How do people who smoke perceive a tobacco retail outlet reduction policy in Aotearoa New Zealand? A qualitative analysis

Abstract

BackgroundAotearoa New Zealand plans to greatly reduce tobacco retail outlets, which are concentrated in areas of higher deprivation and perpetuate health inequities caused by smoking and borne particularly by Māori. However, we lack in-depth analyses of how this measure could affect people who smoke.MethodsWe undertook in-depth interviews with 24 adults from two urban areas who smoke. We used a novel interactive mapping approach to examine participants’ current retail outlets and their views on a scenario where very few outlets would sell tobacco. To inform policy implementation, we probed participants’ anticipated responses and explored the measure’s wider implications, including unintended impacts. We used qualitative description to interpret the data.ResultsMost participants anticipated accommodating the changes easily, by using alternative outlets or bulk-purchasing tobacco; however, they felt others would face access problems and increased costs, and greater stress. They thought the policy would spur quit attempts, reduce relapse among people who had quit and protect young people from smoking uptake, and expected more people to switch to alternative nicotine products. However, most foresaw unintended social outcomes, such as increased crime and reduced viability of local businesses.ConclusionsMany participants hoped to become smoke-free and thought retail reduction measures would prompt quit attempts and reduce relapse. Adopting a holistic well-being perspective, such as those developed by Māori, could address concerns about unintended adverse outcomes and provide comprehensive support to people who smoke as they adjust to a fundamental change in tobacco availability.

Perceptions of Illicit Tobacco Sources Following a Proposed Reduction in Tobacco Availability: A Qualitative Analysis of New Zealanders Who Smoke

“…43 Future research could assess NZ’s approach, which has allowed liberal access to alternative nicotine products, such as vaping devices, and expanded cessation support, 43 a response suggested by participants in this and other studies. 34 , 36 , 44 Recent provisions that increased funding allocated to border monitoring should provide early warnings of rising illicit imports, but the processes established will require careful evaluation. Furthermore, while its maritime borders create barriers to illicit trade, NZ could nonetheless participate in international networks monitoring tobacco trade.…”

“…Data came from a larger qualitative study exploring NZ’s supply reduction policy among a sample of NZ adults who smoked. 34 Daily smoking prevalence in NZ is eight percent 35 ; reflecting sustained excise tax increases, plain packaging, and smoke-free areas, among other recent policies. 36 Regulations limit homegrown tobacco production to 5kg annually and disallow sales, and alternative nicotine sources, via vaping products, are widely available.…”

Tobacco control policy and regulation from diverse perspectives and contexts

“…Finally, returning to the issue of public reactions to tobacco control policies, Graham-DeMello and Hoek explore how adults who smoke might respond to the (then) planned New Zealand policy to greatly reduce tobacco retail outlets. 23 While participants expected the policy would support reduced smoking, they identified potential negative social outcomes. The study provides important insights for countries planning more intensive tobacco control measures.…”