RECEIV EDI ' 1 FEB 2010 MAORI AFFAIRS SELECT COMMITTEE Foundation" SUBMISSION on the Maori Affairs Inquiry into the Tobacco Industry in Aotearoa and the Consequences of Tobacco Use for Maori To the Maori Affairs Select Committee Chair Tau Henare MP Submitted by The Heart Foundation of New Zealand, PO Box 17 160 Greenlane, Auckland 1546 The Heart Foundation requests the opportunity for Professor Norman Sharpe, Medical Director and Maggie McGregor, Strategic Advisor Public Health, to appear before the committee to speak to our submission. For any enquiries please contact : Maggie McGregor The Heart Foundation of New Zealand PO Box 17 160 Greenlane, Auckland 1546 Maq. qiem@nhf.orq.nz; Phone 0274 222 693 The Heart Foundation The Heart Foundation is a New Zealand charity dedicated to reducing the risk of cardiovascular disease, stroke and blood vessel disease for all New Zealanders. Since our formation in 1968, we have funded vital heart research, continued the education of cardiologists and researchers, improved heart disease risk assessment and cardiac care, and promoted heart healthy lifestyles to children and the wider community. Page 1of 6
We wish to make the following general comments: 1. The Heart Foundation of New Zealand welcomes the select committee's enquiry into the tobacco industry and its products. Cardiovascular disease remains the leading cause of death in NZ, accounting for 40% of all deaths. 2. Maori men and women are more than three times more likely to die of heart disease than non Maori of the same age group. Maori women 25 29 years old are four times more likely to be smokers compared to non Maori females in this age group. men and women are more than three times 3. Stopping smoking is the single most effective way to reduce this rate of premature death and disability. The Heart Foundation strongly recommends that the New Zealand Government take this opportunity to establish a comprehensive set of regulations and legislative measures which in the short term restrict, and in the longer term eliminate, tobacco for supply by 2020. Tobacco use is one of the most important factors impeding Maori development and the economic development of the whole of New Zealand. The Heart Foundation in its work sees the impact of heart disease and tobacco use on families and communities. We support the Government's proposal to take a Whanau Ora approach to the rebuilding of families including the reduction and elimination of tobacco use. Cessation of smoking results in a rapid and substantial reduction in heart disease. Approximately 5 years after quitting a smokers death rate is about the same as non smokers. Current New Zealand regulations allow the tobacco industry to exploit both Maori and non Maori for profit. The Heart Foundation of New Zealand congratulates the New Zealand Govemernt for undertaking this pro active enquiry and urges the government, as outlined in the Framework Convention for Tobacco Control (FCTC), to take bold steps to reduce the demand for and supply of tobacco and thus the levels of illness, death and disadvantage suffered by Maori in New Zealand. Pacific families are also affected by smoking with Pacific people having the second highest rates of smoking following Maori. Smoking by Pacific women increased from 23% in 1996 to 27% in the 2006 census. So we urge that our recommendations are accepted for Maori as it will also benefit others. Page 2 of6
We raise the following specific comments in relation to terms of reference #5 : the policy and legislative measures which are necessary to address the findings of the Inquiry? Recommendation 1: New Zealand develop a comprehensive set of regulations and legislative measures which in the short term restrict, and in the longer term eliminate, tobacco sales by 2020. The Heart Foundation is a member of the Smokefree Coalition, and a signatory to the Coalition's Vision for Tupeka Kore Aotearoa: a tobacco free New Zealand by 2020: That future generations of New Zealand will be free from exposure to tobacco and will enjoy Smokefree lives. The vision will be achieved by (i) protecting children from exposure to tobacco, (ii) reducing the demand and supply of tobacco products and (iii) increasing successful quitting. A detailed and comprehensive plan is outlined in 'Achieving the vision' available from the Heart Foundation or the Smokefree Coalition. Recommendation 2: All tobacco displays are removed from point of sale by December 2010. Tobacco advertising is illegal in New Zealand, however very dynamic marketing can be achieved through displays at point of sale. We know that such displays influence the behaviour of young people. Year 10 students who are exposed to retail displays more than three times a week are three times more likely to become smokers'. We know that most smokers start the habit before they are 18, so any initiatives which reduce this form of marketing to young people are likely to prevent uptake by a vulnerable part of the population. Displays also have a negative impact on smokers who are trying to quit. An Australian study showed that one in five smokers trying to quit and one in eight recent quitters avoided stores where they usually bought cigarettes, in case they might be tempted to purchase them". Public awareness of tobacco retail displays