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WHO Says NZ's Tobacco Control Nearly Among The Best In The World - Expert Reaction

New Zealand is one step away from joining a small club of countries that have implemented all of the World Health Organization's best-practice guidelines around tobacco control.

The latest report from the WHO says New Zealand is carrying out most of the "MPOWER" tobacco control guidelines, with the final hurdle being banning all forms of tobacco advertising country-wide.

Türkiye, Brazil, Mauritius, and the Netherlands are all implementing all of the tobacco control guidelines at the highest level, and NZ is one of eight countries that are nearly there.

The SMC asked experts to comment.

Professor Richard Edwards, Professor of Public Health and co-Director of ASPIRE2025, University of Otago, comments:

"The WHO report on the implementation of the 'MPOWER' suite of tobacco control measures puts Aotearoa New Zealand at the forefront of global efforts to tackle the harms due to tobacco smoking. New Zealand is one of only 12 countries judged as meeting best practice for at least four out of five of the MPOWER components - which includes key demand reduction interventions such as introducing smokefree environments policies, providing comprehensive smoking cessation support and implementing robust mass media campaigns, health warnings on packs and taxation of tobacco products.

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"This is good news for safeguarding the current and future health of the people of Aotearoa and for tackling the huge inequities in health that tobacco smoking causes.

"However, the MPOWER report only reports on the implementation of demand reduction tobacco control measures. What it doesn't acknowledge is the even better news that Aotearoa New Zealand will soon be introducing truly world-leading measures to regulate and restrict the supply of smoked tobacco products. These measures were included in the Smokefree Environments and Regulated Products Act that became law in December 2022, and include greatly reducing the number of retailers selling tobacco in August 2024 and removing the nicotine from all cigarettes and tobacco in April 2025. A 'smokefree generation' policy will also be introduced in 2027 so that it is illegal to sell cigarettes and tobacco to people born after 1 January 2009. None of these measures have been implemented by any other country which explains why Aotearoa New Zealand is attracting such intense interest and praise from the global public health community.

"The measures included in the Smokefree Environments and Regulated Products Act combined with supporting measures included in the Smokefree Aotearoa Action Plan such as targeted enhanced support to stop smoking create the real possibility of imminently achieving Smokefree Aotearoa goal. That would reduce smoking to minimal levels and greatly diminish the suffering and avoidable deaths that it currently causes, particularly among Måori and Pacific peoples. If so, it will be one of Aotearoa's greatest public health achievements and could inspire other countries to introduce similar approaches and hence have truly global implications for enhancing public health."

No conflict of interest declared.

Associate Professor Anaru Waa, Senior Lecturer/Researcher, Eru Pomare Māori Health Research Centre, University of Otago, and co-director of ASPIRE2025, comments:

"MPOWER is a semi-regular report of the World Health Organisation comparing how countries that have ratified the Framework Convention (FCTC) on Tobacco Control are performing in relation to their tobacco control obligations. MPOWER refers to Monitoring tobacco use and prevention policies; Protecting people from tobacco smoke; Offer help to quit tobacco use; Warning people of the dangers of tobacco; Enforcing bans on advertising, promotion and sponsorship; Raising tobacco taxes.

"In the latest MPOWER report Aotearoa/New Zealand rates highly compared to other countries in relation to meeting its FCTC obligations but does not make it into the top four. Compared to these top four countries it seems Aotearoa/New Zealand comes up short in relation to protecting young people from vaping. This includes regulating: how these products are advertised and promoted; and the wide range of vape flavours that are clearly appealing for young people.

"The FCTC has played a vitally important role in supporting countries to work together to address the tobacco epidemic. Up until 2022 Aotearoa/New Zealand’s tobacco control programme has consistently been comparable to other world leading countries but has, at times, lagged behind in its investment in tobacco control and in particular protecting Māori from the harms of tobacco.

