Kiwiblog

Martin Johnston at NZ Herald reports:

About 70,000 fewer adults smoke tobacco daily now than three years ago, the latest official survey has found. …

However, a preview snippet of the results, already published on the ministry’s website, says the provisional data indicates that about 17 per cent of people aged 15 or older are daily smokers. That equates to about 600,000 people.

The prevalence was more than one-tenth lower than in 2009, when the ministry found that 19 per cent of adults smoked daily.

Tobacco control and public health advocates have hailed the reduction as a vindication of the Government’s efforts to cut smoking.

It is good news. Almost everyone who smokes, would like to give up – but they are addicted.

The focus should continue to be on policies that actually work at reducing smoking.

Smoking rates

Prevalence of daily tobacco smoking among people aged 15 or older:

23 per cent 2002/03
19 per cent 2006/07
17 per cent 2011/12

The breakdown by gender and ethnicity is interesting. In 2008, the prevalance rates were:

• European women 21%
• Maori women 49%
• Asian women 5%

Also ironically, those who can least afford to smoke, are more likely to smoke. Those in the bottom quintile for deprivation were 2.7 times more likely to smoke than the top quintile.

The average number of cigarettes smoked appears to be 5,000 a year for a smoker, which is 200 packs of 25 a year. At $15 a pack, that is $3,000 a year – to help kill yourself.

Simon Collins at NZ Herald reports:

The ban made all tobacco products and lighters “contraband”, imposing disciplinary consequences if prisoners or guards were found with them.

Dr Lukkien said the ban was effective. Confiscations plunged from 569 lighters and 237 tobacco items in the first month of the ban to two lighters and 12 tobacco items in June this year.

Nurses in all prisons offered nicotine-replacement patches and lozenges to all smokers for up to 12 weeks.

Dr Lukkien said some prisons held barbecues and concerts to involve prisoners in “celebrating” going smokefree, rather than seeing it as a hardship.

A second evaluation, completed this year by Wellington-based Litmus Ltd and Kaipuke Consultants, found that half of the prisoners who had been smokers said they either would not or might not start smoking again after leaving jail.

Excellent. They’ll save money and be healthier.

“Improvements in prisoners’ self-esteem and confidence were also evident. Health staff reported prisoners telling them that having given up a nicotine addiction means that they feel they can give up other addictive behaviour also.”

And drug and alcohol addiction is a major issue with prisoners.

Stuff reports:

Winston Peters has criticised the anti-smoking lobby and Maori leaders, saying ordinary Maori are being saddled with a massive tax on smoking most of them don’t want.

Translation: Winston’s addiction is costing him money. I’ve got a solution for poor old Winnie though. The Government could add Quitline to the list of Super Gold Card services!

Mr Peters also questioned why the Japanese lived so long and have low rates of heart disease and stroke when they have the world’s highest smoking rate and said obesity was the main health concern for Maori, not smoking.

Oh dear, Winston must be lining up to be Health Minister in a Labour-led Government.

Incidentally Winston is wrong. The smoking rate in Japan is 24%. A Gallup poll found 21 countries with a smoking rate of over 30%.

Isaac Davidson at NZ Herald reports:

Corrections Minister Anne Tolley says a smoking ban in prisons has drastically reduced fire-related incidents and dangerous activities, while improving air quality for inmates.

Mrs Tolley said safety in prisons had improved since lighters and matches had been taken from inmates a year ago.

Officials said fire-related incidents fell from 76 in 2010/11 to 21 in 2011/12.

The smoking ban was introduced in July last year after a 12-month campaign to encourage inmates to quit.

“It has also removed the opportunity for prisoners to use lighters to melt plastic into dangerous weapons,” Mrs Tolley said.

She said a study of Auckland Prison found air quality had improved significantly and fewer respiratory illnesses had been reported.

