Radio interview with Minister Butler and Raf Epstein, ABC Melbourne - 30 November 2022

Read the transcript of the radio interview with Minister Butler and Raf Epstein, ABC Melbourne on tobacco control and vaping.

The Hon Mark Butler MP
Minister for Health and Aged Care

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RAF EPSTEIN: Mark Butler is the Minister for Health and Aged Care in Anthony Albanese’s Government. Good afternoon.

MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE: Good afternoon, Ralph.

EPSTEIN: I do want to ask you about tobacco and vaping, but if I can begin with the censure. You heard Scott Morrison say there that you're attempting political intimidation, and this is simply retribution. Is he right?

BUTLER: No, of course he's not right. I thought the former Prime Minister's response to this was deeply unfortunate and lacked real insight into the gravity of what he'd done. We had a former high court judge, Virginia Bell, look into this soberly and objectively and she used some pretty strong language. She said that the actions of the former Prime Minister had had a, and this is her language, “corrosive impact on public trust and confidence in government”. I think what Scott Morrison's contribution to this debate today failed to recognise is that if there was any time when the community needed to have the fullest possible trust and confidence in their government, it's during a pandemic. The government, quite rightly, were taking some extraordinary actions to control public behaviour, to do things that we would never contemplate outside of a pandemic or a war or something like that and it's precisely at those times that you need the highest levels of trust in government and particularly the leader of government, the Prime Minister. And I think he's just failed to recognise that.

EPSTEIN: But if you he's so undermined trust in government, if you say what he's done is so terrible.

BUTLER: I didn't say that Virgina Bell said that.

EPSTEIN: I understand that but if that's all true, why do you need to add to it with the censure motion? Why can't he just be left with the sins you say he is guilty of? Why do you need the vote as well in the Parliament.

BUTLER: There's got to be an expression by the parliament of censure for something that really undermines every possible tenet of our system of responsible government. Virginia Bill said that as well. She said it fundamentally undermined the principles of responsible government, which frankly have underpinned the Westminster system for centuries. Parliament, and through the Parliament the Australian people, deserve to know who is holding the levers of executive power.
I think the problem with Scott Morrison's approach to this is that he failed to recognise that in our system, the British system and others like it, the Prime Minister is the first among equals.

The Prime Minister doesn't have absolute power. The Prime Minister is the first among equals in Cabinet Government. The Crown or the Governor-General swears a Minister for Health, a Minister for Finance and Minister for Defence and so on, to administer that part of the Government. They don't swear the Prime Minister to administer everything. I mean, that would offend every notion we have about ensuring power is shared.

EPSTEIN: Everything you're saying may be true. Why do you need the censure if the damage is as significant as you say it is? Let's say I accept every point you've made. I want to try and drill down. Why do you then need also to have a censure motion in Parliament if the damage has already been wrought? Why do you need the vote?

BUTLER: Surely there's got to be an indication by the Parliament that it will not stand for that in the future. Surely there's got to be that indication. I was surprised that the Leader of the Opposition didn't support it, or at least even tried to soften it, if that if they felt that was necessary.

The idea that that a Prime Minister, of all people, could so trash the longstanding principles of responsible government, undermine trust at a time when the community needed trust in a government that was taking extraordinary measures to control the pandemic. The idea that all of that could happen be found to happen by former judge of the high court. And the parliament just shrugged his shoulders, I think would be unthinkable.

EPSTEIN: Mark Butler is the Minister for Health and Aged Care. I appreciate your time this afternoon, Mark, but I do want to get on to vaping because I think you're going to move soon, but you're doing some extra ramping up of the labelling on tobacco products. Can you just tell me what you're doing there?

BUTLER: It's the ten-year anniversary of our plain packaging legislation for cigarette packs, which was driven by a great Victorian Nicola Roxon, who was my boss for a number of years when I was a junior health minister. She drove that against really strident opposition, obviously from the tobacco industry. But at the time Peter Dutton, who was the shadow health minister, who said it was a “bridge too far” and we had to deal with court case after court case. But what was a world first is now pretty commonplace around the world. 26 countries followed our lead after we won all of those court cases, but unfortunately, nothing's happened in the last nine years. And so what was really innovative world leading regulation is now pretty stale, and the tobacco industry has found ways to innovate and get around those decade old regulations and start to market their deadly products again in a way that is attractive to people, particularly to young people.

We've talked with the tobacco control sector about this. And today I announced 11 new measures that we will seek to release in legislation next year and obviously go through a Senate committee process and suchlike to start to deal with those innovations the tobacco industry has done. What we've found is that while we a leader of the pack, forgive my pun there, we were really leading the world in this area ten years ago and we've now started to lag. And so we've looked at what Canada's doing, what New Zealand is doing, a range of other countries really to continue to drive down those rates of smoking below where they are now. They're much lower than they were ten years ago, but there's still more than 2 million people who are smoking. And we know that that will lead likely to a ten-year gap in life expectancy between long term smokers and non-smokers and a range of other dreadful health conditions.
 
EPSTEIN: What's actually changing on the packaging or what do you propose to change?

BUTLER: I want to update the graphic warnings. Research has shown that the people have become quite desensitised to warnings that were really quite shocking years ago but people have got a bit more used to. We're going to standardise pack sizes, standardise the cigarette size, start to deal with some of the additives that the industry has started to put into their cigarettes. Things like crush bombs in the filter where you sort of squeeze the filter and you get a rush of menthol, a range of other innovations the industry is using to make their deadly products seem more attractive. We want to start to knock that off and really do what we intended to do ten years ago, which is to remove the marketing attractiveness of this product from the tobacco industry.

