Biennial Oceania Tobacco Control 2013

It is with real pleasure that I join you at the opening of the Biennial Oceania hui.  I am pleased to see so many here who are doing such important work in tobacco control.

Your conference theme says it all:  "A Smokefree Oceania: getting there together".

As a region we are making great progress in tobacco control.  I was extremely heartened to hear that the Pacific Health Ministers supported the adoption of the Tobacco-Free Pacific Goal by 2025 at the Tenth Pacific Health Ministers Meeting held in July. 

We must continue to work together, and to support and learn from one another.  It is great to see the World Health Organisation’s regional office represented here today as they play a key role in aiding these regional endeavours.  The Framework Convention on Tobacco Control also provides an excellent framework for countries to work together.

Some years ago, we might have all thought the dream to be smokefree was exactly that – a dream.  

Today I pay tribute to all those champions in this room who have turned the dream into reality, through sweat, determination and hard work.

A couple of months ago, the world celebrated the fifty year anniversary of a man whose greatest legacy was articulated in the now legendary “I have a dream” speech delivered in the 1963 March on Washington.

It is fitting, therefore, to reflect on the lessons of life left us by Dr Martin Luther King, about his experience of change:

“Human progress is neither automatic nor inevitable…..every step towards the goal of justice requires sacrifice, suffering and struggle; the tireless exertions and passionate concern of dedicated individuals.”

Now for all of you who may think what you do each day is just part of your nine-to-five job; the outputs and activities of your role as a health promoter; a clinician; an educator; a researcher; a field worker – I encourage you to think again.

The goal to achieve a Smokefree Oceania is a mission of life - and I mean that literally.      Our concerted goals across the Pacific, Australia and Aotearoa are to reduce smoking prevalence and to prolong life for future generations. 

I know, full well, that such a pursuit has required the tireless exertions, the sacrifice and passion of the Triple A: an entire army of Advocates, Analysts and Advisors.  As we open our conference I want to extend my gratitude to you all for the difference you are making in this ultimate race of life.

I turn now to acknowledge our guests from around the Pacific and Australia, to extend a welcome to you all including:
·       Dr Temo Waqanivalu, World Health Organisation Representative Office in the South Pacific, Suva;
·       Adjunct Associate Professor Tom Calma (National Centre for Indigenous Studies);
·       and someone we know well, Dr Colin Tukuitonga (who is now Director of Public Health at Secretariat of the Pacific Community, Noumea).

A particular thank you goes to Dr Jan Pearson, Conference Chair, and Murray McCormick, President of the Cancer Society for leading the organisation of this conference.

Can I also extend my congratulations to Stephanie Erick who has just been appointed the new Director of ASH New Zealand.  I look forward to working with you.

It is an honour to be hosting Oceania 2013 in Aotearoa.

It is particularly timely to think about New Zealand’s situation, as we look back over the last few years of some fairly exciting tobacco reform.

In March 2011 our Government adopted the goal to be essentially a smokefree nation by 2025.   This was in response to the recommendations of a landmark parliamentary tobacco inquiry by the Māori Affairs Committee; and ever since, has remained a beacon of hope for us all in our quest to reduce smoking prevalence and tobacco availability to minimal levels. 

Like the 2018 smoking targets adopted at both state and federal level in Australia, in New Zealand we have negotiated a set of mid-term targets in the Ministry of Health’s Statement of Intent.  Those targets aim to reduce daily adult smoking prevalence down to 10 percent by 2018, and to at least halve the stubbornly high rates among Maori and Pasefika peoples.

The differentiation of smoking rates by ethnicity is something I am extremely concerned about.  
While the smoking prevalence in 2011/12 for adults over 15 years was 16.5%; it was much higher for Pasefika at 23.1% and Maori 38.4%. 

I cannot regurgitate those rates without thinking of the wider whanau beyond them.   I think about the impact as seen in our family cemeteries – too many relations who have left the world before their time, damaged by the devastation that tobacco wreaks on their lives; and general capacity to thrive.

This conference then, deals with the facts of these fatalities, through four broad lens:
·       Increasing effective cessation
·       Regulating and legislating
·       Reducing Initiation and
·       Exposing risks to the goal.

The first theme, then increasing effective cessation. Over the last four years, we have set “Better help for smokers to quit” as one of the Government’s six priority health targets.

The target requires 95% of all hospital patients who smoke to be given brief advice to quit and offered evidence-based cessation support.  The target has since been extended to primary care as well, where at least 90% of smokers seen in general practice should receive the same intervention with a special focus on women who are pregnant.

I am very aware that for change to be enduring we also need to be proactive in supporting positive and healthy lifestyles free from tobacco and which can produce results. 

A major priority for me in this regard is the Pathway to Smokefree 2025 innovation fund.  $5 million a year has been set aside to fund innovative programmes - of which quite honestly we are spoilt for choice.

The first fourteen contracts have been let and I thank all those organisations who put in tenders and I am sure there will be discussion of some of these projects at this conference.  The second round of registrations of interest closed just last week and I am told we have another sixty proposals to consider, which is fantastic!

In thinking about the second theme of regulating and legislating, I want to recognise the incredible momentum that we have benefitted from in advancing plain packaging.

Of all the areas where we can help and learn from each other the development of strong comprehensive legislation and policy reform in ‘plain packaging’ is particularly important.

It has now been over a year since Australia’s tobacco plain packaging restrictions started to come into force. 

Nowadays, the only cigarette packs on sale in Australia have been in the prescribed drab brown colour with the enhanced graphic health warnings.  And not a trace of tobacco company branding imagery to be seen – just a simple brand name in a plain type face.  As my mokopuna would say, it’s awesome! Or maybe in this case she would say it is awful!

