Showing posts with label tobacco. Show all posts
Showing posts with label tobacco. Show all posts

Friday, February 27, 2009

Carcinogen sales remain strong

Despite the global financial crisis sales of carcinogens remain strong with BAT profits growing 20% in  the year to December 31BAT is the world's second largest producer of carcininogens. Quote, The Financial Times:
"Although tobacco consumption is declining worldwide, tobacco companies have continued to grow profits during the past decade.
In the US and Europe, where public health programmes have reduced smoking rates, the fall in volume has been offset by price increases. Emerging markets, where tobacco use is still growing also countered the decline in developed countries.
The World Health Organisation estimates that the number of smokers will grow from 1.3bn in 2006 to 1.7bn by 2025, with the bulk of new smokers coming from Asia and eastern Europe".
The world's largest carginogen producer, Altria, is ranked as a strong buy its share price falling from a peak of $75 to its current $15 over the past year.  US cigarette taxes are due to increase from 39 cents per pack to $1 but Altria is well placed to shrug this off.  Its earnings per share grew at 10% in 2008 as it initiates a move into ethyl alcohol sales.

I'll keep a watch on both BAT and AltriaBAT is making a huge effort to increase sales of smokeless tobaccos and to improve the public image of this less carcinogenic product.  Altria bought the smokeless tobacco company UST (formerly the US Tobacco Company) for $10 billion last year.  Smokeless tobacco sales have been growing at 7% in the US as cigarette sales fall.

Sunday, September 07, 2008

More deceit from big tobacco

This article in The Age suggesting that tobacco companies knew that ciarettes contain a pollonium isotope that makes smoking a packet and a half of cigarettes equivalent in radiation exposure to 300 chest X-rays per year.  They kept quiet about it as they have with some many of the other deadly features of this habit. The more I look at the evidence the more I back my radical plan to get really tough on smoking - let's end this outrageously dangerous and stupid practice within one generation.

Thanks for The Age reference Damien Eldridge

Friday, July 06, 2007

Taxing alcohol & tobacco products

I found this webpage from the Australian Taxation Office on excise charges on alcohol and tobacco products very useful. Taxes ideally should reflect damages of these products which are presumably related to alcohol and carcinogen content respectively. With respect to alcohol this is volumetric taxation rather than ad valorem taxes levied on product value.

All forms of alcohol except wine are taxed volumetrically - at least as excise taxes – though there are quantity discounts for larger volumes sold, I assume in pubs and bars:


1. Low alcohol beer (less than 3% alcohol) in containers less than 48 litres is taxed at $32-78 per litre of alcohol exceeding 1.15% of volume. In larger volumes (greater than 48 litres) the tax drops to $6-54. Low alcohol beer on tap at the pub should be a comparative bargain!

2. High alcohol beer (greater than 3.5%) is taxed at $38-20 in low volumes and at $26-85 in larger volumes again per litre of alcohol exceeding 1.15% of volume. Not such a great bargain at the pub!

3. Other spirits are taxed at $60-42 per litre of alcohol.
Drinking spirits seems to attract an exceptionally high volumetric charge. If damage is proportional to alcohol content it would seem to make sensed to reduce the tax on spirits and raise it on beers. There would also seem to be no obvious basis for the quantity
discounts given to pubs.

Beer has three rates (full, medium and light) purported to encourage responsible drinking, resulting in $0.33 and $0.22 per standard drink. Spirits come out to be $0.75 per standard drink (except for brandy, which for some historical reason is $60.42). The per standard drink rates are taken from an information sheet put out by the Alcohol and other Drugs Council of Australia. So, given that firstly, the tax is paid on alcohol volume, and secondly that the rates are higher for higher alcohol drinks, the system is not only volumetric, but has built in incentives to consume lower alcohol drinks.

Wine is taxed on an ad valorem basis based on value. For cheaper cask wines this means a much lower rate of tax per unit alcohol than other alcoholic beverages.

Wine is thus treated quite differently from beerm, spirits and RTDs.

The problem seems to be mainly with wine. When the GST was introduced and various taxes done away with, the Wine Equalisation Tax was set such that prices didn’t change too dramatically. The WET rate is 29 per cent of the wholesale sale value (ad valorem). This makes it difficult to compare with the rates for other drinks, but the ADCA fact sheet quotes the WET to be about $0.22 per standard drink on bottled wine ($0.69 on a bottle selling for $32, according to a submission to a 2002 Senate Inquiry on the topic) and $0.07 on cask wine.

