When New Zealand officials announced a unique, comprehensive plan last week to effectively end cigarette smoking in their country, tobacco researchers and health policy advocates elsewhere around the world perked up their ears.
In fact, the policy is so sweeping that it could represent what experts refer to as the “endgame” in the fight against tobacco.
“New Zealand’s package in the endgame is an extraordinary and far-reaching set of measures that have always been talked about but never implemented,” said Geoffrey Fong, a researcher on tobacco policy at the University of Waterloo in Ontario. “That’s very exciting and potentially very powerful for the world.”
The proposal from New Zealand’s health officials would effectively ban anyone 14 years or younger from purchasing cigarettes — for their entire lifetimes. It would raise the minimum age to buy cigarettes every year beginning in 2023. The new policy is expected to be enacted next year.
Officials say their goal is to decrease the number of New Zealanders who smoke cigarettes to just 5% of the population by 2025. Currently, 11% of the adult population smokes.
Now, tobacco researchers and health policymakers around the world say they will be closely watching the results to see if such an effort could be replicable elsewhere.
“This would be an amazing example or a template — like an experiment, right? If it works there, then definitely there is a chance it will work elsewhere,” said Wael Al-Delaimy, an epidemiologist at the University of California San Diego.
Researchers agreed that wide-ranging bans, like the one proposed in New Zealand, should be accompanied by other tobacco reduction measures in order to maximize effectiveness.
Health officials in New Zealand have proposed a handful of other measures alongside the ban, including limiting the number of retailers where tobacco can be sold. Eventually, only low-nicotine cigarettes will be allowed.
“Tobacco is a very powerful, addictive substance. So if you ban this without a well-thought-out plan, without all the resources, it could have the backlash of black market smuggling and so on. That’s real,” said Al-Delaimy.
In New Zealand, cigarettes are taxed so heavily that a pack costs roughly $20 U.S. dollars. A black market already exists to circumvent those high prices, and some critics of the proposal worry the ban will exacerbate that.
Other opponents include owners of many of the nation’s thousands of gas stations and corner stores, which are often called “dairies.”
Sunny Kaushal, chair of the Dairy and Business Owners Group, told The Associated Press that he hoped the country could find another way to eliminate smoking without “destroying dairies, lives and families in the process.”
Data collected from New Zealand could help inform other governments considering similar options, said Fong, who leads the International Tobacco Control Policy Evaluation Project, a worldwide effort to track the effects of tobacco policies.
“Whenever you’re the first country, you don’t truly know what’s going to happen,” Fong said. “But if there is strong evaluation… then that’s going to open the doors for a lot of other countries to consider some or all of those policies there.”
New Zealand has a number of unique factors — including its island geography and liberal politics — that could make such a comprehensive set of policies more difficult to enact in other places, Fong added.
In the United States, smoking bans at the federal level are few and far between. An executive order signed by President Bill Clinton in 1997 banned smoking inside federal buildings, and the Department of Transportation fully banned smoking on all passenger flights in 2000.
Instead, America’s many indoor smoking bans are controlled by states and municipalities. Roughly a dozen states do not have a statewide indoor smoking ban, and several others exempt bars and some other types of businesses.
Al-Delaimy, the researcher at UCSD, lived and worked in New Zealand for five years. There, his research about the effect of secondhand smoke on bar employees was referenced by the Ministry of Health during its efforts to pass an indoor smoking ban in the early 2000s. In 2004, New Zealand became the third country to implement such a ban.
Since he moved to California, Al-Delaimy has worked with the state’s Department of Public Health to conduct tobacco research to help inform policymakers.
Within the U.S., even a liberal state like California — which was the first state to pass a ban on smoking in restaurants — would face challenges in enacting a ban like New Zealand’s, Al-Delaimy said.
For one, there’s no guarantee that states neighboring California would follow suit with bans of their own. “People can just go buy it from there,” he said. Another factor is what American Indian tribal communities decide to do. Some may choose to allow the sale of cigarettes on tribal land.
“It’s not an easy fix or a light switch to say, ‘OK, let’s do it.’ It means a lot of support from communities, government and the tobacco control community,” he said. “To have an example in New Zealand is going to really help this discussion go forward.”
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