NSW Tobacco Strategy 2012-2021

 
NSW Tobacco Strategy
              2012–2021
NSW MINISTRY OF HEALTH
73 Miller Street
NORTH SYDNEY NSW 2060
Tel. (02) 9391 9000
Fax. (02) 9391 9101
TTY. (02) 9391 9900
www.health.nsw.gov.au

This work is copyright. It may be reproduced in whole or in part for study or
training purposes subject to the inclusion of an acknowledgement of the source.
It may not be reproduced for commercial usage or sale. Reproduction for
purposes other than those indicated above requires written permission from
the NSW Ministry of Health.

© NSW Ministry of Health 2019

SHPN (CPH) 190379
ISBN 978-1-76081-199-0

Further copies of this document can be downloaded from the
NSW Health website www.health.nsw.gov.au

July 2019
Contents

Foreword...................................................................................................................................2

Executive Summary.................................................................................................................3

Part One
Background and Context for Tobacco Control in NSW....................................................4
Introduction............................................................................................................................................................................................. 4
Policy Context........................................................................................................................................................................................ 4

Part Two
The Approach to Tobacco Control in NSW.........................................................................5
Working in Partnership...................................................................................................................................................................... 5
Key Partners............................................................................................................................................................................................ 6
Guiding Principles................................................................................................................................................................................ 6
Goals, Targets and Priority Areas................................................................................................................................................ 6
Supporting National Strategies to Reduce Tobacco Related Harm.......................................................................... 8

Part Three
Priority Areas............................................................................................................................9
Public Education................................................................................................................................................................................... 9
Cessation Services...............................................................................................................................................................................11
Aboriginal Communities..................................................................................................................................................................13
Groups with High Smoking Prevalence...................................................................................................................................15
Advertising and Promotion............................................................................................................................................................17
Second-hand Smoke.........................................................................................................................................................................19
Young People........................................................................................................................................................................................21
Research, Monitoring, Evaluation & Reporting...................................................................................................................23

References...............................................................................................................................25

                                                                                                                                   NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 1
Foreword

It is hard to believe that just a few decades ago we     New initiatives in this Strategy are focused on
smoked in our workplaces, our homes, in cars, buses,     restricting smoking in outdoor areas commonly
trains. In fact everywhere - with ashtrays overflowing   frequented by children, young people and families
and long-suffering non-smokers having to put up          including:
with second hand smoke.
                                                           Playgrounds
                                                         n	

So it is gratifying to consider how far we have come       Public sports grounds and swimming pools
                                                         n	

in persuading people to give up smoking or not to          Public transport stops
                                                         n	

take it up in the first place.                             Entrances to public buildings, and, from 2015
                                                         n	

                                                           Commercial outdoor dining areas.
                                                         n	
Campaigns to get us to quit smoking started slowly
and have increased in incremental steps – introduced     The NSW Government will lead an education
by different governments and always with bipartisan      campaign to inform the community, businesses and
support.                                                 affected agencies about these changes.

So that now, fewer students are taking up smoking        And we will continue to monitor and enforce
and fewer adults smoke.                                  restrictions on tobacco advertising and promotion.

But, despite this, smoking remains the leading cause     For the benefit of the health of us all, I invite you
of preventable disease and death in NSW –                to join with the NSW Government in welcoming
accounting for around 5,200 deaths and 44,000            these initiatives.
hospitalisations a year.

That is why I am pleased to release this Strategy
which places NSW at the front of tobacco control
in Australia.

                                                         Jillian Skinner MP
                                                         Minister for Health
                                                         Minister for Medical Research

PAGE 2 NSW HEALTH NSW Tobacco Strategy 2012-2021
Executive Summary

The NSW 2021 Plan sets robust targets on reducing     Local Health Districts will also be supported to
smoking in order to decrease chronic disease and      ensure that there is no smoking anywhere on NSW
combat rising health costs.                           Health grounds.

The NSW 2021 Plan states that the NSW                 The Strategy is comprised of three parts. Part
Government will:                                      One provides the background to tobacco control in
                                                      NSW. Part Two sets out a partnership approach to
  Reduce smoking rates by 3% by 2015 for non-
n	
                                                      achieving the objectives, including key principles and
  Aboriginal people and by 4% for Aboriginal          priority areas. Part Three describes the actions which
  people by 2015; and                                 will be taken by the NSW Government and partners
  Reduce the rate of smoking by non-Aboriginal
n	
                                                      in the non-government sector and timeframes under
  pregnant women by 0.5% per year and by 2% per       each priority area.
  year for pregnant Aboriginal women by 2015.
                                                      A feature of this Strategy is its focus on some of the
The NSW Tobacco Strategy 2012–2021 sets out the       most disadvantaged groups in our society. Many of
actions that the NSW Government will take to          these groups have much higher rates of smoking
reduce the harm which tobacco imposes on our          than the general population - for Aboriginal people
community and achieve the NSW 2021 Plan targets.      it is at least double the rate of the non-Aboriginal
                                                      population. To address these particular needs, the
The Strategy will see NSW make a number of public
                                                      population-wide approaches that have been
outdoor areas smoke-free in order to protect people
                                                      effective and delivered substantial reductions in
from the harmful effects of second-hand tobacco
                                                      smoking prevalence in the past will be maintained
smoke.
                                                      and complemented with additional targeted
                                                      approaches to assist disadvantaged groups to quit
The Strategy includes:
                                                      smoking and to reduce the associated
  A focus on addressing tobacco smoking in
n	                                                   disproportionate levels of death and disease.
  populations with high smoking rates, particularly
  Aboriginal communities, women smoking in
  pregnancy, mental health consumers and people
  in corrections facilities;
  Enhanced programs to help smokers quit; and
n	

  Measures to protect people from harmful second-
n	

  hand smoke in outdoor areas.

