Minister for Health and Aged Care – press conference – 13 September 2023

Read the transcript of Minister Butler's press conference about tobacco control legislation being introduced into Parliament, and aged care.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, everyone. I'm joined today by Professor Tanya Buchanan who is the Chief Executive of Cancer Council Australia and Professor Emily Banks AM from the ANU, one of Australia's foremost authorities on tobacco control. In addition to her role at the ANU, Professor Banks is a member of the NHMRC Council – so the principal body overseeing Health and Medical Research in Australia – and chairs the NHMRC Health Research Impact Committee. I’ll be asking Professor Buchanan and Professor Banks to say a few words later on and take all the difficult questions of detail.

Today, as with every day this year, more than 50 Australian families will lose a loved one to tobacco, in spite of all of the efforts and all of the substantial progress that our country has made in tobacco control over five decades or more. Today, I'm introducing the first suite of major reforms to tobacco control in more than 12 years, since Nicola Roxon introduced her landmark world-leading plain packaging reforms, back in 2011. Twelve years ago, Australia led the world with those reforms in tobacco control. We had to defend substantial legal action by the tobacco industry. But we won all of that litigation and since then, dozens of countries have followed Australia's lead and introduced plain packaging reforms.

But while we lead the world 12 years ago, we now lag because of a decade of inaction. Not an additional reform added to the package of reforms that Nicola Roxon, my predecessor, introduced back those 12 years ago. We’re advised that we are not, as a country, currently on track to meet the targets that are set out in the National Tobacco Strategy for continued reductions in smoking rates over the course of this decade: to get them below 10 per cent by 2025 and to get to 5 per cent or less by the end of the decade in 2030.

The reasons for that are pretty clear, over the course of that decade of inaction, Big Tobacco – the tobacco industry – has adapted to the reforms that were introduced by Nicola Roxon. They've innovated; they’ve been clever and cunning and making their deadly product more appealing to appear more cool, particularly to younger Australians.

This is why we're starting to see a flatlining of those decades-long reductions in tobacco, and most concerningly, we're starting to see an actual increase in the rates of smoking among the youngest Australians – particularly those aged under 25. This package of reforms, which I'll talk about in some detail, is targeted at all of those tactics and all of those innovations that Big Tobacco put in place over the course of the last decade.

They are things like additives and flavours being added to cigarettes. For example, the 'fresh burst' brand of cigarette has a menthol capsule in it, so that as you're smoking a cigarette, you get a burst of minty freshness into your mouth. These sorts of things will be stamped out. The shape and the appearance of cigarettes and the packs have changed substantially over the course of the last decade as industry has tried to make them more visually appealing, particularly to young smokers. Cigarettes like the so-called 'Vogues', which are long slim, bright white cigarettes deliberately designed to look good on an Instagram post – these will be stamped out, as well. And some of the descriptions of brand names of cigarettes that seek – misleadingly – to suggest that these are somehow healthier brands, things like: 'organic', 'smooth', 'light' and all of those innovations, they will be stamped out as well.

We have taken a very much evidence-based approach to this, following a deep review of existing tobacco regulation, but also best practice across the world. We now, as I said, lag the rest of the world and we need to look to others to understand cutting-edge tobacco control regulations. Countries like Canada, countries like New Zealand, have pushed the envelope and responded to those tactics that have been put in place over the last decade by Big Tobacco, the tobacco industry. We've assessed all of those best practice measures, and they are now incorporated into a Bill which has also been the subject of substantial exposure and consultation.

If I can just go through a few of the measures that are included in this Bill. We accepted the advice that we need to update and modernize the health warnings on cigarette packages, in particular. There's clear evidence that the community has become somewhat desensitised to what were shocking warnings, shocking images 12 years ago. So those will be updated. We'll be expanding the advertising prohibitions, with which people will be very familiar, because they've been in place for many years now for cigarettes. But there is a loophole that doesn't cover e-cigarettes or vapes. We'll be expanding those prohibitions as well.

