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Journal Article

The New Zealand medical journal

N.Z.Med.J.

15-Jun

120

1256

U2587

JID: 0401067; CIN: N Z Med J. 2007;120(1256):U2585. PMID: 17589553; RF: 24; epublish

New Zealand

1175-8716; 0028-8446

PMID: 17589555

eng

Journal Article; Review; IM

Unknown(0)

17589555

Smokers need new products and policies to escape smoking's risks. And the next generation needs policies that will better protect them from becoming smokers. Low-nitrosamine tobacco snuff (hereafter termed 'snuff') is 20 times less dangerous than cigarette smoking. Its sale as nasal snuff raises the question as to how long cigarettes, including cigars and pipe tobacco, should continue to be sold and allowed to hasten the deaths of 4000 New Zealanders annually. Oral snuff has helped to reduce smoking to unusually low levels in Swedish men, is much less dangerous than smoking, and does not cause lung or mouth cancer. Moreover, smokeless tobacco (which includes snuff) could reduce smoking-caused health inequity for Maori. Snuff can improve population health, and more so if more smokers switch to it. Continued bans on snuff are now regarded by some experts as unsound public policy. Added to the mountain of evidence against cigarettes, sufficient evidence now exists for Government to use snuff to create safer tobacco choices for smokers, end cigarette sales altogether, and thus end the cigarette smoking deaths epidemic--in which 200,000 New Zealanders have died so far. The New Zealand Government can: Fund media campaigns to inform smokers of their new choices, and to urge them to quit smoking. (The 2007 Budget commits an extra $11 million per year for 4 years, an excellent start.) Regulate for warnings on snuff cans stating that snuff is "addictive but much safer than smoking", and regulate imports to only permit reduced-risk low-nitrosamine products. Tax each class of tobacco products proportionate to the respective risks of each. (Tax cigarettes at 20 times the snuff rate, instead of at the same rate.) Legislate, to expand the Smoke-free Environments Act's aims to include ending the sale of cigarettes and ending smoking deaths--i.e: Allow oral snuff to compete with cigarettes for market share (and for the smoker's nicotine receptors). Reduce addiction to smoking, by decreasing the nicotine content of cigarettes by 5% every 6 months. (Below 20% of current levels, most smokers will quit or switch to snuff.), Allot cigarette supply quotas to manufacturers and importers, decreasing by 5% every 6 months, on the grounds that cigarette smoke is irremediably toxic. The summed effects of these changes could end cigarette sales within 10 years, and prevent 90% of cigarette deaths within 22 years thereafter.

Cause of Death, Female, Harm Reduction, Humans, Incidence, Male, New Zealand/epidemiology, Policy Making, Risk Factors, Smoking/mortality/prevention & control, Survival Analysis, Tobacco Industry/legislation & jurisprudence, Tobacco Use Cessation/methods, Tobacco, Smokeless/adverse effects

Laugesen,M.

20070615