Australia Tobacco Strategy: PBS and Policy Review Report

This report provides a critical literature review and policy brief concerning Australia's tobacco strategy. It begins by examining the Pharmaceutical Benefits Scheme (PBS) and its role in providing smoking cessation treatments, including nicotine replacement therapy, varenicline, and bupropion. The review explores the effects of increased tobacco use on smoking prevalence and related health disparities, particularly among socioeconomically disadvantaged groups and Indigenous populations. It then assesses the impact of improvements in smoking cessation programs, emphasizing the role of general practitioners and innovative mobile-based approaches. The report highlights the government's initiatives, such as behavioral interventions and pharmacotherapy, while addressing barriers like lack of resources and clinical knowledge. Finally, the report presents a policy brief that synthesizes the findings and suggests recommendations for future strategies in combating tobacco use and its adverse health consequences in Australia.

Tobacco Strategy
Literature

Table of Contents
INTRODUCTION...........................................................................................................................3
SECTION 1: CRITICAL LITERATURE REVIEW.......................................................................3
The current use of Pharmaceutical Benefits Schemes (PBS) provided smoking cessation
treatment services in Australia....................................................................................................3
The effects of the increase use on smoking prevalence and smoking related health disparities
in Australia..................................................................................................................................5
The effects on improvements on smoking prevalence and smoking related health disparities in
Australia......................................................................................................................................7
SECTION 2: POLICY BRIEF.........................................................................................................8
Title.............................................................................................................................................8
Executive Summary....................................................................................................................9
Introduction.................................................................................................................................9
Background and Importance of the problem...............................................................................9
CONCLUSION..............................................................................................................................11

INTRODUCTION
Tobacco is a serious concern when it comes to well being and safety of humans as excess
consumption of it causes sever chronic diseases and health issues which are long term and can be
implicating harmful impacts on the life of an individual. Governments and administrative bodies
in different regions around the world is working for making potential schemes which are
important enough to take proper care and raise awareness in population about the effective
processes and strategies to overcome the addiction of tobacco. The present report covers
appropriate literature in relation to the effective cessation and treatments developed by
government in Australia. In the next section a proposal is developed in regards to a policy
suggested after effective review of the literatures and the schemes of administration.
SECTION 1: CRITICAL LITERATURE REVIEW
The current use of Pharmaceutical Benefits Schemes (PBS) provided smoking cessation
treatment services in Australia.
According to the views of Melissa Middleton, The Pharmaceutical Benefits Scheme
(PBS) was introduced as limited scheme in 1948 by Australian government. As per the scheme
free medicines were provided to pensioners and around 139 medicines which are life saving and
disease preventing were given free to members in the community which means the whole
population of Australia. With the help of Pharmaceutical Benefits Scheme (PBS) in present day
the government is effectively providing timely, reliable and affordable access to all the necessary
and basic medicines to Australian population. This lead to making Pharmaceutical Benefits
Scheme (PBS) an essential part to the broader National Medicines Policy of Australian
Government(Bayly M and et. al).
Moving to Smoking cessation there are three major interventions available on the
Pharmaceutical Benefits Scheme (PBS) that are nicotine replacement therapy (NRT), varenicline
and bupropion. In the year July 2017, A committee known as Pharmaceutical Benefits Advisory
Committee (PBAC) presented a major submission in order to list the nicotine replacement
therapy in gum and lozenges form to Pharmaceutical Benefits Scheme (PBS)(Beaglehole R and
et. al). Moving along with time the Pharmaceutical Benefits Advisory Committee (PBAC) found
out the improved efficiency of gum and lozenges these are used in combination with nicotine
patches.

