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ABSTRACT
AIM: To provide preliminary high-level modelling estimates of the impact of denicotinisation of tobacco on changes in smoking prevalence in Aotearoa New Zealand relative to the New Zealand Government's Smokefree 2025 goal.
METHODS: An Excel spreadsheet was populated with smoking and vaping prevalence data from the New Zealand Health Survey and we projected business-as-usual trends. Using various parameters from the literature (New Zealand trial data, New Zealand EASE-ITC Study results), we modelled the potential impact of denicotinisation of tobacco (with no other tobacco permitted for sale) out to 2025. In addition to the base case (considered most likely), Scenario 1 used estimates from a published expert knowledge elicitation process, and Scenario 2 considered the addition of extra mass-media campaign and Quitline support to the base case.
RESULTS: With the denicotinisation intervention, adult daily smoking prevalences were estimated to decline to under 5% by 2025 for the European/Other ethnic grouping (in the base case and both scenarios) and in one scenario (Scenario 1) for Maori (2.5%). However, prevalence did not fall below 5% in the base case for Maori (7.7%) or in Scenario 2 (5.2%). In the base case, vaping was estimated to increase to 7.9% in the adult population by 2025, and up to 10.7% in one scenario (Scenario 1).
CONCLUSIONS: This preliminary high-level modelling suggests that mandated denicotinisation has a plausible chance of achieving the New Zealand Government's Smokefree 2025 goal. The probability of success would increase if supplemented with interventions such as mass-media campaigns offering Quitline support (especially if predominantly designed for a Maori audience). Nevertheless, there is much uncertainty with these results and more sophisticated modelling is forthcoming.
Tobacco smoking caused an estimated 4,790 attributable deaths in Aotearoa New Zealand in 2019 (95% uncertainty interval (UI): 4,510 to 5.100).1 The total health loss, including morbidity, in 2019 was estimated at 116,000 disability-adjusted Me years (DALYs) lost (95%UI: 108,000 to 125,00c).1 Furthermore, smoking causes health inequities and results in poorer health for Maori relative to non-Maori.23 Exposure to second-hand smoke causes an estimated 347 additional attributable deaths per year in New Zealand, and an additional 9,022 lost DALYs per year.4
This high health burden means that the health benefits of tobacco control can be extremely large. The highest-impact intervention in one...