There will, as I said, be prohibitions on additives and flavours that are can't be added to tobacco products to make them more palatable and more attractive. There will be a better regulation of product design features of the type that I've talked about or shape, the appearance of cigarettes and the package will be standardised. What the industry has tried to do is to have a myriad of different appearances of package sizes, filter sizes, stick sizes, to try and make them more appealing. We will be stamping that out as well. We will also be putting, as I've said, in place restrictions on the brand names that industry has started to use. We will be taking up international best practice to require the insertion of health warnings into packs and into pouches.

These will be warnings that physically will be required to be inserted into all packs. We will be introducing mandatory disclosure of sales data from the tobacco industry, as well as sponsorship and advertising activity by the industry, so that we have a very clear line of sight, as government, about what the industry is up to. We will also be following Canada's lead in putting in place so-called dissuasive messages on individual sticks.

Now we have them on the packages as a result of Nicola’s reforms 12 years ago, but we will be proposing to put them on individual sticks, as will be introduced in Canada over the next 12 months. And we'll be consulting and researching more on the precise nature of those messages. And finally, can I say, we'll also be putting in place improved enforcement and compliance arrangements, as well, by adding to the existing criminal penalties regime a civil penalties regime that will – we're confident – encourage and incentivise further compliance as well.

We'll be seeking broad support across the Parliament for these measures. I think the right message to the Australian community will be that the Parliament broadly supports these measures that have been the subject of very, very deep consultation and analysis, as I've said, of international best practice. I hope that the Opposition comes around to supporting these measures.

Obviously, they'll want to go through the Bill in some detail. It's a very large piece of legislation. It is, though, very important that this Bill passes the Parliament well before the 1st of April 2024, because the legislation that was introduced by Nicola Roxon 12 years ago has a sunset clause in it. That means that all of those regulations will sunset – will cease to take effect – on the 1st of April, if they are not replaced by new legislative measures.

As I said, nothing was put in place over the last 10 years, out of the nine years plus of the former Coalition government. It falls to Labor to update and to replace the landmark world leading measures that Nicola Roxon put in place more than a decade ago and which have been so effective over the course of that period of time.


I'm going to ask Tanya and Emily to say a few words, then we'll be happy to take questions on these tobacco measures. And then after that, if people have questions on other matters, I'm happy to take them as well. Thank you.

CANCER COUNCIL AUSTRALIA CEO, PROFESSOR TANYA BUCHANAN: Thank you, Minister Butler. The Cancer Council very much welcomes the legislation that is being presented today. And I'd like to congratulate Minister Butler and his Department. This is a really significant step towards reducing smoking prevalence in Australia. As Minister Butler said, this is legislation that is based on international best practice and evidence and it really is a big step and bringing us closer to getting towards that less than 5 per cent smoking rates by 2030.


More than 250,000 Australians are predicted to die over the next 20 years from smoking-related cancers alone. And this is a really truly unacceptable statistic because smoking-related cancers are entirely preventable. So Parliament really can and must intervene and support this legislation in order to change the course of that trajectory. This is legislation that simplifies, it modernises and it helps to future-proof tobacco control in Australia.

Australia has a very proud legacy of being world leaders in tobacco control, and Minister Butler has indicated he wants to see us as world leaders again. We have seen substantial declines in smoking prevalence rates in Australia. But tobacco does remain our leading cause of preventable ill health and illness and our leading cause of preventable cancers. So, we want to see to Australia take up this legislation, we want to see Parliament support this legislation, and we want to really work hard towards achieving that less than 5 per cent smoking prevalence by 2030. Australia has the evidence, we have the expertise, and we have the experience to achieve that target. Cancer Council strongly supports this legislation, and we encourage all members of parliament to do the same.


