QUESTION
Introduction to the Queensland Cancer Fund.
From a desperate need in the community during the 1960’s to address concerns regarding cancer, the Queensland Cancer Fund (QCF) was born. Forty years on, the QCF is strategising to continue raising funds to combat the dreaded disease and supply sufficient treatment facilities for cancer patients. The organisation remains a ‘not for profit’ firm, although employing a range of professional staff for the services provided. The activities conducted by the QCF are diverse, but structured to allow the organisation to achieve its aims that include advancing cancer research and treatment and to increase community awareness of cancer. Similarly, research into cures for cancer, facilities for patients, cancer help lines and education programs all represent key areas that the QCF are involved in.
Environmental Tobacco Smoke
This submission addresses the concerns of environmental tobacco smoke (ETS) in public places, namely pubs, clubs, casinos and restaurants that causes illness and death to workers and patrons. Research is extensive and supports the long held belief that tobacco smoke is harmful. It is fact that over 4000 chemicals are contained in tobacco smoke including tar, addictive nicotine, carbon monoxide and carcinogens that cause cancer (Jarred, 2001:2 and AHMAC, 2000:3). Passive smoking, as ETS is often referred to, occurs when non-smokers inhale smoke that is either exhaled or emitted by smokers. For the thousands of hospitality workers and patrons exposed to ETS in licensed premises, the proposed review by the Government of the Queensland Tobacco and Other Smoking Products Act 2001 is extremely overdue.
Key Developments
Scientific research first began to appear during the 1970’s linking passive smoking and respiratory diseases but it wasn’t until 1981 that medical research on the effects of passive smoking was first published (Hirayama cited Jarred, 2001:16). Decades later in 1995, the Herron Report recommended that smoking not to be permitted in enclosed places including restaurants and hotels. Further, the report suggested the inclusion of outdoor areas specifically for smokers and that employees not be forced to service these areas (PEHS, 2000: 4). A few years later, the National Tobacco Strategy 1999-2002/3 was endorsed by all State and Commonwealth Health and Police Ministers with the major aim being the reduction of exposure to environmental tobacco smoke. The Queensland Tobacco Action Plan 2000/01 – 2003/04 emerged soon afterwards. The strategy objectives and key strategy areas were to reduce exposure to tobacco smoke thus forming the framework of the document (Turner, 2001). Finally, Queensland followed the majority of the states with ETS legislation and passed the Tobacco and Other Smoking Products (Prevention of Supply to Children) Amendment Bill 2001 on May 3 2001 to be effective 31 May 2002 (NOHSC, 2001).
The Silent Killer
The statistics reveal a frightening story for the effects of tobacco smoke. For the thousands of scientific publications linking tobacco smoke to over 50 diseases, more than 3000 Queenslanders die annually due to tobacco related causes (QCF, 2002a:8). With less than a quarter of the state’s adult population being smokers, their filthy habit significantly contributes to this annual death toll that incidentally, far exceeds the state’s yearly road toll. Worst of all, smoking is the leading preventable cause of premature death and illness in the state but the Government still haven’t acted to end the disgusting conditions that hospitality workers or patrons have to endure in licensed premises. Instead, the community has to suffice with a measly review only of the act instead of immediate action of no smoking bans. Smoke free areas within an establishment simply do not work, as smoke drifts and ventilation systems are useless, exposing non smokers to environmental tobacco smoke (TDHHS, 2003). Research shows that workers and customers are being exposed to high levels of cardio and geno toxic tobacco by products that cannot be removed via ventilation systems (Repace and Lowry, 1993).
