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Dominion Post 10 May 2006
By MURRAY LAUGESEN printable version:www.endsmoking.org.nz/enewsThirdWay10May06.pdf
Janice Pou paid the ultimate price for her
smoking, and now her legal claim against British American Tobacco (BAT)
has failed. Ironically, if the company had sold her smokeless tobacco
instead of cigarettes, she might well be alive today. Few smokers have had
the chance to try such products, which provide nicotine without the risks
of smoking.
Although BAT has emerged with a court
victory, volume sales of smoking tobacco and cigarettes per adult have
halved since 1990, and the industry ultimately faces oblivion unless it
becomes part of the solution and sells smokeless tobacco, a much less
risky product. Ironically this could be, on balance, a positive for
public health.
The Maori Party apparently wants all
tobacco products including smokeless, banned from sale, but this could
take several stages. A new group, SmokeLess New
Zealand, says thousands of lives could be saved – by smokers
switching to cheaper, safer, smokeless tobacco.
Mrs Pou, of Invercargill, started smoking cigarettes at
age 17. Until she died of lung cancer at age 52, cigarettes cost her
$160,000 at today's prices. To sue BAT she subjected herself to
exhausting cross-examination in her last days. In the High Court in Auckland in March her
personality, her smoking career, and the smoky times of her teenage
years, were dissected over five weeks by a parade of experts and opposing
teams of lawyers.
To Mrs Pou smoking was important. She could either quit, or
risk early death – a dilemma, rather than a choice. The court has
ruled her lung cancer was not BAT's fault,
because she did not overcome her addiction and quit when she could have.
But tobacco smoking can be as difficult to quit as heroin.
So was it all her fault? The court chose
to emphasise individual responsibility and free
will. Unfortunately nicotine addiction impairs motivation to quit, and
smokers currently have no other way of getting addictive nicotine besides
smoking.
The health system advises smokers to
quit, under threat of death. Some find it easy, while 4000 die annually,
failing to quit in time. Mrs Pou was in that top 5 per cent of smokers, who need a
cigarette first thing in the morning and who smoke more than 20
cigarettes a day.
MRS POU was responsible for her own
fate, says the court. But should smokers be entirely left to their fate?
Government, in receipt of nearly $1 billion in tobacco tax, could provide
more prompts, more products and more permissions:
* Fund more media campaigns to make
quitting top-of-mind for all smokers;
* Make it easier to quit – market
smokeless, safe, addictive nicotine products, that
smokers want to switch to. Pharmac could
underwrite start-up companies, and the potential world market is huge;
* Permit low-risk smokeless tobacco
(Swedish oral snuff) to be sold alongside cigarettes.
Health groups currently oppose the sale
of smokeless tobacco, hoping pure nicotine products alone will suffice.
Smokers, however, face a one in two
chance of dying early from their smoking, and cannot buy addictive
nicotine as either pure nicotine or smokeless tobacco.
In Sweden, smokeless, spitless tobacco (oral snuff) is now more popular
than smoking among men, and is gaining in popularity among women. Snuff
provides sufficient nicotine to satisfy an addicted smoker. Mrs Pou probably had never
heard of nasal or oral snuff.
If Mrs Pou had switched from cigarettes to Swedish oral
snuff, she would not have developed lung cancer, her overall risk of
dying early would have decreased by 95 per cent, and her chances of
developing mouth cancer, an uncommon cancer, would have been decreased 80
per cent.
The tax on personally imported snuff is
nearly $400 per kg, (including gst), the same
as for cigarettes, but if taxed according to its death risk, tax on snuff
should be 95 per cent lower. Then snuff could begin to push cigarettes
off the shelves.
We cannot say whether the late Mrs Pou would have ever
switched to smokeless. She at least might have tried smokeless, whereas
abstinence from tobacco and nicotine was always a step too far.
Dr Murray Laugesen chairs SmokeLess
New Zealand, a charitable trust promoting life-saving choices for
smokers. www.smokeless.org.nz
This story was also published by Otago
Daily Times 12 May 2006, p. 9, as Smokeless solution to cigarettes.
________________________________________________________________________
Ministry of Health to wipe 'Smoking Kills' off the packet
The Ministry of Health today released its consultation document on
health warnings for cigarette and tobacco packets.
http://www.ndp.govt.nz/publications/smokefree-environments-regulations-1999-2006.pdf
Have your say - closing date 13 June. Responses to gordon_mckenzie@moh.govt.nz
________________________________________________________________________
Fourteen warnings are proposed, with seven in circulation at any
one time.
