Tobacco is the largest single modifiable risk factor for chronic disease, killing almost 50% of those who become addicted to it. There are 1.2 billion smokers in the world and some of the worst affected countries are in Asia. Efforts to discourage and restrict marketing have proved effective in reducing use. In April 2010 the Australian government announced that all cigarettes would be in plain packaging designed to be as unattractive as possible and it was implemented in 2012. Big Tobacco immediately challenged the decision and fought through the Australian courts and the World Trade Organization. Finally, the last of the WTO appeals has been dismissed and Australia’s public health actions were deemed legal. Big Tobacco fought so hard because Australia’s actions have been followed by many other countries and one of the world’s worst anti-health risk factors is being forced to retreat. This explains why the tobacco industry is pushing vaping so hard, as a way to make up some of their profits. We must continue to resist a new vaping epidemic. The continued decline of smoking in Australia is shown in this table (The Australian Institute of Health and Welfare 2020). Plain packaging of cigarettes works to save lives.
Table S2.14: Tobacco smoking status, people aged 14 and over, 1991 to 2016 (per cent)
| Smoking status | 1991 | 1995 | 2001 | 2007 | 2010 | 2013 | 2016 |
| Daily smoker | 24.3 | 23.8 | 19.4 | 16.6 | 15.1 | 12.8 | 12.2 |
| Current occasional – weekly | 2.8 | 1.6 | 1.8 | 1.3 | 1.5 | 1.4 | 1.3 |
| Current occasional – less than weekly | 2.4 | 1.8 | 2.0 | 1.5 | 1.4 | 1.6 | 1.4 |
| Ex-smoker(a) | 21.4 | 20.2 | 26.2 | 25.1 | 24.1 | 24.0 | 22.8# |
| Never smoked (more than 100)(b) | 49.0 | 52.6 | 50.6 | 55.4 | 57.8 | 60.1 | 62.3# |
COVID-19. Lives can be saved by following public health advice on face masks and social distancing.
A new paper in PNAS shows the effectiveness of wearing facemasks in reducing the spread of COVID-191.
A further meta-analysis of 172 studies funded by WHO and published in the Lancet affirmed the value of social distancing and the use of face masks and eye protection to avoid person-to person virus transmission. All were observational studies as it is hard to see how ethics approval could ever be given for a RCT2. Despite this limitation the evidence is now accumulating about the value of masks and social distancing.
One interesting “side-effect” of wearing masks and social distancing is that influenza transmission has been reduced with far few cases being reported. This is very good news, but it poses a new challenge for public health next season. Influenza vaccine will have to be more widely used to prevent a larger epidemic developing.
- Zhang R, Li Y, Zhang AL, Wang Y, Molina MJ. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proceedings of the National Academy of Sciences 2020: 202009637.
- Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020.
Colin Binns, MBBS, PhD
Editor-in-Chief, Asia-Pacific Journal of Public Health
School of Public Health, Curtin University, Perth, Australia
Wah Yun Low, PhD
Managing Editor, Asia-Pacific Journal of Public Health
President, Asia-Pacific Academic Consortium for Public Health
Deputy Executive Director, Asia Europe Institute
University of Malaya, Kuala Lumpur, Malaysia
Victor Hoe Chee Wai, MBBS,PhD
Webmaster, Asia-Pacific Academic Consortium for Public Health
Department of Social and Preventive Medicine, Faculty of Medicine
University of Malaya, Kuala Lumpur, Malaysia