Wine has a higher alcohol content than beer or RTDs (which must be less than 10%), but the lower tax for most wines could in theory be due to the positive health affects that are attributed to wine. I don’t have any evidence for this next statement, other than the occasional headache after drinking cheap bubbly, but it is possible that the tax system encourages the consumption of wine with greater impurities including methyl alcohols, and hence worse health effects. Whether this is true or not, the very low tax on cask wine is out of proportion to other taxes and is a very weak disincentive to over-consume.

GST is payable on the price including excise or WET (I think paying a tax on a tax is a bit of a rort).

However, despite the volumetric tax which is applied to most alcohol products, it still gets plenty of airplay: “Dr Herron said taxation of alcohol should also be restructured with the aim of reducing harm in the community. ‘The basic taxation should be one determined by the volume of alcohol in the product with the necessary adjustment to promote responsible consumption.’ ” from SMH 31 Jan 2007

With respect to tobacco products:
1. Tobacco is taxed at $0.24301 per stick (for sticks not exceeding 0.8 grams) irrespective of tobacco composition. On a pack of 25 this is $6 per pack.
2. Other forms of tobacco (wet snuff, loose tobacco) the charge is a massive $300 per kilogram.
This isn’t ‘volumetric ‘in intent at all given that there are strong arguments for believing smokeless tobaccos are much safer than cigarettes. Cigars and pipe tobacco also see safer than cigarettes.

Even if damages are more difficult to map in terms of the composition of tobacco this does not seem a sensible arrangement.

Economists would also say that these taxes, in a second-best world, should be larger the less elastic are demands since then the excess burden or deadweight loss associated with raising a given amount of revenue is minimised. Since demands for alcohol and tobacco are quite inelastic this suggests a case for high taxes.

On the other hand some of these goods are often consumed by low income people so, to that extent, the taxes are regressive.

This post might be obvious to people working in these industries but some of these ideas are new to me. I would greatly appreciate knowing if I have got the interpretations wrong.


Thursday, March 29, 2007

Smoking

I have been working for the last couple of weeks on smoking. If you want to get a good feel about the dimensions of the global smoking epidemic I recommend this site.

If you wish to become very well informed about harm reduction approaches to dealing with the smoking catastrophe I recommend this site. It is an excellent source of information - 50 live links that will introduce you to a vast literature much of which is genuinely surprising.

Friday, March 23, 2007

Chop chop

A tax on tobacco will encourage the use of illegal, untaxed sources of tobacco or chop chop*. Smoking chop chop means that the Commonwealth Government loses out on revenue (in 2003 the estimated loss was $500 million) but, more importantly, that the tax on legal tobacco to avoid health problems will indirectly create new health problems since chop chop is, in many ways, a less healthy product than legally-produced tobacco. Fungi spores, caused by inadequate drying of tobacco, cause severe medical conditions (in addition to those caused by legal tobacco) in the use of chop chop that might be related to what are called ‘tobacco grower’s lung’ problems.

This means that the tax set to restrict legal tobacco use must be set lower than you would otherwise set it in order to restrict tobacco consumption**. To put the matter equivalently: Tobacco consumption could be better controlled by taxes if substitution towards chop chop could be reduced.

There has been some work done in the past on chop chop consumption by Gilbert Geis , The NSW Cancer Council and Renee Bittoun. Today I went to RMIT University too learn some more about chop chop consumption from Professor Tim Fry. I learnt that in the past, chop chop consumption has been concentrated in the tobacco-growing states Victoria and NSW. This suggests that chop chop is illegally diverted tobacco from commercial plantations. As in previous studies Tim found that chop chop consumers tended to believe it was healthier to smoke chop chop than legally sold tobacco because it was free of industry-added chemicals – an incorrect belief.

That all tobacco production will cease in Australia, from 2008, suggests that a dramatic reduction in the supply of chop chop will occur, so that taxation revenue from tobacco should be boosted. So too should the demand for legally-produced tobacco increase. This also means tobacco taxes can be raised further to reduce cigarette consumption with less concern over substitutions towards chop chop.

One thing that occurred to while I was listening to Tim was whether it is in fact easy to grow and cure tobacco. There are plenty of websites out there showing you how to grow it, how to cure it and marketing seed for the home grower (they will export 600 cigarette tobacco seeds to Australia for $24). If it is as easy as it seems then the disappearance of diverted chop from commercial tobacco plantations may be replaced by backyard production. If it is imported then it will presumably be expensive enough so that the supply restriction will still bite.

