Minister for Health and Aged Care - press conference - 28 February 2024

Read the transcript from Minister Butler's press conference on vaping, private health insurance, tobacco and the Community Pharmacy Agreement.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks for coming out this morning. I'm joined today by Zahlia and Shyla Short, who I'll introduce a little later and their mum Rakesh. They have travelled from the Illawarra, where they live and I'll talk a bit about what they do and their social media profile and the influencer campaign they're going to be a part of. But let me just say, by way of introduction, this Government views vaping as a very serious public health menace.
Vaping or e-cigarettes were sold to our community and communities right around the world as a therapeutic good that would be a really useful tool for hardened smokers, usually middle aged and older Australians who have been smoking for decades, but were finding it really difficult to kick that habit. We now know, after a few years of this health experiment though, that vaping is something very different. This is a deliberate and cynical exercise by the Big Tobacco industry to recruit a new generation to nicotine addiction. You just have to look at some of these products to recognise that these are deliberately targeted at young people. A blueberry raspberry bubble gum flavoured vape - that's just one of the many, many vape flavours here. That just demonstrates that this is a product targeted at kids and very young Australians.
We also know that now 9 out of 10 vape stores around Australia are located within walking distance of schools. And this is no accident. This is because those vape stores know that their target market is our school children, and very young Australians. That's why school communities and parents are up in arms. Week after week, month after month, plans for new vape stores to be opened down the road from their schools. And tragically, this objective of Big Tobacco is working in Australia and in countries right around the world. We know that around 1 in 6 high school students are regular vapers. And around 1 in 4 very young Australian adults. Increasingly we're hearing about this becoming an issue not just in high schools, but in primary schools, as well. School communities, principals, school boards now report this as the number one behavioural issue in their schools.
Vaping also is a serious health risk, in and of itself. These vapes contain about 200 chemicals. Chemicals that are used for weed killer. Chemicals that are used to de-ice airport runways. Chemicals that are used for nail polish remover. And we learned this week, chemicals that are used to embalm dead bodies in funeral parlours. These are dangerous, dangerous chemicals that young people are ingesting into their lungs. Almost every week, we receive new research that demonstrates the health damage that is being done to young Australians from these products. This week, we heard from the Australian Dental Association, about an alarming rise in the incidence of “black gum disease” among 12 to 15 year olds. A rise that they put down, very clearly, to the prevalence of vaping in high school communities. We also know that the serious nicotine addiction which is flowing from these products is impacting learning behaviours and mental health of young Australians as well.
Most importantly, perhaps, though, we also know that vapers are three times more likely to take up cigarette smoking, and all of the health risks that for decades we've known are associated with smoking. Tragically, the only cohort in our community where cigarette smoking is on the rise is the youngest members of our community. We must always bear in mind that at the end of the day, that was the objective of Big Tobacco. The broader community and governments right across the world were deceived by Big Tobacco - have no illusions about that.
But the purpose of today's launch is to recognise that young Australians themselves are being overwhelmed with misleading messages and false information every single day from Big Tobacco. Messages that “this is cool”. Messages that “this is the healthy alternative for young people”. I'm advised that TikTok has 18 billion posts with the hashtag #vape. Posts that are deliberately designed to promote vaping. I'm advised that Instagram has 18,000 vaping influencers who are there promoting messages in support of vaping behaviour. And we need to fight back on this. We have an obligation as government to get better information out to young Australians about the health risks associated with this behaviour and these products.
And that's why today I'm launching an influencer-led youth vaping campaign targeted particularly at 14 to 20 year olds. This is a new approach for Government information campaigns, which as all of you know, have traditionally been run through traditional media, like television, newspapers, and the like. We know though, we've got to use the media that young people are using, and increasingly that is TikTok, Youtube and Instagram. We are partnering, for the first time, directly with social media influencers: people who young people are listening to, people who are communicating every single day through these channels with young Australians, people who are keen and determined to put those better messages, that better information out to young Australians, so they can learn the truth about the risks associated with these products.
And I'm delighted that two of those influencers are joining us here today, Zahlia and Shyla Short, two sisters from the Illawarra. They're here with their mum, Rakesh. Zahlia and Shyla are two highly successful junior surfers who have an extraordinary surfing career ahead of them. But they're not here to surf. They're also here because they have really strong social media profiles. And they are two of a number of influencers that have been selected, through a PR agency process, to partner with the Australian Government, to get those new messages out there, that better information to young Australians: that this is a risk to their health, in and of itself, it is a risk to their health. So I'm delighted to hand over to Zahlia, who's going to talk a bit about her profile, the reasons why she's decided to partner with the Australian Government, then I'm happy to take questions about this or any other matters. So thank you, Zahlia.
