Every year, tobacco use costs the United States healthcare system nearly $170 billion in direct medical costs for the treatment of smoking related illnesses (Xu, Bishop, Kennedy, Simpson, & Pechacek, 2015). As a result, an increasing emphasis has been placed on funding preventative campaigning that encourages individuals to abstain from smoking tobacco products. In addition, funding for smoking cessation resources has increased in the U.S. since the 1990s. These efforts seek to lessen the burden that tobacco use has on the healthcare system as well as on the health of individuals.
Considering this, it was only natural that I take a look at tobacco products during my first few weeks here in Australia. I didn’t have to look far. In comparison to the U.S., Australia is way more aggressive in the manner in which tobacco use prevention is handled. For instance, let’s have a look at cigarettes. You’ll have to shell out about $20-$30 AUD ($14.27-$21.41 USD) per box of cigarettes, a price that would astonish most Americans. In comparison, one could get the same pack of cigarettes for $5-7 USD in my home state of Florida. To combat these prices, here in Australia there is a trend to “roll your own” tobacco products. If you are able to get your hands on a pack of cigarettes, it’s hard to ignore the giant blaring warnings about the harm that cigarettes can do to the body. This message can even be seen on cigarette vending machines. See for example this pack and vending machine that I came across.
In contrast, take a look at a pack of cigarettes in the United States. Notice the how plainly labeled it is compared to the Australian pack.
Now for the more important question; have preventative efforts tailored toward reducing tobacco use been effective? Let us turn to the National Drug Strategy Household Survey (NDSHS), a comprehensive survey boasting almost 24,000 respondents. According to the NDSHS, there have been a number of preventative measures that have been taken on the national level:
1. Tax increases on tobacco products.
2. Education programs and national campaigns
3. Plain packaging of tobacco products
a. This prohibits companies from “customizing” their tobacco products, requiring the removal of all branding.
4. Labeling tobacco product packaging with updated and larger graphic health warnings
5. Prohibiting tobacco advertising, promotion and sponsorship
6. Providing support for smokers to quit including through subsidies for smoking cessation supports on the Pharmaceutical Benefits Scheme
As a result of these efforts, there has been a steady decrease in the smoking rates of adult and adolescent populations since 1993. From 2010 to 2013 there was significant decrease reported daily smokers; a decrease from 15.1% (2.7 million) to 12.8% (2.5 million) was observed for the ≥14 year old population (Australian Institute of Health and Welfare, 2014).
The United States equivalent of the NDSHS is the 2014 National Health Interview Survey (NHIS), a nationally representative survey with 36,697 respondents over the age of 18. During 2005-2014, the prevalence of cigarette smoking among U.S. adults decreased from 20.9% (45.1 million persons) to 16.8% (40.0 million persons) (Jamal et al., 2015).
These statistics show that both countries have impacted their respective rates of smoking significantly over time despite differences in preventative outreach. However, both countries still have large smoking populations that will continue to pose a financial burden to the respective healthcare systems of each country.
Although there is a decreasing trend in both countries, the U.S. notably has a larger smoking population. On first impression, Australia seems to be more progressive in terms of health policy and preventative efforts than the U.S. The bottom line is that population-based interventions including tobacco price increases, comprehensive smoke-free laws, high-impact tobacco education mass media campaigns, and barrier-free access to quitting assistance, are critical to reduce cigarette smoking and smoking-related disease and death in all countries.
Australia seems to be more progressive in terms of health policy and preventative efforts than the U.S. It will be interesting to find other preventative strategies that have been implemented successfully here in Australia and how different these strategies are in comparison to the U.S. I’ve only been here a week, I can only imagine what I’ll come to find during my 4 month stay here.
Australian Institute of Health and Welfare. (2014). National drug strategy household survey detailed
report 2013. (Drug statistics No. 28). Canberra: Australian Institute of Health and Welfare.
Jamal A., Homa D.M., O’Connor E., Babb S.D., et al (2015). Current cigarette smoking among adults
United States, 2005-2014. MMWR Morbidity Mortal Weekly Rep, 64(44), 1233-1240.
Xu, X., Bishop, E. E., Kennedy, S. M., Simpson, S. A., & Pechacek, T. F. (2015). Annual healthcare
spending attributable to cigarette smoking: An update. American Journal of Preventive Medicine,