                                                            NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 3
PART ONE

Background and Context
for Tobacco Control in NSW

Introduction                                             The magnitude of the problems caused by tobacco
                                                         continues to present a significant burden for NSW.
The death toll in Australia from smoking will pass the   Smoking is responsible for around 44,000 hospital
one million mark within this decade.1 More than          admissions every year and causes the deaths of over
900,000 Australians have already died prematurely        5,200 people in this state each year. 8
because they smoked. Tobacco has been labelled
one of the great killers of the twentieth century,       Estimates of the annual social costs of tobacco use
causing unnecessary death, disease and disability on     in NSW for 2006/07 are $8.4 billion with tangible
a large scale. 2                                         costs of $2.9 billion.9 A study by Collins and Lapsley
                                                         found that while real tangible costs grew 24 per cent
Tobacco adversely affects almost every organ in the      from 1998/99 to 2006/07, real intangible costs fell
body. Evidence about the dangers of tobacco              by 14 per cent. Significantly, these results show that
continues to mount. Smoking greatly increases the        total real social costs are estimated to have fallen by
risk of many cancers and is a major cause of chronic     around four per cent since 1998/99, reflecting the
obstructive pulmonary disease and ischaemic heart        decline in smoking-attributable mortality in NSW
disease. 3 It is also clear that exposure to second-     over this period.
hand smoke involves adverse health effects including
an increased risk of asthma and sudden infant death      Despite these findings, smoking rates remain
syndrome for children.4                                  unacceptably high, particularly among Aboriginal
                                                         people and those from low socioeconomic,
NSW is proud of its successes in tobacco control.        disadvantaged and other specific groups. Over the
These include:                                           period 2006-2009, 33.9 per cent of Aboriginal
                                                         people aged 16 years and over in NSW were current
  Since 1997, there has been a significant decrease
n	
                                                         smokers (33.5 per cent of Aboriginal males and
  in the proportion of adults who were current           34.2 per cent of Aboriginal females).10 In the general
  smokers (24.0 per cent to 15.8 per cent in 2010).      population, more males are current smokers than
  Smoking by secondary school students has
n	
                                                         females (18.1 per cent compared to 13.5 per cent)
  declined by 6 percentage points - falling from         and since 2009, there has been an increase in
  14.6 per cent in 2002 to 8.6 per cent in 2008. 5       current smoking among males and females aged
  Nine out of ten adults now live in smoke-free
n	
                                                         16-24 years.11
  homes.6
  Lung cancer rates have now fallen to levels last
n	
                                                         Policy context
  seen in the 1960s mainly due to tobacco control.7
  NSW public education campaigns have been
n	                                                      The NSW Tobacco Strategy 2012–2021 is informed by
  used across Australia and internationally in           relevant policy frameworks at the international,
  countries such as China, the United States and         national and state level. This includes the World Health
  Canada.                                                Organization's Framework Convention on Tobacco
  NSW led the rest of Australia by introducing a
n	                                                      Control at the international level, the National
  comprehensive package of legislative reforms in        Partnership Agreement on Preventive Health and the
  2008 to protect children from tobacco. The             National Partnership Agreement on Closing the Gap
  reforms introduced a ban on the display of             in Indigenous Health Outcomes at the national level
  tobacco, a single point of sale for tobacco and a      and the NSW 2021 Plan, the NSW Cancer Plan 2011-
  ban on smoking in cars when children under the         2015 and the NSW Tobacco Action Plan 2005-09 at
  age of 16 years are present.                           the state level.

PAGE 4 NSW HEALTH NSW Tobacco Strategy 2012-2021
PART TWO

The Approach to Tobacco
Control in NSW

Working in partnership                                                   Key partners and stakeholders include the
                                                                         health care system, social service organisations,
The challenges confronted by all governments                             non-government organisations, Aboriginal
working in tobacco control are complex and require                       organisations, relevant industry groups
the formation of partnerships with the community                         (retailers, media, pharmaceutical etc), unions
and the adoption of a ‘whole of government’                              and professional associations.
approach. The NSW Government recognises that
past achievements in tobacco control in NSW have                         To achieve our targets there is a recognised need to:
resulted from partnerships with strong allies and the
                                                                           Strengthen long standing partnership
                                                                         n	
ongoing commitment of non-government agencies
                                                                           relationships;
and local health services to tobacco control.12
                                                                           Identify and form new partnerships in order to
                                                                         n	

Partnerships were a central feature of the previous                        expand opportunities for tobacco control
Tobacco Action Plan and remain vital for this                              interventions within
Strategy. Collaboration between government and                             a range of community settings;
non-government agencies in NSW will continue to                            Work with a range of partners to improve the
                                                                         n	

underpin tobacco control approaches in NSW –                               sustainability and accessibility of quit smoking
delivering benefits in terms of enhanced efficiency                        services within the community for different
and effectiveness and ensuring successful                                  population groups; and
implementation of the actions in this Strategy.                            Build the capacity of different organisations and
                                                                         n	

                                                                           health workers to implement tobacco control
Delivering a comprehensive tobacco control strategy                        programs.13
requires action in a variety of settings. Key settings
for tobacco control in NSW include workplaces,                           The figure below demonstrates the approach
schools, media, the built environment, health services                   to tobacco control in NSW.
(particularly mental health services), the hospitality
industry and prisons.

Figure 1. Approach to tobacco control in NSW

                                                          NSW Population
                                                          Individuals
                                                          Familes

        Sectors                                           Communities                                Settings
        Health care system,                                                                          Community, health
        non government                                                                               system, media,
        organisations,                                       Tobacco                                 workplaces, tertiary
        Aboriginal                                        Control in NSW                             education facilities,
        organisations, relevant                                                                      schools, youth
        industry groups                                                                              centres, built
        (retailers, media,                                                                           environment, mental
                                                          Governments
        pharmaceutical etc),                                                                         health services,
                                                          Australian
        unions, professional                                                                         prisons, hospitality
                                                          State/ Territory
        associations                                                                                 industry
                                                          Local

Adapted from the National Preventative Health Strategy Figure 1.6 Working Together.14

                                                                                 NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 5
Key partners                                             Reducing inequity – addressing the differences
                                                       n	

                                                         in health status in the community by recognising
Key NSW Government agencies responsible                  and responding to the special needs of those
for implementing actions under the NSW Tobacco           groups whose health is poorest, especially
Strategy 2012–2021 include:                              Aboriginal people.16
                                                       n Working in partnership – recognising that many
  NSW Health, including the NSW Ministry of
n	
                                                          factors that influence health are outside the direct
  Health, Local Health Districts, Justice Health and      control of the health system and developing
  Multicultural Health Communication Service              strategic partnerships across government,
  Cancer Institute NSW
n	
                                                          industry, business, unions, the non-government
  NSW Department of Education and Communities
n	
                                                          sector, research institutions, youth groups and
  NSW Department of Premier and Cabinet
n	
                                                          communities as required.17
  (Division of Local Government)                       n	Capacity building – focusing on organisational
  Corrective Services NSW
n	
                                                          change, workforce development, resource
  Community Services
n	
                                                          allocation and leadership that incorporates
                                                          advocacy and relies on partnerships. By working
Key partners involved in supporting actions
                                                          across sectors, there is potential to build
under the Strategy include:
                                                          individual skills, strengthen community action and
  Cancer Council NSW
n	
                                                          empower organisations to promote sustainable
  National Heart Foundation (NSW Division)
n	
                                                          health behaviours and support healthy
  Aboriginal Health and Medical Research Council
n	
                                                          environments.18
  Action on Smoking and Health
n	
                                                       n	Engaging communities – engaging with people
  Australian Respiratory Council
n	
                                                          where they live, work and play and informing,
  NSW Quitline
n	
                                                          enabling and supporting people to make healthy
  Universities and research groups
n	
                                                          choices. Relevant settings may include home,
  Aboriginal community controlled health
n	
                                                          work, school, youth centres, workplaces and
  organisations                                           community.
  Aboriginal communities
n	
                                                       n	Ensuring effective implementation – providing
  Aboriginal peak organisations
n	
                                                          a strong infrastructure that supports individuals
  Culturally and linguistically diverse communities
n	
                                                          and communities in making and sustaining
  Mental health organisations
n	
                                                          healthy choices and measures progress in
  GP divisions
n	
                                                          achieving targets.
  Medicare Locals
n	