"While the FCTC continues to be important it hasn’t caught up with moves in some countries towards ending smoked tobacco use. At the end of 2022 New Zealand became a world leader in this space with new legislation that, if it works as intended, will see profound reductions in smoking prevalence. In particular, the legislation is expected to address disproportionately high smoking among Māori and Pacific peoples. However, Aotearoa/New Zealand needs to do better in relation to protecting young people from vaping. New vaping regulations that are coming in are unlikely to achieve this and we need to urgently consider how we can address their appeal and ease of access for young people."

No conflict of interest declared.

Professor Janet Hoek, University of Otago, Wellington, and co-Director of ASPIRE2025, comments:

"The WHO’s report on the global tobacco epidemic assesses Aotearoa New Zealand’s implementation of the MPOWER measures highly. We are among the highest achieving countries for monitoring the prevalence of tobacco use, implementing smoke-free environments, providing cessation services, requiring large, graphic on-pack warning labels and plain packaging, undertaking mass media campaigns, and using excise tax to decrease the affordability of tobacco. These are all important measures, yet they have not reduced inequities in smoking prevalence that place a heavy and disproportionate burden on Māori and Pacific peoples, in particular."

"To realise equitable reductions in smoking prevalence, the Government recognised we must go beyond MPOWER measures. The retail reduction, denicotinisation and smokefree generation policies that will come into effect over the next five years are visionary measures that will accelerate declines in smoked tobacco use among all population groups.

"The WHO report also reminds us that vapes (referred to as electronic nicotine delivery systems, or ENDS) require prudent regulation. The measures used to assess vape regulation, such as disallowing indoor use, requiring health warnings, disallowing advertising and sponsorship, and applying minimum age of sale restrictions, have not prevented the rapid rises in youth vaping we have seen in Aotearoa. Evidence that 25% of young Māori women aged 14 to 15 vape every day reveals the failure of our current measures to protect young people. Despite new regulations that will restrict specialist vape stores from operating within 300m of a school, some retailers are nonetheless establishing these stores ahead of the regulations coming into effect. It is difficult to view these moves as anything other than the cynical targeting of young people and we urgently need more effective regulation of vapes.

"How satisfied should we be with our report card? We need to focus less on the WHO assessment and more on what is happening in our communities. Until we have reduced on-going inequities in smoking prevalence and ensured that vapes may be accessed and used only by adults who wish to stop smoking, we should not congratulate ourselves."

Conflict of interest statement: "I receive or have received funding from the Health Research Council of New Zealand, the Royal Society Marsden Fund, and the Cancer Society of New Zealand. I serve on several advisory groups that develop and assess smokefree measures."

Dr Victoria Egli, Research Fellow and co-lead of Kia Mau Te Ora, Faculty of Medical and Health Sciences, The University of Auckland, comments:

"New Zealand needs to do more to protect children from the harms of tobacco by banning all forms of tobacco marketing including vape products. The newly released WHO report shows New Zealand could easily join the four countries that have implemented all the WHO's best-practice guidelines for controlling tobacco, making us one of the best performing countries in the world! But we can’t get there unless the Government implements a complete ban (and enforces that ban!) on all forms of tobacco marketing nation-wide.

"According to Ministry of Health reports the number of children starting to vape has quadrupled. Research conducted by my team and others helps us understand why. When children walk to and from school and spend time in their neighbourhoods with friends, vape shops and promotional signage is right there.

"The Government has recently introduced legislation that will prevent the opening of new vape stores within 300m of schools. The location of stores selling these harmful products is important, but our research shows that children’s neighbourhoods are wider than 300m. If the Government were to ban the sale of all tobacco and vape products from 500m network boundaries around all schools and all child-centred spaces (like playgrounds and movie theatres) this would go further to reducing children’s exposure to the marketing and sale of these products.

"When children take-up vaping, there are potential health harms, and these are often accompanied by indirect harms on learning and behaviour in school. The New Zealand Government has an obligation to ensure children have the highest standard of health and education and to make decisions that are in the best interest of children. How can allowing tobacco companies to market and sell harmful vape products to our children in the neighbourhoods where they live, play and go to school be in the best interests of our children?"

No conflict of interest

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