As the world-leading new Smokefree legislation approaches its second reading in Parliament, new survey data has been released showing that we are gaining on our goal of a Smokefree Aotearoa by 2025.
That is, unless you look at the rates for Māori and Pacific people.
We see a different story for Māori and Pacific people. Although we see that rates - especially among wāhine Māori - have reduced, on the current trajectory, Māori will not reach the Smokefree 2025 goal.
So, how did we get here? It’s a complex interplay between colonisation, poverty, legislation and social determinants of health.
Smoking has been treated as a normal consumer product, despite the public knowing for more than 70 years (the average life expectancy for Māori is 75) that it has devastating consequences. In fact, half of all long-term smokers will die from a smoking-related disease, and a quarter of all deaths among Māori are caused by smoking.
We know about the increased death, illness and disability suffered by smokers. We know poverty and mental illness increase the likelihood of people smoking, as does belonging to other marginalised groups. Socio-economic marginalisation has been a reality for many whānau Māori for generations. Knowing this, knowing the cost and continuing to let tobacco companies and retailers profit at the expense of New Zealanders, is being complicit in the deaths of 14 people a day.
Hāpai Te Hauora CEO Selah Hart.
The Smokefree 2025 Action Plan aims to achieve the Smokefree 2025 goal with three key measures: reducing the nicotine content of cigarettes to reduce the addictiveness; reducing supply through restricting the number of retailers of cigarettes; and employing a “sinking lid” and preventing the sale of tobacco products to people born in 2009 and after, thereby reducing the number of young people becoming addicted to cigarettes. Preliminary modelling shows denicotinisation, when combined with other interventions, could potentially achieve the Smokefree 2025 goal for all New Zealanders.
I would like to acknowledge the tireless work of those before us. The achievements thus far have been significant, and I acknowledge the work done to this point by rangatira such as the Māori Affairs Committee with their landmark inquiry into the tobacco industry in 2010, and the tireless efforts of many others since then.
Behaviour-change strategies that are used for smoking cessation focus heavily on evidence generated by Pākehā researchers, yet the success of strategies created by Māori, implemented by Māori, for Māori, is clear. Support for smoking cessation and reduction of harm is similarly clear from extensive consultation with and feedback from Māori communities. Ensuring that Māori are leaders and decision-makers in the Smokefree 2025 kaupapa will ensure that we all reach the Smokefree 2025 goal, together.
As a society, we clearly recognise that the negative effects of smoking disproportionately affect Māori, and the potential benefit for health equity for Māori. This Bill is an important move to reduce overall smoking rates, but is also an important move toward equity for Māori. Hand-wringing, lip service and inaction simply will not do as much as solid public health intervention through legislation, proper resourcing and culturally competent leadership.
Māori and Pacific people must be counted, and all New Zealand has a collective responsibility to ensure that when we succeed, we all succeed together.
Selah Hart is the CEO of Hāpai Te Hauora, the largest Māori Public Health organisation in New Zealand. Hāpai are national leaders in population health, health promotion and education, policy, advocacy, research & evaluation, and infrastructure services.