is high, as is support for a retail display ban. In 2008, 67 percent of New Zealanders supported a ban on tobacco retail displays; 59 percent of all smokers supported this stance~". Over 80 percent of submissions made during the recent public consultation supported a complete ban on tobacco retail displays~v. Countries that have imposed a ban on tobacco retail displays report there has been no substantive impact on retailers. In Saskatchewan, Canada there was no evidence of adverse effects on small retailers and no increase in shoplifting a year after implementation of a display banv. In Ireland, a tobacco retail display ban went into effect in 2009 with 97% compliance amongst retailers". A longitudinal study (before and after) of 13 15 year olds in 4 regions of Ireland found that recall of tobacco brands dropped from over 80% to just over 20%, and there was a 10% drop in confidence in one's ability to purchase cigarettes after the banv". New Zealand's average Page 3 of6
age of smoking uptake is 14, so these findings indicate the impact a tobacco retail display ban would have on smoking uptake in New Zealand. Recommendation 3: To support the measures to restrict supply (as in recommendation 1) a sustainable counter marketing programme is developed and implemented in 2010. An increased range and depth of tobacco control programmes and services are required to 'counter' the strong position of tobacco within New Zealand and within Maori communities in particular. We support the government taking a 'Whanau Ora' approach to rebuilding Maori communities and reducing the impact of tobacco through; media and social action campaigns, easily accessible cessation services and nicotine replacement therapies. Recommendation 4: Taxation policies are implemented to reduce consumption and uptake by youth including: (a) (b) (c) An immediate increase in tobacco tax supported by and annual increase of 5% per year as recommended by the World Bank and the World Health Organisation A dedicated tax, (from the increased and existing tobacco taxation revenue (currently over $1B), established in 2010. The tax to be used to fund services/programmes ranging from health promotion programmes, enforcement, cessation/quit services, research and advocacy services. The harmonisation of tax on loose tobacco with that on manufactured cigarettes Taxation is the most effective tool in reducing consumption and youth uptake. There is a clear inverse relationship between tobacco taxes and tobacco consumption. For every 10% increase in excise tax, there is up to 5% reduction in consumptionv"'. What's more, youth, minorities and low income smokers have been seen to respond more than other groups of smokers to this tobacco control measure, making it one government policy that would address the socio economic inequalities attributed to tobacco use. Youth, minorities and low income smokers are two to three times more likely to quit or smoke less than other smokers in response to the inherent price increaseix. Loose tobacco is taxed lower than tailor made/manufactured cigarettes. This provides smokers with a cheaper tobacco product to buy. It also allows easier financial access by rangatahi/youth to loose tobacco. Page 4 of6
Recommendation 5 The Government actively monitors, demonstrates and reports how it meets its international obligations under the FCTCx each year The New Zealand Government is party to the Framework Convention on Tobacco Control (FCTC). Part of the obligation is to take measures to promote the participation of indigenous individuals and communities in the development, implementation and evaluation of tobacco control programmes that are socially and culturally appropriate to their needs and perspectives. As a Party the Government is responsible for meeting these obligations. The Heart Foundation encourages the Government to take this opportunity to take bold and comprehensive steps to reduce the health, social and economic impact of tobacco on the indigenous people of New Zealand. Page 5 of6
References 'Paynter, J, Edwards R, Schluter, PJ, Mcduff, 1. Point of Sale Tobacco Displays and smoking among 14 15 year olds in New Zealand: a cross sectional study. Tobacco Control 2009: 18(4): 268 274 " Wakefield, M, Germain D, Henrikson L. The Effect of retail cigarette pack displays on impulse purchase. Addiction 2008: 103 (2): 322 8 '" UMR Research Ltd. Cigarette displays omnibus results: Cancer Society of New Zealand, 2008. " Ministry of Health, Reveiw of Tobacco Displays in New Zealand: Consultation Document and Summary of Results of the Consultation Document. Wellington, MOH 2007 " Saskatchewan Coalition for Tobacco Reduction. Letter from June Blau and Lynn Greaves to the Ontario Provincial Government Standing Committee on Financial and Economic Affairs. Regina, 2005 " Eamonn Rossie, 2009. v" McNeil A and Chen Y. 2009 v"' Thomson G, O'Dea D, Wilson N, Edwards R Government paralysis?: Stable tobacco prices mean preventable deaths and disease, and persisting health inequalities in New Zealand Department of Public Health, University of Otago, Wellington, New Zealand " Mackay J, Erikson E, The Tobacco Atlas, 2002.Geneva: World Health Organization * World Health Organization (2). Framework Convention on Tobacco Control. www.who.int/tobacco. 2009. Page 6 of6