Submission on the Smokefree Environments and Regulated Products (Vaping) Amendment Bill - Alcohol Healthwatch
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Submission on the Smokefree Environments and Regulated
Products (Vaping) Amendment Bill
30 March 2020
Alcohol Healthwatch is an independent charitable trust working to reduce alcohol-related
harm. We are committed to working in accordance with the principles of the Treaty of Waitangi
and the cornerstones of the Ottawa Charter. We are contracted by the Ministry of Health to
provide a range of regional and national health promotion services. These include: providing
evidence-based information and advice on policy and planning matters; coordinating networks
and projects to address alcohol-related harms, such as alcohol-related injury, fetal alcohol
spectrum disorder; and coordinating or otherwise supporting community action projects.
Thank you for the opportunity to provide feedback on the Smokefree Environments and
Regulated Products (Vaping) Amendment Bill.
We do not wish to speak to this submission.
If you have any questions on the comments we have included in our submission, please
contact:
Dr Nicki Jackson
Executive Director
Alcohol Healthwatch
P.O. Box 99407, Newmarket, Auckland 1149
P: (09) 520 7035
E: director@ahw.org.nz1. We welcome the Government’s proposed amendment Bill to ensure the current Act is up-
to-date to cover all regulated products (including vaping products).
2. Legislation is urgently needed to regulate the marketing, availability, flavours and safety
of these products, particularly vaping products. We set out below our support for specific
components of the Bill and provide recommendations for strengthening the proposed
legislation. Our recommendations support those made by the New Zealand Cancer
Society.
Importance of a public health approach
3. Alcohol Healthwatch recommends that a broad public health approach be taken to
addressing the harm from unhealthy commodities. Taking a siloed, administrative
approach to each unhealthy commodity is burdensome and fails to recognise the shared
determinants of unhealthy consumption (e.g. of tobacco, vaping, gambling, alcohol,
unhealthy food, etc.) and subsequent prevalence of non-communicable diseases.
4. These shared determinants include marketing (especially advertising and sponsorship),
price and availability.
5. Ideally, New Zealand would develop strength-based policies that enable healthy
environments and communities to flourish. Community settings would be health
promoting environments, where all advertising of unhealthy commodities is minimised,
availability is restricted and the price of the product reflects its health and social harms
(costs that are borne by individuals, families, communities and society).
Links between smoking and alcohol use
6. Alcohol Healthwatch recognises that efforts to reduce smoking and use of nicotine may
assist New Zealanders to also reduce their drinking. This is especially important for young
people; given they experience disproportionately more harm from drinking.
7. A study of New Zealand smokers in 2007/08 found that one-third (33.1%) had a drinking
pattern that was considered hazardous (i.e., AUDIT scores greater than and equal to 8).
This figure was much higher than for non-smokers (at 13.1%).1
8. Concurrent use of substances may affect consumption of either product. This is due to
the reciprocal influences between alcohol and tobacco on their consumption. Studies
show that alcohol increases craving to smoke, decreases time to initiation of smoking,
and increases smoking self-administration.2
9. Of importance to alcohol use, tobacco and nicotine have been found to increase alcohol
craving, decrease subjective (intoxicating and sedating) effects of alcohol, and increase
alcohol consumption.2
10. The reduced intoxicating and sedating subjective effects of alcohol following nicotine
administration has significant public health implications, through potentially increasing the
likelihood of heavier drinking episodes. If individuals that smoke and drink do not feel as
‘drunk’ while using both substances concurrently, heavy drinking may be perpetuated.2
11. In a large cross-sectional survey of past-year smokers in England, smokers who reported
starting a quit attempt in the past week also reported a lower-risk drinking pattern,
including less frequent binge drinking. They were also more likely to report current
attempts to reduce their alcohol consumption, when compared with smokers who did not
report a quit attempt in the past week.3
12. Therefore, Alcohol Healthwatch supports evidence-based measures that reduce smoking
and regulate nicotine-related products, especially to protect young people and reduce
inequities in alcohol- and tobacco-related harm.
1Recommendations
Smokefree areas must also be vapefree
13. We strongly support a requirement that all smokefree areas be vapefree including
designated local Council outdoor smokefree areas and any future smokefree areas (e.g.
cars).
Making smokefree areas also vapefree will reduce the risk of vaping becoming
normalised, particularly among non-smokers and young people.
