Smoke and mirrors in tobacco debate

Varying takeaways from annually reported smoking trends have led to accusations of the Government “cherry-picking” its data.
The minister behind the repeal of smokefree legislation argues New Zealand is still on-track for Smokefree 2025, but a national survey suggests that the decline in daily smoking rates has stalled or perhaps even reversed.
Following the release of the 2024 NZ Health Survey data, Associate Health Minister Casey Costello and Labour leader Chris Hipkins each sent out a press release. Even though they were based on the same dataset, the two releases painted two very different pictures of where smoking trends are headed in Aotearoa.
The Government’s press release mentioned the national smoking rate of 6.9 percent, and said “most of the survey data shows a continuation of the great progress that’s been made in the last few years”. 
Costello set a goal of dropping the total smoker population by 80,000 people. She acknowledged it was “a big ask” but said similar drops had been achieved in previous years with the same regulatory regime.
Costello used the percentage figure of daily smokers at the head of her announcement, but raw numbers when discussing goals.
Hipkins didn’t look at percentages at all, and instead opened with the raw figures: he claimed the daily smoker population rose this year from 284,000 to 300,000. 
Costello framed the 80,000 reduction target as a “final push” to reach Smokefree 2025. But under her leadership, the Smokefree Environments and Regulated Products Amendment Bill repealed incoming legislation that would reduce the number of tobacco retailers from 6000 to 600, cut 95 percent of nicotine from cigarettes and ban the sale of tobacco products to anyone born after 2009. 
Costello told Newsroom that if we looked at the data, it would show smoking rates trending downwards across the board, especially among vulnerable populations like Māori.
Māori smoking rates indeed dropped 3 percent in the past year. But the national percentage of daily smokers, which is how the Smokefree 2025 goal is measured, saw its first rise since 2013, after a gradual 10 percent drop over that same timeframe. This rise was by just one-tenth of a percentage point, which the survey says was not statistically significant.
A spokesperson for Hipkins said the Labour team used the same dataset to inform their press release, saying, “you can clearly see a steady decline in the number of adults smoking daily until it comes to a grinding halt this year and goes back up.”
When asked why the two press releases reported different statistics from the same survey, Hipkins’ spokesperson said the Government had cherry picked the data and overlooked “the obvious trend”.
Costello’s other piece of smokefree legislation, the second half of the above bill, takes aim at vaping and is set to become law after an imminent third reading. This bill would aim to curtail the rising trend of youth vaping by banning the sale of disposable vapes, amending packaging requirements, and increasing the penalties for illegal sale.
In the same national survey as before, youth vaping trends saw a steep rise. The current year saw 11.1 percent of the total population reported as a daily vaper, up from 2.6 percent in 2017. 
This rise was not steady. It jumped steeply during the 2019/2020 period, overlapping with the pandemic lockdowns.
But even within this year, the rise was not uniform; the 18-25 year-old age range was responsible for the majority of the thrust, indicating that university-aged Kiwis during the lockdown period saw the highest increased rate of vape use.
This period followed a landmark ruling in 2018, in which nicotine giant Philip Morris International successfully won a case against the Ministry of Health arguing that the Smokefree Environments Act 1990 did not apply to aerosolised nicotine. The modern vape was suddenly available for retail, and it was advertised heavily at youth.
The same company that helped usher in the age of the modern vape, Philip Morris, also has a monopoly on heated tobacco products in New Zealand. These are the same products that Costello’s repeals target with an excise tax reduction, while excise taxes on other products continue to rise. For comparison, in her latest press release, Costello announced the excise tax increase for tobacco products would be 2.23 percent, in line with inflation.   
Meanwhile, four university medical experts have penned a letter in the British Medical Journal in which they argue any professional doctors in Parliament who fail to resist the repeal of smokefree legislation is violating their medical oath to “first, do no harm”. 
The letter concludes that the changes will cause suffering and cost lives. “The burden of illness will disproportionately be borne by the disadvantaged. The repeal breaches the duty of care expected of those trusted to act for the public good.”
Thhe passive acceptance of these changes by figures like Health Minister Dr Shane Reti “not only disregards their duty of care as politicians but violates the oaths they took as medical practitioners and the ethical principles they remain bound to,” the letter says.
Dr Cindy Towns, from the University of Otago’s bioethics centre, is the lead author. She believes it would be “unequivally unethical” for any doctor to support the repeal.