Australian Tobacco Action Plan 2007 - 2011

Western Australian
Tobacco Action Plan

2007 – 2011
HP10422 Nov’07 22324
Produced by Tobacco Control Branch

© Department of Health 2007
Western Australian Tobacco Action Plan 2007 - 2011
Foreword
The Western Australian Tobacco Action Plan (WA TAP) 2007-2011 provides a framework for tobacco
control activities in Western Australia for the next five years. It outlines public health policy on
tobacco control for Western Australia and facilitates implementation of key recommendations of the
National Tobacco Strategy (NTS) 2004-2009.
Although there has been significant progress made in the reduction of tobacco smoking rates in
Western Australia, smoking remains the main cause of preventable drug-related death and disease
in Western Australia. The greatest burden of tobacco-caused death and disease occurs among those
most in need. Each year tobacco use kills over 1,400 Western Australians and places an enormous
strain on the health budget of WA, being responsible for $60 million per year in hospital costs alone.
This five-year plan aims to improve the health of Western Australians by reducing the harm caused
by tobacco, especially among priority population groups. The WA TAP 2007-2011 is based on best
practice in tobacco control and complements and builds on existing international, national and state
policy frameworks and guidelines.
Significant progress has been made in the past year to further strengthen tobacco control legislation
in WA. The Tobacco Products Control Act 2006 was passed in the Western Australian Parliament on
28 March 2006 introducing a number of new tobacco control initiatives including a licensing scheme
for retailers and wholesalers and bans on tobacco advertising at point of sale. As of 31 July 2006 a
total ban on smoking in all enclosed public places, including pubs and clubs was also introduced.
Implementing the key strategies outlined in this plan is achievable if collectively government,
non-government agencies and other stakeholders work together. Maintaining strong partnerships,
strengthening legislation and progressing the comprehensive range of strategies outlined in the plan
will ensure that the quality of life of all Western Australians is advanced.
The Hon Jim McGinty MLA

Minister for Health
1
Table of Contents
Foreword 1
Background 3
The WA Tobacco Action Plan 2007-2011 consultation 3
The WA Tobacco Action Plan 2007-2011 structure 3
Section 1: Context of WA Tobacco Action Plan 2007-2011 5
1.1 International context 5
1.2 National context 6
1.3 Western Australian context 6
Section 2: Overview of WA Tobacco Action Plan 2007-2011 9
2.1 Goal 9
2.2 Priority population groups 9
2.3 Objectives 10
2.4 Key action areas 10
WA Tobacco Action Plan 2007-2011 framework 12
Section 3: Evidence for action 13
3.1 Harm caused by tobacco use 13
3.1.1 Death 13
3.1.2 Disease 13
3.1.3 Exposure to Second Hand Smoke (SHS) 13
3.1.4 Hospitalisation 13
3.1.5 Cost of tobacco smoking to the community and the Health Care System 14
3.2 Prevalence 14
3.2.1 Adults 14
3.3 Smoking by specific priority population groups 14
3.3.1 Aboriginal and Torres Strait Islander (ATSI) peoples 14
3.3.2 People from Culturally and Linguistically Diverse (CaLD) backgrounds 14
3.3.3 People with a mental illness 14
3.3.4 Offenders and detainees 15
3.3.5 Young people 15
3.3.6 Parents and carers of children 15
3.3.7 Pregnant women 15
3.3.8 People living in rural and remote locations 16
3.3.9 People at high risk of or with chronic diseases 16
3.3.10 People living in low socioeconomic circumstances 16
Section 4: Action areas and activities 17
Section 5: Current activity in tobacco control in Western Australia 31
Section 6: References 39
Section 7: List of acronyms 42
2
Background
The Western Australian Tobacco Action Plan (WA TAP) 2007-2011 will essentially be a tool to guide
tobacco control activities in Western Australia for the next five years. It outlines public health policy
on tobacco control for Western Australia and facilitates implementation of key recommendations of
the National Tobacco Strategy 2004-2009.
While the National Tobacco Strategy 2004-2009 provides a national framework for tobacco control
in Australia, individual jurisdictions are responsible for determining the detail of their involvement
in the strategy. The WA TAP 2007-2011 focuses on those recommendations and strategies most
relevant to Western Australia.
The WA Tobacco Action Plan 2007-2011 consultation

In response the National Tobacco Strategy 2004-2009 the Tobacco Control Branch (TCB) of the
Department of Health (WA) coordinated the development of the WA TAP 2007-2011 in consultation
with a wide range of stakeholders from government and non-government organisations that have an
interest in tobacco control issues.
The consultation process for development of the WA TAP 2007-2011 provided stakeholders with a
number of avenues through which to contribute their feedback. These consisted of:
1. An information session with a Commonwealth commissioned tobacco control expert
regarding the National Tobacco Strategy 2004-2009.
2. A state-wide audit of current tobacco control activities and achievements.
3. A consultation workshop held in February 2006.
4. Distribution of a draft framework in April 2006 seeking comments.
5. Distribution of a draft plan in July 2006 seeking comments.
6. Collation of stakeholder comments and recommendations September/October 2006.
A temporary delay in the timeline for finalisation of the WA TAP occurred in late 2006 due to
development of the WA Health Promotion Strategic Framework (WA HPSF). In order to avoid possible
confusion and to facilitate alignment between the documents, the delay was intended to contribute
to better achieving overall state-wide health promotion objectives.
The WA Tobacco Action Plan 2007-2011 structure

The WA TAP 2007-2011 is divided into five sections.
Section One discusses the contextual issues for future tobacco control activities in WA and provides
a short description of the most relevant international, national and state documents, which
offer important scientific evidence about tobacco-related harm as well as policy frameworks and
guidelines for tobacco control.
Section Two provides an overview of the plan and outlines the goal, objectives, action areas and
priority population groups requiring special attention.
Section Three presents key data and information on harm caused by tobacco use and exposure in
Western Australia.
3
Section Four outlines action areas and recommended activities to be employed over the next five
years. Timeframes and data sources for key indicators are provided (where available) and those
involved in the development and implementation of activities are identified.
Section Five provides self-reported details of key agencies involved in tobacco control in WA and
information about the current and ongoing programs they deliver. This will be updated annually via
Internet posting at www.health.wa.gov.au/watap.
4
Section 1
Context of the WA Tobacco Action Plan 2007-2011
The WA TAP 2007-2011 complements and builds on existing state, national and international
documents, which provide important scientific evidence about tobacco-caused harm as well as
policy frameworks and guidelines for tobacco control. A short description of the most relevant is set
out below.
1.1 International context

1.1.1 World Health Organisation’s (WHO) Framework Convention on Tobacco Control
(FCTC).
The WHO FCTC was developed in response to the globalisation of the tobacco epidemic1. Essentially
the FCTC is an international tool to reduce consumption and the increasing death toll arising from
tobacco consumption worldwide. The treaty and its protocols address diverse issues relating to
tobacco manufacturing, trade and consumption2. Recommendations contained in the FCTC include:
Price and tax measures to reduce demand for tobacco.
Non-price measures to reduce demand for tobacco, namely:
Protection from exposure to tobacco smoke.
Regulation of the contents of tobacco products.
Regulation of tobacco product disclosures.
Packaging and labelling of tobacco products.
Education, communication, training and public awareness.
Regulation of tobacco advertising, promotion and sponsorship.
Demand reduction measures concerning tobacco dependence and cessation.
1.1.2 The 28th United States Surgeon General’s Report on Smoking and Health: The
Health Consequences of Smoking.
For over 40 years the US Surgeon General has published evidence-based reports on the harmful
health effects of smoking. The evidence reviewed in the most recent report, The 28th United States
Surgeon General’s Report on Smoking and Health: The Health Consequences of Smoking, and other
reports of the Surgeon General concludes the following:
Smoking harms almost every organ in the body, causing many diseases and reduces the health
of the smokers in general.
Quitting smoking has immediate as well as long-term benefits.
Smoking cigarettes with lower yields of tar and nicotine provides no clear benefit to health.
The list of diseases caused by smoking has been expanded to include abdominal aortic
aneurysm, acute myeloid leukaemia, cervical cancer, kidney cancer, pancreatic cancer,
stomach cancer, periodontitis, pneumonia and cataracts.
Second hand smoke is a serious health hazard that causes premature death and disease in
children and non-smoking adults3.
5
1.2 National context

1.2.1 The Australian National Tobacco Strategy 2004-2009
In March 2005, the Ministerial Council on Drug Strategy (MCDS) endorsed the National Tobacco
Strategy 2004-2009. The Strategy is a statement of the resolve of federal, state and territory
governments to work together and in collaboration with non-government agencies on a long-
term, comprehensive, evidence based and coordinated national plan to reduce the harm caused
by tobacco smoking in Australia. The goal of the National Tobacco Strategy 2004-2009 is ‘to
significantly improve health and to reduce the social costs caused by, and the inequity exacerbated
by, tobacco in all its forms’4. To achieve this the Strategy has committed to eight areas for action.
They include:
1. Regulation of tobacco.
2. Promotion of Quit and smoke free messages.
3. Cessation services and treatment.
4. Community support and education.
5. Addressing social, economic and cultural determinants of health.
6. Tailoring initiatives for disadvantaged groups.
7. Research, evaluation and monitoring and surveillance.
8. Workforce development.
1.3 Western Australian context

