Between the time you read this this morning and the time Nova Scotia’s Health Minister Jamie Muir welcomes delegates to a conference on smoking policy in Clementsport tomorrow morning, smoking will kill four or five Nova Scotians.

The precise number is impossible to pin down, but since smoking kills an estimated 1,650 people in the province every year, the 24-hour period between this column and tomorrow’s conference should see about four or five smoking-induced deaths.

On a per-capita basis, that’s a lot more than die from smoking in other provinces. But then, a lot more Nova Scotians smoke than residents of other provinces — half again as many as in British Columbia, for example.

Health planners constantly stress the need to move away from illness care toward disease prevention and the promotion of healthy habits. Since research implicates smoking in so many diseases, it’s an obvious target for public health policy; one with fairly quick payoffs in reduced health-care costs.

For years, public health organizations like the Cancer society and the Heart and Stroke Foundation have urged the province to take action against our high smoking rates. For a time, it seemed as though the province was listening. It hired Merve Ungurain to develop a comprehensive anti-smoking plan, and committed $450,000 to the project.

Ungurain will present his recommendations at the Clementsport conference in a talk titled: Reducing Tobacco Use — What Works, and subtitled: A Comprehensive Tobacco Control Strategy for Nova Scotia.

As Ungurain will tell delegates tomorrow, what works in getting people to stop smoking and keeping youngsters from taking it up, is higher prices and bans on smoking in public places.

In 1995, Massachusetts introduced a comprehensive program that included higher taxes and municipal restrictions on smoking in public places indoors. By 1999, smoking rates among youths had fallen from 36 per cent to 30 per cent.

Between 1992 and 1999 in Massachusetts, smoking rates among pregnant women fell from 25 per cent to 13 per cent. Smoking rates for all Massachusetts residents dropped 33 per cent over the same period, versus only 10 per cent in the rest of the country.

Using a similar strategy — bans on smoking in public places combined with higher tobacco taxes — California has experienced a 50 per cent cut in tobacco consumption since 1989.

The payoff was swift: 14 per cent fewer lung-cancer deaths in California since 1989, and 33,000 fewer deaths from heart disease during the same period.

Nova Scotia has the highest rate of smoking in Canada, at 29 per cent, and the highest consumption of cigarettes per smoker. Twenty-eight per cent of our pregnant women smoke, as do 31 per cent of teens between 15- and 19-years old.

At those rates, estimates GPI Atlantic, a Timberlea-based think-tank, 65,000 of today’s children and teens in Nova Scotia will become regular smokers, and 15,000 of them will die from their addiction by middle age, losing about twenty-two years of life each compared with non-smokers.

If provincial policy could persuade just 10 per cent of Nova Scotia smokers to quit, says GPI, “the province would save $1-billion over thirty years and save 92,000 life years, compared to the costs incurred if these quitters had kept smoking.”

Whether the province is prepared to implement such a comprehensive policy seems increasingly doubtful. In a series of public statements, Muir and other senior provincial officials have hinted that Nova Scotians should not expect too much from them.

Instead, Muir has returned to the old chestnuts of anti-smoking education for young people and money to help addicted adults buy nicotine gum.

Unless supported by price increases, anti-smoking campaigns aimed at young people are notoriously ineffective. And subsidizing sales of nicotine gum won’t do anything for the thousands of non-smokers involuntarily exposed to smoke at their work places in the bar and restaurant industries.

The government needn’t try to blame its failure to act on the deteriorating economy. A province-wide ban on smoking in bars, restaurants, bingo halls and community centres wouldn’t cost a thing. Increasing the tax on cigarettes by $10 per carton — restoring price levels that existed before the Mulroney administration caved in to big tobacco  would actually bring in money.

The government has a stark choice between forcefully trying to discourage smoking, and empty words. Jamie Muir’s actions tomorrow will tell us which choice it has made.