Ten months down the track, all the signs are the policy is working exactly as intended.   The evidence is telling us smokers are being put off by the plain packs.  They now think the same cigarettes are lower quality, and they find them less satisfying.  And they think more and more about quitting.  The Australian packs are in fact so off-putting; they have even won an international marketing award for how skilfully they have been designed to be a turn-off.

Other research here in New Zealand and overseas builds the scientific case that tobacco products in unbranded packs with prominent health warnings are unattractive to young people and help dissuade them from taking up smoking at all.
Further research and evaluation of the impact of plain packaging is underway, and we can expect to start to see the results next year.  I am confident this will confirm that plain packaging works and that it is the right thing to do. It is such an important final step in preventing the tobacco marketers from pushing their product. 

However, it is important to remember that no-one is expecting to see a large or sudden drop in smoking prevalence immediately following the introduction of plain packaging.  We need to be watchful that this is not put up as a false standard of success by the tobacco industry or the bloggers and any other media that they continue to be able to influence.

We must not be distracted from the pivotal change that has occurred.  Young people are being put off ever starting or even thinking about starting.  Smokers have another strong signal and a frequent reminder to prompt them to at least try to quit.  Alongside increases in tobacco excise tax and other measures, we know that this will flow through to lower smoking prevalence.

The important message for you here today is to reconfirm that our Government is committed to introducing plain packaging as part of our drive to Smokefree 2025, and we are continuing to progress the legislation and regulations to make this a reality.
When I secured Cabinet’s agreement to proceed in February, I announced that I intended to introduce the necessary legislation into Parliament this year.   I fully intend to deliver that Christmas present.

The legislation will then be open for submissions to select committee, an important democratic process that usually takes around six months.  That should see us through to around the middle of next year.   The bill will then get reported back to Parliament, ready for its final readings and to pass into law.

Our view, like Australia’s, has always been that plain packaging can be introduced in a way that is consistent with our international trade obligations.  The World Trade Organisation system is the internationally agreed venue to test and confirm that view.

I would say to us all here today – to stand firm in our resolve to see this change happen.  

We should know we are not alone - Ireland has now officially announced it has joined the race to become the second country in the world to introduce plain packaging.  And it has also adopted a tobacco-free 2025 goal.

Ours, then, is a test of endurance.   We know we still have several stages to pass through.  Even once the legislation is passed, we still need to develop regulations to bring all the detailed requirements into force under the new law, and that will also take some time.

Detailed requirements are needed to make sure every aspect of tobacco products and tobacco product packaging are properly controlled.  We must not only end the tobacco pack advertising in use now, but also future-proof against any new marketing tricks or gimmicks that tobacco companies might try.

Because plain packaging is a policy very much with the end of tobacco in sight.

In the meantime, with our eyes firmly on the finish line, New Zealand continues to make the running. Our commitment to introduce plain packaging is unabated.  And we are still progressing without delay.

While I’m on the issue of trans-Tasman cooperation, another obvious area we could focus on as a region, given the large amount of travel between our countries, is the anomaly of duty-free tobacco.  We have again seen Australia leading the way here by reducing its incoming traveller’s duty-free concession down from 200 cigarettes to 50. 

I am working with my colleague the Minister of Customs to address this issue in New Zealand as soon as possible.  It is quite foreseeable that one day soon we could have no duty-free tobacco available for travel across Oceania.

The third area of focus at this conference is reducing initiation 

Our major commitment in this area has been to ensure that tobacco excise taxes continue to be raised by 10% every year.

Since 2010 the Government has significantly lifted the tobacco excise tax with a series of annual increases.  Typical retail prices have risen over 50% since then.  The 2012 Budget included a further programme of four cumulative annual tobacco excise increases of 10% each year through to 2016.

By 2016 tobacco excise tax will have more than doubled since 2010.  While the final retail price is set by the market, it is expected to rise to over $1 per cigarette in 2016, which is likely to be a significant psychological price point.

Total taxes now amount to over $12 per pack of 20 – one of the highest rates in the world.  Drastic moves for a crisis issue.

Finally I want to just touch on one particular issue in the fourth area of focus for this conference, exposing risks to the goal.

And that is the somewhat controversial issue of smoking in cars with children on board.

Our Government has indicated that it prefers non-legislative measures to address this issue. 

I am personally of the view that if we are really committed to supporting vulnerable children in this nation, then removing the traumatic health impact of tobacco fumes from their vicinity would be a good place to start.

You don’t have to be an expert to know that second-hand smoke accumulates in vehicles, even with windows open.  

All of us should understand that it is a serious health hazard and children are particularly vulnerable.   Glue ear, asthma, respiratory disease – all of these conditions result in thousands of hospital admissions each year.  But more than anything else, I cannot fail but be disappointed for the future of our children when the significant adults in their lives, fail to take their health into consideration, before lighting up.

It goes without saying, children are dependent on older drivers for their transport needs.  They have little or no ability to prevent other people smoking in a vehicle in which they are travelling.   I ask us all – who will speak up for them?

I can say that smoking in cars with children on board will be a key message in the next Smoke-free campaign that is currently being developed by the Health Promotion Agency – and if I could leave one message with this conference and indeed wider – it would be to encourage us all to be creative and be bold in speaking up for the children who are innocent passengers in a journey that endangers their health.

Finally, I have to admit to feeling somewhat emotional when I think that this is my last opportunity to address this conference in my current role as a Minister responsible for tobacco control.

I can tell you all now – that with or without the ministerial warrant I will continue to share your passion for eliminating the damage and destruction of tobacco harm from all of our lives.

And my absolute commitment to you all, is to join with you again, twelve years on from now, in 2025, when my fervent hope is that we will indeed be celebrating a Smokefree Oceania!