Denise Sullivan

Wednesday, March 31, 1999

Thank you Denise for accepting our " rendez-vous ". May I ask you to introduce yourself ?

My name is Denise Sullivan and I am Coordinator of the Smoking & Health Program of the Health Department of Western Australia. I am a graduate of Curtin University, with a BEd in literature and Graduate Diploma in Library & Information Studies.  I am currently studying towards an MPH at the University of Western Australia.
I have been involved in tobacco control for almost 4 years.

1. You told me 1999 will be the 16th year of quit campaign. What are the main evolutions, the main changes in the way these campaigns were/are organised?

The Smoking and Health Program was established in 1983. The Smoking and Health Program implements a range of strategies targeting specific populations and settings within the community. Strategies implemented by the program are consistent with the international literature on tobacco control and include: mass media campaigns, public policy, legislation, structural change, school education and public education, promotion and sponsorship, smoking cessation support, intersectoral collaboration (for sustainable programs) and research and evaluation.

Key achievements over the past 16 years (though not all directly or solely attributable to the Smoking and Health Program!) include:

* a 22% decline in the prevalence of smoking in the adult population (down from 32% in 1984 to 25% in 1997).
* a significant decrease in the prevalence of smoking among 12 to 17 year old secondary school students (down from 23% in 1984 to 18% in 1996).
* reductions in the ease of access that young people have to cigarettes sold through retail outlets (89% of retailers willing to sell to minors in 1992 compared to 28% in 1998).
* proclamation of the Tobacco Control Act 1990, which prohibits most forms of tobacco advertising and promotion and provides for the establishment of the Health Promotion Foundation of Western Australia (Healthway).
* implementation of the Health (Smoking in Enclosed Public Places) Regulations 1999 on 29 March 1999 which prohibit smoking in enclosed public places with some exemptions for some sectors of the hospitality industry subject to certain conditions.
* implementation of the Occupational Safety and Health Amendment Regulations (No.2) 1999 which prohibit employers, employees and self-employed persons from smoking in enclosed workplaces. The regulations do not prohibit the public from smoking in a designated smoking area within an enclosed workplace. Employers cannot require employees to work in a designated smoking area.
* growing community support and involvement in tobacco control initiatives.
* increased collaboration between government and non-government agencies, the business community, community groups, service organisations and schools on tobacco control initiatives.

2. You maybe recall I liked very much an "old" TV spot about quitting, with a child learning how to ride a bike. Is there an evolution as well in the themes used for TV spots?
Are some more effective than others?
Do you "recycle" spots from other parts of Australia or some other countries or you only use your own clips?

The Smoking and Health Program conducts an annual Quit Campaign. The campaign plays an important role in motivating, encouraging and supporting smokers to quit smoking. The campaign uses a combination of mass-media advertising, public relations and community education initiatives (involving health professionals, workplaces and regional health promotion officers) to promote its health messages. Research and evaluation is an important component of the campaign in order to ensure it continues to be vital and effective.

Western Australia is the only state to have maintained an ongoing commitment to the delivery of an annual, integrated and comprehensive mass-media driven campaign targeting adult smokers.

The campaign targets adult smokers with a smoking cessation message. The campaign uses hard hitting, graphic advertisements, which aim to raise awareness of the health effects of smoking and motivate smokers to quit now rather than some time in the future.

The Smoking and Health Program aims to present new health information with each phase of the campaign in order to 1) raise awareness of the various health effects of smoking, 2) to present new news in order to maintain public and media interest in the campaign and 3) to demonstrate that scientific evidence on the harm caused by smoking continues to accumulate.

The advertisements developed for the Quit Campaign continue to evaluate well and achieve high awareness and approval among its target group, as well as positive knowledge and attitudinal changes, and increased quit activity over the campaign period.

Some of our most memorable Quit advertisements include:

* Sponge (1984). This advertisement depicted the average amount of tar that would accumulate in a smoker's lungs over a year being squeezed out of a sponge into a glass jar.
* Lifelines (1995)(male and female versions). These advertisements used text to illustrate the shorter life expectancy of smokers. Text on the left side of the screen described the life experiences of a non-smoker, who lived to old age. Text on the right side of the screen depicted the shorter life experiences of a smoker, who died at middle age. The advertisement promoted new research which showed half of all smokers will die prematurely from tobacco-caused diseases, and that half of these deaths will occur in middle age.

The Smoking and Health Program generally commissions the development of new materials for its campaigns, but also uses advertising developed by other states and countries. The 1984 Quit Campaign used the Sponge (1984) advertisement originally developed by the New South Wales Quit Campaign. The 1985 Quit Campaign, Only Dags Smoke Fags (1985), used advertisements developed for a Canadian (?) campaign.

The Smoking and Health Program also participates and supports other state and national campaigns, such as the Smarter than Smoking Campaign (1995 on) and the National Tobacco Campaign (1997 on).