Litigation
For further consideration by the Government, is the emergence of litigation surrounding passive smoking. Several cases over recent years highlights that the judicial system is recognising the links with ETS and illness incurred by individuals. The National Occupational Health and Safety Commission published the findings of two recent cases. In the first instance, $466,00 was awarded by the NSW Supreme Court to a bar worker against her former employer in May 2001 who had served 23 years with the company. The jury found her throat cancer was a direct result of second hand smoke being inhaled by the bar attendant. In another case, a restaurateur had to pay $7600 in damages to an asthma sufferer who suffered a 2 month bout of severe asthma triggered by ETS in the restaurant. The court found the restaurant liable on breach of contract, breach of duty of care in negligence an occupier’s liability. The Government has ignored since 1986 the potential of liability of employers relating to tobacco compensation claims. Specifically, the Commonwealth Attorney General noted that ‘injury from passive smoking is reasonably foreseeable and that consequently such an injury could give rise to an action for damages at common law’. Five years later, the same was emphasised by the President of the Senate ‘the onus now appears to fall on employers and managers of facilities to take a more positive role in protecting non smokers’ (PEHS, 2000:6) The Government cannot disregard any longer the plight of workers or patrons in environments filled with tobacco smoke.
Existing No Smoking Bans
Finally, the idea of completely smoke free licensed premises is not new. Other countries have already implemented legislation banning smoking in restaurants and bars demonstrating their commitment and concern to non smokers. Ottawa introduced smoke free by laws in 2001 (NOHSC, 2001). The by laws ban smoking in all public places and workplaces. A year later, El Paso in Texas also found itself with similar bans (Huang, De and McCusker, 2004). Most impressive was Ontario’s bans in 1998, which sets them as pioneers in the field of no smoking bans in licensed premises (Ascenzi, 1998). By January of this year, five US states and 72 municipalities have passed laws that prohibit smoking in almost all workplaces, restaurants and bars. This is excellent and now Queensland must lead the way for Australia’s turn in implementing permanent smoke free legislation to protect all non smokers. The Premier of Queensland, Mr Peter Beattie, on a recent trip to Ireland was able to observe first hand no smoking in licensed premises in pubs visited. Mr Beattie, take the challenge and lead the ‘Smart State’ into introducing no smoking legislation immediately.
The Benefits of Smoke Free
In anticipating the hospitality industry association’s defence in not wanting this type of legislation to be introduced for fear of financial loss, the QCF wish to advise that non smoking premises are good for business. Evidence from those countries with no smoking bans in place have reported encouraging effects to their revenues. Sibbald (2001) found that a positive impact occurred in Canada after the bans were introduced. Restaurants and bars in Ontario are attracting more non smoking patrons while retaining smokers (either lighting up outside in the street or reducing their intake) (Ascenzi, 1998). A little more closer to home, an entrepreneurial bowls club on the Sunshine Coast went smoke free in 2001 (QCF, 2002b). The Maroochydore Swan Bowls Club has since enjoyed a substantial increase in membership of over 150% since the ban. The claims that smoke free policies would cause financial hardship simply aren’t true, as this research shows.
Conclusion
This submission has presented research and evidence that supports legislation of no smoking at all in licensed premises. The notion of conducting a review of the Tobacco and Other Smoking Products Act 2001 is inadequate. The sole recommendation is to introduce legislation immediately to ban smoking in all licensed premises for the protection of both workers and patrons. The effects of ETS are well documented and researched and cannot be ignored any longer by the Queensland Government. Action must be taken now to stop the premature death of thousands of Queenslanders that can be prevented with clean air that workers and patrons deserve.