  Australian Government
n	
                                                       Goals, Targets and Priority Areas
  Local councils
n	

  Local Government and Shires Associations
n	
                                                       Our Goal
  of NSW
  Tertiary education providers
n	                                                    To improve the health of the people of NSW and to
  Catholic and independent schools
n	                                                    eliminate or reduce their exposure to tobacco in all
  Consumer and media organisations
n	                                                    its forms.

                                                       Our Objectives
Guiding Principles
                                                         Reduce the number of people using tobacco
                                                       n	

The following six principles underpin                    Prevent the uptake of smoking especially
                                                       n	

the implementation of this Strategy:                     by children and young people
                                                         Prevent exposure to second-hand smoke
                                                       n	

n	A population approach - focusing on improving         and the harm it causes
   the overall health status of the community,           Reduce smoking among Aboriginal people
                                                       n	

   delivering sustained, effective and comprehensive     and other disadvantaged populations
   programs that promote and support healthy             Decrease tobacco related death and disease
                                                       n	

   living for all.15

PAGE 6 NSW HEALTH NSW Tobacco Strategy 2012-2021
Our Targets                                             Our Priority Areas
The NSW 2021 plan includes the following targets        The achievement of these targets will require renewed
in regard to reducing smoking rates:                    efforts in implementing our program of anti-tobacco
                                                        public education campaigns, enhanced attention
n	Reduce smoking rates by 3 per cent by 2015           to cessation support, a strong commitment to
   for non-Aboriginal people and by 4 per cent          monitoring and enforcing regulatory reforms and
   by 2015 for Aboriginal people; and                   action to prohibit smoking in commercial outdoor
                                                        eating areas to further protect the community from
n	Reduce the rate of smoking by pregnant               the health consequences of second-hand smoke.
   Aboriginal women by 2 per cent per year and
   reduce the rate of smoking by pregnant non-          A greater focus is needed on smoking in Aboriginal
   Aboriginal women by 0.5 per cent per year.           communities, smokers from culturally and linguistically
                                                        diverse (CALD) communities, low socioeconomic
NSW is also committed to the targets set in the         and other disadvantaged groups. To achieve the
National Partnership Agreement on Preventative          objectives of this Strategy, eight priority areas based
Health (NPAPH) to reduce daily smoking among            on best practice approaches to tobacco control
adult Australians aged 18+ to 10 per cent or lower by   will be addressed:
2020. The Agreement sets interim targets for States
and Territories of a 2 percentage point reduction       n   Public Education
from the 2007 baseline by 2011 and a 3.5 percentage
                                                        	Continue and build on public education
point reduction from this baseline by 2013.
                                                          campaigns to motivate smokers to quit.

                                                        n   Cessation Services
The NSW target to reduce smoking rates by
3 per cent by 2015 for non-Aboriginal people and        	Continue to provide evidence based cessation
by 4 per cent by 2015 for Aboriginal people is            services to support smokers to quit.
measured by the NSW Health Survey Program               n   Aboriginal Communities
and includes daily and occasional smoking by
people 16 years of age and older.                       	Work in partnership with Aboriginal communities
                                                          and peak bodies to reduce smoking and exposure
The NPAPH target is based on the National Drug            to second-hand smoke among Aboriginal people.
Strategy Household Survey administered by the
                                                        n   Groups with High Smoking Prevalence
AIHW and includes only daily smoking by people
18 years of age and older. The NSW specific             	Strengthen efforts to reduce smoking among
targets based on the 2007 baseline figure of 17.2%        people in low socioeconomic and other groups
is to achieve 15.2% by 2011 and 13.7% by 2013.            with high smoking prevalence such as some
                                                          culturally and linguistically diverse groups.

Under the NSW Tobacco Strategy 2012–2021,               n   Tobacco Advertising and Promotion
NSW will also:                                          	Regulate the advertising and promotion of
                                                          tobacco products and restrict the availability and
n	Reduce the proportion of students who have
                                                          supply of tobacco, especially to children.
   ever smoked tobacco by 1 per cent per year
   to 2017; and                                         n   Second-hand Smoke
                                                        	Strengthen efforts to reduce exposure to second-
n	Increase the proportion of adults living in smoke-
                                                          hand smoke in workplaces, public places and
   free households by 0.5 per cent per year to 2017.
                                                          other settings.

                                                        n   Young People
                                                        	Strengthen efforts to prevent the uptake
                                                          of smoking by young people.

                                                        n Research, Monitoring, Evaluation & Reporting
                                                         	
                                                        	Strengthen research, monitoring, evaluation
                                                          and reporting of programs for tobacco control.

                                                              NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 7
The NSW Ministry of Health will take the lead in         The Australian Government also indicated its
coordinating and monitoring the implementation of        intention to consider removing the duty-free
the Strategy across government. A mid-term review        allowance on tobacco products for international
of progress towards the targets and implementation       travellers entering Australia. The Australian
of actions will be undertaken in 2014. The NSW           Government will also continue to participate in
Ministry of Health will report on population level       international negotiations for a protocol to eliminate
indicators of smoking prevalence. Other key              the illicit trade in tobacco products under the WHO
indicators from the Strategy will be reported on         Framework Convention on Tobacco Control.
a regular basis by other lead agencies.
                                                         The NSW Ministry of Health supported these
                                                         measures through the NSW submission to the
Supporting national strategies                           National Preventative Health Taskforce Discussion
to reduce tobacco related harm                           Paper Australia: the Healthiest Country by 2020. In
                                                         addition, NSW prepared a joint submission on behalf
The Australian Government has a range of specific        of the Northern Territory, Western Australia, South
tobacco regulatory responsibilities. These include the   Australia, Tasmania, New South Wales and the
regulation of tobacco products through trade             Australian Capital Territory Health Ministers for the
practices legislation, the prohibition of sponsorship    Australian Government Henry Review – Australia’s
and advertising of tobacco products, the regulation      future tax system. This submission highlighted the
of tobacco packaging (including cigarette contents       important role that taxation plays in tobacco control
and graphic health warnings on cigarette packs) and      and recommended that the Australian Government
regulating taxes on tobacco products.                    increase the price of tobacco through taxation and
                                                         that it abolish duty-free sales of tobacco products.
While the focus of this Strategy is on what NSW will
do, it is recognised that there are a number of
reforms outside the control of the NSW Government
that would further reduce the harm caused by
tobacco. Of critical importance is increasing the
price of tobacco, plain packaging of tobacco
products, eliminating the remaining forms of tobacco
advertising and enhancing national
anti-tobacco public education campaigns.

