End Smoking NZ (ESNZ) is proposing two new methods for controlling smoking – first to reduce imports of cigarettes at the border, and secondly by reducing the nicotine per cigarette. Both methods have been researched, but neither has been used in any country. Both would require legislation, we suggest it be called the End Smoking Act 2021.
The methods are put forward by Dr George Laking, chair of ESNZ, an organisation with 35 years of uninterrupted experience in research and advocacy on tobacco control. Associate Minister of Health Dr Ayesha Verrall seeks proposals to shape the government’s plan for tobacco control. These ideas will be included in our submission to the Ministry of Health this month.
1: Reducing imports of cigarettes by 20 percent from each company’s imports the previous year, continuing on a yearly basis.
Cigarette sales would decrease by nearly 60 percent over 4 years. We first proposed this policy to progressively reduce tobacco imports by statute in the NZ Medical Journal in 2010. No-one else has adopted the same policy overseas to our knowledge. Geographical isolation and a capable border service make our country favourable for this approach. The policy embraces the idea that the first duty of a health service is to detoxify the patient and remove the poison, that is, cigarettes for smoking, which kill 10 New Zealanders per day. Moreover the best point for a concentrated strike against disease is the vector, in this case the import of tobacco into our country.
Restrictions on imports would work in support of New Zealand’s retail tobacco price regime. This measure would start before and continue alongside the reduction in nicotine per cigarette described below. ESNZ has documented that current policies are already resulting in collapse in tobacco imports by 8 percent annually in recent years. All that is needed is legislation to formalise and strengthen this process. Legislation would be needed in 2021 before import restrictions could be applied. The effects would be seen from 2022 onward.
2: Reduction of nicotine per cigarette from present industry-determined levels of 9 mg to a new legislated maximum of 0.4 mg nicotine.
This is a 96 percent reduction, to create a very low nicotine cigarette, the VLNC. Cigarette consumption would decrease by a further 22 percent. Although regulation under the prevailing law could offer a convenient pathway to mandate VLNCs, we recommend enactment within a new law. This sends a more durable message of Parliamentary support for the change. When these very low nicotine cigarettes come in, old style cigarettes will no longer be stocked. Instead smokers will be encouraged to persist with VLNCs, or quit, or take up vaping.
This policy has been researched since 1994 in the United States, and since 2010 by End Smoking NZ members in their paper “Four Policies to end sales of cigarettes and smoking tobacco in New Zealand by 2020”. The policy is backed by many researchers in New Zealand and other countries. One of our group has researched the weights of the cigarettes and the nicotine in each brand. This policy could be legislated in 2021, with introduction of VLNCs beginning one to two years thereafter. Delay may be due to objections from tobacco companies losing their rights to sell non-VLNC combustibles. The beginning of VLNC would mark the end of the sale of non-VLNC combustible cigarettes, with smokers either smoking VLNCs or quitting or taking up vaping.