Wide-ranging strategies & leadership needed for Smokefree NZ – Hapai Te Hauora

Tobacco prices are set to go up by just over 11 per cent on January 1, in the last of a series of annual tax-based price rises announced in the 2016 budget. A 25-pack of cigarettes will cost more than $40.

“Whilst we have been in support of this policy led by Dame Tariana Turia and other key Māori political leaders, which sought to raise the price of cigarettes progressively so they became unaffordable for people to begin smoking in the first place, it now seems we need to do something different,” says Mihi Blair, GM of the National Tobacco Control Advocacy Service at Hāpai Te Hauora. “Instead of placing the onus on those suffering from tobacco addiction, the Government needs to use the money generated from these taxes to actually invest into a range of comprehensive and strategic public health, harm reduction and disease prevention measures to help reduce our rates of smoking for those who have not yet been able to quit.”

Raising tobacco price is widely seen as the most single most effective tool for reducing tobacco use overall. There has been a drop in smoking rates since the introduction of excise tax in 2011. However, the latest NZ Health Survey figures still show problematic social differences; For example, the percentage of current European/Other respondents who currently smoke has dropped sharply, while the percentage of Māori who smoke has decreased far less.

CEO of Hāpai Te Hauora, Selah Hart stated “it’s good that this is the last of the excise tax increases, because the statistics show they’ve done their job at reducing tobacco consumption overall, but that it’s rightly coming to an end because those who are left smoking now are the ones who need the most help. We can see that the interventions thus far have still not achieved equity and that’s where the focus must be in the next phase leading up to 2025 if we are really going to hit this goal.

“The positive effects of the tax hikes seem to be limited to the more privileged among us,” says Blair. “Put simply there are far, far fewer dairies that supply cigarettes in Remuera, Auckland’s wealthiest suburb, than in Manurewa, its least wealthy suburb, and that pattern is nationwide.”

Research in Australia suggests that lower income smokers quit in greater numbers when tax increases first hit, but that they are much more likely to relapse over time.

“Pressing the tax hike button over and over favours the more privileged, because privilege means you have other resources to help you quit.” says Blair. Higher income smokers have been shown to have lower nicotine dependence, greater self-efficacy, and higher success rates when they try to quit than lower-income smokers.

“To support low-income smokers in quitting, we need to stop punishing them and start redistributing the money from tobacco sales more effectively,” says Blair. “As long as tobacco is still for sale in Aotearoa, the tax paid on it should be earmarked for the communities that are suffering the most from tobacco harm.”

Smokefree advocates have already criticised the government for minimising spending on anti-smoking initiatives (“$1.7b in and $43m out,” 2018). Money from tobacco tax goes into the government’s consolidated fund, and only a tiny proportion – less than 2.5%, according to some estimates – goes back into quitting and prevention programmes.

Blair believes we need strong leadership to achieving Smokefree2025 and is calling for the Government’s long awaited Action Plan to detail what this actually looks like. “We need to introduce other measures such as reducing supply of tobacco and taking nicotine out of tobacco. We need to quickly act in legislating smoking alternatives like vaping to make sure adults who are quitting can access them.”

“Our communities need access to healthy lifestyle choices, not just dairies full of cigarettes and highly processed food. We need targeted and comprehensive interventions that suit the needs of Māori and Pacific peoples. And we need those in positions of privilege to consider those struggling with tobacco addiction, so we don’t lose another generation of parents, grandparents, uncles and aunties to smoking.”