Opinion | Smokers’ opinions are counted

Philip Morris, the third largest tobacco company in New Zealand, has suddenly become interested in hearing the opinions of adults who smoke. They have set up a website “My Opinion Counts” and invited customers to contribute their views on tobacco control measures. However, Philip Morris’s interest is too little, too late. Researchers and policy makers have been using scientific surveys and interviews to understand smokers’ views for many years, and the results show that smokers’ perceptions do not align with the fears of this ‘dying industry’.

Because of this large body of work, we know that the majority of smokers are not concerned by the recent move to place tobacco displays out-of-sight (and retailers are similarly unfazed). Smokers know where they can purchase cigarettes, and have welcomed this policy because it will see a potent trigger for relapse among those who have quit and a source of tobacco advertising to children removed.

The New Zealand arm of the 2009/10 International Tobacco Control Survey (ITC) found that the majority of smokers supported removing tobacco retail displays, and endorsement of this policy grew over the two survey waves (from 60% to 68%). Opinions on other possible retail changes were also sought in this survey; the results show that over half of adult smokers agreed that:

• the number of places allowed to sell tobacco products should be gradually reduced (55%)
• tobacco sales should be restricted to dedicated outlets where children are not allowed to go (62%)
•  tobacco products should only be sold special places where quitting products are also sold (62%)

Smokers from Māori and Pacific Island communities gave even higher levels of support to each of these measures, as do surveys that include non-smokers. The 2010 Health and Lifestyles Survey (adults aged 18+) and the 2009 ASH Snapshot (Year 10 students) both found that two-thirds of respondents agreed the number of places selling tobacco should be reduced to make the product less easily available. The ITC also revealed that nearly half of smokers are willing to see tobacco sales phased out in ten years if effective nicotine replacement products are available (46%).

From other research we know that smokers are very concerned about preventing youth initiation, because four out of five people who smoke regret the fact they smoke and say they would not start smoking if they could live their lives over again. We also know that most smokers support recent tobacco control measures, and believe the government should be doing more. Put simply, they welcome changes that help to create environments that support their quit attempts and prevent young people from becoming addicted to tobacco. While the tobacco industry wants us to believe that the majority of their customers have made an ‘informed choice’ to continue smoking, the choice most smokers desperately wish to make is to become smokefree.

Tobacco companies always object to new tobacco control measures and claim these will adversely affect smokers. History shows none of their “concerns” has any substance; smokers support the measures, which help increasing numbers to quit. Far from acting on real adverse effects – the profound health consequences for smokers – tobacco companies have manipulated cigarette composition. Tobacco products have been engineered to be increasingly addictive and more palatable, strategies that deliberately undermine smokers’ freedom of choice by making quitting harder. Research published in 2011 by British American Tobacco’s own scientists vividly demonstrates this point: they reported that cigarette butts collected from New Zealand contained significantly more nicotine and tar than those collected from the other countries studied (only the South African cigarette butts had equal or higher levels).

Tobacco companies know that many smokers are troubled by the potential for devastating health effects, spawning the creation of ‘low harm’ products to keep these customers hooked. The alternatives have included so-called ‘light’ and ‘mild’ cigarettes, which, perversely, contained more nicotine than full-flavour cigarettes, precisely because people who switched to these variants were at risk of quitting – an outcome that would be bad for business.

The tobacco industry is fighting for its survival, using every means at its disposal, including websites like Philip Morris’s “My Opinion Counts”, ostensibly to allow smokers to express their opinions on tobacco control. But smokers would be seriously deluded if they thought this was a benign gesture on the part of Philip Morris. No-one should mistake the tobacco giants’ heightened ‘concern’ for customers ‘rights’ as anything other than concern for their own continued profitability – profitability that depends on continually replacing the 50% of customers who die from using their products.

Ninya Maubach, Janet Hoek, Richard Edwards, Phil Gendall, and George Thomson.