Winston Churchill Fellowship to Australia – Cerys Humphreys Gwynedd Council Fellowship period – Jan – Feb 2014

Purpose of Fellowship To investigate how the implementation of policies and interventions by rural local authorities (or equivalent agencies) and national health promotion agencies in Australia, are contributing to the decline in prevalence of alcohol and tobacco use. To examine how under represented and non-represented groups in Australia are able to access alcohol and tobacco health-promotion services/interventions in both rural and urban areas. To examine the link between tobacco use and increased alcohol- consumption within mainstream and indigenous populations and its effects on poverty.

Reducing tobacco prevalence Current prevalence rate in Australia = 16%. State of Victoria = 13%. Certain areas (such as Mosman, a suburb of Sydney = 4-5%) Certain indigenous communities = upwards of 40%

Organisations Visited Cancer Council Victoria VicHealth Australian Drugs Foundation Queensland Health James Cook University Drug Arm Australasia Wuchopperen Health Service Quitline Victorian Aboriginal Community Controlled Health Council Latitude Research Dr Tony Jewell Wollongong City Council Municipal Association of Victoria Healthy Together Good Sports Programme Alcohol and Other Drugs Council of Australasia Australian National Preventative Health Agency (ANPHA)

How have they managed to reduce tobacco rates? High tobacco taxes Mass media public education campaigns Smoke free spaces (inc. legislation)

Evidence Studies have shown that making workplaces, homes and cars smoke-free: decreases the numbers of cigarettes that people smoke; increases the quit attempts that smokers make; reduces the number of relapses that smokers have; increases the numbers of people who quit; decreases the exposure of others to second-hand smoke (environmental tobacco smoke); and having smoke-free homes also lowers the chances that children will take up smoking.

Smoke free spaces - definition No tobacco products at all? Designated smoking areas? Ban in public spaces, still can smoke in private areas? Voluntary/Statutory?

Smoke free areas Prisons Playgrounds (within 10 metres) Malls Patrolled Beaches (within the flags) Enclosed public spaces Smoke free suburbs Cars (under 18) Sports grounds (within 10 m) Universities (some)

Smoke free areas Outdoor eating areas Within 4 metres to an entrance to a public building Enclosed or covered bus stop/taxi rank Hospitals Sports stadiums School grounds Train stations Within 10 m of Council properties

Smoke free areas – target groups Pregnant women Indigenous populations Young people Smoke free workplaces

Effectiveness Police heavily involved in policing such as smoke free cars. Limited workforce to patrol rural and remote areas. All states have different tobacco legislation – can be both positive and negative. Strong community support for change. Nanny state?

Understanding population needs

Smoke free messages – indigenous population feature Aboriginal & Torres Strait Islander faces, voices and imagery; avoid negative themes; positive, inspirational and light-hearted; simple clear language; use familiar (and local) Indigenous people; use local language, Aboriginal words and style of talking; have a storytelling approach; use Aboriginal & Torres Strait Islander imagery and art work; feature true stories and real people; feature messages which relate to ‘here and now’ and harness the strong sense of family and kin.

Smoke free city? Proposal to ban smoking from Central Business District in Melbourne. Streets, laneways, footpaths and any public space. No details as yet as to how this would be enforced.

Tobacco – out of sight Unlike alcohol, tobacco is not a product that you see in daily life. Actively search for tobacco products – not made easy. Quit support messages seen everywhere.

Any questions?