Initiatives and strategies, including those reflecting the action areas of the Ottawa Charter, used to promote health and reduce tobacco smoking in Australia

What this dot point is asking

This dot point asks you to describe Australia's tobacco control measures, explain how they reduced smoking and its burden of disease, and classify each measure against the Ottawa Charter action areas. Tobacco is the classic application case because every action area can be illustrated and the data show a clear long-term decline.

Why tobacco matters

Tobacco smoking has long been one of the leading preventable causes of burden of disease in Australia, driving cancers, cardiovascular disease and respiratory disease. Daily smoking among adults has fallen from roughly a quarter of the population in the 1990s to around one in ten today, one of the great public health successes, achieved through sustained, layered health promotion rather than a single measure.

Key initiatives and the Ottawa Charter

Build healthy public policy. Government policy has done the heavy lifting:

• High and rising tobacco excise (taxation), making cigarettes among the most expensive in the world to reduce affordability.
• Plain packaging laws, which removed branding and added large graphic health warnings.
• Bans on tobacco advertising, promotion and sponsorship.
• Laws banning the sale of tobacco to minors.

Create supportive environments

Smoke-free laws ban smoking in workplaces, restaurants, pubs, public transport and many outdoor areas, making the non-smoking choice the easy default and protecting people from second-hand smoke.

Develop personal skills

Mass-media campaigns such as the long-running Quit campaign and graphic anti-smoking advertising teach people the risks and the skills to quit, supported by services such as the Quitline phone counselling line.

Strengthen community action

Organisations such as Quit and the Cancer Council work with communities and have built broad public support that made tough policies politically possible.

Reorient health services

GPs are encouraged to ask about smoking, advise quitting and prescribe nicotine replacement therapy, shifting clinical care toward prevention.

Evaluating the strategy

The strength of Australia's approach is that it uses every Ottawa Charter action area at once, so policy, environment, education and clinical care reinforce one another. The result is a sustained fall in smoking prevalence and, with a lag, falling rates of lung cancer and other smoking-related disease. Remaining challenges include higher smoking rates among some groups, such as people in low socioeconomic areas and Aboriginal and Torres Strait Islander communities, and new products such as vaping, which has prompted further policy responses.

When asked to evaluate, judge effectiveness against criteria such as reach across the population, the determinants addressed and the reduction in smoking prevalence and tobacco-related burden of disease over time.