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Home » Chapter 18: Harm Reduction

Chapter 18 Potential for harm reduction in tobacco control

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- Further updates
- Forthcoming updates to Tobacco in Australia: Facts & issues
Foreword
Acknowledgments
Introduction
Chapter 1 Trends in the prevalence of smoking
- 1.1 A brief history of tobacco smoking in Australia
- 1.2 Overview of major Australian data sets
- 1.3 Prevalence of smoking—adults
- 1.4 Prevalence of smoking—young adults
- 1.5 Prevalence of smoking—middle-aged and older adults
- 1.6 Prevalence of smoking—teenagers
- 1.7 Trends in the prevalence of smoking by socio-economic status
- 1.8 Trends in prevalence of smoking by country of birth
- 1.9 Prevalence of tobacco use among Aboriginal peoples and Torres Strait Islanders
- 1.10 Prevalence of smoking in other high-risk sub-groups of the population
- 1.11 Prevalence of smoking among health professionals
- 1.12 Prevalence of use of different types of tobacco product
- 1.13 Smoking by Australian states and territories
Chapter 2 Trends in tobacco consumption
- 2.0 Introduction
- 2.1 Production and trade data as a basis for estimating tobacco consumption
- 2.2 Dutiable tobacco products as an estimate of tobacco consumption
- 2.3 Self-reported measures of tobacco consumption
- 2.4 Expenditure on tobacco products
- 2.5 Industry sales figures as estimates for consumption
- 2.6 Comparisons of quality and results using various estimates of tobacco consumption in Australia
- 2.7 Per capita consumption in Australia compared with other countries
- 2.8 Tobacco consumption not captured in government or industry figures
- 2.9 Estimates of total tobacco consumption in Australia
- 2.10 Factors driving changes in tobacco consumption
Chapter 3 The health effects of active smoking
- 3.0 Introduction
- 3.1 Smoking and cardiovascular disease
- 3.2 Respiratory diseases (excluding lung cancer)
- 3.3 Smoking and cancer
- 3.4 Lung cancer
- 3.5 Other cancers
- 3.6 Reproductive health
- 3.7 Pregnancy and smoking
- 3.8 Child health and maternal smoking before and after birth
- 3.9 Increased susceptibility to infection in smokers
- 3.10 Eye diseases
- 3.11 Dental diseases
- 3.12 Gastro-intestinal diseases
- 3.13 Musculoskeletal conditions
- 3.14 Skin
- 3.15 The impact of smoking on treatment of disease
- 3.16 Smoking and diabetes
- 3.17 Inflammatory conditions and autoimmune disease
- 3.18 Other conditions with possible links to smoking
- 3.19 Smoking and accidents
- 3.20 Nicotine and carbon monoxide poisoning
- 3.21 Health effects for young people who smoke
- 3.22 Poorer quality of life and loss of function
- 3.23 Smoking, dementia and cognition
- 3.24 Genetic influences on tobacco-caused disease
- 3.25 Smoking compared with or in combination with other pollutants
- 3.26 Health effects of brands of tobacco which claim or imply delivery of lower levels of tar, nicotine and carbon monoxide
- 3.27 Health effects of smoking tobacco in other forms
- 3.28 Health 'benefits' of smoking?
- 3.29 Smoking and body weight
- 3.30 Total burden of death and disease attributable to tobacco by disease category
- 3.31 Morbidity and mortality due to tobacco-caused disease and socio-economic disadvantage
- 3.32 Health effects of smoking other substances
- 3.33 Health effects of chewing tobacco, and of other smokeless tobacco products
- 3.34 Public perceptions of tobacco as a drug, and knowledge and beliefs about the health consequences of smoking
- 3.35 Health and other benefits of quitting
- 3.36 The global tobacco pandemic
Chapter 4 The health effects of secondhand smoke
- 4.0 Background
- 4.1 What is secondhand smoke?
- 4.2 What is in secondhand smoke?
