New Zealand's Smokefree 2025 goal is looking increasingly unachievable, as the Ministry of Health's annual Health and Independence Report highlights smoking rates among Māori are decreasing at a far slower rate than projected.
The report was released this week and shows that Māori smoking rates have fallen by 17%, to 32.5% - a significant disappointment given the goal of a 50% reduction by 2018. Smoking rates among the general population, however, are tracking roughly to target, making the entrenched inequities for Māori even more apparent.
"Together with other public health advocates, Hāpai has been warning of this risk of not achieving a smokefree future for Māori for some time now," says Lance Norman, CEO of Hāpai Te Hauora. "We've consistently said that a stronger focus on reducing smoking inequities is needed. The best way to address the inequitable harm experienced by Māori is to reduce the supply of tobacco in our communities, and to ensure smoking cessation services and tools are culturally appropriate and widely available."
A briefing paper on tobacco retail availability and smoking prepared by the University of Otago and the Cancer Society showed that neighbourhoods which score higher on deprivation indices have a greater concentration of tobacco retailers. With Māori being more likely to live in high deprivation areas, Norman says this has an obvious link with Māori smoking rates. "You can't look at this sort of data and not see that the disproportionate availability of tobacco in our communities has a direct effect on smoking rates, and that it entrenches health inequity."
Norman stated on Radio New Zealand that a review of the investment approach of the excise revenue also needs to be happen. ‘There needs to be an inequities lens placed on contracts. The data is showing that it's Māori and Pasifika communities suffering, so the contracts should only go to organisations who have proven track records of their ability to access these communities to support them appropriately.
Hāpai Te Hauora General Manager for Tobacco Control Advocacy, Mihi Blair, recently addressed the Māori Affairs Select Committee on this issue. Although the Smokefree 2025 goal arose from an inquiry led by the Māori Affairs Select Committee, Blair warns that this early Māori leadership in smokefree advocacy was not fully integrated into the policies which followed. "The input from whānau, hapū and iwi, who provided much of the necessary stories, evidence and solutions within the initial inquiry and report, has since been ignored."
Hāpai have requested a meeting with Minister Salesa who was awarded the tobacco control portfolio when she became the Associate Minister of Health, to urge her to implement the following recommendations so that Smokefree 2025 can be achieved for all New Zealanders:
- Review the reinvestment from the revenue raised from tobacco excise to focus on targeted population groups
- Well-resourced and kaupapa driven services co-developed with the end users
- Revolutionise and intensify mass media
- Harm reduction products such as vaping that focus on pathways to quit
- Supply control to greatly diminish the availability of tobacco products within communities
- A taskforce with strong Māori representation to support the development of a comprehensive tobacco control strategy to reach Smokefree 2025 with Māori as the priority.