1.3.1 WA Health – Our Strategic Intent 2005-2010
The WA Health Strategic Intent 2005-2010 outlines key intentions and commitments for the next five
years to deliver a healthy WA.
The vision of this document is to ‘Improve and protect the health of Western Australians by
providing a safe, high quality, accountable and sustainable health care system’5.
To achieve this vision the document sets out and describes six priority areas:
Healthy workforce
Healthy hospitals
Healthy partnerships
Healthy communities
Healthy resources
Healthy leadership.
1.3.2 Western Australian Health Promotion Strategic Framework 2007-2011

The Western Australian Health Promotion Strategic Framework 2007-2011 (WA HPSF) outlines
the key directions for the promotion of healthier and safer lifestyles for the Western Australian
population over the next five years.
6
The WA HPSF takes a ‘cluster’ approach to the prevention of chronic diseases such as cardiovascular
disease, diabetes and certain cancers. This approach targets a number of risk factors shared by
these and other chronic conditions, namely, physical inactivity, poor nutrition, smoking, harmful
alcohol use and obesity. The WA HPSF also identifies priorities for action to prevent injury.
The WA HPSF promotes the use of population based approaches to ensure that appropriate
prevention activities occur across the continuum from wellness to ill health, for the overall
population, specific sub groups and individuals at greater risk of harm. This whole-of-system
approach shares the responsibility for health promotion across the health system.
In relation to preventing smoking, the WA HPSF outlines seven key strategic directions for action:
1. Effectively monitor and enforce legislative controls on the sale, supply, advertising and
promotion of tobacco.
2. Increase the urgency of stopping smoking and of protecting others from exposure to second
hand smoke.
3. Reduce exposure to second hand smoke.
4. Improve access to smoking cessation support across the continuum of health care and the
community.
5. Discourage the uptake of smoking by young people.
6. Broader community engagement in tobacco control interventions and issues.
7. More innovative programs to address smoking among Aboriginal people and other high-risk
groups.
The WA TAP 2007-2011 lists a broad range of specific recommended activities that are aligned with
the NTS and encompass the aforementioned strategic directions of the WA HPSF.
7
8
Section 2
Overview of WA Tobacco Action Plan 2007-2011
WA Tobacco Action Plan 2007 -2011
The Western Australian Tobacco Action Plan (WA TAP) 2007-2011 continues on from and builds on
the framework developed under the previous WA TAP 2001-2004. It outlines public health policy on
tobacco control for Western Australia and facilitates implementation of key recommendations of the
National Tobacco Strategy (NTS) 2004-2009.
The WA TAP 2007-2011 is a framework that enables government, non-government organisations,

individuals and community groups to work in collaboration to achieve successful tobacco control
outcomes. It is an evidence based reference tool for anyone associated with tobacco control in
Western Australia, and is intended to contribute to the design and development of programs and
activities across the state.
The WA TAP 2007-2011 also aligns with other key strategic initiatives within WA Health, including
Health Networks and the WA Health Promotion Strategic Framework (WA HPSF).
Monitoring and reporting on the WA Tobacco Action Plan 2007-2011

As part of its state-wide policy coordination role in relation to tobacco control, the Tobacco Control
Branch of the Department of Health will be responsible for collating data on the implementation
of the WA TAP 2007-2011 and reporting on its progress to the Commonwealth Government and key
stakeholders.
2.1 Goal
To improve the health of Western Australians by reducing the harm caused by tobacco, especially
among priority population groups.
2.2 Priority population groups

Priority population groups means any population group that is, or traditionally has been excluded
from tobacco control planning, decision-making, or the benefits of tobacco control programs or
interventions. Priority populations have disproportionate rates in relation to population numbers,
tobacco use or tobacco-related morbidity or mortality, and experiences a disproportionate rate of
exposure to tobacco smoke and tobacco industry promotional practices7. They include:
Aboriginal and Torres Strait Islander people
People from culturally and linguistically diverse backgrounds
People with mental illness
Offenders and detainees
Young people
Parents and carers of children
Pregnant women
People living in rural and remote locations
People at high risk of or with chronic diseases
People living in low socioeconomic circumstances
9
2.3 Objectives
In order to achieve its goal, the WA TAP 2007-2011 aims to:
Prevent the uptake of smoking.
Reduce the number of people using tobacco.
Reduce exposure to tobacco and the harm it causes.
2.4 Key action areas

To address the WA TAP 2007-2011 objectives, there are four action areas.
2.4.1 Regulation
The health effects of exposure to second hand smoke (SHS) are well documented and indisputable.
Numerous scientific studies have demonstrated that exposure to SHS causes a number of illnesses
and diseases, including lung cancer and heart disease. Tobacco control legislation includes
programs, which place control on the promotion, sale and use of tobacco products in order to
limit the exposure of people within the community to second hand smoke, encourage non-smokers
particularly young people, to not start to smoke and to reduce smoking rates in the community
generally.
This action area will include a series of strategies to address the following:
Regulating the promotion of tobacco products.
Regulating the place of sale of tobacco products.
Regulating place of use of tobacco products.
Regulating the packaging of tobacco products.
Regulating tobacco tax.
Regulating tobacco products.
Action Area 1 relates to NTS 2004-2009 Policy Area 1 – Regulation of tobacco.
2.4.2 Community education

Western Australia is a leader in public education and information strategies aimed at raising
awareness of harm caused by tobacco in the community. A range of government and non
government agencies conduct public education strategies that promote the effects of smoking on
health in an effort to encourage smokers to quit smoking and deter young people from taking up
smoking. These public education strategies range from state-wide mass media based campaigns
to community-based programs and a wide range of public advocacy on tobacco control issues.
The recommended activities in relation to this action area centre on maintaining and improving
advocacy and existing education strategies, as well as ensuring a collaborative and cooperative
approach to developing and conducting community based initiatives that target priority population
groups and the general community.
Promotion of prevention, cessation and smokefree environment messages.
Building the capacity of those working in tobacco control at a national, state or local level.
10
Broader community engagement in tobacco control interventions and issues.

More innovative programs to address smoking among Aboriginal people and other high risk
groups.
Action Area 2 relates to the NTS 2004-2009 Policy Area 2 – Promotion of Quit and Smokefree
messages and Policy Area 4 – Community support and education.
2.4.3 Cessation services and treatment

Quitting smoking remains one of the most important measures to reducing smoking-caused death
and disease in Western Australia.
Quitting smoking at any age results in immediate health benefits, irrespective of how long a person
has been smoking. Many people find quitting difficult and usually need multiple attempts to quit
successfully. It is therefore important that all smokers have access to a range of smoking cessation
services and treatments that are appropriate and accessible to them in order to maximise their
chances of success.
Behavioural and support services.
Pharmacotherapies.
Counselling and referral by health professionals.
Action Area 3 relates to NTS 2004-2009 Policy Area 3 – cessation services and treatment.
2.4.4 Research and evaluation

Comprehensive research and evaluation activities are important for ensuring that current and
proposed tobacco control programs and policies are appropriate and effective. Effective research
and evaluation will assist with priority setting, identifying new and emerging trends and issues,
reflecting on achievements, and establish future goals.
Research to develop new methodologies for tobacco control.
Evaluation of the effectiveness of current tobacco control activities.
Monitoring of smoking behaviour, attitudes and prevalence.
Analysis and dissemination of research findings.
Action Area 4 relates to NTS 2004 –2009 Policy Area 7 – Research, evaluation and monitoring and
surveillance.
NTS 2004-2009 Policy Area 5 – Addressing social, economic and cultural determinants of health,
Policy Area 6 – Tailoring initiatives for disadvantaged groups and Policy Area 8 – Workforce
development will be integrated across all WA TAP 2007- 2011 Action Areas 1-4.
See Figure 1: WA TAP 2007-2011 Framework
11
Figure 1: WA Tobacco Action Plan 2007 - 2011 Framework
Goal
To improve the health of Western Australians by reducing the harm caused by tobacco,
especially among priority population groups.
Objectives
To reduce the To reduce exposure

To prevent the
number of people to tobacco and the
uptake of smoking.
using tobacco. harm it causes.
Action areas
1. Regulation 2. Community 3. Cessation 4. Research and
Education Services and Evaluation
Treatment
Regulation of Promotion of Behavioural and Research on new
tobacco prevention, support services, methodologies,
promotion and cessation and pharmacotherapies, evaluation of
products, place smokefree counselling and tobacco control
of sale, place of use, environment referrals by health activities,
packaging, tax. messages. professionals. monitoring of
smoking behaviour,
analysis &
dissemination of
findings.
Priority population groups
Aboriginal and Torres Strait Islander people; people from culturally and
linguistically diverse backgrounds; people with mental illness; offenders and
detainees; young people; parents and carers of children; pregnant women;
people living in rural and remote locations; people at high risk of or with
chronic diseases; people living in low socioeconomic circumstances
12
Section 3
Evidence for action
This section provides data and information on the extent of the harm caused by tobacco use and
exposure in Western Australia.
3.1 Harm caused by tobacco use

