The West Coast District Health Board is the only one in the country meeting the national target of advising people to quit smoking — but the advice is largely falling on deaf ears.
In line with the Government's goal of a Smokefree New Zealand by 2025, DHBs are expected to reach 90 per cent of smokers using their services, with advice on ditching the habit that kills 14 New Zealanders a day.
Figures released last week by the DHB show it has over-achieved the target, reaching 91 per cent of patients. But only 21 per cent of them actually quit.
The results are in line with warnings that the Government's goal of slashing smoking rates to 5 per cent of the population by 2025 is now unlikely to be met.
In a national policy statement presented at a recent West Coast board meeting, the DHBs say New Zealand is not on track to achieve the smokefree goal and inequities remain, particularly for Māori, Pacific, and people on low incomes.
There had been some progress since the goal was adopted 10 years ago, the position paper said.
"Adult daily smoking rates have declined since 2011 from 20 per cent to 11.6 per cent in 2019 to 2020 but we have enormous remaining inequities with adult Māori and Pasifika smoking rates of 30 per cent and 20 per cent respectively."
There had also been noteworthy successes in reducing smoking rates in young people, the DHBs noted.
In a 2019 year 10 survey 2 per cent of 14 and 15-year-olds were daily cigarette smokers, but again, the rates were higher rates in Māori and Pasifika youth.
Reaching the Smokefree New Zealand goal would take a four-fold increase in the number of people quitting each year and a concentrated focus on Maori ad Pacifika.
"We need to dramatically increase successful quitting numbers by at least 40,000 a year; half the quitters must be Māori and one-third Pasifika to achieve equitable cigarette smoking rates", the DHBs said.
Achieving that would not be possible without more funding, the DHBs said.
"Additional funding has been provided ... however, this is insufficient to achieve the scale of the increase in smoking quitters required.
"A $4.625m investment per year, at median cost per quitter of $4473 would yield 2635 additional quitters per year compared to the additional 40,000 quitters per annum that are required to meet the target as outlined below."
About half a million New Zealanders are smokers and reaching the 5 per cent goal would take 300,000 cigarette smokers to quit permanently in the next four years in 4.5 years.
"This equates to roughly 60,000 successful quitters each year. At present we are achieving approximately 15,000 quitters each year."
Mental health and addiction service users had particularly high rates of smoking, at about 43 per cent, rising to 70 per cent for Maori and 59 per cent for Pacific people, and that group would need more intensive help to quit over a longer period.
Stop Smoking Services have been shown to be cost-effective both internationally and in New Zealand, and were less than the health costs of tobaccos related diseases.
"A New Zealand modelling study has estimated that a targeted stop smoking support intervention that costs $100,000 a year would only need to support three to four people who smoke to quit to break even — that's $25,000 to $33,000 per quitter."
The MOH contracted face-to-face Stop Smoking Services currently cost significantly less than this, ranging from $653 - $3857 per quitter (median cost $1755) for the period July to December 2020, the position paper said.
The smokefree position paper was included in the public excluded section of the West Coast DHB meeting last month.
It was moved into the open meeting by chairman Rick Barker, but DHB staff would not release the document to the Greymouth Star until last week, after repeated requests and a complaint to the Ombudsman.