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The NZ Government has published a Discussion Document outlining an Action Plan for the Smokefree Aotearoa 2025 goal. This blog is one of a series examining key aspects of the plan to help inform the debate and submissions. Here we examine the proposals to reduce the retail availability of tobacco products and find these have a good evidence base. Along with additional measures outlined in the proposals, reducing tobacco retail availability could allow NZ to realise the large health gains, cost-savings, and health equity-benefits of reaching the Smokefree goal. In a separate blog that will be published soon, we examine arguments opposing proposals to reduce tobacco availability, and review the evidence on which these arguments draw.



Easier access to tobacco retailers is associated with higher odds of youth smoking [1, 2], increased smoking among established smokers [3], and lower odds of quitting [4-6]. Residents of socially deprived neighbourhoods in Aotearoa NZ are exposed to many more tobacco outlets than those living in more affluent neighbourhoods [7, 8]. The Government’s proposals set out three different strategies to reduce tobacco retail availability: a) license all retailers of tobacco and vaping products, b) significantly reduce the number of tobacco retailers based on population size and density, and c) restrict tobacco sales to a limited number of specific store types. In this blog, we discuss the evidence base for each of these three measures.

Licensing tobacco retailers

As the Government’s proposals note, retailer licensing is a pre-requisite for reducing tobacco retail availability, providing a tool to manage retailer numbers (each outlet would require a licence that could specify operating conditions, and licence numbers can be fixed). Evidence suggests most NZ retailers will apply for a licence and continue to sell tobacco should such a policy be introduced [9]. In jurisdictions where licensing for tobacco outlets has been implemented, such as Finland and South Australia, the outlets that stop selling tobacco tend to be hospitality venues (e.g. restaurants, bars, clubs) where tobacco sales were relatively minor [4, 10]. However, to influence behaviour substantially, a large reduction in tobacco retailers (by 90 or 95%) is required to drive up the ‘full cost’ of tobacco (i.e., the time and resources needed to obtain the product) [11-14], meaning a licensing scheme alone will not reduce retailer numbers sufficiently to affect population health. The Government must therefore introduce additional measures to bring about a meaningful reduction in tobacco retailer numbers.

Reducing tobacco retail outlets based on population size and density

Capping numbers relative to population size and density could greatly decrease retailer numbers. For example, introducing a cap of no more than one tobacco retailer in an area of 10,000 residents, as opposed to the status quo of one per 800 residents [8], would help substantially reduce New Zealanders’ exposure to tobacco outlets. This approach would need to account for differences in baseline numbers of tobacco retailers across different districts, to ensure that tobacco retailer density is reduced sufficiently (i.e., to the point where it affects behaviour) in the most socially deprived communities, where those most at risk for smoking-related harm reside [11, 15]. Consideration would also need to be given to rural smokers living in areas with lower outlet density, where further increases in the ‘full cost’ of obtaining tobacco could create or increase inequities [8]. Focusing tobacco retailer reductions in urban and suburban areas and increasing smoking cessation support in rural areas (e.g. through targeted Quitline advertising), or additional government support for pharmacies in small towns to provide smoking cessation support, are options that could mitigate these potential inequities.

Restricting tobacco sales to specific outlets

The Government is also considering restricting tobacco sales to a limited number of specific outlets, such as specialist R18 (‘adult only’) stores, or pharmacies. Modelling studies from the BODE3 Programme (University of Otago) indicate that restricting tobacco sales to pharmacies only could gain an estimated 42,700 quality-adjusted life-years (QALYs) and $741 million in savings to the health system (see Appendix). However, most of the projected health gains would come from smoking cessation counselling provided by pharmacists to people purchasing tobacco, rather than reductions in retailer numbers.

A modelling study that examined interventions focussing only on reducing the number of tobacco retail outlets (i.e., without providing cessation support at the point of purchase) suggested limiting tobacco sales to 50% of existing alcohol outlets and nowhere else would most effectively reduce smoking prevalence and bring future health and cost gains [13; see Appendix]. A survey of NZ smokers supports these findings; the survey compared hypothetical retail reduction policies and found selling tobacco at only 50% of the existing liquor stores or only at pharmacies were rated most likely to prevent youth smoking initiation and help smokers to quit [16].

Both approaches would avoid frequent youth exposure to tobacco sales (youth tend to visit convenience stores frequently [17]), thus helping prevent smoking uptake. They would also remove cigarettes from smokers’ usual place of purchase, which could help quitters avoid cues that trigger impulse buys and relapse [18]. An advantage of limiting tobacco sales to 50% of existing liquor stores is that these are already R18 licensed outlets, although since selling alcohol and tobacco together may reinforce the strong association these products have with each other, it would be preferable to create different R18 tobacco-only outlets. Restricting sales to a similar number of R18 stores would likely have a similar or greater effect as the 50% of liquor stores option.

