By Marewa Glover & David Sweanor
New Zealand led the world in the fight against smoking-related illnesses with its Smoke-Free Environments Act 1990.
Almost three decades and several amendments later, New Zealand is on the threshold of passing another revolutionary piece of public health legislation.
Yesterday the Associate Minister of Health, Nicky Wagner, announced a further step in legislative change that will see nicotine for use in vaping products legalised for import, marketing and sale by the end of 2018.
The move has signalled the Government's support for smokers to switch to the harm-reduced alternatives. Referring to vaping, she went as far as encouraging every smoker to "take it up".
Very large numbers of smokers worldwide, keen to reduce risks, have switched to vaping products, various forms of smokeless tobacco, medicinal nicotine and products that heat, rather than burn, tobacco.
Non-combustible tobacco and nicotine products are also evolving rapidly making it difficult for governments to keep up.
In a bold and progressive move, Wagner is establishing a pre-market approval process that could see some of these new products available to New Zealand smokers in early 2018.
The process neatly provides a more rapid and cost-effective means of considering new smoke-free products than the current system requiring a change of legislation every time an advance in science and technology provides a better way to help people stop smoking.
The question remains, will these changes go far enough to achieve the Smokefree 2025 goal? Some anti-smokers think not and they have proposed a regressive abolitionist plan that frankly could have been written last century.
The threat to Smokefree 2025 is not a lack of science, technology, business viability nor consumer interest, but rather a collective failure of vision.
It isn't that smokers do not want to quit smoking, but that they are dependent on nicotine and are given few options other than the deadly inhalation of smoke in order to get it.
The aspiration was to reduce the number of people smoking tobacco to 5 per cent or below. If two thirds of the remaining smokers switch to smoke-free products, which is significantly fewer than the proportion saying they would like to quit smoking, the goal is achieved.
Unfortunately, to some of the world's anti-smoking advocates, "smoke-free" doesn't mean just stopping smoking.
Instead the absolutist goal of total nicotine abstinence is held up as the real goal. This is despite the fact we've known for decades that while people smoke for the nicotine, they die from the smoke.
The culprit in this public health disaster is the inhalation of the products of combustion, rather than the use of dependence-producing but relatively innocuous nicotine.
A visionary approach to tobacco and nicotine would switch from this abstinence-only approach which is lacking in compassion and ethics, let alone viability.
People make hundreds of small choices a day, many of them to reduce their risk of disease or harm, for instance, wearing a seatbelt, using a condom, or hiding their PIN number when they use an ATM.
It's unusual to have a government more progressive on tobacco control than some leading tobacco control academics and workers but we've seen it before and we're seeing it again.
The only other country to fully embrace a harm reduction approach to smoking and shift to reducing inequities is the United Kingdom, but even the US is now catching up by embracing the concept of a continuum of risk and helping smokers move to non-combustion alternatives to cigarettes.
The trend towards a pragmatic risk-reduction approach to nicotine use will invigorate efforts to reduce the carnage of smoking, and New Zealand looks set to once again be in the vanguard.
The New Zealand Government's moves send a clear message that it is smoke that causes smoking-related disease (not nicotine) and that it is massively safer to use a smoke-free nicotine product.
The next step is to ensure a range of such products will be easier to access than smoking products.
Which means they will be sold by retailers convenient to the groups that need them at a cheaper price than combustible tobacco.
The culture of alienating and shaming smokers, and by dint of similarity, vapers, also needs to be curbed.
This is not about punishing sin but saving lives. Discrimination against people who vape or use other non-combustion forms of nicotine, by the imposition of time-wasting inconveniences due to unfounded bans by businesses and district health boards should be discouraged.
If we are to reach the most alienated smokers who feel unfairly taxed and excluded, we need to shift to an approach that treats them with dignity and empowers them to make decisions to protect their health.
Smoke-free products will not only massively reduce smoking-related disease, they can literally deliver New Zealand's Smokefree goal and save many thousands of lives.
Regulation that too heavily restricts access to them ironically protects the cigarette trade. Ensuring people who smoke have easy access to a broad range of alternatives to cigarettes gives a gift to humanity rather than another undeserved break to the cigarette business.
• Marewa Glover is an associate professor in public health at Massey University and chair of End Smoking NZ.
• David Sweanor is an adjunct professor of law at the University of Ottawa who has helped develop many countries' tobacco controls including New Zealand's Smoke-free Environments Act.