Clara Molot. Cutting through the haze
Smoking rates in some sectors remain stubbornly high as the nation’s Smokefree target looms. What are the options to stub it out, writes
Martin Stewart reclines against a pedestrian barrier on Cambridge’s main street. His long, slender legs extend into the sidewalk. He hunches his back, resting one arm back on the iron structure.
His other hand remains near his lips, gently grasping a newly lit cigarette. The smoke plumes away from Martin’s lip, following the wind down Victoria Street.
This is Martin’s last week as a smoker. He has decided to quit, ten years after he had his first cigarette. On Monday morning, Martin will go to his GP to get the free patches and nicotine gum.
He reflects on his last week as a smoker. ‘‘I look at it, and I know it’s dirty. I know it affects other people,’’ he says, shifting the cigarette between his fingers.
‘‘I guess that’s addiction.’’ Martin started smoking at 24 – ‘‘I couldn’t tell you why, honestly,’’ he says laughing.
Ten years later, he has decided to quit for his own health, and the health of his family.
We talk about New Zealand’s Smokefree 2025 goal, which has been in place since March of 2011. The Government defines success as less than five per cent of the population smoking daily.
Since the programme’s creation, a tobacco tax policy has been a central component, with yearly increases in taxes of at least inflation, plus ten per cent over the last decade.
The price of cigarettes, now about $20 for a pack of 30, wasn’t part of Martin’s reasoning in deciding to quit.
The Smokefree goal is four years away. ‘‘That’s not going to happen,’’ Martin scoffs.
And, he’s right.
At the current rate, New Zealand won’t be smokefree by 2025 and Ma¯ ori will take even longer – until 2061, according to a new report by the Ministry of Health.
From 2007 to 2020, smoking rates decreased from 17 to just over 10 per cent in New Zealand’s European/other population, from 39 to 28 per cent among Ma¯ ori, and from 24 to 18 per cent among Pacific peoples. That’s an average decrease of 25 per cent.
The reduction in youth smoking has been greater – closer to 75 per cent. Where eight per cent of Year-10s smoked daily in 2006, only two per cent reported doing so in 2017.
‘‘I was an adult when I started smoking. I made an adult decision,’’ Martin explains. For medical experts, though, reducing smoking rates in New Zealand is about more than simply confining it to the adult world.
Janet Hoek is co-director of the Aspire 2025 Center, a tobacco control research group, underscores the urgency.
Smoking kills two-third of its long-term users and it’s ‘‘quite clear that we are not on track to meet [the 2025 goal],’’ she says grimly.
When factoring electronic cigarettes into the equation, the data looks even worse. The Ministry of Health notes that between 2018/19 and 2019/20, there had been a 0.9 per cent drop in overall daily smoking rates. But, Lutetia Harding, chief executive at the Asthma and Respiratory Foundation NZ, says that Action for Smokefree 2025 (ASH) data shows a slight increase of .3 per cent in daily smoking rates from 2017 to 2019, and a larger increase among young Ma¯ ori. Harding calls this upturn ‘‘worrying.’’ ‘‘Prior to reports of e-cigarette use in 2015, smoking prevalence was falling substantially,’’ she says, but ‘‘the rise in popularity of vaping has actually corresponded with the first small increase in smoking rates seen in over a decade.’’
The Ministry of Health has stated that vaping may be an important tool in transferring people off cigarettes.
But Harding sees it differently.
‘‘If vaping was the ‘magic bullet’ to help smokers quit, this just wouldn’t be the case,’’ she says.
In April Associate Health Minister Dr Ayesha Verrall proposed a new, bold plan to achieve the 2025 goal.
The number of retailers would be cut to specific R18 stores and pharmacies and nicotine content would be cut.
The plan would prohibit filters on cigarettes, as a means of decreasing smoking but also cutting down some of the 7 trillion tobacco butts cast off as litter each year.
Significantly, the plan would raise the age of purchase yearly, essentially creating a smoke-free generation.
The proposal reflects the thinking of experts in the field on ways to drastically curb nicotine use. Hoek describes the plan as ‘‘bold, innovative, and comprehensive’’.
She says Aspire had identified two measures with potential to greatly reduce smoking rates, both of which are central to the Ministry of Health’s proposal: curbing availability by reducing the 6000-8000 retail outlets which currently sell tobacco products and decreasing the nicotine content to minimal and non-addictive levels.