Challenges of tobacco retail outlet reduction policies

Finding an approach key stakeholders accept, and that will not unfairly advantage some existing retailers over others, may present some challenges [9]. Restricting tobacco sales to specialist R18 stores or pharmacies treats all current retailers equally, and so addresses this challenge. In terms of implementation, one approach the tobacco industry may lobby for is ‘grandfathering’, which exempts existing retailers from the policy changes (new measures would only apply to new retail outlets) [19]. While retailers may also view this option as more acceptable, outlet numbers would decrease extremely slowly, only through a retailer closing or selling its business, therefore meaningful reductions in tobacco availability would not be achieved by 2025 [20].

Amortization, where existing tobacco retailers are given a reasonable amount of time to phase out their existing stock and cease selling tobacco products would bring faster change [19, 21]. During this transition period, small independent retailers could be assisted to replace tobacco with other goods or services. As some small retailers may be more affected by the policy than others [22], temporary measures such as government payments [21] or assistance from small business advisors, could also be considered to support the small retailers most impacted.

Not all pharmacists may support moves to sell tobacco in pharmacies [14][23], but support is likely to increase if they see this measure as a time-limited contribution to the Smokefree 2025 goal. Some may also see it as an important opportunity to provide smokers with cessation consultations, support and products, thereby fulfilling, rather than contradicting, their role of health professional [23, 24]. Other potential benefits of selling tobacco only in pharmacies (as opposed to other specialist adult-only outlets) are that – as highly trained health professionals – pharmacists are not likely to sell tobacco to people under 18 years. Further, pharmacies have sound security measures at their premises (given prescription drug storage requirements).

There are now many international policy precedents where communities and governments have implemented measures to reduce the number of tobacco retailers [25]. The NZ Government has set out bold, world-leading proposals; if implemented, these would be the first true ‘endgame’ measures for tobacco availability, and are likely to improve population health and decrease health inequities, by reducing smoking uptake and creating environments that support quitting. In another soon to be published blog, we will explore in more detail the arguments for and against these supply reduction measures.

*Author Details: LR is based in the Department of Preventive and Social Medicine at the University of Otago and is also a member of the Tobacco Control Research Group at the University of Bath. JH, RE, GT, and FPVDD are members of the Department of Public Health at the University of Otago Wellington. LM is based in the Department of Preventive and Social Medicine at the University of Otago. All authors are members of the ASPIRE 2025 Centre at the University of Otago.


Comparison of the results from various tobacco retail reduction modelling studies for NZ (all using the same BODE3 tobacco model, with lifetime benefits and cost-savings, with a discount rate of 3%)

Tobacco control intervention Health gain in QALYs (95% uncertainty interval [95%UI]) Cost-savings to the NZ health system in $NZ million (95%UI) Extra details
Pharmacy-only sales combined with smoking cessation counselling (with 26% of pharmacies involved, 259 outlets in total) [12] 41,700


(33,500 to 51,600)




($531 to $1010)

Most of the health gain (74%) was due to the provision of cessation advice over and above the limiting of sales to pharmacies. There was a 3.1 times higher per capita gain for Māori than non-Māori. The modelling was informed by a NZ survey of pharmacists [26].



Phased reduction in outlets over a 14 year period – ultimately down to only 18 outlets remaining [14]





(16,500 to 48,200)



($328 to $985)

There was a higher per capita health gain for Māori than non-Māori for this and all the other modelled interventions (at least 3 times).
The most effective of four modelled tobacco retail outlet reduction strategies, that is, limiting sales to 50% of alcohol outlets and nowhere else; 386 stores nationally [13] 26,500


(15,600 to 42,100)



($302 to $829)

The other modelled interventions (a 95% reduction and limiting to 1km or 2km from schools) all had less impact. Alcohol outlets have the advantage of already being R18 outlets. However, there some disadvantages, including the strong pairing of alcohol and smoking.



Public Health Expert Briefing (ISSN 2816-1203)