References
Ascenzi, Joseph (1998) Bars and Patrons Adjust To – and Ignore – New Law. The Business Press, Ontario, Jan 19 1998
ASH (2003). Smoke Free Public Places For The A.C.T. Action on Smoking and Health. Downloaded 10th May 2004
http://www.ashaust.org.au/publications/ACTsubm03.doc
Huang, P., De, K. A. and McCusker, M. E. (2004) Impact Of A Smoking Ban On Restaurant and Bar Revenues. Morbidity and Mortality Weekly Report, Atlanta, Feb 27 2004
Jarred, W. (2001) Towards Improved Public Health, Research Bulleting no 3/01. Queensland Parliament Library. Downloaded 10th May 2004
http://www.parliament.qld.gov.au/Parlib/Publications_pdfs/books/rb0301wj.pdf
NOHSC (2001). Environmental Tobacco Smoke Watching Brief 2001. National Occupational Health and Safety Commission. Downloaded 10th May 2004
http://www.nohsc.gov.au/ResearchCoordination/watchingbriefs/etspages/ETSWatchingbriefSept2001.pdf
NPHP (2000). National Response To Passive Smoking In Enclosed Public Places and Workplaces. A Background Paper. Downloaded 10th May 2004
http://www.nphp.gov.au/publications/legislation/smoke_passive.pdf
PEHS (2000). Smoke Free Public Places. Regulatory Impact Statement. Public and Environmental Health Service. Downloaded 10th May 2004
http://www.dhhs.tas.gov.au/publichealth/smokefreeareas/pdfs/smokefree_RIS.pdf
QCF (2002a). Smoking Kills, A Submission On Behalf Of Public Health And The 553, 000 Queensland Smokers Who Want To Quit. Queensland Cancer Fund. Downloaded 10th May 2004
http://www.qldcancer.com.au/cancer_info_and_services/PDF/SmokingKills.pdf
QCF (2002b). Smoke Free Club Bonanza. Queensland Cancer Fund. 14 May 2002, media release. Downloaded 10th May 2004
http://www.qldcancer.com.au/Whats_New/Default.html
QCF (2004). Premier Checks Out Irish Smoking Bans For Queensland. Queensland Cancer Fund. 1 May 2004, media release. Downloaded 10th May 2004
http://www.qldcancer.com.au/Whats_New/Default.html
SOLUTION
Introduction to UnitingCare, Australia
35 years young and growing, UnitingCare, Australia is a voice for over 2 million people across the country, providing community services across the nation and beyond. A team in excess of 35,000 in 1300 locations, aided by 24,000 volunteers, UnitingCare is an ‘agency of the National Assembly of the Uniting Church in Australia. From food and clothing, education and recreation to finding work and exploring spirituality, UnitingCare helps people all over the country aim for a better quality of life. Fostering an atmosphere of community, UnitingCare works with various stakeholders to help make the world a better place.
UnitingCare does almost 50% of its work in the domain of health care, working considerably with the aged. The rest of United Care’s work is divided almost equally in the areas of Emergency Support, Disability Services and working with Children and Families. (UnitingCare Australia 2012)
The Problem Gambler
This submission focuses exclusively on the ‘problem gambler’, an individual who can exist in either the real world or the virtual world. Defined simply as a person who suffers from “poor financial and/or health outcomes” (McCormack & Griffiths 2011), a problem gambler suffers from the ability to limit his monetary spends and the time he spends while engaging in the activity of gambling. The need to gamble or to pay off debts resulting from gambling can affect not just the individual, but also his/her immediate family and the community at large he/she resides in. Such individuals often find themselves struggling to hold down jobs, often causing chaos in their community – sometimes even courting arrest, and are more often than not estranged from their families. It is the effort of this submission to encourage the government to realize that it is not just 115,000 gamblers surveyed who are defined as problem gamblers, in fact, not just the 280,000 additional gamblers who are defined as those with a moderate level of risk, but the communities in which these 400,000 people and the additional lives that each one affects, that puts in excess of a million Australians at risk each year. (Australian Government Productivity Commission 2010)
Key Developments
Under the purview of the Productivity Commission Act of 1998, the Commission was asked to do some preliminary research into the rather popular but often controversial gambling industry. Fast forward to November 2008, and the Commission was asked to update their report, with one decisive change. This was no longer a fact finding mission, but the Commission was actually asked to come up with some recommendations based on their research. The report, popularly referenced now as Productivity Commission (2010), did all that it was asked to and more. In a brilliantly researched and rather controversial publication, the report looks at everything from benefits that the people and government derive from this industry, to the major problems that arise out of it.
