Should NZ lift the legal age for buying tobacco to 21? Monday, 30 January 2017

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.