Hon Tariana Turia
Associate Minister of Health

Thursday 8 November 2012 SPEECH
Tobacco-free Aotearoa Conference

11.00am, Te Papa Tongarewa, Wellington,

I have been greatly looking forward to this biennial tobacco control conference.

And I want to thank the Health Promotion Agency, and the National Tobacco Control Working Group, for holding us all to account in an issue of such significance.

It is a real pleasure, to also share the stage as we open this conference, with Professor Robert Beaglehole and Ben Youdan who have both contributed enormously to the wider gameplan for tobacco reform.

I can hardly believe the progress we have witnessed since we were last together in November 2010.

At that hui, I referred to the passing earlier that year of legislation providing for three tobacco excise increases.

The Māori Affairs Select Committee had just released its momentous report, and during the course of the hui I announced the Government had also just agreed to the removal of tobacco retail displays.

In March the following year the Government, by and large, accepted the recommendations of the Māori Affairs Select Committee.

Most importantly, it adopted the goal, both aspirational and inspirational, of an essentially smoke-free New Zealand by 2025, a goal taken up with enthusiasm by the tobacco control community. I don’t think we could have asked for a more conducive environment or stronger endorsement for our work as we move forward.

There is, however, no room for complacency.

And that is why the impetus of being held to account is so critical.

I heard it said once that ‘cigarettes are killers that travel in packs’.

No matter how we dress it up, the reality of tobacco consumption is dire.

An estimated 650,000 New Zealanders, almost one in every five people over the age of 15, continue to put their health and lives at significant risk by smoking.

This figure includes approximately 155,000 current smokers who are Māori, which is about 45% of the Māori population aged between 15 and 64.

I come to you today with one message – and that is we must do all we can do to make the difference, to support our loved ones to lead strong, healthy lives.

It will take leadership.

Leadership, whānau by whānau, family by family; community by community.

We do not have the powerful resources of the tobacco industry behind us. We know too that the industry has a compelling marketing machine that is able to represent tobacco use in ways which are associated with glamour and sophistication.

But if I know anything about the people in this room, I know that you have never let a challenge deter you from the goal of protecting and respecting health.

You understand better than most the ways in which tobacco contaminates the air; pollutes our hair and clothes; stains our teeth; damages our lungs; diminishes our life expectancy; overloads our cancer mortality rates; and so it goes on. You are, therefore, the best people to be the champions we need to lead.

Ours must be a campaign based on mobilising the nation to rid our wonderful country of this harmful substance.

We know the health impacts; we know the costs to the nation of treatment and hospitalisation; we have buried too many whose lives were cut short by diseases associated with tobacco use.

And so, it is indeed timely to lift our game – if we are to rid New Zealand of the harms caused by tobacco.

We must never under-estimate the difference we can make in the lives of others. We must stand united, and we must believe that we can do this.

Leadership is not about what is done for us or to us – it is about what is done by us. That, indeed, is the very basis of self-determination.

We can and will stand strong against the impact of tobacco harm, if we are to achieve a future in which we are self-determining; and in which the generations who follow on will have a powerful sense of control over their own health and wellbeing.

The vision for tobacco control is encapsulated in the goal of a smokefree Aotearoa by 2025.

Of course the 2025 target is ambitious and we are ambitious for ourselves, for our children and our children’s children.

So then, the challenge to lift our game is upon us – how can we do more whether it be in cessation, health promotion, community action, policy or research? There is a Chinese proverb that gives us some ideas – it says to us - a person who removes a mountain can do it, one stone at a time.

We started with tax. The tobacco excise bill, passed by the House just a few weeks ago, extends the momentum built up by the previous three tobacco excise tax increases in April 2010, January 2011 and January 2012.

There will be 10 per cent increases in the tobacco excise on 1 January each year for the next four years. These increases are on top of the existing annual CPI adjustment which maintains the real value of the tax. We should have raised the tax of 50% and then 10, 10 – that would have given our goal to 2025 a good start!

The increases to date have contributed to manufactured cigarette sales falling by almost 9 per cent and sales of roll-your-own tobacco falling by over 21 per cent between 2009 and 2011. We must celebrate this- and appreciate that ongoing excise tax increases will result in further declines in tobacco consumption.

These results are no surprise. We know that increasing the price of tobacco is the single best action to reduce tobacco consumption and consequently tobacco-related harm.
Raising tobacco excise also encourages people to quit and discourages uptake. Does it mean that Government’s job is done? Of course not. Taxation alone cannot get us to the target without a lot of support from other policy initiatives.

Lifting the game means we go to bat from many different angles.

I’m pleased to see the workshop with Skye Kimura entitled ‘out of sight out of mind’. The removal of tobacco displays from retail outlets has been in force since July this year and has very high levels of compliance with retailers. The world did not end as predicted.

