Insights and Evaluation, Health Promotion Directorate, National Public Health Service, Te Whatu Ora-Health New Zealand, Level 16, 101 The Terrace, Wellington 6011, New Zealand.
Health Promot Int. 2024 Jun 1;39(3). doi: 10.1093/heapro/daae060.
Despite the inclusion of both individual interventions and population-based measures in the Aotearoa New Zealand (Aotearoa NZ) Tobacco Control Programme, the gap between Māori, Pacific peoples and European/Asian/Other (EAO) populations in tobacco use has not decreased significantly. Tobacco control interventions that focus on individual behaviour change have produced little impact towards reducing tobacco smoking inequities for Māori and Pacific peoples in Aotearoa NZ. Using data from the New Zealand Health Survey (NZHS), this research investigates the impact of the wider determinants of health and individual-level factors on inequities in tobacco use between Māori, Pacific peoples and EAO. A conceptual framework was developed to support the theoretical positioning of this research and to inform data categorization, framing, discourse, analyses and interpretation. We conducted hierarchical regression to examine the effect of factors from each domain on ethnic inequities in tobacco use. We found that socioeconomic factors accounted for a significant amount of the disparity in adults currently smoking between Māori and Pacific peoples and EAO. Our results suggest that socioeconomic factors may be a more effective target of intervention than individual behaviours for reducing tobacco-related inequities. Addressing the broader determinants of health through comprehensive cross-agency cooperation to reduce ethnic inequities in tobacco use in Aotearoa NZ is likely to be more effective than individual behaviour change approaches.
尽管新西兰（Aotearoa NZ）的烟草控制计划包括个人干预措施和基于人群的措施，但毛利人、太平洋人民和欧洲/亚洲/其他（EAO）人群在烟草使用方面的差距并没有显著缩小。专注于个体行为改变的烟草控制干预措施对减少毛利人和太平洋人民在新西兰的烟草使用不平等现象几乎没有产生什么影响。本研究利用新西兰健康调查（NZHS）的数据，调查了健康的更广泛决定因素和个人因素对毛利人、太平洋人民和 EAO 之间烟草使用不平等的影响。为了支持本研究的理论定位，并为数据分类、框架、论述、分析和解释提供信息，我们制定了一个概念框架。我们进行了层次回归分析，以检验每个领域的因素对烟草使用种族不平等的影响。我们发现，社会经济因素在目前吸烟的成年人中占毛利人和太平洋人民与 EAO 之间吸烟差异的很大一部分。我们的研究结果表明，社会经济因素可能是减少与烟草相关的不平等的更有效干预目标，而不是个体行为。通过全面的跨机构合作来解决健康的更广泛决定因素，以减少新西兰的种族烟草使用不平等，可能比个体行为改变方法更有效。