3.1.1 Death
Tobacco smoking is the largest single preventable cause of death and disease in Australia. In
Australia, tobacco accounts for over 15,500 deaths each year8.
In Western Australia, an estimated 18 percent of all male deaths and 10 percent of all female
deaths in 2001 were due to tobacco smoking. Between 1983 and 2001 more than twice as many
males died than females9.
In Western Australia between 1983 and 2001, tobacco was responsible for 29,044 deaths, an
average of over 1,500 deaths per year. Five conditions were responsible for 85 percent of tobacco-
caused deaths over this period, including lung cancer (30%), ischaemic heart disease (23%), chronic
obstructive pulmonary disease (19%), stroke (8%) and atherosclerosis (5%)9.
3.1.2 Disease
Tobacco smoking is a major risk factor for a range of disabling and fatal conditions including
cardiovascular and lung diseases and some cancers. In addition, men and women are at risk of
developing a number of gender-specific health problems due to smoking, such as reduced fertility or
menstrual problems in women and impotence in men. Women who smoke during pregnancy are at
greater risk of miscarriage, premature labour, and stillbirth, bearing an unhealthy birth weight baby
or experiencing complications during labour10.
3.1.3 Exposure to Second Hand Smoke (SHS)

Exposure to SHS is also a significant cause of disease, including some cancers, cardiovascular
disease, bronchitis, pneumonia, and irritation of the upper respiratory tract, increase frequency
and severity of asthma symptoms, new cases of asthma and Sudden Infant Death Syndrome (SIDS) in
babies. The ‘irritant’ effects associated with exposure to SHS on the eyes, nose, throat and airway
passages are also well known10.
3.1.4 Hospitalisation
In Western Australia in 2004, tobacco was responsible for 14,714 hospital admissions and 84,281
bed days11. In 2001, five tobacco-related conditions were responsible for 68 percent of the tobacco-
caused hospital admissions in that year, including chronic obstructive pulmonary disease (24%),
ischaemic heart disease (21%), lung cancer (9%), atherosclerosis (7%) and cardiac dysrhythmias
(7%)9.
13
3.1.5 Cost of tobacco smoking to the community and the health care system
Tobacco smoking places a substantial financial burden on the community. Health economists have
estimated that in 1998-99 the tangible and intangible costs of smoking to Australia were $21.1
billion12.
The tangible costs refer to the total combined cost of health care expenditure, loss of human
productivity, fires and resources used in abusive consumption. The intangible costs refer to the loss
of life.
In 2001, smoking related hospitalisations cost the West Australian health care system over $60
million11.
3.2 Prevalence
3.2.1 Adults
A survey conducted in 1984 reported that 32 percent of adult Western Australians smoked. In 2004,
the prevalence of smoking among Western Australians aged 14 years and over was 15.5 percent13.
Twenty three percent of adult males are daily smokers compared to 19 percent of adult females14.
3.3 Smoking by specific priority population groups

3.3.1 Aboriginal and Torres Strait Islander (ATSI) people
Aboriginal people comprise approximately 3 percent of the total population in Western Australia15.
In 2004-05, 50 percent of ATSI people were current daily smokers compared to 17 percent of non-
Indigenous people14,16. Over one third (35%) of young Aboriginal people aged 12 to 17 years have
smoked regularly17.
The high prevalence of smoking within the Aboriginal community means that the effects of active
and passive smoking are greatly magnified. ATSI people experience higher mortality rates from
a number of diseases caused by smoking compared to the general Australian population18. These
conditions include cardiovascular disease, respiratory disease, and a number of cancers. In Western
Australia, the rates of hospitalisation and death from conditions caused by smoking are estimated to
be 2 to 5 times higher for Aboriginal people compared to non-Indigenous people19.
3.3.2 People from culturally and linguistically diverse backgrounds (CaLD)

Many people migrating to Australia and refugees come from countries where smoking rates are high.
Among men, those born in the Middle East, Southern Europe and Western Europe have the highest
smoking prevalence20. Western Australia has a culturally and linguistically diverse population
comprised of many different ethnic communities.
3.3.3 People with mental illness

People with mental illness have significantly higher smoking rates than the general population.
The 1997/98 Survey of Mental Health and Wellbeing found that 43 percent of Western Australians
diagnosed with mental illness were current smokers compared with 24 percent of the general
population. People with mental illness also experience higher mortality rates from cancer, heart
disease, circulatory diseases and respiratory diseases than the general population21.
14
3.3.4 Offenders and detainees

In 2004, almost 84 percent of the Western Australian adult prisoner population and 68 percent of
juveniles identified themselves as smokers on receival to custodial institutions. Aboriginal people
are highly over-represented in the prison system, representing approximately 3 percent of the
general WA population but 46 percent of the prisoner population.19
Poor educational attainment, unemployment, social isolation, interpersonal conflicts, financial

dependence, mental illness and substance abuse are features common to prisoner populations.
Women’s prisons have the additional concerns related to the risks to the unborn child and young
children23,24,25.
Historically cigarettes have been purchased by adult prisoners through the prisoners’ canteen at a
discounted rate of $2-$3 cheaper than the same packet in the community. Further compounding
the smoking problem in prison is that prisoners usually smoke a brand of pouch tobacco, which
has higher nicotine and tar content than manufactured cigarettes. Furthermore shared ventilation
systems in accommodation units expose all prisoners and staff to tobacco pollutants.
3.3.5 Young people

Most adults who smoke commence this behaviour as adolescents. The younger someone starts to
smoke, the more likely they are to be heavy users of tobacco and, consequently, the greater risk
they have of ill health from smoking26. The prevalence of smoking among WA students aged 12 to 17
years is at its lowest level since 1984. Current smoking prevalence has decreased from 11.5 percent
in 2002 to 6 percent in 200527.
In 2005 8.7 percent of students had smoked in the last month, 17.6 percent in the last year and 31.5
percent had ever smoked at least part of a cigarette27.
3.3.6 Parents and carers of children

In Australia, almost 40 percent of children under 12 years of age live in homes where at least one
adult is a regular smoker28. Second hand smoke is considered a factor in respiratory infections,
middle ear infections, the onset and worsening of asthma, decreased lung function, eye and
nose irritation, low birth weight and sudden infant death syndrome29,30. The benefits of reducing
children’s exposure to second hand smoke at home also includes reduced school absenteeism,
increased school performance, reduced uptake of smoking and decreased consumption of tobacco
among children who smoke30.
3.3.7 Pregnant women

Nearly 18 percent of Western Australian women smoke during pregnancy31 and an estimated 5,000
Western Australian babies are born to mothers who smoke each year. Unfortunately, half of women
who quit smoking throughout their pregnancy relapse within six months of delivery and 70 percent
relapse within 12 months32.
Indigenous women are also more likely to smoke during pregnancy when compared to non-
Indigenous women33,34. A recent survey into the health of Western Australian Indigenous children
found that 49 percent of Indigenous women used tobacco whilst pregnant35. Research from other
states has found that in some Indigenous communities, up to 72 percent of women smoke whilst
pregnant36.
15
Pregnant women who smoke have a greater risk of:

having an unhealthy birth weight baby
Sudden Infant Death Syndrome (SIDS)
premature labour
miscarriage
ectopic pregnancy
the child developing respiratory problems such as asthma, croup, bronchitis and pneumonia.
3.3.8 People living in rural and remote locations

Rural residents are more likely to smoke than Perth metropolitan residents. In 2004 the Kimberley,
the Pilbara-Gascoyne, Midwest-Murchison and the Goldfields-South East of Western Australia had
significantly higher proportions of both male and female smokers compared with other areas of the
State37.
People living in rural and remote locations have less access to general and specialist public health
medical services making it less likely for them to be referred to the Quitline or be prescribed
smoking cessation treatments20.
3.3.9 People at high risk of or with chronic diseases

Smoking is a key risk factor for a number of the chronic disease conditions that affect Western
Australians, which include: cardiovascular disease, type 2 diabetes, several cancers, asthma and
arthritis. In 2000, these conditions were responsible for almost half of the total burden of disease in
Western Australia38.
In 2005, the hospitalisation costs for a number of key preventable chronic diseases in Western
Australia were approximately $114 million - cardiovascular disease (47 million), preventable cancers
($41 million), diabetes ($17 million), lung cancer ($ 6 million), and asthma ($3 million)39.
Reduction in the number of people smoking is fundamental to the achievement and maintenance of
health throughout the life cycle, and extending into future generations6.
3.3.10 People living in low socioeconomic circumstances

Unlike the situation in many other countries, in Australia since the advent of mass media campaigns,
smoking prevalence has reduced in parallel among higher and lower socioeconomic status (SES)
groups. Nevertheless, there remains a clear relationship between SES and smoking, with people
in blue collar occupations, the unemployed and those with less formal education smoking at
significantly higher rates than people in white collar jobs and those with tertiary qualifications4.
16
Section 4
Action areas and activities
4.1 Regulation: Regulating the promotion, the place of sale, the use and packaging of tobacco products and regulating
tobacco tax and products.
Action Area 1. Regulation

