Source: Stuff, 30 January 2017
Amid concerns smoking rates may no longer be declining for some
groups, raising the legal age for buying tobacco from 18 is seen by
many as a key weapon in the fight against cigarette use.
But at least one public health academic is not so
sure.
"It's just a way of criminalising people," Massey
University associate professor of public health Dr Marewa
Glover said
Last year, California raised the legal age for buying
tobacco products from 18 to 21, except for active military
personnel. Hawaii also has a minimum age of 21 and there are moves
under way to lift the minimum age in Texas to 21.
According to a paper in the American Journal of Public Health,
at the start of the 20th century more than a dozen US states banned
cigarettes, and at least 14 had set age limits of
21, Time reported.
This country has a Smokefree 2025 goal, aiming to
have fewer than 5 per cent of the population smoking on a
daily basis.
But a paper in the NZ Medical
Journal (NZMJ) last year said current
trends suggested the Smokefree 2025 goal will
not be met, and will be missed by a substantial margin
for Maori and Pacific peoples.
Professor Tony Blakely from the Department
of Public Health at Otago University said much more could be done
to control tobacco use.
Given the Smokefree 2025 goal "it's just
unethical to not lift the minimum age for buying
cigarettes by one year each year. We could do that, just keep
lifting the minimum age of buying cigarettes", Blakely
said.
Tobacco imports could be reduced each year: "We could get
serious about tobacco outlets ... It's crazy to allow that ease of
access."
Glover, who has raised concerns that continuing tax hikes on
cigarettes have got to a point where they are hurting the welfare
of some smokers, said the advice the Government received from
public health academics needed to be reviewed.
"It's all the same old stuff."
There was too little Maori expert input, she said
"There needs to be an inquiry into this punitive, top
down, stigmatising public health approach."
The "very judgmental, moral" approach to public health needed to
be changed, Glover said.
"Academics are claiming we have evidence the onslaught of
increased taxes every year will work. What about the evidence it's
not working for Maori and Pacific people?"
The Smokefree goal of 5 per cent of people
or fewer smoking was a "random" figure. What if the realistic goal,
taking into account factors that made people more likely to smoke,
such as mental illness, was 15 per cent - about the level which had
been reached?
She was concerned the public health system was failing some
groups, Glover said.
"Young Maori aren't concerning me. They are doing better than
ever in a way but their strengths aren't being recognised. They
have to live with an incredible amount of of discrimination and
stigma, and I think they are coping."
The NZHS 2015/16 annual update said 16 per cent of
adults smoked at least monthly, while 14 per cent were daily
smokers. That was down from 20 per cent and 18 per cent in
2006/07.
For youth (aged 15 to 24) daily smoking by non-Maori males
- averaging survey data from 2014/15 and 2015/16 - was put at
15 per cent, while for Maori males it was 27 per cent. Among
females, smoking was at 8 per cent for non-Maori, and 34 per
cent for Maori.
Graphs show a fairly steady decline in daily smoking by surveyed
non-Maori female youth. For the other three youth groups, while the
trend has been downward, in recent years the picture painted by the
graphs doesn't seem so clear cut.
The NZMJ article raising concerns about the
2025 goal looked at daily smoking data from the NZHS, Census
and the Health Promotion Agency's Health and Lifestyle Survey. All
three showed a decline in overall adult daily smoking but there
were important discrepancies, the paper said.
"The Census presents more encouraging results for smoking
decline among Maori and Pacific than the NZHS, with the latter
indicating there has been no statistically significant reduction in
daily smoking prevalence in these groups since 2006/07 (after
adjustment for differences in the population age structure over
time)," it said.