Tale of Two Nations: New analysis highlights New Zealand’s smoke-free progress vs. South Africa’s struggles

South Africa’s proposed new restrictions on safer alternatives to cigarettes will hold the country back in the fight against smoking-related harm, according to a landmark report released today by international health experts.

Tale of Two Nations: South Africa vs. New Zealand, published by Smoke Free Sweden, presents a stark contrast in policy approaches, showing how New Zealand’s embrace of harm reduction strategies has driven historic declines in smoking rates, while South Africa’s stance risks stagnation and increased illicit trade. 

The compelling report details how New Zealand has nearly halved its smoking prevalence in just five years through progressive policies promoting safer alternatives such as vaping. It is now on the brink of achieving official ‘smoke free’ status, where less than 5% of the population smoke. 

By contrast, South Africa’s smoking rates are almost FOUR TIMES HIGHER, exacerbated by heavy-handed regulations that fail to differentiate between harmful combustible tobacco and reduced-risk alternatives.

“By providing people who smoke with safer alternatives, clear public health messaging and a regulated but accessible market, they have achieved a remarkable drop in smoking rates.

 “Meanwhile, South Africa’s punitive approach has led to persistently high smoking rates and rampant illicit trade, showing that prohibition does not work.” 

Key findings from the report include: 

• New Zealand’s smoking prevalence has dropped from 12.2% in 2018 to just 6.8% in 2023 largely due to harm reduction policies. 
• South Africa’s smoking prevalence is almost four times higher at 25.8% after decades of traditional tobacco control measures. 
• South Africa’s illicit cigarette market now accounts for nearly 60% of total sales, fuelled by prohibitionist policies. 
• New Zealand’s public health campaigns actively promote vaping and other safer nicotine products as viable quitting tools, whereas South Africa’s proposed legislation (the Tobacco Products and Electronic Delivery Systems Control Bill) would impose strict limitations on access and information. 

The Tale of Two Nations report argues that countries seeking to reduce smoking-related harm should learn from New Zealand’s approach rather than adopting restrictive policies that drive consumers toward illicit markets and continued smoking. 

“This report is the first in a series comparing international approaches to smoking reduction,” added Dr. Human. “As more countries debate the future of tobacco control, we must champion policies that prioritise harm reduction and public health outcomes.” 

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