General Practitioners Aotearoa opposes the Government’s recent decision to fund specific smoking cessation products, namely vaping kits.
As New Zealand’s only independent organisation representing general practitioners, General Practitioners Aotearoa (GPA) is committed to keeping an open mind and supporting evidence-based strategies to reduce smoking prevalence and improve public health.
We are very concerned that the Government is funding these products without robust scientific validation of their efficacy at helping people stop smoking.
The Ministry of Health’s 2021 Guidelines for Helping People Stop Smoking emphasise the importance of behavioural support and medicines with proven effectiveness.
Lack of scientific evidence
Recent evaluations of vaping products have not shown any significant efficacy in helping people stop smoking.
For instance, a study assessing a “vape to quit” initiative reported that it had only limited success. Only 16% of participants were both smokefree and vapefree after the programme.
A third of participants gave up smoking for vapes, but most participants were still smoking at the end of the programme.
The report says nicotine-containing e-cigarettes were “popular in all cohorts”, which may indicate part of the problem: 22% of study participants were dual users at the end of the programme, still smoking and vaping as well.
Health risks associated with vaping
Emerging evidence indicates that vaping poses significant health risks, including lung damage and potential links to lung cancer.
Research has demonstrated that vaping, even without nicotine, can have immediate negative effects on lung function. A recent study found that vaping reduces oxygen intake, similar to the effects of smoking tobacco.
While long-term studies are ongoing, concerns have been raised about the potential link between vaping and lung cancer. Vaping exposes users to known cancer-causing chemicals, and research suggests that smoking or vaping nicotine can increase lung cancer risk.
Concerns regarding policy development
We are particularly troubled by reports suggesting that Associate Health Minister Casey Costello has adopted positions aligning with tobacco industry interests.
Documents indicate that proposals to freeze tobacco excise taxes originated from her office. We are concerned that tobacco industry-friendly perspectives are having a say on public health policy. This sort of influence should stay in the 1950s where it belongs.
Furthermore, the Chief Ombudsman has criticised Minister Costello for withholding documents related to tobacco policy. Without transparency, wehave little faith in the decision-making processes.
Policy prescriptions
We urge the government to:
- Reassess funding decisions: Ensure that all funded smoking cessation products are supported by rigorous scientific evidence demonstrating their effectiveness.
- Maintain transparency: Adhere to transparent policy development processes, free from potential conflicts of interest or undue influence from industry stakeholders.
- Engage healthcare professionals: Consult with medical experts and front-line healthcare providers in the formulation of public health strategies to combat smoking.
Our commitment remains steadfast in advocating for public health policies grounded in scientific evidence, transparency, and the best interests of the communities we serve.
Update: Response from Associate Minister of Health Casey Costello
On March 10, GPA received the following response from the associate minister:
Updated GPA position
As well as the above information from the Associate Minister, we have been contacted by ASH, an organisation the supports the use of vaping as a smoking cessation strategy.
GPA remains open to new information and evidence, and are willing to update our position if the Board becomes convinced that on balance vaping is an appropriate smoking cessation tool.
On balance, the Board remains unconvinced.
The authors of the Cochrane Review, quoted by Casey Costello, point out the limitations in the evidence in their own report:
“…longer, larger studies are needed to fully evaluate EC safety.”
“The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates. Further RCTs are underway. To ensure the review continues to provide up‐to‐date information to decision‐makers, this is a living systematic review. We run searches monthly, with the review updated when relevant new evidence becomes available.”
We also note there are recent studies and publications that claim vaping does not help most people quit smoking, and that vaping causes harm. For example, this Healthline article quoting studies by the CDC and others.
We are not willing to endorse the use of nicotine-containing e-cigarettes without the necessary long-term, large studies to assure their safety. We also believe the government should not spend taxpayer money on nicotine products without being extremely certain they will not cause more harm down the line.