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Government policymakers are being urged to follow Canada and Australia by putting inserts in packs of cigarettes showing New Zealanders how to quit smoking.
In a Public Health Communication Centre briefing, Aspire Aotearoa Research Centre co-director and University of Otago public health researcher Prof Janet Hoek and Otago Business School marketing researcher Dr Philip Gendall said reliance on conventional cessation measures such as pictorial warning labels, tax increases, health warnings and reduced visibility of tobacco products in stores had played a key role in decreasing the prevalence of smoking in New Zealand.
But that decline had plateaued since 2023, and the measures had not reduced substantial inequities between Māori and non-Māori.
Prof Hoek said the warning labels had communicated important harms, but did not provide advice on quitting, or inspire people who smoked to believe they could quit.
‘‘Our recent study found that efficacy inserts — small cards placed inside tobacco packages offering advice on smoking cessation — could be a highly effective, low-cost way to support smoking cessation in New Zealand.’’
She said the centre conducted several studies examining whether efficacy messaging could complement on-pack warnings and increase the likelihood people would attempt to quit.
Preliminary work involving in-depth discussions with people who smoked found they would welcome advice that could help them quit.
‘‘We identified themes people would find motivating, including the importance of family, the financial burden of smoking and maintaining good health.
‘‘We developed these ideas into pack efficacy insert prototypes, using ideas from Canada, which has required pack inserts for more than a decade, and Australia, which has just mandated these inserts, and then tested responses to insert components using two discrete choice experiments.’’
She said a sample of 970 respondents included people who smoked daily or weekly, or who had recently quit smoking.
‘‘We oversampled Māori respondents so we could compare response patterns from Māori and non-Māori respondents,’’ Prof Hoek said.
‘‘Respondents evaluated sets of inserts that compare themes (price, health or family), headline styles (questions or statements) and message formats (informational or testimonial). They identified the elements they thought would increase confidence in quitting and be seen as helpful to someone thinking about quitting.
‘‘We found strong support for affirming messages that could complement warning labels.’’
Māori respondents, people aged under 35 and people with children aged under 16 were especially responsive to family-oriented themes — themes that emphasised the effect of smoking on whānau and intergenerational wellbeing.
The findings had important implications for tobacco control policy, Prof Hoek said.
‘‘New Zealand should mandate the use of efficacy inserts because they represent a low-cost, evidence-based approach that aligns with policy implemented in Canada and Australia.
‘‘Instead of treating tobacco packaging solely as a harm communication medium, the government has an opportunity to promote agency, foster hope and outline the benefits of quitting.
‘‘Failure to introduce efficacy inserts represents a missed opportunity to adopt international best practice and support the population groups most affected by smoking’s harms.’’