For many New Zealand children, smoking is seen as a "normal" adult activity. They see people in their family smoking, people smoking in the street, and in movies and videos. They see tobacco products on sale in dozens of bright packs in their local dairy and supermarket.

In some socio-economic and ethnic groups, more than 45 per cent of the 20-24 age group still smoke. At the same time, more than 4,500 people die from tobacco-related disease in New Zealand every year.

For researchers in the Health Promotion and Policy Research Unit in the Department of Public Health, University of Otago, Wellington (UOW), these figures are a challenge and a concern.

"This indicates that, while deaths from smoking are entirely preventable, the rate of policy change is slow," says Dr George Thomson. "We need to know how change could be made much faster."

To this end, Thomson and colleagues Dr Nick Wilson and Associate Professor Richard Edwards have been engaged in a wide range of research projects to uncover the influences on tobacco policy and, thus, how more rapid policy change could be made. Their recent and current projects include the New Zealand arm of the International Tobacco Control Policy Evaluation Survey, Pursuing the Endgame for Tobacco Control, the Smokefree Policymaking for Kids project, and others on the impact of retail tobacco displays.

It is inevitable that this public health research is described by those with vested interests as being "controversial". A study on the use of "power walls" to display tobacco concluded with a recommendation banning them in dairies and other retail outlets. The response from retailers was that it would cost them thousands of dollars and put many out of business.

"The response illustrates the problem of having a dangerous addictive drug sold commercially alongside milk and bread," says Thomson. "The local and international evidence shows quite clearly that these displays are an unhealthy influence on children and people trying to quit. As for the claim that retailers will be badly affected if they are banned - as with commercial complaints about smoke-free bars - again the international evidence shows these arguments don't stack up."

The New Zealand Government is currently re-examining the "power walls" issue. Open displays of tobacco products were recently banned in New South Wales, Australia.

The researchers attribute dedicated toboacco taxation as one significant reason why other countries or jurisdictions are doing better than New Zealand in reducing smoking. This tax can be used for tobacco control policies and Thomson says that, with at least 10 countries and six US states applying such a system, it needs to be considered for New Zealand.

"Tobacco control is chronically underfunded here, and a dedicated tax would help reduce health inequalities for Māori and low-income households. We are arguing for a dedicated tax payment of at least $100 million, rising to at least $200 million in five years."

The researchers also point to an apparent reluctance of some MPs to support tobacco-control policies. One of their studies showed that almost half of 21 MPs who spoke in Parliament (2000-2005) about the health impacts of second-hand smoke denied or were sceptical about its risk to others.

"Tobacco control is chronically under-funded here, and a dedicated tax would help reduce health inequalities for Māori and low-income households."

At the same time, public opinion is often much more sympathetic to smoke-free policies. The Wellington researchers have shown that most people are in favour of smoke-free public places such as parks, particularly where there are children's playgrounds. In an Upper Hutt study, 83 per cent of those questioned supported the idea. Another study of local politicians showed that nearly all were aware of the role-modelling for children from public outdoor smoking.

"We're keen to explore further what determines these kinds of policies that affect smoking around children," says Edwards. "We've received a grant from the Health Research Council on how to achieve progress on smoke-free homes, cars and community property. A similar ongoing study through the Marsden Fund is investigating how to better communicate innovative tobacco-control policies to key audiences such as policy-makers and media people. While yet another study is looking at intervention strategies to reduce the very high tobacco use in Māori communities."

The issue of tobacco-control policy is a dynamic area of public-health research. The researchers at OUW aim to find a way by which substantive new and innovative policies can be adopted, helping to reduce the serious health and economic burden from tobacco use in New Zealand.

Further details of this tobacco-control research can be found at http://www.wnmeds.ac.nz/academic/dph/research/HIRP/Tobacco/index.html

Funding