New Zealand's tobacco control programme 1985-1998

Objective-To review the impact of New Zealand's tobacco control programme f rom 1985 to 1998 on smoking prevalence and tobacco consumption, and to esti mate the scope for further reduction. Design-Country case study; interventions, with outcomes ranked internationa lly across time. Setting-New Zealand 1985-98; for 1985-95, 23 OECD countries. Interventions-Between 1985 and 1998, New Zealand eliminated tobacco adverti sing, halved the affordability of cigarettes, and reduced smoke exposure in work time by 39%. Main outcome measure-Reduction in adult smoking prevalence and in tobacco p roducts consumption per adult. Results-Changes in prevalence 1985-98: in adults (aged 15+ years), -17% (fr om 30% to 25%) but short of the 20% target for 2000; in youth (aged 15-24 y ears), -20% (from 35% to 28%); and in Maori adults (aged 15+ years), -17% ( from 56% in 1981 to 46% in 1996). Changes in consumption 1985-98: tobacco p roducts per adult aged 15 + years, -45% (2493 to 1377 cigarette equivalents ); cigarettes smoked ner smoker. -34% (22.7 to 15.0 per day). Between 1985 and 1995 New Zealand reduced tobacco products consumption per adult more ra pidly than any other OECD country, and reduced youth prevalence more rapidl y than most. The acceleration of the decline in cigarette attributable mort ality rates in men and in women age 35-69 years averted an additional 1400 deaths between 1985 and 1996. Between 1981 and 1996 smoking prevalence amon g blue collar workers decreased only marginally, and in 14-15 year olds, ro se by one third between 1992 and 1997. Conclusion-In 13 years, New Zealand's tobacco control programme has been su ccessful in almost halving tobacco products consumption, particularly by lo wering consumption per smoker. With strong political support for quit campa igns, increased taxation, and the elimination of displays of tobacco produc ts on sale, the consumption could theoretically be halved again in as littl e as 3-6 years.