A decade of tobacco control efforts in New Zealand (1996-2006): impacts on inequalities in census-derived smoking prevalence.

INTRODUCTION

Smoking prevalence in New Zealand is highly related to socioeconomic disadvantage and ethnicity, with particularly high smoking prevalence among the Māori population. In the 10-year period from 1996 to 2006, a range of tobacco control activities were implemented in New Zealand. Uniquely in New Zealand, the national census has regularly included questions on smoking status. The purpose of this paper is to inform policy by examining the relationships between smoking prevalence and age, sex, socioeconomic position, and ethnicity, comparing data from the 1996 and 2006 national censuses.

METHODS

Socioeconomic deprivation was measured using the year-specific NZDep index of socioeconomic deprivation for small areas, based on 9 variables from the relevant census. Ethnicity (Māori, Pacific, and European & Other) was assessed using self-definition. Smoking information from each census is stratified by age group, sex, NZDep, and ethnicity.

RESULTS

The strong relationship between small-area socioeconomic deprivation and smoking prevalence remained unchanged in New Zealand over the decade 1996-2006. Smoking prevalence continued to be associated with Māori ethnicity independently of small-area socioeconomic deprivation. Smoking prevalence reduced modestly between 1996 and 2006 but increased in some age/sex/ethnic/deprivation groups.

CONCLUSIONS

The findings of this analysis provide information to support the design and implementation of tobacco control policies in New Zealand over the next 10 years and suggest that current tobacco control policies need to be strengthened and additional, more carefully targeted, measures implemented.