I’d be interested if readers have experience of chop chop. I am particularly interested if you have ever heard of it and, if so, on information about where it is sold, its quality and how much it costs.

* The term most likely originates from use of the expression 'chop chop' in Australia to refer to chopped up fodder and sugar cane fibre used for feeding animal stock.

** To the extent there are complementarities with other untaxed, socially-undesirable goods, such as cannabis or alcohol, one might wish to set the tax higher than without such complementarities.

Wednesday, February 07, 2007

Aussie tobacco-growing industry disappears

The Australian tobacco-growing industry has ended with an industry-government buyout of all producers. All cigarette products consumed in Australia will now be imported. The advantage for the anti-smoking lobby is that the price of illegally-grown tobacco ('chop-chop') will increase so taxes levied on legally-sold cigarettes will have a bigger impact in reducing smoking and its health costs.

Of course the illegal tobacco-growing industry in Australia might expand when the possibility of illegally diverting supplies from legal tobacco growers ends. Also, some illegal tobacco might be imported. There might also be the substitution of herbs (marijuana?) and other products for legal tobacco which will lead to yet another round of discussions on health effects.

Indeed, on substitutions I was interested to read in W.J. Peasley's enthralling The Last of the Nomads that the desert-based nomadic aboriginals in WA collected their own native tobacco from the bush which they chewed and stored behind their ear for repeated consumption.


Update: I checked on commenter FXH's query and it does seem, apart from the ACCC exemption, to be illegal to grow tobacco - not just to sell it.

Wednesday, January 31, 2007

More nicotine for your dollar from the merchants of death

The Harvard School of Public Health have published a study showing that the nicotine content of cigarettes has increased in the US by 11% during the period 1997-2005. Nicotine is the primary agent that makes smoking addictive.

As I recently suggested it is inappropriate to define smoking in terms of the number of cigarettes consumed. Smoking is a nicotine delivery vehicle. Consumers change their smoking practices in response to such things as changed prices – with price increases they puff harder and inhale longer to achieve desired nicotine concentrations in their brain. This has significant effects in offsetting the effects of higher cigarette prices on health. It is also well-known that smokers who switch to low nicotine cigarettes increase their smoking intake to maintain nicotine levels.

Judge Kessler in the US District Court for the District of Columbia has also made it clear that tobacco companies modify nicotine levels to sustain addictions. Indeed these companies ‘…can and do control the level of nicotine delivered in order to create and sustain addiction’. Sworn evidence by ex-industry insiders in a number of other legal cases (cited in the Harvard study) make it clear that firms manipulate nicotine levels to maintain addictions.

The Harvard study shows that tobacco companies have increased nicotine yields per cigarette by 1.1% annually from 1997-2005 and by 1.6% annually from 1998-2005. This occurred in all types of cigarettes – mentholated, full-flavour, ultra-light – the lot. It occurred by increase nicotine concentration in the ‘tobacco rod’, by reducing the effectiveness of the filter on cigarettes and by reducing the cigarette burn rate which encourages more puffs per cigarette and hence more nicotine intake. More nicotine is delivered per puff and ceteris paribus per dollar.

The effect of these measures is to make it easier to get addicted to smoking. It also enables low income consumers to maintain their addictions in the face of rising cigarette prices.

Thursday, January 18, 2007

Puff harder, the price went up

An attractive paper by Jérôme Adda & Francesca Cornaglia in the September 2006 American Economic Review (a preprint here) re-examines popular accounts of the price-sensitivity of the demand for cigarettes.

Smoking can be defined as a process by which agents give their brains a nicotine hit. Nicotine is a psychoactive stimulant and one of the most addictive drugs around. Cigarettes are an efficient nicotine delivery device – once inhaled nicotine can reach the brain’s pleasure centres in less than 10 seconds where it increases the release and delays the metabolism of dopamine. It is this dopamine release that smokers seek.

This suggests that if the price of cigarettes rises because of a tax increase that consumers might endeavour to increase the nicotine they gain per cigarette by smoking each cigarette more intensively. This might occur by puffing harder, increasing the number of puffs, inhaling for longer periods and blocking ventilation holes on the cigarette filter. If this is true then the conventional findings that the demand for cigarettes is reasonably responsive to price (elasticities of the order of -0.4) in the short-run and a higher elasticity in the long-run (perhaps -0.7) might overstate the health benefits from smoking.

