Historic day in health, as plain tobacco packs hit the shelves

Finally, 20 years after Cancer Council Australia first recommended plain packaging on the basis of evidence that branded packaging influences smoking take-up, its time has come. From tomorrow, all tobacco retailers in Australia will be required by law to only sell tobacco products in plain packaging.

What a great day for public health.

Some readers will disagree. Not the majority - surveys show most Australians support plain packaging. But having written on this topic before, I expect criticism from sceptics, anti-"nanny state" crusaders and tobacco industry trolls masquerading as both. So let's pre-empt the arguments against plain packaging with some facts.

1) Plain packaging won't work.

Why then have tobacco companies thrown tens of millions of dollars at stopping plain packaging, in the small Australian market alone? Industry marketing reports show that glossy packaging glamorises smoking for young people. The tobacco companies know branded packaging works, and that without addicting younger smokers they are out of business. Simple.

Even more compelling are early reports of smokers saying that the tobacco in plain packs has been changed and tastes worse. It hasn't. Same old poison. More likely, it's the pack stripped of its clever branding and finery that is allowing smokers to finally taste what tobacco is really like.

2) Smokers will buy their tobacco no matter how it's presented.

Perhaps established smokers will - we never claimed otherwise. The aim of plain packaging is to protect young people from seductive packaging. This is where the major health gains are expected. However, from what we're seeing, plain packaging may exceed our expectations as a trigger for discouraging smoking even among established smokers.

3) Sales of fancy cigarette cases will skyrocket.

This theory got a run when graphic pack warnings were introduced in Australia more than six years ago. There was a small spike in the sales of cigarette cases, but it didn't last. Research showed the cases were an aid to quitting - users who were affected enough by the graphic warnings to hide them ultimately quit in significant numbers.

4) Smoking is a free choice.

This line has been trotted out ever since governments began looking at ways to reduce smoking prevalence in the 1970s. People can still choose to smoke, but more than half of Australia's smokers wish they could quit; nine in 10 wish they'd never started. In the days when most of Australia's 2.8 million smokers became addicted, information warning them of the dangers was drowned out by the big-budget marketing machine telling them that smoking was a glamorous activity. A choice is only good if it's an informed choice.

5) Governments would ban smoking if tobacco tax wasn't such a good revenue source.

We need much lower smoking rates before we can feasibly talk about bans. Can you imagine trying to enforce a law that would instantly turn Australia's 2.8 million regular smokers into illegal drug users?

Tobacco excise is often unfairly characterised as a tax grab. The fact is it has been the single most effective government measure for driving down smoking rates in Australia. If a government's job is introducing policies that improve the population's life expectancy and quality of life - and those of us in public health think it is - then tobacco excise has been an outstanding public policy success.

We also know that advertising restrictions have worked in concert with price control to discourage smoking in young people. And that's what plain packaging is - an advertising restriction.

With around one in six Australians smoking, we still have a lot to do in public policy to reduce the death and disease of the nation's number one preventable cancer risk factor.

When smoking eventually becomes so marginalised that it is no longer a population health problem, the era of mass-marketed tobacco use that began early in the 20th century will probably be looked upon as a brief, cultural aberration.

I imagine people will look with curiosity at a time when millions of consumers became addicted to a product that for most did nothing to enhance their lives, drained their wallets, damaged their health and then killed them prematurely.

Those who look for reasons to oppose anti-smoking measures will be on the wrong side of history.

We're writing a new chapter of that history tomorrow, with plain packaging.

This blog also appears on The Punch.