TOBACCO CONTROL EXPERT, AUSTRALIAN NATIONAL UNIVERSITY, PROFESSOR EMILY BANKS: Thank you. Everybody in Australia has lost someone, there is no family that is untouched by smoking. I think about my beloved grandmother Liza with such bad emphysema that she was breathless in her final days. I lost my first boyfriend, Patrick, a couple of years ago to lung cancer and my dear friend Anne-Marie left behind three teenage sons when she died of lung cancer. Every Australian family has those stories. We've lost an estimated 500,000 people to smoking-related diseases since the year 2000. And we lose more than 20,000 people a year. The cost of the Australian economy is of the order of $137 billion a year. Smoking is responsible for 50 per cent of deaths in Aboriginal and Torres Strait Islander people aged 45 and over. Almost all people who smoke wish they had never started and up to two thirds will die from their habit.

Now this terrible toll is not caused by a virus or a natural disaster. It is caused by the conscious and deliberate acts of the tobacco industry in addicting people as children and making their products as appealing as possible. We know what we need to do to reduce smoking. And tobacco control is the ultimate team sport. It takes bold leadership and the kind of legislation that is being put forward, tabled today, in Parliament. It needs to be enacted by the Australian community and its representatives, starting with that broad legislation and measures we know work, like price, like bans on advertising, mass media, and smoke-free spaces and support for people. And all of those things work to reduce the uptake of smoking by young people and to improve quitting behaviour.

The legislation that's been tabled today is an absolute game-changer, because it will allow Australia to, once again, get ahead of industry and lead the world in tobacco control. It brings together the legislation across multiple Acts into a single Act and creates enduring laws for some of our most successful measures. It will hold industry accountable by mandating disclosure on sales, pricing. And overall, most importantly, it is evidence-based.

I thank everyone who has contributed to this: the Minister, the public servants who have drafted it, the community who have and do support it, the people who have generated the evidence and all the people who will work to enact it. And to our elected representatives: we know that every day you make history. But some days, more than others. The day you pass this legislation, you will have made a huge difference to the health and wellbeing of people in Australia. You'll be saving lives, 100,000 lives at a time.


I'd like everyone to imagine a world without tobacco, I'm imagining memories of my grandmother having long walks; meeting Patrick at our school reunion next month; meeting Anne-Marie in the park with her grandchildren. I know that, with this legislation, we can make a future that is better than our past. In particular, that future is supported by this new legislation. Thanks.

JOURNALIST: If this passes, the Government that will give retailers and industry time to comply with the new changes. For those that don't, what sort of penalties may we see?

BUTLER: The Bill contains a 12-month transition period to allow a very substantial change, frankly, to the packaging, the size, the look and so on and so forth, of the products as I've outlined. We think 12 months is an appropriate transition period for industry. We've consulted on that. We’ve heard some feedback from industry and we've taken the decision that 12 months is the appropriate time. In addition to that, retailers will also have an additional three months, essentially to phase out existing stock. So that will also take place over the course of the first half of 2025. We think that is the right time. As I said, there are strong compliance measures and penalties contained in the legislation. That's a mix of criminal and civil penalty measures, which we think is appropriate, to calibrate penalties to the sort of level of egregiousness, if you like, of the offence.

JOURNALIST: With the individual warning labels on cigarettes, do you have any idea of what that would say, or what that could look like, and has industry given you much feedback on that concept and how they feel about it?

BUTLER: I'm not particularly aware of the industry feedback, that works through the Department. There are very clear protocols in place, at an international level, which we follow as signatories to the WHO Treaty on Tobacco Control. I don't engage with industry at all, nor should any member of the Parliament on these measures, given the terms of the Treaty to which Australia is a Party. But we will be working very closely and, as I said, market testing those messages that might be included on individual cigarette sticks. There's sort of five or six different messages, I think, that Canada is looking at, like 'poison in every puff' and a range of the sorts of messages that you'll be familiar with having appeared on the front of packages. I'm not sure whether Emily or Tanya have any insights into the evidence behind that, but we think that's an area where some further research is required, and those messages ultimately will be proclaimed through regulation under powers that are contained in the Bill.