JUNIOR PROFESSIONAL SURFER & SOCIAL MEDIA INFLUENCER, ZAHLIA SHORT: Thank you, Minister. Thank you for having us. We are so excited to be a part of something that we're so passionate about. We've experienced this through a family member, our community, and we want to lend a voice and be of help to raise awareness to the risks of vaping.
JOURNALIST: So how much will it cost to hire these influencers and what makes you think this will be good bang for buck for taxpayers?
BUTLER: We announced in the Budget last year that that we would spend $63 million on a strong tobacco and vaping campaign, the first investment in public health information in this area for many, many years. Around $11 million of that will be dedicated to a youth vaping campaign. And this is the first phase of that. We're partnering with Spotify, we're partnering with Year13, those partnerships are already rolling out. And there is in total $250,000 allocated to partnerships with a number of influencers - Zahlia and Shyla are just two of them - but a number of influencers. These influencers have been selected by a PR agency on the basis of their reach. We've been keen to make sure we have a diversity of influencers. We've got healthy sporting identities like the Short Sisters and others in the in the sporting field. We've got influencers who appeal to a gaming audience. We've got young comedy influencers as well. All of this will be published in the usual way, in the same way we publish details when we advertise through your organisations. But this, we are confident, is a very good investment by the Commonwealth. We've got to get better information out to young people. And if we're going to get better information out to young people, we've got to use the media that they are reading and listening to. We know we are behind the eight ball already. As I said: 18,000 influencers on Instagram who are supported by Big Tobacco to promote pro-vaping messages. 18 billion posts already out there on TikTok, promoting vaping. We can't just leave that field vacant. We've got to get on the playing field, we've got to fight back. And partnering with young Australians like Zahlia and Shyla, who have credibility with the audience we're trying to reach, is the best way that the Commonwealth can exercise its obligation, which is to get good information out to young people.
JOURNALIST: Can I just quickly ask about health insurance. I just want to ask how much you expect health insurance premiums to go up by, and when you're going to make that decision.
BUTLER: I'm going through a proper process and I've gone back to the industry and indicated my expectation they sharpen their pencil. This has always been a process where government should have consumers at the front of their mind. We're going through a very difficult cost of living crisis that swept the world over the last couple of years. And I'm not going to do a tick and flick that simply approves the first claims that are put to the insurance industry. Now, I saw your paper’s story this morning, Sarah. And I'd say with respect, that if there's a “row” about this, it's a “row” between the Australian newspaper and the private health insurance industry - which has come out this morning and said that your story was a beat up, that it was a complete fiction.
It is not unusual at all for these decisions to be made in the last week of February or the first weeks of March. In the Howard Government, that was the custom: the last week of February or the first two weeks of March were the customary times for these decisions to be made. In the Howard Government, in the Rudd Government in the Gillard government. Sussan Ley, when she was Health Minister, made the decision in March and announced that. Now I recognise that Greg Hunt typically made these decisions earlier than all of his predecessors. But it is not unusual for Government to really press the private health insurance industry to come up with a better number. And, frankly, to their credit, the private health insurance industry this morning has recognised that that is the job of government. This is the usual process that we're following. Now, of course, I want to make sure that the industry has as much time as possible to communicate the ultimate decision I make. But my overwhelming objective is to get the best deal for consumers. And I make no apology for that.
JOURNALIST: Vaping, I think you referred to it as a failed public health experiment: this idea of people moving off cigarettes onto vaping as like a cessation tool. I've heard some concerns from GPs who worry that maybe they don't have the right expertise, the right resources or education to actually help people get off vaping. In terms of like, you know, obviously the plans that have been introduced would be for people to get a prescription to access a medical vape if that if they need, if their doctor says they need to. What extra resources, if any, education etc. will GPs get as part of that plan? And I guess more broadly, when will we see the details of the last stage of the vaping crackdown that you are to introduce?
BUTLER: Thanks, Josh. To the first point, we commissioned the Royal College of General Practitioners to update their clinical advice to their members. Because from the 1st of January, we broadened the options for prescribing, to ensure that all GPs and all prescribing nurse practitioners were able to prescribe vapes or e-cigarettes as a therapeutic good - so as a smoking cessation device available on prescription through pharmacies. We tried to broaden that pathway from the only several hundred GPs that previously had been approved to do that. But we recognise that we need to upskill GPs in this. This is a new therapeutic product, relatively new only been around for a few years. So we commissioned the College of GPs to do that, and that has been rolling out over the last several weeks. To your second question, I intend to introduce legislation in the next setting fortnight in March, that will be the next stage of our vaping reforms. And that legislation will outlaw the sale and the supply of vapes.

