Want to Close the Gap? Eradicate commercial tobacco

For over 70 years, public health efforts have chipped away at the harms of smoking, saving millions of lives. But profiteers have adapted relentlessly to regulation. Their resilience shows that it isn’t enough to do harm reduction forever. The root cause of harm must be addressed: we have to eradicate commercial tobacco.

The tobacco industry is led by those who knowingly profit from addiction, disease and death. Their tactics – aggressive marketing, political lobbying and strategic litigation – sustain cycles of addiction and inequity in families and communities. 

No matter how many times tobacco industry writers invoke ‘social responsibility’ in corporate reports, their motives – and the harms of smoking – are undeniable. Public health can’t be protected in their presence. It’s time to move on from regulating tobacco incrementally, and on to eradicating it. 

Eradication should be a central goal of public health. Globally, over eight million deaths are attributed to tobacco use every year. This is 22,000 deaths every day.

In Australia, tobacco use accounts for 24,000 deaths annually, more than 65 every day. We have an ethical obligation to ease this suffering. 

Eradication would also meet another obligation, one specific to Australia: Closing the Gap. Smoking-related deaths cause a staggering 37 per cent of all deaths among First Peoples. 

Learning from the past, acting for the future

The disparity in smoking deaths between First Peoples and non-Indigenous Australians reflects the colonial origins of tobacco production. As tobacco production industrialised, smoking products – including cigarettes, and more recently vapes and e-cigarettes – became widely available and cheap.  

In this time, tobacco industry strategists learned which communities to target for profit, and they continue to target them today. This amounts to structural colonial violence committed by, and on behalf of, investors in tobacco. It will have to be addressed by eradication. There’s no other way to protect public health. 

Australian institutions can change – consider our previous public health successes. Just as we phased out asbestos, leaded petrol, engineered stone, and choking hazards at the Easter show, we can stop tobacco harms. 

Harnessing community leadership

Eradication is about people. Community leadership, including Indigenous community leadership, is critical for designing culturally safe pathways out of addiction.

Initiatives that are truly community-led and use Indigenous knowledges can be the foundation of eradication. Scaling up elements of successful community-led programs like Tackling Indigenous Smoking and the Koori Quit Pack mailout is a good place to start. 

At the same time, the state must hold tobacco profiteers accountable for their actions. Real leaders expose and counter dodgy corporate tactics, including misinformation and compliance evasion. This can be prevented by proactive programs and when misconduct is obvious, legal action. Leaders across government, industry and political parties have to put their fellow citizens’ survival over profits and dividends. 

Eradication is achievable

It takes courage to build consensus. But community-wide leadership can dismantle the structures perpetuating harm. Still, it has to be clear that eradication isn’t about taking away personal freedom. It’s about gaining freedom: freedom from addiction. 

As they craft strategies that empower Australians to lead addiction-free lives, policymakers should direct their efforts to the real goal: eradicating tobacco. 

Most people who smoke want to quit or wish they’d never started. Yet two out of three people who smoke will die from a smoking-related illness. With leadership and compassion, policymakers can empower Australians to lead addiction-free lives.  

What next?

Recent reforms that restrict access to vapes and e-cigarettes are steps in the right direction. But they must be scaled up, supported by systemic change and a shift in leadership culture. 

The nicotine-free generation approach seen in the United Kingdom and previously passed (but then repealed) in New Zealand is bold and worth pursuing. Phasing out the sale of non-therapeutic products can reduce the chance of addiction, especially in cities.  

Australian wealth will also have to be divested from tobacco profiteers. Ultimately, it will be necessary to require regulators to delist companies. This would be an outright, national refusal to profit from suffering. 

This is a fight Australia can’t afford to lose. The time to act decisively is now.

Together, we can achieve a future free from the harms of commercial tobacco and make equity a reality in public health. 

This piece is co-published with ANU Policy Brief