BANKS: I can just add to that. Our team has been involved in some of the reviews behind this. And one of the things about having a message on the actual cigarettes itself is it's something that seen most by smokers and those around them repeatedly during the day. So they need to be very punchy, they need to be short, so they fit on the cigarettes. But they're very important in terms of reinforcing the warnings that are already out there in mass media, the warnings that are actually on the packet. And it's another step towards having a really clear reminder about the harms of smoking.

JOURNALIST: And do you think that will also be in early 2025?

BUTLER: That’s right, we will be wanting these measures to be put in place as early as possible. But as I said, our sense is we need to do more market testing on this to make sure we get the precise nature of the message right.

JOURNALIST: You said the smoking rates, or you've observed, smoking rates are going up for under 25. Can you give us an idea of what those figures are?

BUTLER: Tanya, you might want to add to this because this is data from the Cancer Council Victoria, I think, that's very recent. I've talked publicly about the role that we are confident vaping is playing in that really disturbing set of data that shows the only cohort in our community where smoking rates are going up are under 25s. And we know from emerging research, it doesn't take rocket science to conclude this, but vaping is acting as a gateway to cigarettes. People who vape are three times as likely to take up smoking. That's no coincidence. We know that the tobacco industry is behind e-cigarettes and vaping with the clear strategy of recruiting a new generation of nicotine addicts and the tragedy is: it's working.

We're very focused, first of all, on making sure that that cigarettes, in and of themselves, are as unappealing as they possibly can be and contain very clear messages – as Emily said – of the clear harm that are involved in smoking cigarettes. We also need to stamp out vaping. And as you know, we've got a range of measures we're developing with state and territory governments to do that. But we've got to do both. We can't just do one. It's very clear that tobacco industry has a clear strategy to connect these two things as part of their objectives of recruiting that new generation to vaping and then to smoking.

JOURNALIST: On that issue, what work is happening, whether it be research or programs, or department work to help young people quit vaping so that when vapes are banned they don’t turn to smoking? That strikes me as being a real gap there in information or resources for people?

BUTLER: I might ask Emily to add to this, but this is obviously a very major concern of all governments. I think what we're finding right now – I'll come to your question in a second Natassia – but what we're finding right now is that increasingly governments around the world are taking stronger and stronger measures in response to vaping. A week ago, France expressly referenced the announcements that we had made here in Australia and have indicated they will be following our tough measures. Over the last 24 hours, reports indicate that the Sunak Government in the UK has expressly, again, referenced measures that we've announced here in Australia and indicated their intention to follow those tough measures on recreational vaping.

The concern of all governments is the connection between smoking, whether that's because vapes exist as a gateway, or frankly, because we intend to stamp out vapes. That's why in the Budget, we've created a range of measures to provide support and information to the community, including the youngest members of our community, about the dangers of vaping and of cigarettes. There has not been a population wide information campaign funded by the Commonwealth about smoking since 2015. We had I think, around $70 million allocated in the Budget for public information campaigns. That will be a mix of traditional tobacco campaigns that are framed in a modern way, but also targeted campaigns, particularly to young people, about the dangers of vaping as well as smoking. We're talking to Education Ministers about that, school communities and also, obviously, researchers like Emily and others who are researching young people about these issues all the time.

As well, in the Budget we included additional resources to support people in smoking cessation, and people who need support for nicotine addiction. That will include young people, because so many young people are now and are using vapes. We recognise the need to expand those resources, the traditional resources like Quitline, Tackling Indigenous Smoking supports for Indigenous communities – where smoking rates are much higher than the national average – and also finding ways in which particular cessation supports can be put in place for vaping. I might see if Emily has some insights into that.

BANKS: I think governments and communities around the world are terribly concerned about the level of youth vaping. Research has clearly shown that young people who vape are three times as likely to go on to smoke. The issue with cracking down, then, is to make sure that we support those people because nicotine is one of the most, if not the most, addictive substances known. And at the moment, it's an area where industry has moved much more rapidly than our response to it. There are currently bodies working on guidelines about how to help young people to quit vaping. We do know that two-thirds to three-quarters of people who quit smoking, do so unaided. So they actually go cold turkey.

