“I was seeing large numbers of people suffering from smoking-related illnesses: children in homes where parents were smoking, and adults with terrible chronic lung disease, which was making it hard for them to walk to the letterbox, or developing heart disease prematurely.
“Tobacco smoking makes many lives miserable and cuts lives short. And that has wider impacts for their families and communities,” he says.
Bullen decided to train in public health and is now a professor in the field, leading several major studies into tobacco harm and how to quit smoking.
He has just received $1.44 million from the Health Research Council for a world-leading study comparing the effectiveness of a newly approved drug in New Zealand – cytisine – with gradually tapering off nicotine products, which is often tried by people wanting to quit.
The study launching later this year will be unique in assessing the effectiveness of these treatments on people who use several different nicotine products over long periods.
“Many people who smoke also vape or use other nicotine products, like heated tobacco and oral nicotine pouches that are becoming very popular.
“They want to make a clean break, not only from smoking, but also from vaping and the other products,” says Bullen, who currently heads the University’s Department of General Practice and Primary Care, is Director of the Transform Faculty Research Centre, and is involved in the centres for cancer, heart and addiction research.
Cytisine resonates with many New Zealanders, because it’s a compound found in kōwhai trees, he says.
If cytisine proves effective for quitting multi-pronged nicotine use, there could be commercial opportunities to grow kōwhai in New Zealand to manufacture the drug as a treatment for nicotine dependence, he says.
However, Bullen warns it would be dangerous for people to try to use material directly from the tree.
In 2024 to 2025, just over 17 percent of New Zealanders reported smoking and/or vaping daily. This soars to 39 percent for Māori, 28 percent for Pacific people, 26 percent for people aged 18 to 24, and 22 percent for people with disabilities.
Some people use alternative nicotine products to try to give up cigarettes, but end up using these products regularly as well as smoking, he says.
“Cigarettes are expensive, so some use alternative nicotine products because they are cheaper, more socially acceptable or convenient.
“However, use of multiple products is associated with an increased risk of nicotine dependence and harmful health effects.”
Bullen says smoking cigarettes is the most harmful, followed by using heated tobacco and vapes. More research is needed on the long-term effects of vaping.
Quitting smoking is probably the single most beneficial change people can make for their health, says Bullen.
“People who smoke for many years, reduce their lifespan by about a decade, on average. And often they have a lower quality of life before their premature death.“
The good news is, if people quit smoking, they can actually reclaim years of life that would have been lost.”
