Desperate to Win the Smokefree Race, New Zealand Resorts to Prohibition

    Bhutan was the first country to ban the import and sale of tobacco, in 2004. But New Zealand is held up as the country to watch.

    In the global race to eliminate tobacco smoking, New Zealand was first out of the stalls with its 1990 Smoke-free Environments Act. The law banned smoking inside public buildings such as schools, in workplaces and on public transportation. It extended restrictions on advertising and established an agency to replace tobacco-industry event sponsorship It remains a milestone achievement that the law became an exemplar during the writing of the United Nations’ Framework Convention on Tobacco Control.

    Since then, other countries have snuck past us. But the home of the all-conquering All Blacks rugby team does not like to be outstripped. The original law has been amended several times to keep up.

    On December 9, the government proposed changing the law again to arrive at its Smokefree 2025 goal (smoking prevalence of 5 percent or below) as fast as possible. A raft of new measures will include continually raising the age at which people can buy cigarettes. From 2027, the legal age to purchase tobacco would rise year-on-year from the current 18. This means that children now aged 13 and below face a lifetime ban on legally buying tobacco.

    The new law will introduce a licensing system for tobacco retailers, reducing the number approved to 5-10 percent of the current estimated 8,000 outlets. The law will also ban filters and other characteristics of cigarettes that researchers claim make smoking appealing or palatable, such as flavors.

    A person would have to smoke 20 of these ultra-low nicotine cigarettes to get the same amount of nicotine.

    Another startling proposed change will abruptly cap the nicotine level in cigarettes so low that it is said smoking will no longer be sustainable for people who rely on nicotine. Whilst the government has not revealed the level, academics who wrote the plan recommended that the nicotine yield from a cigarette should be no more than 0.05 percent. Compared to an average cigarette currently on sale in New Zealand, a person would have to smoke 20 of these ultra-low nicotine cigarettes to get the same amount of nicotine. US tobacco company 22nd Century, the main supplier of very low nicotine cigarettes used in local trials, was quick to applaud the plan. It has been recommended that the price of these is set at a prohibitive minimum.

     

    With only three years to hit a target of a smoking rate of 5 percent or below, any consideration for people who smoke has been tossed aside. All that matters for New Zealand tobacco control is glory.

    The New Zealand Smokefree 2025 goal started out as a “dream.” In 2011, it became “an aspirational goal.” The government at that time did not have any evidence that the demanded 5 percent was achievable. Given the vast inequity between the daily smoking rates of the dominant NZ-European population (14.6 percent) and the Indigenous Māori (37.6 percent), the risk was that an overzealous tobacco control might further marginalize Māori, who are overrepresented among the most deprived groups and make up over half of people imprisoned—despite being only 15 percent of the population.

    Since 2015, the switch from smoking to vaping has steadily increased. New Zealand’s latest figures strengthen the evidence that vaping triggers increased smoking cessation. We now have the same perfect inverse association between smoking and risk-reduced products that’s seen in the United Kingdom (also with vapes); in Japan and South Korea (with heated tobacco products); and in Norway, Sweden and Iceland (with oral snus).

    Source: Ministry of Health. (December 2021). New Zealand Health Survey. Annual data explorer

      

    Harsh Consequences for Māori

    Māori still have high smoking rates but we are seeing a more rapid drop in prevalence. Daily smoking in 2020/21 among Māori has dropped to 22.3 percent. The inequity in smoking between Māori and NZ Europeans remains constant, however. Just over 8 percent of NZ European adults aged 15-plus now smoke daily. If their transition from smoking to vaping is not interrupted, hands down they will pass the 5 percent mark.

    With success on the way using a harm reduction approach, why take the whip to Māori and risk unintended negative effects? Support with aroha (love) has always been our preferred cultural way. And there’s the rub. It is the dated white-Western global tobacco control sector, intent on complete elimination of all tobacco and nicotine use, that wields the whip. They’ve been looking for a real-world environment where they could test their worst ideas, and New Zealand’s isolation makes us a perfect petri dish.

    Māori, heavily overrepresented among lower-income groups with the highest smoking rates, will bear the brunt.

