Philippe Boucher's Rendez Vous Judith Watt
Rendez-vous with Judith Watt
By Philippe Boucher
RENDEZ-VOUS Tuesday, February 9 1999
Thank you Judith for accepting our " rendez-vous ".
May I ask you to introduce yourself ?
I have been working in tobacco control for ten years.
I started out as the first full-time co-ordinator of the UK's national No Smoking Day campaign. After four years, I moved on to work on policy issues in the Tobacco Program at the Health Education Authority in London. For the last three and half years, I have been working in Australia as the Executive Director of Quit in Victoria.
I return to London next week for family reasons but I hope to keep in touch with developments in tobacco control. As David Sweanor has been known to say - it's alright for smokers, they can quit tobacco but tobacco control advocates can't give it up!
First question: We recently read that VicHealth is "in the process of launching a new research centre focusing on ways to cut smoking levels and consumption. The centre possibly the first of its type in the world, will investigate legal,
economic, social and regulatory aspects of smoking and the tobacco industry".
Could you give us some more details about this project?
While VicHealth was created under a Tobacco Act in 1987, there was no specified amount which had to be spent on tobacco control - unlike sports sponsorship which was allocated 30% of VicHealth's annual income. The stagnation in smoking prevalence from the early 1990s led to many calls for more resources to be put into tobacco control.
VicHealth decided last year that funding a new research centre would be one way it could contribute more. Having consulted with a number of people across Australia, the idea for the centre to concentrate on legal, economic and social issues began to take shape.
Bids to house the centre are to be submitted by the end of March 1999 and funding could start to flow as soon as 1 July.
VicHealth hopes that by stimulating research in these areas, more pressure can be brought to bear on governments to substantially increase funding for education programs and support services.
2. Andrew Penman of the New South Wales Cancer Council expressed his concern about the growing number of school children who smoke in Australia. He called for "a different approach to getting the anti-smoking message across", focusing less exclusively on youth.
How do you feel about this analysis?
I absolutely agree that we need to focus on adults (including young adults) if we are to make progress in reducing smoking at a population level. That "different approach" is now more widely accepted in Australia since we launched the National Tobacco Campaign in June1997. This mass media campaign, backed up by improved services for smokers, is notionally targeted at 18 to 40 year old smokers.
However, we know from the campaign monitoring and evaluation (to be published in the near future) that it is also having an impact on people outside this age group.
Of course, we also now have the proof that the industry's strategy to counter our efforts is to urge governments to focus their funds solely on prevention campaigns aimed at children (or on what they term "more important" drug issues). The Minnesota documents on the Internet includes a Corporate Affairs Plan for Philip Morris Australia which sets out precisely how the company seeks to influence politicians to support only "youth non-smoking campaigns".
They know what we know (if we're being honest) that campaigns aimed only at children don't work and only serve to reinforce the idea that smoking is something you do when you're an adult.
So, if you're 14 years old and want to be grown up, what's a kid to do?
The initial funding for this national campaign from the Commonwealth government was a significant improvement on previous levels of expenditure but it was provided on the understanding that the states would join in and back it up.
Sadly the level of support from some states has been very poor so the impact of the campaign has been uneven across the country. This is very disappointing given the immense amount of work and goodwill which went into creating a national collaboration and in view of the promising results of the campaign.
3. Beside the content of the messages, there is the problem of the amount of money available for tobacco control.
It seems the Federal government collects 4.5 billion Australian $
(2.88 US$) in tobacco taxes and spends 2.2 million Australian $
(1.4 million US$) in tobacco control: about 7 cents per capita.
In the US, some activists ask for a minimum budget of 6 dollars per capita.
How much do you think is appropriate?
We must be guided by the evidence and the evidence from the early California campaign is clear - the level of spending on the program is directly related to its impact on smoking rates. We should be spending at least $3 to $4 per head on the basis of the evidence we already have and be prepared to spend more if the evidence is there.
For the record, while the federal government now collects all the tax on tobacco, the states still receive more than half of that income back in direct grants so there is no excuse for state governments to not to substantially increase their expenditure on smoking and health programs too.
4. The State of Victoria was among the first in the world to create a dedicated levy to fund tobacco control through a Health Foundation.
Do you think this structure is still a model to look after when tobacco control funds are allocated?
As I explained above, there is no dedicated amount of VicHealth funds for tobacco control. Sports organisations in Victoria continue to receive three times the amount of money which goes into tobacco control.
And non-tobacco health issues receive six times the amount of money which goes into tobacco control.
VicHealth's income is tightly controlled by the government and it is required to finance a very wide range of health promotion programs and research so there is only so much to go around. The Californian experience of concentrating a proportion of tobacco tax just on tobacco control programs, rather than more generally on other health issues, has achieved much more significant results in reducing smoking.
The original idea of using tobacco tax to buy out tobacco company sponsorship was fine but that job was finished many years ago.
With hindsight, there should have been a "sunset clause" in the Act so that after the buyout of tobacco sponsorship was achieved, the funds were spent on tobacco control programs.
While the initial sponsorship buyout in Victoria sent an important message, other states managed to pass legislation to ban tobacco advertising and sponsorship without diverting public health dollars into sports organisations.
Indeed, Australia as a whole banned tobacco advertising and sponsorship (with limited exceptions) without a sponsorship buyout.
5. Your experience in Victoria is coming to an end. Could you tell us the main lessons you derive from your stay?
That I've had a great time here in Australia.
I've worked with some terrific colleagues and I'm proud of what we have managed to achieve over the last few years.
That we won't see great progress in reducing smoking rates until we secure significantly greater funds
- either from governments or, more importantly, by forcing the companies to pay compensation for the damage they cause.
That we need a star team not a team of stars.
When tobacco control efforts are fragmented, with Quit campaigns, cancer and heart organisations, and other organisations in every state doing their own thing, the already meagre resources are further sub-divided, reducing any possible impact.
That we must properly evaluate our programs and be prepared to stop programs which don't show evidence of working and continue to support programs which are working even though they might not look "new and innovative".
What you feel like adding :
Always remember what Stephen Woodward calls "the scream test": if the industry is complaining about what we are doing, we're doing the right thing; if we can't hear their screams, we doing the wrong thing.
Thank you Judith for taking the time to be with us today.
Prepared by Philippe Boucher mailto:IslandErsk@aol.com
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