  1. Marsh L, Vaneckova P, Robertson L, et al. Association between density and proximity of tobacco retail outlets with smoking: a systematic review of youth studies. Health & Place 2021;67:102275.
  2. Finan LJ, Lipperman-Kreda S, Abadi M, et al. Tobacco outlet density and adolescents’ cigarette smoking: a meta-analysis. Tobacco Control 2019;28(1):27-33.
  3. Paul CL, Mee KJ, Judd TM, et al. Anywhere, anytime: Retail access to tobacco in New South Wales and its potential impact on consumption and quitting. Social Science & Medicine 2010;71(4):799-806.
  4. Halonen JI, Kivimäki M, Kouvonen A, et al. Proximity to a tobacco store and smoking cessation: a cohort study. Tobacco Control 2014;23(2):146-151.
  5. Chaiton MO, Mecredy G, Cohen J. Tobacco retail availability and risk of relapse among smokers who make a quit attempt: a population-based cohort study. Tobacco Control 2018;27(2):163-169.
  6. Reitzel LR, Cromley EK, Li Y, et al. The effect of tobacco outlet density and proximity on smoking cessation. American Journal of Public Health 2011;101(2):315-320.
  7. Marsh L, Doscher C, Robertson LA. Characteristics of tobacco retailers in New Zealand. Health & Place 2013;23:165-170.
  8. Marsh L, Doscher C, Cameron C, Robertson L, Petrović‐van der Deen FS. How would the tobacco retail landscape change if tobacco was only sold through liquor stores, petrol stations or pharmacies? Australian and New Zealand Journal of Public Health 2020;44(1):34-39.
  9. Robertson L, Marsh L, Hoek J, McGee R, Egan R. Regulating the sale of tobacco in New Zealand: A qualitative analysis of retailers’ views and implications for advocacy. International Journal of Drug Policy 2015;26(12):1222-1230.
  10. Bowden JA, Dono J, John DL, Miller CL. What happens when the price of a tobacco retailer licence increases? Tobacco Control 2014;23(2):178-180.
  11. Luke DA, Hammond RA, Combs T, et al. Tobacco town: computational modeling of policy options to reduce tobacco retailer density. American Journal of Public Health 2017;107(5):740-746.
  12. Petrović-van der Deen FS, Blakely T, Kvizhinadze G, Cleghorn CL, Cobiac LJ, Wilson N. Restricting tobacco sales to only pharmacies combined with cessation advice: a modelling study of the future smoking prevalence, health and cost impacts. Tobacco Control 2019;28(6):643-650.
  13. Pearson AL, Cleghorn CL, van der Deen FS, et al. Tobacco retail outlet restrictions: health and cost impacts from multistate life-table modelling in a national population. Tobacco Control 2017;26(5):579-585.
  14. van der Deen FS, Wilson N, Cleghorn CL, et al. Impact of five tobacco endgame strategies on future smoking prevalence, population health and health system costs: two modelling studies to inform the tobacco endgame. Tobacco Control 2018;27(3):278-286.
  15. Caryl FM, Pearce J, Reid G, Mitchell R, Shortt NK. Simulating the density reduction and equity impact of potential tobacco retail control policies. Tobacco Control 2020;doi:10.1136/tobaccocontrol-2020-05600.
  16. Robertson L, Gendall P, Hoek J, Cameron C, Marsh L, McGee R. Smokers’ perceptions of the relative effectiveness of five tobacco retail reduction policies. Nicotine & Tobacco Research 2017;19(2):245-252.
  17. Paynter J, Edwards R, Schluter PJ, McDuff I. Point of sale tobacco displays and smoking among 14–15 year olds in New Zealand: a cross-sectional study. Tobacco Control 2009;18(4):268-274.
  18. Burton S, Hoek J, Nesbit P, Khan A. “Smoking is bad, it’s not cool… yet I’m still doing it”: Cues for tobacco consumption in a ‘dark’market. Journal of Business Research 2015;68(10):2067-2074.
  19. Myers AE, Hall MG, Isgett LF, Ribisl KM. A comparison of three policy approaches for tobacco retailer reduction. Preventive Medicine 2015;74:67-73.
  20. Robertson L, Marsh L. Estimating the effect of a potential policy to restrict tobacco retail availability in New Zealand. Tobacco control 2019;28(4):466-468.
  21. Ackerman A, Etow A, Bartel S, Ribisl KM. Reducing the density and number of tobacco retailers: policy solutions and legal issues. Nicotine & Tobacco Research 2017;19(2):133-140.
  22. Robertson L, Cameron C, Hoek JA, et al. Prevalence and characteristics of tobacco purchases in convenience stores: results of a postpurchase intercept survey in Dunedin, New Zealand. Tobacco Control 2019;28(6):696-700.
  23. Longley M. Cigarettes in pharmacy is a smoking hot issue. Pharmacy Today 2017.
  24. van der Deen FS, Pearson AL, Wilson N. Ending the Sale of Cigarettes at US Pharmacies. Journal of American Medical Association 2014;312(5):559.
  25. Robertson L, Marsh L, Edwards R, Hoek J, van der Deen FS, McGee R. Regulating tobacco retail in New Zealand: what can we learn from overseas. NZ Med J 2016;129(1432):74-79.
  26. Petrović-van der Deen FS, Wilson N. Restricting tobacco sales to only pharmacies as an endgame strategy: are pharmacies likely to opt in? Aust N Z J Public Health 2018;42(2):219-220.


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