From time-to-time, the Smoking and Health Program has conducted mass-media campaigns on other tobacco issues. For instance, the Let's Clear the Air Campaign (1990, Passive Smoking), the Young Women and Smoking Campaign (1991/2 to 1994) and the Passive Smoking and Children Campaign (1995).

The duration of our campaigns is very dependent on budget and ranges from 4 to 6 weeks on average.   

3. We know that prohibiting smoking at work is a very effective way to help people quit smoking. What is the situation now in Western Australia for the work places as well as for public places in general?

On 29 March 1999 two sets of regulations took effect in Western Australia. They are:
* the Health (Smoking in Enclosed Public Places) Regulations 1999 which prohibit smoking in enclosed public places with some exemptions for some sectors of the hospitality industry subject to certain conditions.
* the Occupational Safety and Health Amendment Regulations (No.2) 1999 which prohibit employers, employees and self-employed persons from smoking in enclosed workplaces. The regulations do not prohibit the public from smoking in a designated smoking area within an enclosed workplace. Employers can not require employees to work in a designated smoking area.

Copies of the regulations can be accessed at
http://www.slp.wa.gov.au:8080/statutes/swans.nsf

The regulations have broad community support. However, it is acknowledged that exemptions under the regulations which cover enclosed public places have upset some groups. The exemptions mainly apply to hotels and taverns and the international casino.

The health groups support the regulations, but would have preferred that they went further. Some sectors of the hospitality industry would have preferred greater scope for exemption from the regulations.

4. Money is often a critical issue for tobacco control programs. What is your budget for 1999?
How does it compare with the preceding years?
How much is that "per capita" (considering the number of people living in Western Australia)?
Can you explain how it is used (the different campaigns funded) and how you are organised (staff, relations with NGO's).

The 1998/99 budget for the Smoking and Health Program is AUD $1.4 million (includes salaries). In 1984, the budget for the program was AUD $2 million. There has been a gradual decline in the budget for the program as well as increased pressure to do more.

The per capita spending on tobacco control in Western Australia was about 72c in 1997. This is less than half the per capita spending on tobacco control in Western Australia during the 1980s.

The Smoking and Health Program employs 11 staff. The program comprises a Coordinator, two senior project officers (campaigns, legislation and policy), two project officers, an investigator, four health promotion officers and a secretary.

The lion's share of the budget goes toward the development, implementation and evaluation of the Quit Campaign (50 to 75%), and the remainder is allocated across a number of legislation, public policy and special programs. This program differs from some states in Australia in that one agency has primary responsibility for public education, policy and the enforcement of tobacco control legislation.

The program works in closely with key government and non-government health agencies in this state. They include the Asthma Foundation, the Australian Council on Smoking and Health, the Cancer Foundation, the National Heart Foundation, the Health Promotion Foundation of WA (Healthway), peak medical associations, doctors, nurses, pharmacists, dentists, regional health education officers and Aboriginal health workers.

Other government agencies and community groups and service organisations the program works with include the Police Service, local government, school communities, service organisations and local drug action groups.

Other state and national health and medical agencies, committees and working groups that the program works with include the National Quit Coordinators'
Group, the National Expert Advisory Committee on Tobacco and the National Tobacco Policy Officers' Group.

The successes of the Smoking and Health Program are very much a consequence of the spirit of willing support and collaboration that exists between agencies in this State and nationally which share an interest in tobacco control.

5. What is the "state of the opposition" in Western Australia?
Is the tobacco industry still very active?
Are there regular threats about the funding of the tobacco control programs?

Health groups are very proactive on tobacco control issues in this State, and work in close partnership with one another. As a consequence, the tobacco industry monitors very closely developments in this State and is quick to respond to perceived threats. It is interesting to note that the Australian Hotels Association (AHA) and the WA Tobacco Retailers Association seem to have close affiliations with the tobacco industry. The AHA lobbied particularly hard during the drafting of regulations to prohibit smoking in enclosed public places. Not surprisingly, a number of concessions were made to that industry group in the gazetted regulations.

Political support for tobacco control is reasonably strong among opposition parties, but less so among Government members. Fortunately, the current Minister for Health is very supportive of tobacco control and demonstrates a willingness to persevere with issues.

What you feel like adding :

While the successes of the Smoking and Health Program are pleasing, there are number of issues which remain of concern to health groups in this State:

* the decline in the prevalence of smoking among adults has stalled at around 25% since 1994.
* the higher prevalence of smoking among young men (36%), young women (30%) and Aboriginal people (48%)
* the decline in the prevalence of smoking among 12 to 17 year old students has stalled at around 18% since 1993. A 1996 survey also showed a slight increase in the prevalence of smoking among 16 to 17 year olds.
* a 1996 survey showed that the 'supply' of tobacco to minors by friends, family, etc. is now the primary source of cigarettes for young people.
* the need to strengthen existing tobacco control legislation to further restrict/prohibit tobacco sponsorship, point-of-sale advertising and promotions, and limit exemptions from prohibitions on smoking in enclosed public places.

Thank you Denise for taking the time to be with us today.