The rate of smoking in Whanganui has not changed in three years - despite almost $1.7 million being spent to stub out the habit.
A Whanganui District Health Board committee heard last week that smoking had increased in Whanganui from 19.1 per cent of people in 2013 to 19.6 per cent in 2016.
During those three years, the health board has had $435,000 each year to spend on stop-smoking programmes, Te Oranganui received $225,000 and the Whanganui Regional Health Network at least $161,295, making a total of at least $1,691,295.
Whanganui Regional Health Network contracts manager Chloe Mercer told the health board's combined statutory advisory committee that the region had the second highest percentage of smokers in New Zealand.
With 37.5 per cent of Maori and 18.4 per cent of Pacific Islanders regularly smoking, both groups are higher than the national average.
"We've flatlined in terms of change in the amount of smokers - though that isn't for want of trying," Ms Mercer said.
She said data suggested some success in getting people to quit, with the health board meeting the government target of 5 per cent for the number of smokers enrolled into stop-smoking programmes.
However, she believed any reduction in smoking was offset by population changes.
"What we have is more people leaving Whanganui who are non-smokers and more coming in who are smokers."
Health board member Dame Tariana Turia - who has been a leading anti-smoking campaigner - was concerned the money was not being spent effectively.
"To think of spending, quite frankly, and wasting a million dollars and it's not working ... that bothers me hugely," she said. "I would sooner charge people more for their cigarettes."
Dame Tariana said the board might have to rethink how health services were communicating with the public about the issue.
"We need to change the way we send messages to smokers.
"Our goal is about saving people's lives. We can't stop people from doing anything, but let's give people another message, and let's help them to address the addiction."
The former Associate Health Minister suggested smokers could be given help in a similar manner to those who receive drug and alcohol counselling.
"When I was at Te Oranga nui, we had a young man working for us [who] was a recovering alcoholic," she said.
"He took our alcohol addiction process and introduced it into cigarette smoking - it was extremely effective."
The Whanganui health board receives $435,000 each financial year for stop-smoking services, and from July 2016, the regional health network received an additional $340,000 for a smoking reduction contract from the Ministry of Health.
Combined with the health board's underspend from the previous year, a total of $962,000 will be spent on anti-smoking services this year in the Whanganui region.