In April 2010, the Australian Government announced
a range of national tobacco control strategies in a
bid to reduce smoking rates. Strategies included: an
increase in tobacco excise of 25 per cent, enacting
legislation to require cigarettes to be sold in plain
packaging, amending legislation to bring restrictions
on tobacco advertising and sales on the internet into
line with restrictions on other media and at physical
points of sale and additional funding for anti-
smoking campaigns targeting disadvantaged
populations. To further assist quitting by low-income
people, the Australian Government announced in
December 2010 that concession card holders will be
able to access nicotine patches under the
Pharmaceutical Benefits Scheme (PBS) from
February 2011, meaning the products are free of
charge to concession card holders. Since December
2008, Nicotine Replacement Therapy (NRT) has
been available to Aboriginal and Torres Strait
Islanders through the PBS.

PAGE 8 NSW HEALTH NSW Tobacco Strategy 2012-2021
PART THREE

Priority Areas

Public Education
Continue public education campaigns                              The actions under this priority area will build on the
to motivate smokers to quit                                      effective anti-tobacco public education campaign
                                                                 approaches that have been implemented over past
There is strong evidence that public education
                                                                 years. Adult-targeted campaigns will continue to
campaigns are one of the most effective population
                                                                 highlight the health consequences of smoking as the
strategies to reduce tobacco consumption. Public
                                                                 key motivator for smoking cessation. By providing
education campaigns help to personalise the health
                                                                 fresh insights and delivering messages that are
risks of smoking and increase people’s sense of
                                                                 personally relevant to smokers, campaigns will aim to
urgency about quitting.19
                                                                 limit self-exempting beliefs and focus on delivering a
The Cancer Institute NSW has lead responsibility for             strong message to quit, and stay quit.
the design, delivery and evaluation of anti-tobacco
                                                                 The development, implementation and evaluation of
public education campaigns in NSW. Since 2004,
                                                                 new campaigns to highlight the danger of tobacco
over 40 anti-tobacco campaigns have been
                                                                 use to people from culturally and linguistically diverse
implemented using a variety of styles of
                                                                 backgrounds, people with mental illness, prisoners
advertisements, from graphic to emotive executions,
                                                                 and Aboriginal communities will also form a key part
to maximise personal relevance and believability
                                                                 of the Strategy. These groups within the community
among smokers to motivate quitting. Examples of
                                                                 have a higher rate of tobacco use and have shown
these high performing campaigns include What’s
                                                                 a smaller decrease in tobacco use in response to
Worse, Sponge and Everybody Knows.
                                                                 previous Government anti-smoking messages.

Public Education
Continue public education campaigns to motivate smokers to quit
Actions                               Responsibility             Timeframe – Year         Measurement
                                                             1    2     3     4      5
Build on, develop, implement          Cancer Institute NSW   n    n     n     n      n    Recognition of campaign
and evaluate a range of               Justice Health                                      activity
anti-tobacco mass media               Corrective Services
campaigns which:                      NSW                                                 Quitline calls & website traffic
a)	Utilise a variety of styles and   NGOs
    communication channels to
    maximise personal relevance
    and believability among
    smokers to motivate quit
    attempts;
b)	Have sufficient frequency,
    reach and intensity to have
    an impact at the population
    level; and
c)	Utilise a range of mediums
    to ensure maximum
    relevance, reach and impact
    on CALD groups, low
    socioeconomic smokers
    and smokers from other
    disadvantaged groups,
    including the custodial
    population.

                                                                       NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 9
Public Education
Continue public education campaigns to motivate smokers to quit
Actions                            Responsibility             Timeframe – Year       Measurement
                                                          1    2     3     4     5
Develop public education           Cancer Institute NSW   n    n     n     n     n   Recognition of campaign
campaigns for Aboriginal           Aboriginal peak                                   activity
people that smoke:                 bodies
a)	Using existing effective       Aboriginal                                        Quitline calls & website traffic
    mainstream campaigns           communities
    complemented by                                                                  Culturally relevant
    Aboriginal specific                                                              representation of Aboriginal
    campaign elements; and                                                           people and smoking
b)	Public education campaign                                                        environments /situations in
    messages developed and                                                           mainstream and Aboriginal
    refined for Aboriginal                                                           specific tobacco public
    people.                                                                          education campaigns
Develop innovative approaches      Cancer Institute NSW   n    n     n     n     n   Response to online advertising
to online advertising and social                                                     and social media strategies
media strategies as part of
tobacco campaign strategies
to encourage, support and
promote quitting.
Develop partnerships with          Cancer Institute NSW   n    n     n     n     n   Organisations undertaking
key organisations in NSW           NSW Health                                        campaign related support
(including NGOs, Aboriginal                                                          activities
peak organisations and primary
care services) to extend the
reach of campaigns.
Develop partnerships with          Cancer Institute NSW   n    n     n     n     n   National and inter-state
other states, territories, the     MOH                                               partnerships established
Australian Government and
internationally to maximise the                                                      National campaigns effectively
impact and cost effectiveness                                                        implemented in NSW
of campaign development and
placement.
Conduct education campaigns        Cancer Institute NSW   n    n     n     n     n   Value adding activities
to ensure the community is         NGOs                                              identified
aware of the risks associated      NSW Health
with exposure                                                                        Community awareness of
to second-hand smoke,                                                                second-hand smoke related
particularly for children.                                                           harm

Key:
MOH – NSW Ministry of Health
MHCS – NSW Multicultural Health Communication Service
NGOs – Non-government organisations

PAGE 10 NSW HEALTH NSW Tobacco Strategy 2012-2021
Cessation Services
Continue to provide evidence                                     Actions for this priority area focus on enhancing
based cessation services to support                              the high quality and effectiveness of the Quitline
smokers to quit                                                  telephone and online services and on better
                                                                 integrating referral pathways to and from the Quitline
Complementing anti-tobacco public education
                                                                 with the health system, primary care services and
campaign strategies are cessation support services
                                                                 relevant non-government organisations.
to help smokers to quit. These cessation services
include a range of programs such as the NSW                      There is also a need to increase smokers' awareness
Quitline, online services, specialised cessation                 and understanding of pharmacotherapies, particularly
services, brief interventions provided by health                 for highly dependent smokers. Evidence suggests
professionals and workplace programs.                            that there are considerable benefits in enhancing
                                                                 brief interventions by GPs and other health
There is now increasing recognition in Australia of the
                                                                 professionals.
need to increase the proportion of smokers who
access the Quitline and for additional strategies to
increase smokers’ confidence in their ability to quit.