Moving along in the year March 2018, the Pharmaceutical Benefits Advisory Committee
(PBAC) made suggestions for listing the nicotine gums and lozenges on the Pharmaceutical
Benefits Scheme (PBS) as more therapies for treating nicotine dependence and healing the
addiction of people towards it. Then in the year 2019 medicines for smoking cessations was
approved by the minister for help as per the post market review. The post market review will
also reassess the Pharmaceutical benefit schemes restrictions in order to collect the largest
available benefits and evidences for building best clinical practices and cost efficiency as well as
effectiveness. This review will be carried out under the Australian governments post market
monitoring program. The major objective behind this review and monitoring activity is to ensure
the continued cost effective, if and best quality use of medicines that are listed under
Pharmaceutical Benefits Schemes (PBS).
Basically, Pharmaceutical benefits scheme is available to all Australians who are
residents and have an appropriate current Medicare card. There are other members to who are
eligible and holds the ability to enjoy the scheme and these are those overseas visitors from
countries that are part of Australia’s Reciprocal Health Care Agreement (RHCA). Presently the
countries with which Australia has Reciprocal Health Care Agreement (RHCA) are United
Kingdom, New Zealand, Malta, Italy, Sweden, the Netherlands, Ireland, Finland, Norway,
Slovenia and Belgium.
Presently the smoking cessation treatment therapy of Pharmaceutical benefit scheme in
Australia is covering three effective greeting therapies that are Bupropion which was listed on
PBS in the year 2000. The next is nicotine replacement therapy (NRT) which was listed on 1st
May 2000 for respiration, 1st December 2008 for Aboriginal and Torres Strait Islanders people
and the last is for general population which was introduced in the years 2011 in February. The
Varenicline was launched or listed on PBS in 2008.
In Australia, they were around 373934 people who was supplied with smoking cessation
therapies and subsidies of Pharmaceutical benefit schemes. Around 90,000 people who was
applied with these smoking cessation therapies taking their initial steps in quitting cigarettes and
smoking by using Pharmaceutical benefit schemes subsidies and smoking cessation therapies.
Amongst all the people around 340000 were given Varenicline the other 130000 patients were
supplied with nicotine replacement therapy and lastly around 60,000 people were supplied
Bupropion with descriptions and proper medication treatments.

The effects of the increase use on smoking prevalence and smoking related health disparities in
Australia.
In Australia and many other regions in the world smoking and addiction of it is inversely
related to several social economic status with disadvantaged groups in the population who are
most likely to begin smoking and continue it till their lifetime(Ekpu V U, Brown A K.Gilmore A
B and et. al). As per the diagram data is presented by the national drug strategy household survey
on smoking by various social economic characteristics of Australians belonging to age group of
14 and more in the year 2019.
As per the diagram and the statistics presented in it 63% of individuals have never
smoked in their lives who are of 14 years of age and above that. 22.8 percent of person have
become ex smokers and left smoking years ago and around 14% of person are currently smoking

as per the data of Australia. These figures are then more bifurcated and clearly presented with
different characteristics and features.
Another image is presented which shows the trends overtime in smoking and socio-
economic status in Australia(Greenland S J, Johnson L, Seifi S). According to the graphical
representation in the image it shows the prevalence of regular smoking extracted by the national
drug strategy household survey from 2001 to 2016. As per the image It is seen that in the period
of 2001 2016 regular smoking declined.
Ill health and breach of premature deaths in Australia is a serious disability which is
being faced big and shoes Ace clear gradient across social economic status groups. There are
people who are at benefit as they can afford better food and housing as well as health for
themselves and holds better choices and knowledge for their help the behaviour. The concerning
group are those who are disadvantaged lacks the ability to afford better life and have the options
and live with multiple risks to their health and care. Lower socioeconomic status of an individual
is associated with increasing rate of a reducing physical abilities and increasing the chances of
severe health issues.
In Australia there are also a clear social gradient amongst people who regularly smoke
having lower education and income which is directly linked to their excessive smoking practice
and Ill behaviours. Australians having lower socioeconomic status are highly proportionate of
getting under chronic diseases which becomes a burden on their mortality in comparison to those
having better life choices and advantageous situations in their lives(Hawkins B, Holden C,

