MATTERS OF PUBLIC IMPORTANCE

Dr REID (Robertson) (15:48): There are moments in public policy when we should be very clear what is at stake, and tobacco and vaping controls is one of them. The Liberal-National-One Nation coalition is seeking to use current pressures and current challenges in the tobacco market as an argument for weakening the controls Australia has built over decades. This would be a profound public health error because tobacco is not any ordinary product.

It is a product that causes disease by design. In the emergency department, I see those consequences. I see patients with severe COPD arrive unable to complete a sentence because they are too breathless to speak.

I see patients sitting bolt upright, shoulders lifting with every breath, exhausted by the physical effort required simply to move air in and out of damaged lungs. I see oxygen saturations fall and carbon dioxide levels rise. I see patients placed on non-invasive ventilation because their lungs can no longer adequately perform one of the most basic functions of human life.

Sometimes, despite all of that intervention, all of that treatment, they will continue to tire. That is the clinical reality of smoking related lung diseases. For many patients, the deterioration is slow and the deterioration is relentless.

Walking to the bathroom is difficult. Showering is exhausting. A flight of stairs becomes near impossible.

Then come the recurrent infections, the repeated hospital admissions, home oxygen and the ever-increasing dependence on others for the most basic parts of daily life. This is why Australia has strong tobacco controls—not to inconvenience smokers and not to make a political point but because governments have a responsibility to reduce preventable disease and have a responsibility to reduce premature death.

We know what happens when fewer people smoke. There's less lung cancer, there's less cardiovascular disease, there's less chronic respiratory disease, there are fewer admissions to the hospital, there are fewer medications required, and there are fewer trips to the GP. Then there are fewer families watching someone they love progressively lose the ability to breathe and suffocate to death.

I reject here, right now, any proposal or any proposition that would weaken tobacco controls or make tobacco easier or cheaper for people to obtain in our country. That's not pragmatism. That is surrendering public health policy to short-term political convenience.

Australia has spent decades changing the culture around smoking, because the medical evidence has demanded it. We should not walk backwards now. Our responsibility in this place is not to make tobacco consumption easier.

It is to make preventable disease less common, it is to protect the next generation from addiction, it is to help people who already smoke quit, and it is to reduce the number of patients who end their life tethered to oxygen, struggling for breath because of a product we already know causes devastating disease. Good public health policy requires resolve, and, on tobacco, Australia has shown that resolve, and, now, we should show it again.