Gendall Philip, Hoek Janet, Marsh Louise, Edwards Richard, Healey Benjamin
Department of Marketing, University of Otago, Dunedin, Otago, New Zealand.
BMJ Open. 2014 Apr 17;4(4):e004631. doi: 10.1136/bmjopen-2013-004631.
We examined whether the supply routes via which New Zealand adolescents aged 14-15 years accessed tobacco had changed during a period of dynamic policy activity.
We analysed data from seven consecutive years (2006-2012) of the New Zealand Action on Smoking and Health (ASH) Year 10 survey, a nationwide cross-sectional annual survey.
All New Zealand schools teaching Year 10 students are invited to participate in the survey; school-level participation rates have ranged between 44% and 58% and more than 25 000 students have responded to the survey in each year. The results presented draw on the subsample who reported smoking when surveyed (N∼9200). The data were weighted by age, ethnicity and school socioeconomic status (SES) to remove effects of systematic over-response by New Zealand Europeans and under-response by those in lower SES groups from trend analyses.
The survey measured adolescents' main reported tobacco supply source.
Smoking prevalence declined significantly (8.1%) over the period examined (linear tend coefficient: -0.74; 95% CI -1.03 to -0.45, significant p<0.01). Friends showed a significant decline in relative importance as a supply source while caregivers and other sources showed a significant increase over the period examined.
The findings show that social supply, particularly via friends, caregivers and others, such as older siblings, is a key tobacco source for adolescents; commercial supply is much less important. The findings raise questions about the additional measures needed to reduce smoking among youth. Endgame policies that make tobacco more difficult to obtain and less appealing and convenient to gift merit further investigation.
我们研究了在政策动态变化期间，14 - 15岁的新西兰青少年获取烟草的供应途径是否发生了变化。
我们分析了新西兰吸烟与健康行动（ASH）十年级学生年度调查连续七年（2006 - 2012年）的数据，这是一项全国性的横断面年度调查。
所有教授十年级学生的新西兰学校均受邀参与该调查；学校层面的参与率在44%至58%之间，每年有超过25000名学生回应调查。呈现的结果基于调查时报告吸烟的子样本（N≈9200）。数据按年龄、种族和学校社会经济地位（SES）进行加权，以消除趋势分析中新西兰欧洲人系统性过度回应和低SES群体回应不足的影响。
该调查测量了青少年报告的主要烟草供应来源。
在所研究的期间内，吸烟率显著下降（8.1%）（线性趋势系数： - 0.74；95%置信区间 - 1.03至 - 0.45，p<0.01，具有统计学意义）。在研究期间，朋友作为供应来源的相对重要性显著下降，而照顾者和其他来源的重要性则显著增加。
研究结果表明，社交渠道供应，特别是通过朋友、照顾者以及其他人员（如哥哥姐姐），是青少年获取烟草的主要来源；商业渠道供应则重要性低得多。这些发现引发了对于减少青少年吸烟所需额外措施的疑问。使烟草更难获取、降低吸引力且不方便赠送的终局政策值得进一步研究。
