In March 2011, the Government set a goal that by 2025 less than 5 percent of New Zealanders will be smokers. Chris Bullen, Dr Ilaisaane Fifita, and Martin Wilkinson debate the issue of a smokefree New Zealand.
Bold action from politicians
Our national aspirational goal of dramatically reducing smoking in New Zealand from the current 15 percent to five percent or less of the population in the next seven years may seem a fantasy to some. I believe it is still a realistic target.
“Should we?” is the first question to ask. Is it the right thing to do? I believe doing all we can to support people who smoke to quit is one of the most important ‘right things’ we should pursue as a nation.
The facts are indisputable: smoking is one of the leading preventable causes of premature death and disability. It is a major contributor to ethnic and socioeconomic inequities. Our tolerance of the tobacco industry and its damaging products is responsible for an estimated 5,000 premature deaths each year. The costs to our healthcare system are huge.
The other question is “Can we?”. To mix slogans, yes, we can (make New Zealand smokefree again). But to do so will require bold action on the part of our politicians. They have acted boldly before – the Smokefree Environments Act was world-leading when introduced decades ago.
New policies should be introduced and existing policies enhanced to support more people who smoke to quit.
A first step: earmark the $1.7 billion the government collects in tobacco taxes to help more smokers to quit. We need to allocate far more than the current $62 million to supporting communities and families to become smokefree – incentives are effective and need to be considered as part of the mix.
Second, less harmful nicotine products, like e-cigarettes, must be more available for smokers to use. Simultaneously, a reduction in the nicotine content of all tobacco products should be mandated.
Third, to reduce violent raids on dairies, tobacco retailers should be offered support on how to run viable businesses without selling cigarettes. Let’s take smoking and the health impacts it causes far more seriously: we should and we can.
Chris Bullen is a Professor in Public Health at the University of Auckland and Director of the National Institute for Health Innovation. His main research focus is on finding more effective ways to help people who smoke to quit and improve their health.
Increased tobacco taxes
Yes, we should be determined to be smokefree by 2025. Recently, there have been arguments against prioritising the smokefree goal over other social issues. I personally believe that people should be allowed to make their own choices. However, the detrimental effects of smoking on health not only concern the smoker but also non-smokers, who are involuntarily exposed to tobacco smoking. The issue of second-hand smoke becomes heightened when children are involved, because they may not speak up when exposed to tobacco smoking.
Another key issue is that, unlike with other products, there is no safe level of smoking. Some people get addicted after smoking just a few cigarettes. Therefore, prioritising the smokefree goal is important to the long-term wellbeing of the New Zealand society as a whole, as it concerns not only the smokers but the entire population.
Although the smokefree target has resulted in reductions in overall smoking in the country, smoking rates among Māori and Pacific people remain high, which adds to the challenge to achieve the goal to reduce smoking prevalence below five percent by 2025.
Research has found that increasing taxes on cigarettes is the most effective policy to reduce tobacco use and deter new smokers from emerging. While raising taxes on cigarettes has been effective over the past few years, a further increase in current tobacco taxes will be required to achieve the smokefree target by 2025. However, there are concerns about the effect of these taxes on smokers who are already living with financial hardship but have an addiction. So a comprehensive approach is required to achieve the target, rather than just relying on tobacco taxes.
At the same time, we should be cautious not to replace tobacco with new products such as e-cigarettes and start the vicious cycle again. Scientific evidence on the health effects of these products is only beginning
to develop and there should be long-term policies and regulations put in place to protect both smokers and non-smokers.
The statistics at the end of 2018 will be very telling on whether or not we can reduce smoking prevalence below five percent by 2025.
Dr Ilaisaane Fifita is a Professional Teaching Fellow in the Department of Marketing at the University of Auckland. Her research interests include consumerbehaviour, culture and social marketing in the context of tobacco control.
Smokefree? No free to smoke
New Zealand’s Smokefree 2025 policy is, amongst other things, to use state power to make smoking so expensive and inconvenient that pretty much everyone stops. It goes too far.
Don’t smokers impose costs on others, through their second-hand smoke and medical bills, and don’t these justify preventing smoking? Stopping people smoking over others justifies regulations we already have, such as banning smoking in workplaces, and maybe ones we could have, such as banning smoking in cars with children. But it won’t justify stopping people smoking when the passive smoking risk is nil or minute.
As for the healthcare costs, smokers already more than pay their way through tax, and that isn’t counting the savings on their pensions. Using state power to drive smoking down to zero needs a better argument; avoiding costs to others is a dead duck.
So we come to stopping people harming themselves. I like freedom but tobacco isn’t just another commodity. Smoking is a risk to smokers’ health, and it is addictive too. Many smokers want to give up. Smoking ought to be regulated.
On the other hand, health isn’t everything, not every smoker is addicted, and not every addicted smoker minds being addicted. Anti-smokers often can’t understand it, but some people are happy smokers, that is, they prefer smoking to not smoking and they don’t yearn to give up. The state should leave them alone.
Martin Wilkinson is a Professor of Politics and International Relations at the University of Auckland. He has worked for a number of years on the ethics of paternalism, especially in public health, and the ethics of organ transplantation.
This article was published in the Spring edition of Ingenio and was republished with permission. For the original, click here.
Disclaimer: The ideas expressed in this discussion reflect the views of the guests and not necessarily the views of The Big Q.
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