Who needs to be Who is involved in this Timeline Data sources for key indicators currently
Recommended activities
influenced? activity? 07 08 09 10 11 available
Promotion, sale, packaging

1.1 Implement Tobacco Products Retailers WA Health
Control Act 2006 and associated AIEH
regulations. Wholesalers
Employers/
Employees
General Community
Tobacco Companies
1.2 Develop and implement state- Retailers WA Health
wide compliance programs to support AIEH Police
regulation of promotion, place of sale, Wholesalers Local Government
place of use and packaging of tobacco Employers DOCEP
products. Employees
General Community
Tobacco Companies
Place of use
1.3 Support and advocate for Occupiers NGOs Percentage of people reporting no exposure
increased public non-smoking outdoor Local Government Healthway to smoking in everyday life.
areas and events. Regulators Local Government l AIHW 2001
Event Managers Lottery West
WA Health
DCA
17
18
Place of use (continued)

1.4 Support the development and Employees WA Health Percentage of children in homes where
implementation of Smokefree projects Employers Healthway parents are smokers and parents smoke
and policies not covered by legislation. Local Government Local Government indoors and in cars.
Government agencies NGOs l ACAM Survey
Government agencies
Employers l NDSHS 2004, 2007, 2010
Employees l ASSAD 2005, 2008, 2011
1.5 Develop and implement Smokefree Employees WA Health
WA Health System Policy across all WA General Community NGOs
health services and facilities.
1.6 Support the development of a DPC NGOs Percentage of government funded
whole of government policy that Government funders DPC residential, mental health and correctional
restricts tobacco promotion, sale and Event Managers WA Health facilities that prohibit or limit smoking
use at any venue or facility that is Healthway indoors.
funded (in whole or part) or owned
by Government.
1.7 Worksafe WA to continue to Employers DOCEP Percentage of people who report no
educate and enforce regulations 3.44A Employees Employers smoking at their workplace.
to 3.44I of the Occupational Safety and
Health Regulations 1996, dealing with l NDSHS 2004, 2007, 2010
protection from tobacco smoke within
the workplace.
1.8 Advocate for changes to tobacco State Government DOCEP

control legislation to be reflected in Commonwealth WA Health
Occupational Safety and Health Act. Government Employers
Workplace OSH
Committees
Regulation of tobacco products

1.9 Advocate for further Commonwealth NGOs
Commonwealth regulation of tobacco Government
product promotion. State Government
1.10 Advocate for tobacco industry to Commonwealth WA Health
be required to disclose the contents of Government State Government
tobacco products. NGOs
1.11 Advocate for increases in taxation Commonwealth NGOs Average number of cigarettes students
to discourage the use of tobacco Government aged 12 to 17 years can buy on an average
products. week’s pocket money.
l
ASSAD, 2005, 2008, 2011
Average reported price paid for cigarettes
by adults.
l
NTC 2008
1.12 Support initiatives to regulate Commonwealth NGOs
nicotine under Commonwealth poisons Government WA Health
legislation.
1.13 Advocate for continued effective Commonwealth NGOs
health warnings on cigarette packets. Government
1.14 Develop and implement tobacco Local Government WA Health
sellers licensing scheme. Employers
Employees
General Community
Tobacco Industry
19
20
Regulation of tobacco products (continued)

1.15 Investigate opportunities Regulators WA Health
for Nationally consistent Tobacco industry Commonwealth
tobacco control legislation. organisations
NGOs
Legislative review
1.16 Conduct reviews of current Retailers WA Health
tobacco legislation in line with Wholesalers Healthway
legislative review provisions. Employers/
Employees
General Community
Tobacco Companies
Police
Local Government
Other state
government agencies
4.2 Community education: Mass media, cessation support, exposure to tobacco smoke, priority populations, policy
and legislation
Action Area 2. Community education

Cessation support
2.1 Promote the Quitline as Quitline standards working NGOs Patterns and numbers of calls to the Quitline
a reliable source of cessation group – Develops standards based WA Health and hits to the website.
information and support. on a National Quitline Review that Retailers
would enable the Quitline to deliver
a responsive, consistent and research Enforcement Officers
based effective service to smokers in
Australia.
WA Health
2.2 Extensively promote the NGOs DAO Pre and post campaign Quitline activity.
Quitline counselling service Healthway NGOs Cessation self-help material uptake among
and other smoking cessation WA Health health professionals and health services.
services among health service
providers and consumers.
Mass media
2.3 Develop, provide adequate Quit Group – Facilitates the NGOs Percentage awareness of campaign
funding and support National sharing of knowledge, expertise, WA Health advertising and recall of message among
information and resources among
and state-wide media State and Territory Quit organisations Commonwealth and smokers and recent quitters.
campaigns. and heads of comprehensive, State Government l
dedicated tobacco control programs. Pre and Post campaign evaluation.
Healthway
Commonwealth and State l
Percentage of quitters who attribute
Government quitting to campaign.
Tobacco Campaign
planning group
2.4 Develop, implement Smokers NGOs Tracking study of smokers’ attitudes,
and support long term Non-smokers WA Health knowledge and awareness of the health
comprehensive media Healthway effects associated with smoking pre and post
campaigns that personalise campaign activity.
the health risks of smoking, Tracking study of cessation activity among
increase knowledge of the smokers.

quitting process and motivate l
TCB Tracking study 2002-2005.
quitting.
l
AIHW Reduction in disease and deaths
caused by smoking.
21
22
Exposure to SHS
2.5 Promote messages to children DET NGOs Existence of mass media campaigns and
to prevent the uptake of smoking Community health WA Health community based activity targeting youth.
through mass media campaigns and nurses Healthway l
ASSAD 2005, 2008, 2011
school based education and harm Commonwealth and DET
minimisation strategies. State Government Enforcement Officers
Retailers
2.6 Promote Smokefree and other Community groups Healthway

tobacco control messages and DSR WA Health
policies at public events and/or Commonwealth and NGOs
community projects. State Government
Local Government
2.7 Promote awareness regarding Employers DOCEP (Worksafe)
exposure to environmental tobacco employees and unions WA Health
smoke in the workplace. Commonwealth and NGOs
State Government
Local Government
2.8 Promote public awareness and WA Community WA Health Percentage of adult smokers who report
understanding of the health risks WA Health NGOs regular smoking, smoking outdoors and in
associated with the exposure to Commonwealth cars.
environmental tobacco smoke in Government
l
all settings eg. Homes, cars and in Government agencies ACAM Survey, AIHW
public places. State Housing
Percentage of school students reporting
Commission
exposure to tobacco smoke at home.
l
ASSAD 2005, 2008, 2011
2.9 Support the development of a WA Community NGOs

national public education campaign WA Health
to reduce the exposure of children Worksafe
and adults to environmental Commonwealth
tobacco smoke. Government
State Housing
Commission
Priority populations
2.10 Develop and Implement CaLD community NGOs
culturally sensitive and relevant groups Healthway
tobacco education strategies in ATSI Community WA Health
partnership with priority population groups CaLD community groups
groups. ATSI Community groups
2.11 Integrate tobacco control Local Government NGOs
education into existing health Community groups WA Health
and life skill programs and
interventions.
Parents, youth, children
2.12 Provide support to parents and WA Community NGOs

others to prevent the uptake of Local Govt WA Health
smoking among children. Community Groups Healthway
Youth services
Parents and Carers
Children/youth
2.13 Encourage women planning General Practice NGOs
a pregnancy, pregnant women, Aboriginal Medical WA Health
new mothers and their partners Services
to quit smoking through targeted Healthway
education campaigns, programs and WA Health
BI screening.
2.14 Implement initiatives Local Government General Community
that build on the high level of Youth Services NGOs
community support for tobacco Community groups
control measures and encourage CaLD Groups
and facilitate broader community ATSI Groups
engagement in tobacco control Tertiary Institutions
interventions and issues.
23
24
Policy and legislation

2.15 Provide advice on WA Community WA Health
Smokefree policy development WA Health
and implementation for
hospitals and healthcare
campuses.
2.16 Provide advice on General community WA Health
Smokefree policy development Employers
and implementation for Employees
workplaces. Local Government
2.17 Develop and conduct Local Government Local Government
education programs to promote WA Health
compliance with tobacco Police
control legislation.
4.3 Cessation services and treatment: Workforce development, cessation support, dependence and NRT management,
staff cessation and integration of cessation support.
Action Area 3. Cessation services and treatment