    Taking advantage of a political party mostly new to governance and keen on authoritarian rule, prohibitionists have had their complete wish list adopted. As with much recent legislation, the new Smokefree law is likely to be pushed through parliament next year under urgency.

    And make no mistake, the negative consequences for Māori, at a time of increased racial tensions, are likely to be severe. Every previous form of drug prohibition around the world provides a case study. People won’t all just stop using what’s banned; they won’t all just switch to vaping when we know that it can take people years, and that many never do.

    Illicit markets will scale up to fill the void where there should be a regulated market. Competition over such markets can bring violence, and Māori, heavily overrepresented among lower-income groups with the highest smoking rates, will bear the brunt. The government response to illicit sales will mean criminalization and arrests, further swelling the grossly disproportionate numbers of Māori who are incarcerated.

    With smoking rates highest among the most deprived groups, there is a clear prospect that they, and people who resist being bullied to change, will experience increased marginalization. The illicit tobacco market here has already grown due to the high price of tobacco. In anticipation of its further expansion, the proposed law will ramp up policing and fines.

    A recently passed law banning smoking, vaping and use of smokeless products in vehicles when minors under 18 are present set a precedent for fining consumers directly. It is likely that we will now see more people fined for sharing their tobacco with partners or family members, for example, who fall under the legal age for purchase.

    Though not indicated, it is likely that the final wording of the law will additionally ban growing or importing tobacco for one’s own use, both of which are currently allowed. Purchase of nicotine will likely be restricted too, to prevent people from doctoring low-nicotine cigarettes, and this will affect some people who mix their own e-liquids.

    Our sizable Indian and Asian communities will be hurt economically, as they own the majority of the small retail businesses that sell tobacco. When raised tobacco taxes made cigarettes unaffordable for a large proportion of people who smoked, we saw a surge in aggravated robberies of such stores, in an illustration of ignored unintended consequences.

    The abrupt cut in the nicotine strength of cigarettes will cause hundreds of thousands of people to go into withdrawals. Whilst some people experience mild nicotine withdrawal symptoms like restlessness, sleep problems and difficulty concentrating for a short period of days, others can experience severe symptoms. People with mental health conditions have disproportionately high smoking rates. For them, abrupt nicotine withdrawal could exacerbate their condition. Rather than days of discomfort, some people could experience an increase in depression and anxiety over weeks. People taking psychiatric medicines may need ongoing monitoring and dosage adjustments.

    A legal risk-reduced product market can effectively eliminate smoking without prohibition and punishment. New Zealand was on track to do that.

    Yet discussion of any negative effects of Smokefree 2025 is being ridiculed and suppressed in New Zealand, with the prohibitionist choir all singing from the same song sheet. They claim that society has reached a consensus that the proposed prohibition is socially just, progressive, even morally right. Only selected yes-men and women, dedicated prohibitionists or naïve newbies unschooled in critical thought, are “consulted” or given credence. Consumers are absent or ignored.

    There is nothing kind about the plan. It is a dangerous precedent that will no doubt be copied to address other public health targets, such as sugar, fried food and alcohol.

    As proven in Sweden and Norway, a legal risk-reduced product market can effectively eliminate smoking without prohibition and punishment. New Zealand was on track to do that. It is now taking a disastrous wrong turn.

     


     

    Photograph by Marc via Flickr/Creative Commons 2.0

    Both The Influence Foundation, which operates Filter, and the Centre of Research Excellence: Indigenous Sovereignty & Smoking, which the author founded, have received grants from the Foundation for a Smoke-Free World.

    • Dr. Marewa Glover is a Maori behavioural scientist, and the founder and director of the Centre of Research Excellence: Indigenous Sovereignty & Smoking (COREISS) in New Zealand (funding disclosure), which has an international focus on reducing tobacco related harms among Indigenous peoples.

      She received a 2018 Professional Advocate award from the International Network of Nicotine Consumer Organizations. She was a finalist in the 2019 New Zealander of the Year awards. Neither Dr. Glover nor COREISS have any commercial interests in nicotine products.

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