Speech: Maori Tobacco Intelligence Summit

Maori Tobacco Intelligence Summit; Te Papa Museum

Friday 29 May 2009; 10.30am

Hon Tariana Turia; Associate Minister of Health

 

It is interesting to be here, at Te Papa Tongarewa, talking about Maori Tobacco Intelligence.

 

It would be my greatest joy, to know that tobacco was something that we would only find stored in the archives; on the shelves of history.

 

If we had time to explore the collections here we might come across a tobacco cutter dating back to 1900 or a tobacco box, circa 1937.

 

Or if we were really adventurous we might line up for Time Warp and go back to 1840.

 

There we would find an account of gifts given at the signing of Te Tiriti o Waitangi in the Bay of Plenty including:

Þ eight pounds of tobacco and twelve pipes for chiefs at Opotiki;

Þ five fancy pipes and half a pound of tobacco at Te Kaha;

Þ Two fancy pipes and half a pound of tobacco at Torere; and

Þ Eleven fancy pipes and five pounds of tobacco at Whakatane.

 

It defies belief – that at the point of signing our most sacred document, tobacco would be offered as a gift – a gift which we now know kills people in numbers too big to ignore.

 

Fast-forwarding to today, I only wish that tobacco was known as a relic of the past. But unfortunately as you all know, much better than me, tobacco consumption is as rife as ever.

 

Not only has per capita tobacco consumption increased by about one percent in 2008; but the percentage of New Zealanders smoking, at 21 percent, is also a one percent increase from 2007.

 

Can you believe that….with all the programmes and services and phenomenal legislation such as the Smokefree Environments Act, we are still seeing an increase in the rates? It is a mystery to me.

 

Of course the most critical fact that motivates all of us to be here today is that 45% of Maori aged 15 to 64 years are current smokers.

 

There is surely no more obvious indicator of the need for a tobacco control strategy in New Zealand than the reality that about 5000 deaths each year are attributed to tobacco use.

 

One in two long term smokers will die of smoking related diseases. Those that die lose on average fifteen years of life.

 

None of these statements are new, but I offer no apologies in repeating them.

 

We are losing generations of our people, dying in middle age. Even more tragic is the fact that up to 46% of Maori Sudden Unexplained Death in infancy are attributed to smoking.

 

The biggest issue of all, bigger even than the fact that people are smoking, is the root causes for why people smoke.

 

We need to come to grips with the triggers that cause people to pick up the pack in the first place – is it to relieve stress, to reduce anxiety, to forget about other things happening in their lives?

 

We have to make the commitment to each other; to our whanau; to make long term change in the interests of our future.

 

I am pleased to know that you want to review where you are at in the terms of the Maori Tobacco Control Strategy; and to set yourselves a new platform from which to navigate the new political and economic environment.

 

This is a good opportunity to announce that I am seeking to review the smoking cessation services currently available to New Zealanders – and this commitment is now written into the Statement of Intent negotiated between the Minister of Health and the Ministry.

 

My motivation is simple – I am unconvinced that smoking cessation services and Quitline are making the difference we need.

 

As a parent to children and mokopuna who have tried to quit smoking with varying levels of success I fully accept the finding that smokers take an average of fourteen attempts to quit successfully.

 

But there are other issues which continue to puzzle me.

 

I wonder about the role modeling theory. George and I are non-smokers and yet all six of our children, at one time, took up smoking. It broke my heart.

 

And then I think of two of my sisters, both who were stalwart smokers – so much so, that they would persevere with the habit even while they were shivering outside in the cold – such was the grip of their addiction.

 

Yet they were able to give up – not because of any quit smoking programme or replacement therapy – their motivation was bound up with their responsibilities to their mokopuna.

 

And so I ask myself, is whanau ora what we need to be focusing on rather than interventions and campaigns that seem to burn up money but fail to make the difference?

 

We need leadership; we need to focus on the outcomes that matter; and we need to remain firmly fixed on the empowerment of whanau.

 

This summit is an opportunity to hear from all of you, how the varying initiatives in place to help smokers to quit, have been accepted by Maori. I want to know whether cessation advice and high quality cessation support services across the health sector are actually having direct outcomes in reducing smoking rates.

 

My deep held suspicion is that the more effective approach would be to reduce tobacco supply in the first place.