We know that a lot of people who want to quit vaping will be able to do that unaided, but there probably will be some people who will need additional support. I think we also have to recognise that the young people are the victims here. They've actually been had this product aggressively marketed to them and been told it's cool and harmless. We know that lungs are designed to breathe air and that we need to avoid vaping and smoking. We need to make sure that we've got measures in place. It is an area where doctors and researchers are actively working on strategies to support people to quit. Quitline is definitely getting calls from people saying my teenager, or teenagers themselves ringing to say, they need to help to quit vaping. It's absolutely critical that we fill in those gaps.

JOURNALIST: On vaping, stakeholders are saying that your reforms on vapes is doubling down on the policy that doesn't work and has led to the proliferation of vapes on the black market. What is your response to these concerns?

BUTLER: I've seen some of these reports and these are stakeholders with a pretty clear interest often driven by the stores that are selling vapes right now. We put those comments in the perspective of the interests that are behind that. The decision that we've taken to announce the vaping measures that I did in May, were not taken lightly. We listened to the experts. We analysed the research that was there about what is a very clear public health menace to younger Australians in particular, and we took the view that we have a responsibility here to stamp it out.

This is a clear strategy that will unravel all of the hard work of the last 50 years and to recruit a new generation of nicotine addicts. And as I said in some of my earlier remarks, I think governments around the world are recognising that we only have an opportunity now. The best time to start would have been a few years ago. The second-best time to start on this public health menace is right now. Now I know that some, usually with a commercial interest in these matters, have said it's too late and it's gone too far – that we effectively need to raise the white flag on what is a public health menace to younger Australians. That is not the view of this Government. It's not the view of state and territory governments, Liberal and Labor alike, which have indicated a firm determination to work with us closely to ensure we stamp this out.

JOURNALIST: Just another issue, are you concerned at all about the rate of growth in aged care beds given Australia's ageing population?

BUTLER: We had a range of concerns, Jess, as you know, when we came to Government. Concerns that were outlined in the Royal Commission report into Aged Care about the staffing levels in aged care about the quality of care being provided to residents who work so hard to build a community we're lucky to live in right now. We had a comprehensive package of commitments at the election which we're now rolling out, particularly to deal with staffing. As you know, our commitment is to put nurses back into nursing homes and that's still a relatively new measure it only came into effect a little while ago, but it's already substantially lifting the number of those specialist nursing positions in aged care, lifting the wage of aged care workers. Now of course, we have a job of work to do to expand residential aged care and home care, for that matter, as we see the baby boomer generation now start to hit those critical ages where they start to seek homecare support and then a few years later, start to seek residential care support.

Obviously, there are a range of different factors that bear down on decisions about investing in new residential aged care capability, rising interest rates and a range of other things I'm sure are part of that. Anika Wells as our Aged Care Minister is working with stakeholders right now on the sustainability of the industry. That will include the fitness for purpose of current accommodation settings, which take account of interest rates and a range of other things as well. I think this is a complex area. We're looking at it very closely to make sure that we put in place the settings that encourage investment in new aged care capability, including residential aged care capability because the country is definitely going to need it.

JOURNALIST: It’s essentially the providers though that are saying staffing reforms are preventing them from building new places?

BUTLER: I've seen you report that one provider has said that. We're very confident that providers recognise the critical importance of lifting the staffing ratios and also the skills mix in residential aged care. They know that over a long period of time, we have seen an inexorable decline in the presence of registered nurses, in particular, in aged care while we've also seen the frailty and the dependence of the average resident climb. This has been an utter contradiction in the way in which residential aged care has been staffed and we've been determined to fix it and we've been determined to fix it with the support of residential aged care providers. Thanks everyone.

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