Cessation Services
Continue to provide evidence based cessation services to support smokers to quit
Actions                                   Responsibility          Timeframe – Year         Measurement
                                                             1      2     3     4     5
Continue to implement and promote         Cancer Institute          n     n     n     n    Website traffic and number
the iCanQuit website to provide           NSW                                              of registered users
greater opportunities for interaction     NSW Quitline
and support smokers to quit.
Build on and promote Multilingual         Cancer Institute   n      n     n     n     n    Calls to the Multilingual
Quitline services and enhance             NSW                                              Quitline
coordination between this service         MHCS
and tobacco control programs              NSW Health
delivered by health services.
Comply with the National Quitline         Cancer Institute   n                             Achievement against National
Minimum Standards and contribute          NSW                                              Quitline Minimum Standards
to any national reviews of the            NSW Quitline
standards.                                MOH
Enhance recruitment to and                Cancer Institute                n                Evaluation of the Quitline
effectiveness of the Quitline to          NSW                                              conducted
ensure it is an effective and high        NSW Quitline
quality service accessed by an            MOH                                              Proportion of smokers that
increasing proportion of smokers.                                                          utilise the Quitline
Develop and implement strategies          Cancer Institute   n      n     n     n     n    Quitline referrals from other
to improve the integration of the         NSW                                              agencies
Quitline with other programs              NSW Quitline
across the health system, primary         NSW Health
care services and relevant non-           NGOs
government agencies with a priority       MHCS
focus on CALD communities, low            Justice Health
socioeconomic and disadvantaged
groups, including the custodial
population.
Provide training in best practice         NSW Quitline              n           n          Number of workshops
smoking cessation (particularly brief     NSW Health                                       conducted and staff trained
interventions) to a range of health       Universities
professionals and health workers          NGOs                                             Changes in health
including mental health staff, nurses,                                                     professionals and other
allied health, dentists, medical staff,                                                    workers confidence
Aboriginal Health Workers, drug and                                                        to implement brief
alcohol workers and other relevant                                                         interventions with clients
groups including non-health sector
professionals who work with
disadvantaged populations.

                                                                        NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 11
Cessation Services
Continue to provide evidence based cessation services to support smokers to quit
Actions                                 Responsibility         Timeframe – Year       Measurement
                                                           1    2     3     4     5
Develop strategies to promote           Cancer Institute   n    n     n     n     n   Calls to Quitline by pregnant
cessation services to pregnant          NSW                                           women and their families
women and the families of pregnant      NSW Quitline
women.                                  NSW Health                                    Quit attempts by pregnant
                                        GP Divisions                                  women and their families

                                                                                      % of women who
                                                                                      smoke during pregnancy
Develop, implement and review           NSW Health         n          n           n   Let’s take a moment, Brief
NSW Ministry of Health policies         NGOs                                          intervention for smoking
and systems to ensure patients and                                                    cessation – a guide for health
clients of health services:                                                           professionals implemented
a)	Receive appropriate and                                                           and regularly updated
    consistent management of
    nicotine dependency;                                                              Managing Nicotine Dependent
b)	Are routinely asked about                                                         Health Clients guide
    their smoking status and are                                                      implemented and regularly
    supported to quit while being                                                     updated
    treated and post discharge;
c)	Have their smoking status and                                                     Health services reporting on
    treatment routinely recorded to                                                   the proportion of patients
    enable consistent protocols for                                                   whose smoking status is
    smoking cessation treatment;                                                      assessed and
    and                                                                               the proportion of patients
d)	Are reported on in terms of                                                       identified as smokers offered
    smoking status and the provision                                                  NRT and supported to quit
    of smoking cessation care and
    outcomes.
Under the Healthy Workers Initiative, NSW Health                n     n     n     n   Quitline referrals from the
promote the Get Healthy Information NGOs                                              Get Healthy Information
& Coaching Service® to workplaces     Workplaces                                      & Coaching Service®
and refer callers wishing to quit
smoking to the Quitline.
Key:
MOH – NSW Ministry of Health
MHCS – NSW Multicultural Health Communication Service
NGOs – Non-government organisations

PAGE 12 NSW HEALTH NSW Tobacco Strategy 2012-2021
Aboriginal Communities
Work in partnership with Aboriginal                          While these results are encouraging, there is much
communities and peak bodies to reduce                        more that needs to be done, as Aboriginal people
smoking and exposure to second-hand                          remain twice as likely as non-Aboriginal people to be
smoke among Aboriginal people                                current daily smokers.

The level of poor health and disadvantage experienced        The drivers of the high rate of smoking among
by Aboriginal people is significant. Aboriginal people       Aboriginal people are complex and include both
experience greater levels of chronic disease and             historical and contemporary processes. Evidence
injury and have shorter life expectancies than the           suggests that smoking is highly normalised in
non-Aboriginal population. The burden of disease             Aboriginal communities and that strong social
and injury study for the Aboriginal and Torres Strait        factors drive early initiation and can act as barriers
Islander population of Australia which was published         to smoking cessation among Aboriginal people. 22 23
in 2007, shows that the Aboriginal health gap
accounted for 59 per cent of the total burden of             The involvement of Aboriginal community-controlled
disease for Aboriginal people in Australia in 2003.          health organisations in providing leadership, policy
Tobacco was the largest risk factor and was                  development, program implementation and the
responsible for 17 per cent of the health gap and 12         evaluation of tobacco control strategies in
per cent of the total burden of disease. 20                  partnership with governments, health services and
                                                             non-government organisations will be critical
The 2006-2009 Report on Adult Aboriginal Health              if we are to achieve further reductions in the
from the NSW Population Health Survey found that             prevalence of smoking among Aboriginal people.
since 2002-2005 there has been a significant decrease
in the proportion of Aboriginal adults who were
current smokers (41.3 per cent to 33.9 per cent). 21

