Hague Kevin: Smoke-free Environments (Controls and Enforcement) Amendment Bill — Third Reading 
Text is incorporated into the Bound Volume 
Hague Kevin: Smoke-free Environments (Controls and Enforcement) Amendment Bill — Third Reading 
[Sitting date: 14 July 2011. Volume:674;Page:20128. Text is incorporated into the Bound Volume.] 
KEVIN HAGUE (Green) 
: 
 Tena koe Mr Deputy Speaker. Nga mihi nui ki a koe. Others in this debate have already mentioned the 5000 deaths per year from smoking-related diseases. When we reflect on the work the Health Committee has done and on the succession of members of this House who referred to that number extensively in the Committee stage debate on the Smoke-free Environments (Controls and Enforcement) Amendment Bill we see that it has been the number of deaths it has been the years of life lost it has been the much larger number of people whose quality of life has been compromised every year and it has also been the economic cost of that sickness and death that have formed the backdrop of the determination to take effective action. 
We had an interesting discussion in the Committee stage on what the correct historical antecedents were. Paul Hutchison the chair of the select committee referred to a 1960 Richard Doll paper. Personally I go to Doll and Hill in 1956 as my marker of the first study that authoritatively linked lung cancer and cigarette smoking. That is important because one of the arguments heard against legislators such as us taking action against the power of the tobacco industry and taking action to control tobacco is the argument of individual choice. There certainly is in health theory a strand of thinking that says that individuals make choices. I link this back to an even earlier date: 1776 Adam Smith and his  
Wealth of Nations. 
 He sets out a philosophy that says that individuals consider the benefits and costs of potential courses of action and then choose on a rational basis the one that has the best balance of benefits and costs. When we link that into evidence about disease that is non-communicable but is linked instead to a behaviour it leads to a strand of thinking that says that individuals make rational choices about their lifestyles and therefore it is not up to legislators to step in to interfere with those. 
The problem with that thinking is this: it fails to explain the pattern of health and disease we actually observe. If the pattern of cigarette smoking we see in New Zealand were explained by rational choices then something truly extraordinary would be going on because the rates of smoking amongst Maori amongst Pacific Islands people and amongst poor people are very much higher than the rates amongst those who are relatively better off in society and those who are relatively privileged in society. We could conclude only that smoking and all of the tobacco-related disease that is associated with it is effectively a disease of marginalisation. That says that a model based on the idea of individual choice fails to explain what we actually see and that a model based on providing people with more information so that they will make better choices will also fail. That is why we have to step in. We have to step in to address the environments that surround those marginalised populations. 
Coincidentally Paul Hutchison this morning hosted a breakfast here in Parliament for Sir Michael Marmot who was formerly the chair of the World Health Organization Commission on the Social Determinants of Health. Sir Michael gave a fascinating discourse on those environmental determinants. In passing I thank Paul Hutchison for hosting that and the New Zealand Medical Association which has been hosting Sir Michael’s visit. That theory of environmental determinants sets out to address the risk environments in which populations find themselves: the risk environments of racism the risk environments of poverty and those other social and economic inequalities in our society. Effectively those environments and the environments this bill seeks to address—the immediate environment of advertising both on the internet and in retail stores—create a “smoke-ogenic” environment. This bill is a substantial step forward in addressing that. Ultimately we will need to create a fair and just society in which those structural inequalities are addressed and eliminated. Ultimately we will need to do that and we need to work towards that goal. 
In the short term I would like to celebrate the achievement of Associate Minister of Health Turia and others in bringing this bill to the House and seeing it through. I know there will be people from those various passionate community groups that Minister Turia and others have referred to who are watching this debate and listening to it both in the gallery and at home. I know they will feel a sense of pride and achievement in this major step forward. I thank them for their contribution. I think members will be aware that at earlier stages of the debate I pushed for this bill to go a bit further than it does. I am sorry it did not do that but today is a day for celebrating what the bill does because it will make a major contribution. 
In closing I say as indeed others have in this third reading debate that this is not the end of the journey. As Paul Hutchison said there is still a very long way for us to go. I turn once again to the findings of that landmark inquiry by the Maori Affairs Committee. Let us celebrate this achievement today but tomorrow set ourselves up for the next step forward—the next step that will implement the rest of the recommendations of the Maori Affairs Committee. Kia ora tatou.