“Despite scaremongering before its introduction, the smoking ban has been a real success. Staff and prisoners will continue to be offered nicotine replacement therapy, as part of a wider plan to treat offenders with addictions.”

I recall the predictions of riots!

Labour’s Iain Lees-Galloway has said:

The Government is deliberately ignoring health data that doesn’t tell the story it wants the public to hear, Labour’s Associate Health spokesperson Iain Lees-Galloway says.

“Statistics collected by the Ministry of Health reveal that every district health board (DHB) except one is failing to get close to acceptable rates for early smoking cessation intervention.

“The Government wants us to believe it has made smoking cessation a priority. These figures highlight the reality – it hasn’t, “Iain Lees-Galloway.

“The Ministry of Health expects 90 per cent of smokers who see a GP to be provided with advice and help to quit, yet only one DHB is reaching that target.

“No other DHB is even close. In fact, on average they are underperforming by 57%.

“Tony Ryall, of course, is allergic to bad news, so these figures never get reported.

 “Interestingly he talks up statistics around smokers who end up in hospital* and the advice they get there.

“But only reporting smoking cessation activities in hospitals is ludicrous. Far more people see their GP than go to hospital.

This is an interesting issue. Lees-Galloway is taking about two seperate things – the proportion of smokers who see their GP who get advice and help to quit, and the proportion of smokers in a hospital who get advice and help to quit.

The hospital figure is the official national health target. It was 90% and has just gone up to 95%. The DHB average was 95% in the first quarter of 2011/12 and slipped back to 89% in the second quarter. Six DHBS made 95% and 12 made 90%, while eight did not.

Now hospitals are actually run by DHBs. DHBs control hospitals. A DHB has the ability to put in place policies around offering quit smoking services to patients. Also be aware that the average person spends hours or days in hospital, so it is easier to do something additional to the reason they are in hospital.

GPs are not employed by DHBs. They are private entities, that only get a portion of their income from the Government. The ability of a Government to get GPs to do something is very limited, and frankly it is silly of Lees-Galloway to think they can.

Now from what I can tell, the DHBs only started funding GPs to even code their patients as to whom are smokers and non-smokers. Sure it is recorded in notes in long-hand, but it is a big job to go through every file and mark them in the database as a smoker.

The new target for GPs only started this year, and they noted:

Unlike the other health targets, this measure started from scratch as provision of advice and help to smokers was not recorded previously nor even offered routinely.

So imagine what is involved to get every GP in NZ recording the status, and then also recording if they offered quit smoking assistance. I’ve worked in a medical centre. The average visit is around 15 minutes, and covering anything apart from the immediate problem slows things down a lot. Now this is not to say it is not a good idea – it is. But expecting 90% achievement in the first year is silly.

The data is from the annual ASH survey of Year 10 students, which has around 30,000 responses.  That’s a really good trend. 12 years ago 70% of Year 10 students had smoked, and now it is 30%. What do readers think is the reason? Peer pressure? Price? Law changes?

A huge difference by ethnicity. In 2011 they are:

• Have smoked - European 23.5%, Maori 53.8%, Pacific 38.9%, Asian 11.7%
• Regular smokers – European 5.6%, Maori 18.1%, Pacific 10.7%, Asian 2.6%
• Daily smokers – European 2.4%, Maori 10.3%, Pacific 5.9%, Asian 1.2%

However Maori Year 10s have had the biggest decline over the period also.

Christopher Snowdon from the Adam Smith Institute blogs on the push for plain packaging the the UK:

The coalition of state-funded anti-smoking groups have started revving up their trusty public relations machine for yet another legislative campaign. While their temperance counterparts concentrate on minimum pricing, the anti-tobacco lobby has its heart set on ‘plain packaging’.  …

It is one thing to force a manufacturer to label a product with a warning, but quite another to confiscate the packaging in its entirety to create public propaganda from private property. Rather than helping people make informed decisions, it seems that the overriding goal of plain packaging is to annoy the tobacco industry, inconvenience retailers and stigmatise consumers. Few of us will feel especially sympathetic towards the cigarette companies, but hard cases make bad law and the senseless trampling on property rights, along with the likelihood that the temperance lobby and diet police will emulate the anti-smoking trailblazers (as ever), has implications that go far beyond tobacco.

