Higher tobacco taxes here and in Australia are a first step to reducing numbers of smokers. Martin Johnston reports on how this is being received and what else could be on the cards
You could almost believe Maori Party MP Hone Harawira when he joked that the New Zealand and Australian governments had organised a joint attack on the tobacco industry.
No sooner had New Zealand announced a three-stage increase of more than 30 per cent in the tobacco excise tax than Australia came out with a one-hit 25 per cent rise, plus a bold plan to strip tobacco packaging of its allure and its bright colours.
A packet of 25 here will go from around $13.30 on Wednesday, to $17 in 2012. Roll-your-own cigarettes, currently taxed less, will go up even more.
And that's not all.
On instructions from Associate Health Minister Tariana Turia, the Ministry of Health has resurrected a proposal - rejected by Health Minister Tony Ryall last year - to force tobacco in shops out of sight under the counter or into the cupboard.
It will be out of view of customers, especially non-smoking children and recently-quit smokers, who researchers say can be influenced to smoke, by the glitzy "power wall" displays.
A groundswell has been building for a slew of changes, such as banning smoking in cars carrying children, de-branding cigarette packets and forcing tobacco companies to gradually reduce the addictive nicotine content of tobacco.
In a survey cited by Turia, half of respondents said tobacco should not be on sale in 10 years.
Could this be the tobacco "end game" long sought by control campaigners? They can hardly believe the latest developments.
"It's beyond anybody's hopes six months ago," says George Thomson, a public health researcher from Otago University at Wellington.
"If we got plain packaging here within 18 months to two years, the combined tax/plain packaging/displays-ban package would be a far larger package than we have had, probably since the late 1980s
"The tax rises then were large. That was extremely effective. That is the best achievement we have had in New Zealand. This would be the nearest thing. The effect then was encouraged by the huge public controversy over the Smokefree Environments [Bill] which resulted in the 1990 law.
"Everything came together to work very well then. It looks as though it may happen again."
Hopes of radical change have been building since last year, when Parliament's Maori affairs committee announced it would hold an inquiry into the tobacco industry and the effects of smoking on Maori. Harawira was the instigator.
Maori are disproportionately affected by smoking. They start smoking at a younger age (median age 11.6), and in adulthood some 46 per cent smoke, more than double the rate of 20 per cent for the whole adult population.
Maori groups trooped into the committee hearings to tell of the devastating impact of smoking on their whanau, hapu and iwi - the emotional impact of losing fathers, mothers and spouses in middle age, and also the economic hardships of losing a breadwinner.
Smoking and secondhand smoke kill about 5000 people a year in New Zealand, including 600 Maori. Half of long-term smokers die of smoking-related disease and, on average, they die 14 years prematurely.
Harawira made the point that the annual Maori death toll from smoking was the same as the number of Maori Battalion deaths throughout the whole of World War II. He said that because of this, it had been suggested New Zealand needed a statute to commemorate "the unknown smoker".
Smoking has been declining in New Zealand for several decades, but at the current rate of decline it will be 70 years before the prevalence is near zero.
Some hope the increasing number of teenagers who report never having had even a puff of a cigarette will flow through to result in a rising number of non-smoking adults.
Groups such as the Smokefree Coalition and Action on Smoking and Health (ASH) see the hearings as an unprecedented opportunity to influence tobacco control policy.
They want us to be "smokefree" by 2020. By this they mean tobacco - which they portray as an addictive poison - will be virtually unavailable and no-one will want it anyway.
Their agenda includes:
* Annual tax increases of 20 per cent, considered one of the most potent ways of reducing demand
* Expanded help to quit
* Banning misleading branding and descriptions like "smooth", "rich" and "mild"
* Banning sugar and flavourings from tobacco because they make smoking more palatable and encourage young people to start smoking
* Licensing of tobacco retailers
* Restricting the amount of tobacco that can be sold and reducing the quota annually.
The Auckland Regional Public Health Service wants smoking banned on beaches, at bus stops and many other outdoor public places to complement the legislative ban on smoking in workplaces.
