New Zealand is proposing bold new tobacco-control measures in a bid to become "smoke-free" by 2025, with plans to break the generational cycle of smoking in a move that experts say could have global implications for the future of the industry.
The ambitious legislation introduced to parliament in July set out three world-first measures aimed at reducing the prevalence of smoking to fewer than 5 percent of New Zealand's population of 5 million.
First, the bill would remove virtually all the nicotine from cigarettes and tobacco, leaving only very low levels of the addictive substance.
The second key measure would see the number of outlets selling smoked tobacco products drastically reduced, while the third seeks to create a "smoke-free generation" by prohibiting the sale of tobacco to anyone born from 2009 onward.
The fines for selling tobacco to people born from that year on would be up to NZ$150,000 ($92,700) and NZ$50,000 for supplying it.
"It's obviously quite radical, no one else anywhere in the world has proposed anything like this," said Richard Edwards, a professor of public health and co-director of the ASPIRE 2025 Research Center at the University of Otago, Wellington.
Edwards hopes the steps could spell the beginning of the end for the global smoking epidemic, by setting a precedent for other countries.
"If these measures are implemented and they're successful, this could have enormous implications for the tobacco industry because why wouldn't another country like Japan, or the Philippines or the U.S. look at it and say, ah, we should do something like that as well."
New Zealand's adult smoking rate is relatively low at 10.9 percent, but stark disparities in smoking prevalence and smoking-induced harm exist between the wider population and the country's indigenous Maori and Pacific Islander populations.
The smoking rate among Maori adults is more than double the national rate at 25.7 percent, and the prevalence among Pacific Islanders is also significantly higher at 19.9 percent.
The higher smoking rates among Maori can be traced back to the European colonization of New Zealand, according to Te Ara -- The Encyclopedia of New Zealand. Tobacco brought over by the Europeans was quickly taken up by Maori and became a standard trade item by the 1800s. Unlike their European counterparts however, smoking among Maori was not restricted by gender or age, with men, women, youth and children all taking up smoking.
Other potential contributors to the higher rate of smoking identified by researchers include the highly social nature of Maori culture, and the overrepresentation of Maori in lower socio-economic groups.
Due to this disparity, government projections show New Zealand's European population would likely achieve smoke-free status by 2025 under existing tobacco control measures, but Maori would not reach the goal for decades, prompting the dramatic shift in approach.
Modeling commissioned by the New Zealand government shows the bill's endgame strategy would substantially reduce overall health inequality between Maori and non-Maori New Zealanders.
According to the modeling, the measures would reduce the gap between Maori and non-Maori mortality in those aged 45 and over by as much as 22.9 percent for Maori females compared with non-Maori females, and a still very large 9.6 percent for males.
"In all our previous research, we have never seen a single health intervention with the potential to reduce health inequities this much," said modeling authors Tony Blakely, Andrew Waa and Driss Ait Ouakrim in an article for online news outlet The Conversation.
The bold new plan is not without criticism, however, with some -- including New Zealand's tobacco industry -- saying the strict measures will fuel a black market for cigarettes and tobacco and cause further harm.
"By reducing the retail availability and implementing a generational ban for smoked tobacco, the bill risks fueling growth of the illicit tobacco market which already accounts for 11.5 percent of tobacco sold in New Zealand," a spokesperson for British American Tobacco New Zealand told Kyodo News.
New Zealand's right-wing ACT party has also come out in opposition of the bill.
Karen Chhour, the social development and children spokeswoman for the ACT party, in a statement likened the policies to prohibition, a strategy that she said has never worked and always has unintended consequences.
"Eventually, we will end up with a black market for tobacco, with no standards or regulation, and people will be harmed," said Chhour, who said she is a former smoker.
New Zealand's Associate Health Minister Ayesha Verrall has hit back at the claims the bill is akin to prohibition, emphasizing there would be no criminalization of users -- only those selling -- and nicotine would still be available for purchase elsewhere, including in the form of vapes and e-cigarettes, the New Zealand Herald reported.
The government has responded to the concerns by committing NZ$10.39 million over four years to resource specialist investigation and enforcement capacity within customs, as well as intelligence and electronic forensic capability.
In professor Edwards's eyes, the fears of fueling the illicit tobacco trade should not deter New Zealand from pursuing the measures, as he explains the possibility of further harm due to poor quality products sold through the black market is not really a concern.
"Smoking black market cigarettes is no different from smoking cigarettes from Philip Morris, they all kill you exactly the same," said Edwards. "Smuggled cigarettes are usually products that have been made in other countries by the tobacco industry...they're no different, more or less dangerous than a non-black market cigarette."
Though New Zealand is the first to propose such measures on a country-wide level, other countries and towns across the globe have implemented similar measures to varying degrees of success in recent years, as global momentum to phase out tobacco builds.
The town of Brookline, Massachusetts, a wealthy suburb just outside Boston in the United States, introduced a bylaw in September 2021 that forever prohibits anyone born after 1999 from purchasing tobacco and vape products, effectively creating a smoke-free circuit-breaker akin to that which New Zealand is proposing.
However, Brookline's bylaw applies only to the predominantly white town of around 60,000 residents, where the smoking rate of adults was only 6.8 percent in 2021.
Eamonn, a 40-year-old smoker and office worker in Wellington who did not wish to share his surname, said strong measures are a welcome move. But he expects it will take longer than three years to meet the goal of becoming a smoke-free nation.
"Personally, I think they should just make the sale of tobacco products illegal now," said Eamonn, who like many smokers wants to kick the habit.
"I do think that if the availability of tobacco was reduced, then people would have to grow their own, maybe they'd have to buy from a black market or something, but either way you'd have less smokers."
The bill successfully passed its first reading in July and lawmakers hope to pass the final legislation by December 2022.