Who needs to be Who is involved in this Timeline Data sources for key indicators
influenced? activity? 07 08 09 10 11 currently available
Workforce development
3.1 Train and support health care and Health Professionals NGOs Percentage of smokers attempting to
community workers to assist different Social Workers WA Health quit prompted by health professionals.
population groups to quit through Community Workers Health Services
l
evidence based brief intervention smoking CHPRC – ECU Number of referrals to the GP
cessation advice, individual counselling Healthway Quitline referral project.
and group courses.
3.2 Encourage undergraduate and Universities WA Health Percentage of graduate health

graduate training programs for all TAFES NGOs professionals aware of tobacco related
relevant health professionals to include Colleges Tertiary Institutions health effects and guidelines and best
tobacco and smoking cessation modules, Healthway practice in addressing smoking.
which provide knowledge on tobacco
l
control practices, priorities, resources Course outlines/core curricula.
and referral opportunities.
3.3 Support the development of an Peak health WA Health

accreditation scheme for health professional NGOs
professionals trained in delivering smoking Accreditation bodies
cessation counselling. WA Health
Cessation support
3.4 Publish and distribute tailored self- Health Professionals NGOs
help quitting resources that are accessible WA Health
to different population groups.
25
26
Cessation support (continued)

l
3.5 Ensure the delivery of Health Professionals NGOs Providers of cessation services.
l
individual counselling and group Accredited WA Health SFWAHS Policy evaluation.
cessation courses are appropriate organisations
and accessible to smokers from
different population groups.
l
3.6 Ensure smoking cessation Peak priority WA Health ADIS Quitline reporting.
advice and support provided population bodies DAO
through the Quitline telephone Quitline standards
counselling service is readily working group
accessible and able to meet the
needs of smokers from different
population groups.
l
3.7 Promote and support WA Health Healthway SFWAHS Policy evaluation.
the management of nicotine Corrective Services Prison management
dependence in a variety of Workplace management
settings in particular people SFWAHS
with mental illness, in-patients, Policy Coordinators

prisons, emergency care settings
and workplaces.
l 2006 National Quitline Standards Final
3.8 Ensure the Quitline telephone WA Health TCB
counselling service meets the ADIS Counsellors DAO Report.
agreed National minimum Quitline standards l
2006 Quitline standards Implementation
standards. working group Report.
3.9 Ensure electronic smoking WA Health NGOs

cessation support services are TCB
available.
l
3.10 Provide smoking cessation Hospital WA Health SFWAHS Policy evaluation.
advice and support to all health Administration CSPs
service staff who smoke. WA Health NGOs
Cessation support (continued)

3.11 Provide support to schools Schools NGOs
to assist students already School nurses WA Health
smoking to reduce or quit
smoking.
Dependence and NRT management
l
3.12 Develop and implement Health Professionals WA Health Let’s Take A Moment
l
best practice guidelines in WA Health National GP Guidelines
the treatment of tobacco
dependence within different
population groups and settings.
l
3.13 Establish mechanisms for WA Health WA Health Let’s Take A Moment – NSW Health
l
the identification and treatment NGO National GP Guidelines
l
of all smokers in contact with WA WA Health Strategic Plan
l
health services. WA Health - Health networks
3.14 Support the provision of Employers WA Health

subsidised nicotine replacement Health Services NGOs
therapy. Commonwealth Commonwealth
Government Government
Staff Cessation support
3.16 Provide smoking cessation Private sector WA Health
support to the private business management NGOs
sector to assist staff who smoke. Small Business
Development
Corporation
Chamber of
Commerce
Business sector
27
28
Integration of cessation support

3.17 Encourage private health Private health funds WA Health
funds to provide rebates for Commonwealth NGOs
smoking cessation treatments/ Government
services.
3.18 Where appropriate Local Government WA Health
integrate BI smoking cessation DEET NGOs
intervention into other health DCD
and life skill programs and WA Health
interventions.
4.4 Research and evaluation: Legislation, evaluation of tobacco control activities, data collection on smoking
prevalence, consumption, behaviour, priority populations, economic and social costs and NRT uptake.
Action area 4. Research and evaluation

Legislation
l
4.1 Conduct surveys to monitor Retailers WA Health 2004 S2Ms survey
l
the willingness of retailers General Community ASSAD 2005, 2008, 2011
to sell tobacco products to WA Health
children.
Tobacco control activities
4.2 Conduct ongoing audit and Tobacco control WA Health
evaluation of tobacco control agencies
activities in Western Australia.
Data collection
l
4.3 Support the development WA Health WA Health Number of patients identifying as smokers on
of a uniform state-wide system Health Information admission to hospital.
within hospital settings for the Division
collection of data on patients
smoking status.
l
4.4 Increasing data set on WA Health WA Health Health Information Division
pregnant women including WA Health
smoking status, history and
consumption.
l
4.5 Support and coordinate WA Health TCB ASSAD 2008, 2011
l
National surveys for example General Community DAO NDSHS 2007, 2010
ASSAD and NDSHS in order to DET
collect data related to tobacco Primary and
use. secondary schools
29
30
Action area 4. Research and evaluation
Data collection (continued)

4.6 Investigate options for CEITC WA Health
improving the collection of data Universities Healthway
on smoking to better represent ICHR NGOs
priority population groups Dept of Multicultural
particularly CaLD groups and Interests
Aboriginal and Torres Strait Ethnic Communities
Islander people. Council
Peak CaLD
organisations
4.7 Support priority driven Universities WA Health
research to guide tobacco Researchers Healthway
control programs and policy NGOs
development.
4.8 Ensure collection of data WA Health WA Health
on the morbidity and mortality, NGOs
expenditure and social costs of
tobacco.
4.9 Research uptake and Researchers WA Health
attitude towards NRT product Pharmaceutical Healthway
efficacy and use. companies
Section 5
Current activity in Tobacco Control in Western Australia
The following table provides self-reported details of key agencies involved in tobacco control in WA
and information about the current and ongoing programs they deliver. This directory can be used
to quickly identify who is involved in specific tobacco control activities and whether there may be
opportunities for collaboration. This section will be updated annually via Internet posting at www.
health.wa.gov.au/watap.
Organisation Activity
Alcohol and Drug Information Name of Program: Quitline (WA)

Service Target Group(s): Western Australian smokers wanting quitting
PO Box 126 information and support for themselves and others.
MOUNT LAWLEY WA 6929 Aim of Program: To provide telephone counselling to support smokers
Phone: (08) 9442 5000 wanting to quit and those wanting to help others to quit.
www.dao.health.wa.gov.au
Asthma Foundation of WA Name of Program: Newborns Asthma and Parental Smoking Project
(NAPS)
36 Ord Street
WEST PERTH WA 6005 Target Group(s): Pregnant women and new mothers including
Phone: (08) 9289 3600 Indigenous women living in Western Australia.
www.asthmawa.org.au
Aim of Program: To reduce the prevalence of smoking among
www.smokefreebaby.org.au
pregnant women and new mothers in Western Australia and contribute
to a reduction in childhood asthma and associated poor health
outcomes.
Name of Program: NAPS Indigenous Women’s Project
Target Group(s): Pregnant Indigenous women and new mothers living
in the Perth metropolitan area and Wheatbelt region.
Aim of Program: To reduce the prevalence of smoking among
Indigenous pregnant women and new mothers in Western Australia
and contribute to a reduction in childhood asthma and associated poor
health outcomes.
Australian Council on Smoking Name of Program: Tobacco Control Advocacy

and Health Target Group(s): Policy makers, opinion leaders, the media and the
Level 1, 46 Ventnor Avenue broader community.
WEST PERTH WA 6005 Aim of Program: The long term aim of ACOSH is that outlined by the
Phone: (08) 9212 4300 World Health Organisation, “to improve the health of a population by
www.acosh.org eliminating or reducing their consumption of tobacco products and
exposure to tobacco smoke”.
Cancer Council WA Name of Program: Make Smoking History Campaign and Fresh Start
Program
Tobacco Programs
46 Ventnor Avenue Target Group(s): Primary – Adult smokers, particularly those of lower
WEST PERTH WA 6005 socio-economic status; Secondary – General community and health
Phone: (08) 9212 4333 professionals.
www.cancerwa.asn.au/prevention/
Aim of Program: Contribute to state efforts to reduce the prevalence
tobacco/
of smoking among adults in Western Australia. Make Smoking History
uses a comprehensive range of strategies to reduce tobacco-caused
harm, with mass media a key component. The Fresh Start Program
specialises in cessation support, offering group quitting courses to the
public and workplaces, and training for health professionals in helping
others to quit. The Cancer Council WA also plays a major role in the
development of public policy and research on tobacco at state and
national levels.
31
Child Health Promotion Name of Program(1):Optimising School Nurse Involvement in Youth

Research Centre Based Tobacco Control Programs
Edith Cowan University Target Group(s): School nurses, 11-17 year olds, teachers and
Pearson Street parents.
CHURCHLANDS WA 6018 Aim of Program: The purpose of this Healthway funded research
Phone: (08) 9273 8268 project is to examine, prioritise and empirically test promising
areas of research and intervention success in youth tobacco control
including harm minimisation strategies targeting 11-17 year olds,
involving teachers, parents and in particular, school nurses. The
program is also designed to build capacity at two tiers: by training
school nurses to deliver smoking cessation and harm minimisation
interventions and by working with young researchers to build their
research experience and capacity in the area of smoking cessation.
Name of Program(2): Parental Smoking Cessation and Children’s
Smoking Attitudes and Behaviours
Target Group(s): Parents of young children aged 4 – 8 years.
Aim of Program: This Healthway funded study aims to determine the
most effective harm reduction strategies and messages for use with
parents of young children to develop an intervention aimed at helping
parents quit smoking and communicate more effectively with their
children about smoking.
Department of Health – Commonwealth

