Protecting the community from tobacco related hazards
Audrey Maag, Acting Manager | Strategic and Regulatory Policy Branch, Centre for Population Health
NSW has made strong gains in recent years in reducing rates of current smoking among adults, from 22.5% in 2002 to 16.4% in 2013 Among secondary school students, current smoking rates have also reduced significantly, from 13% in 2002 to 7.5% in 2011. Despite these gains, smoking remains one of the leading causes of preventable disease and death in NSW, accounting for around 5,500 deaths  and 46,000 hospitalisations  per year. Smoking greatly increases the risk of many cancers and is a major cause of heart disease.
A strategic approach
The NSW Government is taking a comprehensive approach to further reducing smoking in NSW, as outlined in the NSW Tobacco Strategy 2012-2017. This includes strategies to reduce demand, such as quit smoking campaigns, dedicated cessation services including the Quitline and integration of brief intervention and smoking cessation support into routine clinical care; measures governing the sale, display and advertising of tobacco that aim to control the supply of tobacco and protect children from its harmful effects; and measures to protect people from second-hand smoke.
There is no safe level of exposure to second-hand smoke. It can cause a range of illnesses including coronary heart disease and lung cancer in non-smoking adults. In children it can cause increased risk of asthma and sudden infant death syndrome.
On 7 January 2013 amendments to the Smoke-free Environment Act 2000 came into effect, prohibiting smoking in a range of public outdoor areas including public transport stops and stations, within 10 metres of children’s play equipment, within 4 metres of pedestrian access points to public buildings, in open areas of public swimming pools and in spectator areas of sporting grounds or other recreational areas while an organised sporting event is being held. From 6 July 2015, smoking will also be banned in commercial outdoor dining areas. These sites were chosen because they are frequented by families and children and there is limited opportunity to avoid second-hand smoke. They built on the successful implementation of smoking bans in indoor public places in 2000, which are now widely accepted by the public.
Bans on smoking in public areas are in place because smoke-free environments are effective in reducing exposure to second-hand smoke. They also support efforts to quit, provide fewer opportunities to smoke and contribute to the denormalisation of tobacco smoking. 
Improving compliance with the law
The key to compliance with smoke-free legislation is a combination of education and enforcement. NSW Health has taken a staged approach to achieving compliance with smoke-free outdoor legislation. In 2013 NSW Health focused on education and compliance monitoring. In December 2012 and January 2013 a public notice campaign was undertaken, informing people about the new laws. ‘No Smoking’ signage and fat sheets were distributed, both of which are freely available through the NSW Health website. A state-wide compliance monitoring exercise was conducted between March and May 2013, with 1055 sites visited, approximately 635 smokers observed and 510 cautionary notices given out. The exercise identified that the highest level of non-compliance was at public transport stops and stations.
In 2014 the focus has been on continued education and compliance monitoring, together with enforcement. This began with joint ‘Police Transport Command- Connect’ operations with the NSW Transport Police at train stations across the Sydney CBD and the Central Coast in late 2013 and early 2014. Eight volunteers from the South Eastern Sydney, Central Coast, Western Sydney and Nepean Blue Mountains Public Health Units teamed up with NSW Police officers to issue on the spot fines to people who were smoking on train platforms. Following this NSW Police were authorised to issue on the spot fines under the Smoke-free Environment Act 2000 at public transport stops and stations.
In April 2014 a centralised Tobacco Enforcement Unit (TEU) was established to coordinate all enforcement activity for breaches of outdoor smoking bans (except on hospital grounds, which is the sole responsibility of local health districts). The TEU works with Authorised Inspectors in public health units across NSW to respond to complaints from members of the public about breaches of smoking bans. Authorised Inspectors conduct compliance monitoring in response to complaints, provide education to members of the public about smoking bans and work with property and building owners to display ‘No Smoking’ signage and remove butt bins. TEU officers work with other Authorised Inspectors to conduct enforcement activity in areas where complaints have been substantiated. This includes issuing on the spot fines of $300 or warnings, where appropriate.
Since the start of May and as at the end of November, the TEU has visited all 15 local health districts. Most people do the right thing - out of approximately 48,500 people observed at sites visited, 831 were seen to be breaching outdoor smoking bans (98.3% compliance). TEU Authorised Inspectors have issued 187 penalty infringement notices and 605 cautions. These figures do not include the number of fines issued by NSW Police officers under the Smoke-free Environment Act 2000 or other fines issued for smoking at train stations under transport legislation.
Into the future the TEU will continue to work with Public Health Units on education, compliance monitoring and enforcement, focusing particularly on areas with there are lower levels of compliance with smoking bans. The Ministry of Health and local health districts will work together to prepare for the introduction of smoke-free commercial outdoor dining in July 2015.
An online form has been created to make it easier for members of the public to report areas where breaches are occurring.
In August a media release was issued about the government’s response to smoking in public outdoor places.
- Current smoking in adults by sex, NSW 2002 to 2013NSW Population Health Survey (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health
- Current smoking by sex, secondary school students: All ages, NSW 1984 to 2011 NSW School Students Health Behaviours Survey (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.
- Smoking attributable deaths sex, NSW 1997 to 2011Preliminary deaths data, Australian Coordinating Registry. Centre for Epidemiology and Evidence, NSW Ministry of Health.
- Smoking attributable hospitalisations by sex, NSW 1988-99 to 2012-13 NSW Admitted Patient Data Collection and ABS population estimates (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health.
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