KEY POINTS:
Health Minister Pete Hodgson was all bluster and balderdash when asked if he would increase tobacco taxes, as recommended this week by public health experts at the Wellington School of Medicine and Massey University. "Tobacco control is a high priority for this Labour-led Government," he burbled. "It is
the largest single cause of preventable death in New Zealand." This was hardly a ringing endorsement of the experts' proposal, or an indication Mr Hodgson was inclined to move in that direction. As such, it suggested the Government has only a hazy notion of how to reduce the rate of smoking.
At first glance, the experts' proposal seems radical. It foresees a steady increase of tobacco taxes until, within a decade, the cost of cigarettes has risen from the current $10.50 or so for a packet of 20 to about $25. Lifting prices, say the researchers, is the most proven effective way of lowering tobacco use. There is good reason to think they are right. Indeed, Clearing the Smoke, the Ministry of Health's five-year plan for tobacco control, released in 2004, placed price increases at the top of a list of effective anti-smoking measures, based on strong scientific evidence. It was, the document said, "probably the most important single intervention to reduce smoking initiation".
Yet that advice has been ignored by the Government. Previous tobacco tax increases in 1991, 1998 and 2000 prompted sudden and substantial drops in cigarette sales. But nothing similar has been done since, and, in relative terms, smoking has become a more affordable habit. Instead, the Government has concentrated on legislation that restricts the promotion and marketing of tobacco and protects people from second-hand smoke, along with education campaigns and the subsidisation of quit programmes.
This has not worked. After a period of initial success, there has been little change in the number of smokers for several years. About a quarter of people overall, and most notably Maori, continue to smoke. As adults quit, they tend to be replaced by new young smokers.
Nonetheless, the Government seems happy to plod down the same path. Its latest initiatives have focused on banning the display of cigarettes in retail outlets and placing graphic pictorial warnings on packets. There is nothing to suggest this will have a dramatic impact. More of the same rarely does. What is needed is the fresh approach suggested by the health experts, backed as it is by evidence that suggests it will work.
If the Government is hesitant about this, it is probably because much of the financial hardship from price rises would fall on a low-income group ill-equipped to bear it. That, however, presupposes smokers have no desire to quit what is now a widely reviled habit. Tax increases would supply another, particularly strong, reason to stop smoking. Any public disapproval over a rise could be negated by ensuring the added take was spent on anti-smoking initiatives. Experience in several American states, where support increased when the revenue was tagged to programmes to help people quit or stop them smoking in the first place, confirms as much.
The public health experts suggest the two strands of their programme would halve the prevalence of smoking in the next decade. If that is a guesstimate, at least it is informed by research into the impact of tax increases. It must also be set alongside the ineffectiveness of the current approach. A continuation of that policy will cost many millions and likely yield minimal progress. Why not, then, try a more cost-effective approach that promises far more?
