Effective Access to Tobacco Dependence Treatment, New Zealand

At the beginning of 1998 New Zealand lacked tobac-co dependence treatments. Only a small amount of Government funding was committed to smoking cessation programmes and it was difficult for many people to find help in quitting. Most of the cessation programmes availa-ble were offered by the private sector. These programmes were few in number, often expensive and tended to target white, middle-class smokers. There was little help available for Maori – New Zealand’s indigenous population – 50% of whom smoke. In addition, broader tobacco control measures that would indirectly support smoking cessation were lacking. Health warnings were weak, smoke-free environments largely confined to offices and public transport, and there had not been a significant increase in tobacco excise since 1991. For several years the tobacco control community in New Zealand lobbied for a smoking cessation media campaign and the provision of help for individuals. The Government listened. In 2003, New Zealand has one of the most advanced mixes of population-level smoking cessation initiatives in the world. In five years it has gone from almost zero Government funding of smoking ces-sation programmes, to funding of around NZ$ 13 million per annum. This is nearly 50% of the total New Zealand tobacco control budget.1 The initiatives include a national Quitline, subsidized nicotine replacement therapy (NRT), Maori-focused quit services including quit support and NRT for Maori women and their whanau (families), and a hospital-based quit service for inpatients and their families. Broader measures supporting smoking cessation are also in place or planned, including stronger health warnings, a ban on point-of-sale advertising, legislation that proposes to ban or severely restrict smoking in workplaces, and sig-nificant excise increases in 1998 and 2000.