The good news about smoking cessation

New Zealand is leading the world towards a smoke-free future. So news that Aotearoa New Zealand has been labelled the ‘most deteriorated’ by the Global Tobacco Industry Interference Index should not be taken as badly as the headlines suggest. The rhetoric — and the ranking — fail to acknowledge New Zealand’s extraordinary success in driving smoking down to some of the lowest levels in the world. We are close to a smoke-free population – a target of 5% or less – and already have a smoke-free generation.

The “downgrade” appears to reward legislation on paper rather than results on the ground. The repeal of the 2022 retail-reduction law was portrayed internationally as backsliding, yet the real story is more nuanced — and far more hopeful.

When we look at the full data on youth and adult smoking, the picture is overwhelmingly positive. Youth smoking remains at historic lows: the ASH Year 10 Survey shows daily smoking at just 1%, even lower for non-Māori students. These are unprecedented achievements. Among Māori youth, daily smoking has fallen from one-in-three in the early 2000s to only a few percent today.

The latest 2024/25 New Zealand Health Survey confirms the same patterns in adults. Daily smoking sits at around 7 percent – with women very close to the target at 5.3 percent prevalence – and the long-term trend continues downward. Despite commentary claiming “failure” to reach 5 percent smoke-free target, this misreads the data.

Smoking rates are falling at two to three times the pace seen before 2018 and Pasifika and Māori rates even faster, although the most recent Māori result suggests that smoking rates dropped only marginally to 15 percent last year.

Had pre-2018 progress continued, it would have taken another 20 years for the total adult population to reach the smoke-free goal and much longer for Māori and Pasifika. Following the post-2018 acceleration — aligned with increased access to regulated vapes — most Māori and Pasifika groups are now only around five years away – if the recent trends continue. That is an equity gain of global significance.

The recent rapid decline is no accident. Since 2018, when nicotine alternatives became widely available in the form of vapes, adult smoking has dropped faster than at any time in our history — particularly among Māori women, whose smoking rate has halved since 2019. Vaping, while not risk-free, has provided a far less harmful alternative to burning tobacco, and costs around 10 times less than cigarettes.

Yes, youth vaping rose sharply until 2022 — largely due to weak regulation at the time — but it has since levelled off and, according to the ASH data, is now falling. Crucially, this increase did not lead to any increase in youth smoking. Smoking continued to drop to the lowest levels ever recorded. For some young people who once experimented with cigarettes, vaping may have replaced smoking rather than reigniting it.

This is what harm reduction looks like in practice: helping adults quit deadly smoking while reducing youth uptake through sensible controls. It is not a choice between protecting young people and supporting adults — New Zealand can and is doing both.

Of course, vaping requires strong regulation, and youth access must be tightly controlled. But shifting public attention away from smoking toward moral panic about vaping risks obscuring the fundamental point: it is the smoke, not the nicotine, that kills. In fact, a priority is helping older adults who smoke to quit; after all they are at the highest risk of early disease and death.

New Zealand’s record speaks for itself. It is a story worth telling and spreading. We should celebrate what is working, stay focused on protecting youth, and support the remaining people who smoke to move to smoke-free alternatives.

Aotearoa is closer than ever to becoming truly smoke free. Let’s not lose sight of this extraordinary achievement.