Increase the cost of cigarettes to snuff out smoking in Nunavut: study
"Price is the single most important influence on tobacco consumption levels, cessation and prevention"
More than two of every three Nunavut Inuit smoke daily despite the increased risks to these smokers of developing tuberculosis, lung cancer and other illnesses, along with the high cost of a daily tobacco habit, which can range up to $6,000 a year for an individual smoker.
To reduce the number of smokers in Nunavut, a recent study urges the Government of Nunavut to enact “substantial tobacco price increases, indoor and outdoor smoke-free restrictions, underage purchasing restrictions, as well as mass media campaigns, evidence-based prevention and cessation programs,” concludes a recent report called “Smoking: can it change? Supuutuqniq asitjirunnaqpaa.”
The GN will have to increase taxes on cigarettes to discourage many from smoking, this research study says.
There’s strong, evidence from around the world showing that “price is the single most important influence on tobacco consumption levels, cessation and prevention,” says the study, prepared by Mary Jean Costello of the University of Waterloo, and researchers with the GN’s health and social services department.
Smokers living in places with higher cigarette taxes are more motivated to quit and more likely to quit successfully, and those with lower income are “actually more likely to think about quitting, try to quit or cut down as a result of an increase in tobacco taxes compared to their wealthier counterparts,” the study says.
The GN should consider setting a minimum legal price for all tobacco products and paraphernalia along with more tobacco cessation services like support groups, treatment centres, tobacco specialists, “quit smoking” camps and other activities.
Free nicotine replacement therapy, such as gum and patches, is needed, and there should be stronger enforcement of outdoor restrictions and the selling of tobacco to minors.
The minimum price of tobacco should be increased to at least as high as the price of tobacco in the Northwest Territories and adjacent provinces, after adjusting for general differences in purchasing power, the study said.
Last February, MLAs did approve a tobacco tax increase that raised the price of cigarettes across Nunavut, making the territory’s tobacco tax rate the third highest in Canada, behind the NWT and Prince Edward Island.
Smokers started paying $1 a package more for packs of 25 pre-made cigarettes, bringing the price per pack to more than $18, along with an additional four cents a gram for loose tobacco.
The study’s findings, discussed at the recent International Congress on Circumpolar Health in Fairbanks, Alaska, also shed light on why Nunavummiut smoke and what they say about quitting.
Many participants told researchers they continue to smoke because it’s a habit or part of their regular routine. Others said people use tobacco because they are bored or because there is nothing else to do.
Several reported “positive emotional and social effects” that encouraged people to use tobacco, such as feeling “calm, relaxed, cool, pretty, proud, and more social.”
Many said people commonly use tobacco to relieve stress or “to free your mind.” Others said people continue to smoke because they see other people smoking or because “everyone else smokes”.
The study was based on 26 focus groups and individual interviews conducted from May to June 2010 with 113 participants, 16 years and over, in Cambridge Bay, Iqaluit, Rankin Inlet.
And, while there was interest within these communities in quitting smoking, “actual quitting was less common.”
Among the suggestions from participants to encourage less tobacco use:
• Ban tobacco in communities;
• Restrict tobacco sales through regulatory bodies, similar to alcohol education committees;
• Offer more youth activities and programs;
• Involve youth in creating and delivering smoke-free messages (such as was recently done in a National Inuit Youth Council video production);
• Provide tobacco-specific education and training for health care practitioners;
• Allocate more money to smoking cessation programs;
• Start prevention efforts earlier, in elementary school;
• Decrease the cost of healthier alternatives to tobacco, such as healthy foods, fruits and vegetables; and,
• Consider the link between alcohol and tobacco when developing cessation programs and services.
The most common reasons for wanting to quit included the risk of developing smoking-related health effects, knowing someone who suffered from a smoking-related health effect, the cost of cigarettes, and having been told to quit by a doctor.
Some mentioned people may call the Nunavut Quitline, but “this was seen to be a relatively new service that no participants had appeared to try.”
Many reported that it’s difficult to quit and not start again. People continue to use tobacco because they are addicted, that “…it’s like their body’s used to that chemical and it’s a [relief] to have that chemical put into you again because it’s so normal to them.”
The most common barriers to quitting included the social acceptance and widespread use of tobacco.
Emotional triggers such as boredom and stress were also reported as barriers.
Many said few formal quitting supports were available within their communities to help those who wanted to quit smoking.
Family, friends and elders were perceived as important supports, the study notes, but, several others indicated that some elders may “unintentionally condone smoking” because many of them smoke themselves.
“Actually, every elder I see now are smoking. And since the Inuit tradition is ‘respect your elders’ then elders should really mainly be saying to the young ‘quit smoking’ but how can they say that when they’re the ones smoking too,” a participant said.
The research found kids start smoking early, for some as early as two to six years of age.
Most first try cigarettes that they get from parents, other family members or friends. They try because they want to “fit in” or have seen others using tobacco.
Most buy tobacco from stores, but family and friends are also common sources, and they use tobacco socially, with friends or family at breaks and parties.
Most are aware of the health effects of tobacco use including premature death, lung cancer, and respiratory problems, and they know the financial and social consequences of tobacco use.