Smokefree 2025 could save NZ$400m in healthcare costs and banish smoking for good
New Zealand’s proactive approach towards lowering cigarette smoking rates is proving to be a success. The smoking rates are already some of the lowest in the world, as vaping seems to have helped many people quit smoking cigarettes, and young teenagers are not picking up the habit at all.
However, Māori numbers remain high, as well as the number of smokers in poorer areas of New Zealand in general. The Ministry of Health has announced a new campaign called “Smokefree 2025” that is designed to create a smoke-free generation.
Smoking is recognized as one of the main public health problems worldwide and accounts for a high financial burden to healthcare systems and the society as a whole. It is the number one preventable cause of death.
Smoking is the leading cause of preventable health inequities, being responsible for up to two years of the life expectancy gap experienced by Māori. In 2021/22 around one in 12 (8%) of adults smoked cigarettes daily, but this rose to one in five (19.9%) among Māori.
Australia, in comparison, isn’t managing to reduce its high number of smokers (almost 9%; between 11% and 12% in youth), probably due to the reduced availability of vaping as a prescription is needed. In New Zealand, it is precisely vaping that is deemed responsible for the fall of smoking cigarettes into obscurity.
“Smokefree 2025”
New Zealand’s Ministry of Health has said that around 4,500 New Zealanders die from tobacco each year, and the country needs a “new approach” to banning smoking. Several public health organisations have endorsed the proposals.
The original plans for a smoke-free generation of New Zealanders underwent a public consultation stage and were first announced in April.
The plans will have to go through the legislative process but are unlikely to face obstacles as Smokefree 2025 is the headline message of the Labor Party, which has a majority in New Zealand’s parliament.
Smoking is responsible for one in four cancer deaths in New Zealand, and around half a million New Zealanders smoke every day. The impact is greatest among the Māori, New Zealand’s indigenous population: Māori women have the highest smoking rate in the country, with about 30% smoking daily.
Cancer is the leading cause of death for Māori women and the second leading cause of death for Māori men.
Health care costs are estimated to be NZ$1.6 billion in health care costs, including but not limited to the cost of 340,000 hospital admissions to treat smoking-related conditions.
With a planned reduction of smokers from 6.8% to under 5% as indicated by the Smokefree 2025 project, these costs are projected to go down to NZ$1.2 billion, saving up to NZ$400 million in the healthcare system annually.
A reduction of 1.8% in a year isn’t unheard of – as smoking rates reduced by 2.0% the year before.
Share of adults who smoke
There has been a continuous decline in the number of smokers worldwide in recent decades, as the World Bank data shows. The trend has been almost universal, but the countries that take an evidence-based proactive approach to mitigating smoking, such as New Zealand, are having more success.
New Zealand smoking statistics
This year 29,260 students from 310 schools took part in the 24th ASH Year 10 Survey. The survey is one of the largest and longest running surveys of youth tobacco and vaping behaviours and attitudes in the world, and the largest smoking survey in Aotearoa after the Census. It has run annually since 1999, when it found 15.6% of Year 10 students (14-15 years of age) smoked cigarettes daily.
By the end of 2023, for teenagers aged 14 to 15, daily cigarette smoking is almost obsolete at 1.2%. Only 6.8% of adults reported smoking daily, down nearly 2% from the previous year and down 10% on the decade.
The numbers of those who have never tried a cigarette continue to increase at a significant rate, reaching 87.8% compared to 85.8% the year before.
This coincides with an almost 4% increase in Māori youth never smoking rates (73.8% to 77.7%) and in particular an almost 6% increase in never smoking by Māori girls (71% to 76.8%).
The vaping rates of Māori girls, though, tell a more concerning story with them vaping more than 2.5 times the average rate.
The proportion of Year 10 students (14-15 years of age) vaping regularly has also decreased significantly for the second year running in the annual ASH survey of Kiwi youth, dropping by almost 2 percent (18.2% in 2022, 16.4% in 2023).
In the poorest fifth of the population, one in four adults smoke.
Tangible and intangible costs of smoking
Tangible costs of smoking
- Lost productivity and worker absences
- Family members caring for someone with a smoking-related disease
- Health care costs, including the cost of hospital admissions
Intangible costs of smoking
- Years of life lost from premature deaths
- Lost quality of life from living with a serious illness
Extrapolating the numbers from an Australian 2019 report to the New Zealand population that has similar smoking rates, the tangible costs of smoking in New Zealand include NZ$1.1 billion in lost productivity and worker absences, NZ$0.45 billion for family members caring for someone with a smoking-related disease and NZ$1.6 billion in health care costs, including the cost of 340,000 hospital admissions to treat smoking-related conditions.
Intangible costs, such as the years of life lost from premature deaths in that year or lost quality of life from living with a serious illness, are estimated to be a massive NZ$25 billion per year.
Rates and cost of hospitalisation of smokers
The mean cost of hospitalisation per patient in Iran in a 2017 research paper was 67% higher for current smokers and 17% higher for former smokers compared to never smokers, indicating that smokers are, in general, a more expensive patient than a non-smoker.
It is also much more common for smokers to end up in a hospital, up to 40 per cent compared to a never smoker. These stats are almost universal for all countries in the world.
References
- https://www.ash.org.nz/youth_regular_vaping_decreases_for_2nd_year_in_a_row_in_ash_year_10_survey_daily_smoking_remains_very_low
- https://dashtickets.nz/healthcare-system/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804450
- https://globalactiontoendsmoking.org/news-and-press/press/new-zealands-smoking-rates-plummet-while-australias-stall/
