Health and tobacco

Few public health campaigns have been as successful as that which is determined to see New Zealand free of all tobacco smoke by 2025.
It may be an aspirational goal, with little chance of absolute success (how, for example, will visitors to New Zealand who smoke be prevented from doing so?) but in terms of improvement to the national health, there can be little argument.

The effects of the Smoke-free Environments Amendment Act have over the past seven years been generally accepted as beneficial, once the full effects of its ban on smoking in bars, restaurants and clubs had been felt.

Another piece of legislation to reinforce the strength and purposes of anti-smoking campaigning was passed all but unanimously in Parliament this month, in the form of the Smoke-free Environments (Controls and Enforcement) Amendment Bill.

This bans from next July retail displays of tobacco products and the advertising of them, including on the Internet, lest those innocent of tobacco's dangers be tempted to experiment. In Parliament, the tobacco retailer was demonised as preying on young people by positioning displays of tobacco products alongside the confectionery, thus making smoking attractive - or so the Associate Health Minister, Tariana Turia, claimed.

She also spoke of "power walls" of tobacco products confronting young people in dairies, which, she said, also encouraged them to try smoking.

Mrs Turia may have a direct line into the psyche of the young, but it is rather more likely that peer pressure and the temptations of the illicit product are as influential on teenagers today as they have always been. But her overstated language illustrates just how effective has been the anti-smoking campaign.

As if to further emphasise how the campaign has elaborated from a justified health measure into something rather less warranted, platoons of officials equipped with the authority of Smoke-free Enforcement Officers will be created to enforce these laws and will be able to impose instant fines.

Yet to come are the laws requiring plain packaging and greater efforts by the anti-smoking lobby to prohibit smoking in any public place.

And the Auckland District Health Board recently floated the prospect of refusing to employ people who smoke tobacco products. The lobby argues largely on the health case alone, claiming some 4500 people die each year from smoking-related diseases. Census data, most recently from 2006, shows the prevalence of smoking for the population 15 years and over was 20.7%, the trend from 1976 indicating the prevalence had slowed and was decreasing over time, including by boys and girls.

Similarly, a tobacco use survey from 2009 supported these data, its key findings showing about 21% of adults were smokers but rates were declining, and 18% of 15-19-year-olds were smokers, down from 22.9% in 2006.

Data relating to the use of another recreational drug, alcohol, provides a useful contrast. The 2007-08 alcohol and drug use survey showed alcohol was the most commonly used recreational drug, with 85% of 16-64-year-olds using it in the previous year; six out of 10 had consumed enough to feel drunk at least once; and youth, Maori and women, Pacific Island men and people living in deprived neighbourhoods were more likely to drink higher amounts than recommended. As many as 1000 people die annually directly from alcohol-related causes.

Those who argue anti-smoking legislation goes too far do so on grounds it intervenes in rational personal choice, even when that choice is for an addictive drug. The difficulty with this argument is a right of personal liberty ceases to be that when it affects the rights of others. It has been well demonstrated passive smoking can be harmful to individuals forced to inhale the smoke exhaled by others.

The case for liberty is on less solid ground, too, when the cost of smoking to the public purse, estimated to be $1.7 billion a year, is considered.

Perhaps in anticipation of a strengthened anti-alcohol lobby, some of the liquor industry giants are also recognising possible threats to their business: Lion Nathan intends to print health warnings on its bottle labels, as in Australia. The health argument proved the case for the anti-smoking lobby; it is inevitable that a similar argument will lead to a long-overdue change in our attitudes towards alcohol abuse.


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