1.
You are not the only one smoking this cigarette.
2.
Your smoking can harm your kids
3.
Smoking causes blindness
4.
Cigarettes are a heart breaker.
5.
Emphysema is a living hell.
6.
Smoking causes mouth cancer.
7. 9
out of 10 lung cancers are caused by smoking.
8.
Smoking doubles your risk of stroke
9.
Smoking clogs your arteries
10.
Smoking causes gangrene
11.
Tobacco use can make your impotent
12
Smoking causes foul and offensive breath
13
Tobacco smoke is poisonous.
14
Smoking is highly addictive.
The good news.
- The NZ Quitline is mentioned on all packets, with the
slogan you CAN quit.
- Pictorial warnings
and more space for warnings.
- Many diseases are
mentioned for the first time, such as stroke.
- The Ministry of Health
has finally delivered its consultation document on warnings,
personally promised by Hon Damien O Connor when the Smokefree Bill was passed in 2003.
- A lot of research has
gone into these warnings.
- Addiction has been
upgraded to 'Smoking is very addictive'.
The bad news
1.
SMOKING KILLS has been omitted. While
it is helpful to explain the pathology of smoking diseases, it is the
duty of the Ministry to continue to inform smokers that they have a 50%
risk of dying early if they keep smoking past age 35. In many cases
smoking does not cause any disease, but it carries ten times the risk of
sudden death compared with nonsmokers. The worst thing smoking does to so
many is it kills them before their time, and the
main reason smoking control is so important.
SmokeLess New Zealand says, regardless of whether
Smoking Kills convinces anyone to quit, whether risk data is
persuasive, smokers have a right to be told this startlingly serious
truth. After all the government is complicit in cigarette purchase and
sales, because it takes nearly $1 billion in tax, and has no plans
yet to phase out cigarettes or replace them with smokeless.
The
Ministry plans these warnings for vulnerable young people,
and Maori. Warnings, however, also set the policy and social
climate in which smokers quit, add to the common knowledge about smoking,
and discharge the Ministry's duty to inform consumers about the risks.
Failure to mention smoking eventually kills half of those
continuing to smoke beyond age 35 does not discharge the government's
duty as a non-regulator of adult cigarette sales. Adolescents have a right to
know the facts and make up their own mind on life and death issues,
instead of being warned on their social fears of dog breath,
which their friends will educate them on anyway.
2.
The Ministry has grouped the warnings under the headings of role modelling, physical health, social fear and poison. A
further category of basic information for smokers is needed. For
example, smokers are not given useful information such
as "It is the smoke that kills and the nicotine
that is addictive." Such basic information would make it easier
for smokers to embrace nicotine to help them quit.
3. Foul breath has been included. The picture suggests serious
dental neglect. Many smokers emit a harsh tobacco breath, but a foul
breath means infection and decay.
4. Inaccurate wording. Tobacco use can cause
impotence?. This is only true if
it is changed to "Smoking tobacco can
cause impotence." or "Smoking can cause impotence."
Smokeless tobacco does not cause impotence. Impotence is due to atheroma of the small arteries, and there is no
compound in smokeless or unburnt tobacco that
can do this. (Smoking leads to the formation of thromboxane
a2 in the body which can precipitate blockages in arteries.)
5. The cigar message is misleading because
the whole truth is not stated. Apart from pipe tobacco and snuff tobacco,
the safest tobacco product on the market at the present time is the
cigar. For example, "Cigars are not a safe
alternative to cigarettes." is true, but not the whole truth, because
a smoker would still be much better off smoking cigars than
cigarettes. See www.endsmoking.org.nz/cigarsmokingrisks.htm
where we show that
· Risks for non-inhaling cigar smokers one sixteenth that of
cigarette smokers.
· Risk for cigar smokers who inhale cigar smoke
is equal to about 10 cigarettes a day.
6 Smoking causes gangrene, and other such
messages about uncommon complications of smoking, would be more accurate
if they said Smoking can cause gangrene. As they stand, one could
equally say "Smoking seldom causes gangrene." As with
Smoking causes mouth cancer, The picture tells the story powerfully,
and the text does not need to overstate the case. It is
different with smoking clogs the arteries because in NZ this would be a
true prediction for most smokers.
SmokeLess New Zealand appreciates the difficulty of
getting it right, and will be making its own submission in the next few
weeks.
- Murray Laugesen
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