Marewa Glover

Marewa Glover: Anti-tobacco zealot turned harm reduction advocate

In this instalment of our Harm Reduction Heroes series, Snusforumet talks to Dr. Marewa Glover, director of the independent Auckland-based Centre of Research Excellence: Indigenous Sovereignty & Smoking, who takes issue with New Zealand’s image as a bastion of progression in the tobacco harm reduction (THR) arena. 

Last winter, New Zealand introduced anti-tobacco legislation, the Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Bill, with the aim of making the country smoke-free by 2025. 

The bill’s most headline-grabbing aspect was a generational tobacco ban. Starting in 2023, anyone born on or after January 1, 2009, is barred for life from purchasing combustible cigarettes. Someone aged 14 when the legislation became law would therefore never be able to legally purchase tobacco. 

Another plank of the bill is to reduce the nicotine content of cigarettes by up to 95 percent, while a third is to reduce the number of shops allowed to sell cigarettes from 8,000 to between 500 and 1,000.

Many global public health authorities heralded the proposed legislation as groundbreaking.

The UK government even recently published ‘The Khan review: making smoking obsolete,’ an independent report by Dr. Javed Khan OBE outlining the government’s ambition to make England smokefree by 2030 that was heavily influenced by New Zealand’s approach.

Smoking prevalence has diminished in New Zealand from 27% in 1992 to 18.4 percent in 2011-12 and then to 10.9 percent in 2020-21 — one of the lowest in the world.

New Zealand, it would seem to an outsider, is doing things right.

‘A step in the wrong direction’

But praise for New Zealand’s approach has not been unanimous, particularly at home.

The new legislation saddened Marewa Glover of the Auckland-based Independent Centre of Research Excellence: Indigenous Sovereignty & Smoking, one of New Zealand’s most prominent THR advocates.

“It’s yet another step in the wrong direction,” she tells Snusforumet. 

“The negative consequences of previous ‘smoke-free’ legislation, such as much higher prices for tobacco, are already resulting in an increase in young people committing robberies to steal tobacco and being charged and imprisoned for such crimes.”

For Marewa, it’s not even the age restrictions that deserve the most scrutiny. 

“It’s a sleight of hand,” she continues. 

“Most people are focusing on the age ban, and they’re overlooking that the government is about to reduce the nicotine yield in cigarettes by around 95 percent to below 0.05 mg per gram. They’re taking it down to almost a trace level. That is major.”

Risks of ‘nicotine-free’ policies

Many people with mental health problems have high levels of nicotine dependency, says Marewa. 

Marewa worries that if cigarettes are made essentially nicotine-free, what will those dependent on nicotine from cigarettes do? After all, their dependency is not just going to vanish.

“They’re going to look elsewhere for relief,” says Marewa. 

“We could see an increase in alcohol use, we could see an increase in marijuana use, which in New Zealand is still illegal, and we could see a rise in the use of stronger drugs.”

And then, of course, there’s the black market. Because of previous legislation that raised tobacco prices to stratospheric levels, New Zealand has seen a spike in the number of robberies of shops selling tobacco products.

It’s not just about ever-weaker cigarettes, however. The government’s plans to drastically reduce the number of outlets licensed to sell tobacco could also be disastrous, according to Marewa Glover.

“Many youth gangs are already becoming involved in the black markets to supply tobacco,” she says. 

“Because New Zealand is an island and we’re a three-hour flight from our nearest neighbour, cross-border smuggling is difficult. As a result, people have to source the black market tobacco internally, so they steal the tobacco from shops.”

Exacerbating inequality

And now, Marewa says, with the new law, the government plans to reduce the number of retailers allowed to sell tobacco will likely intensify criminal activity on that smaller number of outlets.

Marewa also believes that the new legislation will exacerbate inequality in New Zealand. Her view is that the law will create a larger bureaucracy, increase enforcement activity, and funnel more people from disadvantaged backgrounds into the justice system.

She explains that sixty-two percent of women in prison in New Zealand are Maori, emphasizing the plight of the country’s main indigenous group, which makes up around 16 percent of the country’s population.

“We have major inequity, and major disproportionate inequity going on. This legislation will mean more inequity, not less,” Marewa explains.

“This is neo-prohibition legislation and it is not consistent with harm reduction – it is top-down and not person-centred. It is punitive and not compassionate. It is wrong.”

Marewa Glover: ‘I had a hatred for smoking’

Marewa’s commitment to the rights of nicotine users is a little surprising given her background as a born-again non-smoker. 

“I was one of those stereotypical smokers who gives up and then spends their whole time stigmatising and demonising smokers,” Marewa says. 

“I was very judgemental. I had smoked so much that I developed chronic bronchitis in my twenties. To actually give up, I had to develop a hatred for smoking.”

Marewa is a former Professor of Public Health at Massey University and a former chair of End Smoking NZ, a charitable trust that lobbied for tobacco harm reduction for more than a decade. 

As a behavioural scientist, Glover has led and collaborated on many studies resulting in more than 120 scientific publications. But it was a Dutch student on placement at the University of Auckland around ten years ago who triggered Marewa’s transition from rabid anti-smoker to a more compassionate advocate of THR. 

Marewa and the student were discussing ways of dissuading people from smoking, when Marewa came up with the idea of impregnating cigarette filters with dye, in the same way that banks impregnate bank notes with pigment to deter bank robbers. 

“Then we could shame smokers,” Marewa says. “I was quite serious, but I horrified this student who said, ‘How awful – how can you even think of doing something like that to someone?’ And I thought, ‘Oh god, you are right!’” she recalls.

“The thing is, within the echo chamber of tobacco control, such nasty ideas were celebrated. And this is still happening now in New Zealand. The zealots and prohibitionists are still in control.”

NZ nicotine pouch ban ‘was insane’

Snus has long been banned in New Zealand, and nicotine pouches were outlawed in 2020 as part of The Smokefree Environments and Regulated Products (Vaping) Amendment Bill, in what was another loss for tobacco harm reduction advocates. 

“The banning of nicotine pouches was just insane,” Marewa says. “According to the data, they represent even less risk than vapes. Why would you ban them if your goal is harm reduction? Unless your goal is purely to ban nicotine.”

Marewa fears that New Zealand is heading towards an illiberal future regarding public health. She says it’s anathema to suggest New Zealand is on a slippery authoritarian slope but thinks it’s undeniable.

“I was there 30 years ago, when I was being accused, as a policy analyst, of being a public health Nazi and I was partly responsible for the slide towards this illiberal future,” says Marewa Glover. 

“I truly believed that we were trying to reduce death and disease. But I’ve seen it with my own eyes from the other side and know that is not the truth. There is definitely a slippery slope. And what we have now? This is not democracy. This is a loss of human rights.”