Having smokefree areas as vapefree will minimise role modelling of vaping to children
and lessen the risk that they see vaping as a cool recreational behaviour, rather than
a tool to help people who smoke to switch to vaping.
Having smokefree areas also vapefree will reduce public confusion and make
Smokefree/vapefree restrictions easier to enforce.
Making smokefree areas also vapefree would signal that second-hand aerosols are
not harmless, and would protect clean-air settings.
Many people who vape in smokefree settings believe second-hand aerosol (SHA) is
simply steam.4 Systematic reviews have found that vaping products emit numerous
toxic substances depending on the device and how it is used. 5 The long-term health
impacts of exhaled vapour from vaping products are still unclear.
Prohibit Advertising and Sponsorship
14. We strongly support prohibiting advertising and sponsorship of all vaping products,
including on-line marketing.
Currently the tobacco and vaping industries are aggressively marketing their products
to young people. In addition to advertisements on TV, radio and billboards young
people say they are being bombarded with vaping marketing on social media.
The most recent data from 2019 shows an increase in regular smoking and vaping for
Year 10 students, with a greater increase for Māori than non-Māori.6
We urgently need this legislation to protect young New Zealanders and ensure
inequities reduce rather than widen.
15. We recommend that a policy framework is created and applied to the advertising and
sponsorship of all unhealthy commodities, including alcohol. We believe that the evidence
of the harmful effects of alcohol and unhealthy food advertising is as compelling as it is
for tobacco and vaping.
16. In New Zealand, there are significant inequities in exposure to alcohol advertising
(especially through alcohol sports sponsorship and shop-front advertising at licensed
premises). As such, there is no justification to apply prohibitions of advertising and
sponsorship only to tobacco and vaping products. A much wider public health approach
is required to protect young people and future generations of New Zealand children.
2Support Minimum Age Restrictions
17. We strongly support restricting the sale of all vaping products and smokeless tobacco
products (e.g. heat not burn) to those aged 18 years and over.
A key purpose of this legislation is to discourage young people and children from taking
up smoking or vaping. A 2019 New Zealand school survey showed that 37.3% of 14-
15-year olds reported they had tried vaping,7 equating to more than 22,000 14-15 year
olds. In the same study, more than one-half (58.5%) of Māori 14-15-year olds reported
that they had tried vaping.8
Additional resources will be needed to effectively monitor and enforce the legislation
to ensure minors do not access tobacco or vaping products.
Restrict Availability of Tobacco and Vaping Products
18. We do not support the sales of any vaping products by generic retailers.
Currently, vaping products are widely available and sold at dairies, service stations,
supermarkets, two-dollar shops and bottle shops (i.e. generic retailers). Having vaping
and tobacco products so widely available makes them far too easy for young people
to access.
New Zealand research found generic retailers have little knowledge about the vaping
products they sell.9 People who smoke need high-quality advice to quit smoking using
vaping products successfully. We believe that any limits to the flavour range that
generic retailers can sell does not address our concerns regarding their level of ability
to provide useful or accurate advice on how to quit smoking.
If the Government does decide to allow three flavours of vaping liquids to be sold in
generic stores, we urge that vaping devices only be sold in specialist stores, to provide
a barrier to youth uptake.
19. We strongly recommend that vaping products should only be available through specialist
(age-restricted) vape shops, pharmacies and cessation providers.
Restricting vaping products to licensed specialist shops, pharmacies and cessation
providers will mean that products are more likely to be sold to people wishing to switch
from smoking to vaping. In addition, it may assist in reducing the uptake by minors
and non-smokers.
Selling vaping products only in specialist stores may also reduce children’s exposure
to vaping products and therefore limit the curiosity this exposure might arouse.
20. We recommend all staff at specialist vape shops, and all other places vaping products are
sold, be required to complete certified smoking cessation training.
Many people who smoke find vaping unsatisfying or difficult to master. People wanting
to quit smoking need specialist advice to quit and switch to vaping successfully.
Having certified trained staff will help ensure that people who are trying to quit receive
supportive and higher-quality, best practice advice.
3 Vaping is more effective in helping people stop smoking when used with ongoing
support from a Quit programme.
21. We recommend that all retailers selling vaping products and/or cigarettes and tobacco
should be licensed (not just registered).
All stores selling vaping products need to be licensed and be required to provide sales
information and data. Licensing fees should be set to cover the additional monitoring
and enforcement required to ensure minors do not have access to vaping products
and that other legislative requirements are met.
