New Zealand’s anti-smoking policy: The Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act

Why did the New Zealand government decide to intensify anti-smoking policies?

In 2011, the New Zealand government set a goal to reach “Smokefree 2025”: fewer than 5% of New Zealanders smoking by 2025. This was particularly targeted at reducing smoking in the Māori population where – contrary to the population-wide trends – smoking rates were increasing. Māori women were experiencing among the highest lung cancer rates in the world. ⁴³ Māori Affairs Committee, Inquiry into the tobacco industry in Aotearoa and the consequences of tobacco use for Māori, 49th Parliament, November 2010, 1.10A, retrieved 6 October 2023, https://www.parliament.nz/resource/en-nz/49DBSCH_SCR4900_1/2fc4d36b0fbdfed73f3b4694e084a5935cf967bb

To meet its 2025 goal, the government focused on raising the cost of tobacco. It increased tobacco excise tax by inflation plus 10% each year between 2010 and 2020. ⁴⁴ Gendall, P., Gendall, K., Branston, JR. et al., ‘Going ‘Super Value’ in New Zealand: cigarette pricing strategies during a period of sustained annual excise tax increases’, Tobacco Control, 2022, retrieved 6 October 2023, https://tobaccocontrol.bmj.com/content/early/2022/08/25/tc-2021-057232 It supported this with stop smoking campaigns, and standardised packaging for tobacco products.

These measures made New Zealand the second most expensive place in the world to buy cigarettes (after Australia), ⁴⁵ KPMG, Illicit tobacco in New Zealand, 2017, https://assets.kpmg.com/content/dam/kpmg/uk/pdf/2018/07/new_zealand_Illicit_trade_in_tobacco.pdf and led to the proportion of people over 15 years old who smoke at least once a month nearly halving, from 19.7% to 10.9%, between 2010/11 and 2020/21. ⁴⁶ Ministry of Health New Zealand, New Zealand Health Survey, ‘Tobacco Use: Current smokers’, 2010/11-2021/22, retrieved 6 October 2023, https://minhealthnz.shinyapps.io/nz-health-survey-2021-22-annual-data-explorer/_w_18d68b66/#!/explore-indicators

But continuing on that trajectory would be too slow to meet the 2025 target. And while overall smoking rates were improved, those for Māori people over 15 years old still stood at 25.7% in 2020/21 (down from 40.3% in 2011/12). ⁴⁷ Ministry of Health New Zealand, New Zealand Health Survey, ‘Tobacco Use: Current smokers’, 2010/11-2021/22, retrieved 6 October 2023, https://minhealthnz.shinyapps.io/nz-health-survey-2021-22-annual-data-explorer/_w_18d68b66/#!/explore-indicators
  The government agreed to develop a Smokefree Aotearoa 2025 Action Plan to accelerate its progress. ⁴⁸ Ministry of Health New Zealand, ‘Smokefree Aotearoa 2025 Action Plan - Auahi Kore Aotearoa Mahere Rautaki 2025’, 2021, retrieved 6 October 2023, https://www.health.govt.nz/publication/smokefree-aotearoa-2025-action-plan-auahi-kore-aotearoa-mahere-rautaki-2025

What did the New Zealand government implement?

The Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act came into force in January 2023. The act introduced three major new policies to reduce smoking:

A maximum of 600 retail premises would be allowed to sell smoked tobacco products (just 10% of retailers in 2022). ⁴⁹ May, T., ‘New Zealand bans cigarette sales to everyone born after 2008’, The New York Times,  14 December 2022, retrieved 6 October 2023, www.nytimes.com/2022/12/14/world/asia/new-zealand-smoking-ban.html Retailers must apply to the government for one of these spots if they wish to continue selling these products after 30 June 2024.

