No smoke without fire

Photo: ODT files
Photo: ODT files
New Zealand loves leading the way, setting the standard, beating the big boys, making waves, and making up for our size, isolation and relative insignificance by making headlines.

Our latest claim to fame? Ours will be the first military in the world to be smoke-free.

It is part of the Government's equally ambitious and world-leading commitment to make New Zealand smoke-free by 2025.

This follows years of work on the issue. In 1990 the Smoke-free Environments Act came into force. In 2004 it was amended to make all indoor workplaces including bars and restaurants smoke-free (New Zealand was the third country to do so).

The Defence Force is going another step further, hoping to beat the general target by five years, setting its smokefree goal at 2020 and urging other government departments to match it.

That means reducing the overall 10%-12% smoking rate in its 14,000 personnel in three years. To do so it will ban smoking on bases, on operations and in military housing - neither will it allow vaping or e-cigarettes.

It is a tall order, but Commander Karen Ward is adamant it can be done. After all, this is the military: orders must be followed!

There may be more chance of success as the rates of smokers in the military are lower than the general population, where 17% of adults aged 15 and over smoke. The figures are considerably higher for Maori (38%), Pasifika (24%) and young adults aged 18-24 (24%).

There will be those left with no small sense of irony, however. Soldiers are expected to die for their country, yet they cannot have a smoke? The injuries they could sustain in conflict are surely likely to be even most costly - to themselves and the health system - than the damage from smoking. And soldiers were encouraged to smoke in the past and issued tobacco. It was seen as an important stress relief.

As it is for others. For some vulnerable groups, the transition is not so straightforward.

There are already concerns in the mental health fraternity about the impact on patients, who often smoke to relieve extreme stress, and for whom drug and alcohol addictions may be part of a complicated mix. Stopping smoking because a setting has been deemed smoke-free is not a simple matter of will power. The recent tragic deaths of two young patients, who died after leaving smoke-free hospital settings to smoke and were unsupervised, have highlighted the difficulties.

Another frightening consequence of raising tobacco prices to discourage smoking has been the rise in black market activity and the associated violent crime.

It is a conundrum, for the smoke-free aims are of course noble and important: better health, social and economic outcomes for individuals and society. Many countries are going down the same path. In health settings, staff deserve to be protected from secondhand smoke, yet patients' rights and circumstances - especially in times of crisis - are paramount. One-size-fits-all smoke-free policies have their limitations.

In reality the ``smoke-free'' label is a slight smokescreen. It is acknowledged it is impossible to eradicate smoking entirely; the target is actually to have fewer than 5% of the population smoking. With smoke-free figures showing 605,000 New Zealand adults still smoke, there is a long way to go.

Former prime minister and United Nations Development Programme head Helen Clark is back in New Zealand and has become the patron of ASH NZ, the Action for Smoke-free 2025. She and chairman Robert Beaglehole​ are pushing for efforts to be ramped up if the Government is to meet the goals.

The figures show 700,000 people have given up smoking. Change is possible, therefore. But the last cohort - and those choosing to start smoking - is likely to provide the greatest challenges. People should not get lost in the ``meeting targets'' mantra. Slow and steady might be the best way to continue.


 

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