Department of Health and Australia has developed the National Tobacco strategy since 1999.
Ageing The revised strategy, the National Tobacco Strategy 2004-2009
(NTS 2004-2009) which builds on initiatives in the previous strategy,
GPO Box 9848 was endorsed by the Ministerial Council on Drugs Strategy on 12
PERTH WA 6001 November 2004. The NTS 2004-2009 reflects evidence around the
Phone: 1800 198 008 health effects of tobacco and the views of experts on the best ways
www.health.gov.au to reduce tobacco related harm. The NTS 2004-2009 also reflects
common agreement between the Australian Government and States
and Territories toward broad policy direction that is needed to reduce
tobacco related disease.
WA Health
WA Health Name of Program: The six strategic directions or priority areas WA
Health follows are: Healthy Workforce, Healthy Hospitals, Healthy
189 Royal St
Partnerships, Healthy Communities, Healthy Resources and Healthy
EAST PERTH 6004
Leadership.
(08) 9222 4222
Target Group: All Western Australians.
Aim of Program: Healthy Communities: To focus on improving
lifestyles, working on the prevention of ill health, and the
implementation of a long-term, integrated health promotion
program. This will be done in collaboration with government and non-
government agencies, general practitioners, and community groups.
32
WA Health (continued)
Health Policy and Clinical Name of Program: Health Networks – Models of Care.
Reform Division Target Population: General Population of WA
Health Network Branch At risk population groups.
1 Centro Avenue
Subiaco WA 6008 Aim of Program: Policy development to reduce the prevalence of
smoking through primary, secondary and tertiary prevention.
Chronic disease models of care provide the overarching policy and set
the direction for service delivery for population and health conditions.
Priority has been given to reduce the incidence of chronic disease
such as diabetes, heart failure, chronic pulmonary obstructive disease
(COPD), asthma, renal disease, stroke and arthritis. These chronic
disease models focus on reducing the prevalence of smoking to
improve health outcomes.
Respiratory Health Network Name of Program: Smoke Free WA Health System.

(sponsor) Target Population: All patients, staff, visitors and contractors to WA
Health Network Branch health sites and facilities.
1 Centro Avenue Aim of Program: From 1 January 2008, smoking will not be permitted
Subiaco WA 6008 on all Department of Health (DOH) premises and grounds throughout
Western Australia. This policy will apply to all staff, patients,
visitors, contractors and other persons who enter DOH owned or
leased buildings, grounds or vehicles for any purpose whatsoever.
The rationale is simply that environmental tobacco smoke (ETS) is
an occupational health and safety issue for staff, patients and the
community.
Health Policy and Clinical The Population Health Policy Branch is responsible for development of
Reform Division healthy lifestyle and chronic disease prevention policy and strategic
planning. The Branch recently developed, in consultation with
Population Health Policy Branch. other experts, the Western Australian Health Promotion Strategic
189 Royal Street Framework 2007-2011. The Branch manages the contracting of major
East Perth 6004. tobacco control campaigns and programs to the non-government
Phone: (08) 9222 4478 sector.
North Metropolitan Area Name of Program: Prohibition of smoking on the King Edward
Health Service – King Edward Memorial Hospital for Women (KEMH) site
Memorial Hospital for Women Target Group(s): Staff, patients and visitors of KEMH.
374 Bagot Rd Aim of Program: To reduce exposure of environmental tobacco smoke
SUBIACO WA 6008 among staff, patients and visitors of KEMH and encourage staff,
Phone: (08) 9340 1407 patients and visitors of KEMH that smoke to make a quit attempt.
wchs.health.wa.gov.au/
North Metropolitan Area Name of Program: Prohibition of smoking on the Princess Margaret
Health Service – Princess Hospital for Children (PMH) site
Margaret Hospital Target Group(s): Staff, patients and visitors of PMH.
Roberts Rd Aim of Program: To reduce exposure of environmental tobacco
SUBIACO WA 6008 smoke among staff, patients and visitors of PMH and encourage staff,
patients and visitors of PMH who smoke to make a quit attempt.
Office of Mental Health Name of Program: WA Smoking Cessation and Mental Health Strategy
Department of Health 2005-2010
189 Royal Street Target Group(s): Psychiatric in-patients (public hospitals) and staff of
EAST PERTH WA 6004 psychiatric in-patient units.
Phone: (08) 9222 4099 Aim of Program: Reduce the prevalence of smoking in psychiatric in-
www.mental.health.wa.gov.au patient units.
33
South Metropolitan Public Name of Program(1): Tobacco Brief Intervention Program In Mental
Health Unit Health in partnership with the Alma St Centre in the mental health
service in Fremantle.
PO Box 546
FREMANTLE WA 6959 Target Group(s): Health professionals and clients at the Alma St
Phone: (08) 431 0200 Centre, Fremantle Mental Health Service.
Aim of Program: To develop and implement a tobacco cessation
project for staff and clients at the Alma Street Centre.
Name of Program(2): Support implementation of the WA Health

Smokefree WA Health System Policy across SMAHS
Target Group(s): Staff, patients and visitors, contractors and other
persons who enter DOH owned or leased buildings, grounds or vehicles
in SMAHS.
Aim of Program: To reduce exposure to environmental tobacco smoke
among staff, patients and visitors in DOH facilities in SMAHS.
Name of Program(3): Smoking cessation for respiratory inpatients with

smoking related illnesses. The project is a collaborative partnership
between SMPHU and the Respiratory Health Networks.
Target Group(s): Primary: Inpatients at Fremantle and Royal Perth
Hospital with smoking related respiratory illness.
Aim of Program: To identify whether successful smoking cessation
programs incorporating NRT, cognitive behavioural elements, post
discharge follow-up and family involvement that have been successful
interstate and overseas would be as successful in two public hospitals
in WA namely RPH and FH.
Tobacco Control Branch The Tobacco Control Branch (TCB) of the Department of Health
Department of Health (formerly known as Quit WA) is located within the Environmental
Health Directorate of the Health Protection Group. The TCB is
PO Box 8172 responsible for:
Perth Business Centre
l State-wide tobacco control policy development, coordination and
PERTH WA 6849
strategic planning.
l Administration and monitoring of legislative tobacco control
measures.
l Coordination and funding of tobacco cessation services including
the Quitline telephone cessation service, online cessation program,
online GP education and production and distribution of cessation
self help material.
l Monitoring and collating evaluation of the performance of tobacco
control programs.
l Aligning the State health strategic plan and the tobacco control
workforce plan to build capacity with key stakeholders and health
professionals regarding tobacco control interventions.
l Advising on resource allocation in relation to the management
of state-wide programs to reduce the prevalence and uptake of
smoking.
34
WA Country Health Service Name of Program: Brief Intervention
Area Office Target Group(s): In-patients and Out-patients.
189 Wellington Street
Aim of Program: To undertake Brief Interventions including
EAST PERTH
assessment, feedback and referral relating to the alcohol and tobacco
PO Box 6680 Perth Business Centre
use of clients. The aim is to reduce harm caused by alcohol and
WA 6892
tobacco and to provide supportive and non-judgemental care.
Phone: 08 9223 8572
Name of Program: WA Smokefree Health Service Policy
Target Group(s): Employees, patients, visitors and contractors.
Aim of Program: To implement the policy as per the supporting
guidelines.
WA Country Health Service Name of Program1: Collie Brief Interventions Program

South West Area Health Service Target Group(s): In-patients at Collie Health Service and Staff at
6 Fairbairn Road Collie Health Service Community Education.
BUSSELTON WA 6280
Aim of Program:
Phone: (08) 9752 6300
Primary - To increase the percentage of patients who reduce smoking.
Secondary – Increase staff skills in screening and referral for smokers
and increase screening and referral by GP’s.
WA Country Health Service Name of Program2: Newborns Asthma and Parental Smoking Training
Midwest Murchison Population Target Group(s): Child Health Nurses.
Health
Aim of Program: Educate Child Health Nurses.
PO Box 22
GERALDTON WA 6531 Name of Program(1): Smokefree Hospitals Project
Phone: (08) 9956 2213
Target Group(s): WA Country Health Service Midwest Murchison
employees, patients, visitors.
Aim of Program:
Primary - to reduce exposure of environmental tobacco smoke to
staff, patients and visitors.
Secondary - increase quit attempts by staff and patients.
Name of Program(2): SmokeCheck Training (through Say No to Smokes

Project)
Target Group(s): Aboriginal health professionals and health
professionals working with Aboriginal people.
Aim of Program: Up skill health workers and health professionals
working with indigenous clients to provide motivational interviewing
and brief intervention to their clients.
Name of Program(3): Brief Intervention Training

Target Group(s): Health professionals specifically targeting Allied
Health, Nurses, Pharmacists and Pharmacy Assistants, Dentists, Dental
Assistants, Practice Nurses and GP’s.
Aim of Program: Up skill health professionals to provide motivational
interviewing and brief intervention to their clients.
35
WA Country Health Service Name of Program(4): Staff quit smoking support
Midwest Murchison Population Target Group(s): All WA Country Health Service Midwest Murchison
Health (continued) employees who smoke.
Aim of Program: To support staff who smoke to quit.
Name of Program(5): How to Quit Information Sessions