Mackinder S). The social economic disparities in mortality rates from diseases associated with
smoking and increasing use of tobacco is highly affecting the health of an individual and
exposing them to other risky and unhealthy severe diseases which will be affecting their lives
and depreciates there living tome in the world.
As per studies it is found out that among Aboriginal and Torres Strait Islanders
population the smoking rate is subsequently High and it relatively impact on smoking
attributable conditions and makes them different from comparison with non indigenous people.
People have suffering from several heart diseases and the common cause behind them all is
smoking attributing to deaths amongst the indigenous Australians and leading to serial other
diseases like lung cancer chronic obstructive pulmonary disease.
Thus, a serial disparity which is created by smoking over health and welfare of people in
Australia. there are various evidences that shows that social economic disparities in mortality
and mortality from tobacco related diseases have been increasing over time(Jarman H). Smoking
have been and still is been a very serious and cognitive concern for people in Australia for which
Australian government and several other administrative bodies is taking serious steps in order to
raise awareness and make changes in the society by discouraging them for using tobacco and
focusing towards a better life with better life options and choices.
The effects on improvements on smoking prevalence and smoking related health disparities in
Australia.
In views of Nicholas. A. Z (2009), the rule of general practice nurse smoking cessation
and treatment services as well as suggested initiatives to enhance general practices as a setting
for effective programs for smoking action services. The author have highlighted the extent that
general practitioners holds appropriate contact and connection with population. General practice
have an extensive reach to the people as number of smokers sees the general practitioners every
year at least for once. Hence, as per the author this is a strategic and a strong strategy for
increasing and improving smoking prevalence in Australia(Kim H, Liew D, Goodall S). The
practice of general practitioners do have substantial barriers in incorporating these routinely and
there are certain initiatives taken in order to remove these barriers and overcome them. These
barriers can be removed by education upgrading knowledge of general practitioners in smoking
cessation and of practice staff members as well.

Medical students should be made aware about and taught about tobacco and related
cessation techniques, clinical guidelines and practices should be introduced, support should be
provided for guidelines and implementation of these practices to pharmacotherapies and many
other. According to Thornton. L. (2017), tobacco and its increasing use is becoming a major
health issue in Australia as it is estimated that around 15,000 deaths in Australia have been
taking place every year during it. Australian government have been working really effectively
and efficiently in making sure that people are free from such practice and tobacco consumption
reduces in the country(Marsh L and et. al). There are strong initiatives which are taken by the
government such as face to face and telephone based behavioural interventions their brief
motivational advices and individual counselling takes place. Along with it, pharmacotherapy like
nicotine replacement therapy and many other 2 also takes place to support smoking cessations.
There are several different barriers and challenges that has to be faced and dealt by the
health and care professionals where aspects like lack of access to smoking cessation resources,
lack of clinical knowledge and skills as well as lack of clinical time is concerned. In order to
reduce implication and introduce better strategy mobile based approaches for example an
application or applications are potential source to address different barriers of these healthcare
professionals which can be used by the government and the people in order to improve and
improvise smoking prevalence and smoking related disparities in the country.
Smartphone and smart technologies is a part of day-to-day lies and every moment of
individuals which provides an effective solution and strategy to monitor and improve their health
and other related aspects. The author also suggests that an effective and high-quality smoking
cessation application is an easy and accessible resource which will help individuals in providing
support to the larger population possible irrespective of their geographical location with
convenient and easy features(Mendelsohn C P and et. al). This mobile application can also help
in collecting and bringing better information and data regarding the support and efficiency
provided through it to the people and to the person suffering through addiction of smoke and
tobacco.

SECTION 2: POLICY BRIEF
Title
“To explore the impacts of tobacco consumption on mortality of people in Australia and to
identify appropriate interventions.”
Executive Summary
The policy brief is concentrated and developed to look over the concerning aspect of
increasing consumption of tobacco and nicotine by people. Through to different literatures and
sources presented it is determined that the root cause of the problem is highly rated with socio-
economic status and factors of an individuals life. The concerns in regards to tobacco is
important to address as the mortality and immortality rate of the country is being affected by it
and it is needed to be handled with proper solutions and care. The policy will be regarding
increasing awareness amongst population in order to raise their knowledge and in order to
provide then clear knowledge about increasing tobacco consumption and smoking practices.
Introduction
Tobacco consumption is one of the leading and most concern in cause of death and
disease in Australia. Every year thousands of Australians die due to tobacco related illness and
get hospitalized due to diseases related to excessive tobacco consumption. Along with it every
year economic and social costs related to tobacco use in Australia is regularly increasing.
Smoking rates are significantly rising in Australian community specially in some disadvantaged
groups. People belonging to lower socio economic communities having substantially higher rate
of smoking then general public and population(Middleton M, Nielsen S). The freezing and
highly affecting concern is the smoking rate and its increment among indigenous Australians
which is almost doubled the rate of over all population in Australia.
In concern with smoking prevalence it is determined that generally Australian population
is declining but in the identified high risk groups smoking prevalence and not declining or
decreasing. Therefore, the increasing and keenly evaluative concern and the problem is is
increasing rate of tobacco consumption in disadvantaged group of society as per aspects of
socioeconomic status and their mortality rate.
Background and Importance of the problem
 Why is the issue important?

