This is the first published report comparing the overall toxicity of cigarette brands across countries using risk assessment and intensive machine smoking, and adjusting for smoke nicotine and the mortality distribution between disease groupings. The method provides a relative toxicity score as a rational basis for regulating cigarette emissions across all brands sold. Holiday Extra-mild’s overall estimated identifiable toxicant emission levels would reduce 39%, and its cancer risk by 37%, if this cigarette was required by regulation to have the same emissions as a certain Canadian regular brand, Export A full flavor. Regulation to reduce brand differences in emissions, without employing charcoal filters, would reduce total cancer risk by 13% for Holiday Extra-mild, based on measurable toxicants. Any toxicity reduction from including a charcoal filter would be additional.

This is the first published report comparing what charcoal filters can do in a cigarette company laboratory with what they do in a commercial cigarette. Over the last 40 years cigarette company scientists have reported that charcoal can reduce aldehydes and hydrogen cyanide emissions in cigarette smoke by 75%-80%. In two Mild Seven charcoal filter brand variants sold in New Zealand containing minimal charcoal, no such reduction in these emissions was seen. Emission reductions seen with the charcoal filters as reported 40 years ago, could today lower a brand’s overall identifiable toxicity by over 40%, mainly by reducing gases toxic to lungs, heart and blood vessels. Whether overall total brand toxicity would be reduced by this much is uncertain, as currently unidentified toxicants may not be susceptible to removal by charcoal filters. With more certainty, effective filters could reduce total cigarette cancer risk by at least 5%, or 80 deaths a year.

Lung cancer is an important cause of mortality in New Zealand. This study examined trends in socioeconomic and ethnic inequalities in lung cancer mortality, between 1981 and 1999. In men, socioeconomic inequalities in mortality were demonstrated in 1981, and persisted over the study period, despite the fall in overall lung cancer mortality in men. For women, with the increase in lung cancer mortality between 1981 and 1999, an increase in socioeconomic inequalities was also seen. This was due to a disproportionate increase in mortality of lower socioeconomic groups. Divergent mortality trends by ethnic group were seen in both men and women, which led to an increase in ethnic inequalities between 1981 and 1999. Qualitative predictions suggest that these socioeconomic and ethnic inequalities will continue to increase over time unless concerted public health action is taken.

Almost a fifth of New Zealanders, and over 30% of high school students, are exposed to secondhand smoke in their homes. Maori and those in low-income households are more likely to be exposed than others. New Zealand evidence indicates a significantly increased risk of death for those who live in a household with smokers, with over 250 deaths per year attributed to secondhand smoke in homes. Substantial Government investment in tobacco control is needed to reduce these deaths.

New Zealanders’ knowledge about secondhand smoke (SHS) effects has greatly improved since 1989, but this knowledge may be shallow. Wellington area surveys indicate that many people are not aware that the major consequences of SHS are strokes and heart disease. Increased public support for smokefree homes in the last decade does not necessarily result in smokefree homes. Less than half of 14–15 year olds (with at least one parent who smoked) reported having a smokefree home. Increased investment in mass media campaigns on SHS issues is needed.

Data from the 2002 Youth Lifestyle Study of secondary school students were analysed to investigate the primary sources of tobacco products, barriers to purchase, and revenue generated from the sale of tobacco to underage youth. Among smokers, more than 40% had purchased tobacco products from commercial sources. The revenue to Government from sales of tobacco to 14–16 year old students, alone, was calculated (conservatively) at $12.5 million in 2002. Greater investment is needed to reduce youth tobacco use, and it would be appropriate to use some of the money generated by under-age sales to help reduce tobacco use among youth.

The Can Quit Practice Programme was developed for general practices with a focus on the skills of the practice nurse in providing quit support. The quit rates achieved in the Can Quit Practice Programme evaluation confirm that smoking cessation programmes can be successfully implemented and maintained within general practices. Important components of providing quit support in general practices were: an autonomous role for practice nurses; well-managed practice procedures; adequate consultation time; and adequate funding for health promotion.

The relationship between alcohol consumption and health is complex. This study summarises harms and benefits of alcohol to the health of Maori and non-Maori populations in New Zealand. Overall, 4% of all deaths in 2000 can be attributed to alcohol; many due to injuries involving young people. The health burden of alcohol is dependent on drinking patterns as well as volumes, and so varies markedly by age, sex, and ethnicity.

Tobacco tax as a health protecting policy: a brief review of the New Zealand evidence
N Wilson, G Thomson

This review found that there is good evidence that tobacco taxation is associated with reduced tobacco consumption in the New Zealand setting. There was also some limited evidence for equity benefits from taxation increases. Two New Zealand studies suggest the potential for higher tobacco prices contributing to the control of youth smoking rates. There is a need for considerable improvement in tobacco taxation policy in this country, to better protect public health and to improve equity.