Aboriginal Communities
Work in partnership with Aboriginal communities and peak bodies to reduce smoking and exposure
to second-hand smoke among Aboriginal people
Actions                           Responsibility             Timeframe – Year        Measurement
                                                         1    2     3     4     5
Provide training to Aboriginal    NSW Health             n                           Knowledge, skills, attitude and
Health Workers and other          Cancer Institute NSW                               awareness of Aboriginal Health
relevant health workers to        Universities                                       Workers and other relevant
improve skills in the provision   AHMRC                                              workers
of smoking cessation advice       NGOs
and in developing community-                                                         Proportion of clients
based tobacco control                                                                who smoke identified
programs.
Develop and implement             NSW Health             n    n                      % of Aboriginal Health Workers
strategies to tackle the high     AHMRC                                              who smoke
levels of smoking by Aboriginal
Health Workers.                                                                      Attitude and awareness of
                                                                                     Aboriginal Health Workers to
                                                                                     smoking
Deliver best practice smoking     NSW Health             n    n     n     n      n   Aboriginal clients routinely
cessation brief interventions     Cancer Institute NSW                               asked about their smoking
as part of routine service        AHMRC                                              status, brief interventions
delivery to Aboriginal clients.   Universities                                       implemented and cessation
                                  NGOs                                               support provided as required
Develop and implement             Cancer Institute NSW   n    n     n     n      n   Strategies implemented
strategies to enable the NSW      AHMRC
Quitline to better meet the       NSW Quitline
needs of Aboriginal people
who smoke.
Develop and implement             NSW Health             n    n     n     n      n   % of Aboriginal people
policies and projects in          AHMRC                                              in custody who smoke
collaboration with peak           Justice Health
Aboriginal organisations,         Corrective Services
Corrective Services NSW and
Justice Health to decrease
smoking by Aboriginal people
in custody.

                                                                   NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 13
Aboriginal Communities
Work in partnership with Aboriginal communities and peak bodies to reduce smoking and exposure
to second-hand smoke among Aboriginal people
Actions                            Responsibility             Timeframe – Year       Measurement
                                                          1    2     3     4     5
Encourage and support              NSW Health             n    n     n     n         % of Aboriginal women
pregnant Aboriginal women to       AMIHS                                             who smoke during pregnancy
quit by providing best practice    AHMRC
cessation interventions.                                                             % of pregnant Aboriginal
                                                                                     women who live in smoke-free
                                                                                     homes

                                                                                     Number of quit attempts
                                                                                     and intention to quit
Establish a high level NSW         MOH                    n    n     n     n     n   Advisory Group established
Aboriginal Tobacco Advisory        AHMRC                                             and key strategic approaches
Group to advise on tobacco         Cancer Institute NSW                              identified and agreed
control efforts for Aboriginal
people in NSW.
Review existing evidence           NSW Health             n    n     n     n     n   Review completed
and current projects being         MOH
implemented to reduce              AHMRC                                             Effective models identified
Aboriginal smoking in NSW and      Cancer Institute NSW                              and integrated into strategic
identify effective models that                                                       approach and planning of
can be built upon in the future.                                                     the NSW Aboriginal Tobacco
                                                                                     Partnership Group
Strengthen partnerships            NSW Health             n    n     n     n     n   Number and range of
and collaboration between          AHMRC                                             organisations and partners
key organisations in NSW to        Cancer Institute NSW                              delivering programs
develop and deliver sustained      NGOs
and coordinated Aboriginal
tobacco control programs
especially between AMS and
health services.
In partnership with peak           NSW Health             n    n     n     n     n   Knowledge, attitude and
Aboriginal organisations, NGOs,    AHMRC                                             awareness of tobacco among
health services and other          Cancer Institute NSW                              Aboriginal organisations
relevant groups:                   NGOs
a)	Build the capacity of                                                            Tobacco control programs
    Aboriginal organisations                                                         developed, implemented
    and staff to develop and                                                         and evaluated by Aboriginal
    implement tobacco control                                                        organisations
    programs; and
b)	Support Aboriginal                                                               Number of smoke-free
    organisations to move                                                            organisations (change from
    towards smoke-free                                                               baseline measure)
    workplaces and events.
Support national tobacco           MOH                    n    n     n     n     n   Nationally funded programs
control efforts to reduce          AHMRC                                             to reduce Aboriginal smoking
Aboriginal smoking and             Cancer Institute NSW                              implemented in NSW
ensure coordination with NSW       NGOs                                              coordinated with NSW activity
programs.                          Universities
Build tobacco control capacity     NSW Health             n    n     n     n     n   Knowledge, skills, attitude and
within Aboriginal Community        AHMRC                                             awareness of Aboriginal Health
Controlled Health Services.                                                          Workers and other relevant
                                                                                     workers
Increase awareness and use         NSW Health             n    n                     Uptake of NRT through PBS in
among Aboriginal people            AHMRC                                             NSW
that smoke of NRT products         Universities
available through the PBS.         Cancer Institute NSW
Key:
MOH – NSW Ministry of Health
MHCS – NSW Multicultural Health Communication Service
NGOs – Non-government organisations
AHMRC - Aboriginal Health and Medical Research Council

PAGE 14 NSW HEALTH NSW Tobacco Strategy 2012-2021
Groups with High
Smoking Prevalence
Strengthen efforts to discourage smoking                     n	  People in drug treatment have smoking rates
among people in low socioeconomic                                 ranging from 74-100 per cent. 27
and other groups with high smoking
prevalence such as some culturally and                       Within the actions under this priority area, targeted
linguistically diverse groups                                populations include people from low socioeconomic
                                                             groups, people with mental illness, people with drug
Over the past 40 years, smoking prevalence has               and alcohol dependency, people in correctional
declined significantly in the general population.            facilities and other population groups with high
However, the decline has been less evident amongst           smoking prevalence such as some culturally and
the most disadvantaged. Smoking rates are high               linguistically diverse groups. Specific strategies for
among people from low socioeconomic groups,                  Aboriginal people are covered under the Aboriginal
Aboriginal people, those who are unemployed,                 Communities priority area.
homeless or imprisoned and those with a mental
illness or drug or alcohol dependency. For example:          Working in these settings is complex and poses many
                                                             challenges for tobacco control. A range of
n	Smoking rates among people in NSW correctional            approaches will be implemented over the life of this
   facilities are around 76 per cent24 and the               plan in partnership with correctional facilities, mental
   prevalence is higher among inmates of psychiatric         health and social service organisations to build the
   wards. 25                                                 capacity of these services to contribute to tobacco
                                                             control efforts and discourage smoking among
n	People who self-reported mental or behaviour
                                                             disadvantaged communities.
   problems have smoking rates of 32 per cent
   compared to 20 per cent of those who do not
   report these problems with rates significantly
   higher among people admitted to a mental health
   hospital. 26

 Groups with High Smoking Prevalence
 Strengthen efforts to discourage smoking among people in low socioeconomic and other groups
 with high smoking prevalence
 Actions                            Responsibility           Timeframe – Year          Measurement
                                                         1    2       3     4     5
 Build on existing advocacy for     MOH                  n    n       n     n     n    Monitor real price of tobacco
 staged tobacco tax increases       Cancer Institute                                   increases over time
 to encourage smokers from low      NSW
 socioeconomic groups to quit.      NGOs