The Australian have been working over the issue of increasing tobacco consumption and
smoking the country(Myers A E and et. al). According to the literature presented above there
are several different therapy programs and smoking cessations developed as well as to
promote these services an administrative body that is Pharmaceutical benefit scheme have
also introduced for looking over and keeping proper check over all the areas of cessations
offering the best to the population.
There are smoke-free policies as well in Australia such as self regulation, smoke free
regulation, introduction of free dining and several others. Not just the smokers are affected
with there practices and tobacco consumption addiction but the others in the area who are
surrounded by them in their day to day lives and stay in close contact are also affected due to
it and their health is also negatively impacted. This is why it is important for government to
look over the problem and bring in appropriate changes for improving individuals and
population health.
 What does the research tell us?
According to the research it is identified that there are various and highly extensive measures
taken up by the government and responsible parties in order to reduce the impacts and
influence of tobacco smoking on population(O’Dowd A). Pharmaceutical benefit scheme is a
program which is introduced by Australian government to look over all the tobacco cessation
and introduce them effectively in market to all the groups who highly require them to reduce
their addiction and to overcome the challenges they are facing in life due to it. Then again
effecting and improvement strategies are also examined and determined in the literature
presented above where solutions like extra training to general practitioners and better use of
technologies is suggested for incrementing awareness in population and keeping them
updated about their health requirements as well as changes they need to bring in their
lifestyle for better and longer life span.
 What are the Implications of the research?
The research conducted above represented various information regarding the situation which
is being faced by Australians and the government in Australia regarding smoking cessation
and tobacco consumption( Palmedo P C and et. al). As per the determination and information
gathered through research there are several concerning aspects highlighted beginning with
the increasing effect of tobacco consumption on mortality rate of those disadvantages groups

who are unaware and lacks understanding as well as knowledge in the field. Moreover,
moving along in the research there are some improving strategies which are identified which
signifies that education and training is one of the serious and strong solution which can bring
improvement and which has imposed improvement over use of tobacco cessations and
therapies(van der Deen F S and et. al).
 Recommendation of policy and programs.
There are numerous policies and procedures which could be devised in order to deal with the
identified issues and challenges in the most effective and efficient manner surrounding the
region using the products of tobacco. To begin wife the first and the foremost suggestive
action is imposing National tobacco taxes on all the products which are made of tobacco as
well as increasing taxes on those items as which are complementary to it and supports its
consumption and usage.
Along with that there are number of large scale policy changes which can also be
implemented to limit the public health concerns associated with tobacco. Warning labels are
the basic requirement but government also have to make better use of Technology as it is an
integral part of the day-to-day lives of individuals belonging to any society and any group of
communities. Technology is one important resource which will be extremely helpful in
increasing and uplifting awareness in the market and amongst people of Australian
community about the harmful and unhealthy effects of incrementing tobacco consumption on
lifelong health of individuals as well as passing the risk to next generations.
CONCLUSION
The report above discussed different literatures in regards to tobacco strategies and
patients developed by Australian administrative parties in regards to tobacco consumption and
increasing concerns. The work and information collected above concludes the harmful and
rapidly increasing and healthy impacts of smoking and tobacco consumption over the population
in Australia as well as over their mortality rate. There are negative aspects which are being
surrounded by incrementing consumption of nicotine which can be reduced by using effective
strategies and programs developed by government which are overlooked by Pharmaceutical
benefit scheme.

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