Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
Public Health, University of Otago, Wellington, New Zealand.
Tob Control. 2024 Mar 19;33(e1):e25-e31. doi: 10.1136/tc-2022-057834.
Aotearoa New Zealand plans to greatly reduce tobacco retail outlets, which are concentrated in areas of higher deprivation and perpetuate health inequities caused by smoking and borne particularly by Māori. However, we lack in-depth analyses of how this measure could affect people who smoke.
We undertook in-depth interviews with 24 adults from two urban areas who smoke. We used a novel interactive mapping approach to examine participants' current retail outlets and their views on a scenario where very few outlets would sell tobacco. To inform policy implementation, we probed participants' anticipated responses and explored the measure's wider implications, including unintended impacts. We used qualitative description to interpret the data.
Most participants anticipated accommodating the changes easily, by using alternative outlets or bulk-purchasing tobacco; however, they felt others would face access problems and increased costs, and greater stress. They thought the policy would spur quit attempts, reduce relapse among people who had quit and protect young people from smoking uptake, and expected more people to switch to alternative nicotine products. However, most foresaw unintended social outcomes, such as increased crime and reduced viability of local businesses.
Many participants hoped to become smoke-free and thought retail reduction measures would prompt quit attempts and reduce relapse. Adopting a holistic well-being perspective, such as those developed by Māori, could address concerns about unintended adverse outcomes and provide comprehensive support to people who smoke as they adjust to a fundamental change in tobacco availability.
新西兰奥克兰计划大幅减少烟草零售店的数量，这些零售店集中在贫困程度较高的地区，加剧了吸烟导致的健康不平等，毛利人尤其受到影响。然而，我们缺乏深入分析这项措施将如何影响吸烟者。
我们对来自两个城市地区的 24 名成年吸烟者进行了深入访谈。我们使用一种新颖的互动式映射方法来研究参与者当前的零售点以及他们对仅有少数几个零售点销售烟草的情景的看法。为了为政策实施提供信息，我们探讨了参与者预期的反应，并探讨了该措施的更广泛影响，包括意外影响。我们使用定性描述来解释数据。
大多数参与者预计会很容易适应这些变化，他们会使用其他的销售点或大量购买烟草；然而，他们认为其他人将面临获取困难和成本增加，以及更大的压力。他们认为该政策将促使更多人尝试戒烟，减少已戒烟者的复吸率，并保护年轻人不吸烟，预计更多的人会转向其他尼古丁产品。然而，大多数人预见了一些意料之外的社会后果，如犯罪增加和当地企业的生存能力下降。
许多参与者希望戒烟，他们认为减少零售点的措施将促使更多人尝试戒烟并减少复吸。采取整体福祉的视角，如毛利人所倡导的，可能会解决对意外负面后果的担忧，并为正在适应烟草供应基本变化的吸烟者提供全面支持。