 Implement measures                 NSW Health           n    n       n     n     n    Assistance measures for
 to promote cessation               Cancer Institute                                   disadvantaged smokers
 assistance for smokers from        NSW
 CALD communities, low              NGOs
 socioeconomic and other            MHCS
 disadvantaged groups.              NSW Quitline
 Further strengthen                 NSW Health                                         Assistance measures for
 partnerships with social service   Cancer Institute                                   disadvantaged smokers
 and mental health organisations    NSW
 to build the capacity of these     NGOs                                               Knowledge and attitudes
 groups to contribute to tobacco    Social service                                     of staff in relation to tobacco
 control efforts.                   organisations
                                                                                       Tobacco control goals reflected
                                                                                       in relevant service plans and
                                                                                       policies
 Review and fully implement the     NSW Health           n    n       n     n     n    Progress reports on
 NSW Health Smoke-Free              Cancer Council NSW                                 implementing the Smoke-Free
 Health                                                                                Health Care
 Care Policy in mental health                                                          Policy & Guidelines for Smoke
 and drug and alcohol facilities.                                                      Free Mental Health Services

                                                                     NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 15
Groups with High Smoking Prevalence
Strengthen efforts to discourage smoking among people in low socioeconomic and other groups
with high smoking prevalence
Actions                            Responsibility            Timeframe – Year       Measurement
                                                         1    2     3     4     5
Increase referrals by GPs and      NSW Health            n    n     n     n     n   Referrals to Quitline and
other health professionals in      Cancer Institute                                 the iCanQuit website from
disadvantaged areas to Quitline    NSW                                              NSW Health and GPs
and the iCanQuit website.          NSW Quitline
                                   GP Networks
Provide information to GPs and     NSW Health            n    n     n     n     n   Information disseminated
other health professionals         Cancer Institute
to highlight that people           NSW                                              Knowledge and attitudes of
with common mental health          NGOs                                             health professionals regarding
problems can succeed in            GP Networks                                      smoking and mental illness
quitting and benefit from
greater control of withdrawal
symptoms.
Develop, implement and             Justice Health        n    n     n     n     n   Policies developed and
evaluate a range of appropriate    Corrective Services                              implemented
strategies to reduce smoking       NSW
prevalence and exposure to         MOH                                              Exposure of staff and inmates
second-hand smoke amongst                                                           to second-hand smoke
custodial populations and
workforce specific to the                                                           Smoking rates among prisoners
correctional environment.
                                                                                    Quit attempts &
                                                                                    pharmacotherapy use
Develop and implement              Justice Health        n    n     n     n     n   Plan developed and
the Collaborative Tobacco          Corrective Services                              implemented
Initiatives                        NSW
Plan through the Corrective
Services NSW and Justice
Health Tobacco Working
Group to guide tobacco control
activities in the NSW custodial
setting.
Increase awareness and use         MOH                   n    n                     Uptake of NRT through PBS in
among low income groups that       Cancer Institute                                 NSW
smoke                              NSW
of NRT products available
through the PBS.
Key:
MOH – NSW Ministry of Health
MHCS – NSW Multicultural Health Communication Service
NGOs – Non-government organisations

PAGE 16 NSW HEALTH NSW Tobacco Strategy 2012-2021
Advertising and Promotion
Eliminate the advertising and                                 brought into effect significant reforms in NSW
promotion of tobacco products and                             to restrict the availability and supply of tobacco,
restrict the availability and supply                          especially to children and young people. More
of tobacco, especially to children                            can be done to further reduce the advertising and
                                                              promotion of tobacco products.
Tobacco advertising portrays tobacco smoking as a
regular and socially acceptable activity. Tobacco             The Australian Government has significant
advertising can also undermine the warnings about             responsibilities in this area, including the regulation
the adverse health effects caused by smoking.                 of tobacco products through trade practices
                                                              legislation, the prohibition of sponsorship and
Research suggests that displays of tobacco can
                                                              advertising of tobacco products and the regulation
influence children’s perceptions about the availability
                                                              of tobacco packaging, including cigarette contents
and accessibility of cigarettes in their community. 28
                                                              and graphic health warnings on cigarette packs.
In addition, tobacco displays have been found to
                                                              NSW will build on the Australian Government
make it harder for intending quitters to quit
                                                              commitment to bring restrictions on tobacco
smoking. 29
                                                              advertising and sales on the internet into line with
Tobacco sponsorship, advertising and point of sale            restrictions on other media and at physical points of
promotions have been restricted and progressively             sale by strengthening state legislation to expressly
phased out over time. The commencement of the                 prohibit the sale of tobacco on the internet.
Public Health (Tobacco) Act 2008 on 1 July 2009

Advertising and Promotion
Eliminate the advertising and promotion of tobacco products and restrict the availability and supply of
tobacco, especially to children
Actions                             Responsibility            Timeframe – Year        Measurement
                                                          1    2     3     4      5
Monitor and enforce the             NSW Health            n    n     n     n      n   Compliance with legislation
requirements of the Public
Health (Tobacco) Act 2008.                                                            Warning notices/ prosecutions

                                                                                      Survey data on source of supply
                                                                                      of cigarettes for children and
                                                                                      whether they have been asked
                                                                                      for proof of age
Review data collection and          NSW Health            n    n                      Review completed and
reporting systems for the                                                             recommendations implemented
Public Health (Tobacco) Act
2008 and implement key
recommendations.
Continue to implement the           NSW Health            n    n     n     n      n   Scheme implemented
retailer notification scheme and
review its effectiveness.                                                             Number of retailers registered
Conduct retailer education          NSW Health            n    n     n     n      n   Knowledge of retailers
campaigns (including those          MHCS                                              about tobacco legislation
specifically tailored for CALD
groups) to raise tobacco retailer                                                     Compliance with legislation
awareness of their obligations
under the law and increase                                                            Retailer education available
compliance with legislation.                                                          in other languages
Publicise successful                NSW Health            n    n     n     n      n   Prosecutions publicised in the
prosecutions to enhance                                                               media
community and retailer
awareness.

