Politics / Health

Casey Costello will release 'independent advice' about benefits of heated tobacco products

16:07 pm on 2 October 2024

New Zealand First Minister Casey Costello will release the independent advice she received about what she says are the merits of heated tobacco products being used to help people quit smoking.

In a sitdown interview with RNZ on Wednesday, Costello said she had never claimed heated tobacco products (HTPs) were safe, just that they were less harmful than smoking.

"Health confirmed that it's less harmful than smoking. So what we're talking about is harm reduction products to send people on a pathway to quit smoking.

"What we knew was that heated tobacco as an alternative to smoking was less harmful than smoking, considerably less harmful. But we definitely weren't saying it was safe, or suggesting take that up instead of smoking," Costello said.

On Monday RNZ revealed officials had told Costello that Philip Morris would be the biggest winner from tax cuts for HTPs, which they said were toxic and more harmful than vaping.

Despite a long list of problems Treasury identified with the proposal, Costello claimed she had got her own "independent" advice to the contrary and went ahead with a 50 percent excise tax cut for HTPs, at a cost of up to $216 million.

Associate health minister Casey Costello. Photo: RNZ / Samuel Rillstone

RNZ has been assured that advice will be made public this week.

It includes international studies, advice from ASH, and other evidence from countries like Japan regarding their use of HTPs to cut smoking rates.

"This will all be released, it's not an issue," Costello said.

"With Japan, they don't have vaping, and they saw a significant decrease in smoking using alternate tobacco products.

"We are trying to do a process by consent, rather than coercion, and presenting alternate products as an alternative because we knew vaping wasn't working for everyone," she said.

Last week, Costello declined to be interviewed on that independent advice and did not answer specific RNZ questions about it.

However, on Wednesday, she said she was surprised by the coverage, because she had not realised "until this point that this was an issue" in terms of where the advice had come from.

The advice was not part of the Cabinet paper she took to ministers.

"It's 10 to 12 pages long. It's not usual to attach evidence to a Cabinet paper," she said.

Prime Minister Christopher Luxon. Photo: RNZ / Samuel Rillstone

Prime Minister Christopher Luxon has backed her decision making, despite having not seen the independent advice himself.

RNZ asked Costello whether she was confident the prime minister would not regret his comments, and that the advice was sound and legitimate, to which she responded "yeah absolutely".

The minister said the excise tax cuts to HTPs was part of a "range of things we're looking at to achieve the smokefree 2025 target".

"This was just about these products, which already exist in the market, and could we perhaps make it slightly more attractive than a pack of cigarettes, and therefore look at whether that was successful in getting people to stop smoking, for those that vaping hasn't worked for."

Given the independent advice still is not public, RNZ asked Costello whether she appreciated some might be concerned it had come from the tobacco industry, given Philip Morris was a big winner of the tax cuts to HTPs.

She reiterated she did not know the independent advice was an issue until this week.

The government has committed to a 12-month trial of HTPs to see whether they help people quit smoking.

The snag, however, as revealed by RNZ earlier on Wednesday, is the main supplier, Philip Morris, has been forced to pull its device from sale.

The device used to heat the tobacco is classified as a vape and has been caught by Labour's regulations forcing devices to have removable batteries and child safety mechanisms, which kicked in on 1 October.

Documents show Costello tried to have the regulations delayed for two years, but the Cabinet only agreed to a six-month delay from the original date of 21 March.

The 'IQOS' product, made by Philip Morris, is the only HTP on the market. Photo: RNZ/ Luke McPake

Costello told RNZ on Wednesday her request to delay the regulations was not connected to HTPs.

"I knew I was introducing legislation, which was part of our coalition agreement, to ban disposable vapes this year.

"So, my concern was around doing changes before we were doing the total blanket ban of disposable vapes."

She said rather than "messing around with the market repeatedly changing things" it would be easier to delay the regulation changes and allow the blanket ban legislation to be passed first.

That legislation is currently before the select committee.

Costello said she did not know Philip Morris' products would not comply.

"Those are things that I couldn't have known ... what we knew was we had a product in the market, now that has changed."

Costello told RNZ she had never spoken with Philip Morris about wanting their HTPs available for people as a tool to quit smoking.

"It's not about Philip Morris, this is about a product, it's not about the company.

"We've seen with vaping - every change that's occurred in the vaping market the market has pivoted and created products that were compliant.

"The market will pivot again - that's what they do, so it's not up to me to talk to manufacturers.