This would build on city and district councils' growing practice of putting up signs asking people not to smoke.
Many have said they want an eventual prohibition on tobacco, and Gisborne's district health board urged the committee to push for tobacco to be declared an illegal drug, available to addicts only via a doctor's prescription.
Harawira, perhaps surprisingly, is treading carefully. Activist Harawira has publicised his bill to ban smoking and the production or sale of tobacco. Politician Harawira hasn't put it in the parliamentary ballot for private member's bills.
He realises he has started something big - a broad-based coalition calling for radical change. But he doesn't want to blow it by running ahead of public opinion.
"We need to be measured, innovative, in a way that encourages New Zealanders not to see it as 'banning tobacco', but 'smokefree Aotearoa' - positive, rather than people all moaning about the outcome."
He was encouraged by the near-unanimous support in Parliament for the tax rises bill introduced by Turia, his party's co-leader.
"When we discussed it in caucus we had no idea how it was going to go. The support was overwhelming, which suggests that not only do a majority of New Zealanders want us to be smokefree, but that feeling is starting to percolate throughout Parliament, and regardless of party affiliation.
"I feel lucky for the Maori affairs select committee that Tariana was able to get this through early because it gives us a gauge on the feeling of the House as to what kinds of measures we might want to take as well as the kind of timeline and the strength we might want to put in our recommendations."
The committee is likely to report in June.
Turia, a minister outside cabinet, has portfolio responsibility for tobacco control, but she faced an uphill battle. It is understood that when she faced opposition from Ryall, she went over his head to Prime Minister John Key.
Some insiders had expected at least some of the extra $200 million the Government will receive from tobacco sales - it now takes $1.1 billion a year in excise and GST - would be dedicated to quit-smoking services.
Survey results published by George Thomson and his colleagues in February found 59 per cent of smokers would support a tax rise if the extra revenue was used to promote healthy lifestyles and support quitting.
But the Government, which is spending $57 million this year on tobacco control, including $8.5 million for nicotine replacement therapy and other quit-smoking medicines, rejected tagging the tax rises for this work because it "over-complicates Government finances and adds little benefit".
Not everyone agrees. Thomson's paper says at least 10 countries and at least nine US states have dedicated tobacco taxes.
Australia will be the first country to force tobacco into plain packaging. Industry logos, promotional text, imagery and colours will be banned from mid-2012. Product names will be in a standard colour, position, font and size. Health warnings and gruesome pictures of tobacco-related diseases such as mouth cancer will become larger.
Becky Freeman and Simon Chapman, of Sydney University's public health school, say in the Age newspaper that the industry has invested heavily in packaging cigarettes to increase their appeal.
"In the industry's own words, packs aimed at younger women should be 'slick, sleek, flashy, glittery, shiny, silky and bold'."
The industry has threatened legal action over de-branding in Australia and British American Tobacco NZ says it would act here if necessary to protect its intellectual property rights.
The industry also claims the move may increase the illicit trade in tobacco, but others say a black market in tobacco is unlikely to flourish because most smokers want to quit.
Otago University marketing expert Professor Janet Hoek says plain packaging would lead to a decrease in smoking initiation.
"We know branding makes tobacco look attractive. It gives it aspirational values. These are often very appealing to young people.
"Some of the work we've done has explored plain packaging with young people. They say it looks nerdy, try-hard and budget - not the sort of pack they would want to be seen with.
"Why would somebody want to experiment with something when it doesn't look very cool, to have a pack that's completely plain."
Retail displays are the next battleground. The ministry will accept submissions until 21 May.
Britain, most Australian states and territories and Norway are among places which have banned these displays.
ASH says studies show that seeing tobacco marketing in shops increases the likelihood of young teens experimenting with smoking - the first step to addiction.
British American says there is "little compelling international evidence" that banning retail displays would lead to smoking rates declining.
"We support the views of many retailers who say a ban on the retail display of tobacco products will have a significant impact on the viability of their businesses."