Reform proposals ‘game-ending’ for tobacco

Can we seriously picture a future generation of 50-year-olds who are still too young to smoke?

The Government has proposed a raft of radical changes to tobacco smoking controls, including sweeping cuts to tobacco retailers and the banning of tobacco sales to new smokers.

The Smokefree Aotearoa 2025 Action Plan proposals, released as a discussion document yesterday, include limiting tobacco sales to specific R18 stores or pharmacies and the reduction of nicotine in products.

Associate Health Minister Dr Ayesha Verrall said the Government wanted to hear from the public and businesses involved about what measure might be viable to further decrease New Zealand’s already reducing tobacco smoking rate.

‘‘About 4500 New Zealanders die every year from tobacco, and we need to make accelerated progress to be able to reach that goal. Business as usual without a tobacco control programme won’t get us there,’’ she said.

‘‘We need a new approach . . . These include proposals on reducing the access to tobacco through different retail outlets, as well as reducing the palatability of cigarettes by addressing the use of menthol crush-balls filters and filters themselves, and potentially creating a minimum price for cigarettes and tobacco as well.’’

A possible ‘‘smokefree generation policy’’ could ban the sale of tobacco to under-18s from 2022, meaning anyone born after 2004 would be unable to buy tobacco. Currently, there are no restrictions on where tobacco can be sold.

At least 80 per cent of it is sold through convenience stores, service stations, on-licensed premises and supermarkets, the proposal document said.

‘‘There is not very high profit margins on tobacco in New Zealand because the tax is so high, but there is an issue about whether you lose the other business, that comes with tobacco people going into convenience stores and buying a loaf of bread or milk or whatever. And I think that is something we really do want to hear from retailers on.’’

Professor Boyd Swinburn, chairman of advocacy group Health Coalition Aotearoa, said that the recommendations were likely ‘‘game-ending’’ for tobacco.

‘‘There is clear evidence that restricting retail availability is a central strategy for reducing the damage from all harmful products.’’

A just exit for small business owners such as dairies, was needed, he said.

Would a cigarette that has only a fraction of the usual levels of nicotine be worth smoking? The Government hopes not. The Proposals for a Smokefree Aotearoa 2025 Action Plan, released yesterday, says that the dramatic reduction of nicotine is definitely on the table.

‘‘Reducing nicotine content to minimal levels would likely decrease the number of young people trying smoking as they would not expect to get a hit from nicotine,’’ the plan said. ‘‘It should also stop the progression to addiction among those who do experiment and prevent relapse in people who are trying to quit smoking.’’

This is blue-sky thinking at this stage. Such a move would require manufacturers to play ball. But it is one of a series of proposals that are so drastic you might almost feel sorry for those hardy souls who insist on clinging to their filthy and increasingly expensive habit.

That is until you realise how many people have been wilfully taking up smoking since the launch of anti-smoking measures and price hikes.

There are alarming numbers in a section that describes health inequities. The greatest inequities are among girls aged 14 to 15, the report says. In 2019, 6.8 per cent of Year 10 Ma¯ ori girls smoked daily compared with 0.8 per cent of Year 10 nonMa¯ ori, non-Pacific girls.

The inequities continue into young adulthood, when Ma¯ ori women smoke at more than four times the rate of non-Ma¯ ori women.

These teenagers were born into a world in which anti-smoking messages are everywhere and cigarettes are both expensive and harder to get. A packet of 20 cigarettes now costs about $35. How does anyone afford it?

Despite price rises, some smoking rates are stubbornly persistent. But does this call for measures that might seem almost draconian?

One measure that could be described as such is a proposal to create a smokefree generation by forever banning the sale of tobacco to people younger than 18 from 2022 onwards. This means anyone born after 2004 would never be able to buy tobacco.

Can we seriously picture a future generation of 50-year-olds who are still too young to smoke?

Cutting down on outlets that can legally sell tobacco is more reasonable. Pushing up the price of an addictive product much further risks hitting the poor the hardest.

The proposal warns that our smokefree target will not be met. Modelling shows that a business-as-usual approach means ‘‘New Zealand will not meet its smokefree goal by 2025, and Ma¯ ori will not reach it until 2061’’.

In 2011 the Government clarified that ‘‘smokefree’’ means fewer than 5 per cent of us smoking. As of 2020, we have 10.1 per cent of

Pa¯ keha¯ smoking, 18.3 per cent of Pacific peoples and 28.7 per cent of Ma¯ ori.

Perhaps the target was unrealistic?

But there is a certain cognitive dissonance in some arguments against the proposals. ACT’s social development and children spokesperson, Karen Chhour, said: ‘‘As a former smoker I have to say I’m sick and tired of this Government trying to socially engineer us into changing our behaviour.’’

Of course, the vast majority of former smokers quit because government health measures made cigarettes too expensive and socially unacceptable, or made vaping more appealing. All of those measures are examples of social engineering.