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High support for a tobacco endgame by Pacific peoples
who smoke: national survey data
The attitudes of smokers to tobacco control interventions is
highly topical in New Zealand given the current inquiry by the Māori
Affairs Select Committee into tobacco issues.1
Presenters to this Committee have raised the need for a tobacco endgame strategy
(e.g.2), and this idea has currency among
Māori leadership,3 non-governmental
organisations,4 and amongst other
researchers.5
6
In the 2006 Census 30.3% of adult Pacific peoples in New
Zealand reported being smokers, compared to 19.4% of the European
population.7 Tobacco use is a substantial
burden on the health of Pacific peoples8 and is
likely to be contributing significantly to the health inequalities between
Pacific peoples and other New Zealanders (e.g. see the emerging differences in
lung cancer mortality rates9). Harm to health
and expenditure on tobacco is also likely to be holding back the social and
economic development of Pacific communities.
Pacific peoples support improved tobacco control, and in a
2008 national survey (smokers and non-smokers) there was much stronger support
than average for tobacco regulation.10 This
high level of support contrasts somewhat to that of Pacific
policymakers—at least for extending smokefree
regulations.11 Here we describe the results of
another national survey that considered attitudes of Pacific smokers to a range
of tobacco control policy options.
Methods—The New Zealand arm of the
International Tobacco Control Policy Evaluation Project (ITC Project) uses as
its sampling frame the New Zealand Health Survey (a representative national
sample with boosted sampling of Pacific peoples). From this sample we surveyed
adult smokers (n=1376) including 90 Pacific peoples respondents in Wave 1 (Wave
2 included 49 Pacific peoples). Further details of the methods (including
response rates, attrition and weighting processes) are available in online
reports (available at:
In the analysis presented here we exclude Māori from
the comparison group of “European/Other” but this group did include
Asian New Zealanders. All results are for Wave one of the survey (unless
otherwise stated) and were weighted and adjusted for the complex sample design
to represent the national population of all Pacific peoples (and non-Pacific)
smokers in New Zealand.
Results—There was strong majority
support for five key tobacco control interventions among Pacific smokers (see
Figure 1). Support was statistically significantly greater than among the
European/Other ethnic group smokers for: greater government action on tobacco
(p=0.001), and controls on where tobacco could be sold (i.e., only in shops
where children were not allowed [p=0.009]). The majority support for more
regulation of tobacco companies, support for a ban on cigarette sales in 10
years and support for higher tobacco tax (if the revenue is used for quitting
support), was also stronger than among the European/Other population, but not
statistically significantly so.
Figure 1. Support for key tobacco control
interventions by Pacific peoples and European/Other smokers in New Zealand
![]() Notes:
* If effective nicotine substitutes that are not smoked
became available (Wave 2 data).
** If all the extra money was used to promote healthy
lifestyles including helping smokers wanting to quit. But these differences by
ethnicity were not statistically significant in a multivariate analysis (i.e.,
non-significant in two out of three
models12).
Bars indicate 95% confidence intervals.
Majority support by Pacific smokers was also voiced for the
following:
For these interventions Pacific smokers usually
had higher levels of support than European/other smokers but not at
statistically significant levels. In contrast to the above list, only minority
support was voiced for tobacco companies being required to sell cigarettes in
plain packages (47.0%) and 50.0% thought smoking should be allowed on
lifeguard patrolled beaches.
Conclusions—This national survey
found majority support among Pacific smokers for a wide range of tobacco control
interventions—with these generally exceeding that for the European/Other
population of smokers and also Māori smokers (for all results in the
Figure13). The high level of support for
endgame approaches (e.g. banning tobacco sales in 10 years) and rigorous policy
measures (e.g., banning sales in shops where children are present) are
particularly striking, given the lack of media coverage or public debate about
these measures at the time of data collection. The Māori Affairs Select
Committee and other New Zealand policymakers should take into account this high
level of support when proposing new tobacco control measures, especially those
aiming to control the tobacco epidemic with a well defined endgame
strategy.
Competing interests: Although we do
not consider it a competing interest, for the sake of full transparency we note
that some of the authors have undertaken work for health sector agencies working
in tobacco control.
Disclaimer: Dr Api Talemaitoga is an
employee of the New Zealand Ministry of Health. The opinions expressed in this
letter are the authors’ own, and do not necessarily reflect Ministry of
Health policy.
Acknowledgements: The ITC Project New
Zealand team thank: the interviewees who kindly contributed their time; the
Health Research Council of New Zealand which has provided the core funding for
this Project; and our other project partners (see: http://www.wnmeds.ac.nz/itcproject.html).
Nick Wilson*1, Richard
Edwards1, George
Thomson1, Deepa
Weerasekera1,
Api Talemaitoga2
1 Department of Public
Health, University of Otago, Wellington
2 New Zealand Ministry of
Health, Wellington
* For correspondence: Associate Professor Nick Wilson,
email: nick.wilson@otago.ac.nz
References:
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