Adda and Coraglia build on work by William Evans and Matthew Farrelly (1998) and Jeffrey Harris (1980) in confirming such compensatory behaviour particularly among heavy smokers. They find that a 1% increase in taxes causes a 0.4% increase in smoking intensity. Smokers not only cut their smoking with a tax increase but compensate by smoking more intensively.

Smoking more intensively has the additional health cost of causing cancer deeper in the lung – see Michael Thun et al. (1997) – an adverse effect from a health perspective. This suggests that the value of excise taxes on cigarettes as a means of improving health has, in the past, been overstated.

Tuesday, January 16, 2007

Libertarian paternalism & drug policy issues

I got a buzz from reading the Becker-Posner blog on libertarian-paternalism. Their argument is in part a criticism of C. Sunstein & R. Thaler’s ‘Libertarian Paternalism is Not an Oxymoron’ .

Sunstein & Thaler claim it is both possible and legitimate for private and public institutions to affect behaviour while respecting freedom of choice because people's preferences are ill-formed and their choices are influenced by behavioural quirks such as default rules, framing effects, and starting points. Equipped with an understanding of behavioral findings of bounded rationality and bounded self-control, libertarian paternalists seek to steer choices in welfare-promoting directions without eliminating freedom of choice. This view, in turn, was responded to by Daniel Klein’s ‘Status Quo Bias’. This debate has impacts on the sorts of arguments posed for restricting smoking or the intake of obesity-causing foods.

Libertarians believe individuals should be allowed to pursue their own interests unless their behaviour negatively impacts on others. So individuals should be allowed to buy the food they want but drunk drivers should be constrained because they harm others. But modern research shows that individuals may not have enough information to effectively pursue their interests so, it is argued, government regulations and rules might help guide them to the better pursuit of interests they would have if they had additional information. A libertarian paternalist accepts these information arguments for government regulation but also stresses considerations such as bounded rationality and self-control.

Consider a person who smokes, but has an internal conflict between his stronger ‘self’ who wants to quit, and his weaker ‘self’ who continues to smoke when he feels under pressure or in social situations. The weaker self does not stop smoking because of limited self-control. Paternalism here seeks to help the more dispassionate self gain control over the choices made by the conflicted individual because of his dual selves. Such paternalism might take the form of high cigarette taxes, so that weak selves would not want to smoke so much or of ordinances to limit smoking in restaurants, bars, and other social situations to protect weak selves from temptation. The argument is that individuals are ‘happier’ if given a helping hand to exercise self-control. They might even be happier with high cigarette taxes though Posner notes smokers never lobby for higher taxes!

But Posner notes that libertarianism does not assume adults always know their interests or even are always able to act on their interests when they know them. It does assume that adults know their own interests better than government officials or professors. In addition being able to make mistakes through having the right to make one's own choices leads to more self-reliant, competent, and independent individuals. For example prisoners often lose the ability to make choices for themselves after spending many years in prison where life is rigidly regulated. Thus libertarians claim is that the ‘process’ of making choices leads to individuals more capable of making good choices.

Also it is difficult to distinguish libertarian paternalism from unadulterated paternalism because it is difficult to decide with objective criteria where ‘bounded rationality and bounded self-control’ are important and where they are not? Posner claims that models of rational addiction do as well if not better than models of bounded self-control when applied empirically to smoking behaviour. Why adopt models of bounded self-control in this case?

Take another illustration: Is the obesity problem due to bounds on rationality and control? If so, why did it not happen earlier, or why is the gain in weight so much greater in certain countries? If it cannot answer these questions is not libertarian paternalism simply substituting an intellectual's (or bureaucrat's, politician’s) beliefs about should be done for the judgment of others. Libertarians recognize the temptation in us to control choices made by others and so are in favour of allowing people to make their own choices unless there are external effects. Moreover, even well-intentioned government officials are subject to the cognitive defects that are supposed to affect choices by others. Can one have confidence that they will promote individual interests better than these individuals do themselves?

Posner therefore believes that the case for classical libertarianism is not weakened by the literature motivating libertarian paternalism. Indeed, when similar considerations are applied to government officials and intellectuals the case for classical libertarianism is strengthened!