EPSTEIN: On vaping, it is so obvious to so many of us how many people are vaping? It appears to be almost entirely unregulated; I realise there are significant regulations there. You've got a very short consultation process what do you think you'll end up doing?

BUTLER: We've got a short consultation process to deal with one part of what has become a very serious challenge. And I think your listeners will understand that there are now more people we think vaping in Australia than are smoking cigarettes and that number has skyrocketed through COVID.

It really has got away from most governments I think, and as a group of health ministers we meet very regularly and we're talking a lot about this. But education authorities are telling us that that at school level, even primary school level, the most serious behavioural issue that school principals and teachers are facing right now is vaping. We hear story after story of young people, young children getting seriously unwell by using vapes. Inhaling nicotine without understanding it. Getting “nic-sick” which is a new saying that young people have now.

EPSTEIN: Sorry can I interrupt, what’s “nic-sick?”

BUTLER: Getting sick on nicotine

EPSTIEN: Oh right. Got it.

BUTLER: So sick on nicotine. There are a whole range of new things, and we're talking about products that are that are labelled with pink unicorns that have a bubblegum flavour. These are not marketed to you and me, Raf.

EPSTEIN: So are you going to change the labels. Will you be regulating the labelling?

BUTLER: One of the things we've put our consultation paper out through the TGA, the Therapeutic Goods Administration, is whether we learn the lessons of plain packaging from cigarettes and look at the labelling that the marketing of these things. I mean, why on earth would you be marketing bubble gum flavored vapes with pink unicorns on them except to appeal to children, not even adolescents, young children. But there are a range of other things that have got away from us. Import controls, for example, on this. Greg Hunt, to his credit, tried to put an import control regulation on vapes when he was the health minister. It lasted 36 hours before his party room rolled him because a number of them had been got to by the vaping industry. We're consulting about that as well.

But health ministers at a state level understand that the commonwealth can't do it alone. States can't do it alone, and for that matter, health departments can't do it, let alone we need doing policing efforts at a state level. We need policing efforts at the border because these things are coming in in a very uncontrolled way. The thing I'd say is we're determined to come to grips with this. But can I tell your listeners, it’s not going to be easy and it's not going to be quick because this has become a heavily unregulated market.

EPSTEIN: Are we going to get the labelling? Is that something that you think is likely to happen? Will there be a limit on the labelling or will you actually impose an import restriction? Where are you likely to land?

BUTLER: They are two of the things that we've put out in our consultation paper today. As you've said, we want to turn this around relatively quickly. Two of the very important things we're consulting on is import controls on these products, labelling controls, controls around the addition of flavours, for example, bubblegum and fruit flavors. Those are things we're consulting on. But, as important as they are, it's a bigger issue than that. We are going to start to talk to states - New South Wales and the Commonwealth are leading this process after being asked to do that by all the jurisdictions. Health ministers have a meeting in January focused on this issue, so we don't pretend this is going to be easy. But across all jurisdictions there's a very high level of determination to deal with what is becoming a very serious health issue for our children.

EPSTEIN: And would you put an age limit? There is an age limit for cigarettes and tobacco products. Are you considering an age limit?

BUTLER: There is an age limit now. You're not supposed to sell vaping products to under 18 year olds, but it's happening all over the place.

EPSTEIN: I thought there was a loophole around whether or not it's a vape?

BUTLER: That's become entirely unregulated and I think when the TGA has done testing, when other authorities have been doing testing on vapes that are being sold in convenience stores, service stations and the like, we're finding the vast bulk of them have nicotine in them but aren't labelled as such. And you're only supposed to be using nicotine vapes if they are prescribed as part of a smoking cessation program that clearly isn't happening across the country.

EPSTEIN: And what about punishing people? I mean, I know that you can drive a truck through the law, you're not supposed to sell vapes to people under the age of 18, would you -maybe it's something for the states, do you increase the punishment for selling to young people?

BUTLER: For example, in New South Wales, there was a big push into trying to clean up some of this. There were substantial fines imposed on a number of businesses doing the wrong thing. The TGA has acted and imposed fines where people have been doing the wrong thing as well. But this has become so widespread so quickly that it is going to take a determined effort on the part of all governments to start to get it back under control. Today's consultation paper, I hope, starts that effort. I'm very confident that all health ministers across the country, Liberal, Labor, that doesn't matter, everyone's very focused on starting to get some control on this.

EPSTEIN: What's a bigger threat to health vapes or cigarettes?

BUTLER: They're very different. At the end of the day, smoking tobacco is still one of the biggest killers of Australians. More than 20,000 Australians die from tobacco related causes every single year. In my lifetime, a million Australians have died from tobacco. So they are very different and they're different types of challenge. I don't want to compare them or rank them in that sense. Vaping, though, is a very serious challenge for our youth. And when I say youth, I mean quite young children at primary school age during these sorts of things. They're not smoking cigarettes at the at the rates that, you know, you and my generation were smoking cigarettes, Raf. And that's a very good thing. But we don't want to sort of make one achievement and have it replaced by another problem which is vaping.

EPSTEIN: I appreciate all your time today. Final question. New Zealand's banning smoking I think in a few years time, are we going to go down that road?

BUTLER: Look, that's not something we're looking at right now. That's not the tobacco strategy that was developed over a long period of time of engagement with the public health sector and so on. Obviously, we're watching what New Zealand's doing closely. Canada is also, you know, one of the world leaders in tobacco regulation. We'll continue to learn from what each of us is doing around the world. But I've announced what we intend to do today, and that's our focus right now.

EPSTEIN: Thanks for your time.

BUTLER: Thanks, Raf.

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