February 2007 For printer friendly version click
Nicotine and tobacco products vary in
- The risk for cigarette smokers of dying
early is over three times the risk of not smoking at all. Bjartveit 2005
- The risk of taking snuff regularly is
about 5% of the risk of cigarette smoking. Levy 2004
- The risk of taking snuff is less than
the risk of living with a smoker (and breathing their smoke).
- The extra risk of early death or
hospitalization from using nicotine gum for five years is zero. Murray 1996
Cigarette smoking risks
- Continuing to smoke cigarettes past age
35 years of age kills one in two smokers before their time. Doll 1994
- Cigarettes have killed 190,000 New
Zealanders since 1950. Peto 2004
- Cigarette smoking is killing over 4000
New Zealanders per year. NZ MoH
- Cigarette smoking is killing 12 New
Zealanders per day. NZ MoH
Current progress in reducing the percentage
of adults who smoke cigarettes
- In 2006, 21% of New Zealand adults smoked. NZ Census
- The percentage of adults who smoke
cigarettes is reducing by 1% per year, or by 0.3 percentage points
per year Based on NZ MoH, 1990-2004
- At this rate it will take 60-100 years
to end smoking, and longer in Maori.
Most things short of banning
cigarette sales have already been done
- Cigarette smokers cannot light up
indoors in public spaces.
- Cigarettes cannot be advertised.
- In many supermarkets cigarettes for
sale are already out of sight.
warnings are expected on cigarette packets by 2008.
What is missing is a policy
package designed to end the sale of cigarettes. Smoking is a relapsing drug addiction. Any
policy package should include reduction of cigarette nicotine, and
switching from cigarettes to smokeless products for maintaining the
is a drug problem
cigarette smoke, the
toxic smoke gases (carbon monoxide, hydrogen cyanide etc) are mixed up
with the addictive nicotine (which gives the pleasurable nicotine hit).
Smoke and its toxic gases is not the only
delivery method for nicotine. Nicotine can be absorbed rapidly from
mouth or nose. Before any cigarette sales ban, many smokers will seek
out more effective smokeless nicotine products if these are on sale.
Government can support their research and development.
too strong for many smokers. All
cigarette brands contain more nicotine than necessary, so that smokers
who cut down still stay hooked.
to reduce nicotine content of
cigarettes. Nicotine content of cigarettes can be measured by bench-top
test. Nicotine content can be gradually reduced, evenly across all
Acknowledgment that smoking is a drug
problem. Once smokers
know they need and can buy other kinds of nicotine in place of cigarettes,
they could avoid most of the health risks from smoking.
Alternative nicotine products. Research and development is needed to
bring more effective nicotine products to market. At present smokers
have little choice.
Cigarette manufacturers monopolise the delivery of nicotine to NZ addicts. Nearly 99% of nicotine is sold as
cigarettes, - the most dangerous way for addicts to obtain nicotine.
only half the nicotine comes from cigarettes. More Swedish men snuff than smoke. A
lifting of the sales ban on oral snuff, which is 95% less dangerous
than cigarettes, could lower NZ mortality.
Perpetuation of smoking from one
generation to the next. Unchallenged legal sale. As long as cigarettes are on sale to
adults, adolescents can obtain cigarettes and become addicted to
obtaining a nicotine fix from inhalation of cigarette smoke – and
another generation is hooked, often for life.
Ban cigarette sales to adults. As tobacco is not grown commercially,
and all tobacco for making cigarettes is imported, as only one cigarette
factory remains after 2006, and border control is efficient, a law to
stop tobacco manufacture and sales will be effective.
Need for a group to champion the end of
cigarette sales. Health
groups have been afraid to support a ban on sale for fear of a prohibition
label. Meantime, cigarettes continue to kill 4000 people p.a.
New Zealand will act as a catalyst for societal
support to end cigarette sales, while remaining open as to exactly what
supporting policies will be needed.
No other country has done it before. Where do we look for proof that it can be
Proof of concept - Sweden shows that smoking can be beaten. It has
used smokeless to combat smoking. Sweden has the lowest rates of smoking among
Western countries, and the lowest rate of lung cancer. The New Zealand solution may benefit from allowing the
sale of Swedish moist oral snuff (snus) to increase smokers’
choices and success in quitting.
Dr Murray Laugesen QSO chair; Prof Ross McCormick, Sir John Scott KBE, Trish
Fraser MPH, Dr Marewa Glover, Trustees