 

I will be watching with great interest, the progress of the Tobacco Control Bill introduced in Scotland this year. The Bill proposes banning the display of tobacco products at point of sale, arguing that point of sale marketing is a powerful tool that the State can control. The Bill creates a new offence with a maximum penalty of twenty thousand pounds or six months in jail for people selling tobacco illegally. There will also be on the spot fines for retailers who sell to under eighteen year olds, and sales bans against those retailers who consistently sell to underage smokers. The Bill is justified on the grounds of health promotion targeted for the benefit of children.

 

Other jurisdictions, including Australia, Great Britain, Ireland and Scandinavia have all introduced legislation which included a ban on tobacco displays – the Saskatchewan province of Canada having particularly impressive results in terms of the decline in prevalence rates amongst 15 to 19 year olds; as indeed is the evidence from Iceland.

 

The Himalayan country, Bhutan, has gone one step further and banned both smoking in public and the sale of tobacco.

 

So why are we, in this brave country, failing to act?

 

Another area that I want to keep alive, is the suggestion to raise taxes on rollies to the same level as ready made cigarettes.

 

One of my motivations for this is knowing that roll-your-own cigarettes are more likely to be smoked by 15-17 year olds than any other brand. The most common reason given by young people is that roll-your-owns are cheaper than manufactured cigarettes.

 

Increasing the price on roll-your-owns may therefore have some immediate benefits in larger health gains for our young.

 

We know that about fifty percent of New Zealand smokers smoke roll-your-own cigarettes. This is a very high rate, in fact no other country has roll-your-own smoking at anything close to our level.

 

The taxation on roll-your-own tobacco was last equalized in 1995. Perhaps it is time, nearly fifteen years later, to increase the tax on roll-your-owns to encourage smokers to quit or reduce consumption.

 

It seems to me that increasing taxation on tobacco products is something that is worth exploring if we are genuine about wanting to prevent uptake.

 

If increasing the tax on tobacco is the most proven intervention we can do to reduce intervention so why aren’t we doing it?

 

Recently I looked at some data from the Irish Office of Tobacco Control that shows without a doubt that the intervention of tax increases had an immediate impact in reducing cigarette smoking prevalence.

 

These are just a few of the ideas I am wanting to pursue : the review of smoking cessation; the banning of tobacco products at point of sale; and the taxation of roll-your-own tobacco.

 

There are of course others I am interested in. I want to learn more about e-cigarettes; electronic cigarettes. In fact our marae is considering taking this up as a whanau trial, so I have a particular reason for my focus.

 

I’d like to hear about the campaigns targeting youth: “Smoking not our future” and Smokefree Cars.

 

And I am very keen to know about specific, tangible things we can actually do, today. Ideas such as targeting a couple of achievables to ensure Aotearoa is compliant with the World Health Organisation’s Framework Convention on Tobacco Control.

 

Things like making a stand that tobacco industries must have no role in public health or getting rid of duty free tobacco.

 

I want to see marae and kura truly own the kaupapa of being auahi kore.

 

I am also very supportive of the Tobacco out of Aotearoa Bill which my colleague Hone Harawira has devised : a Bill which comprises a range of strategies and legislative options to achieve the vision of Aotearoa being a tobacco-free nation.

 

I want to thank Te Reo Marama, Te Roopu me Mutu/the Quit group and the Health Sponsorship Council for having the insight and the initiative to call this summit.

 

There are many more of course, there is the amazing work that nurses and midwives do; there are all the Maori health providers; there’s Te Hotu Manawa Maori; and let’s not forget the cause champions we have within our whanau too.

 

And finally I want to remind us all that tobacco was first introduced to Maori by Captain Cook in 1769. It was not part of our heritage; not part of our history. It rapidly took hold as an object of negotiation in trade; as a product for export; as a commodity.

 

But we can do something about that, if we join together, collaborate and create solutions which we know will work.

 

The brink of recession is a perfect time to throw everything up for debate; to have a fresh look at outcomes; at cost-effectiveness; at reliability of results.

 

We need to be really clear, are we serious about making the changes?

 

I am prepared to put my hand up today, and say I choose to be part of the solutions; for us to be the architects of our destiny. Are you prepared to take the journey with me?