Whanganui's smoking rate has increased in the last three years, despite tens of millions of dollars in funding being poured in nationwide to stamp it out.
Regional Health Network figures showed the number of people smoking in Whanganui increased in the last three years by 2 per cent to 19.3 per cent, during a time when the national rate decreased.
The Ministry of Health has admitted it is unlikely to achieve its Smokefree 2025 target, which aimed to reduce smoking prevalence to "minimal levels" in the next decade. Around 17 per cent of Kiwis still smoke at least monthly.
GP and clinical smoking champion for Whanganui Dr John McMenamin said big efforts were being implemented to reduce smoking rates.
He said more than 1000 people a year were quitting annually throughout the region, but the challenge was to stop young people starting - by hitting them in the pocket and the heart.
"The concerning thing is it means the uptake of smoking is increasing. It means more than 1000 people took up smoking [each year]."
Dr McMenamin said tobacco tax increases of 10 per cent a year had priced out a lot of teenagers, but hadn't affected people in their 20s as much.
"For that group, the only effective initiative is tax increases. We're very supportive of the cost going up," he said. "It's the number one health issue we need to address."
He said asking young people if they wanted to be around for their family and whanau in future encouraged them to think about the impact their smoking has on others.
The government announced this year annual tobacco tax increases would be extended until at least 2020, when a pack would cost $30.
Maori and Pacific smokers in Whanganui smoke at 36.5 per cent 27.1 per cent respectively - both higher than the respective national average of 33 and 23 per cent.
A Whanganui District Council meeting last week recommended the Smokefree Bylaw, which prohibits people from smoking in specific council-owned parks and areas, be reviewed.
Councillor Martin Visser said the revised bylaw needs strengthening so people could be fined for smoking in restricted places or dropping cigarette butts.
"We need something with some teeth. We can send our own signals. It's here on the ground where we can make a difference."
The Government spends $56 million annually on tobacco control, and Whanganui DHB contributes around $435,000 to smoking services each year.