Dr NELSON (10:53 PM) —I rise tonight to continue my lifelong campaign against the tobacco industry and their apologists. I start by pointing out to the House that on 5 November 1998 the Thai government required the following message to be mandated as a health warning on cigarette packets: `Smoking causes impotence'. Whilst that is true—and I am not calling for such a health warning to be added to Australian cigarette packets—I am this evening calling for a warning that smoking is a major cause of blindness to be added to the current range of forceful, factual and explicit warnings.

I direct the attention of the House to a study published in the Medical Journal of Australia on 16 August this year by Associate Professor Paul Mitchell from the Department of Ophthalmology at the University of Sydney and two of his colleagues. They examined a lot of research not only here in Australia but also overseas. They looked at recent population based cross-sectional data from four countries, including Australia, together with data from two large cohort studies that have consistently identified smoking as the strongest environmental risk factor for age-related macular degeneration—the leading cause of blindness in Australia. All of these studies have shown that people who currently smoke are two to five times more likely to develop age-related macular degeneration than non-smokers or past smokers. Several studies have demonstrated a dose response relationship with pack-years of smoking and, conversely, a decreased risk with longer duration since the person stopped smoking.

There are currently around 34½ thousand Australians aged over 50 years with legal blindness—in other words, they qualify for blind pension benefits. In over 80 per cent of these people, blindness is due to age-related macular degeneration. The authors of this study estimate that there are currently about 100,000 people in Australia with late stage AMD, of which around 20,000 may have it directly attributable to smoking. They further estimated that there are currently more than 8,200 Australians whose blindness from late stage AMD can be attributed directly to smoking. They have separately provided evidence that around 10,000 Australians are currently likely to be blind as a result of smoking. At present the only preventable confirmed risk factor for AMD is smoking. The researchers estimate that smoking may now be responsible for around 20 per cent of all cases of blindness in Australians over the age of 50 years. As 80 per cent to 90 per cent of blindness in Australia occurs in those over 50 years of age, there is a similar overall proportion of people blind as a result of smoking.

Knowledge of the role of smoking in causing many specific diseases is unfortunately unacceptably low, although of course I know that the Chief Government Whip and every other member of the government is fully aware of this. Unfortunately, that level of knowledge is not possessed by every member of the electorates that we represent. For example, a recent Victorian study found that the percentage of smokers able unprompted to nominate specific conditions linked to smoking was 54 per cent for lung cancer, 38 per cent for emphysema, 38 per cent for heart attack, 20 per cent for unspecific cancer, 17 per cent for asthma and 22 per cent for bronchitis and respiratory problems.

We know that at any one time about 10 per cent of smokers are actually thinking of giving it up, and that where health warnings play a significant role is with that one smoker in 10 or indeed with pregnant women who are smoking and are naturally contemplating giving it away. I believe that there is compelling evidence to have added to the list of health warnings that we currently have on cigarette packets in Australia, `Smoking is a major cause of blindness.' Whilst I realise that some would indeed advocate following the Thai model of `Smoking causes impotence', I do not believe at this stage there is sufficient evidence to warrant that that will necessarily do anything in Australia other than to make those particular brands attractive to young people.

Question resolved in the affirmative.

House adjourned at 10.59 p.m.