Mike Daube. Curtin University, Perth, Australia

In Australia, the latest high-profile battle between governments, health authorities and the tobacco industry has been over the recent successful introduction of ‘plain packaging’ of all tobacco products. ‘Plain packaging’ is of course a euphemism—the packs are dominated by strong, graphic warnings; the pack design and colour are carefully researched to be as unattractive as possible; and the overall impact is to turn the pack into something neither children nor adults want to be associated with.

On 1 December 2012, Australia became the first country in the world to require all tobacco products to be sold with plain packaging. The Australian plain packaging story is well described by Chapman and Freeman in their book, ‘Removing the Emperor’s Clothes: Australia and Tobacco Plain Packaging’. The Irish and UK governments have recently legislated to introduce plain packaging; other countries have declared an interest in following their example, and the battleground has shifted from Australia to those countries and international trade disputes.

Plain packaging was never seen as the magic bullet for tobacco cessation: it was and remains part of a comprehensive approach to tobacco control that includes taxation, regulation (for example on advertising bans, point-of-sale promotion and protection from the harms of passive smoking) and strong, sustained public education campaigns. The primary aim of plain packaging was to discourage future generations from starting to smoke. The impacts of plain packaging should therefore be considered in a long-term context. However, early indications show a wide range of positive impacts relating to adults, children and adolescents. Peer-reviewed research shows many beneficial outcomes including in areas such as outdoor smoking, reductions in noticeable public display of packs, calls to telephone support and coaching services aimed at smoking cessation (e.g. Quitline), propensity to smoke, attitudes to brand image and support among smokers.
In global terms, Australia is a small tobacco market. The epic fight against plain packaging in

Australia was never simply about preserving that small, local market. It was rather an attempt to avoid the creation of this successful precedent for action elsewhere. For more than 2 years, there are important lessons from the Australian experience for other countries. Plain packaging has been described as ‘a case book example of effective tobacco control—a policy measure driven by evidence, carefully designed and now rigorously assessed’. It is clear that it can bring substantial benefits to the community as part of a comprehensive approach to tobacco control. The tobacco industry’s arguments failed in Australia; they should not be allowed to become zombie arguments—killed off in one country, but brought back to life in others in the hope that credulous decision-makers will not be aware of experience elsewhere. Governments should follow expert health advice and implement this important, evidence-based public health measure.

Mike Daube is Professor of Health Policy at Curtin University. He has extensive national and international experience in public health. Prof Daube was Western Australia’s first Director General of Health from 2001 – 2005 and Chair of the National Public Health Partnership. He has been a consultant for the World Health Organisation, the International Union against Cancer, and governments and NGOs in over 30 countries. He has been honoured for his work by many national and international organisations, including recently the American Cancer Society’s Luther Terry Distinguished Career Award.

Prof Daube is President of the Australian Council on Smoking and Health, Co-chair of the National Alliance for Action on Alcohol, Chair of the WA Network of Alcohol and Other Drugs, Patron of Local Drug Action Groups Inc. and chair or member of many other government and NGO committees. He was previously President of the Public Health Association of Australia and Deputy Chair of the National Preventative Health Taskforce.

Prof Daube received an Officer of the Order of Australia (AO) on the 2014 Australia Day Honours List for distinguished service to medicine, particularly in the area of public health policy and reform, through advisory roles with leading national and international organisations, and to youth.