                                                                    NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 17
Advertising and Promotion
Eliminate the advertising and promotion of tobacco products and restrict the availability and supply of
tobacco, especially to children
Actions                            Responsibility           Timeframe – Year       Measurement
                                                        1    2     3     4     5
Conduct regular training to        NSW Health           n    n     n     n     n   Regular training and skills
ensure Authorised Inspectors                                                       update sessions conducted for
are appropriately skilled                                                          Authorised Inspectors
and supported to monitor
compliance with legislation and
assist with prosecutions.
Monitor and review the Public      MOH                  n    n     n     n     n   Regular reviews conducted and
Health (Tobacco) Act 2008 to                                                       key findings implemented as
ensure its effective operation                                                     appropriate.
and identify whether further
amendments are required.
Develop a protocol for             MOH                  n    n                     Protocol developed
compliance with Article 5.3 of
the World Health Organization
Framework Convention on
Tobacco Control (FCTC)
regarding transparent
communication with the
tobacco industry.
Contribute to initiatives to       MOH                  n    n                     Issues relating to
determine the optimal design       Cancer Institute                                Commonwealth legislation put
of plain packaged cigarettes       NSW                                             forward in appropriate forums,
to reduce their appeal and         NGOs                                            considered and implemented as
increase the impact of health                                                      appropriate
warnings.
Review compliance data             MOH                  n    n     n     n     n   Data monitored regularly
relating to tobacco vending
machines to determine whether
tobacco vending machines
represent a risk of sales
to minors.
Examine options to phase           MOH                  n    n                     Options examined and
out tobacco sales on NSW                                                           recommendation made
Government premises.
Amend the Public Health            MOH                       n                     Legislation amended
(Tobacco) Act 2008 to
expressly prohibit the sale of
tobacco on the internet.
Key:
MOH – NSW Ministry of Health
MHCS – NSW Multicultural Health Communication Service
NGOs – Non-government organisations

PAGE 18 NSW HEALTH NSW Tobacco Strategy 2012-2021
Second-hand Smoke
Reduce exposure to second-hand                               Smoke-free environments are effective in reducing
smoke in workplaces, public places                           non smokers’ exposure to second-hand smoke and it
and other settings                                           is argued that they contribute to the denormalisation
                                                             of tobacco smoking. Smoke-free environments are
It is well established that there is no safe level of
                                                             also beneficial for smokers by supporting their
exposure to second-hand smoke and that it causes
                                                             efforts to quit and reducing the consumption of
a range of serious health problems including
                                                             cigarettes as smoke-free environments provide fewer
coronary heart disease and lung cancer in
                                                             opportunities to smoke.
non-smoking adults. 30 Children are particularly
susceptible to health damage caused by second-               Local councils in NSW have been progressively
hand smoke due to their immature immune systems              introducing smoke-free policies in outdoor areas
and their smaller airways. Children can suffer a range       such as children's playgrounds, swimming pools
of health problems including increased risk of asthma        and beaches. The NSW Government will amend the
and sudden infant death syndrome from exposure               Smoke-Free Environment Act to protect the
to second-hand smoke. 31                                     community from harmful second-hand tobacco
                                                             smoke in a number of outdoor settings, including:
                                                             at public sports grounds, within 4 metres of the
                                                             entrance to a public building and in commercial
                                                             outdoor dining areas.

Second-hand Smoke
Reduce exposure to second-hand smoke in workplaces, public places and other settings
Actions                            Responsibility            Timeframe – Year        Measurement
                                                         1    2     3     4     5
Amend the Smoke-free               MOH                   n    n     n     n     n
Environment Act 2000 to
prohibit smoking in the
following areas:
a)	In public playgrounds within
    10m of children’s play
    equipment;
b)	In open areas of public
    swimming pools;
c)	In major sporting facilities
    and at public sports
    grounds;
d)	At public transport stops
    and stations;
e)	Within 4m of the entrance
    to a public building; and
f)	In commercial outdoor
    dining areas.
Continue to monitor and            NSW Health            n    n     n     n     n    Number of complaints
enforce the Smoke-free
Environment Act 2000.                                                                Number of inspections
                                                                                     and % premises complying
                                                                                     with the legislation

                                                                                     Prosecutions and warning
                                                                                     notices issued
Conduct a targeted                 NSW Health            n    n     n     n     n    Education activities conducted
communications strategy            MHCS
(including for CALD groups) to                                                       Level of awareness of the Act
ensure licensed premises and                                                         and its provisions across the
other employers are aware of                                                         hospitality industry
their obligations under the Act.
Continue to monitor and            MOH                   n    n     n     n     n    Number of infringement
enforce the ban on smoking in      NSW Police                                        notices issued by NSW Police
cars when children under the
age of 16 years are present.
Build the capacity of Authorised   NSW Health            n    n     n     n     n    Regular training and skill
Inspectors to enforce smoke-                                                         update sessions conducted
free legislation.

                                                                   NSW Tobacco Strategy 2012-2021 NSW HEALTH PAGE 19
Second-hand Smoke
Reduce exposure to second-hand smoke in workplaces, public places and other settings
Actions                              Responsibility         Timeframe – Year       Measurement
                                                        1    2     3     4     5
Review and fully implement the       NSW Health         n    n                     Review conducted and policy
Smoke-Free Health Care Policy        NGOs                                          revised as appropriate
for NSW Health.
                                                                                   Number of NSW facilities which
                                                                                   achieve totally smoke-free
                                                                                   health
                                                                                   care status
Increase awareness of                NSW Health         n    n     n     n     n   % population reporting their
parents, particularly those          AHMRC                                         home and car is smoke-free
from CALD communities, low           NGOs                                          (especially CALD, low SES and
socioeconomic groups and             MHCS                                          Aboriginal populations)
Aboriginal people,
of the health risks to children of
second-hand smoke and ban on
smoking in cars with children.
Under the Healthy Workers            MOH                n    n                     Guidelines developed and
Initiative, develop and                                                            implemented
implement guidelines and other
resources for workplaces and
other settings wishing to go
smoke-free.
Conduct research on impacts of       MOH                n    n                     Research conducted and
second-hand smoke to health.                                                       recommendations made
Support the implementation           MOH                n    n     n     n     n   % of strata schemes which
of smoke-free multi-unit             NGOs                                          introduce smoke-free
residential dwellings by strata                                                    requirements
organisations through the
promotion of guidelines.
Advocate at a national level         MOH                n                          Discussions held with the
for a national approach on the                                                     Australian Government and
issue of removing smoking ban                                                      other states
exemptions for casino private                                                      and territories
gaming areas.
Develop and implement options        NSW Health         n    n                     Options paper finalised and
for reducing smoking on NSW                                                        action taken to progress
Health facilities.                                                                 recommendations
Promote smoke-free policies          NSW Health         n    n     n     n     n   Number of tertiary facilities
in youth centres and tertiary                                                      and youth centres introducing
education facilities, including                                                    smoke-free policies
TAFE, universities and private
colleges.                                                                          % of young people exposed to
                                                                                   second hand smoke in tertiary
                                                                                   facilities and youth centres
Introduce a strengthened             MOH                n    n                     Powers granted to Local Health
enforcement regime for the                                                         Districts
Smoke-Free Health Care Policy
through penalty notices.                                                           Policy Directive issued on
                                                                                   use of penalty notices
Key:
MOH – NSW Ministry of Health
MHCS – NSW Multicultural Health Communication Service
NGOs – Non-government organisations

PAGE 20 NSW HEALTH NSW Tobacco Strategy 2012-2021
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