Tobacco taxes and bold measures are crucial to realising the Government’s smoke-free 2025 goal, writes Janet Hoek, Richard Edwards and Anaru Waa.
The ODT editorial of December 3 raised important questions about the measures required to bring smoking prevalence in New Zealand below 5% for all population groups - the Government's smoke-free 2025 goal.
The article challenged the role continued excise taxes should play in the strategy to achieve this goal, and pointed to increases in burglaries of dairies and seizure of illicit tobacco as evidence of a ''big business'' black market and increasing hardship among smokers.
We appreciate an opportunity to discuss these points.
As the ODT noted, the increasing cost of tobacco prompts many smokers to make a quit attempt. We have worked with hundreds of smokers wishing to quit and the vast majority cite price, together with health concerns, as the most common reasons for wishing to quit smoking.
As well as cueing smokers to quit, the increasing cost of tobacco deters young people from experimenting with smoking and reduces the risk they will subsequently become addicted to nicotine.
Rather than stop using this highly effective measure, we have an opportunity to consider how we manage two important and related factors: the widespread availability of this lethal product, and how the revenue generated through tobacco excise tax is used.
Implementing the approaches we outline below would address hardship and crime potentially caused by rising tobacco prices, continue to prompt quit attempts, and make tobacco less accessible to young people.
Currently, tobacco is sold in many bars and in almost all dairies, service stations, and supermarkets; there is no register of sellers and no licensing system (as there is for alcohol). Allowing tobacco products to be so widely and easily available is both illogical and inconsistent with the smoke-free 2025 goal.
One new measure would be to restrict tobacco sales to R18 licensed stores, which would sell nothing but tobacco. This approach would have many benefits. First, it would greatly reduce the number of tobacco retail outlets and reframe tobacco as a restricted and toxic product.
If tobacco outlets could not be located within a specified distance of schools and other areas where children and adolescents gather, this measure would also help decrease smoking uptake among young people. Second, it would remove smaller retailers' concern that they would lose business if they stopped stocking tobacco and their competitors did not.
Third, it would reduce relapse to smoking among quitters, many of whom report resuming smoking because tobacco is so easily available. Reducing outlet density would decrease opportunities for unplanned purchases that trigger relapse and make every tobacco purchase a deliberate one.
Finally, restricting the number of outlets selling tobacco would allow these premises to have better security, thus reducing the potential for robberies.
The article correctly points out the substantial revenue tobacco excise tax generates. These funds go into general Government coffers and are not dedicated to developing or implementing programmes to help smokers to quit or to deter non-smokers from starting.
Our studies show that more than 80% of smokers regret smoking and would not smoke if they could live their lives again. Given smoking is much more common among people with lower incomes, there are strong ethical reasons for arguing that revenue from tobacco excise taxes should be used to assist the thousands of smokers who wish to become smoke-free.
Rather than stopping tobacco excise tax increases as the editorial suggests, maintaining this strategy would continue to prompt quit attempts and deter smoking uptake, both of which are crucial to the 2025 goal. Using revenue from tobacco taxes to provide stronger, community-oriented, support would help smokers to quit.
Targeting this support and designing it specifically to assist groups where smoking is more common could bring profound health, social and economic benefits to these groups, and reduce stark health disparities.
Our detailed studies of support for different policy measures show a targeted approach has widespread public endorsement, including from most smokers, who support excise taxes if these are used to fund cessation programmes.
Excise taxes could also fund other measures, such as comprehensive social marketing campaigns that reinforce smoke-free norms and further discourage experimentation with smoking.
We welcome continued debate over the most effective - and appropriate - ways to realise the smoke-free 2025 goal, which is still achievable if the Government continues using proven measures but also adopts new evidence-based measures, including those we have outlined above.
-Janet Hoek, Richard Edwards and Anaru Waa co-direct ASPIRE2025, one of the University of Otago's research themes.