That legislation will be enforceable, if it passes the Parliament, will be enforceable by state and territory governments. So what you'll see, finally, is state and territory governments working in partnership with Commonwealth agencies. As you know, the ABF - the Australian Border Force - and the TGA have, since the 1st of January been provided with extra resources to do our job, which is to stop these things coming in over the border in the first place. We've seized 360,000 vapes since the 1st of January. That is almost three times as many vapes as were seized in the entire 2023. So this is already having an impact. But we also, on the ground, need to outlaw the sale and supply of all vapes - except those that are approved as prescription vapes and have a permit from the Office of Drug Control. So we will be introducing that in March. I'm really hopeful for support from the Opposition. Peter Dutton has not yet come out and indicated the Opposition's view. I really encourage them to listen to the views of parents and school communities and public health experts about the need to shut this thing down.
JOURNALIST: Just on that: you introduce it in March, when would you hope it would be in force, i.e. when will we start seeing these vape shops actually start closing down?
BUTLER: We were aiming to have this enforced on the 1st of July. But that of course is subject to the passage of the legislation through Parliament. We need the support of the opposition here. There’s got to be a strong message out of the Parliament. Just as there's going to be a strong message from young influencers, like Zahlia and Shyla, that this thing is a serious public health menace. So I do call on Peter Dutton to take a constructive view about this. He made some encouraging noises when we first announced this, that he recognised this is such a serious concern among parents and school communities. But we haven't yet got an indication about their willingness to support our legislation. Natassia, and then I'll come across.
JOURNALIST: The 360,000 figure that you just said, in terms of vape seizures, what portion is that from your understanding of how many vapes typically come in, in the month? And is there capacity for the TGA to scale up on that 360,000, because as we can see, there are still plenty of products making their way in.
BUTLER: Look from that from the time I first announced our plans here, I've tried to be frank and honest, as the Australian Border Force officials and Commissioner Outram has been, that this is a hard job. These things don't come in in shipping containers with a big vape sign on the side of them. This is very organised criminal behaviour. Increasingly, we are understanding the involvement of organised crime in this market. This is a lucrative source of revenue for organised criminal gangs. Your papers published some material on that yesterday on their front pages. This is now the subject of fierce gang warfare down in Melbourne, but broadly across the country. Illicit tobacco and vapes are providing a lucrative source of revenue for these gangs to undertake their other criminal behaviour, like sex trafficking and drug trafficking. So we know they're going to do everything they can to get these things in, just as they do to get cocaine in and heroin in and a whole lot of other illicit drugs that have been, for a long time, unable to be imported. But we've got to do all that we can to shut down the supply. We've got to stop these vaping stores opening up down the road from our schools. To your question, though, how many vapes do we know came in secretly into the country? We don't know that. We know that this is a tough job, we have provided Border Force and the TGA with many, many millions of dollars in additional resources to lift their seizure behaviour. You're seeing that already in only the first couple of months.
JOURNALIST: What's the government doing about flavoured nicotine pouches, which are being promoted by some Australian influencers on platforms like Instagram? And is the government concerned they could erode progress in getting people off nicotine altogether?
BUTLER: Yes, I am concerned. This is this is a relatively new product that I think is only sort of broken into the public debate very, very recently. I'm seeking advice about that. And I'll have more to say about it in due course.
JOURNALIST: How many 14 to 20 year olds are you hoping to reach through this campaign? And when will the first post be up?
BUTLER: These posts will be up very, very soon. The influencers that we have engaged with, have a mix of breadth and depth if you like. Some of them have very, very large followings that are quite diverse. Some of them have, you know, relatively smaller followings - which still sound very impressive to me - in the tens of thousands. I don't know how many followers you have, Zahlia, but they are very focussed followers who listen very deeply to the messages. So we're trying to get a bit of a spread here. If I can give you a sense, though, about one experience we've had. Over the summer, we partnered with the Cancer Council, who in turn partnered with a range of young social media influencers, to run a campaign about skin cancer. An “end the trend” campaign pointing out the dangers of tanning behaviour for young Australians. And already there are tens of millions of posts and follows that have flowed from that campaign, which has only been running over the last several weeks. So we know that the reach of these influencers is very, very broad. But we are trying to get a mix of sort of breadth and depth. Again, I will say that skin cancer campaign was through a partner like Cancer Council. This is a new approach by the Commonwealth, directly partnering with social media influencers. This is, I think, a new way for governments to reach young people with the information that governments think young people should have and need to have. So we'll obviously be evaluating this. We'll be monitoring it very closely to see the success of it. But I'll come back to the point. We can't reach young people through traditional advertising. You know, they're just not watching and reading it. We've got to go to where they are. And that is through influencers, like Zahlia and Shyla.
