The Government’s Goal for a Smokefree New
Zealand by 2025: more decisions, and more detail, are urgently
In their Response to the Report from the Māori Affairs
Select Committee (MASC) Inquiry,1 the New
Zealand Government has articulated the goal of a smokefree nation by
2025.2 This is a wise and visionary move, which
is critical to protect the health of all New Zealanders in the face of the
ongoing tobacco epidemic. It is also consistent with strong public (and often
majority smoker) support for progress with tobacco
control.3–8 Nevertheless, a close reading
of the Response to the MASC Report suggests that the Government has avoided
decisions it could make now, and there are many areas of the Response that
urgently need further detail.
The Table below briefly summarises some of these
requiring decisions and/or detail
The goal in the Government’s Response is defined as:
“reducing smoking prevalence and tobacco availability to minimal levels,
thereby making New Zealand essentially a smoke-free nation by 2025”.
However, such an important goal deserves to be more clearly defined. Doing so
will make progress measurable. For example, the goal could be “a daily
smoking prevalence of <0.5% of the adult population with an interim milestone
of <10% by 2018”. Or the goal could be “a complete ban on the
sales of tobacco in 2025” (with the few residual smokers having to grow
their own tobacco). The latter option has many advantages as it communicates an
unambiguous message: (i) to the tobacco industry that its time in this country
is up; and (ii) to youth and current smokers that there is no long-term future
in smoking (and thus every reason not to start, or to quit now).
In a previous NZ Medical Journal
editorial9 some of us stated that detailed and
urgent implementation planning is required. The Government’s Response
promises “further detailed work” to set “mid-term
targets”, but avoids saying when those targets will be set. Instead of
noting that: “The Government is considering ...”, the Response would
have achieved more if it provided details on the process by which a
more detailed plan will be formed (e.g., a task force), and the timeline
this will follow. The Response states that the “Government already
has a comprehensive action plan”, but the last such plan was for the 2004
to 2009 period. A new Ministry of Health plan for tobacco control has been
urgently needed since 2009.10 In particular,
critical decisions need to be made now about which of the following four major
mechanisms will be pursued: (i) an annual “sinking lid” on tobacco
sales down to a sales ban11-13; (ii) an ongoing
system for regular tobacco tax increases until a sales
ban12; (iii) a system for phasing down nicotine
levels in tobacco12 14; and (iv) using
alternative nicotine delivery products during the tobacco phase-out
around why proposed new legislation is not more comprehensive
The proposed legislation that will eliminate tobacco displays at point-of-sale to which the Response refers, appears to be a highly desirable step towards the goal. However, there is also an opportunity for proposed law changes to ensure NZ maintains parity with other developed countries, many of which have adopted more far-reaching tobacco control policies. Examples include banning smoking in cars with children and expanding smokefree areas (e.g., the outdoor areas at hospitality venues16). Other opportunities including updating the current sets of graphic health warnings17 and declaring an intention to introduce plain packaging with Australia.18
bipartisan support for the goal
We note that the “2025” date is five electoral cycles away. Responding to the tobacco epidemic requires major political parties to forge substantial common ground, as has already occurred in some policy domains in NZ (e.g., superannuation, nuclear-free policy, and putting a price on carbon emissions). Developing (and committing to) a shared tobacco control agenda will be pivotal to bringing about the tobacco endgame – and moves to achieve this cooperation need to outlined by the Government.
Many other issues require attention if rapid progress
towards the goal is to be made. Key examples include:
New Zealand policies against international best practice, behind which New
Zealand currently sometimes lags (e.g., smokefree cars with
children19 and expanded smokefree
areas16). Further aligning tobacco control
policies internally to reduce policy
incoherence20 is also desirable.
capacity of the Ministry of Health tobacco control team, especially if a Tobacco
Control Agency is not to be implemented. At present there are only a small
number of staff dedicated to tobacco control, offering limited capacity to deal
with the large body of work required to achieve the goal.
the overall level of fragmentation of the tobacco control sector in New Zealand
and enhancing the extent of knowledge transfer between different DHB districts
and between organisations.
that progress for Māori is as rapid as for non-Māori in the path
towards the tobacco endgame. This will require a mix of national and local
policies, led by iwi (tribes) or undertaken in close partnership with iwi, local
health agencies and non-governmental agencies.
summary, the goal of a smokefree nation is an important step forward, but
achieving this will only be possible if it is supported by sustained leadership
across major political parties, by the necessary work on the major mechanisms,
and appropriate timetabling and resourcing. If these are achieved it will be a
major advance for the health of the population and an important way to reduce
the still substantial health gaps between Māori and non-Māori New
Department of Public Health, University
of Otago, Wellington2
Marketing, University of Otago, Dunedin3
Whakauae Research Services, Whanganuifirstname.lastname@example.org
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