Licence conditions need to be placed to limit the density of vaping retailers and restrict
their proximity to schools and early childhood centres/care centres.
22. We strongly recommend the Bill be extended to prohibit the sale of ordinary cigarettes and
tobacco by generic retailers (e.g. dairies, service stations and supermarkets).
Currently, tobacco can be sold at any place, at any time and by anyone in New
Zealand. It doesn’t make sense that there are currently no restrictions on where
cigarettes and tobacco, our most deadly legal products, are sold. Cigarettes have been
shown to kill as many as two-thirds of its long-time users10,11 yet it is more available
than bread and milk in New Zealand.
For the first time in 20 years, regular smoking prevalence in 14-15-year olds has
increased rather than decreased in New Zealand (significant increases in non-Māori,
non-Pacific students).12 This has occurred over the last few years alongside a rapid
increase in ever-trying or regular vaping. We cannot afford to let this trend continue.
There are nearly four times more shops selling tobacco in lower-income communities
compared to higher-income communities in New Zealand.13
When tobacco is more available, more children start smoking, and fewer people quit.
Restricting the availability of tobacco (e.g. removing it from generic retailers) would
greatly reduce uptake of smoking by young people and would also encourage and
support smokers to quit, as tobacco wouldn’t be as easy to access.
There is strong public support (68%) for reducing the number of places allowed to sell
cigarettes and tobacco in New Zealand with only 16% disagreeing.14
We urgently need legislation to make this deadly product less available in our
communities to enable New Zealanders to live healthier, happier lives.
23. We do not support displays of vaping products in stores and believe the in-store display
restrictions on tobacco should also extend to vaping products.
Vaping products should not be permitted to be displayed in generic stores or in the
shop-front windows of specialist shops. The marketing of vaping products and e-liquids
use bright colours and sophisticated yet subtle cues to attract children’s and young
people’s attention.
424. We also believe that the display of vaping products on-line should be prohibited. There
should be no exemptions for vaping products from internet displays, irrespective of
website age-gating.
Plain packaging and health warnings are needed
25. We support plain packaging (standardised packaging) being applied to all vaping products
(including heat-not-burn products).
Currently vape marketing is aimed at young people. Packaging and names of vape
products are a key marketing tool used by vape manufacturers. They use colour,
design and names to appeal to young people. Many flavours have names that have
strong appeal with young people but not necessarily established smokers, e.g. Unicorn
Milk, Honey Bear, Stoned Smurf. Names such as these, promote experimentation
among young non-smokers.15
Plain packaging will reduce the appeal of vaping products to children. All avenues of
marketing through packaging should be made plain and standard, as is required for
cigarettes and tobacco.
Standardised packaging needs to be applied to all vape products and e-liquids.
Restrictions need to limit flavour names to generic descriptions to effectively control
marketing of these products particularly to young people.
26. We support health warnings on all nicotine products.
All nicotine products need to have large warning labels stating Nicotine is highly
addictive.
Products need safety standards
27. We strongly support the need to regulate the safety (including for inhalation) of vaping
products, smokeless tobacco products and future products introduced to the market.
Vaping products should be required to be assessed through the same safety standards
already applied to other Quit smoking tools, such as nicotine replacement therapies.
Restrict flavours that appeal to young people
28. We strongly support restricting all flavours that appeal to children, including those available
in specialist vape shops.
Limiting the range of flavours at generic retailers to tobacco, mint and menthol will not
prevent youth from accessing vaping products. This is because research shows both
mint and menthol flavours are very appealing to young people.
Systematic reviews have found that flavours increase the appeal, decrease the
perception of harm and increase willingness to try e-cigarettes.16
Flavours may be the most important reason for adolescents trying e-cigarettes.17
New Zealand research has found flavours play a major role in vaping initiation for
current smokers, former smokers and never smokers including young people. 18 Fruit
flavours were most popular among all three groups, while people who have never
smoked also liked confectionery/sweets and lolly flavours.19
5 Flavours such as fruit, chocolate and bubble gum are attractive to young people. Many
flavours also have names that have strong appeal to young people such as Honey
Bear, Unicorn Milk and Stoned Smurf.20
The legislation needs to ensure that flavours that are the most appealing to young
people and non-smokers are banned including in specialist shops, as many young
people will still access products on-line and from older family members and friends.
