1. Is the New Zealand Quitline & NRT distribution programme appropriately resourced?
Nick Wilson* (Otago University, Wellington)
Chris Bullen (Auckland University, Auckland)
George Thomson (Otago University, Wellington)
*Health Promotion and Policy Research
Unit (HePPRU)

2. High need for smoking cessation support
Note ethnic group %s in population

3. Demand for Cessation Support
Most smokers in developed countries (>80%) regret starting (ITC Project data).
NZ data consistent with this
65% of NZ smokers have made a quit attempt in past 5 years (NZTUS data)

4. Programme description: Quitline & NRT
On-going mass media campaigns promote the free phone Quitline
Eligible callers sent a voucher (‘Quitcard’) redeemable at pharmacies
Subsidy is around 95% of the retail price of NRT

5. Reach of the Quitline
1.3% of all smokers register with the Quitline every 6-month period (n>30,000 / year)
Quitline is most popular source of advice (>friend/family or GP) (NZTUS data)
Callers & NRT dispensing – responsive to paid advertising (including for Māori & Pacific)

8. Evaluation of Programme Components
Access nationwide & to all ethnic groups – but Pacific smokers under- represented
2002/03 evaluation: Processes well accepted – 70% used whole 4 week course of NRT.
Voucher redemption rate (>=1 voucher): 76% of Māori; 87% of non- Māori (p<0.001)
For full details see

10. Service effectiveness is relatively high
12-month self-reported quit rate: 18%
6-month self-reported quit rates (intention-to- treat analysis): 17% for Māori, 22% non- Māori
Māori NRT redemption associated with increased quitting at 6 months: OR=1.78 (1.00–3.16)
For full details see

11. Cost-effective Including counselling + NRT costs:
Cost per smoker who quit for a year: $
Cost / lifetime quitter: $3198 – 7120
Cost / QALY gained: $2449 – (much better than breast screening)
NB: Conservative assumptions (ignored short- term health gains, work productivity).

12. Programme strengths Accessibility good – nationwide reach & low price
High user acceptability
Political acceptability (print media data)
Effective (quit rates) & cost-effective (per quitter, per QALY)
Sustainable investment that continues to develop
Evidence-based treatment protocols

13. Programme weaknesses
Inadequate funding given need (majority of smokers unaware of the NRT aspect)
Lack of secure funding
Relatively under-promoted & “Subsidised access to NRT” an under-used theme
Pacific smokers under-represented (at 5.2%)
Quitline promotion not synchronised with demand surge (eg, new smokefree law)

14. Summary
Available evidence: Quitline and mass subsidisation of NRT are successful & cost-effective public health interventions in NZ.
Funding is inadequate in terms of: need, likely demand (if adequately promoted), & demand at special times.

15. Acknowledgments Michele Grigg & Judy Li of The Quit Group
for providing data & helpful comment.
For funding support for conference attendance on
a related topic: US National Institute on Drug Abuse,
US National Cancer Institute,
Robert Wood Johnson Foundation,
National Heart Foundation of New Zealand.