I asked people who had cancer about the Government’s tobacco policies - here’s what they said

Monday, 23 December 2024

Joel Maxwell (Te Rarawa) is an experienced senior journalist and Stuff’s kaiwhakamāori/translator.

OPINION: In 2022, the Labour Government passed its smokefree generation law. It would ban the sale of ciggies to anyone born after 2008 and stop the tobacco industry from getting its yellowed hands on future generations. It would significantly cut nicotine (the addictive substance in cigarettes) and cut the number of stores able to sell them.

In February, the new Government, as per its coalition agreement, scrapped the legislation.

According to 2022 modelling, in information supplied by Health Coalition Aotearoa, the combined measures in the repealed law would avert about 8150 early deaths over 20 years. Of those, 2811 would be Maori.

These are the coalition Government’s 8150 zombies, the living dead of Aotearoa, a population big enough to fill Gore, left to die prematurely.

Of all the things this Government pulled in its first full year - the Māori wards, the Treaty principles bill, dumping Te Aka Whai Ora, the sinking economy- the zombies are the worst. If cancer can be reinstated then anything is possible.

But maybe I’m overreacting to all this early death stuff?

Just in case, I talked to people who have had cancer about the Government’s smoking policy.

Why cancer? Well, it’s the Fred Astaire to smoking’s Ginger Rogers. If we’re going to have more of it than necessary (along with a bunch of other diseases, obviously), we should at least hear from people who have experienced it.

Helen Prankerd is Pākehā, lives north of Wellington, was previously an office manager and is 73. That is one year older than her father, Doug Preston, when he died from lung cancer. It was his second bout of lung cancer and his third brush with the disease following bowel cancer that struck a decade earlier.

Helen doesn’t smoke, but lived with smokers till she was about 50. Her dad smoked from his teenage years till he quit, aged 40.

She remembers her own first cancer diagnosis like it was yesterday.

Helen was approaching her 65th birthday when she got a callback from a routine mammogram, which she was initially “very laid-back” about. They probably just wanted to do another scan, Helen thought; she’d probably just moved during the first.

Her husband at the time said he should go with her, but she didn't think it was necessary.

He went anyway, and “through the process that day, it became pretty clear I had breast cancer”.

She was lucky, she says, they caught the cancer early. But she still needed surgery, chemotherapy, immunotherapy and then radiation therapy at the end.

Breast cancer was a “huge shock”, but Helen says the bigger shock came three years to the day after her first diagnosis when she was told she had another cancer, which turned out to be ovarian.

Her surgery for this in March 2020, five days into the first Covid lockdown, sounds about as lonely as you can get. She entered Wellington hospital alone - lucky to still get the surgery, but on her own, segregated - as the nation went into hibernation.

She spoke to me the day before she turned 73. There’s been a “trail of little things all the time” that need treatment on her journey over the past eight years.

She needs restitching for hernias from her surgery, she has osteoporosis from her breast cancer medication, she has ongoing thyroid problems. Her treatment needs treatment.

“I mean, you’re alive, and I’m more than happy to be alive, but you do keep fighting all these things, along the way.”

You move on, she says, and put cancer out of your mind, but it still “remains somewhere at the back”.

Helen says the law repeal is “ridiculous” - it’s well known that smoking causes cancer. Its effect on Māori particularly bothers her.

“If you look at the Treaty, under health, we’re supposed to be protecting our Māori people, and surely, by making smoking more easily accessible it isn’t protecting anyone.”

Helen has an uncomplicated counter-argument to scrapping the smokefree law: “If you can avert someone getting cancer, then that's the best thing.”

Ngaroimata Reid lives in Auckland, is a doctoral candidate at the Auckland University business school, is Māori and is 58. Her father, Gordon MacDonald died, from cancer aged 48, her paternal grandmother died from cancer, and her maternal grandmother lost a breast to cancer.

Ngaroimata was diagnosed with breast cancer in 2019 and says screening “literally saved my life”.

Without the diagnosis, cancer would have taken over everything in her body, she says. The disease travels quickly in her family.

Her dad was fixing something in his car one day, “and two weeks later he was dead”.

“I think this government is just so short-sighted it’s not funny. There’s this huge focus on the here and now. Whereas us as Māori … we’re intergenerational. Anything that happens for Māori, happens a generation at a time.”

In this way, cutting smoking rates has followed the same intergenerational path as loss and re-emergence of reo Māori speakers. Her grandparents were native speakers, her parents didn’t speak te reo, she and her siblings learned it at school, and now her own son has grown up in kōhanga and is a fluent speaker again.

