Nash Stuart: Customs and Excise (Tobacco Products—Budget Measures) Amendment Bill — First Reading Second Reading In Committee Third ReadingText is incorporated into the Bound VolumeNash Stuart: Customs and Excise (Tobacco Products—Budget Measures) Amendment Bill — First Reading Second Reading In Committee Third Reading[Sitting date: 26 May 2016. Volume:714;Page:11441. Text is incorporated into the Bound Volume.]STUART NASH (Labour—Napier): I often agree with much of what Mr Tabuteau says but on this point I am going to have to disagree with him. But I will say that I do believe this is not enough. The University of Otago and a number of other studies have concluded that it needs to be at least 20 percent or a one-off shock of 40 percent. But that is no reason in my view not to vote for this bill because anything that increases the price of tobacco is a step in the right direction and let us address the other issues as we go forward.Mr Tabuteau raised an interesting point and it was that all we are doing is taking the money out of the pockets of poor people who smoke and as a consequence of that they will miss out on the necessities of life. But can I quote and it is about a 30-second quote from an academic study that dispels Mr Tabuteau’s concerns around that: “Another issue related to increasing taxation is its financial impact on existing smokers many of whom are welfare beneficiaries or on low incomes. It has been noted that increasing the price of tobacco (which due to addiction is experienced as a necessity commodity) may threaten smokers’ ability to ‘purchase the essentials of a healthy lifestyle’.” The study here is Giskes et al. 2007. “Indeed tobacco companies have cited the link between poverty and ill health as a strategy to argue against significant price increases.” That study is Clifford et al. 2014. “However this ignores the fact that tobacco is responsible for about half the mortality difference between the highest and the lowest income groups”—reference Marmot 2010—“so the health gains from making tobacco unaffordable will be much greater than the health risks posed by the (temporary) additional financial strain this will entail.”This is an important point and it was raised in the select committee because a number of us did question the impact or the burden on the poorest in our society who do smoke. It was acknowledged as a risk but the academics presented three or four papers that actually showed the benefit to society was greater than the risk posed by the financial impact on the poorest in our society and it is the reason why I am supporting this.Tax has two purposes: the first is to raise money and the second is to influence behaviour. The main purpose of this is no doubt to influence behaviour. We want people in this country to stop smoking and we need to send a very very clear signal that smoking is no longer cool. I think this message is getting across the developed world in fact. So when John Travolta lights up on television that is no longer cool; that is exceptionally uncool. We need to send that signal around the image as well.But there are a number of academic studies that show that this is the right thing to do i.e. increase excise tax. Professor Beaglehole and Professor Wilson had a very interesting paper that showed that the increases in excise tax are actually having a diminishing impact because what we are left with at the moment is that those who were going to give up smoking with the 2010 and 2012 increases actually did. We are now left with the real hard-doers—those in society whose addiction is incredibly real and is very powerful. This is why I would like to see this tax hypothecated and by that I mean the money raised from this tax the $425 million raised from this tax go directly to the health budget. Certainly what a number of the papers say is that with the money raised it is imperative that it actually goes towards smoking cessation programmes to really help those who need help.As mentioned in my first speech this is a very powerful addiction. I have read that an addiction to nicotine is actually more powerful than an addiction to heroin. So let us not kid ourselves that just because the price goes up people will go cold turkey the next day. They will not. They need help and we must provide them with that help.Another large international study on the effectiveness of tax and price policies for tobacco control was undertaken by the International Agency for Research on Cancer to evaluate the strength of available evidence across 18 countries on the effects of tax and price policies to prevent and reduce tobacco use. The actual name of the study was Effectiveness of Tax and Price Policies for Tobacco Control. The conclusion was based on extensive evidence reviewed. The recommendation was that “To improve public health by reducing tobacco use governments should adopt relatively simple tobacco excise tax structures that emphasize specific taxes and that include regular tax increases that outpace growth in general price levels and incomes.” But what it also again reiterated was that Governments should use tax revenues “to fund comprehensive tobacco control programs and other health promotion activities” given that such programmes lead to further reductions in tobacco use.So it was with slight concern that I did hear the Associate Minister of Health the Hon Peseta Sam Lotu-Iiga stand up and say that the money raised from this would go towards hip operations and knee operations. There is no doubt that we need further spending in the health sector and Ms King has highlighted this a number of times. But what I would have really liked Mr Lotu-Iiga to do and to work with Dr Coleman is to say: “Hey we’re going to raise $425 million. Let’s put aside $100 million or $50 million or let’s do some studies to really address this problem. We need to put aside a certain amount of money and go out to the public and say that we understand the pain that a number of people are going to go through. As a consequence of that I’m now putting aside $50 million that will increase the size of the Quitline programme or increase funding for a number of smoking cessation programmes by 100 percent or 200 percent or 300 percent.”There are a number of researchers in this country who understand this and understand the magnitude of the problem but who also understand what needs to be done to address this problem and help those who are suffering from a nicotine addiction. I think if the Associate Minister of Health the Hon Peseta Sam Lotu-Iiga worked very closely with the Minister of Health they could come up with a really innovative programme to drive the country towards the 2025 target of being smoke-free.A 1997 study showed that as costs increase smoking becomes less attainable and less attractive to a potential new generation. Louisa Wall actually talked about this. The number of young people who have smoked is horrendous. So not only do we need to target education programmes or help to those who are trying to quit smoking I believe we also need to undertake a new radical and hard-hitting education programme to those in schools. We have got to start with the young people and say: “Hey you know what? This is what smoking can do to you.” Let us get not just at those who are buying the packets with the ugly pictures on the back; let us go to the really young ones and say to them: “You know what? You want to be a cool rugby player? You want to be a star netballer? You want to do well at school? You want to live a good healthy life? This is what smoking does to you—it kills you.”That sounds pretty melodramatic I must admit but the evidence is absolutely overwhelming: smoking kills. We need to get that message out there not only to those who are engaging in the habit at this point in time but also to young people so they are not even tempted to start. The interesting thing is with all due respect to Louisa Wall she said she tried a cigarette due to peer pressure. We have got to change that whole model round so peer pressure is now about how it is incredibly uncool to smoke—do not start. That is the message we need to send out there. We are supporting this bill. We do think the excise tax needs to be substantially higher as indicated by a number of researchers in this country but it is a start. Thank you very much.