This project was conducted by Ivana Barbalich, supervised by Janet Hoek.
New Zealand’s equity-focused endgame goal (Smokefree 2025) aims to reduce smoking prevalence to minimal levels (i.e., <5%) in all population groups by 2025. Inadequate progress has stimulated discussion of innovative measures to reduce smoking prevalence. We explored how people experiencing lower material wellbeing perceived these measures by conducting 20 in-depth interviews with people who smoked daily, were aged between 21 and 53, earned less than the median income (NZD33 900), and had marginal or inadequate income sufficiency. We used an elicitation exercise to probe participants’ views on smokefree policies, including potential endgame measures, and analysed their responses using qualitative descriptive analysis and reflexive thematic analysis. Participants favoured increasing personal support to quit and reducing nicotine levels in cigarettes, but generally opposed tobacco excise tax increases and paying people to quit. While many privileged their right to “choose,” some recognised that stronger policies could restore the loss of agency addiction caused. Participants felt smoking’s powerful addictiveness remained poorly understood, and called for smoking to be recognised and treated as an addiction. Although they supported intensifying existing measures or introducing new measures, several participants used tobacco industry rhetoric to frame smoking as a choice, a framing that could inadvertently reinforce the stigma they experienced. Presenting smoked tobacco as an addictive product engineered by a deceptive industry, may make it easier for participants to access the expanded support and compassion they sought. Participants supported several endgame measures, including denicotinisation; however, greater public understanding of addiction is needed to reduce stigma, support self-efficacy, and foster smoking cessation. Industry denormalisation campaigns could challenge views of smoking as a personal choice, decrease self-blame among people who smoke, and present endgame goals as likely to enhance agency.
Barbalich, I., Gartner, C., Edwards, R., & Hoek, J. (2022). New Zealand smokers’ perceptions of tobacco endgame measures: a qualitative analysis. Nicotine and Tobacco Research, 24(1), 93-99.
Hoek, J., Barbalich, I., Edwards, R., & Gartner, C. (2021). A qualitative analysis of how people who smoke and manage lower incomes perceive the Smokefree 2025 goal. The New Zealand Medical Journal (Online), 134(1535), 83-87.
Health Research Council of New Zealand programme grant 19/641 (2019)