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Smoking’s sunset a step closer – Expert Q&A

The Health Select Committee has given the green light to the Smokefree Bill this week. Its report makes additional recommendations as well, like capping the number of tobacco retailers to no more than 600.

Yesterday, Action for Smokefree 2025 (ASH) released its Year 10 survey, which shows very low smoking by adolescents – but a slight rise in daily vaping overall, and a larger rise for Māori teens.

The SMC asked experts to respond to the Committee’s report.

Professor Janet Hoek, University of Otago, Wellington, and co-Director of ASPIRE2025, comments:

“The Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Bill outlines three core measures that are very likely to reduce smoking prevalence. The Health Select Committee has recommended retaining all three.

“Evidence from trials and modelling suggest that ‘denicotinisation’ (lowering the nicotine content in tobacco products), the first of these measures, will quickly reduce smoking prevalence and we believe this measure should be introduced as soon as possible.

“However, the other measures presented in the Bill are also important in achieving a Smokefree Aotearoa. The retail reduction measure recognises that it makes no sense to treat a toxic product like tobacco as though it were a normal consumer product. Several studies and reviews report strong associations between tobacco outlet density and youth smoking; reducing outlet numbers will protect young people while removing temptation from the many people who smoke and want to quit.

“Thirdly, the smokefree generation policy recognises that there is no safe age to begin using tobacco; this far-sighted measure will also protect young people.”

What will be the effects on inequalities in smoking?

“Importantly, all three policies are pro-equity and will help reduce smoking prevalence among all population groups. Modelling shows that all three will reduce health inequities caused by smoking. For example, reducing retail will lower the concentration of tobacco outlets in higher-deprivation neighbourhoods, thus helping to reduce smoking uptake and supporting cessation. The ‘smokefree generation’ measure is strongly pro-equity, and the younger demographic profile of Māori and Pacific populations means the impact will be greater among these peoples. Furthermore, the Bill and Action Plan recognise the importance of Māori leadership, which inspired the work now represented in the Bill’s core measures.”

How will reducing the number of tobacco retailers affect local retailers like dairies?

“Reducing the number of outlets selling tobacco will improve community wellbeing, and enhance the safety of retailers. Tobacco products cause many harms; they are deeply harmful to people who use them, and to whānau and communities, and they also cause harm to the people who sell these products.

“Media reports of retail crime often cite theft of tobacco and vaping products. Removing tobacco from small dairies will help remove an important risk to the business and staff working there. There are strong reasons why vaping products should only be sold by specialist retailers and it will be important to turn our attention to measures that will reduce youth vaping, which is rising in Aotearoa NZ.”

How significant is this proposal and how does it compare to other countries?

“Aotearoa NZ’s approach is truly world-leading, based on robust evidence, and very likely to bring profound public health benefits. Other countries, including the US, are considering denicotinisation; retail reduction measures are in place or planned in some countries, and several countries are planning to create not simply a smokefree generation but a nicotine-free generation. The Government has positioned Aotearoa as a global leader in proportionate and well-designed policy and, just as we saw with plain packaging when Australia introduced this measure, we expect many other countries to move quickly to follow our lead.”

Conflict of interest statement: “I receive (or have received) funding from the Health Research Council, Cancer Society, and Royal Society Marsden Fund.”

Dr Kelly Burrowes, Auckland Bioengineering Institute, University of Auckland, comments:

How do vaping rates compare to smoking rates in Aotearoa?

“While smoking rates are declining, vaping and overall nicotine use is on the rise. Electronic cigarettes (ECs) or vapes are touted as a safer alternative to conventional cigarettes but their long-term health effects are unknown. However, evidence is mounting that EC use is not benign. The e-liquids used in ECs and the resulting aerosol have been found to contain dangerous chemicals, including carcinogens, heavy metals, and some flavouring chemicals.

“The ASH survey results show decreasing smoking rates but vaping rates are increasing much more rapidly than this, and do show that nicotine use in adolescents is increasing. This is particularly concerning as adolescent brains are still developing and nicotine addiction acquired at this age is much harder to kick.

“Dual use – vaping and smoking – increases the chances of harm by exposing the user to both sets of chemicals.”

What are your comments on the Health Committee report?

“The Health Committee has recommended that the Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Bill be passed. This bill aims to continue to stifle smoking rates and meet the Smokefree Aotearoa target of smoking rates 5% or lower by 2025.

“These amendments consist of three parts that will be phased in over the next several years: 1. Reducing availability by reducing the number of retailers able to sell smoked tobacco products (from ~6,000 currently down to a maximum of 600), 2. Reducing appeal and addictiveness by enforcing reduced nicotine levels, also known as denicotinisation (with a maximum strength of 0.8 mg/g), and 3. Creating a Smokefree generation by banning the sale of smoked tobacco products to people born on/after 1st January 2009. These are bold and world-leading initiatives with limited or variable evidence of their success in smoking reduction, but all innovative policies involve risks. Smoking is the single largest preventable cause of death worldwide contributing to 1 in 10 of all deaths.