“You can see those changes happening, generation after generation. Smoking is the same.”

Her grandparents smoked rollies, she says, her parents smoked, she smoked from her teens to late 20s, then quit. Now hardly any of her children' s generation have started.

This approach needs to continue, she says. “Unless you have a government that supports that, Joel, we really haven’t got a shitshow.”

Back in 2019, Ngaroimata did not even feel a lump in her breast before screening caught her cancer. “It was a total shock, and I remember when I was diagnosed I just fell apart in the breast surgeon’s office. I just fell to bits.”

She had a breast removed, she says, and will take hormone blockers for the rest of her life. Her own cancer, discovered mid-2019, came the year after her sister was diagnosed with a rare tumour on her femur bone, which broke after the tumour ate through it.

“It was a double-whammy for us.”

You might come out the other end of cancer, says Ngaroimata, but it’s always there in the background of everything you do.

“My sister has a permanent limp because they put a rod in her femur bone … she’s constantly reminded.

“Having no breast, I’m constantly reminded of the cancer that I’ve had.”

Now, what I think

What is death? Well, when you die, you can no longer pay taxes. When you die, you can no longer vote. When you die, you no longer complain about the neighbour’s barking dogs, or paying off your credit card. But when you die, you no longer enjoy a chocolate sundae, either. When you die, you no longer contribute anything to anything, and you never take anything either.

What I’m trying to say is that when you die, everything that was important in all those millions of seconds of life is no longer important because you are no longer here, permanently, forever, amen.

As a counterpoint our Government offers: ramraids.

Yep, spin has finally reached its limits. The Government’s excuses for scrapping the law are so utterly feeble, so morally vacant, they would make Jiminy Cricket sigh disgustedly, and spit on the ground.

More than 8000 early deaths? The law could drive up ramraids! More than 8000 early deaths? A black market in tobacco! More than 8000 early deaths? How do you tell the age of who can and can’t smoke?! More than 8000 early deaths? Too few stores left!

National apparently faced a billion-dollar hole in tax revenue from reduced smoking rates. ACT, NZ First - who knows? It was apparently a line item in ACT’s alternative budget, and was only added to NZ First’s manifesto after people had started voting.

I do know that while we cannot avoid death, we can - on average - avoid doing it prematurely.

I spoke to Māori health researcher Associate Professor Andrew Waa on the issue and he says that extending the smoking tail out by years will lead to a significant number of Māori dying unnecessarily. When the coalition deal was announced, he was of course upset by the planned axing of the legislation, but says he was probably more upset by “the failure of our democracy”.

The number of calories required to lift the truth and throw it down the well is astronomical. Smoking is a hugely addictive, person-killing activity. The coalition Government’s changes - with no meaningful consultation - eased pressure on smoking, opening the door to thousands of unnecessary deaths.

So why do it?

We now have the tacked-on phase two of the royal commission inquiry into our response to Covid - a pandemic that claimed millions of lives globally, but initially saw the annual mortality rate drop overall in Aotearoa. That’s year-on-year, negative people dead: someone call the negative ambulance.

I’m all for learning how to do things better in future but this wasn’t something that failed catastrophically, just something that succeeded imperfectly.

Personally, I think there should eventually be a royal commission inquiry into this Government’s handling of tobacco regulation, including its links to the tobacco industry, the consequences for public health and a reckoning on the number of people who died unnecessarily from this Government’s actions; the failings in meeting Treaty of Waitangi obligations and the particular impact on Māori - obviously with an eye to stopping it happening again.

Winston Peters, Christopher Luxon and David Seymour.

What have they achieved in sum total in their political careers? What will they ever achieve? Will it ever cancel out the unnecessary deaths of thousands of New Zealanders, a fate to which they are happy to consign us? Theirs is a political legacy of staggering anti-achievement. A nullity of progress. If that modelling is even partly correct, they will leave the country a deader place than it would have been if they hadn’t signed that coalition deal.

If you want to criticise my opinion, go ahead. I might be anti coalition-government policy, but I’m pro being-alive. That the two are at odds is something no amount of spinning can explain.

Ngaroimata, Helen, they are just two people of many who have lived with cancer and understand it - to hear them speak is to realise the obscenity of the Government’s spin.

This transcends spin because it transcends politics. We deserve the truth, and life. We should never accept anything less.