Interview Q&A

Who: Dr. Becky Freeman

When: August 8th, 2017

Where: University of Sydney; Charles Perkins Centre

* In bold are my questions, and in the regular font are Dr. Freeman's responses. *

How did you pick this career path?

In high school, thought “yeah Ill be a doctor” and then once she got to university se realized she really didn’t want to do that but, realized there were many other ways to be involved in healthcare. She got a Bachelors degree in biochemistry and a Masters degree in health promotion. A tobacco control lecturer came to her grad school one day and she was blown away by tobacco control; policies, advocacy and research element. It had everything that she was extremely interested in. Started working for Canadian Lung association. Then noticed if you have a PhD behind your name people are way more willing to work with you, more helpful, and people end to ask your opinion when it came to making policy. Knowledge is seen as more expertise.  She is originally from Edmonton, Canada, far north.

Can you explain a little bit about how social media has affected tobacco control?

Social media hadn’t taken off yet when she stared her PhD, advertisements were mostly based on print ads and billboards. So her first paper was about how tobacco “looks” on YouTube. She watched the videos that were most viewed for the search word “tobacco” and most were actually pro-smoking, and she even saw a couple that were talking about how “interesting” smoking was, and another about a smoking fetish. However, one of the most viewed was for an anti smoking ad, one that would never be able to be aired anywhere but online because of how graphic it was. When looking on Facebook for tobacco ads, she found a British American tobacco network, comprised of employees from large tobacco brands with Facebook’s. They would post images of new pack designs, events etc.. However, this was in violation of the FCTC, the WHO’s Framework Convention on Tobacco Control which is an “involuntary pledge that tobacco companies wouldn’t advertise online.” The big tobacco brands’ response was that “we cant really control what our employee’s post online.” She also looks at how Twitter can enhance a brands corporate image. Companies that produce tobacco are allowed to post things like “We’re a top employer” “We believe in women’s rights” “We are an equal opportunity company” “Voted best company to work for 2016” in order to get people to like them. Not even ads about smoking, but about how great their company and work force are. There is an advertising law in Australia about advertising tobacco on Internet; you are under no circumstances allowed to do it. However, the lines are blurred when it comes to the Internet, because something posted in another country via Facebook, it can reach Australia and technically it isn’t breaking any laws. Mauritius is only successful country in the world to have no tobacco advertising whatsoever.

PHILLIP MORRIS INTERNATIONAL is a big tobacco company with a FB page that advertises their company heavily, but not tobacco.

Are you aware of the “Australian Preventative Health Taskforces plan for a Healthier Australia by 2020” and do you think the goal of under 9% daily smokers by 2020 is attainable

I think we will get close. 12.5% is the national rate of daily smokers, which is from the latest survey a few months ago. Since the plain packaging act passed in 2011, there has been a policy slump, which may prevent us from reaching our goal. Maybe we need to ban menthol, or look at the supply chain. We definitely need to put money back into the national campaign for quitting smoking, because that worked well when there was money available to fund it. Each state now runs their own tobacco control campaign, NSW was very good, but other states have not had quite as much success because of the lack of funds.

Has the increased cost of cigarettes helped smokers quit?

Yes, definitely. It was something that we call a spontaneous tax announcement, which means the day that the tax increase is announced it also goes into effect so no company has a chance to cheat the system and figure out a way to lessen the blow on their tobacco sales. The original tax was 25% and every year after that, the taxes go up 12.5%, but these are planned in advance, so some tobacco companies try to slowly raise prices leading up to the tax increase so that the added tax doesn’t seem like as much.

Have black markets popped up for cheaper cigarettes?

No, not really. But that is unique to Australia because it is an island; it’s not bordered by any other country, only sea. We have a tight border control, much more difficult because its an island. Australia is also not a tobacco-growing nation, so shutting down the illegal supply chain is much easier here. You are only allowed to bring in 1 pack of cigarettes duty free, and after that, all other packs of cigarettes get the 25% or higher tax applied to them. Tobacco has to be out of sight in airports, as well as stores in general. The only things you can see in the shops are the huge signs that say SMOKING KILLS in the back

Has the plain packaging act been beneficial to tobacco control?

I think so. There is a rotating set of 14 health warnings, so 7 are in use every year, and then they rotate to the next 7 at the end of the year. Before PPA, 50% of the pack could be brand advertising, and other half had to be Australian health warnings. Look at ones from Thailand; they are even more graphic than ours, with some packs showing dead children and miscarriages.  120 countries have graphic health warnings in use; the US is not one of those countries.

What is the University of Sydney’s policy on tobacco use?

We are completely smoke-free and the shops on campus do not sell tobacco. All we did was sat down with administration a few years ago. The university is attached to a big public university hospital and they are a leading institution, so it would’ve been bad to not go smoke free. Also located in a high-income area, so that also made the ban just a little bit easier. As for the student union, which used to sell tobacco in two shops on campus, the University just gave them the money they would have made from tobacco sales so that the ban didn’t hurt their revenue and they didn’t try to rebel.

What is the class you teach about?

Tobacco control in the 21^st century, all of the policies and history of tobacco use. Teaching about who the global tobacco industry is.

Was smoking ever trendy in AU

Peaked in the 50 60s, just like in the US. And then the Surgeon General announced that smoking kills you, and a majority of wealthier and more educated people quit that day. There was a period in the 90s where no new laws were added and rates were pretty steady.

Do you think people understand the effects of second hand smoke?

Completely. People love smoke free laws and they support them the second the laws come out.  No smoking if there is food served, but you can smoke if there is only a bar for drinks. High traffic areas have banned smoking, and certain councils have their own smoking laws. Bondi beach is one suburb where it is completely illegal to smoke at all.

What in your opinion is the main reason for people to start smoking?

Peer pressure maybe, the main time for people to uptake smoking is between the ages of 17-24, but the rates are still coming down.

How would you transition a campus to smoke free or to have designated smoking areas?

Look at smoking quit website, with the guides on there it is fairly easy. Just talk to administration about the benefits.

Do smokers have higher health insurance?

No, we can’t charge more for smoker’s health insurance.

Are the affects of tobacco talked about in school?

Absolutely, but our youth smoking rate is miniscule and its not something that we really worry about too much.