- 4.3 Thirdhand smoke
- 4.4 Measuring exposure to secondhand smoke
- 4.5 Prevalence of exposure to SHS in the home
- 4.6 Mechanisms of disease
- 4.7 Estimates of morbidity and mortality attributable to secondhand smoke
- 4.8 Cardiovascular disease and secondhand smoke
- 4.9 Lung cancer and secondhand smoke
- 4.10 Cancers of other sites
- 4.11 Effects of secondhand smoke on the respiratory system in adults
- 4.12 Secondhand smoke and increased risk of infectious disease
- 4.13 Secondhand smoke and type 2 diabetes mellitus
- 4.14 Secondhand smoke and mental health
- 4.15 Oral health
- 4.16 Secondhand smoke and pregnancy
- 4.17 Health effects of secondhand smoke for infants and children
- 4.18 Other health effects
- 4.19 Public attitudes to secondhand smoke
- 4.20 Health effects of secondhand smoke on pets
Chapter 5 Influences on the uptake and prevention of smoking
- 5.0 Introduction
- 5.1 Stages in the uptake of smoking
- 5.2 Factors influencing uptake by young people overview
- 5.3 Early biological factors
- 5.4 Adolescence and brain maturation
- 5.5 Temperament, mental health problems and self-concept
- 5.6 Intentions, attitudes and beliefs
- 5.7 The home environment
- 5.8 The smoking behaviour of peers, and peer attitudes and norms
- 5.9 The educational environment
- 5.10 Cultural background
- 5.11 Accessibility of tobacco products to young smokers
- 5.12 Affordability of tobacco products
- 5.13 Products and packaging created to appeal to new users
- 5.14 Smokefree policies
- 5.15 Tobacco advertising and promotion targeted at young people
- 5.16 Smoking in movies, TV and other popular culture media
- 5.17 Factors influencing uptake of smoking later in life
- 5.18 Uptake: a concluding note
- 5.19 Prevention: an introductory note
- 5.20 Approaches to youth smoking prevention
- 5.21 Reducing tobacco access and supply
- 5.22 Taxation and pricing of tobacco products
- 5.23 Reducing product appeal
- 5.24 The profound effects of the denormalisation of smoking
- 5.25 Media campaigns and young people
- 5.26 Appropriate responses to the problem of smoking and movies
- 5.27 Parent family home targeted interventions
- 5.28 Peer-based approaches
- 5.29 School-based interventions
- 5.30 Harnessing predictors of uptake to prevent smoking
- 5.31 Other drug use
Chapter 6 Addiction
- 6.0 Introduction
- 6.1 Defining nicotine as a drug of addiction
- 6.2 Pharmacokinetics
- 6.3 Mechanism of action
- 6.4 Pharmacological effects
- 6.5 Mood effects
- 6.6 Cognitive effects
- 6.7 Clinical populations
- 6.8 Interactions between tobacco smoke and medications
- 6.9 Predictors of nicotine dependence
- 6.10 Acute effects of nicotine on the body
- 6.11 Tolerance, dependence and withdrawal
- 6.12 Measures of tobacco dependence
- 6.13 Addiction and the adolescent smoker
- 6.14 Smokers’ attitudes to and beliefs about addiction
Chapter 7 Smoking cessation
- 7.0 Introduction
- 7.1 Health and other benefits of quitting
- 7.2 Quitting activity
- 7.3 Theories about smoking and quitting
- 7.4 What finally prompts smokers to attempt to quit?
- 7.5 What we know about how smokers are persuaded to attempt to quit
- 7.6 How smokers go about quitting
- 7.7 Environmental and biopsychosocial factors that influence quitting
- 7.8 How can relapse be prevented?
- 7.9 Increasing smoking cessation at the population level
- 7.10 Role of health professionals and social services
- 7.11 Smoking cessation and pregnancy
- 7.12 Cessation interventions for people with serious health conditions
- 7.13 Cessation assistance: printed self-help materials
- 7.14 Cessation assistance: telephone- and internet-based interventions
- 7.15 Individual and group-based cessation assistance
- 7.16 Pharmacotherapies for smoking cessation
- 7.17 Contingency management/incentives
- 7.18 Alternative therapies and emerging treatments
- 7.19 Interventions tailored for age and/or gender
- 7.20 National policy and progress in encouraging and supporting cessation
Chapter 8 Tobacco use among Aboriginal and Torres Strait Islander peoples
- 8.0 Introductory note
- 8.1 Aboriginal and Torres Strait Islander peoples: social disadvantage, health and smoking—an overview
- 8.2 History of tobacco use among Aboriginal and Torres Strait Islander peoples
- 8.3 Prevalence of tobacco use among Aboriginal and Torres Strait Islander peoples
- 8.4 Smoking among Aboriginal and Torres Strait Islander children and teenagers
- 8.5 Types of tobacco used by and levels of consumption among Aboriginal and Torres Strait Islander peoples
- 8.6 Smoking cessation and Aboriginal and Torres Strait Islander peoples
- 8.7 Morbidity and mortality caused by smoking among Aboriginal and Torres Strait Islander peoples
- 8.8 Economic issues relating to tobacco use among Aboriginal and Torres Straits Islander peoples
- 8.9 Attitudes to and beliefs about smoking among Aboriginal and Torres Strait Islander peoples
- 8.10 Tobacco action initiatives targeting Aboriginal and Torres Straits Islander peoples
- 8.11 The relationship between tobacco and other drug use in Aboriginal and Torres Strait Islander communities
- 8.12 The tobacco industry and Indigenous communities
- 8.13 Policies for advancing tobacco control programs among Aboriginal and Torres Strait Islander peoples
- 8.14 The effectiveness of population-level tobacco control strategies
- 8.15 The role of health workers and community organisations
Chapter 9 Smoking and social disadvantage
- 9.0 Introduction
- 9.1 Smoking prevalence and exposure to secondhand smoke among priority populations in Australia
- 9.2 Trends over time in smoking among priority populations in Australia
- 9.3 Contribution of smoking to health inequality
- 9.4 The relationship between tobacco smoking and financial stress
- 9.5 Smoking and intergenerational poverty
- 9.6 Tailored and targeted interventions for low socioeconomic groups
- 9.7 Explanations of socio-economic disparities in smoking
- 9.8 Are current strategies to discourage smoking in Australia inequitable?
