Experts working to reduce the harms of tobacco have discovered serious flaws in the New Zealand government's plan to achieve its smoke-free 2025 goal. Scholars from Australia and New Zealand, funded by the Ministry of Health, claim that the focus on 'denicotinization', or the simulation of tobacco without nicotine, will have the most significant impact.
The New Zealand government will allow ministers to achieve their 2025 targets by:
A significant reduction in the number of retail stores that can sell tobacco will make it illegal to sell the substance to anyone born after a specific date in order to foster a "smoke-free generation" by removing most of the nicotine from tobacco "to reduce its attractiveness and addictiveness." The government's model for this initiative is being reviewed by a group including Clive Bates, Ben Youdan, Ruth Bonita, George Laking, David Sweanor, and Robert Beaglehole, who have found "significant flaws" because "the model is based on a fundamental and flawed assumption that reducing nicotine in cigarettes compared with conventional practice will reduce smoking by 85% within five years." They continue by saying that "the assumptions that are used as key inputs to the model stem from a misinterpretation of a randomized controlled trial of smoking cessation interventions in New Zealand in 2009-10, which included very low nicotine content (VLNC) cigarettes.
They said that the issue lies in the fact that the relationship between the trial design and regulatory intervention for smoking cessation among the whole population is not significant. Their findings cannot be applied to legislative models, which include the fact that volunteers from e-cigarette clubs who have called the quit smoking hotline received medication and behavioral support, and the intervention group was also given free very low nicotine content cigarettes and instructed to smoke if they felt like it. The trial intervention only lasted for eight weeks and its impact was evaluated six months later.
This experiment does not account for the most likely reactions to measures aimed at reducing nicotine consumption, such as switching to electronic cigarettes, entering the larger illicit market, or finding alternative methods by consumers or manufacturers.
The author of the comment states that the model "made unsubstantiated assumptions based on a misunderstanding of the smoking cessation trial, in which the provision of nicotine-free cigarettes to people who have attempted to quit smoking was used as an enhanced standard cessation intervention.
It fails to reflect the current trends of government intervention in the form of nationwide regulation, which it was expected to represent.
It did not take into account the illicit trade of regular tobacco and other alternative methods, which could be significant and must be incorporated into any models for nicotine reduction measures.
For the purpose of decision-making, modeling of legislation should more accurately reflect the real-world processes involved (such as illegal trade, loopholes, and the shift towards electronic cigarettes), and place greater emphasis on the transparency of assumptions, sensitivity testing, and scenario analysis.
The organization suggested that the New Zealand government "reconsider its confidence in evaluating and analyzing the impacts of its policy to support the Cabinet's move towards nicotine-free initiatives.
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