JOURNALIST: Just to jump back briefly to private health, it was back in December that you, to borrow your phrasing, told the private health insurers to sharpen their pencils. Have they come back to you with revised offers, for want of a better phrase? Are they currently sitting on your desk, noting what you've said there about the timing of any decision? And are you convinced that they have made a better offer?
BUTLER: It's a diverse industry. And what usually happens is that some will come back with a position that that is satisfactory, and others will need a further nudge. So there's no uniform response to that question, Matt. I've had to go back to some again. So yes, December was the first time, but this is, to some degree an iterative process, before you get to a position where, across the industry, you're in a position to announce a position for the industry. That's always been the approach: not to announce some and then announce others later. You announce when the whole industry is settled.
JOURNALIST: Back to vaping. You talk about the vast amount of content on these social media platforms? Have you had discussions with Meta and TikTok? Have they been productive, if you've had them? And when it comes to legislation, should we look at strengthening the laws and the way that we did with tobacco advertising, and imposing penalties on people who do target, and those algorithms which target young children?
BUTLER: Late last year, just before Parliament rose, we passed legislation to update our tobacco control measures. They were going to otherwise sunset in April. And as you might remember, a lot of them were traditional tobacco control measures around the packaging, the cigarette presentation, the stick presentation - which were, again, very much designed to appeal to young people. But what we also did in that legislation was to bring social media and vaping into the long-standing advertising prohibition. So now it is unlawful to advertise vapes and cigarettes on social media, as it is through traditional media channels. So that only passed last year, but we will be monitoring that very closely.
JOURNALIST: Tell us a bit more about your experience with vaping. Like do your friends vape? When you go to a party are many people vaping? Could you just tell us a little bit about your experience?
SHORT: Of course, obviously, being a teenager, I see it a lot. I see it firsthand with friend and I feel like there's a big stigma around it being cool, like the Minister said. They even talk about the impacts and how addicted they get to it. It's considered cool in our community. I had a family member go through it and our biggest worry was how much she knew of the damage. I think the biggest thing with our age group is that there's such a lack of education, no one really knows the damage and it's really underestimated. But also like in the environment, I experience it in the ocean. I'm obviously I'm a surfer so in the water I see wrappers on the beach, I see the actual vapes on the beach. So yeah, in all aspects of my life, I experience the issues and risks.
JOURNALIST: New data coming out tomorrow shows that there's been quite a bit of success in bringing down the smoking rate and the tobacco excess is also going up 5 per cent a year. Is that increased taxation a) inflaming what we're seeing in terms of the escalation of violence around illicit tobacco? and b) do you think it's necessary given that smoking rates have come down significantly?
BUTLER: The challenge for us was, to step you back through it, tobacco excise, as you known Natassia, had been increasing for many years through the last government. They increased year on year by, I think, more than 120 per cent over the course of their time in government. Then as the increases in excise fell back to the normal indexation, we actually saw cigarettes drop in price in real terms. A price signal, we know from all of the evidence, is an important part of the toolbox in tobacco control. We couldn’t see a situation where cigarette prices actually started to reduce in real terms. That's a big driver for us taking the decision we did. But we are conscious of the fact that this is a complex market. We've got vapes on the one hand, we've got illicit tobacco, and we've got legal tobacco. What we also did, as you know, is announce about $188 million in additional resources for tackling illicit tobacco. That is an activity led through the Australian Taxation Office. But obviously, those Ministers are working very closely with us, to make sure that they have real effect.
And that will change the approach of Border Force. It will be much more what they describe as an end-to-end approach in controlling imports, which means they'll be partnering with source countries, to try and shut down the supply of illicit tobacco from their source, rather than just waiting here in Australia for them to come in. They'll also be trialling new technology including artificial intelligence in ways to detect this at the border - pilots that will be starting over the course of this year. So, as with vapes, I'm under no illusion about the challenge we face here in shutting down this market and stopping the supply of these things coming in over the border in the first place. We've provided very substantial additional resources, the tens of millions for Border Force and the TGA on vapes, the $188 million for illicit tobacco, because we're determined to make sure that we do our job of protecting Australians from these public health menaces. And also, frankly, shutting down a really lucrative source of revenue for some really bad organised criminal gangs.
JOURNALIST: The Community Pharmacy Agreement is supposed to start on Friday. Where are those negotiations? And will anything be in place by next week?
BUTLER: I'm pretty sure there's a negotiation still happening. Like, right now. I've been, from time to time, meeting with leaders of the Guild. I met with the President yesterday. Our negotiating teams have been meeting this morning. I'm not sure whether they still are, but they had a meeting scheduled this morning. We both really want a deal. But this is complex material. You know, we are working through it. We’ve both devoted very substantial resources to the negotiation process, and it's still underway. Thanks, everyone.

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