"There will still be some product available. I think it's relating to 97 percent so there's clearly other products that are still available. So whether they grow their market share, I don't know."

She rejected the suggestion she had advocated for HTPs and that it made little sense not to ensure there would be products available.

"I never even announced it - it was there, it was in the Budget ... it was something I never made a big thing about, it was just something that existed."

Casey Costello speaks to RNZ in a sitdown interview. Photo: RNZ / Samuel Rillstone

Once the trial gets off the ground - and Costello said she did not know if that would happen - HTPs will be categorised differently at Customs to identify what was coming into the country.

Together with smoking quit rates, she said there would be information to judge at the end of the trial how effective they had been.

And Costello said she had the backing of Quit Smoking providers because "we've got a common target, we're trying to get people to quit".

Asked whether the associate health portfolio and the smoking issue was one that kept her awake at night, she described it as "frustrating".

"I suppose what hurts me is, you know, my Dad died from respiratory illness because of smoking.

"I hate smoking, I've never smoked in my life, and so I'm absolutely committed to achieving this target.

"Māori have the highest smoking rates. I'm a Māori. I want people to know that there's hope, and you can quit smoking.

"And that's what I'm committed to doing, and that's what I've got this job for, to fight through and try and come up with those practical solutions."

Labour health spokesperson Ayesha Verrall. Photo: RNZ / Samuel Rillstone

Health Coalition Aotearoa has called for the prime minister to stand Costello down.

Co-chairperson professor Boyd Swinburn said: "The prime minister cannot have confidence in a health minister implementing so many anti-health measures - he needs to stand down associate minister Costello and reverse the HTP decision immediately".

They believe Costello has failed to deliver on standards expected of a minister on transparency, integrity and competence.

The health advisory group said it was the latest in a long series of pro-tobacco industry moves by Costello that were likely to cause more harm at the tax-payer's expense.

"We have a bizarre situation where the government has put aside $216m from the health Budget for lost tax revenue it would have received from a major tobacco company - Philip Morris - while the products it was intended for are no longer legal."

HCA member professor Chris Bullen added the plan to reduce smoking rates by making another tobacco product cheaper was a "dangerous and radical experiment from the start and should never have been approved by cabinet".

"These decisions have real and widespread consequences for the health of New Zealanders - and will take us in the exactly wrong direction on tobacco control," Bullen said.

Labour also believed the minister should be sacked, with health spokesperson Ayesha Verrall pointing out the products the minister made more accessible with the intention of helping people to quit smoking were no longer available.

"Casey Costello has made a fool of the prime minister by [sic] having him in the media yesterday defending her plan for a trial of tax breaks on heated tobacco products in order to, as they say, help people quit smoking."

Philip Morris, the only supplier of HTPs in New Zealand, has been forced to pull its device from sale because it does not meet new safety regulations that came into force on Tuesday.

Documents show Costello tried to have the regulations delayed for two years but Cabinet agreed to a six-month delay from the original date in March.

Verrall pointed out there was no product available for people to use so it was not possible to measure the success of the coalition's proposition that cutting the excise tax on HTPs would help people quit smoking.

"To run that trial, there would need to be a pre-specified set of criteria against which you'd say it was successful. For example, number of people quitting, number of people using the device and being followed up. There's none of those arrangements have been discussed by the government."

Verrall wanted the government to explain the decisions it had made, "Why they think they can run a trial and then not have any product to run it? It's absolutely ridiculous".

Verrall said the minister has either misled Cabinet, or was incompetent.

"If, at the time that decision was made, she didn't level with Cabinet and say that, that means a heated tobacco product trial will have no product that makes a serious problem for her credibility and the position she's put the prime minister in.

"That means she has misled the Cabinet, and meant that all the other ministers sitting around the table who could have used that $216m to fund health or to fund education, had been duped."

Verrall was calling for the $216m set aside to pay for the excise tax on heated tobacco products to be redistributed.

Verrall said that money could have helped settle ambulance workers pay claims, provide for free cervical screening or go towards delivering Dunedin Hospital.

"I should point out that Casey Costello has responsibilities for ambulance services and for women's health, which is why I mentioned those examples," Verrall said.

In a statement, Philip Morris said the products had only yielded about $6m in excise tax revenue in 2023. There was no tax paid on e-cigarettes, a different smoke-free product.

"We will soon make available an enhanced range of innovative smokefree devices for adult consumers in New Zealand," it said.

"Our existing consumers can continue to use their current device and access a range of smokefree consumables in retail as we transition to our new product portfolio."