New Zealand's tobacco control programme 1985-1998.

OBJECTIVE To review the impact of New Zealand's tobacco control programme from 1985 to 1998 on smoking prevalence and tobacco consumption, and to estimate the scope for further reduction. DESIGN Country case study; interventions, with outcomes ranked internationally across time. SETTING New Zealand 1985-98; for 1985-95, 23 OECD countries. INTERVENTIONS Between 1985 and 1998, New Zealand eliminated tobacco advertising, 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 products consumption per adult. RESULTS Changes in prevalence 1985-98: in adults (aged 15+ years), -17% (from 30% to 25%) but short of the 20% target for 2000; in youth (aged 15-24 years), -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 products per adult aged 15+ years, -45% (2493 to 1377 cigarette equivalents); cigarettes smoked per smoker, -34% (22. 7 to 15.0 per day). Between 1985 and 1995 New Zealand reduced tobacco products consumption per adult more rapidly than any other OECD country, and reduced youth prevalence more rapidly than most. The acceleration of the decline in cigarette attributable mortality 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 among blue collar workers decreased only marginally, and in 14-15 year olds, rose by one third between 1992 and 1997. CONCLUSION In 13 years, New Zealand's tobacco control programme has been successful in almost halving tobacco products consumption, particularly by lowering consumption per smoker. With strong political support for quit campaigns, increased taxation, and the elimination of displays of tobacco products on sale, the consumption could theoretically be halved again in as little as 3-6 years.