Journal of the New Zealand Medical Association, 03-April-2009, Vol 122 No 1292
High levels of smoker regret by ethnicity and socioeconomic status: national survey data
Some previous international work has studied levels of regret among smokers. In Australia, Canada, the UK, and the US, the proportion of smokers who agreed, or agreed strongly, with the statement “If you had to do it over again, you would not have started smoking”, was very high (range: 89.2% to 91.3%).1 This study also reported significantly lower regret by higher level of education, but no significant differences by ethnicity or income.
New Zealand is a good country to further explore smoker regret by socio-demographic variables given the ethnic diversity of the population and detailed small area data on deprivation levels. We have asked this same question on regret (as mentioned above) in a survey of New Zealand smokers. The survey involved a national sample of 1376 New Zealand adult (18+ years) smokers and was conducted between March 2007 and February 2008. Further detail on the survey methods is available elsewhere.2
The results, weighted to reflect the national population of smokers in New Zealand, showed that most smokers (83.3%; 95%CI=80.2% to 86.4%) showed regret about starting smoking. There were no significant differences in the level of regret by ethnicity (Europeans 82.8%, Māori 84.7%, Pacific peoples 89.2% and Asian peoples 75.5%). Similarly, there were no significant differences by small area deprivation quintile (range: 81.1% to 85.8%, using NZDep2006). Nevertheless, those reporting “smoking-induced deprivation” (subjects who reported spending money on cigarettes in the last six months which would have been better spent on household essentials like food) were significantly more likely to report regret (89.1% versus 81.4%, odds ratio=1.87; 95% confidence interval=1.04 to 3.37).
These results are fairly similar to those reported for youth smokers in New Zealand for a very similar question. The NZ Tobacco Use Survey found that 72.3% of youth smokers aged 15-19 years regretted starting smoking (82.2% for Māori and 68.7% for non-Māori).3
These high levels of regret are consistent with the previous work in developed countries1 and further highlight that regret is widely shared among different groups of smokers. Such high levels of regret help to justify government action to substantially expand existing tobacco control interventions and smoking cessation support (which New Zealand still uses at below full potential4). They also support arguments for governments to explore more innovative regulatory options to advance tobacco control, such as re-designing the tobacco market in order to accelerate reductions in smoking prevalence.5 6
Competing interests: The first two authors have previously undertaken work for government and non-government agencies involved in tobacco control.
Nick Wilson,* Richard Edwards, Deepa Weerasekera
Department of Public Health, University of Otago, Wellington, New Zealand
Acknowledgements: The ITC Project (NZ) team thank: the interviewees who kindly contributed their time; the Health Research Council of New Zealand which has provided the funding; and our other project partners (see: http://www.wnmeds.ac.nz/itcproject.html).
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