Two of these major areas of concern – problem gambling and population health issues – were studied in detail with an emphasis on not just solving them, but looking at ways in which their impact can first be mitigated and then eventually eradicated. As one can expect, not all these findings are popular, especially considering the massive sums of money involved to some of the major stakeholders.
As one would expect, the findings of these reports gave rise to so much data, that it has encouraged further research, with publications such as International Gambling Studies, Analysis of Gambling Behaviour, Journal of the National Association for Gambling Studies, Journal Of Gambling Issues, among others finding plenty of fodder to chew on. (referenced articles of said journals provided)
What’s been done so far
UnitingCare participated in the research done by the Productivity Commission and made oral and written submissions which were given due consideration while preparing the 2010 report (UnitingCare 2009). Director Susan Helyar was an active participant in this process and also reviewed the draft recommendations made by the Commission, and highlighted strengthening help services for problem gamblers, gaming (poker) machine standardization, shutdown period for machines and educating the gamblers as distinctive areas that needed to be urgently addressed. (UnitingCare 2009)
In March 2011, the Australian Churches Gambling Taskforce was launched. Uniting Church joined hands with several other leading Churches in the country to kick start this initiative. Reverend Alistair Macrae, President of the Uniting Church and also the Forum Chair of this Taskforce, made an impassioned address declaring that 10 people in addition to one child on an average are affected by the actions of problem gamblers. Reverend Macrae declared that 30% of gamblers are at risk, and demanded that growth in the gambling industry cannot come at the cost of human lives. He asked that pre-commitment measures be made mandatory (UnitingCare 2011), forcing gamblers to set a limit for themselves before they start. The logic behind this initiative is that most gamblers are affected by a losing streak, believing at some stage their luck will change, and will keep spending money they don’t have. A pre-commitment though, even if a high figure, is a decision taken before the gambler gets caught in the rut, and will at the very least mitigate some of the risk.
The Taskforce continues to remain active, and actively engages with the media and local communities to continue the process of what it labels “poker machine reform”.
New Research
Perhaps the most worrying new information that has come to light over the last couple of years is that Australia might be underestimating the number of problem gamblers we have. Michael Walker and Elena Svetieva of the School of Psychology, University of Sydney published a paper in May 2010 where they have critiqued the technique used by Gambling Research Australia (GRA) to determine their numbers, highlighting that the CPGI (Canadian Problem Gambling Index), which is what the GRA is using as a benchmark, “only weakly measures problem gambling” (Walker & Svetieva 2010).
The paper looks to distinguish between pathological gambling and problem gambling, citing that the Australian Government is measuring the former. While there is no doubt that there is a distinct correlation between the two, there exists no standardized measure to equate the two. In some ways pathological gambling is a mental state, a disorder, and is considerably less prevalent in society in comparison with problem gambling. The paper concludes that the CPGI is an excellent tool, but it measures the wrong thing, and my using its findings to identify problem gamblers, the Australian Government is ignoring a large group of people that would come under the ambit of Problem Gambling. The only way forward that it recommends is development of new measurement criteria, because tools like DSM (Diagnostic and Statistical Manual) and SOGS (South Oaks Gambling Screen) fall short.
Litigation
While there isn’t a great history of litigation involving gambling, there are a few landmark judgments and some exciting cases in progress. Some of these claim ‘common law negligence’ against the venue where gambling took place, while there are also plenty which assert ‘a breach of statutory duty’. There are also some cases under review where the courts are examining whether there has been a violation of the Trade Practices Act 1974, under the guise of unconscionable conduct. While a lot of these cases hold emotional merit, it is hard for a court to absolve the claimant of ‘self-responsibility’. Too often parallels are drawn with cases where alcohol abuse takes place, and casino and club owners tend to walk away scot free, clear of any responsibility. (Australian Government Productivity Commission 2010)
However, in a humane society, encouraging an overstretched individual to spend money he doesn’t have cannot and must not be left unchecked, and it is time that the government offers sufficient protection for those who are beyond a state of helping themselves. There is just too much at stake!
