Associate Health Minister Casey Costello. Photo: RNZ / Samuel Rillstone
Quit-smoking providers say a downturn in referrals is something that will need to be addressed if they are to meet Smokefree targets.
The country's frontline smokefree service providers met with the Associate Health Minister Casey Costello last week, to discuss what they needed to ensure the country meets its Smokefree 2025 goals.
Costello is putting together a refreshed Smokefree action plan, after repealing the previous government's legislation.
Labour's reforms would have created a smokefree generation, reduced the number of retailers, and cut nicotine levels in tobacco.
The backlash from opposition parties and public health experts has been fierce.
But Costello said despite the "noise", the frontline providers she has met with were onboard.
The New Zealand First MP spent last week on a road trip, attending hui with 25 stop smoking providers around Aotearoa, to ask them what has been working, what has not, and what else they need to hit the target.
Casey Costello developing new Smokefree Action plan
"The fact that they will be engaged in the process about decisions we make moving forward, what does the regulatory regime look like, how do we put tobacco and vaping controls in that are enforceable, they will be part of that process. And so it's been really positive," Costello said.
The daily smoking rate sits at 6.8 percent. The goal is fewer than 5 percent by the end of 2025.
Costello said the modelling suggested that was on track, just by doing business-as-usual.
"We will achieve that target, but it wouldn't be across all population groups, so I want to make sure that we are targeting the population groups."
And the closer it gets to the goal, the harder things are.
Those last few are what the minister calls the "hardcore" smokers, and said the providers that can help them quit had told her people were not getting referred.
"There has been a significant downturn in referrals, and is not really clear why that was occurring. So it's about getting all of the health services, and health agencies, and all the social service agencies to start driving people to the quit-smoking programs, and get that support needed," Costello said.
Te Wakahuia Manawatu Trust is one of those providers.
Its chief executive, Delwyn Te Oka, said referrals had plummeted since Covid.
"I think primary care and secondary care, since Covid, have been inundated with other issues and complexities within their services. And having the time to be able to ask the questions, get the information from whanau, and then make referrals hasn't for whatever reason, or doesn't appear to have, been a priority," she said.
Te Oka said the meeting with the minister was positive, and was confident actions would be taken to address the downturn in referrals.
"She has given an absolute undertaking that she will ensure hospitals and primary care are better supported," she said.
Jo Urlich from Te Tiku Hauora in Northland says it is not just a stretched health system that is slowing progress down.
She said there was no more "low-hanging fruit" and the last group of smokers coming in had a greater level of addiction, and often needed support with other health and social needs.
"Compared to where we were maybe five years ago, definitely referrals are hard to come by, particularly good quality referrals. So what we mean by that is people who know why they've been referred, and are wanting to be referred."
Urlich said a lot of what she discussed with the minister was looking at whether what had worked in the past was still working now, as well as what products and support tools are out there, and more building of community networks to help with the referrals.
She admitted she was disappointed the government had repealed the previous government's reforms, but was confident Smokefree 2025 would still be achievable.
"I think it's not that those things are necessarily off the table forever. I think it's more about the perspective and making sure that whatever we do, we do it right, and don't cause any unintended harm. But, yeah it would be amazing if we could be the first country to ever have a smokefree generation," she said.
Costello maintained that repealing Labour's legislation was the right thing to do.
"All the health survey data says that ten, twelve years ago we had 120,000 young smokers between the ages of 15 to 24. We now have 19,000 so we virtually have a smokefree generation without doing anything. It was a soundbite that wasn't really meaning anything and wouldn't have been in place til 2027 anyway," she said.
Costello said the government would also work with quit-smoking providers to develop quit-vaping services.
Urlich said that was one of the primary concerns providers raised with the minister.
"It's not so much around people using vaping as a stop-smoking tool, it's about our rangatahi and our youth taking up vaping. I think that's of concern that there's not really the support services in place yet," she said.
Hana Halalele says there needs to be more clarity. Photo: Dominic Godfrey / RNZ
Hana Halalele from the Oamaru Pacific Island Community Group said the meetings were mostly about establishing relationships and acknowledging the work providers have done so far.
"I think people left the room relatively clear, in terms of what the expectations are, and what that means," she said.
But she believed there needed to be more clarity around the support that would come to community providers
"We've only got another year of the contracts we have, so I guess my question is, as a manager, if we're going to embed good intergenerational practice, there does need to be further discussion around ongoing financial sustainability."