Hon Tariana Turia Associate Minister of Health

Thursday 12 August 2010; 1pm Speech

Aukati Kai Paipa Hui-a-Tau Te Manukanuka o Hoturoa Marae, Manukau

I have been thinking a lot about the science of change.

In doing so I have been pondering the concept of critical mass, the threshold having been reached where suddenly the unexpected becomes expected, the improbable becomes a possibility.

For those of us who are cooks, we will be familiar with the concept of a tipping point. It’s that moment when boiled sugar transforms into toffee; when eggs coagulate, or vegetable stock turns into gravy.

In much the same way, how can we achieve the moment of wonder in everyday life when we can realize that change is imminent; the boiling point has been reached?

In the context of today’s hui, I am contemplating the theory of the tipping point in relation to tobacco control.

What does it take to turn the tide, to spark the revolution in which people will radically adjust their behaviour, break through the ebb and flow of their daily routines to enable change to occur?

Jamaican-British author, Malcolm Gladwell, in his international bestseller described the tipping point as “that magic moment when an idea, trend or social behaviour crosses a threshold, tips and spreads like wildfire”.

I want to say to us all today – we are at that tipping point with tobacco now. It is with such pleasure that I can stand before a marae full of Aukati Kai Paipa providers, and reaffirm our potential for change.

Never before have we seen the levels of support amongst politicians and the public for stronger tobacco control measures.

At the very start of this year, we received the report of the 2008 Health and Lifestyles Survey conducted by the National Research Bureau which revealed overwhelming public support for ending tobacco sales.

Half of the 1600 people surveyed agreed that cigarettes and tobacco should not be sold in New Zealand in ten years time; including a massive 25% of current smokers.

Six months after that survey was reported, I was able to announce a massive surge in the numbers of smokers attempting to quit, with an increase of nearly 4000 smokers registered with Quitline and the amount of nicotine replacement therapy rising by a third.

The monthly gross expenditure on nicotine replacement therapy has now hit $1.5 million – an unprecedented but very welcome advance.

All of these various reports give me great confidence that we are on the fast-track to our vision of change.

And I’m referring to a vision probably best expressed in the aspiration of the Smokefree Coalition "that future generations of New Zealanders will be free from exposure to tobacco products and will enjoy tobacco free lives".

We must seize the moment and do everything that we can to meet the vision of a smokefree Aotearoa by 2020.

I would hasten a guess that every one of us here has been touched by personal loss associated with smoking prevalence.

Multiply the loss of a loved one by 600 and we would be coming close to the number of Maori deaths that occur, relentlessly, year in, year out, because of smoking.

That level of loss is a crisis for our economy; a tragedy for our communities; and a catastrophe for our whanau. We are all the poorer for our loss, and we cannot let this moment go without notice.

We must count the cost of human heartbreak; the denial of aspirations; as a major barrier to our potential.

The good news however, is that we are at the point of no return, in which we all understand the heightened sense of urgency with which we are investing in the vision of being auahi kore.

We can sense the momentum as we accelerate progress in tobacco control across all fronts.

On Tuesday this hui opened with the irrepressible Mr Hone Harawira, a man on a mission if ever there was one. Hone has been a driving force behind the Maori Affairs Select Committee inquiry into the tobacco industry.

Never before in Aotearoa has the tobacco industry been placed under such scrutiny – and that in itself is a very good thing. But there is also the life-changing testimony of whanau who have shared their experiences around the impact of tobacco use within their midst. I know that many of you also participated in the process and I want to really thank you for the difference you have made.

The impact that this inquiry has had right across the House was evident in the speeches presented by Members in the debates supporting the recent tobacco excise tax increase.

At a personal level, I found that whole debate profoundly moving. The call for action right across Parliament was compelling, and it was extremely satisfying to get to the vote – and hear the Bill was voted in by a massive 118 votes to four – so it was evident that there was a mood for change.

Another aspect of the change package is the proposal to remove tobacco displays from retail outlets.

Over 1000 submissions have been received and I am looking forward to receiving advice from the Ministry of Health about our next steps.

The Minister of Corrections has announced a ban on smoking in prisons as of 1 July 2011 and we are now spending upwards of six million dollars across the 32 aukati kai paipa providers of Aotearoa.

All of these actions remind us that for change to be most effective, it must take place on many fronts.

We all know why action is necessary.

Tupeka Kore Aotearoa 2020/Tobacco Free New Zealand 2020 suggests that eradicating smoking from New Zealand is the single most important and attainable policy action to reduce inequalities in mortality for Maori and Pacific peoples.

We have to do everything possible to help people quit smoking and to stop young people from being tempted or attracted to take up the habit.

But although we probably all share a bedrock belief in the power and potential for change, I do not want us to become complacent or to assume that lasting results will come from continuing to do what we have always done.

Of course change is unsettling, and I know that some of the changes in the sector recently have raised questions. But we can no longer accept the status quo if we are really committed to making a difference with regard to smoking.

The projections tell us that it will be year 2050 before Maori smoking rates get below twenty percent, if we keep doing what we are currently doing. I don’t’ know about you, but I can’t wait that long – I am impatient for improvements to happen now.

And so I have been speaking publicly about my desire to encourage more collaboration in the sector, particularly between DHBs and Aukati Kai Paipa services. We must do better at ensuring that people get referred to the most appropriate service; and that we have the follow-up in place, to ensure cessation initiatives can be effective.

We have a lot on our agenda. We will all be awaiting the report of the Maori Affairs Select Committee with great interest, as we consider its implications for a pathway forward.

We must be prepared to be bold, and to look critically at our workforce and our programmes, to ensure access and responsiveness are uppermost in our priorities.

I am pleased that the new specialist cessation contracts have a new output which will monitor outcomes for quitters. I want to see success measured not in activities and events, but in actual outcomes achieved.

Professional competencies, within the context of the Drug and Alcohol Practitioners Association of Aotearoa New Zealand, will bring heightened interest and confidence in the strength of providers and the capacity of a specialist cessation workforce.

Finally, I come back to your conference theme around the philosophy of te ahi kaa, those who are the keepers of the home fires.

And I want to place on record my admiration and my gratitude to all of those whanau, all of those marae, all of our kura, all of our cultural institutions who are setting a pathway forward to reduce smoking prevalence and related harm.

I am thinking of our local heroes, our whanau champions, who continue to fight to protect the health and wellbeing of our families by their insistence on being smokefree.

And I encourage those who have made tentative steps to remove smoking from their homes and organisations, to gain heart from the fact that we are indeed at a tipping point, in which the appetite for change is evident.

Together, we collectively seek to create a smoke free future for our mokopuna; a world without smoke.

The mood is ripe for change. All we need to do, is to reach out to one another to know that transformation is on our horizon; and being smokefree is now well within our view. Tena tatou katoa.

ENDS

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