- 9.9 Are there inequalities in access to and use of treatment for dependence on tobacco-delivered nicotine?
- InDepth 9A Addressing smoking in highly disadvantaged and other priority groups
Chapter 10 The tobacco industry in Australian society
- 10.0 Introduction
- 10.1 The tobacco growing industry
- 10.2 The global tobacco manufacturing industry
- 10.3 The manufacturing and wholesaling industry in Australia - major international companies
- 10.4 Other importers operating in the Australian market
- 10.5 Retailing of tobacco products in Australia
- 10.6 Retail value and volume of the Australian tobacco market
- 10.7 Market share and brand share in Australia
- 10.8 Trends in products and packaging
- 10.9 Brand portfolio strategies in the Australia market
- 10.10 The tobacco industry exposed: tobacco industry document repositories
- 10.11 Corporate responsibility and the birth of good corporate citizenship
- 10.12 The tobacco industry's revised stance on health issues
- 10.13 Industry efforts to discourage smoking
- 10.14 Ethical issues related to tobacco farming and production
- 10.15 The environmental impact of tobacco production
- 10.16 The environmental impact of tobacco use
- 10.17 Public attitudes to the tobacco industry
- 10.18 The investment of public funds in tobacco - the case for divestment
- 10.19 The future of the tobacco industry
- In Depth 10A-Strategies-for-influence
  - 10A.1 Strategies for influence - Overview
  - 10A.2 The arguments
  - 10A.3 Mechanisms of influence—Industry-funded research
  - 10A.4 Mechanisms of influence—undermining public health organisations
  - 10A.5 Mechanisms of influence—mobilising support from the industry and those with shared aims
  - 10A.6 Mechanisms of influence—media relations
  - 10A.7 Mechanisms of influence—political lobbying
  - 10A.8 Mechanisms of influence—participation in regulatory review processes
  - 10A.9 Mechanisms of influence—litigation
Chapter 11 Tobacco advertising and promotion
- 11.0 Background
- 11.1 The merits of banning tobacco advertising
- 11.2 Tobacco industry expenditure on advertising
- 11.3 Commonwealth (national) legislation
- 11.4 State and territory legislation
- 11.5 Tobacco advertising legislation violations
- 11.6 Marketing of tobacco in the age of advertising bans
- 11.7 Promotional events
- 11.8 Trade promotions
- 11.9 Retail promotion and access
- 11.10 Smoking in movies as promotion
- 11.11 Internet promotion
- InDepth 11A: Packaging as promotion: Evidence for and effects of plain packaging
- InDepth 11B: Licensing of tobacco sellers
- Attachment 11.1 TAP Act report to parliament
Chapter 12 Tobacco products
- 12.0 Introduction
- 12.1 Tobacco in cigarettes
- 12.2 Other types of tobacco products
- 12.3 Chemicals and contaminants in tobacco products
- 12.4 Emissions from tobacco products
- 12.5 Measuring emissions and exposure to tobacco products
- 12.6 Additives and flavourings in tobacco products
- 12.7 Menthol
- 12.8 Construction of cigarettes and cigarette filters
- 12.9 Labelling of tobacco products in Australia
- Attachment 12.1 Health warnings
- Attachment 12.2 Reduced fire risk (RFR) cigarettes
Chapter 13 The pricing and taxation of tobacco products in Australia
- 13.0 Introduction
- 13.1 Price elasticity of demand for tobacco products
- 13.2 Tobacco taxes in Australia
- 13.3 The price of tobacco products in Australia
- 13.4 The affordability of tobacco products
- 13.5 Impact of price increases on tobacco consumption in Australia
- 13.6 Revenue from tobacco taxes in Australia
- 13.7 Avoidance and evasion of taxes on tobacco products
- 13.8 What is the 'right' level of tobacco taxation
- 13.9 Future directions for reform of tobacco taxes
- 13.10 Arguments against tax increases promoted by the tobacco industry
- 13.11 Are tobacco taxes regressive?
