According to the most accepted theory, the translation of Aotearoa (the Māori name of New Zealand) would be “long white cloud”. It may therefore seem ironic that the term appears in the title of the New Zealand government program aimed at eliminating a cloud, namely the cloud of smoke produced by cigarettes and similar things. Yet this is no coincidence, as Smokefree Aotearoa 2025 bases its goal on the so-called Te Tiriti or Waitangi principles, which involve Māori representatives in achieving equitable outcomes in public health matters for indigenous people. The latter is in fact the first victim of inequalities relating to tobacco addiction. The Action Plan launched at the beginning of the month represents a firm stance by the government, but although it has been welcomed by the local and international medical-scientific community, it has also raised numerous criticisms.
Smokefree Aotearoa 2025 Action Plan
The Action Plan was presented on Thursday 9 December 2021, supported by Prime Minister Jacinda Ardern, leader of the Labor Party. The plan represents the latest act of a ten-year process aimed at reducing the percentage of smokers among New Zealand citizens to 5% by 2025, a goal that is difficult to achieve unless the urgent measures proposed are implemented. Although the current percentage of adult smokers is decreasing, it stands at around 13% distributed in a heterogeneous way, but the figures show a surge for citizens of Māori origin.
The plan is based on the opinion of representatives and experts from different areas of expertise, ethnicities and interests. It is subject to public consultation and it is structured in six points. The most significant points include the prohibition of tobacco products without minimum nicotine levels, a drastic reduction in the number of sales points for these products, and the creation of a smoke-free generation. This last action, the one that caused the most sensation, provides for gradually raising the minimum age for purchasing cigarettes, making it illegal for life for those who will be 14 years old or less when the law comes into force.
Health Minister Ayesha Verrall insisted on saying that such bold measures are necessary to achieve the project's goal for all New Zealand ethnicities, especially the Māori minority. The Action Plan has been welcomed by public health experts around the world as a historic "game changer" if not "the endgame" in the fight against tobacco addiction.
Nonetheless, even such massive government intervention was criticized.
The first criticism concern the economic aspect. As pointed out by the opposition party ACT NZ, in fact, the measures of the plan would entail considerable losses for about 8000 retailers, since only a small percentage will receive the necessary authorization to continue selling cigarettes. In this regard, as reported in an NPR article, the president of the Dairy and Business Owners Group, Sunny Kaushal, has called for alternative measures that do not lead to the ruin of "dairies, lives and families in the process".
A different issue concerns electronic cigarettes. Although they remain one of the main tools available to smokers to overcome their addiction and are not directly affected by the Action Plan, they would be overshadowed by the drastic measures envisaged. If on the one hand the lobby of e-cig manufacturers complains about this downsizing, on the other hand some opponents have denounced how the plan, by not intervening on e-cigarettes, in fact creates a new potential problem. At the moment, little is known about the long-term damage of e-cigs and the data show how the number of users, especially in the younger groups, is following an upward trend, opposite to that of 'traditional' smokers.
Furthermore, the prohibitionist measures of the Plan could further exacerbate the issue of the black market in cigarettes, which has already experienced an expansion due to the high taxes imposed on tobacco products, especially among the poorest communities who are the main victims of smoking. Another negative aspect could be that current smokers, being able to buy only products with a minimum quantity of nicotine, would be pushed to buy many more cigarettes to satisfy their addiction. Such a scenario would once again hardly hit the poorest people in society, especially the Māori minority.
Further criticism focuses on moral issues. Someone wonders to what extent a liberal state can interfere in the private choices of its citizens. In this regard, the most controversial action is the creation of a smoke-free generation. The Minister of Health and the Prime Minister continue to argue that it is necessary to ensure that young people, rather than detoxify, never come into contact with tobacco. However, neither one nor the other has yet provided exhaustive answers on the possible anti-liberal drifts of the plan, but only reiterated how the expected benefits outweigh the inevitable sacrifices.
Is a world model possible?
Despite the skepticisms, the Action Plan represents the most multifaceted and all-encompassing intervention ever proposed worldwide in the fight against tobacco addiction. For this reason, as argued by Geoffrey Fong, leader of the International Tobacco Control Policy Evaluation Project, it will be essential to carefully monitor the evolution of the situation in New Zealand, to assess whether this type of policy can constitute a model that can also be implemented elsewhere. Naturally, the ocean archipelago has a number of features conducive to the success of the project, such as the relatively small number of inhabitants (about five million) and its insularity. As a result, the same measures may not have the same effects in other places such as the nearly 40 million California residents, who could easily circumvent restrictions by purchasing cigarettes in neighboring federal states. Nonetheless, the Action Plan, which is likely to come into effect next year, will represent a globally unique experiment. Only through a meticulous analysis will we be able to weigh the costs and benefits, and to consider whether or not to extend similar measures against the cloud of cigarette smoke beyond the boundaries of the "Long White Cloud".
Translated by Simona Taravella