Smoking prevalence in New Zealand from 1996-2015: a critical review of national data sources to inform progress toward the Smokefree 2025 goal.

AIM

The New Zealand Government has committed to a goal of becoming a smokefree nation by 2025. This study analysed recent smoking trends using three national data sets to: i) assess progress towards the smokefree goal; and ii) critically evaluate New Zealand's main national-level data sources on smoking prevalence for measuring progress towards the Smokefree 2025 goal.

METHODS

Trends in adult (age 15+) daily smoking prevalence from 1996 to 2015 were compiled from three data sources: the New Zealand Census, the New Zealand Health Survey (NZHS), and the Health and Lifestyles Survey (HLS). We compared key features of the surveys (eg, sample size, ethnicity classification), examined composite trends across surveys, and analysed differences between and within surveys over time.

RESULTS

Both the Census and the NZHS show a decline in adult (age 15+) daily smoking over the past 18 years, from 23-25% in 1996/97, to around 15% in 2014/15, with broadly consistent findings from the HLS since it began in 2008. However, recent NZHS findings do not suggest substantive reductions in daily smoking prevalence, particularly for Māori and Pacific populations, with 2014/15 rates of 35.5% and 22.4% in these populations respectively, and no statistically significant change since 2006/07. NZHS has advantages over the New Zealand Census and the HLS for the purposes of monitoring annual progress towards to the Smokefree 2025 goal.

CONCLUSION

These data collectively suggest that recent declines in smoking prevalence are modest and clearly inadequate for achieving the Smokefree 2025 and interim 2018 goals, particularly for Māori and Pacific peoples. Continuation and improvement of tobacco-related surveillance is crucial for monitoring progress toward the 2025 goal.