The New Zealand Guidelines for Helping People to Stop Smoking (the Guidelines) provide health care workers with updated guidance for use during their contacts with people who smoke.
Smoking kills many people prematurely and is a significant cause of health inequities. Around 4500 New Zealanders die each year from a smoking-related disease, among whom 350 die from exposure to second‑hand smoke and the remainder die from the direct effects of smoking. In 2020, 12% of all New Zealanders smoked tobacco every day, with rates higher for Māori (29%), Pacific peoples (18%), people with mental health and addictions, and people living in the most socioeconomically deprived areas compared with the population as a whole.
In 2011, the New Zealand Government set a goal of reducing smoking prevalence and tobacco availability to below minimal levels (below 5%) by 2025. New Zealand is not on track to meet the Smokefree 2025 goal at the current rate of decline, especially in Māori and Pacific peoples.
The Guidelines are one way of tackling our Smokefree 2025 challenge. They aim to empower health workers with up-to-date knowledge about the evidence for effective smoking cessation interventions available in New Zealand. Health workers see many people who smoke and are uniquely placed to provide expert advice and support to help them stop smoking. Health workers have an obligation to help New Zealand to become smokefree.
These Guidelines replace the 2007 and 2014 New Zealand Smoking Cessation Guidelines. They remain structured around the ABC pathway introduced in the 2007 Guidelines. However, the definitions of A, B and C (see below) are expanded to emphasise the importance of making an offer of cessation support and referring people who smoke to a stop-smoking service.
The ABC pathway
- Ask about and document every person’s smoking status.
- Give Brief advice to stop smoking to every person who smokes.
- Strongly encourage every person who smokes to use Cessation support (a combination of behavioural support and stop-smoking medicine works best); offer to help them access it; refer to, or provide, cessation support to everyone who accepts your offer.
The Guidelines have also been condensed into a new format suitable for health workers in different health or tobacco control work areas. They include an overview of the ABC pathway for all health workers, more detailed information about smoking cessation interventions relevant to specialist smoking cessation practitioners, and information around barriers and facilitators to implementing the ABCs in health settings.
Smoking cessation is a crucial tool to improve health equity in New Zealand. Systematic and structural factors - colonisation, the Crown’s failure to meet obligations under Te Tiriti o Waitangi, institutional racism, limited access to health services and adequate quality of care, and inequalities in the broader determinants of health - have all contributed to the high prevalence of smoking in Māori compared to non-Māori and lower rates of successful cessation.