That is my concern. Already some in the temperance lobby are pushing for all beer and wine to have nothing on its label except required factual information. So if they get plain packaging for cigarettes, then the push will be for beer and wine also to follow suit, and then of course food that is disapproved of.

Secondly, there are sound consequentialist grounds to oppose the policy. There is no evidence whatsoever that the sight of a cigarette pack encourages nonsmokers to take up a notoriously unhealthy habit, and even ASH do not claim that it will have any effect on existing smokers. Numerous focus groups, including ASH’s own “citizen’s jury”, have expressed profound scepticism about the prospects of plain packaging lowering the smoking rate. 

There are a number of initiatives that could well reduce smoking rates, but I tend to agree that plain packaging is not one of them. I doubt it would stop a single person from smoking.

I blogged yesterday about a study that concluded fewer people would take up smoking socially if smoke-free rules extended to areas outside bars.  It was based on a massive 13 interviews.

I wondered how many media outlets reported this study, and how many used their judgement that there is nothing newsworthy in a study of 13 people that purports to reach conclusions that are applicable over the entire population.

Well the answer is depressing. This is a list of media outlets that gave near uncritical coverage to this study of 13 people.

1. Radio 531pi (news)
2. Radio Live Drive (Brent Impey)
3. Radio Rhema (Andrew Urquhart)
4. Newstalk ZB (Larry Williams) (which to be fair had a go at the small size)
5. Radio Dunedin
6. Radio Rhema (news)
7. Radio Live (news)
8. Stuff website
9. Herald website
10. Adelaide Advertiser
11. Launceston Examiner
12. ODT
13. NZ Herald
14. ODT (again)
15. TVNZ7 6 pm News
16. TVNZ7 News at 8

Not bad for a study of 13 people – more media mentions than actual participants.

Stuff reports:

New Zealand researchers believe fewer people would take up smoking socially if smoke-free rules extended to areas outside bars.

The researchers from Otago and Massey universities carried out 13 in-depth interviews with people aged between 19 and 25 in Auckland and Dunedin early in 2011.

Their results have been published online in the journal Tobacco Control.

A study of 13 people? God help me.

The researchers noted that, as with all small scale qualitative research, their study had limitations. 

No kidding.

The Herald reports:

Health bosses want the Auckland Council to ban smoking in all public outdoor areas in the city in a bid to stop children picking up the habit.

The proposed ban would include the city centre, parks, playgrounds, sports grounds, stadiums, parts of beaches, council-controlled land such as around the Auckland Museum and art gallery, and events supported by the council, such as Pasifika.

Why not just go the whole hog and have summary executions of people caught smoking? That would be far more effective in encouraging children not to smoke.

One drawback of an execution policy is that Auckland could suffer significant population loss. So to ameliorate the effects, perhaps adopt the Roman decimation policy – just kill 1 in 10 smokers?

The Press publishes this very useful article from Eric Crampton:

You could be forgiven for thinking that the health system could save $1.9 billion if tobacco had never existed. That’s what the Ministry of Health says smoking costs the public health system.

But, you’d be wrong.

The ministry’s latest estimate of the cost of smoking has nothing to do with the costs that smokers impose on taxpayers or the costs that could be avoided if smoking were to disappear.

Rather, it’s a politically convenient number whose promotion has much to do with gaining voter support for anti-tobacco initiatives and nothing to do with real economic costs.

I was pretty surprised when this figure started being cited earlier this year. It was much higher than the previous estimate of $350 million dollars – a figure produced not by the Big Tobacco lobby but rather by Des O’Dea in a report commissioned by anti-tobacco crusaders Action on Smoking and Health.

