How New Zealand adults who smoked understand novel tobacco ‘endgame’ policies. Qualitative analysis using the associative propositional evaluation model to determine comprehension.

Abstract

Tobacco smoking is a leading cause of early death. In 2022, New Zealand legislated to introduce three previously untried tobacco ‘endgame’ policies aimed at reducing demand for cigarettes and restricting supply. This study aimed to determine how a key stakeholder group, NZ adults with no intent or low belief that they could stop smoking by 2025, understood proposals to restrict nicotine in combustible tobacco and the number of tobacco retailers to a very low level, annually raise the age of purchase, set minimum prices, and ban filters.

The Affective Propositional Evaluation model was used to analyze participants' comprehension of the policies. That model and discourse analysis worked well for distinguishing which policies were familiar to participants and for determining participants' understanding. Responses and discourse on the novel policies (denicotinization, sinking lid on age of purchase, filter ban), the semi-familiar policy (reducing the number of retailers), and most familiar minimum pricing policy differed qualitatively. Compared to familiar policies evaluative judgements of the novel policies were often inconclusive. If approval of a novel policy was expressed, propositional evaluations suggested that approval was for the intent (to prevent young people from smoking) rather than the means to achieve it. The results complement the ‘endgame’ policy literature, adding the strength of feelings towards, and nuances of doubt about, the potential effects and unintended consequences and provides useful information for formulating metrics for future evaluation of ‘endgame’ policies.