Covid-19 and cigarettes: two parallel public health issues

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OPINION: Covid-19 has owned the news agenda for 18 months. It’s political history number one and economic history number one, it’s on the sports pages and in the entertainment section.

And, of course, this is the top priority for health workers and the public health sector. Yet since the first case in New Zealand was confirmed in late February last year, some 8,000 people have died from smoking-related causes. Given the high rates of smoking among Maori, Maori will be significantly over-represented in this death toll.

For Maori, the damage caused by smoking is an existential issue.

Our parents still talk about the toll of WWII on what should have been the rangatira of their generation. Of the more than 3,600 men who volunteered in the Maori Battalion during World War II, 649 were killed or died in active service, a casualty rate of 18%.

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This casualty rate was almost 50% higher than the average for New Zealand infantry battalions. According to a study published in the NZ Medical Journal in February 2020, between 2013 and 2015, 2,199 Maori died from smoking-related causes, accounting for 22.6% of deaths among Maori.

Like Covid, smoking poses a greater threat to the health of brown or poor New Zealanders: the greatest risk of all is for those who are both brown and poor.

The government’s Covid suppression strategy hinges on a significant increase in the number of people vaccinated. The challenge of increasing immunization coverage in the community is reminiscent of some of the challenges we have faced in Hāpai te Hauora and continue to address in our work to eradicate smoking.

The majority of people who have not yet been vaccinated against Covid are not the anti-vaccines making the headlines. Some are unsure, some are confused, many just don’t have the capacity to add an urgent task to their to-do list.

For these people, getting Covid is a distant prospect. Putting food on the table and paying the bills has to be done here and now. For many of the people we work with, the prospect of lung cancer, stroke, or chronic respiratory disease is small compared to the prospect of losing uncertain income. The challenge of feeding and dressing children takes precedence over the challenge of breaking the habit of smoking.

Quitting smoking is difficult. When a large part of a person’s will is absorbed in dealing with the stress of daily life, other challenges are postponed. Add to that the natural human impulse to think ‘she will be right’ or ‘this won’t happen to me’ and you will begin to understand why smoking rates remain stubbornly high in some groups.

Selah Hart, Managing Director of Hāpai Te Hauora.

PROVIDED

Selah Hart, Managing Director of Hāpai Te Hauora.

To persuade people to get vaccinated against Covid, the government and its agencies must tackle the disinformation spread on social media and other channels. This task is insignificant compared to the task of countering the disinformation and outright lies that the tobacco industry has been pushing for many decades.

More recently, tobacco companies sponsored a campaign claiming that restricting tobacco sales would ruin dairies and convenience stores.

Leaving aside the question of whether we should support companies that can only survive by causing permanent damage to their customers, research shows that this claim has no factual basis. Two New Zealand studies published in 2018 and 2020 showed that only 6% of transactions in dairies and small grocery stores included tobacco and at least one other item, and well over half of people who buy tobacco did not buy anything. else. These results were almost identical to those of an earlier American study.

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Vaping is a new frontier for big tobacco companies.

Big Tobacco’s pivot to vaping and e-cigarettes is another example of the industry’s agility – and its determination to maintain its sources of revenue. While vaping can be a useful tool for smokers trying to quit and is less harmful to your health than smoking tobacco, that doesn’t mean it’s safe.

The manufacturers and distributors of vape products are big companies: like all companies, they want to repeat the custom and they want new customers.

Our rangatahi in particular need better information to be able to make better choices, and we need the government and the Ministry of Health to continue to disseminate this information in the community.

In April this year, Associate Minister of Health Ayesha Verrall proposed a new approach to make Aotearoa-New Zealand smoke-free by 2025.

The Minister’s commitment and determination are welcome. We were one of more than 5,100 groups and individuals who submitted a submission on the draft proposals, and we look forward to the release of a final Smokefree Aotearoa 2025 action plan. There is so much at stake.

Selah Hart is Mana Amorangi / Managing Director of Hāpai te Hauora, which holds the Maori regional public health contract for Tāmaki Makaurau-Auckland as well as five national service contracts in the areas of gambling harm minimization, anti-gambling. smoking, mental health and substance abuse and prevention of SUDI.


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