“The National and ACT Parties have different views and oppose these changes. The National Party’s concerns are around reducing the number of retailers over ‘harm to livelihood of many small businesses’ and over the smokefree generation proposal noting limited data on the effectiveness of this approach. And the fact that people’s freedom of choice will be impeded. Instead, National proposes deploying these initiatives in a different order starting with denicotinisation, retail reduction, and finally the smokefree generation. The ACT party raised concerns over illegal importation and organised crime with the proposed restrictions.”

No conflict of interest.

Professor Richard Edwards, Professor of Public Health and co-Director of ASPIRE2025, University of Otago, comments:

“The Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Bill is a landmark for public health policy and legislation in Aotearoa New Zealand. The Health Select Committee (HSC) report recommends that the three key measures in the Bill (mandated denicotinisation – i.e. lowering nicotine content, greatly reduced retail availability of tobacco, and introducing a smokefree generation) should be introduced approximately as set out in the original text.

“This is extremely welcome as research evidence – and logic – suggests that these measures collectively will help ensure that smoking prevalence decreases rapidly and equitably, and hence will greatly bring forward the achievement of the Smokefree Aotearoa goal for all peoples.

“The HSC report makes some additional recommendations. The most important ones are that the Bill should specify a maximum number of retail outlets (600 in total) and a upper limit of nicotine in smoked tobacco products (0.8 mg/g tobacco) rather than leaving this to subsequent regulations. Specifying these limits is a very important addition. However, I believe that the final regulations should require that the nicotine content in cigarettes is no more than 0.4mg/g tobacco, as that level is associated with the clearest evidence for minimising the addictiveness and appeal of smoked tobacco products, and promoting and supporting quitting among people who smoke.

“Similarly, I believe that the final regulations should consider reducing the number of retailers to around 300 – consistent with a 95% reduction on current numbers – as this is likely to have maximum effect in reducing smoking uptake by young people, and triggering and supporting people who smoke to quit.

“The HSC has made some further useful suggestions about restricting online sales to ensure that these are only available to people living in areas with very limited access to tobacco products after the number of retailers has been greatly reduced. Reducing the number of tobacco retailers should also help reduce tobacco-related thefts as the tobacco retailers that continue to sell tobacco can be equipped with enhanced training and security measures.

“Importantly, the legislative measures will be supported by other interventions set out in the Government’s action plan including: enhanced community-based health promotion and smoking cessation support services; greater monitoring and enforcement to prevent tobacco smuggling and sales to minors; and strengthened Māori governance of implementation of smokefree measures at national and community level.

How significant is this proposal and how does it compare to other countries?

“I am delighted that the HSC has supported the world-leading measures that the Government has proposed. The actions taken in Aotearoa could result in significant global improvements in public health. Other countries are already considering following our lead. For example, the USA is considering mandatory denicotinisation, the Netherlands is introducing measures to reduce where tobacco products can be sold and Malaysia and Denmark (among others) are considering introducing a smokefree generation. Just as when Ireland originally introduced smokefree bars and restaurants and Australia implemented plain packs, the example set in Aotearoa with this ground-breaking legislation will likely rapidly be followed by other countries seeking to emulate our success.”

No conflicts of interest.


Selah Hart, Chief Executive Officer, Hāpai Te Hauora, comments:

“Hāpai Te Hauora welcomes the recommendations in the recent Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Bill to restrict the number of approved retailers to 600, introduce a maximum level of nicotine at 0.8mg/g, and the implementation of a Smokefree generation. The expectations laid out for manufacturers and importers of notifiable products (including vaping products) is a promising start to the work that must be done in the area of vaping regulation, particularly among rangatahi Māori. Hāpai also commends the Health Select Committee for its recognition of the impact of smoking rates and smoking-related illnesses on Māori and the subsequent changes recommended to the purpose statement.”

No conflicts declared.

Emeritus Professor Robert Beaglehole, Chair, ASH – Action for Smokefree 2025, comments:

““It is good to see the Bill reported back since there are several good aspects to the Bill.

“The ‘good news’ cigarette smoking story is firstly, the very low rate of adult daily smoking – now 8% – revealed in the latest New Zealand Health Survey. New Zealand/Aotearoa is on track to achieve the Smokefree 2025 goal of an adult daily smoking rate of less than 5%.

“Secondly, the very low rate of youth smoking as shown by the 2022 ASH Year 10 survey results released yesterday. New Zealand/Aotearoa has already achieved a “Smokefree generation” – this is one of the three main proposals in the Bill. Further, daily vaping by young people appears to have levelled off.

“The other two main proposals in the Bill may have unintended effect. The Health Committee recommends cutting cigarette retail outlets to 600 down from over 5000. This will be very hard to accomplish fairly and may unduly penalise cigarette smokers by making it harder for them to obtain cigarettes.

“The mandatory denicotinisation policy, third main policy, will not come into effect for at least two years and thus will not help achieve the 2025 goal. At best, it may encourage the tobacco industry to promote less harmful products such as vaping. But it might also encourage illicit cigarette trade.

“The Government needs to more to encourage and support adult smokers to make more quit attempts more often including by promoting less harmful products such as vaping the best evidence-based aid for cessation.”

No conflict of interest.