Posner’s arguments go to the heart of the case for government intervention in certain markets to restore self-control. The key issues are:

1. Are individuals better placed to make sound consumption decisions than others can for them? 2. Does assigning people freedom of choice lead to better decision-making?
3. Do models of rational choice account for behaviour better than models of self-control?
4. Are those making policy judgements subject to the same behavioural defects as citizens subject to self-control problems?

My answer to 1. is certainly ‘no’ for young individuals whose brains are still developing. Most decisions to initiate smoking arte taken when smokers are young but most smokers wish they had never initiated the habit. My response to 2. is ‘not necessarily’. Addictive consumption choices need not lead to better longer-term decision-making. Certainly though, making individuals responsible for their choices, will overcome the ‘moral hazard’ implications of offering ‘treatment’ and ‘care’ to those who make poor consumption choices. To be clear here I favour such care and treatment options because of their moral hazard costs.

I think point 3. is incorrect. The existence of substantial self-control problems is evident throughout the addictive consumption and obesity literature. To take Thomas Schelling’s famous example – rational choice theory cannot explain why a cocaine addict will agree to sign a document admitting use of illegal drugs and give this document to the manager of a drug treatment clinic with the instruction that if cocaine is detected in his urine the document is to be forwarded to the police. Closer to home – as an ex-smoker - I find it fantastic for anyone to claim that individuals do not struggle to quit smoking even though they seriously want to.

Point 4. has value. Some anti-drugs crusaders do suffer from cognitive defects but many are scientists and doctors who do have good knowledge. The case against smoking is motivated by abundant medical evidence and the self-control issues that smokers face are documented in a vast body of neurobiological evidence. Its playing a silly game to claim it is wrong to believe that ‘experts’ are always right. Of course they are not always right – nor are they inevitably wrong or less well-informed than others.

Thursday, November 16, 2006

Carcinogens in cars not for kids

I posted just a few days ago on the possibility of banning cigarette smoking in cars where children are present. It happened today in South Australia - a bill was introduced to fine those who smoke in cars with children.

Supporters of the bill claim smoking in a car is 20X as dangerous as smoking in a house and that an hour's time spent sitting in a smoke-filled car is equivalent to smoking 3 cigarettes.

These fines are a sound policy move. Market-based approaches to dealing with such external costs are impractical in this situation and protecting children from carcinogens and asthma-causing tars is as sensible as protecting them from harm generally. Adults might come to appreciate the spillover effects of smoking on children and change their behavior elsewhere as well - particularly if this is boosted by a 'moral suasion' campaign which emphasises the particular dangers of passive smoking for young children.

Sunday, November 12, 2006

Vaccines for nicotine addiction & lung cancer

An interesting range of vaccines are being developed to deal with nicotine addiction. They prevent nicotine from activating pleasure centers in the brain.

If you are a smoker but don’t get to use this vaccine all is not lost. Scientists are also developing a vaccine for preventing smoking-induced lung cancer. So far experiments have been carried out on mice.

One wonders if the latter innovation will increase the demand for cigarettes by reducing the user costs of smoking. An earlier post that I made on the related issue of advertising cigarette cures suggests it might.

Passive smoking causes harm

Most people know that smoking is the largest preventable cause of death in the world today. Smoking is the only legal product which kills people when it is consumed as intended. A recent report claims smoking kills half the people who regularly smoke.

Defenders of smoking and opponents of smoking bans however claim that, if smokers internalize the risks of smoking, and are fully informed of its effects, that it unnecessary to target smoking with public policy. They argue the externalities caused by the effects of secondary smoke are so small that they can be ignored. The specific claim is that only 1% of the toxins in cigarette smoke are inhaled by passive smokers an amount so small that it is irrelevant.

But there are plenty of US studies that refute this optimistic picture. Indeed the earliest study (in 1981) of Japanese non-smoking women married to smokers found their lung cancer risks were raised 20-30% and their risk of heart disease by 23%. Recently, I found this interesting excerpt from a recent ABS publication. It further buries the myth that passive smoking is a beat-up by the moral police:

  • The breathing in of tobacco smoke by non-smokers can lead to harmful health effects in the unborn child, and middle ear infections and bronchitis, pneumonia, asthma and other chest conditions in children. It is also linked to sudden infant death syndrome (SIDS).
  • In adults, passive smoking can increase the risk of heart disease, lung cancer and other chronic lung diseases (Queensland Health 2006).
  • 37% of children aged 0-14 years live in households with one or more regular smokers, while 10% of children 0-14 years live in households where there is at least one regular smoker who smokes indoors.
The Queensland Health report cited is of interest. It states that passive smoking is a proven health hazard. Over 600 medical reports have been published linking passive smoking to diseases. In 1999-2001, in Queensland, exposure to passive smoking caused an estimated 21 deaths per year in children aged newborn to 4 years.

