1. Associate Professor Natalie Walker
Tobacco control regulations in a country with a smoke-free goal (New Zealand)
Associate Professor
Natalie Walker

2. Disclosures Funding sources
I receive contestable funding from the New Zealand government to undertake investigator-initiated smoking cessation trials
Industry funding in last five years
Cytisine and NRT provided at no cost
VLNC cigarettes and e-cigarettes purchased
Off label medication use
Cytisine and e-cigarettes

3. 1903: Juvenile Smoking Suppression Act
Fined up to £10 if sold, gave or supplied youth under 15 years with tobacco
Youth fined up to 5 shillings if caught publically smoking
No conviction if had a medical certificate
Women gained right to vote in 1893

4. NZ tobacco control legislation
TV and radio ads banned
Health warnings on packs
Smokefree Environments Act
- No advertising, no oral use
Smokefree workplaces
Pictorial warning labels
- 30% front, 90% back
Endgame goal & smokefree prisons
Counter display bans
??? Smokefree cars, plain packs
[go thru list]
Note that as a workplace, all schools and hospitals are smokefree
Over the past three years the excise tax has increased by 40 %. Currently the average price of a pack of 20 cigarettes is US$12, while 25s is US$16 and a 30 gram pouch of tobacco is US$28.
We are hoping for legislation around plain packs and smokefree cars very soon, and city bylaws to stop people smoking outside bars and restaurants

5. Cessation services in NZ
Brief advice and counselling
1990s Nicotine patch in community pharmacies
Quitline established
Subsidised NRT via vouchers
Health providers provide voucher
NRT over the counter
New cessation guidelines
Health professionals monitored for delivery of ABC
We have also had more than 25 years of smoking cessation support available, as shown here.
I won’t read this out but of note is that we don’t have smoking cessation clinics, the government heavily subsidises the costs of smoking cessation medication, dual use of products is recommended in our treatment guidelines, and GPs and hospitals are required to provide evidence that the have asked every patient if they smoke, and if so, deliver brief advice and quitting support or referral for support. This information is published in national papers so you can see how your district is performing against others..
In addition a voucher system for NRT is standard practice. The voucher is used by Quitline and registered Quitcard providers to provide smokers with access to subsidised NRT. Smokers have to take the voucher to a pharmacy for redemption of product at a very low cost ($US2 for eight weeks supply).
I will come back to the voucher system later

6. Price and duty-free allowance
Annual 10% tobacco tax increases
Price of 20 pack = US$14-18 (€13-17)
Price of 30 gram pouch = US$37 (€35)
Duty free allowance:
50 cigarettes, or
50 grams of cigars, or 
50 grams of tobacco products, or 
Mix of all three weighing not more than 50 grams
[go thru list]
Note that as a workplace, all schools and hospitals are smokefree
Over the past three years the excise tax has increased by 40 %. Currently the average price of a pack of 20 cigarettes is US$12, while 25s is US$16 and a 30 gram pouch of tobacco is US$28.
We are hoping for legislation around plain packs and smokefree cars very soon, and city bylaws to stop people smoking outside bars and restaurants

7. Regulation of e-cigarettes
Medicines Act 1981*
Smoke-free Environments Act 1990
E-cigarettes with nicotine No
E-juice with nicotine
Nicotine-free e-cigarettes
Yes
Nicotine-free e-juice
* Advertising, selling and distributing if therapeutic claim made
[Includes electronic shisha, electronic hookahs, pens or vapes etc]

8. Regulation of e-cigarettes
Medicines Act 1981
Illegal to advertise an overseas website where nicotine- containing e-cigarettes or e-liquids can be purchased.
Smoke-free Environments Act 1990 
Illegal to advertise, sell and distribute e-cigarettes that look like a tobacco product (toy tobacco product) to people under 18 years of age.

9. Regulation of e-cigarettes
People can import up to 3 months' supply of nicotine- containing e-cigarette products for their own use only.
These can’t be supplied, sold or be given away to anyone else.
The use of e-cigarettes in smoke-free places is not prohibited
Aug-Sept 16: Public consultation. Awaiting response

10. E-cigarette use in NZ 2011 2012 2014 Smoking monitor 7% -
(N=480, ≥ 18 yrs, current smokers recent quitters) 7%
ever purchased -
Youth insight survey
(N~3,000, yrs)
Ever tried
20%
Health & lifestyles
(N=2594, >15 yrs)
13%
Ever used
0.8%
Current user*
* Current users defined as “used at least once a day, week or month”

11. Use of e-cigarettes in NZ
Misuse of Drugs Act 1975
Drug paraphernalia or utensils are illegal
Defined as anything used as an aid to take drugs: includes vaporisers or repurposed e-cigarettes
One year’s imprisonment, and/or a fine of up to $500.
NZ National Drug Policy
“to minimise harm from alcohol and other drug use and promote and protect health and wellbeing.”
Jul-Sept 16: Public consultation: do the drug utensil regulations support this policy? Awaiting response

12. Heat-not-burn products (Dec 2016)
Battery-powered holder is legal
Sale and distribution of the tobacco sticks (Heets) is prohibited under the Smokefree Environments Act
No person shall advertise or “import for sale, sell, pack, or distribute any tobacco product labelled or otherwise described as suitable for chewing, or for any other oral use (other than smoking).”

13. Smoking prevalence in NZ
15 yrs and older, currently smoke, 2014/5 NZ census

14. Eight years to go! No roadmap Reduced tobacco supply Total ban
Retailer licencing
Retailer reduction
Total ban
Public support is strong
No political will
Election year

15. NZ tobacco control legislation
work/preventative-health-wellness/tobacco- control
THANK YOU