Women smokers should read beyond the first para of a Herald report today that says they are being offered vouchers for up to $300 if they quit while pregnant.
The vouchers are up for grabs because of the damage a mother’s tobacco use can do to an unborn baby.
Pregnant or not, you have to live in the right area to qualify.
Oh, and your race is an important consideration, too.
If you happen to be neither Maori nor Polynesian, too bad. You will find our health system has become unabashedly racist and isn’t too fussed about weaning you off fags to protect your unborn child.
The fine print is plainly spelled out on the Counties Manukau Health website:
To be eligible, women should be:
Pregnant – up to 28 weeks and
Maaori or Pacific Island and
Living in Manurewa (includes Weymouth, Clendon and Wiri)
According to the Herald report:
The voucher scheme in South Auckland, for groceries, baby products, phone credit, cinema tickets or petrol, is among the latest additions to the Government’s arsenal of quit-smoking schemes in which the main weapon is a four-year programme of annual 10 per cent tobacco tax rises.
The latest price hike took effect yesterday.
But making the price of a smoke almost prohibitive isn’t enough. The team behind the voucher scheme says overseas trials have shown that incentives can motivate quitting by pregnant women who are finding it hard to stop.
At this point of the Herald story we get a hint that non-Polynesian women aren’t being covered by the new scheme.
Because of the persistently high rate of smoking among pregnant Maori women, researchers are looking for new ways to help them quit.
Smoking is declining and in the latest national survey last year, 15.5 per cent of adults of all ethnicities smoked daily. For Maori the figure was far higher, at 36 per cent.
Earlier research found that 44 per cent of pregnant Maori women were smoking when they registered with a midwife and that this had dropped to 34 per cent when discharged from the midwife’s care. For Pakeha, the rate went from 13 per cent, to 10.
Then we learn that smoking during pregnancy contributes to higher rates of miscarriage, pre-term births, low-birth-weight babies’ difficulties during childbirth, sudden infant death syndrome, asthma and glue ear.
Auckland University tobacco control expert Dr Marewa Glover said the affected children, especially girls, were at greater risk of taking up smoking themselves.
But the new voucher scheme has been racially geared to rule out most women and their babies from benefiting.
The Counties Manukau District Health Board is giving vouchers at one week, four, eight and 12 weeks after a woman’s quit-smoking date if she remains smokefree, verified by tests on a machine that measures carbon monoxide.
The vouchers are offered to Maori and Pacific women up to 28 weeks pregnant who live in Manurewa, where the DHB says there are around 370 “smoke-exposed” births a year.
They cannot be exchanged for cash, alcohol or tobacco.
An economic rationale is provided.
The DHB says the benefits of preventing smoking-related birth complications far outweigh the maximum voucher cost of $300 cost for each woman.
“By comparison, a 24-hour period of care for a premature baby costs up to $3000.”
But no rationale is given for the racist basis of eligibility.
To the contrary, the fact is that all pregnant women and their sprogs would benefit.
A review of 19 studies of quit-smoking competitions and rewards, published by the international Cochrane Library in 2011, concluded that “smokers may quit while they take part in a competition or receive rewards for quitting, but generally do no better than unassisted quitters once the rewards stop”.
Theresa Marteau, professor of health psychology at Kings College, London, reviewed research on financial incentives in a study published in the British Medical Journal in 2009. “The theory is that much of our behaviour – 45 per cent – is habitual,” she said. “The idea of incentives is to help break bad habits and, once the new habit is established, the incentive can be removed. But unless you change the environment, the chances of success are reduced.”
The aforementioned “tobacco control expert”, Dr Marewa Glover, seems comfortable about injecting a racist element into the campaign to reduce smoking.
The Herald says:
Dr Glover’s group is trialling another approach called “the Aunties”: Maori women find pregnant women through their community networks and urge and support them to quit smoking – and to register with a midwife.
This Glover sheila does not disguise her ethnically selective approach – nah, let’s call it racist – to combating tobacco.
Since her award winning doctoral research on Māori smoking cessation in 2000, Dr Glover has led and supported many tobacco control focused and kaupapa Māori health research projects including: studying smoking in pregnancy among Māori women; what motivates Māori and Pacific Island people to stop smoking and what they want from cessation services; the health, social and economic consequences of smoking for Māori; and many more.
She established and directs the 21 University of Auckland’s Centre for Tobacco Control Research, described as New Zealand’s only research centre dedicated to tobacco control “and to building Māori and Pacific tobacco control research capability and capacity”.
When it comes to racist policy-making, of course, you are bound to find Tariana Turia eagerly involved.
And sure enough, in October 2012 dear old Tariana returned from a week in Brisbane, attending “the international network of indigenous health knowledge and development conference”.
She said (here):
And I was fascinated at the use of incentives or inducements to encourage clients to come in through the doors, or to model ideal practice (ie pregnant women might be offered grocery vouchers if they stop smoking).
The conference was not necessarily told of the need for race-based eligibility criteria.
But in this country our indigenous people are special people.
So let’s give them special treatment, eh?
And if an explanation is needed, well, we can always bring up the matter of colonisation and recall how the bloody Europeans brought tobacco to this fair land, and how the splendid Maori people have been on the back foot ever since.