- 13.12 Public opinion about tobacco tax increases
Chapter 14 Social marketing and public education campaigns
- 14.0 Introduction
- 14.1 Mass media public education campaigns: an overview
- 14.2 The role of mass media campaigns within a comprehensive smoking control program
- 14.3 Public education campaigns to discourage smoking: the Australian experience
- 14.4 Examining the effectiveness of public education campaigns
- 14.5 Targeting of public education campaigns and different types of media channels
- 14.6 News media coverage
- Appendix 1 National, State and Territory Contacts
Chapter 15 Smokefree environments
- 15.0 Introduction
- 15.1 Why implement smokefree environments?
- 15.2 Public opinion about smokefree environments
- 15.3 Opposition to and weakening of smokefree environment
- 15.4 Smoking bans in key public areas and environments
- 15.5 Smoking bans in outdoor areas
- 15.6 Smoking bans in the home and car
- 15.7 Legislation to ban smoking in public spaces
- 15.8 Immediate impact of smokefree legislation in improving air quality
- 15.9 Effectiveness of smokefree legislation in reducing exposure to tobacco toxins, improving health, and changing smoking behaviours
Chapter 16 Tobacco litigation in Australia
- 16.0 Introduction
- 16.1Personal injury claims against the tobacco industry
- 16.2 Litigation brought by Australian consumer and regulatory groups against the tobacco industry
- 16.3 Litigation relating to injury from exposure to second-hand smoke
- 16.4 Criminal cases against the tobacco industry
- 16.5 Legal cases initiated by tobacco industry
- Attachment 16.1 McCabe
- Attachment 16.2 Australian cases
Chapter 17 The economics of tobacco control
- 17.0 Introduction
- 17.1 Economic terminology and methods
- 17.2 The costs and benefits of smoking to the Australian economy
- 17.3 The economic rationale for intervention in the tobacco market
- 17.4 Economic evaluations of tobacco control interventions
- 17.5 Impact of tobacco control strategies on the Australian economy
- 17.6 Optimal investment in tobacco control
Chapter 18 Potential for harm reduction in tobacco control
- 18.0 Introduction
- 18.1 Assessing the harmfulness
- 18.2 Regulation
- 18.3 Smoking reduction
- 18.4 Reducing the nicotine content of cigarettes
- 18.5 Chemoprevention
- 18.6 Screening
- InDepth 18A: Smokeless tobacco
- InDepth 18B: E-cigarettes
- InDepth 18C: Heated tobacco (‘heat-not-burn’) products
Chapter 19 The WHO Framework Convention on Tobacco Control
- 19.0 Background to the WHO Framework Convention on Tobacco Control
- 19.1 WHO FCTC Governance Framework
- 19.2 Implications of the WHO FCTC for Australia
- 19.3 WHO FCTC guiding principles and general obligations
- 19.4 Obligations relating to demand reduction for tobacco products
- 19.5 Obligations relating to supply-reduction for tobacco products
- 19.6 Other substantive obligations
- 19.7 Obligations regarding international cooperation and exchange of information and resources
- 19.8 Enforcement of the WHO FCTC
- 19.9 Impact of the WHO FCTC and role in the context of global governance
- 19.10 WHO FCTC in a domestic context: Case study example of Australia’s Tobacco Plain Packaging
Appendix 1 Useful weblinks to tobacco resources
- A1.1 International data repositories
- A1.2 Australian data repositories
- A1.3 International tobacco control strategies
- A1.4 Australian tobacco control strategies and documentation
- A1.5 Major reviews on smoking and health
- A1.6 History of tobacco in Australia
- A1.7 Current Australian legislation
- A1.8 Smoking cessation
- A1.9 Smoking and Aboriginal and Torres Strait Islander peoples
- A1.10 Economic costs of tobacco
- A1.11 Tobacco industry document repositories
- A1.12 Some key peer-review journals
- A1.13 Current international legislation
- A1.14 Policy implementation resources
- A1.15 Understanding the tobacco industry
- A1.16 Public perceptions of tobacco as a drug, and public opinion regarding tobacco control policies

See also our 'InDepth' discussions of:

E-cigarettes
Heated tobacco ('heat-not-burn') products
Smokeless tobacco
Tobacco industry—Strategies for influence
Evidence for and effects of plain packaging
Health warnings
Licensing of tobacco sellers

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