New Zealand’s rapid decline in smoking rates – driven by a rapid switch to vaping – is helping to narrow some of the country’s starkest health inequalities, according to a public health expert.
“A Pākehā [New Zealander of European descent] boy born in Waikato [a region in New Zealand’s North Island] today can expect to live eight years longer than his Māori [the Indigenous people of New Zealand] neighbour,” said Ruth Bonita, Emeritus Professor of Population Health at the University of Auckland.
“Pacific infants [children from Pasifika communities such as Samoa, Tonga and Fiji] face mortality rates that have barely shifted in two decades.”
“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.”
Smoking rates collapse
The numbers back up Bonita’s argument. Daily smoking among Māori adults fell from almost 29 per cent in 2011/12 to 14.7 per cent in 2023/24. Across the whole population, smoking dropped from 16.4 per cent to 6.9 per cent over the same period.
The turning point coincided with a sharp rise in vaping. Bonita said: “Trials and real-world evidence show that vaping is more effective for quitting smoking than conventional nicotine replacement therapies.”
Daily vape use grew from under one per cent in 2015/16 to 11 per cent in 2023/24.
“The pace of decline accelerated four-fold after 2018/19. That is not incremental progress. It’s a world-leading success story,” Bonita said. “Correlation is not causation, but the alignment is strong and consistent with international evidence,” she added.
Vaping’s key role
“People smoke to access nicotine but they die from the smoke not the nicotine,” Bonita said. While not risk-free, she argued vaping is “far less harmful” than cigarettes and offers “a practical off-ramp from cigarettes and a path towards being nicotine-free altogether.”
She acknowledged concerns about youth uptake of vaping, but urged perspective. “These measures should not undermine vaping’s role as a cessation tool for the remaining 300,000 adults who smoke.”
Policy steps
Bonita supports strong action to protect young people, including banning disposables, enforcing age-of-sale laws and curbing youth-appealing products. But she said the bigger opportunity lies in targeted measures to lock in the gains among adults. These include:
- keeping cigarette taxes high while ensuring safer alternatives stay affordable;
- integrating vaping into kaupapa Māori [Māori-led] and Pacific-led cessation services;
- providing vape starter kits on hospital discharge with follow-up support; and
- celebrating the success as “a national achievement, not just a statistical footnote.”
A generational opportunity
The Public Health Advisory Committee recently described persistent health inequalities as a “disaster for all of us.” Bonita agrees but said she sees hope in the collapse of smoking rates.
“Ending it will close the gap faster than any other single action available to us today,” she said. “Action on smoking is a once-in-a-generation opportunity, and one we can’t afford to miss.”
Contrast with Australia
New Zealand’s harm-reduction approach contrasts sharply with neighbouring Australia, where strict pharmacy-only rules for buying vapes have fuelled a thriving black market. Public health experts there warn that the crackdown has not stopped young people from accessing vapes, but simply pushed sales underground, making regulation and safety harder to enforce.
