Leading the world in tobacco control

Professor Melanie Wakefield - Leading the world in tobacco control

Smoking is the leading cause of preventable death and disease in Australia, with two in three long-term Australian smokers dying prematurely. Smoking causes many types of cancer, heart disease and stroke, chest and lung illnesses and stomach ulcers. It claims the lives of 15,500 Australians every year, yet frustratingly, the devastating harm caused by tobacco smoking is preventable.

Professor Melanie Wakefield is the Director of Cancer Council Victoria’s Centre for Behavioural Research in Cancer and an NHMRC Principal Research Fellow. She has made it her life’s work to understand how we can change behaviours to reduce cancer risk, particularly as this relates to smoking.

At the time Professor Wakefield started work at Cancer Council in 2001, 22% of the Australian population were still regular smokers and the Government’s hard hitting “Every cigarette is doing you damage” campaign, which Cancer Council and other organisations had contributed to, had hit the airwaves. Whilst it appeared to be having an effect, there was limited evidence about how long campaigns like this should last and what kinds of messages worked best.

Professor Wakefield established a rigorous research program to measure, evaluate and refine anti-smoking campaigns being run across the country. Her research demonstrated that greater investment in mass media campaigns led to more reduction in smoking rates, and that hard-hitting messages about the serious harms of smoking worked best, including among young people. As well, she found mass media campaigns contributed to significant change in how smoking was perceived by the community.

Cancer Council worked to translate this research finding into real world practice, first by advocating for and achieving continued government investment in campaigns, and second, by being amongst a chorus of health groups strongly urging the Government to place graphic images of smoking health outcomes on every pack of cigarettes sold in Australia. These initiatives had two important outcomes. Firstly, people were compelled to acknowledge the damage they were doing to themselves and secondly, the social pressure to quit smoking increased. Smoking rates dropped significantly.

Professor Wakefield continued to undertake research examining the influences on smoking behaviours. Her research results showed the messages people were receiving from mass media campaigns was only one piece of the puzzle and that the design of the cigarette pack itself was highly attractive and potentially distracting smokers from the graphic health warnings.

The Australian Government’s Preventative Health Taskforce, established in 2008, recommended legislating to introduce plain packaging. Cancer Council and its partners, such as the Heart Foundation of Australia, were relentless in promoting the research, some of it going back 20 years, which showed plain packaging would significantly lessen the appeal of such sleek packaging and reduce distraction from the health warnings. Finally, plain packaging was passed into law with no opposition, with Australia becoming the first country globally to do so.

Professor Wakefield led a major independent evaluation, published in the British Medical Journal’s specialist journal Tobacco Control, which showed that plain packaging was working exactly as intended by reducing appeal and increasing health warning effectiveness – and even exceeded expectations in helping some smokers to quit. Professor Wakefield’s rigorous research has also shown the importance of increases in tobacco tax in driving down smoking rates.

Collectively, our research-based achievements in policy reform have led to a halving of smoking rates in Australia over the past 25 years. Today, the Australian smoking rate has dropped to 14% and the rates of young people taking up smoking are at a historic low. The world has taken notice of Australian leadership, with a rapidly growing number of countries introducing their own plain packaging legislation. Despite this, Professor Wakefield and the Cancer Council team are keenly aware that their work is not done whilst smoking continues to cause such a devastating impact on the Australian and global community. With the support of government and the public, they will continue to further investigate and evaluate policies and communication strategies to reduce smoking related harm.