So the costs have gone from $350, to $1.9b – how did they achieve this?

After sorting the population by age, gender, income, ethnicity and smoking status, they then compared the costs of providing health services to smokers as compared to nonsmokers for each group.

The excess costs of the smoking group were tallied up to produce the $1.9b figure.

So what’s the problem?

It’s easiest to think of smoking as bringing forward a whole lot of end-of-life costs.

Smokers die earlier than nonsmokers.

We know that.

And the costs to the health budget of somebody who is dying are rather higher than the costs of somebody who is healthy.

But everybody dies sometime and most of us will incur end-of-life costs that will be paid for by the public health system.

Suppose that a smoker will die at age 65 and a nonsmoker will die at 75. Comparing 65-year-old smokers to 65-year-old nonsmokers and calling the difference the cost of smoking then rather biases upwards the measured costs of smoking.

We ought to be comparing the health costs of a smoker dying at age 65 with the health costs of a nonsmoker dying at age 75.

Yes. This is what I assumed was done. But obviously it did not produce a big enough figure.

The figures assume that in the absence of smoking, smokers would never have imposed end-of-life costs on the health system. But for their smoking, all smokers in this scenario would have died of a sudden, and cheap, heart attack and would only have had average health costs up to that point. That’s clearly nonsense, but the $1.9b figure only makes sense if it’s true.

So the $1.9b is a useless figure. Sadly I doubt it will stop people citing it.

If smoking disappeared tomorrow, your taxes would have to go up to make up the difference. Thank the next smoker you meet for helping to keep your taxes down.

And be as sceptical of numbers coming from the Ministry of Health as you would be of numbers produced by the tobacco industry. Neither is a disinterested party.

Indeed.

The Herald focuses on Fiji:

The second was the introduction of a grandly titled Media Industry Development Decree. It means, among other things, that the Fiji Times, the country’s oldest and largest newspaper, has three months to remove Rupert Murdoch’s News Ltd as its owner or face closure.

If the first development borders on farce, the second should remove any lingering illusions about the regime’s view of democratic niceties. The decree effectively eliminates freedom of expression in Fiji.

Aside from the restriction on foreign ownership, a tribunal has been established to ensure nothing is printed or broadcast against the “national interest or public order”.

In essence, Fijians will no longer know what their rulers are up to. Special attention is being paid to the Fiji Times because, according to the Attorney-General, it has been “the purveyor of negativity, at least for the past three years”.

The move against the media is part of an ongoing removal of Fijians’ rights. This has included the abrogation of the constitution, the squashing of dissent and the dishonouring of pledges for a return to democracy.

There is sadly no evidence that there will be a return to democracy. I can’t see a scenario where the Commodore will give up power and let Fijians actually decide on their Government.

This step should also occasion a rethink by New Zealanders who spend their holidays in Fiji. Tim Pankhurst, of the New Zealand Media Freedom Committee has suggested a boycott.

He has a point. Tourists might like to say that Fijian businesses and jobs should not be penalised for the sins of the regime. But they are undermining their own country’s diplomatic efforts.

Fiji’s tourism-driven economy attracts 60 per cent of its patronage from New Zealand and Australia. No official boycott can be imposed, nor should it be.

But a rethink by would-be tourists would apply further pressure. And if, ultimately, it is up to the Fijian people to send Commodore Bainimarama back to the barracks, tourists temporarily moving away from Fiji for other Pacific destinations would hammer home a message about the pariah status of their rulers.

Rather than out all the onus on consumers, the media could play their part. Rather than just write editorials, APN and Fairfax could refuse to accept advertising for Fiji tourism. That would be a sign of solidarity with their colleagues in Fiji, and show real commitment rather than just words.

The Press lashes FIFA:

Football prides itself on being the “beautiful game”, but the current World Cup in South Africa has been marred by too many ugly refereeing decisions.