This would reduce the uptake of vaping by young people and non-smokers.
Restrict nicotine levels
29. We strongly recommend restricting maximum nicotine levels to 20mg/ml.
Some e-cigarettes, particularly ones that have had substantial youth uptake overseas
(e.g. JUUL) have very high concentrations of nicotine. Nicotine is very addictive, and
it negatively impacts young people’s brain development. New Zealand should restrict
levels of nicotine allowed in vaping products to 20mg/ml, to align with European
regulations.
Rewards involving regulated product prohibited
30. We do not support s34(4) that currently exempts specialist retailers of vaping products
from s34(1). Specialist retailers should also be prohibited from offering any gift or cash
rebate, or the right to participate in any contest, lottery, or game to purchasers or any
person in consideration for the provision of evidence of the purchase of a regulated
product.
References
1 Wilson, N., Weerasekera, D., Kahler, C. W., Borland, R., & Edwards, R. (2012). Hazardous patterns
of alcohol use are relatively common in smokers: ITC Project (New Zealand). Age (years), 66, 33-1.
2 Verplaetse, T. L., & McKee, S. A. (2017). An overview of alcohol and tobacco/nicotine interactions in
the human laboratory. The American journal of drug and alcohol abuse, 43(2), 186-196.
3 Brown, J., West, R., Beard, E., Brennan, A., Drummond, C., Gillespie, D., ... & Michie, S. (2016). Are
recent attempts to quit smoking associated with reduced drinking in England? A cross-sectional
population survey. BMC public health, 16(1), 535.
4 Haggart K, Robertson L, Blank W_L, Popova L, Hoek J. (2020) It’s just steam: a qualitative analysis
of New Zealand ENDS users’ perceptions of secondhand aerosol. Tobacco Control 2020; 0:1–6
doi:10.1136/tobaccocontrol-2019-055368
5 National Academies of Science Engineering and Medicine. (2018) Public health consequences of E-
Cigarettes. Washington, DC: The National Academies Press, 2018.
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7 Walker N, Parag V, Wong SF, et al. Supplementary appendix to: Use of e-cigarettes and smoked
tobacco in youth aged 14- 15 years in New Zealand: findings from repeated cross-sectional studies (
2014-19). Lancet Public Health 2020; published online Jan 22. 2020; published online Jan 22.
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tobacco in youth aged 14- 15 years in New Zealand: findings from repeated cross-sectional studies (
2014-19). Lancet Public Health 2020; published online Jan 22. 2020; published online Jan 22.
https://doi.org/10.1016/S2468-2667(19)30241-5.
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understandings of and attitudes towards selling Electronic Nicotine Delivery Systems: a qualitative
exploration. Tobacco Control. 2019:tobaccocontrol-2019-055173.
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stopping: a prospective study of one million women in the UK. Lancet 2013;381:133–41.
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https://doi.org/10.1016/S2468-2667(19)30241-5.
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14 Health Promotion Agency. Tobacco Control Data Repository Accessed March 2020
https://tcdata.org.nz/HLS%20data/HLS_15.html
15 Hoek J, Edwards R, Waa A, Wilson N, Thomson G. (2020) Public Health Expert Blog: Proposed
Vaping Regulations for NZ: Strengths and Limitations. Posted 24 Feb 2020. Accessed
https://blogs.otago.ac.nz/pubhealthexpert/2020/02/24/proposed-vaping-regulations-for-nz-
strengths-and-limitations/
16 Meernik, C., Baker, H. M., Kowitt, S. D., Ranney, L. M., & Goldstein, A. O. (2019). Impact of non-
menthol flavours in e-cigarettes on perceptions and use: an updated systematic review. BMJ open,
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17 Zare, S., Nemati, M., & Zheng, Y. (2018). A systematic review of consumer preference for e-cigarette
attributes: Flavour, nicotine strength, and type. PloS one, 13(3), e0194145.
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smokers and non- smokers: a cross sectional study. Tobacco Control. Published Online First: 14
February 2020.doi: 10.1136/tobaccocontrol-2019-055469
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smokers and non- smokers: a cross sectional study. Tobacco Control. Published Online First: 14
February 2020.doi: 10.1136/tobaccocontrol-2019-055469
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https://blogs.otago.ac.nz/pubhealthexpert/2020/02/24/proposed-vaping-regulations-for-nz-
strengths-and-limitations/
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