Background The New Zealand government's goal of achieving a smoke-free society by 2025 reflects growing interest in ‘endgame’ solutions to tobacco smoking. However, tobacco companies have framed ‘endgame’ strategies as contrary to individual freedoms and ‘choice’; these claims heighten politicians' sensitivity to ‘nanny state’ allegations and may undermine tobacco control policies. Public support for stronger policies could strengthen political will; however, little is known about how smokers perceive endgame scenarios or the factors underlying their support or opposition to these.
Methods The authors conducted 47 in-depth interviews with four priority groups: Māori, Pacific, young adults and pregnant women; all were smokers or very recent quitters. The authors used thematic analysis to interpret the transcripts.
Results Most participants strongly supported the 2025 smoke-free goal, recognised the broader social good that would result and accepted the personal inconvenience of quitting. Yet they wanted to retain control over when and how they would quit and asserted their ‘freedom’ to smoke. Participants identified interventions that would extend current policy and maintain the autonomy they valued; the authors classified these into four themes: restricting supply, diminishing visibility, decreasing availability and affordability, and increasing quit support.
Conclusions Politicians may have a stronger mandate to implement endgame policies than they appreciate. Participants' use of industry arguments when asserting their freedom to ‘choose’ to smoke and quit suggests a need for denormalisation strategies that challenge industry propaganda, demonstrate how endgame measures would empower smokers and re-iterate the community benefits a smoke-free society will deliver.
- Tobacco endgame
- priority populations
- qualitative research
- public policy
- packaging and labelling
- advertising and promotion
- priority/special populations
- primary healthcare
- tobacco control in Africa
- environmental tobacco smoke
- smoking-caused disease
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All authors are members of the ASPIRE2025 collaboration (http://www.aspire2025.org.nz).
Funding This study was supported by New Zealand Ministry of Health.
Competing interests Although we do not consider it a competing interest, for the sake of full disclosure, we note that all authors have undertaken work for the New Zealand Ministry of Health; JAH, RE, HG and SE have also undertaken work for tobacco control NGOs and have received funding for tobacco control research from the Royal Society Marsden Fund and Health Research Council of New Zealand.
Ethics approval Ethics approval was provided by the University of Otago Human Ethics, Category B (Department of Marketing Ethics Administrator).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The qualitative data for this study were collected as part of a larger project for the New Zealand Ministry of Health. Additional unpublished data will be used in reporting to the ministry and may also be published in academic journals. Under the terms of informed consent signed by participants, only the immediate research team is granted permission to view the raw data.