• A ban on selling smoked tobacco products to anyone born in or after 2009 (equating to a lifetime ban for anyone turning 14 or younger in 2023).
• An 0.8 mg/g limit on nicotine content in tobacco products (compared to approximately 15-16mg/g of nicotine in full strength cigarettes). ⁵⁰ Ministry of Health, ‘Vaping and smoked tobacco regulations published today’, 24 August 2023, retrieved 6 October 2023, www.health.govt.nz/news-media/news-items/vaping-and-smoked-tobacco-regulations-published-today

The policy excludes vaping on the grounds that it is less harmful, and a good alternative to help people quit smoking. The New Zealand government has noted that the long-term impacts of vaping are currently unclear. ⁵¹ Lytton, C., ‘Will New Zealand be “smoke free within three years”?, BMJ, 2022, 379:02672, retrieved 6 October 2023, www.bmj.com/content/379/bmj.o2672
 

What impact is it expected to have?

It is too early to evaluate the act’s impacts. A modelling study estimates that the package of strategies will reduce smoking prevalence to 7.3% for Māori adults and 2.7% for non-Māori adults in 2025, meeting the 5% overall target and significantly reducing the gap between Māori and non- Māori adults. ⁵² Ouakrim, D.A., Wilson, T., Waa, A. et al., ‘Tobacco endgame intervention impacts on health gains and Māori: non-Māori health inequity: a simulation study of the Aotearoa/New Zealand Tobacco Action Plan’, Tobacco Control, 2023, retrieved 6 October 2023, https://tobaccocontrol.bmj.com/content/early/2023/01/10/tc-2022-057655
 

Was there opposition to the act?

The act passed with the support of New Zealand’s governing Labour and Green parties, and the Te Paati Māori party. The opposition National and ACT parties opposed the bill, warning that it would put convenience stores out of business, move tobacco trade to the black market, and increase individuals’ tar intake and expense as they need more cigarettes to maintain the level of nicotine they are addicted to. ⁵³ New Zealand Parliament, Hansard, ‘Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Bill — Third Reading’, 13 December 2022, retrieved 6 October 2023, www.parliament.nz/en/pb/hansard-debates/rhr/combined/HansDeb_20221213_20221213_24
  Supporters say such people can switch to vapes, which convenience stores will be able to sell more easily. Meanwhile, in 2022 the New Zealand government set up a specialist customs team to target and disrupt the illicit tobacco trade.

Polling indicates that the New Zealand public broadly support the act’s measures, with 78% supporting bans to create a tobacco-free generation. ⁵⁴ Edwards, R., Johnson, E., Stanley J., et al., ‘Support for New Zealand's Smokefree 2025 goal and key measures to achieve it: findings from the ITC New Zealand Survey’, Australian and New Zaland Journal of Public Health, 2021, 45:6, retrieved 6 October 2023, https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.13129
 

Will the UK implement something similar?

At the 2023 Conservative Party conference Rishi Sunak announced plans to ban selling cigarettes to anyone born in or after 2009, as in New Zealand. However, he has not indicated that he intends to limit the number of retailers selling cigarettes or restrict nicotine content.

Sunak’s plan faces some opposition, with critics arguing it is ‘nanny statist’ and will promote the black market. ⁵⁵ Swinford, S. and Smyth, C., ‘Smoking ban is biggest health shift in a generation, says Rishi Sunak’, The Times, 5 October 2023, retrieved 6 October 2023, www.thetimes.co.uk/article/uk-smoking-ban-age-rise-cigarettes-rishi-sunak-ljt9sf6nm
   But it has been welcomed by Labour and some Conservatives, including former health minister Sajid Javid. Polling indicates that 71% of British adults support it, and only 17% oppose it. ⁵⁶ YouGov, ‘Would you support or oppose raising the legal smoking age by one year each year, effectively making it so that smoking is illegal for those born on 1 January 2009 or later?’, 25 September 2023, retrieved 6 October 2023, https://yougov.co.uk/topics/health/survey-results/daily/2023/09/25/cbec9/2