The Māori Affairs Select Committee recommended that infringement notices be introduced to better enforce the law for selling tobacco products to minors, and a tightening of the law to prevent retailers’ trading names from being used to advertise the availability of tobacco. These provisions are now in place.

The Ministry of Health, as you know, is working on plain packaging. I want to thank you all for the magnificent efforts you made to write submissions and encourage others to make their views known on the consultation document. I am expecting to take a paper, reporting on the results of the consultation, to Cabinet soon.

There is more to do. When I spoke in Parliament on the recent tobacco taxation bill, I said how impressed I was with the bold steps being made in Queensland where cars carrying children must be smoke-free and where there are extensive smoking bans in outdoor areas including beaches, sports facilities and children’s playgrounds.

There is excellent work being done by local authorities here in New Zealand on smoke-free areas - encouraged, I know, by local workers in tobacco control, many of whom will be here today.

We need to be clear about what we can achieve, and put the plans in place to make the change.

Almost ten years ago we extended protection from second-hand smoke to schools, pubs, bars and other indoor public places. On 3 December 2003 an amendment to the Smoke-free Environments Act 1990 was passed which had huge implications for schools and early childhood centres, retailers, licensed premises, sports clubs and all employers.

I want to mihi to Tukuroirangi Morgan. It was through his work that the legislation proceeded, although he wasn’t in Parliament at the time this legislation went through.
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These were bold, world leading changes at the time, but we have now been overtaken by others, such as Queensland. Now is the time to consider our priorities and further strengthen some of these protections.

I am interested in your views about how we best advance two particular recommendations of the Māori Affairs Select Committee:

o The close monitoring of progress over the next few years towards the Smokefree 2025 goal, and

o Work to assess the compatibility of New Zealand’s duty-free tobacco concession with the smoke-free 2025 goal. In part the concession undermines the objectives of the tobacco tax increases.

It is also important, in my view that media campaigns are expanded.

We do well now with campaigns to discourage smoking uptake and encourage smokers to quit, and I think of those conducted by the Health Sponsorship Council and the Quit Group, and there is good evidence for quality, targeted, media campaigns that can make a significant contribution to bringing down smoking prevalence – such campaigns may need greater emphasis.

The newly formed Health Promotion Agency has a key role to play here – and I look forward to your enthusiastic uptake of this issue Clive (Nelson) in your capacity as Chief Executive.

We are sitting poised on the verge of some breakthrough change.

The most recent ASH Year 10 survey was very encouraging with smoking prevalence among 14 and 15 year olds at its lowest ever and tobacco consumption has fallen dramatically.

We have made gains, but I am very conscious that they have not been spread evenly across society. The Māori Affairs Select Committee recognised this when it highlighted the significant harms to Māori caused by tobacco and recommended action to address the unacceptable inequities between Māori and non-Māori.

I am pleased that the Ministry of Health is presently seeking proposals to establish a National Māori Tobacco Control Leadership Service which will play an instrumental role in providing the leadership and support necessary for reducing the devastating impact of tobacco amongst Māori.

The focus must move from individuals to whānau if we are genuine about making a difference.

There are also huge issues within the Pacific nations, of which Cook Islanders have the highest rates of any nation. I certainly think the Ministry should be looking specifically at initiatives for Pasifika nations.

Another initiative for which I have high hopes is a fund of twenty million dollars, to be spread over four years, under the umbrella of Pathway to Smokefree 2025. It was announced in Budget 2012. This fund will initiate programmes which support positive and healthy lifestyles free from tobacco. I hope we will be in a position to seek proposals early next year.

Finally I want to encourage this forum to consider the campaign around tobacco control as closely aligned with Whanau Ora. Whānau Ora heralds a transformation in our own lifetimes.

At its heart are New Zealand whānau who have been empowered to transform their own futures by taking control of their lives. This includes refusing to take up smoking and quitting by those who do smoke.

This is exactly the leadership I am talking about – leadership in our own homes, our own style – leadership towards a healthy future. And I reflect that we were not born to a service provider; we were born into a whānau; a family.

The Tūranga is an example of the innovation we need. I like its overarching goal to design, coordinate and implement a programme of innovative research as to how to reach our goal. There is an emphasis on research that can be conceived and deliver programmes and results in a cost effective way in a relatively short time-frame.

This practical orientation is important - the Tūranga’s objectives include providing research that meets the needs of policymakers and healthcare providers for evidence that translates into service development. I also want to acknowledge the outstanding work undertaken by Aspire 2025 and other researchers who are providing the much needed foundation for our future.

There is no better time than the present, to start carrying away the stones in order to move the mountain. We can and must do this together.

I am calling on you all to be the champions you can be - to actively promote our goal of a smokefree society. I also need your ideas. You are the people out in the community who know what will work.

If we do this we will have a Smokefree Aotearoa by 2025. Future generations may well depend on what we do here today.

Tēnā tātou katoa

ENDS

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