|
From a Viewpoint
paper in today’s New Zealand Medical Journal http://www.nzma.org.nz/journal/120-1256/2587/-
Call to phase out commercial cigarette sales over next
10 years
Snuffing out cigarette sales and the smoking deaths
epidemic
Murray Laugesen
Commercial cigarettes spread the
smoking deaths epidemic. A law to end their sale can save an estimated
4000 lives and NZ$22 billion annually. A Ministry of Health discussion
paper is now needed to outline a new comprehensive public policy package,
designed to end cigarette sales within 10 years, and end the smoking
mortality epidemic (not just control it). This would include proposals
for legislation which could lead to a member’s bill or a government
bill to amend the Smoke-free Environments Act, with a sunset date for
ending cigarette sales.
Government, however, is likely to
first want assurance it has the support of a wide consortium of medical,
academic, health professional, anti-smoking advocacy and community
groups, working in a strong and united coalition. Adoption of a core aim,
such as “Phase out cigarette sales”, would make the intermediate
steps more coherent, unite the sector, and facilitate public support.
Abstract
Smokers need new products and policies
to escape smoking’s risks. And the next
generation needs policies that will better protect them from becoming
smokers.
Low-nitrosamine tobacco snuff
(hereafter termed ‘snuff’) is 20 times less dangerous than
cigarette smoking. Its sale as nasal snuff raises the question as to how
long cigarettes, including cigars and pipe tobacco, should continue to be
sold and allowed to hasten the deaths of 4000 New Zealanders annually.
Oral snuff has helped to reduce
smoking to unusually low levels in Swedish men, is much less dangerous
than smoking, and does not cause lung or mouth cancer. Moreover,
smokeless tobacco (which includes snuff) could reduce smoking-caused
health inequity for Māori. Snuff can
improve population health, and more so if more smokers switch to it.
Continued bans on snuff are now regarded by some experts as unsound
public policy. Added to the mountain of evidence against cigarettes,
sufficient evidence now exists for Government to use snuff to create
safer tobacco choices for smokers, end cigarette sales altogether, and
thus end the cigarette smoking deaths epidemic—in which 200,000 New
Zealanders have died so far.
The New Zealand Government can:
Fund media
campaigns to inform smokers of their new choices, and to urge them to
quit smoking. (The 2007 Budget commits an extra $11 million per year for
4 years, an excellent start.)
Regulate for
warnings on snuff cans stating that snuff is “addictive but much
safer than smoking”, and regulate imports to only permit
reduced-risk low-nitrosamine products.
Tax each class
of tobacco products proportionate to the respective risks of each. (Tax
cigarettes at 20 times the snuff rate, instead of at the same rate.)
Legislate, to
expand the Smoke-free Environments Act’s aims to include ending the
sale of cigarettes and ending smoking deaths—i.e:
- Allow oral
snuff to compete with cigarettes for market share (and for the
smoker’s nicotine receptors).
- Reduce
addiction to smoking, by decreasing the nicotine content of cigarettes by
5% every 6 months. (Below 20% of current levels, most smokers will quit
or switch to snuff.)
- Allot
cigarette supply quotas to manufacturers and importers, decreasing by 5%
every 6 months, on the grounds that cigarette smoke is irremediably
toxic. The summed effects of these changes could end cigarette sales
within 10 years, and prevent 90% of cigarette deaths within 22 years
thereafter. ___________________________________________________________________________
The concepts involved in this
phase-out plan include:
- Commercial cigarettes spread the smoking
deaths epidemic.
- The sooner the commercial cigarette is
banished the sooner this epidemic can be ended.
- Voluntary abstinence from smoking will
take us so far, but eventually some compulsion will be required to put
a stop to commercial cigarette sales.
- "Prohibition" has two quite
different meanings: Prohibition of smokers smoking and growing
for personal use (opposed) . Prohibition of
cigarette companies selling cigarettes (supported).
- Government won't ban cigarette
sales unless it has the support of medical and health
professional groups.
- The lead up to legislation could take
five years and another 5 years could be needed for the
legislated phase out of sales.
- Ending sales of cigarettes cannot be
considered until fewer people smoke.
- Support measures have to be in place.
Cigarettes have to be cost more, be less accessible, and become less
addictive.
- Alternatives to smoking, whether nicotine
or snuff, need to be known as less harmful, less costly, more accessible, and satisfying for
smokers.
- Once smokers have better products to
help them quit, cigarette sales
can be phased out with less fuss.
- Tobacco addicts, smoking kills.
- A clear statement from the medical
and health professions, that cigarettes (and the other smoking
tobaccos) must go, and their sales stopped within ten
years, will accelerate a decline in smoking. Even if government
does not agree, such statements will enable government to get
tougher on cigarettes and smoking tobaccos (combustible tobacco).
To request the full pdf
or to subscribe/unsubscribe please say so in the subject line to info@endsmoking.org.nz
|