Conclusion
The fact is that Australia as a nation loves Gambling. It is imperative for the government and competing lobbyist groups from the Australian Casino Association and Clubs Australia to understand that UnitingCare is not standing here and yelling let’s put an end to Gambling. Gambling is a fabric in the Australian way of life, and putting down some money on Melbourne Cup Day is tradition. UnitingCare is all for tradition, all for the community and all for some healthy fun.
However, the fact is also that not everyone is having fun. There are enough Australians who just can’t afford to gamble, and they affect not just themselves, but a whole bunch of people around them. The social cost of problem gambling is estimated to be at the very minimum $4.7 billion a year. (Costello 2011). UnitingCare’s aim is to help minimize this, and the process is amazingly simple – start with poker machines (pokies). 86% of problem gambling comes from these machines (Costello 2011). My employing the following steps, we can help reduce this impact of this problem manifold:
1. Mandatory pre-commitment.
2. Define maximum bets per spin at a reasonable figure.
3. Define an hourly loss limit for players.
4. Define a minimum shutdown time for all machines.
Four simple steps and the problem gambler will be much less of a problem.
References
UnitingCare Australia, 2012, About Us, viewed 6 April 2012, http://www.unitingcare.org.au/about-us/our-work.html, viewed 6 April 2012.
Uniting Care Australia, 2009, Draft Report on Gambling, viewed 6 April 2012, http://www.unitingcare.org.au/images/stories/submissions/sub_pcs_draftreport_on_gambling_24dec09.pdf.
Uniting Care Australia, 2009, Submission to Productivity Commission, viewed 6 April 2012, http://www.unitingcare.org.au/images/stories/submissions/sub_productivity_com_gambling_may09.pdf.
UnitingCare Australia, 2012, Media Release: National Gambling Taskforce, viewed 6 April 2012, http://www.unitingcare.org.au/news/51-national-news/720-national-gambling-taskforce.html.
Australian Government Productivity Commission, Gambling, 23rd June, 2010, viewed 6 April 2012, http://www.pc.gov.au/__data/assets/pdf_file/0005/95684/02-overview.pdf.
Australian Government Productivity Commission, Gambling, 23rd June, 2010, viewed 6 April 2012, http://www.pc.gov.au/__data/assets/pdf_file/0007/95713/30-appendixh.pdf.
Costello T, 2011, ABC: Abbott turns his back on problem gamblers, viewed 6 April 2012, http://www.abc.net.au/unleashed/3602514.html
Dixon, M, Newman, T, & Nastally, B 2009, A COMPARISON OF THE PREVALENCE OF AND MAINTAINING CAUSE FOR PATHOLOGICAL GAMBLING IN FRATERNITY AND NON-FRATERNITY MEMBERS, Analysis Of Gambling Behavior, 3, 1, pp. 21-25, Academic Search Complete, EBSCOhost, viewed 6 April 2012.
Jennifer M. Boldero & Richard C. Bell (2012): An evaluation of the factor
structure of the Problem Gambling Severity Index, International Gambling Studies, 12:1, 89-110
Marshall, D 2009, ‘Gambling as a public health issue: The critical role of the local environment’, Journal Of Gambling Issues, 23, pp. 66-80, SocINDEX with Full Text, EBSCOhost, viewed 6 April 2012.
McCormack, Abby and Griffiths, Mark. The effects of problem gambling on quality of life and wellbeing: A qualitative comparison of online and offline problem gamblers [online]. Gambling Research: Journal of the National Association for Gambling Studies (Australia), Vol. 23, No. 1, 2011: 63-81, viewed 07 April 2012.
Walker, Michael and Svetieva, Elena. The CPGI and the National Definition of Problem Gambling [online]. Gambling Research: Journal of the National Association for Gambling Studies (Australia), Vol. 22, No. 1, June 2010: 40-48, viewed 07 April 2012.
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