New Zealand: Perception of the goal of a smoke-free society by disadvantaged smokers

In New Zealand, disadvantaged smokers are more likely to support quitting smoking than other measures and are less aware of the goal of a smoke-free society, a qualitative study suggests. However, their discourse on individual choice, heavily influenced by that of the tobacco industry, exposes them to social isolation.

Launched in New Zealand in 2010, the “Smokefree Aotearoa 2025” objective (“Smoke Free New Zealand 2025”) is to achieve a minimum level of 5% smokers in the population. A few years before its deadline and faced with the difficulty of meeting this objective, health researchers explored the perception of future smoking reduction measures among a sample of smokers from disadvantaged backgrounds.[1].

A preference of disadvantaged smokers for support to stop smoking

In all Western countries, the decline in smoking prevalence is less noticeable among disadvantaged populations than in other sections of society. This observation is also valid in New Zealand, particularly among the Maori and Polynesian minorities. Overcoming the reluctance of these disadvantaged smokers to give up tobacco is one of the challenges in pursuing the 2025 objective.

The limits of the individual approach

One of the pitfalls, pointed out by researchers, of these smokers' speeches is the importance attributed to personal choice in tobacco addiction, which takes up the rhetoric developed by the tobacco industry. This orientation tends on the one hand to ignore the social and commercial dimension of smoking, and on the other hand to lock smokers into a "choice" in fact dictated by nicotine addiction. Disadvantaged populations have less information and less personal and financial resources to quit smoking, and those who do not succeed risk increasing their social stigma, in a context where smoking would only concern a minority.

The authors also point out that the smokers surveyed spontaneously had a wrong understanding of "2025 smoke-free", thinking that it meant stopping tobacco sales, but that they perceived this objective favorably once it was correctly explained.[2]A massive communication campaign to better explain the objectives of this plan and the manipulations of the tobacco industry is therefore considered essential to continue to denormalize tobacco and support future initiatives.

To move away from the individual logic of smoking, the authors recommend structural measures, such as raising the legal age for purchasing tobacco, restricting the number of points of sale and putting into circulation cigarettes with very low nicotine content.[3]The sale of low-nicotine cigarettes is, however, only being considered in combination with greater access to e-cigarettes, a proposal that contrasts with the rather restrictive direction currently being taken by neighbouring Australia on vaping.[4].

The need to denormalize tobacco

Policy measures, such as reducing nicotine levels in cigarettes, could support goals to eradicate smoking; however, a better public understanding of addiction is needed to reduce “stigma,” support self-efficacy, and encourage smoking cessation. Industry denormalization campaigns could challenge the perception of smoking as a personal choice, reduce self-blame among people who smoke, and present end goals as empowering.

Keywords: Smokefree 2025, New Zealand, disadvantaged groups, smokers, denormalization

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[1] Barbalich I, Gartner C, Edwards R, Hoek J, New Zealand Smokers' Perceptions of Tobacco Endgame Measures: A Qualitative Analysis, Nicotine & Tobacco Research, 2021, 1–7.

[2] Hoek J, Barbalich I, Edwards R, Gartner C, A qualitative analysis of how people who smoke and manage lower incomes perceive the Smokefree 2025 goal, NZ Med J, 21 May 2021, Vol 134 No 1535

[3] Edwards R, Hoek J, Waa A, World-leading action plan on smoking will reduce harm, Otago Daily Times. Published 15 September 2021, accessed 15 September 2021.

[4] Tobacco Free Generation, Australia to impose stringent restrictions on vaping, published September 10, 2021, accessed September 15, 2021.