Is the Government right? Will its plan get us to 95 per cent smokefree?
There's been a lot of chatter around the virtual water coolers over the past couple of weeks on whether the Government's plan will actually achieve its stated aim – for 95 per cent or more New Zealanders to be free from cigarette smoking by 2025.
As an epidemiologist and smokefree campaigner for more than 40 years - part of that time at the World Health Organisation - I can see the attractions of the plan, but will it actually work?
A recent good news story justifies some optimism that New Zealand can reach this goal.
There has never been such a rapid fall in cigarette smoking as in the past year.
Although this trend needs confirmation, the latest New Zealand Health Survey shows that fewer than one in 10 adults now smoke daily, down from one in eight a year ago.
This represents about 100,000 fewer adult smokers. The fall has occurred across the whole population including Māori, Pacific people and the poorest New Zealanders.
Only a year ago, it seemed it would be well beyond the middle of the century before these groups reached the goal; now up to 20 years have been cut off the end date.
Young people are also ditching cigarettes - only 1 per cent of 14-year-olds, estimated to be around 500 kids, now smoke daily, down from 15 per cent 20 years ago.
These results are a great launching pad for the Government's bold plan to achieve the 95 per cent smokefree goal.
Crucially, it recognises that smoking is a deep-seated social issue, not just an individual concern, and a major cause of inequalities.
The plan sets out to build community capacity and leadership, helping adult smokers move away from the uniquely harmful cigarettes.
People smoke cigarettes because they become dependent on nicotine, often in the face of stressful lives. Nicotine itself is not the main problem: it is addictive but it does not cause cancer or heart disease.
The problem is the toxins released by burning tobacco that eventually kill half the people who smoke - around 5000 New Zealanders every year. All these deaths are preventable.
There is little doubt that much of the recent fall in smoking rates is the result of the increase in the use of e-cigarettes or vapes. As vaping has gone up, smoking has gone down.
As the Prime Minister said, it is a much safer – and cheaper - way of accessing nicotine for smokers who want to quit cigarettes.
By actively encouraging vaping, the plan will further undermine the dominance of smoked tobacco as a way to access nicotine.
The other precondition for success is for the Government to reduce illegal and tax-free imports of cigarettes by scanning all containers at every port of entry to prevent a rising black market. If we can stop a virus at the border, we can certainly do better at finding containers full of cigarettes.
With increased promotion of vaping to adults who smoke, community-led initiatives and control of the black market, the Government will be well-placed to implement its longer-term objectives: to reduce sales outlets, make cigarettes less appealing primarily by removing nicotine from cigarettes, and to create a smokefree generation.
From 2024 onwards, outlets selling cigarettes will be slashed from 7000 to about 500. Notwithstanding the feigned shock of dairy owners and their association, this proposal has been on the cards for more than a decade.
Another proposed intervention is the removal of nicotine from cigarettes from 2025 onwards, which will make them markedly less addictive and less attractive.
The concept of a smokefree generation reflects the Government's determination to protect young people from cigarettes long-term. From 2027 onwards, children born after 2014 will not legally be able to buy cigarettes.
These longer–term measures will require legislation and take time to have an impact but will ensure that 95 per cent of the population will continue to be free from the harm of cigarettes.
The Government's commitment to investing in communities, supporting harm reduction with less harmful alternatives, amplifying the social movement to smokefree 2025 and dealing to the black market is critical to success and will enable longer-term measures as well.
I am optimistic that, with only four years to go, New Zealand can achieve the 95 per cent smokefree 2025 goal for all. In so doing we will save the lives of thousands of Kiwis.
• Emeritus Professor Robert Beaglehole is an independent global public health practitioner and the chairman of Ash NZ.