A new tobacco ‘endgame’ centre hopes to stamp out smoking, with several approaches on the cards including restricting sales to pharmacies and cigarettes on prescription
The Centre for Research Excellence on Achieving the Tobacco Endgame (CREATE) will be based at the University of Queensland (UQ) and involve researchers from 11 institutions in Australia, New Zealand and Canada, with the aim of phasing out smoking for good.
“CREATE’s goal is to determine the optimal mix of strategies that will help Australia become a smoke-free nation and produce a roadmap outlining how we can implement these strategies,” said Centre Director Associate Professor Coral Gartner.
Restricting sales to pharmacies is among a range of endgame strategies have been proposed, some of which have been partially implemented or are under serious consideration in other countries, said A/Professor Gartner. Cigarettes on prescription is another, more restrictive, possible option.
Examples include regulating the content and emissions of tobacco products to make them non-addictive, less palatable, or to remove the most harmful products from the market entirely based on their toxicant profile.
Supply reduction strategies range from reducing the number of tobacco retailers, restricting sales to particular categories of suppliers such as pharmacies, ending sales to everyone born after a certain year, phasing out commercial cigarette sales and regulated markets or non-profit supply models.
“The focus of the research centre is not ‘cigarettes on prescription’, which would be at the more restrictive end on a scale of possible options that includes many less restrictive alternatives,” said A/Professor Gartner.
“Australia’s smoking prevalence is just under 15 per cent, but we will need a well-designed endgame strategy if we are to achieve close to zero smoking.”
Researchers from the University of Otago in New Zealand have looked at the potential impact of tobacco being only available from certain supplier such as pharmacies, liquor stores or petrol stations.
They said substantially reducing tobacco availability has been identified as a crucial tobacco control strategy both internationally and in New Zealand.
However there could be disadvantages for tobacco being available from pharmacy, they warned.
“The potential disadvantages for pharmacies include increased theft – although they do currently have existing security systems for medications – and increased workload, as well as damage to their reputation from the contradiction of distributing medications and promoting health while selling tobacco, and also contributing to the normalisation of smoking.
“In addition, this policy is only feasible if there is support from pharmacists for selling tobacco.”
A different New Zealand study found a quarter (26%) of all participating pharmacists thought it was ‘very likely’ to ‘extremely likely’ that their pharmacy would sell tobacco if pharmacies were made the only permitted type of retail outlet in New Zealand, and 17% thought it was ‘somewhat likely’.
“These percentages increased to 37%and 43%, respectively, if such an endgame strategy had been proven to be successful elsewhere (in a place like Iceland) after one year of implementation,” said the authors.
Meanwhile CREATE said it will focus research efforts on what an appropriate endgame target and timeframe should be, and the best way to eliminate smoking disparities and stop children’s exposure to second-hand smoke.
“Australia is a global tobacco control leader and has been at the cutting edge of many new policies,” said A/Professor Gartner.
“An effective tobacco endgame strategy should accelerate the decline in smoking prevalence while assisting governments, retailers and people who smoke to transition to a smoke-free society. CREATE strategies could also influence reductions in low and middle-income countries, where tobacco companies are now focusing their marketing efforts.”
The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame is one of four UQ projects awarded NHMRC funding in the latest round.
The CREATE Investigator Team is a collaboration between UQ, The University of Newcastle, The University of Melbourne, Australian National University, Queensland University of Technology, Cancer Council Victoria, University of New South Wales, Menzies School of Health Research, The University of Otago, The University of Auckland and The University of Waterloo.