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Up in Smoke: What Happened to New Zealand's Tobacco Ban Plan?

— It appears the new government is making an embarrassing attempt to fend off a budget shortfall

MedpageToday
A photo of a paper New Zealand flag flying above an ashtray.
Trump is a writer and a professor of medical humanities.

Despite its diminutive size and geographic isolation, New Zealand has an international reputation for pragmatic and sensible political action. Just 6 days after a terrorist at two mosques in 2019, the government of assault rifles and semi-automatic weapons. During the COVID-19 pandemic, Prime Minister Jacinda Ardern's "team of 5 million" fought the virus with vaccinations, managed quarantines, and "kindness." The teamwork paid off. In 2020, the Bloomberg COVID Resilience Ranking out of 53 countries as the "best place to be in the coronavirus era."

This forward-looking country just took a giant step backward.

As part of the newly elected coalition government's rush to tick off its 100-day list by March 8, the Smokefree Environments and Regulated Products Amendment Act of 2022. This act, passed by the previous Labour government, would have banned selling tobacco products to those born on or after January 1, 2009, reduced the nicotine in tobacco products to non-addictive levels, and slashed the number of outlets allowed to sell tobacco by 90%, from 6,000 to 600. Overall tobacco use was predicted to drop from the by 2025, and the act was expected to create a tobacco-free generation.

Clinical trials and showed Smokefree policies would have reduced mortality rates by , saving annually. Also, it would have saved New Zealand $1.3 billion in healthcare expenditures over the next 20 years, and New Zealanders would have enjoyed a cumulative gain of in disposable (and taxable) income by 2050. This world-leading legislation would have shown that fighting the tobacco industry is possible, encouraging other countries to do the same and perhaps eventually saving some of the people who die annually from tobacco-related causes.

Why would New Zealand's new coalition government, of the conservative National Party along with the libertarian ACT and populist New Zealand First parties, repeal data-driven and life- and money-saving legislation? Without a shred of evidence, Prime Minister Christopher Luxon and his coalition partners have repeatedly claimed restricting tobacco and reducing nicotine levels is experimental (as though that were a bad thing), leading to and a . ACT's health spokesperson Todd Stephenson, for example, the "radical prohibitionism" of creating a smoke-free generation would "push smokers into the arms of gang members."

This rhetoric uncannily echoes the tobacco lobby. Public health experts at the University of Otago recently released a showing that the coalition government's arguments in favor of a repeal closely mirror the tobacco industry's own narratives on this subject.

So suspicious are the similarities between the flimsy remarks of coalition partners and tobacco companies' talking points that the report's authors are calling on all members of parliament to declare any past associations with tobacco companies.

The government's fear-mongering is disingenuous because the Smokefree Act is not a full prohibition. Tobacco products would still have been available, just a lot harder to obtain. Moreover, levels of nicotine would have been reduced by 95%, making cigarettes less addictive and appealing, so more people would have likely quit or not started, presumably driving demand down, not up. Given these outcomes, where exactly would the crazed Kiwis clamoring for black-market tobacco come from?

In a twist to its tobacco-friendly logic, the coalition also promises, , to of cold medicines containing pseudoephedrine, a main ingredient in methamphetamine. These medicines were designated "high risk of harm" under the country's , and made prescription-only in 2011 precisely because pharmacists were confronting robberies. If we speculate about black markets, shouldn't a new supply of over-the-counter pseudoephedrine for New Zealand's meth trade be reason for concern?

In an interview with the news service Newshub, National Party Finance Minister Nicola Willis appeared to inadvertently reveal that the real reason for nixing the Smokefree Act is not crime, but money. Grinding out smoking would "significantly reduce revenue to the Crown," and therefore reduce income to fund its promised tax cuts. (.) In other words, facing a fiscal gap, the new government appears to want citizens to smoke cigarettes at upwards of a pack, of which it receives approximately .

This callous repeal is reminiscent of Jonathan Swift's "Modest Proposal." Instead of urging New Zealanders to boil their infants for food, as Swift urges his Irish readers, the National Party and its partners embrace smoking in an apparent attempt to head off an embarrassing budget shortfall. The Māori Party co-leader Debbie Ngarewa-Packer calls the legislative reversal a "" of the indigenous Māori people, who have among the highest smoking rates in the country. She's right. Māori children will continue to find cigarettes and begin a lifetime of smoking.

Despite , petitions with , and an open letter signed by more than from Health Coalition Aotearoa -- a group of medical professionals promoting public health equity -- the repeal has gone through.

When an expert on smoking-related issues at the University of Auckland, learned about the legislation's repeal, he "felt like buying a one-way ticket out of New Zealand." What a change this is from 2020, when Kiwis flocked home, proud of their country's public health response to COVID.

I sympathize with Professor Bullen. When I moved here in 2020, one of the trade-offs for geographic isolation was sensible, pragmatic public health policy that nudges people in a healthy direction. New Zealand seemed to me a kind of utopia: perhaps a "no place" that's sometimes left off world maps, but also a "good place," where healthcare is a priority right, not a privilege. Still, I haven't lost hope. I am counting on that "team of 5 million" to join me in fighting this cynical embrace of tobacco however we can in order to save the lives of future New Zealanders.

Eric Trump, MS, is a writer and a professor of medical humanities at the University of Otago Medical School in Dunedin in the South Island, New Zealand.