5th Scientific Summit of Tobacco Harm Reduction in Athens, Greece
* Passed in 2020, the Act signalled a shift from harm reduction to prohibition
* It’s current position in smoking control is the result of many decades of anti-smoking efforts and preventive measures, that started in 1945
* Smoking prevalence has diminished in New Zealand from 27% in 1992 to 18.4% in 2011-12
* And then to 10.9% in 2020-21 — one of the lowest in the world
By Duncan Mlanjira
As the world discusses ways to control tobacco smoking, New Zealand is considered a success story in this endeavour after the country implemented a comprehensive Smoke-Free Environments Act in 1990.
This success story was recognised at the 5th Scientific Summit of Tobacco Harm Reduction in Athens, Greece (September 21-22, 2022) that was attended by over 200 participants from 41 countries.
Under the topic, ‘Current Challenges that Governments Face in Smoking Control—The Case of New Zealand’, attention was given to the Vaping Regulation, that was passed in 2020 and signalled a shift from harm reduction to prohibition.
New Zealand’s approach and framework; its achievements; and goals were presented by Marewa Glover — the keynote speaker, who is director of the Centre of Research Excellence: Indigenous Sovereignty & Smoking in New Zealand.
Marewa Glover asserted that New Zealand has become a model for other countries, but its current position in smoking control is the result of many decades of anti-smoking efforts and preventive measures, that started in 1945.
“These included public education, restrictions in industry marketing and advertising, tobacco product advertising bans on TV and radio, and the introduction of tax on tobacco, until finally New Zealand was the first country in the world to implement a comprehensive Smoke-Free Environments Act in 1990 — subsidising routine replacement therapy was not funded until 2006.
“The road was long, and smoking reduction took place at a glacial pace,” she said. “Smoking prevalence has diminished in New Zealand from 27% in 1992 to 18.4% in 2011-12 and then to 10.9% in 2020-21 — one of the lowest in the world.
“Yet, smoking prevalence varies greatly according to income level and it remains higher among the poorest and the most disadvantaged. This shows that interventions to reduce smoking must seek to reduce such inequities; it is particularly important that these inequities are eliminated before thinking about imposing criminalizing policies that could worsen socioeconomic disparities.”
She further said New Zealanders begun vaping in about 2011 and this trend soon spread and the Vaping Regulation, which was passed in May 2020 and came into force in August 2021, signalled a shift from a harm reduction focus to prohibition ― from a focus on improving health to a morally-based form of social engineering.
While acknowledging that New Zealand’s proactive approach was progressive and an exemplar for other countries to imitate, she recommended that people should “stick to a public health approach”.
“The law amended the intentions of the original 1990 Smoke-Free Environments Act, its intention being to prevent the normalization of vaping and to insure no one starts or ever returns to smoking, vaping or using heated tobacco products (HTPs).”
The latest law change that is now being pushed through Parliament proposes to:
i) cut the amount of nicotine in smoked tobacco products to a sub-functional level (e.g., <0,05 mg/g yield);
ii) reduce the number of tobacco retailers across the country from about 8,000 to about 500-1,000; and
iii) increase the legal age of purchase (from today’s 18, the age will start to raise by 1 year every year).
Glover emphasized that this prohibition is not consistent with harm reduction — it is top-down and not person-centred ,that it is punitive and not compassionate.
It will likely cause harm due to:
a) the injury/criminalization associated with black market activity;
b) a worsened mental health;
c) an increased marginalization; and
d) a shift to higher-risk substances.
Therefore, the countries that want to reduce smoking-related harm will face the following challenges:
i) a campaign of disinformation about relative risk of nicotine;
ii) loss of academic freedom;
iii) rise of “liberal paternalism”; and
d) diminishment of the human right to autonomy, dignity & right to consent, e.g., to medical intervention.
Glover concluded by saying that other countries should not forget the historical context (it took New Zealand a generation to get where they are today) and the different social context & disparities per country.
“Times and products have changed. There is now a practical strategy, acceptable to the consumer, that could albeit eliminate smoking across the world.”
She cautioned these other countries to beware of the lies and propaganda campaigns demanding prohibition and of the policies for which there are no real-life scientific trials that record their adverse effects and consequences.