One of the most egregious occurred this week when England’s Frank Lampard was not awarded a goal against Germany despite the ball clearly crossing the goal line after hitting the crossbar.

This must serve as a wake-up call for Fifa boss Sepp Blatter and his top officials to get their heads out of the sand and harness the electronic technology successfully used by so many other sports.

It is a no brainer.

The Dom Post looks at smoking in prisons:

But surely an outright ban goes too far? How about halfway measures first, such as a prison smoking-room, or a ban on smoking in cells? If she is wedded to a total ban, what are known as “cessation assistance” programmes – already available to anyone, including the incarcerated, who want to quit – must be funded appropriately. …

As usual with any broadbrush proposal, the devil will be in the detail. But that detail should acknowledge union unease. The minister has already attended the funeral of one prison guard this year – a political show that bore an uncanny resemblance to former prime minister Helen Clark’s infamous appearance at the Folole Muliaga funeral in 2007. Ms Collins does not want the option of attending another.

What an incredibly stupid comparison, in terms of funerals. Jason Palmer was employed by the Government and died doing his job, and as a result of his job. I don’t know anyone who thinks a Minister should not attend the funeral of law & order professionals who get killed by criminals. In fact it is almost disrespectful not to go.

What that has in common with the circus generated around the Muliaga’s I don’t know.

The ODT also looks at smoking:

With this background, it may have surprised some readers to learn that the inmates of our prisons are permitted to smoke, including in their cells, unlike in Canada, some British prisons, and those in some Australian states, where the practice is banned.

The intention of the Minister of Corrections to ban smoking in our jails from July next year is certainly easily justified on health grounds alone, and the overseas precedent suggests the fears being raised here by vested interests are largely groundless. …

Objectors have raised two main issues: the right of prisoners to smoke in what is effectively their “own home”; and the potential for violent reaction from prisoners required to cease smoking.

The first claim is groundless.

Prisoners are, in effect, tenants.

The State, as landlord, can and does impose conditions of use.

Additionally, prisoners who do not smoke – and prison guards – are entitled to not be confined in conditions where their own health may be damaged by second-hand smoke.

The department has anticipated prisoner reaction by giving a year’s notice of the measure, and by its intention to offer a cessation programme, including nicotine replacements, for those who seek such help.

That approach is not unreasonable.

Meanwhile 65% of people in Labour’s poll say they back the ban, so I expect we will see them come out backing it shortly.

The Press examines the smoking ban in prisons:

From the middle of next year New Zealand’s prisons are set to emulate Australia’s and become smokefree.

It is a long overdue move. It was an anomaly that prisoners could still smoke in their cells as the rest of New Zealand moved increasingly towards a no-smoking regime.

School grounds, hospitals, and other government departments have gone smokefree, as have bars, restaurants and businesses, and, in Christchurch, there is even a smokefree policy in parks.

For many prisoners – two-thirds of inmates – an enforced cold turkey regime will seem a hardship or even a civil rights breach. But those who have committed crimes against society should not expect the right to smoke, just as they cannot legally have alcohol and drugs.

What amuses me is the policy dilemma for Labour. They instinctively are in favour of anything that is anti-smoking but against anything that they see as punitive to prisoners.

So how does Labour solve this dilemma? They run a blog poll to decide their policy

The Dom Post looks at the trans-Tasman relationship:

When Julia Gillard became prime minister of Australia, Prime Minister John Key was the first foreign leader to phone in his congratulations.

He needs to hope his fast dialling finger will deliver a better result than his predecessor, Helen Clark, achieved with her swift flight over for a cup of tea with Kevin Rudd when he got the job – in his time as prime minister Mr Rudd never quite made it to New Zealand for an official visit.

Mr Key, like Miss Clark before him, is smart enough to realise the onus is on Wellington to keep reminding Canberra what the “NZ” stands for in Anzac. The reality, however unpalatable it might be to some, is that New Zealand is simply not as important to Australia as Australia is to New Zealand.

