In New Zealand, smoking is the leading cause of premature mortality for cancer, cardiovascular and respiratory disease. Smoking is also a leading contributor to ethnic and socioeconomic inequities in health and welfare, while imposing financial burdens on the poorest people. Progress in meeting the ambitious Smokefree Aotearoa 2025 goal to reduce adult smoking prevalence to below five percent by 2025 is now significantly off-track.
To get back on track, we advocate a surge strategy based on driving down smoking by facilitating smokers to switch to smokefree alternatives such as vaping products, heated tobacco and smokeless tobacco products. These smokefree alternatives present much lower health risks compared to cigarettes and with the right tax structure can ease financial pressures on smoking households, mitigating both health and economic inequities.
The concept of a public health surge is drawn from management of disasters and emergencies where a rapid increase in capability is essential to meet immediate demands. We argue that the concept can be applied to long-running chronic emergencies where a rapid change relative to business-as-usual is necessary – in this case to meet a target that will otherwise be missed.