Commenting on the alleged adverse reactions in Europe to Kava , Dr Colin Tukuitonga (a Director of Public Health from the New Zealand Ministry of Health): The evidence on which the decision was taken in Europe is based on a series of cases of people with liver problems that have been associated with the consumption of Kava. From an epidemiological point of view, you need to be very careful about that because it may be that there are other factors. Dr Tukuitonga says people using Kava may also drink alcohol, a known cause of liver damage.

Dr Ed Gane, a liver specialist at Auckland and Middlemore Hospitals, New Zealand, says a whole host of viruses, drugs and toxins can cause hepatitis or inflammation of the liver. Dr Gane says hepatitis B is far more likely to cause liver damage and there is a high rate of this in the Pacific, with New Zealand alone having 60,000 sufferers. Dr Gane says isolated reports of Kava and liver disease, certainly in the population of the Pacific islands where Kava is used, are also the countries where there is a very high rate of hepatitis B and it's important someone, who for example is taking Kava and has liver damage, that you make sure they don't have hepatitis B, which is a by far a much more likely cause of their liver damage. Auckland is the largest Polynesian city in the world and Kava root is readily available in stores and is regularly used by the Pacific Island community living in the city.