‘Keeps me up at night’: The biggest health issue facing NSW revealed

The state’s health minister has named illicit tobacco as the single biggest preventable health challenge facing NSW over the next decade, as he acknowledged the government had been caught off guard by the rise of vaping in the community.

Ryan Park told the NSW Great Health Debate that the government had initially hoped vaping would help smokers quit, but was now concerned it would lead to another generation becoming addicted.

“Governments, public health officials, researchers did so much in the last century to curb our tobacco rates and smoking rates, and I don’t want to be the minister that sees that Pandora’s box completely open again,” he said at the Thursday evening event hosted by the Public Health Association of Australia and the University of Sydney.

“I am worried that we will have a generation of young people ... hooked on nicotine again if we don’t try and deal with this issue.”

During the face-off with Coalition and Greens health spokespeople, Park said the government had strengthened regulations and was closing down 15 to 20 illegal stores every week, but acknowledged there was more to do.

“The proliferation of these stores, the availability of these products, and trying to get on top of it as a government … keeps me up at night,” he said.

“I don’t want to leave a legacy where we haven’t really done everything we can.”

The debate asked the state’s health leaders to outline their vision for preventative healthcare in NSW.

NSW Greens health spokesperson Dr Amanda Cohn called climate change the No.1 issue, while shadow minister for health Sarah Mitchell singled out childhood obesity and declining vaccination rates.

Cohn used the debate to call for a standalone preventative health agency in NSW in honour of Victorian Greens MP Dr Tim Read, who died of metastatic cancer last month.

“With the health system in the crisis that it’s in, when the people running the health system are focused day to day on addressing bed block, on addressing ambulance ramping, on making sure people can get the acute care that they need, preventive health becomes an afterthought,” she said.

Cohn said a specialised agency like those implemented in Victoria and South Australia was “the only way” to ensure preventative strategy would be implemented across the state.

Mitchell called for preventative health funding “beyond election cycles” but stopped short of supporting a standalone agency, while Park also expressed doubt that funding a new agency would be more effective than the work of existing bodies.

Gambling reform caused the strongest division among the debate members, who largely agreed on other topics and spoke of collaboration across party lines.

Mitchell said problem gambling was “not black and white” as poker machines were important for the business revenue of regional pubs and clubs, and played a role in community engagement.

“I think it’s easy to make motherhood statements about getting rid of all poker machines … but we’ve got to focus on harmful gambling behaviour, supporting and targeting those who we know are spending money that they can’t afford.”

Cohn spoke of treating a woman in an emergency department who had collapsed as she’d received so little food and water while gambling: “These clubs are not caring for local communities, they’re preying on people with addiction.”

Cohn said the government had spent $1 billion on tax exemptions “handed back to pokies operators” in last year’s budget.

Park said gambling reform was an ongoing issue.

“We’re not going to be sitting here pretending [that] problem gambling isn’t problematic in communities, nor am I going to say that clubs are all evil, because they’re not, and they provide really good employment opportunities,” he said.

He spoke of the challenge posed by online gambling and pointed to recent investment in gambling support services.

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