But not all are happy with the plan to stub out smoking, with those at the frontline of tobacco retail worried about the economic and crime-related consequences.
Sunny Kaushal is president of the Crime Prevention Group, which works to protect dairy owners. Kaushal says that the proposal would hurt small businesses, potentially forcing dairy owners out of business. With nearly half of an average dairy’s revenue coming from tobacco and much of the rest in the staples of bread and milk often linked to people coming through the door for smokes, the impact would be huge, he says.
Hoek sees it another way. Removing tobacco from all dairies would essentially eliminate commercial motivation, she says, and put all shops on a level playing field, with no-one under pressure to sell the products.
The theory doesn’t fly with Kaushal. It would ‘‘only punish dairies’’ who rely on tobacco profit, he says.
Martin Stewart, the man with the cigarette in his hand, agrees.
‘‘I only ever go into the dairy to get smokes,’’ he says. ‘‘Otherwise, for groceries, I’d go to a big supermarket, like Countdown or New World.’’
He is quiet for a moment, taking a drag. ‘‘It seems unfair on the small dairies, I suppose.’’
The proposal also raises questions about tobacco-related crime. There have been concerns about both the increased illegal importation of tobacco as a result of its high cost, and the robberies of dairies for tobacco products.
But this is hard to track as until recently no one has actually been counting how many dairies get robbed or ramraided for smokes.
Police have started tallying products targeted in robberies, however it’s not publicly available.
But what figures there are show between April 2017 and November 2020, there were 1601 commercial aggravated robberies, and that tobacco was taken in nearly half of these.
From all sides of the debate on smoking, Hoek remarks:
‘‘It’s a real challenge that we don’t have clear data from the police – that would enable us to look at what is happening year after year.’’
ACT party leader David Seymour called the lack of clear statistics, ‘‘a real failing.’’
He sees the rush to a Smokefree 2025 having the potential to ‘‘supercharge the black market’’ and drive smokers to crime to feed their habit.
Hoek, contends talk of a tobacco black market has been overplayed by the tobacco industry to keep cigarette prices low and their product in the market.
While police can’t pin tax-driven price rises definitively to an increase in ciggie crime, Inspector Brent Register points out that ‘‘anything that starts rising in price can be a more craved item.’’
From working his beat he it’s clear cigarettes are used as a form of payment among criminals and are easily traded.
The Government has tipped another $1.9 million since March 2020 into antirobbery measures like fog cannons for the protection of dairies, liquor stores and petrol stations.
But Kaushal says that money isn’t enough.
The Government makes an estimated $1.7 billion a year off the excise tax on tobacco, but puts only $61 million into tobacco control.
‘‘Those taxes should help small businesses and the police support this move, ‘‘ contends Kaushal. ‘‘But it needs to come from the Government.’’
Hoek would also like to see the cash going back into dealing with the issue that generated it.
‘‘The problem we have is that the government takes the tax and uses it to build roads and fund the America’s Cup instead of putting it toward helping people quit.
‘‘It seems unethical that the Government is happy to take this money but not invest it back to support.’’
Seymour was against collecting cash this way at all, calling it New Zealand’s most regressive tax, hurting its poorest citizens.
‘‘There is no reason to think that smokers cost $2 billion a year,’’ he said. ‘‘Everybody knows that smoking is bad, nobody smokes thinking that it’s not going to hurt them. There are taxes that are more than adequate. There are rules in place that mean that you cannot irritate other people.’’
Hoek, contended it was simplistic to make it a personal choice argument as research indicated it wasn’t that simple.
‘‘Nobody ever anticipates that they will become addicted and then they are stuck with it. Nobody can make an informed choice.’’
The debate over Smokefree 2025 raises broader questions of choice and representation for –who should get to decide if a person smokes or not? Who should get to decide if someone is allowed to sell tobacco?
These are questions Hoek has spent 30 years studying and she questions the academic basis of Seymour’s stance.
But the politician pushes back, arguing that the common person should have a say in the laws that impact them. ‘‘The argument that philosophers and scientists need to make the rules,’’ he says, ‘‘has been taken on by some of the most odious figures in human history.’’
Meanwhile, the days to 2025 continue dwindling as another tally keeps on growing implacably – the 4500 New Zealanders who die every year from tobacco related harm.
‘‘It’s a real challenge that we don’t have clear data from the police – that would enable us to look at what is happening year after year’’ Janet Hoek