limit the appeal of e-cigarettes to young people and nonsmokers. In this regard, the European Union and the United Kingdom provide excellent regulatory models.
In conclusion, I would like to thank the organisations, agencies and individuals who participated in this inquiry, especially those individuals who shared their personal experiences using e-cigarettes. The committee also heard from witnesses from the United Kingdom and New Zealand, and I thank them for the insight they provided. Finally, I would like to thank my committee colleagues for the consideration of the evidence during what has been a difficult inquiry, and the committee staff for their work, which is always exceptionally professional. I commend the report and, obviously, the dissenting reports to the House.
by leave—I stand here in the very unusual circumstances of being the deputy chair and member of the opposition presenting the majority report of the electronic cigarettes and personal vaporisers in Australia inquiry in use and marketing.
As deputy chair of the committee I would have preferred, and my preference would have been, to have nicotine e-cigarettes evaluated by independent health experts and not politicians. I don't think we're in a position to make scientific judgements on what is harmful and what isn't. We know conclusive evidence, for many years, has shown us that nicotine and tobacco cause cancer and many other illnesses.
I respect the views of the chair of the committee and I congratulate him on chairing the inquiry, always giving everyone the opportunity to talk and ensuring that all views were heard. Having said that, once the committee made that decision and was commissioned by the government to investigate e-cigarettes, it was useful to hear from people around the country and overseas about the negative impacts of smoking and e-cigarettes and their usage here in Australia and in other parts of the world. This includes, as you heard from the member for North Sydney, New Zealand and the UK, where we heard evidence from their health departments, from people involved in this particular industry and from people who had done research in this area.
The terms of reference into this particular report were the use and marketing of e-cigarettes and personal vaporisers and how they may assist people quit smoking, and the health impacts of the use of e-cigarettes and personal vaporisers. This is the area where the majority members of the committee felt that the evidence of health impacts of the use of e-cigarettes and that they cause no harm was not actually there. We accept the fact that they may cause less harm. But that is not a reason to go all-out and ensure that they are sold and marketed, because the evidence is still out. We don't know what the long-term effects are. One of the recommendations in the report says that more research needs to be done and that the research needs to be looked at, perhaps, by members of this committee or other committees every so often to see where it's up to.
One of the other terms of reference was the international approach to legislating and regulating the use of e-cigarettes. We looked at the different jurisdictions around the world, including the UK and New Zealand, and the appropriate regulatory framework for e-cigarettes and personal vaporisers in Australia. In New Zealand we met with the Minister for Health, the select parliamentary New Zealand health committee, the acting high commissioner in New Zealand, the New Zealand Ministry of Health, the technical experts advisory group on electronic cigarettes, and the New Zealand cancer society.
As a reformed smoker myself, I'm extremely wary of experts placed in front of the committee that are sponsored by big tobacco, or of people who, perhaps, receive some form of payment for work done by big tobacco. So I was very dubious of some of the so-called experts that were giving evidence to our committee. My office also received some odd calls during the report process from so-called concerned smokers who certainly had very well-crafted talking points which seemed to be very similar and very well-rehearsed.
The committee does normally work in a coordinated manner, and it did. But this is, I suppose, the first time in my memory—or in my experience here in this House—where the chair has a dissenting report and the deputy chair is presenting the majority report. What I'd really like to note is that one of the things that we on the committee were fairly united on was the TGA—that if, in the future, there is evidence that shows there is no health impact on people, it should go through the TGA. We know that there has already been an application and one that's already been rejected by the TGA, which was an application to allow nicotine use in e-cigarettes. That was in March 2017, I think. There are paragraphs in the report that refer to this. Committee members also noted that the National Health and Medical Research Council concluded in April 2017:
… policy makers should act to minimise the harm of nicotine e-cigarettes until 'evidence of safety, quality and efficacy can be produced'.
That submission to the committee was very hard evidence saying that unless we have more evidence, unless there is more research, we should refrain from changing anything.
This report also gave big tobacco what I think was an absolutely appalling opportunity to influence tobacco policy in Australia. We in this country have prided ourselves on being constantly at the forefront of doing all that we can as governments and agencies to ensure that people have the right information and the tools and assistance to give up tobacco. That is happening at a very fast pace, as we heard the member for North Sydney say earlier. The fact that big tobacco companies were not able to influence, because the committee took very seriously the evidence that we received, but were able to have a voice—to have a platform—is something that we should be wary of. We should ensure that we don't allow them to have a voice, because we've seen the way that they have acted in the past. We've seen the way that they have treated the Australian public for many, many years.
I think the committee said that it wanted to follow the advice of independent experts on nicotine and e-cigarettes. We saw that hard-core smokers in some places could come off nicotine tobacco products and go on to vaping and e-cigarettes. Even though it was less harmful, we still don't have the evidence to show that there is no health impact from e-cigarettes. Until we get that evidence, until science and experts can say that there is no impact on health, we should be very cautious in this area.
I would like to thank the secretariat and my fellow colleagues—the chair, the member for North Sydney—but especially Stephanie Mikac, the secretary; Caitlin Cahill; Timothy Brennan, who accompanied us to New Zealand; Carissa Skinner; and all the other staff members, because I think they do a great, great job in supporting committees. We have seen it firsthand. Mr Deputy Speaker Irons, you were the deputy chair of the Health and Ageing Committee when I was the chair a few years back, and you have seen firsthand the great work that they do. I make the point that without those people supporting and assisting us we wouldn't be able to do these things.