Libertarians who see smoking only as a ‘freedom of choice’ issue and who suppress the role of smoking’s health costs on both smokers and non-smokers alike are missing these points. There are significant external costs of smoking that need to be considered by those adopting the daft position of supporting smoking on the grounds that people have the right to kill themselves.

If you do choose to kill yourself you probably do have that right - though the death will inflict misery on your friends and family. But you definitely have no right to inflict smoke-induced health costs on co-workers, bar attendants and your children. As high taxes on cigarettes are regressive in their income-distributional impact, have low impacts on those hhighly addicted and because most people initiate smoking as immature youth, smoking bans as well as high cigarette taxes make good sense.

Non-smoking wives of smokers can of course walk-out of the marriage or force their spouse to smoke outside and should be encouraged to do so should they value their health.

But a good question is how to stop parents breathing carcinogens over 'their' children. Do they have the 'right' to do this in their 'own home' or their 'own car'? Smoking could be made illegal in cars with non-smoking passengers with hefty fines on those offending but in the home I can't think of a practical policy for limiting smoking that goes beyond providing information about its health consequences. The hope then is that idiot parents will act with consideration towards other non-smoking residents. Of course in schools children should be warned at a young age against inhaling secondary cigarette smoke, to encourage parents who must smoke to do so in a way that prevents secondary smoke from being inhaled by them. The suggestion of giving children the right to sue parents for health damages that can be attributed to passive smoking is an inviting one but there are manifest practical issues of establishing causation.

The main secondary consequence of being a child in a family that does smoke is that there is an increased probability of acquiring the smoking habit yourself.

Saturday, November 11, 2006

Aboriginal substance abuse

One of the most provocative papers at the recent APSAD (Australian Professional Society on Alcohol and Other Drugs) Conference was given by Don Weatherburn, director of the NSW Bureau of Crime Statistics and Research. In it he argued that the high arrest rates of Australian aboriginals were not due to their social disadvantage but primarily directly to substance abuse. Most aboriginal arrests are for drunkenness.

Weatherburn argued particularly for the need to control alcohol intake not by denying the blackfella access to booze but by encouraging local communities who sought to control supply. The paper was obviously influenced by Noel Pearson’s thinking on this issue – Pearson has written a broadly favourable response here.

A couple of points about substance abuse among aboriginals: While there are rising levels of illicit drug consumption (mainly marijuana but also heroin and amphetamines) there are very significant problems with licit drug abuse. Cigarette smoking and alcohol consumption are responsible for much higher mortality than among non-aboriginal populations. Many aboriginals, particularly women, do not drink at all but those who do drink tend to consume at hazardous levels. Rates of cigarette smoking among aboriginals are about twice those of non-aboriginals.

Volumetric tax reforms on alcohol that target alcohol content rather than product value are likely to fall heavily on poor aboriginals for whom cheap cask wine is a major source of alcohol. They may also create incentives to switch toward the use of more damaging illicit drug substitutes such as solvents. This limits the usefulness of general tax measures.

That alcohol is a neurotoxin and that it poses serious health risks might be a difficult message to sell to people who have lost their lands and have been left in an extremely difficult situation. But the effort needs to be made.

Health workers have often stated that cigarette smoking is a relatively minor concern in aboriginal communities given other pressing concerns but this isn’t true. Cigarettes are an expensive habit that impoverishes poor people on a daily basis. But more importantly it reduces life span and this is an important consideration given the persistent major health inequalities that exist between indigenous populations and the non-indigenous – aborigines born after 1996 are expected to live about 20 years less. Reducing smoking to even non-indigenous levels would make inroads into this disparity.

Some form of community-generated restrictions on consumption of licit drugs like nicotine and alcohol are one of the most direct ways of improving aboriginal health. They might have greater impact than targeting more nebulous issues of social disadvantage. Of course, in addition, the full range of legal and other policies for controlling consumption of illicit drugs makes sense. Its an issue I’ll try to look into further.