Lingering on. Many overseas jurisdictions have stopped outlets dispensing tobacco or forced retailers to be licensed, but no so far in New Zealand. Photo / Supplied, File
Lingering on. Many overseas jurisdictions have stopped outlets dispensing tobacco or forced retailers to be licensed, but no so far in New Zealand. Photo / Supplied, File
Opinion
OPINION
Despite strong support within the health sector and public enthusiasm for Minister Ayesha Verrall's Smokefree 2025 Action Plan, sceptics have questioned whether this public health goal remains possible.
It was, after all, first proposed in 2010 by the Māori Affairs Select Committee and accepted by the Government of the day, along with a commitment to reduce the availability of tobacco products, yet has received little serious attention until now. Have we left our run too late?
The goal aims to reduce overall smoking prevalence to under 5 per cent – less than half the 2019/20 daily smoking rate of 11.65 per cent (NZ Health Survey). It's now clear that significantly reducing access to tobacco is one of two key policies that we must introduce if we are to have a realistic prospect of achieving the 2025 goal. The other priority is reducing the level of nicotine in cigarettes.
Unlike alcohol, which only licensed individuals or companies may sell, anyone can sell tobacco, irrespective of who they are or where they are located.
Even vaping products, generally recognised as posing fewer harms than smoked tobacco, are more heavily regulated than cigarettes and tobacco. New Zealand has no national register of tobacco sellers, but it's estimated there are between 5000 and 8000 retailers around the country.
Cigarettes are highly addictive and uniquely hazardous consumer products, yet their easy accessibility undermines decades of health sector efforts to communicate smoking's harms .
To realise the Smokefree 2025 goal, we must act quickly to create an environment that prevents young people getting addicted to nicotine, helps people to quit, and supports them to remain smokefree.
Professor Janet Hoek. Photo / Supplied
Studies show that exposure to tobacco products increases the risk of smoking in children and young people; people who live in areas where tobacco outlet density is higher are at greater risk of trying smoking. There are more tobacco outlets in highly deprived areas, which perpetuates longstanding inequalities in health outcomes.
Studies show that people trying to quit are more likely to relapse if they live in neighbourhoods where there are more tobacco retailers. This risk is hardly surprising, when recent quitters are confronted with easy access to tobacco products every time they shop for groceries or buy petrol impulse purchases become much easier.
Other jurisdictions in the US and Europe have recognised that reducing tobacco availability is a crucial pre-requisite to discourage smoking experimentation and support quitting. The Netherlands Parliament recently voted to end the sale of tobacco in supermarkets and petrol stations. While currently a voluntary stipulation, retailers who do not comply within a certain time will be required to do so. Many States in Australia now require retailers to have licences to sell tobacco products.
These examples illustrate growing international momentum for restrictions on tobacco availability. More fundamentally, they question why New Zealand has been so slow to manage access to a product that kills two-thirds of its long-term users.
The answer to that question includes concerns that restricting tobacco availability could adversely affect retailers. Yet, despite claims some retailers depend on tobacco sales to remain viable, tobacco carries a low profit margin relative to other products.
Candace Bagnall. Photo / Supplied
Recent NZ research found that tobacco purchases may not drive significant store footfall; this and other studies question claims about tobacco's importance and support strong policy measures.
However, reducing the number of tobacco retailers must take place in a consistent, planned manner, across all tobacco retail outlets, to avoid inadvertently creating advantages for some stores.
Small retailers concerned about how they will manage the changes could be offered expert business support to assist them to transition to other products. At the same time, effective smoking cessation support, particularly for Māori and Pacific peoples, must be easily available, sustained, and culturally appropriate.
Over the past decade, progress towards the goal over the last decade has been too slow.
However, the proposed Smokefree 2025 action plan has created an important opportunity to introduce bold new actions that could realise the goal and save thousands of lives.
The grotesque anomaly that allows this deadly consumer product to remain so widely available must be a top priority for action.
• Janet Hoek is a Professor of Public Health and co-director of ASPIRE 2025, a University of Otago Research Centre. Candace Bagnall is Acting Manager Health Promotion for the Cancer Society in Auckland
