The great debate: cigarette packaging

The tobacco industry is powerful all around the world and Australia is no exception. It is a strong pillar of most governments' tax revenue, and in certain countries or provinces, governments' budgets are critically dependent on tobacco taxes.

So on the one hand, governments across the globe are charged with the task of overseeing the healthy development of the industry while on the other it is charged with the task of limiting the industry's growth due to health-related repercussions.

However, earlier this week, Australia's High Court backed a new government law on mandatory packaging for cigarettes that removes brand, colours and logos from packaging - a massive blow to the Australian cigarette industry.

The law requires cigarettes to be sold in olive green packets, with graphic images warning of the consequences of smoking and minimum branding displayed.

Leading global tobacco manufacturers, including British American Tobacco and Philip Morris, had challenged the law.

The new packaging rules are scheduled to be implemented from 1 December 2012.

Authorities have said that plain packaging of cigarettes will help reduce the number of smokers in the country. However, tobacco manufacturers have argued that removing their brand names and company colours from packets will lead to a drastic cut in profits, adding that "it may result in fake products entering the market".

Approximately, 650,000 EU citizens die from smoking which is almost double the population of Malta, while some two million people become sick through smoke-related diseases.

When contacted by MaltaToday about his views over the outcome of the case and how the cigarette industry would be effected if the EU implemented similar tough measures, Charles Saliba, general manager, British American Tobacco Ltd (Malta),  the world's second largest quoted tobacco group selling brands such as Dunhill, Kent, Lucky Strike, Pall Mall, and Vogue, said that the Australian plain packaging case only refers to Australia's legislation, far more different than Europe's legislation, so the outcome shouldn't effect or have an influence on the EU.

According to Saliba, through this law, "only organised crime groups will benefit which sell illegal tobacco on our streets which in turn would fuel the illegal sales of drugs and weapons", adding that "regardless what the package states, people would still smoke".

"We are convinced that plain packaging would only exacerbate an already significant illicit tobacco trafficking problem, and would have other significant adverse unintended consequences including driving down prices which would lead to increased smoking while reducing government tax revenue.

"Through this law, although official quoted figures would seem as if smoking would be on the decrease, the increase in counterfeit cigarette smoking would be on the increase.

"We remain convinced that the Tobacco Plain Packaging Act is not only a bad piece of law, but that it is one that will have many unintended consequences for years to come.

"It is important to remember that the scope of the High Court proceedings was tightly focused on addressing whether plain packaging legislation is contrary to a very specific point in the Australian Constitution. As such, today's decision only concerns Australian constitutional law."

On 24 May 2011 Cancer Council Australia released a review of the evidence supporting the introduction of plain packaging to reduce youth uptake. The review had been conducted by Quit Victoria and Cancer Council Victoria. The review included 24 peer-reviewed studies conducted over two decades, suggesting that packaging plays an important role in encouraging young people to try cigarettes.

The official website of British American Tabacco, states, "we fully support any form of evidence-based regulation but there is no proof to suggest plain packaging of tobacco products will be effective in discouraging youth initiation or encouraging cessation by existing smokers".

According to Saliba, counterfeiters "already do a 'good' job when it comes to counterfeit packaging and this is all counterfeiters were waiting for to have a field day.

Cigarette manufacturers in Australia have claimed that the law is unconstitutional and infringes on their intellectual property rights by banning the use of brands and trademarks.

Saliba says that "if our property (trademarks) would be 'stolen' from us the industry would lose out big time".

As of this month, Norway is believed to be considering plain packaging.

So what is Malta's stand?

Dr Ray Busuttil, Superintendent, Public Health, said that "as signatory to the Convention, Malta follows the directives and recommendations from the FCTC (Framework Convention on Tobacco Control within the WHO and other recommendations from the EU. Malta would support any initiative that will discourage people from smoking.

"In principle Malta is not against such measures. Currently discussions are under way in the EU with a view to reviewing the Tobacco Product directives which will undoubtedly be more restrictive than at present. We would support initiatives that will address our national public health needs."

When asked if he thought people will still smoke regardless of the packaging, Busuttil said that "pictorial images and warnings are gentle reminders about the damage smoking can do to smokers.

"They are instrumental in triggering cessation at the right behavioural stage when the smokers are ready to make positive behavioural changes related to smoking.

"Unfortunately some smokers would not be ready to quit until the smoking- related disease or illness hits home which can too late in the day."

As governments across the globe are charged with the task of overseeing the healthy development of the industry while on the other it is charged with the task of limiting the industry's growth due to health-related repercussions,

Striking the right balance could be quite a task but according to Busuttil safeguarding the health of citizens comes first.

"Any measures the ministry felt necessary were implemented. This was usually done following consultation with the tobacco industry. Despite the fact that they were understandably not always in favour of such measures, the health authorities stood their ground in line with its duty and responsibility to protect public health.

"One must remember that apart from the health impact, smoking has also a social and economic impact on both the smokers themselves as well as society at large."

Meanwhile, when contacted by MaltaToday and asked if she had seen an increase of smokers resorting to counselling provided by the government since the launch of the smoking cessation programmes, Anne Buttigieg, a smoking cessation practitioner (NCSCT UK) from the Health Promotion and Disease Prevention Directorate, said that "whenever we advertise through the media we always register an increase in calls through our quit line free phone and applications for smoking cessation programmes.

"Following local research on the long-term success rate of patient smokers attending our cessation programmes carried out in 2011, it resulted that overall 38% of smokers have managed to quit during the course," she added.

Buttigieg said that "ultimately, any anti-tobacco initiative and decision that needs to be taken is welcomed and most often necessary. Ultimately, the need to encourage smokers to quit and discouraging of new smokers from starting is a public health priority as smoking is neither healthy nor appealing".

Today's smokers

According to Buttigieg, "latest research (HIS) has shown that 20.4% of the population are daily smokers and 5.5% are occasional smokers. Although there was a decrease in the percentage of regular smokers, overall there were no marked differences in the total number of smokers between 2002 and 2008. There was a shift in the number of smokers that moved from daily to occasional smokers.

"According to the European Health Interview Survey of 2008 (EHIS) in all age groups the daily percentage of male smokers is higher than that of females. However, the number of female daily smokers is increasing as more females are taking up smoking daily.

"According to the Health Behaviour in School Children (HBSC), there was also an increase in the number of girls smoking between the ages of 11 and 15 who admitted to smoking once a week, so the gap is expected to continue narrowing. In fact we are addressing this issue and this year we specifically had a campaign that targeted women smokers."

Mortality rate

Buttigieg says that in 2010 there were 366 deaths related to smoking locally: meaning that in Malta one person from every eight deaths dies as a result of smoking, a death that could have been avoided.

New packaging law at a glance

Australia's new tough packaging laws are the first of their kind to be implemented in the world.

However, many other countries such as New Zealand, India, the UK and even some states in the US have been contemplating taking similar measures in a bid to reduce the number of smokers.

Whilst Australia might be a relatively small cigarette market, tobacco companies know that losing here could lead to a deluge of legislation elsewhere in their really big markets.

As a result, the case between the government and the cigarette makers was being watched closely all across the globe.

Therefore, the ruling was likely to give a boost to other countries looking to take similar steps.

The World Health Organisation, alongside other worldwide anti-smoking lobby groups, has applauded Australia's law on plain packaging noting that "the legislation sets a new global standard for the control of a product that accounts for nearly 6 million deaths each year". [35]