Target Group(s): All smokers, specifically those thinking about
quitting or ready to quit.
Aim of Program: Recruit smokers to Fresh Start b) provide
information and support to assist smokers in quitting.
WA Country Health Service Name of Program(1): Tobacco Brief Interventions

Great Southern Public Health Unit Target Group(s): Great Southern health clients (hospitals and
PO Box 5147 Population Health staff with a clinical focus, child, community, allied
ALBANY WA 6332 and maternal health staff).
Aim of Program: Increase number of clients who are assessed for
tobacco use.
Name of Program(2): Tobacco Retailer Compliance Survey

Target Group(s):
Primary – Retailers.
Secondary – Minors and the general community.
Aim of Program: Reduce supply of tobacco to minors.
Department of Corrective Name of Program: Smoking Reform Strategy

Services Target Group(s): All smokers in prisons, work camps and detention
141 St George’s Terrace centres.
PERTH WA 6000 Aim of Program: To reduce incidence of smoking among offenders
Phone: (08) 9264 1275 and detainees in custody by 34 percent within 5 years. To reduce
incidence of smoking among staff of prisons, work camps and
detention centres.
Diabetes Australia WA Smoking is a contributing factor to diabetes complications and

therefore information on smoking is included in such publications as
48 Wickham Street
Don’t Ignore Diabetes (DID). Through the Diabetes Information Advice
EAST PERTH WA 6004
Line (DIAL) Diabetes Educators also provide clients with Quit kits and
Phone: (08) 9323 7699
make referrals to the Quitline.
www.diabetesaustralia.com.au
Healthway Healthway was established under 1990 Tobacco Control Legislation

(now replaced with TPCA 2006) as an independent statutory body. Its
PO Box 1284
core function is to fund activities that promote health, particularly
WEST PERTH WA 6872
that of young people through providing grants to health and research
Phone: (08) 9476 7000
organisations as well as sponsorship to sport, arts, racing and
www.healthway.wa.gov.au
community groups which encourage healthy lifestyles and advance
health promotion programs.
Target Group(s): The broad WA community but with a focus on
young people and children, Indigenous people, rural and remote
communities, economically, socially or educationally disadvantaged
groups, other disadvantaged groups or groups in whom inequalities
exist.
36
Healthway (continued) Tobacco control receives the greatest focus as a health issue through
Healthway’s programs, which support a comprehensive, multi
level approach in Western Australia including public awareness and
education campaigns, prevention of young people taking up smoking,
school and community based projects, advocacy and research,
complemented by sponsorships and the creation of smoke free
environments.
1. Smarter Than Smoking Project (National Heart Foundation WA)
2. Make Smoking History Project (Cancer Council WA)
3. Fresh Start Program (Cancer Council WA) –to December 2006
4. Say No To Smokes (North Metropolitan Area Health Service,
Population Health Unit) – to December 2006
5. Newborns Asthma and Parental Smoking Project (NAPS) (Asthma
Foundation WA)
6. Tobacco Control Advocacy (Australian Council on Smoking and
Health)
7. Tobacco Control Research Development Programs through WA
universities.
And: Healthway sponsorship program - sponsorship of sport, arts and
racing organisations and activities to create smoke free environments
and promote tobacco control messages.
National Heart Foundation Name Of Program(1): National Tobacco Control

(WA Division) Target Group(s): Politicians and other opinion leaders, general
334 Rokeby Road community and smokers.
SUBIACO WA 6008 Aim of Program: To influence politicians and opinion leaders to adopt
Phone: (08) 9388 3343 population wide policies that reduce smoking.
www.heartfoundation.com.au
Name of Program(2): Smarter Than Smoking Project
Target Group(s):
Primary - Young people aged 10 to 15 years in Western Australia, of
which priority populations include young people living in low socio-
economic, and regional areas and young Aboriginal Torres Strait
Islander (ATSI) people.
Secondary - Key intermediaries from health, education and youth
networks working with priority populations, parents, school teachers,
administrators and school nurses.
Aim of Program: To contribute to a decline in smoking prevalence
among 10 to 15-year-olds in Western Australia to 5 percent by the
year 2008.
Name Of Program(1): Heart Health Skill Set (Aboriginal Health Worker

Training)
Target Group(s): Aboriginal Health Workers.
Aim of Program: To educate Aboriginal Health Workers on risk factor
intervention, smoking cessation and Smokefree policy.
Notre Dame University Name of Program: Smokefree University

PO Box 1225 Target Group(s): All students and staff.
FREMANTLE WA 6959
Aim of Program: To encourage all staff and students to uphold the
Phone: (08) 9433 0555
Smokefree status of the university and to provide support for students
www.nd.edu.au
and staff who wish to reduce their level of smoking or to quit.
37
Pharmaceutical Council of Name of Program: Smoking Cessation Program

Western Australia Target Group(s): Visitors and pharmacy clients.
21 Hamilton Street Aim of Program: To encourage quitting as part of a healthier lifestyle
SUBIACO WA 6008 to reduce the cardiovascular risks associated with smoking.
Phone: (08) 9388 2886
www.pcwa.com.au
Telethon Institute of Child Contribution of data and members of the Institute are co-investigators
Health Research on a number of research activities relating to smoking in pregnancy.
PO Box 855 Target Group: Aboriginal women.

WEST PERTH WA 6872
Phone: (08) 9489 7754
www.ichr.uwa.edu.au
Town of Kwinana Name of Program: Quit in Kwinana

PO Box 21 Target Group(s): Adults living in the Kwinana area with an emphasis
KWINANA WA 6966 on women and youth 10-15 years olds.
Phone: (08) 9429 0200
Aim of Program:
Primary – to improve the health of the people of the Town Of Kwinana
by reducing or eliminating their exposure to tobacco smoke.
Secondary – To lower the prevalence of tobacco smokers in the Town
of Kwinana by 5 percent by 2008.
University of Western Name of Program: Solid Boodjari Yorgas (Indigenous Pregnancy and
Australia School of Dentistry Smoking Research Project)
and School of Population Target Group(s): Pregnant Indigenous Women and mothers.
Health
Aim of Program: This Healthway funded research project aims to
35 Stirling Highway investigate issues relating to smoking in pregnant Indigenous women
CRAWLEY WA 6009 using a qualitative approach. Focus groups and interviews with
Phone: (08) 6488 1260 pregnant Indigenous women and mothers who smoke are undertaken
to provide an understanding of attitudes to smoking and factors
associated with smoking.
Curtin University of Name of Program: Web-based alcohol and tobacco intervention

