New Zealand’s Associate Health Minister Casey Costello has been praised internationally for rejecting what she called a “ridiculous” ranking that penalises the country despite its world-leading decline in smoking rates.
Minister rebukes global index
Minister Costello criticised the Global Tobacco Industry Interference Index, arguing it prioritises anti-industry posturing over public health results. “New Zealand’s priority is to reduce smoking, not to score points in an index that rewards hostility toward industry rather than health outcomes,” she said.
The Index, funded by Bloomberg Philanthropies, ranked New Zealand 53rd this year – even as the country’s daily smoking rate has halved in under a decade to just 6.9 per cent.
By comparison, Brunei, which topped the Index, has a smoking rate of 17.2 per cent, while 12th-ranked France has a rate of more than 27 per cent.
Critics question methodology
“Minister Costello is absolutely right: what matters is how many people smoke, not how loudly governments condemn the tobacco industry,” said Dr Delon Human, leader of Smoke Free Sweden and a former secretary-general of the World Medical Association.
“The Global Tobacco Industry Interference Index has become a political tool, not a public health one. It punishes countries that embrace harm reduction and rewards those that block life-saving alternatives.”
New Zealand’s low ranking comes despite one of the steepest smoking declines in the world – a drop driven in large part by the government’s decision to promote vaping as a quitting tool.
Vaping’s role in closing health gaps
Professor Ruth Bonita, Emeritus Professor of Population Health at the University of Auckland, has argued that the switch to vaping has helped accelerate the drop in smoking, particularly among groups with historically high tobacco use.
“Smoking accounts for almost a third of the Māori-non-Māori life expectancy gap. If the Government wants to close the gap quickly, smoking is the low-hanging fruit,” she said.
Daily smoking among Māori adults fell from nearly 29 per cent in 2011/12 to 14.7 per cent in 2023/24. Across the entire population, the rate dropped from 16.4 per cent to 6.9 per cent over the same period, while daily vaping rose from under one per cent to 11 per cent.
“People smoke to access nicotine but they die from the smoke, not the nicotine,” Bonita said. She described vaping as “a practical off-ramp from cigarettes and a path towards being nicotine-free altogether.”
A model for others?
Public health advocates have pointed to New Zealand’s experience as a stark contrast to neighbouring Australia, where strict pharmacy-only access rules for vapes have led to an expanding illicit market.
Smoke Free Sweden, which attributes its own near smoke-free status to widespread use of snus and nicotine pouches, said countries should focus on outcomes, not ideology.
“New Zealand’s results speak for themselves,” said Dr Human. “By allowing adult smokers access to safer alternatives, they are saving lives. That is the real measure of success, not the opinions of Bloomberg-funded pressure groups.”
