by Pippa Starr
4 January 2024
Learning from the UK and New Zealand’s Success in Reducing Smoking Rates
Australia has long been hailed as a leader in tobacco control, boasting stringent measures that drastically reduced smoking prevalence over the past decades. However, recent years tell a different story. While Australia’s smoking rates stagnated, countries like New Zealand, Sweden and the UK forged ahead, achieving significant reductions by embracing evidence-based approaches including tobacco harm reduction (THR). This divergence underscores the need for a critical review of Australia's old tobacco control Non-Governmental Organizations (NGOs) and their anti-vaping advocacy.
Australia’s Tobacco Control Stagnation
Smoking rates in Australia have plateaued over the past six years, a troubling trend in contrast to New Zealand and the UK, which have adopted innovative harm reduction strategies. While Australia maintains a rigid prescription and/or chemist-only model for nicotine vaping products, these countries have allowed adult access to regulated vaping products as part of their public health arsenal.
The result?
Accelerated declines in smoking prevalence and improved cessation outcomes.
The failure of Australia’s restrictive vaping policies is evident in the thriving black market for vaping products, which bypasses regulations and age restrictions.
This unregulated environment not only undermines public health but also exposes youth to potentially harmful products.
Misguided Anti-Vaping Advocacy
Anti-vaping campaigns in Australia often mirror traditional anti-smoking messaging, a flawed approach that conflates the dangers of combustible tobacco with those of vaping.
Unlike smoking, vaping does not involve combustion, which is responsible for the majority of smoking-related harm. Evidence consistently shows that vaping is at least 95% less harmful than smoking and is one of the most effective tools for smoking cessation.
Scare campaigns that amplify risks and downplay benefits discourage adult smokers from switching to safer alternatives while failing to deter experimental youth vaping. This approach perpetuates misinformation and alienates the very populations that could benefit most from harm reduction tools.
Tobacco Harm Reduction: A Proven Strategy
Tobacco harm reduction (THR) is grounded in the principle of reducing harm for individuals unable or unwilling to quit nicotine entirely. Strategies like vaping, nicotine pouches, and heated tobacco products provide safer alternatives to smoking and help smokers transition away from combustible tobacco. The Royal College of Physicians and Public Health England and New Zealand public health advocate for the widespread promotion of vaping as a smoking cessation aid.
The success of THR is evident in the UK’s “vape to quit” programs, which provide vapes to smokers through health services, achieving significant reductions in smoking prevalence. New Zealand's approach also integrates harm reduction with culturally tailored programs, contributing to its rapid smoking rate decline and is now introducing programs including making vaping kits free for smokers.
Reviewing Tobacco Control NGOs
Australia’s tobacco control NGOs have historically focused on abstinence-based policies and punitive measures. While effective in the past, these approaches are inadequate for the current landscape. NGOs should be reviewed with key performance indicators (KPIs) that align with contemporary public health goals, including:
Reducing smoking prevalence.
Promoting harm reduction awareness and adoption.
Engaging with adult smokers through evidence-based messaging.
Preventing youth access to all nicotine products through proportionate regulation.
A New Path Forward
To reclaim its leadership in tobacco control, Australia must reform its outdated approach:
Adopt Evidence-Based Harm Reduction Policies: Permit the regulated sale of vaping products to adults while enforcing strict age restrictions.
Separate Vaping from Big Tobacco: Distinguish harm reduction products from combustible tobacco in public messaging and policy.
Tailor Youth Prevention Strategies: Implement measures targeting youth access and advertising without undermining adult access to harm reduction tools.
Introduce KPIs for NGOs: Measure success based on health outcomes, not ideological adherence.
Australia’s smokers and public health deserve a pragmatic, compassionate, and evidence-based approach. Learning from New Zealand and the UK’s success stories is essential to reversing the stagnation and embracing progress.