Emeritus Professor and chairperson of ASH, Robert Beaglehole, and ASH Director, Ben Youdan, believe that Aotearoa/New Zealand is well on track to smokefree in 2025.

The oped is published on NZ Herald Premuim.

OPINION:

Our decline in smoking in the past four years is extraordinary - equivalent to what took two decades to achieve. New Zealand has recently had some of the most dramatic decreases in smoking in the world, including for Māori and highly deprived groups.

Last month, the New Zealand Health Survey showed the daily smoking rate is now down to 6.8 per cent in adults, half the rate in 2018; almost a quarter of a million fewer Kiwis are now smoking daily, and it puts us in a tiny club of countries that have smoking rates under 7 per cent.

What we have in common with these successful countries is people switching from smoked tobacco to less harmful alternatives. The dramatic declines are accompanied by large uptakes in vaping, leading to a tsunami of 75,000 quitters in Aotearoa in the past year. To reach the smoking goal of 5 per cent or less (that is, 95 per cent or more of all adults being “smokefree”), around 100,000 smokers need to quit over the next two years.

Our decline in smoking in the last four years is extraordinary - equivalent to what took two decades to achieve. Photo / 123rf

The unprecedented progress shown in the New Zealand Health Survey should have been a cause to celebrate. Still, concern at the coalition Government’s intention to repeal the 2022 Smokefree legislation overshadowed this remarkable achievement.

Many have claimed this repeal would jeopardise the Smokefree 2025 goal. However, this is simply not the case. Predictive modelling, which contributed to the scientific underpinning of the legislation, indicated that it would take until 2040 to get smoking rates down to 8 per cent without the law. The reality is that we have already exceeded this expectation. And a closer look reveals that the three headline measures in the act were unlikely to have any impact before 2025.

For a start, the highly touted “smokefree generation” has already been achieved for people under 25. Only 3 per cent of people aged 15-24 smoked daily in 2022/23, a quarter of the rate only four years ago. Besides, the age restrictions in the act wouldn’t have taken effect until 2027.

Our decline in smoking in the last four years is extraordinary - equivalent to what took two decades to achieve. Photo / NZME

The nature of addiction is that demand does not respond rationally to reducing supply. While ever the demand for cigarettes remains high, abruptly limiting tobacco outlets on July 1, 2024 from 6000 to 600 would not significantly impact smoking rates but could penalise the almost 300,000 people still dependent on cigarettes. In addition, a sudden and dramatic 90 per cent reduction in retail outlets from around 6000 to 600 is likely to cause unnecessary chaos, especially in Auckland, with only 30 outlets allocated for about 90,000 people who smoke; each outlet would have to serve on average, approximately two customers every minute.

Finally, removing nicotine from all cigarettes (“denicotinisation”), slated for April 2025, is a de facto ban. The policy is untested at a national level and might not be the game-changer it’s claimed to be. Whether cigarettes stripped of nicotine will encourage people to stop completely, switch to vapes, or resort to criminally supplied regular cigarettes is not known. People smoke for the nicotine released in the burnt tobacco but die from the toxins in the smoke. Understandably, cigarettes without nicotine are not proving popular, and the major US supplier of denicotinised cigarettes is facing financial problems.

The authors argue Aotearoa New Zealand is well on track to be smokefree next year. Photo / Michael Cunningham

The Government emphasises its commitment to reducing smoking rates, particularly by promoting vaping as a safer and more affordable alternative. Vaping could save households up to $5000 per smoker annually, particularly benefiting people in lower-income brackets.

To move forward and convince opponents of repeal that it is serious about its smokefree commitment, the Government must present a robust action plan involving both legislative and non-legislative actions. The focus must be on people with high smoking rates, which include Māori, Pasifika, older people and the most disadvantaged; half of all people who smoke live in the most deprived households in our society.

Legislative options for the Government include outright repeal, revisiting the policy later, or introducing an improved Smokefree Environments Amendment Bill. Ideally, the third option would involve retaining the retail licensing system, legalising a greater variety of safer nicotine products such as snus and nicotine pouches, and gradually reducing retail outlets over time, with a focus on fair access for adults who smoke.

Legislative options for the Government include outright repeal, re-visiting the policy later, or introducing an improved Smokefree Environments Amendment Bill.

Regardless of the option chosen, the Government can immediately implement necessary non-legislative measures, including:

1. Enforcing penalties for sales of both cigarettes and vapes to underage people.
2. Including vaping as the most effective and cheapest cessation tool in all cessation programmes.
3. Promoting information campaigns to encourage reduced-harm products for adults and correct misinformation and stigma about vaping while protecting children from starting vaping.
4. Ensuring that all health professionals and stop-smoking services offer reduced harm products and promote successful “swap to quit” schemes based on the UK model.
5. Scanning all imported containers at the border to control illicit trade and reduce tobacco crime and loss of government revenue.

With these comprehensive measures, and even in the absence of the Smokefree 2022 legislation, the coalition Government can achieve the Smokefree 2025 goal, re-enforcing New Zealand’s reputation as a world leader in tobacco control.

Robert Beaglehole, chair, and Ben Youdan, director from Action for Smokefree 2025