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Can a law create a smoke-free generation?

By Rachel McDonald, the Australian Science Media Centre

Creating a generation of people who never smoke through an age-based ban could prevent 1.2 million deaths from lung cancer globally, according to international researchers.

In a simulation study, the team used historical data on 82 countries including Australia and New Zealand to model the impact of banning the purchase of cigarettes and other tobacco products among people born between 2006 and 2010. The researchers calculated a policy like this could prevent almost half (45.8%) of future lung cancer deaths in men, and around a third (30.9%) in women in 185 countries by 2095.

Similar ‘Smoke-free generation’ laws are being considered in various countries including Australia, with South Australia’s upper house passing legislation last week that would see the sale of cigarettes and vapes permanently banned for anyone born in 2007 or later.

New Zealand passed similar legislation in 2022, however, the law was later scrapped.

Professor Richard Edwards from the University of Otago, a co-author of the research, told the NZ SMC that the lives spared as a result of a ban like this would likely make up about a third of the 3 million lung cancer deaths expected over the period studied.

“The findings, for just one of the many adverse health impacts of using tobacco products, illustrate the enormous potential reduction in deaths and suffering that could be achieved by preventing uptake of smoking, and demonstrates the importance of introducing robust measures to fully protect young people from the risk of becoming addicted to tobacco products,” Prof Edwards said.

Associate Professor Frank Doyle from RCSI University in Ireland said because the paper focused specifically on lung cancer deaths, it likely underestimates the benefits of a smoke-free generation.

“We know that smoking causes lots of other cancers, cardiovascular disease, respiratory diseases, and so on. So, the impact on any such smoking ban for younger people would be even more profound, with many more lives saved over time,” A/Prof Doyle told the SMC Ireland .

However, he said the paper worked on the assumption that a ban would be “perfectly enforced”.

“We know that this is not realistic. In fact, other research is showing that while the prevalence of smoking overall has decreased over time, the rates of smoking are actually increasing in more marginalised groups. There is also always a black market for cigarettes and other substances, so it is unclear how any such ban could be perfectly implemented,” he said.

Josep Maria Suelves from the Public Health Agency of Catalonia told the Spanish SMC that creating a smoke-free generation would need to come from more than just a ban, but it was a goal worth chasing.

“Envisioning a new stage in public health policies to reach the first tobacco-free generations - known as the End Game- is not a pipe dream, nor can it rely solely on the effectiveness of a ban on tobacco sales to those born after a certain date,” he said.

“It requires continuing to promote other measures of proven effectiveness, such as increasing the price of tobacco products, the introduction of neutral packaging, the extension of places where smoking is prohibited, or the regulation of new tobacco and nicotine products with which the tobacco multinationals seek to attract new addicts in adolescence.”

Professor Edwards said South Australia and other jurisdictions considering policies like these were “prioritising the health of future generations” and his research showed NZ’s scrapped policy could have made a difference.

“By repealing this policy which would have prevented the sale of tobacco products to young people born after January 1 2009, the New Zealand Government went backwards on protecting young people from addiction to tobacco products and devastating future health impacts like lung cancer,” he said.

You can find the research here, the SMC NZ Expert Reaction here and the SMC Spain reaction here.

This article originally appeared in Science Deadline, a weekly newsletter from the AusSMC. You are free to republish this story, in full, with appropriate credit.

Contact: Rachel McDonald

Phone: +61 8 7120 8666

Email: info@smc.org.au

Published on: 04 Oct 2024