A public health message on tobacco smoking from New Zealand

Abstract

Tobacco smoking is the leading cause of preventable death and disease worldwide. New Zealand has taken a leading role in controlling tobacco smoking for many years and has now adopted a more radical tobacco control strategy. The new Smokefree Aotearoa 2025 Action Plan will be the most comprehensive anti-tobacco policy in history and could make New Zealand the first country in the world to achieve smoke-free status, defined as an adult smoking rate of no more than 5%. The new policies restricting the availability of tobacco, reducing the nicotine content of cigarettes, and eventually prohibiting the sale of tobacco may lead to less smoking, less nicotine dependence and improved public health. Moreover, new legislation implementing the policy could reduce health inequities between ethnic and socioeconomic groups. Electronic cigarettes are the most common tobacco product used by youths. However, the replacement of smoking by vaping raises health concerns. While vaping is thought to be less harmful than smoking, it is not harmless. It exposes users to nicotine and toxicants, which can lead to addiction and harmful health effects. Public health action is needed to help young non-smokers to remain both smoke-free and vape-free. The tobacco endgame, aiming to permanently end rather than simply reduce the use of combustible tobacco, requires strong political will, since the influence of the tobacco industry is likely to delay any substantive action. Should New Zealand succeed in its large-scale experiment, it may set an example for public health systems worldwide.