Australia is New Zealand’s most important trading partner and its most important security relationship. …

Talk about whether New Zealand and Australia should take their relationship to the next level and look at issues such as a common border can wait until the Australian election is over.

Mr Key’s job is to ensure New Zealand’s interests are not damaged in the meantime.

Miss Clark and John Howard reportedly enjoyed a warm relationship despite their different political ideologies. The hope must be that the state-house son of a refugee and the daughter of a 10 immigrant from Wales can do the same.

The irony is that PM from opposite parties seem to have got on better than PMs from the same side of the spectrum.

The ODT looks at OSH:

It is one of our cultural stereotypes: the rugged, versatile, no-nonsense farmer – the sort of person for whom most regulations are made by townies for townies who have no real understanding of the demands and constraints of a working life in the country; and, further, how the red tape that such people unhesitatingly impose on the rural sector can seriously impact on proven working methods and productivity.

In no other sphere is this more pronounced, or more irritating to some, than on-farm safety: the rules and regulations promulgated by the Department of Labour, Occupational Safety and Health and ACC are frequently seen as at best a brake on freedom and individual responsibility and, at worst, the interfering actions of bureaucrats and the “politically correct”.

Sadly, the reality is that such organisations have reason to be concerned.

According to the latest figures released by ACC, farmers are killing themselves in work-related accidents at the rate of one every 28 days.

Last year, 13 farmers died in accidents on New Zealand farms.

There were 18,600 injuries on farms, with quad bikes, farm machinery and poor animal handling featuring as the most common causes.

Raw figures by themselves mean little. What would be more useful is the injury rate per employee.

The Herald reports:

Taxpayer-funded health officials are calling on the Government to increase tobacco tax and ban smoking in many outdoor public areas such as beaches.

The call from the Auckland Regional Public Health Service for a range of tough measures comes in its submission to the Maori affairs select committee’s forthcoming inquiry into the tobacco industry and the effects of tobacco use on Maori. …

The Auckland service wants the law banning indoor smoking at workplaces extended to playgrounds, outdoor eating areas, beaches, the area outside buildings, cars when a child aged less than 16 is present, public transport stops and pedestrian malls.

I think there is a case for restrictions in playgrounds and cars with children in them. I accept a role to protect kids. But decisions on pedestrian malls and building exteriors are best left to the owners of those places.

The recommendations:

* Ban smokers from outdoor public areas such as beaches.

I’m not sure why beaches should having smoking ban. There is no risk of passive smoking on beaches.

* Increase tobacco tax by 5 per cent plus inflation per year.

Fairly relaxed over that.

* Dedicate portion of tobacco tax take to tobacco control and quit-smoking services.

Seems sensible.

* Ban tobacco vending machines.

Now while it is a legal product.

* License tobacco retailers.

Why?

* Compel tobacco firms to disclose product specifications and marketing strategies.

Product specifications yes, marketing strategies no.

The Herald reports:

A proposal to license tobacco retailers and turn cigarette packs into plain packages bearing only health warnings has found strong support.

Now when I read that, I think of opinion polls and assume people have been talking to members of the public at large. But reading on we find:

In planning for the “end game” of widespread tobacco use, researchers canvassed public health physicians, policy officials in the Ministry of Health and other departments, and journalists.

I don’t think canvassing public health physicians, policy officials and journalists is the same as canvassing the public.

It’s like canvassing gang members in Wanganui on the gang patch ban, and concluding there is strong opposition to it.

I’m not actually against sensible initiatives that seek to reduce the incidence of smoking. But I urge caution against concluding that because policy officials think something is a good idea, that means the public will agree.

Aaron Bhatnagar blogs that a City Vision Councillor voted to ban smoking outside in the Auckland CBD.

Why not just cut out all the in between steps, and just start shooting smokers?