Criticism of moves to reduce the use of tobacco is nothing new. Some people believed major sports events would die when tobacco advertising was banned, bars and restaurants would never be able to cope with smoke-free requirements, and stopping prisoners smoking would lead to mayhem.
The latest plan, if successful, will not mean smoking is stubbed out. Its aim is getting daily smoking down to lower than 5% of all population groups, less than half the 11.6% (464,000 adults) according to 2018 statistics. It has been estimated this would require about 60,000 smokers to quit every year between now and 2025.
The most controversial aspects of the bold plan are the reduction of outlets selling tobacco, the lowering of nicotine levels in tobacco sold, and the outlawing of tobacco sales to those born after 2009. These changes will be introduced between 2023 and 2025.
There are no restrictions on where tobacco can be sold. Currently, there are between 5000 and 8000 retailers and the Government is concerned about the high concentration of outlets in disadvantaged areas.
Under the plan, it is expected that by 2024 outlets will be required to be licensed and it is estimated the number will be reduced to about 500. Some dairy owners have said losing this custom could push them to the wall, but there will be no compensation.
The detail of how the licensing will work is not yet clear, but the Cabinet paper on the plan says the final number of outlets will need to account for geography, with a mix of urban and rural outlets.
The Government discarded other options, including government-run stores or models where retailers did not profit directly from tobacco sales, but among the arguments against them were that they would be too costly and complex or interfere too much with the free market.
By 2025, smokers will be getting less hit for their buck, nicotine levels being lowered to reduce their appeal and addictiveness. The plan is for the nicotine level to be set at a level which prevents people smoking more to compensate.
There is considerable concern that both the reduction in outlets and the lowering of nicotine will contribute to a boost in the black market for tobacco.
The Cabinet paper says an effective enforcement regime combined with increased smoking cessation services, and health promotion and community activity to support the smoke-free goal are essential to mitigate against this risk. How enforcement will be beefed up is not spelled out.
Outlawing tobacco sales to those born after 2009 might initially make smoking appealing to some young people because it will be a forbidden fruit but this seems unlikely to prevail.
The long-term health impacts of vaping and its popularity among those who have never smoked will need to be closely monitored.
What has been given less coverage in the media is the plan’s emphasis on ensuring Maori leadership and involvement (Maori smoking rates remain stubbornly higher than other groups), the funding of more health promotion and community activities to motivate people to quit, and increased support for those stopping smoking.
It will be important that all the pieces of the plan work together well if the reduction sought is to be achieved.
Detrimental effects of the plan for some retailers and black-market fears should not overshadow the grim fact that, as the Cabinet paper points out, tobacco kills as many as two-thirds of its consumers when used as intended. It causes between 4500 and 5000 deaths in New Zealand each year, 2000 from cancer, including more than 1200 from lung cancer.
The time is right for smokings last gasp, or as close as we can get to it.
