Plain cigarette packaging: A policy analysis of Australia's integrated “whole-of-system” model for smoking cessation
Davies, L and Bell, E, Plain cigarette packaging: A policy analysis of Australia's integrated 'whole-of-system' model for smoking cessation, Health, 4, (12) pp. 1271-1275. ISSN 1949-5005 (2012) [Refereed Article]
Introduction: Plain cigarette packaging as a to- bacco control measure is to be implemented in Australia on December 1st 2012. There is mounting evidence for its likely impact on smokers and potential smokers. Yet Australia’s integrated model of smoking cessation and the particular role and opportunities it has created for primary healthcare have not yet been subject to policy analysis in leading international jour- nals. This policy analysis paper explores these new Australian policy developments and de- bates in ways that identify their international relevance to primary healthcare. Policy analysis: There are 57 studies about plain cigarette pac- kaging published since 2002. Of these, 27 looked at the impact of health warnings. These studies support the introduction of plain pack- aging as a tobacco control measure, by increas- ing the efficacy of health warnings and reducing misconceptions about cigarettes. However, the Australian tobacco control reforms are not li- mited to plain cigarette packaging. They include other evidence-based tobacco control measures as part of its primary health care strategy: for example, increasing tobacco excises, a mass media campaign focusing on high-risk and hard-to-reach groups, and a national summit on smoking in prisons. The Australian government has acknowledged the key role of primary health care in health promotion activities, establishing a network of regional primary health care or- ganisations ("medicare locals") in 2011-2012, and expanding the role of nurses in general practice. These initiatives offer general practice a chance to seize "golden opportunities to in- tervene with smoking patients". Conclusions: Whether the combined impact of the Australian government’s recent tobacco control reforms
and its previous measures will be sufficient to reduce daily smoking prevalence to 10% or less by 2020, only time will tell. What is more certain is that the Australian experience of plain pack- aging offers international colleagues in general practice key lessons about the importance of "whole-of-system" approaches, integrating ef- forts at the local to national levels, to tackle smoking cessation. The achievement of Austra- lia’s political leaders in plain cigarette packaging is an extraordinary testament to political will but there is no room for complacency. Primary heal- thcare sectors must continue to lobby political leaders around the world to tackle smoking at the system level where the motivations and be- liefs about smoking are being shaped, espe- cially among disadvantaged groups with lower health literacy.
tobacco control measures, primary healthcare smoking interventions, smoking cessation