By Richard Edwards and members of the ASPIRE 2025 Research Centre
In April 2021 the New Zealand government published a discussion document with a draft action plan for Smokefree 2025. The goal itself is not new; it was first announced by the New Zealand government in 2011, following a recommendation from the Māori Affairs Select Committee of the New Zealand Parliament. Smokefree was defined as minimal prevalence of smoking and availability of tobacco products. Since then, the smokefree sector has called on successive governments to develop a strategy and action plan setting out how the goal will be achieved.
The document sets out a comprehensive strategy that includes several world-leading measures, including to address two currently unregulated areas.
First, it proposes greatly reducing the retail availability of smoked tobacco products and gradually phasing out sales altogether. Strategies include options that would markedly decrease the number of stores able to sell these products (possibly to around 5% of the current number), requiring tobacco retailers to have a licence and restricting tobacco sales to specialist stores or community pharmacies. It also puts forward a ‘smoke-free generation’ policy, where the legal age of purchase for smoked tobacco products would increase by one year every year, effectively meaning that future generations will never be able to legally purchase tobacco products and sales would eventually cease.
Second, it proposes removing virtually all the nicotine from cigarettes and tobacco, so these become much less addictive.
Additional measures to regulate tobacco products are also included in the plan. Proposals include making tobacco products less appealing by removing flavours and other additives, and banning product design innovations that may appeal to young people, such as flavour ‘crushballs’ in cigarettes. The proposals also include banning filters to reduce the environmental harm caused by cigarettes and to prevent filters misleading people who smoke about health risks. The plan also proposes increasing mass media and social media promotions to promote quitting and deter smoking uptake, and enhancing smoking cessation support and community-based smokefree interventions.
Structural changes to strengthen the tobacco control system in New Zealand are also included – most importantly to strengthen Māori (the Indigenous people of New Zealand) governance of the smokefree programme. Other proposed changes are to enhance community actions for Smokefree 2025; improve research, monitoring and evaluation; and strengthen enforcement and compliance-enhancing activities. The plan emphasises achieving equitable reductions in smoking prevalence to reduce the substantial disparities that currently exist due to the much higher smoking prevalence among Māori, Pasifika and low-income communities.
The plan is notable for its comprehensive and ambitious approach, and has attracted global attention due to the inclusion of several innovative policies not yet implemented at the country level. If implemented in full, the New Zealand experience could provide crucial evidence for other jurisdictions wanting to eliminate the health loss, inequity burden and economic burden created by the tobacco epidemic.
Under its ‘business as usual’ approach, New Zealand was on track to miss the Smokefree 2025 goal by a wide margin, particularly for Māori, Pacific and low-SES populations. The action plan provides a realistic roadmap to reduce smoking to minimal levels by 2025. It would also protect the health of current and future generations of young people by minimising their risk of experimenting with and becoming addicted to smoking.
Key NGOs and public health organisations in New Zealand have warmly welcomed the proposed actions, as have many international health researchers and public health experts. Local experts, in collaboration with international colleagues, have initiated a series of blogs commenting on the plan and specific proposals like denicotinisation.
Consultation on the action plan is currently open, with submissions accepted until 31 May 2021. Members of the international tobacco control community can read more about the plan and make submissions here.
Richard Edwards, Nick Wilson and Janet Hoek are Professors of Public Health, George Thomson is Associate Professor of Public Health and Jude Ball is a Research Fellow in the Department of Public Health, Department of Public Health University of Otago, Wellington. Lindsay Robertson is a Senior Research Fellow in the Department of Preventive Medicine at the University of Otago, Dunedin. All authors are members of the ASPIRE 2025 Research Centre. The authors declare no conflicts of interest.