Hague Kevin: Excise and Excise-equivalent Duties Table (Tobacco Products) Amendment Bill — First Reading Second Reading Third Reading 
Hague Kevin: Excise and Excise-equivalent Duties Table (Tobacco Products) Amendment Bill — First Reading Second Reading Third Reading 
[Volume:662;Page:10567] 
KEVIN HAGUE (Green) 
: 
 I begin by learning from Paul Hutchison’s experience and saying that the Green Party understands the reasons for extraordinary urgency on this occasion and supports it. It will be my great pleasure to support the Excise and Excise-equivalent Duties Table (Tobacco Products) Bill. It is an honour to speak in the same debate with the Hon Tariana Turia the Associate Minister of Health—and I congratulate her—and the Hon Annette King who also played a really important role in this country’s progress against smoking. 
Other speakers have commented on the size of this problem. We are talking about the single greatest cause of premature death in this country causing somewhere between 4500 and 5000 unnecessary deaths each year. I take the point that Ruth Dyson made about the increased morbidity associated with smoking. I live on the West Coast and I have had responsibility for the West Coast’s health services. I report that the West Coast has one of the highest rates of cigarette smoking in New Zealand. When I was responsible for the West Coast health services there was constant frustration for me that so many people were dying unnecessary premature deaths. Much of our health service resources needed to be invested in caring for those people and were therefore unable to be used for other purposes. I am sure that the West Coast will welcome this move. 
I also comment on inequalities. The incidence of cigarette smoking is a major reflection of inequalities in New Zealand. According to data from last year our overall smoking rate amongst adults is 21 percent but for Maori it is over 45 percent and for Pacific people it is over 31 percent. That is a major reflection of inequalities in this country. Further in relation to socio-economic status people in the most deprived areas are more than one-and-a-half times more likely to be smokers than those in the least deprived areas. So smoking is a major reflection of socio-economic and ethnic gradients in this country. 
There is some good news: overall smoking rates are declining. Consumption of tobacco products reduced by a third in the period from 1997 to 2008 which the Hon Annette King referred to. That is good news. Also half of 15 to 19-year-olds in 2008 had never tried smoking. That was a very significant increase on the 39 percent in that category just 2 years earlier in 2006. We are making some really good progress so now is the time to ramp up our momentum not to ease off; I commend the Associate Minister of Health for her initiative in this area. 
We are also learning a lot about what makes a difference and about how to do this better. Certainly nicotine replacement therapy as the Hon Annette King just referred to is one of those things that makes a difference. On average a person will make seven attempts to quit before he or she is successful but each of those attempts is twice as likely to succeed if nicotine replacement therapy is used. That is a really important piece of information. In relation to this bill we know that price is an effective mechanism in changing demand. On several occasions now we have referred to the 2000 increase—Paul Hutchison and Annette King referred to it. In 2000 the excise tax was increased by 20 percent and smoking rates dropped by 18 percent. That was a very clear demonstration of that link: increasing the price is effective in reducing demand. 
As Annette King talked about we know that other things would also be successful. I certainly look forward to this House debating a comprehensive range of measures to effect the biggest hit that we can possibly make in tobacco control. The display of tobacco products is an issue that would clearly make a significant difference. The restriction of outlets at which tobacco products are available would also make a difference as would the extension of the Smoke-free Environments Act into other areas. All these areas would make a significant difference and we should be debating and pursuing them. Interestingly the content of cigarettes is also an area that could make a significant difference. 
I particularly pick up on Paul Hutchison’s reference to the Doll and Hill study from I think 1956 which made the conclusive link between cigarette smoking and lung cancer. Effectively that was the birth of a health education approach for our modern era to try to deal with some of the health problems we face. It seemed kind of obvious: if a behaviour is the cause of ill health and other behaviours are available to a person then if we provide more information about the positives and negatives and more education people will choose the healthier option. That is the theory and it is completely wrong. It kind of works for those who have a greater sense of control over their own lives; certainly since 1956 we have seen that in the higher socio-economic grades. Amongst Pakeha New Zealanders for example smoking rates have declined extremely substantially but less so amongst Maori less so amongst Pacific people and less so amongst those who are the most socio-economically deprived. Why is that? It is because this behaviour is not really a choice as with so many of our behaviours. 
Health status reflects a couple of things. It reflects the level of empowerment of a particular community and it reflects the kind of environment that surrounds that community. Health promotion says that if we want to make a difference we need to empower communities especially those that are the most deprived and we need to create environments that facilitate better health outcomes. We do that through community development we do it through creating healthy public policy such as this bill and we do it through personal skills and reorienting health services. I look forward to those things being included in our comprehensive approach. 
The other point to make is that although we are adopting this approach to tobacco in the House today—and it seems that we might have a near consensus on that point—tobacco is one of three big issues that have a really huge effect on New Zealanders’ health status. One of the other two that I draw attention to is the kinds of foods that we eat and the exercise that we do which contribute to cardiovascular disease cancer and many other causes of ill health and death. The other is alcohol. It is an extreme irony to me that in the House today we are debating a systematic approach of increasing the excise tax on tobacco which we know will have an effect on tobacco consumption and will improve New Zealanders’ health status on the day that the Minister of Justice has ruled out an increase in excise tax on alcohol. We know those excise tax increases would reduce alcohol consumption and would improve New Zealanders’ health status. There is an irony. I hope that as a Parliament we are able to learn from this case study and to extend that approach of regulation—a regulatory approach to improving health—to those other areas. If we can learn then the gains that we can make will be extremely substantial. 
I again congratulate the Minister and the Government. The Green Party will support the bill.