Technology Target Group(s): Males and females aged 18-25 years old.
WA Centre for Health Promotion Aim of Program: To reduce harmful and hazardous drinking levels
Research and tobacco consumption among tertiary students via a web-based
PO Box U1987 intervention.
PERTH WA 6845
Phone: (08) 9266 9266
Western Australian Police Name of Program: Alcohol and Crime Investigation Course
Alcohol and Drug Coordination Target Group: Police Officers.
Section
Aim of Program: To inform police officers of changes to legislation
8 Burton Street (including tobacco control legislation) and ensure police have an
CANNINGTON WA 6107 understanding of their role in enforcement and involvement with the
www.police.wa.gov.au Health Department.
38
Section 6
References
1. Who Framework Convention on Tobacco Control www.who.int/tobacco/framework/download/
en/index.html
2. Chukwujindu, M. Ogwezzy, LL.B (Law), B.L. Ratification and Enforcement of the Framework
Convention on Tobacco Control (FCTC): A Panacea for Curbing the Tobacco Epidemics in the
Developing Countries. Framework Convention Alliance, Tobacco Control Project of Nigeria.
3. The 29th United States Surgeon General’s Report on Smoking and Health: The Health
Consequences of Smoking. www.cdc.gov/Tobacco/sgr/sgr_2004/index.htm
4. The Australian National Tobacco Strategy 2004-2009. (2005). Ministerial Council on Drug
Strategy. Commonwealth of Australia.
5. Department of Health Western Australia. 2005. Strategic Intent 2005-2010
6. Department of Health Western Australia. 2007. Western Australian Health Promotion Strategic
Framework 2007-2011.
7. Rose, N. 2004. International Union for Health Promotion and Education, France, First Edition.
8. Begg S, Vos T, Barker B, Stevenson C, Stanley L & Lopez A (forthcoming). The burden of disease
and injury in Australia 2003. AIHW cat. no. PHE 82. Canberra: AIHW.
9. Unwin E, Codde J, Bartu A. 2003. The impact of tobacco smoking on the health of Western
Australians. Perth: Drug and Alcohol Office and the Epidemiology Branch, Department of
Health, Western Australia.
10. Winstanley M, Woodward S, Walker N. 1995. Tobacco in Australia: Facts and Issues 1995, 2nd
edition. Melbourne: Victorian Smoking and Health Program.
11. Epidemiology Branch, Health Information Centre, Department of Health. 2003. Overview of the
major causes of hospitalisations for State residents. Perth: Department of Health.
12. Collins DJ, Lapsley HM. 2002. Counting the costs: Estimates of the social costs of drug abuse in
Australia in 1998-99. Canberra: Commonwealth of Australia.
13. Public Health Division. 1998. Smoking and Health in Western Australia 1998 Resource Book.
Perth: Health Department of Western Australia.
14. Australian Institute of Health and Welfare. 2004. National Household Drug Survey. First Results
(Drug Statistics Series No 13). AIHW cat no. PHE 57. Canberra: 2005.
15. Health Department of Western Australia. 1999. Future Trends and Issues Affecting Health in
Western Australia.
16. National Aboriginal and Torres Strait Islander Survey 2004-05. 2006. Australian Bureau of
Statistics.
39
17. Zubrick SR, Silburn SR, Lawrence DM, Mitrou FG, Dalby RB, Blair EM, Griffin J, Milroy H, De
Maio JA, Cox A, Li J. The Western Australian Aboriginal Child Health Survey: The Social and
Emotional Wellbeing of Aboriginal Children and Young People. Perth. Curtin University and
Telethon Institute for Child Health Research, 2005.
18. AIHW. 2000. National Health Survey: Aboriginal and Torres Strait Islander results, Australia,
1995. ABS Cat. No. 2039.0. Australian Bureau of Statistics: Canberra.
19. Unwin E, Thomson N, Gracey M. 1994. The impact of tobacco smoking and alcohol consumption
on Aboriginal mortality and hospitalisation in Western Australia: 1983-1991. Occasional paper
No. 60. Epidemiology and Health Statistics Section, and Aboriginal Health Policy and Programs
Branch, Health Department of Western Australia: Perth.
20. Australian National Tobacco Strategy 2004-2009. Meeting the Challenges of the Next Five Years
– 5&6. Tailoring to ensure access for disadvantaged groups: Ideas and Resources (6).
21. Coghlan, R, Lawrence, D, Holman, D & Jablensky, A. 2001. Duty of care – physical illness in
people with a mental illness. University of Western Australia, Perth.
22. Total Offender Management System. Department of Justice. Longitudinal smoking data for
2004-2005. 2005.
23. Butler, T & Miller, L. 2003. The 2001 Inmate Health Survey. Sydney NSW. Corrections Health
Service.
24. Olson, J. 2001. Incarceration, homelessness and health. National Health Care for the Homeless
Council Policy Statement.
25. Criminalisation fact sheet IV. 2002. Mental illness among inmates in criminal justice facilities.
Judge David L Bazelon. Centre for Mental Health Law.
26. US Department of Health and Human Services. 1994. Preventing Tobacco Use Among Young
People: A Report of the Surgeon General. Atlanta: US Department of Health and Human
Services, Public Health Service, Centres for Disease Control and Prevention, National Centre
for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
27. Quit WA, Department of Health and the Centre for Behavioural Research in Cancer, The Cancer
Council of Victoria. 2004. Cigarette consumption among Western Australian school students in
2002 – Summary bulletin. Perth: Department of Health, Western Australia.
28. National Health Survey. 2001. Expanded Version 2, Remote Access Data Laboratory (weighted
data). 2004: Australian Bureau of Statistics.
29. National Health and Medical Research Council. 1997. The health effects of passive smoking: a
scientific information paper. Canberra. AGPS.
30. National Drug Strategy. 2002. Environmental tobacco smoke in Australia. National Tobacco
Strategy 1999 to 2002-03. Occasional paper. Canberra: Department of Health and Ageing.
31. Cigarette smoking among women in Australia. 2002. National Tobacco Strategy 1999 to 2002-03
occasional paper. Commonwealth Department of Health and Ageing. Canberra.
40
32. McDermott, L., Russell, A., & Dobson, A. 2002. Cigarette smoking among women in Australia.
Canberra: Commonwealth Department of Health and Ageing.
33. Chan, A., Keane, R.J., & Robinson, J.S. (2001). The contribution of maternal smoking to
preterm birth, small for gestational age and low birthweight among Aboriginal and non-
Aboriginal births in South Australia. Medical Journal of Australia, 174, 389-393.
34. Roberts, C.L., & Algert, C.S. (2000). The urban and rural divide for women giving birth in NSW,
1990-1997. Australian and New Zealand Journal of Public Health 24 (3), 291-297.
35. Telethon Institute for Child Health Research. (2004). Western Australian Aboriginal Child
Health Survey summary booklet; the health of Aboriginal children and young people. Telethon
Institute for Child Health Research.
36. Watson, D.S. (1986). Biparietal diameter in the Australian Aboriginal fetus. British Journal of
Obstetrics and Gynaecology, 93 (4), 339-42.
37. Health Department of Western Australia. 2004. WA Health and Wellbeing Surveillance System.
38. Epidemiology Branch Analysis and Reporting. Hospital system morbidity data for year of
separation 2005. Perth: Department of Health, Western Australia; 2006, unpublished.
39. Somerford P, Katzenellenbogen J, Codde J. Burden of disease in Western Australia: An

overview. Perth: Department of Health WA; 2004.
41
Section 7
List of acronyms
ACAM Australian Centre for Asthma Monitoring
ACOSH Australian Council On Smoking and Health
ADIS Alcohol and Drug Information Service
AIEH Australian Institute of Environmental Health
AIHW Australian Institute of Health and Welfare
ASSAD Australian School Students’ Alcohol and Drug Survey
ATSI Aboriginal and Torres Strait Island
BI Brief Intervention
CALD Culturally and Linguistically diverse
CEITC Centre for Excellence in Indigenous Tobacco Control
CHPRC Child Health Promotion Research Centre
CSP Cessation Service Providers
DAO Drug and Alcohol Office
DCA Department of Culture and the Arts
DOCEP Department of Consumer and Employment Protection
DPC Department of Premier and Cabinet
DSR Department of Sport and Recreation
ICHR Institute for Child Health Research
MCDS Ministerial Council on Drug Strategy
NAPS Newborns Asthma and Parental Smoking Project
NDSHS National Drug Strategy Household Surveys
NGOs Non Government Organisations
NRT Nicotine Replacement Therapy
NTC National Tobacco Campaign
NTS National Tobacco Strategy
OAH Office of Aboriginal Health
OSH Occupational Safety and health
S2Ms Sales To Minors
SFWAHS Smoke-Free WA Health System
SHS Second Hand Smoke
SIDS Sudden Infant Death Syndrome
TCB Tobacco Control Branch
TISC Translation Information Service Centre
WACHS Western Australian Country Health Service
42
Notes:
43
Notes:
44

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Australian Tobacco Action Plan 2007 - 2011

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Western Australian

Tobacco Action Plan

HP10422 Nov’07 22324

Produced by Tobacco Control Branch

The Hon Jim McGinty MLA

The WA Tobacco Action Plan 2007-2011 consultation

The WA Tobacco Action Plan 2007-2011 structure

1.1 International context

1.2 National context

1.3 Western Australian context

1.3.2 Western Australian Health Promotion Strategic Framework 2007-2011

The WA TAP 2007-2011 is a framework that enables government, non-government organisations,

Monitoring and reporting on the WA Tobacco Action Plan 2007-2011

2.2 Priority population groups

2.4 Key action areas

Action Area 1 relates to NTS 2004-2009 Policy Area 1 – Regulation of tobacco.

2.4.2 Community education

Broader community engagement in tobacco control interventions and issues.

2.4.3 Cessation services and treatment

2.4.4 Research and evaluation

See Figure 1: WA TAP 2007-2011 Framework

Figure 1: WA Tobacco Action Plan 2007 - 2011 Framework

To reduce the To reduce exposure

Priority population groups

3.1 Harm caused by tobacco use

3.1.3 Exposure to Second Hand Smoke (SHS)

3.3 Smoking by specific priority population groups

3.3.2 People from culturally and linguistically diverse backgrounds (CaLD)

3.3.3 People with mental illness

3.3.4 Offenders and detainees

Poor educational attainment, unemployment, social isolation, interpersonal conflicts, financial

3.3.5 Young people

3.3.6 Parents and carers of children

3.3.7 Pregnant women

Pregnant women who smoke have a greater risk of:

3.3.8 People living in rural and remote locations

3.3.9 People at high risk of or with chronic diseases

3.3.10 People living in low socioeconomic circumstances

Action Area 1. Regulation

Promotion, sale, packaging

Place of use (continued)

1.8 Advocate for changes to tobacco State Government DOCEP

Regulation of tobacco products

Regulation of tobacco products (continued)

Action Area 2. Community education

increase knowledge of the smokers.

2.6 Promote Smokefree and other Community groups Healthway

2.9 Support the development of a WA Community NGOs

2.12 Provide support to parents and WA Community NGOs

Policy and legislation

Action Area 3. Cessation services and treatment

3.2 Encourage undergraduate and Universities WA Health Percentage of graduate health

3.3 Support the development of an Peak health WA Health

Cessation support (continued)

with mental illness, in-patients, Policy Coordinators

3.9 Ensure electronic smoking WA Health NGOs

Cessation support (continued)

3.14 Support the provision of Employers WA Health

Integration of cessation support

Action area 4. Research and evaluation

Data collection (continued)

Alcohol and Drug Information Name of Program: Quitline (WA)

Australian Council on Smoking Name of Program: Tobacco Control Advocacy

Child Health Promotion Name of Program(1):Optimising School Nurse Involvement in Youth