New Zealand’s tobacco endgame strategy: what is this about?

Tobacco is the deadliest product ever sold for consumption legally.

Yearly, tobacco use kills about 8 million people globally. Recently, there has been a shift from focusing on the control of tobacco use to ending the use of tobacco products (tobacco endgame).

Global targets to reduce non-communicable diseases and tobacco use prevalence

One of the targets of the third sustainable development goal (SDG) is to ensure a reduction of mortality from non-communicable diseases (NCDs) and promote mental health (SDG 3.4). At the 65th World Health Assembly (WHA) in 2012, members adopted the global NCD target of achieving a 25% reduction in premature death from NCD by 2025. At the 67th WHA in 2014, members adopted a global target of 30% relative reduction in current tobacco use among persons aged 15+ years by 2025.

Picture credit: Freepik

Tobacco endgame

Tobacco endgame is aimed at permanently phasing out the use of tobacco products or significantly restricting their use and availability.

While ending tobacco use may seem an impossible feat to achieve, many stakeholders in the tobacco control space believe it is achievable if done strategically. Several strategies have been put forward to achieve the end of tobacco use including tobacco free generation and reducing the level of nicotine in tobacco products.

Tobacco free generation is a tobacco endgame strategy first proposed by Prof A. J. Berrick of Singapore (a Mathematician). This strategy entails phasing out youth access to tobacco products beginning from a certain age to provide them a lifetime protection against nicotine addiction and tobacco-related diseases.

About 90% of those who currently smoke cigarettes started smoking before they were 21 years of age. This implies that after 21 years; it is unlikely that an adult would initiate tobacco use. Tobacco free generation endgame strategy would not only prevent the young from initiating tobacco use but would prevent the tobacco industry from targeting young people to be ‘replacement smokers’. Young people would be protected from the disease, death, and economic consequences of being addicted to nicotine.

New Zealand’s tobacco endgame strategy

On 9 December 2021, New Zealand (NZ) announced its plan to achieve a Smoke-Free generation. The target is to achieve a 5% or less smoking prevalence in the country by 2025. Measures being put in place include reducing access to tobacco products, reducing addiction to nicotine in the population and helping smokers quit. There are six focus areas of NZ’s plan to achieve a Smoke-Free generation, these include:

  1. Reducing tobacco use disparities within the country (Māoris have the highest prevalence of smoking [29%] and are disproportionately affected by tobacco related diseases)
  2. Providing more funding for health promotion activities to mobilize communities to support the Smoke-Free generation strategy
  3. More investment and support for tailored and targeted quit smoking programmes
  4. Lowering nicotine levels in tobacco products to make it easier for smokers to quit and harder for people to get addicted
  5. Reducing access to tobacco products by reducing the number of stores selling tobacco and introducing the Smoke-Free generation policy for age restrictions to purchase tobacco
  6. Making sure tobacco manufacturers and retailers follow the law.

NZ would be evaluating the success of this strategy by monitoring three outcomes; reduced inequality in smoking rates and tobacco related diseases; reduced smoking initiation rates and increase quit rates.

Three key timelines have been proposed to achieve the Smoke-Free generation in NZ.

  • By 2024, reduction in the number of stores selling cigarettes (to reduce access)
  • By 2025, reduction in the level of nicotine in cigarettes (to reduce nicotine addiction)
  • By 2027, Smoke-Free generation kickstarted. Persons aged 14years and younger (in 2021) would be unable to buy cigarettes in their lifetime.

Some FACTS about tobacco control in NZ

  • Deaths attributable to tobacco: 4,000 to 4,500 annually (12 to 13 deaths daily)
  • Illicit tobacco share – 2-3%
  • Prevalence of smoking as of 2018 – 11.6%
  • Highest prevalence among Māoris (29%) and Pacific Islanders (18%)
  • 2011 – Introduced Smoke-Free prisons nationwide
  • 2012 – Ban point-of-sale advertisement and display of tobacco products
  • 2013 – Series of annual tax increases commenced

Author: Catherine O. Egbe, PhD

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  1. December 17, 2021 -

    Yes it’s possible because if it’s not controlled at the moment ,you will find out that at age 15 adolescents will start smoking it. More elightement on the danger of smoking tobacco will go a long way.Thanks for the effort

    • December 20, 2021 -

      @Roli Juliet

      Thank you Juliet 🙂

  2. December 18, 2021 -

    Sure it is possible for Africa to be tobacco free but, it will take a much longer time because of the great influence of the tobacco industry and lack of political will among leader who have vested interest in the tobacco industry!

    • December 20, 2021 -

      @Lutgard Kokulinda Kagaruki

      Hi Lutgard,
      Thanks for your insightful comment. Indeed we need the political will to make this happen in Africa

  3. December 18, 2021 -

    Great piece! It was very informative. I totally agree with the reduction of nicotin in the product. However, don’t you think the focus needs to be more on the manufacturers than consumers in terms of restrictions to purchase of tobacco? If there is no production, then there is no product.
    Limiting supply from outlets will only cause high demand among youths. That’s the case here in Africa.

    • December 20, 2021 -

      @Okeke Christopher

      Thanks Chris for your insightful comment. Indeed, the focus is on the manufacturers as well. There are provisions in the law for the manufacturers which I didn’t cover except for the 6th focus of this strategy which specifically seeks to ensure the tobacco industry follows the law

  4. December 20, 2021 -

    Great piece and very insightful Cath. In addition to political commitment to the end game in Africa, I think youth organizations need to form a united force to create a loud African voice and apply pressure to the African leadership to turn political speeches to reality.

    • December 20, 2021 -

      @Zanele Mthembu

      An important point you have raised Za. We need commitment at regional level. Thank you.

  5. December 30, 2021 -

    Great piece. Africa can achieve this, however, we would need to add more strategies, and more time to achieve the tobacco end game. Funding is major, national sensitization is another, and increasing the legal age to purchase tobacco is key.
    Well done ma.

    • December 31, 2021 -

      @Emmanuel Agbons Abraham

      Thanks Emmanuel for your very insightful comment. I especially liked the fact that you added suggestions of how we could achieve a tobacco-free Africa.

  6. January 2, 2022 -

    A tobacco-free Africa is certainly possible, but adequate and above all sustainable strategies are lacking. Social factors such as corruption and bad governance hamper the fight against tobacco. tobacco industry surveillance policies see their efforts undermined by the corruption of our states. I think that anti-corruption strategies should be included in the fight, which may be specific to tobacco and its derivatives. Dr MAIGA MOUMOUNI

    • January 2, 2022 -

      @MAIGA MOUMOUNI

      Thanks Dr Maiga for your excellent submission. Good point you raised about incorporating anti-corruption strategies to tobacco control.