SmokeLess New Zealand

www.smokeless.org.nz   info@smokeless.org.nz

 Printable version:  www.smokeless.org.nz/lawchanges19May06.pdf

Law changes required to end the cigarette smoking mortality epidemic

Figure 1. Annual cigarette deaths, New Zealand, 1955-2000

Source: Peto et al. Mortality from smoking in developed countries 1950-2000.  www.ctsu.ox.ac.uk

The necessary legislation to control this epidemic is likely to require two bills five to ten years apart.

A first-stage Choices bill which provides increased freedom of choice for smokers wishing to quit

A second Phase-out bill, some five to ten years later, which finally enacts a ban on cigarette sales, and thus put cigarettes out of the reach of children.

Suggested Target dates (See Figure 2)

Consultation and recruitment of support for the concept among doctors and health professionals

2006

Adoption of  the Smokers Choices Bill as a private members’ bill:

2007

Enactment of the Smokers Choices Bill

2008

Enactment of the Cigarette Phase out Bill

2015

Implementation of the Cigarette Phase out Bill, ending the sale of cigarettes and smoking tobacco

2016

·        Bills in parliament set the agenda for public debate. Laws shape society, and educate the public along the way.

·        Historically, the purpose of public health law in New Zealand is to control epidemics. The Smokefree Environments Act 1990 however, restricted tobacco advertising and smoking, but was not designed to end the tobacco mortality epidemic.

·        The Smoke-free Environments Act 1990 now needs to be rewritten to make it strong enough to control the current tobacco mortality epidemic, without interfering with smokers’ desire to stay addicted to smokeless nicotine. As smoking declines, the lethal trade in cigarettes can be phased out.

  The Smokers Choices Bill www.smokeless.org.nz/choicesbill.htm would include:

·        Strengthening of the purpose of the Smoke-free Environments Act

·        Partial reduction of the nicotine content of cigarettes

·        Lifting of the ban on the sale of less harmful smokeless oral tobacco products

Phasing-out of Cigarettes Bill www.smokeless.org.nz/phaseoutbill.htm

The Choices Bill will increase the pace of quitting, and smoking prevalence will decrease more rapidly. When smoking prevalence has fallen substantially, it will be time to phase out cigarette sales. As with the smokefree bars bill, cigarette sales could be timed to end  a year after the bill’s enactment.

_______________________________________________________________

Figure 2. The interaction of legislation and smoking prevalence reduction 2006-2021

From 2006 to say 2008 when the Smokers Choices Bill became law, the expected reduction in adults smoking prevalence is 0.3% per year.

Once the Bill makes quitting easier, a reduction of 1.2 % points per year is expected, resulting in smoking prevalence of 10% within 10 years, at which point the Cigarette Phase Out Bill should be enacted, with effect say one to five years later.

 

Rationale for the Bill as a whole

Various approaches need to be used simultaneously:

A. The public-health-law approach– ‘Control the cigarette smoking mortality epidemic’.

Since 1990, government policy, government publicity, and law changes have been the main driver lowering smoking, and latterly, in reducing second hand smoking. But the smoking death toll has only decreased slightly. (Figure. 1)

·        Further law changes can once again be the driver to lower smoking, a focus for strengthening the government’s comprehensive programme to control the cigarette smoking mortality epidemic.

B  ‘Treat the Addiction’ approaches.

B. 1. Replacement of smoke nicotine with clean nicotine. Improving the supply of pure nicotine to smokers

·        Nicotine gum and later patches sold through pharmacies (from 1985).

·        Lowering the price by subsidising nicotine patches and gum (from 2000 through the Quit Group)

·        Nicotine patches and gum widely available (on general sale through supermarkets)

·        Using nicotine patch and gum simultaneously to give a higher dose of nicotine. (gaining acceptance since 2005)

      B. 2. Reduce the reliance on smoke nicotine by limiting nicotine content in all cigarettes sold

·        Further law changes can make it easier for smokers to quit by lowering the nicotine content of cigarettes.

C. Enlisting cigarette retailers to switch their customers to less dangerous forms of tobacco or nicotine

·        The excise  rate levied on tobacco products should be proportionate to the death risk of each class of product. This will decrease the relative price of less dangerous smokeless tobacco. 

The tobacco deaths epidemic is a problem too big for the health system alone to fix.

© SmokeLess New Zealand