A Qualitative Analysis of Maori and Pacific people's Experiences of Using Electronic Nicotine Delivery Systems (ENDS).

INTRODUCTION: If electronic nicotine delivery systems (ENDS) are to bring public health benefits, members of population groups most affected by smoking must find them an easily adopted and satisfying replacement for smoking. We explored experiences of ENDS uptake and use among Maori and Pacific peoples living in New Zealand and probed factors that assisted transitions from smoking to vaping. METHODS: We recruited 16 participants using whanaungatanga and community advertising. All were aged 18 or over, identified as Maori or Pacific (or both), had smoked at least 100 cigarettes, and were current ENDS users. We undertook in-depth interviews and analyzed the data using a thematic analysis approach. RESULTS: We identified two key challenges that participants reported facing: their search for a satisfying ENDS experience and resisting social cues that could trigger relapse. Two supportive factors facilitated and reinforced smoking to vaping transitions: improved financial and physical well-being, and feeling connected to vaping communities. CONCLUSION: Learning about ENDS devices from those who had successfully switched from smoking to vaping provided much-needed information, reinforced the financial benefits of switching, and could inspire those making this transition to persist until they too become smoke free. IMPLICATIONS: Measures to support transitions from smoking to ENDS use could reduce inequities in smoking prevalence that indigenous people experience. Collective cessation interventions that draw on communities' knowledge and connections may enable smokers to access support that helps them navigate the potentially complex pathway from smoking to vaping.

'The times are changing': New Zealand smokers' perceptions of the tobacco endgame.

BACKGROUND: The New Zealand government's goal of achieving a smoke-free society by 2025 reflects growing interest in 'endgame' solutions to tobacco smoking. However, tobacco companies have framed 'endgame' strategies as contrary to individual freedoms and 'choice'; these claims heighten politicians' sensitivity to 'nanny state' allegations and may undermine tobacco control policies. Public support for stronger policies could strengthen political will; however, little is known about how smokers perceive endgame scenarios or the factors underlying their support or opposition to these. METHODS: The authors conducted 47 in-depth interviews with four priority groups: Maori, Pacific, young adults and pregnant women; all were smokers or very recent quitters. The authors used thematic analysis to interpret the transcripts. RESULTS: Most participants strongly supported the 2025 smoke-free goal, recognised the broader social good that would result and accepted the personal inconvenience of quitting. Yet they wanted to retain control over when and how they would quit and asserted their 'freedom' to smoke. Participants identified interventions that would extend current policy and maintain the autonomy they valued; the authors classified these into four themes: restricting supply, diminishing visibility, decreasing availability and affordability, and increasing quit support. CONCLUSIONS: Politicians may have a stronger mandate to implement endgame policies than they appreciate. Participants' use of industry arguments when asserting their freedom to 'choose' to smoke and quit suggests a need for denormalisation strategies that challenge industry propaganda, demonstrate how endgame measures would empower smokers and re-iterate the community benefits a smoke-free society will deliver.

A qualitative analysis of Maori and Pacific smokers' views on informed choice and smoking.

OBJECTIVES: Tobacco companies frame smoking as an informed choice, a strategy that holds individuals responsible for harms they incur. Few studies have tested this argument, and even fewer have examined how informed indigenous smokers or those from minority ethnicities are when they start smoking. We explored how young adult Maori and Pacific smokers interpreted 'informed choice' in relation to smoking. PARTICIPANTS: Using recruitment via advertising, existing networks and word of mouth, we recruited and undertook qualitative in-depth interviews with 20 Maori and Pacific young adults aged 18-26 years who smoked. ANALYSES: Data were analysed using an informed-choice framework developed by Chapman and Liberman. We used a thematic analysis approach to identify themes that extended this framework. RESULTS: Few participants considered themselves well informed and none met more than the framework's initial two criteria. Most reflected on their unthinking uptake and subsequent addiction, and identified environmental factors that had facilitated uptake. Nonetheless, despite this context, most agreed that they had made an informed choice to smoke. CONCLUSIONS: The discrepancy between participants' reported knowledge and understanding of smoking's risks, and their assessment of smoking as an informed choice, reflects their view of smoking as a symbol of adulthood. Policies that make tobacco more difficult to use in social settings could help change social norms around smoking and the ease with which initiation and addiction currently occur.

Traditional gift-giving and gambling amongst Pacific mothers living in New Zealand.

Cultural variables are implicated in gambling literature as playing an important role in the initiation and maintenance of gambling activity, however there remains a paucity of research that defines and investigates the association between cultural factors, gambling and problem gambling amongst different cultural groups. The first data collection point for a cohort of mothers within the longitudinal Pacific Islands Families study identified that the Pacific cultural practice of traditional gift-giving was associated with gambling activity and expenditure. In this paper, data about traditional gift-giving and gambling are presented from the third collection point within this study. The results support an association between gambling (rather than problem gambling) and traditional gift-giving. This paper contends the need to contextualise Pacific peoples gambling within Pacific cultures. Also a need is identified to examine and address the psycho-social and cultural impacts of gambling for Pacific peoples.

Impacts of inter- and intra- ethnic partnerships/relationships on traditional gift giving in a cohort of Pacific mothers.

Traditional gift-giving (TGG) is an important element of familial obligations among Pacific families. Migration from Pacific homelands to New Zealand and other countries has had an impact on participation in TGG., Many anecdotal accounts have suggested that TGG diminishes when Pacific persons marry outside their ethnic groups. While TGG is an indicator of social cohesion TGG can have direct influence on disposable income. The practice of TGG impacts on health as Income and social cohesion are key determinants of health. Thus TGG Health and social cohesion are closely interrelated and interdependent. The data for this paper is taken from a longitudinal cohort study of 1,398 Pacific children and their families in South Auckland, New Zealand. The study sought participants' responses to questions pertaining to the amounts gifted, the frequency of giving, recipients of the gifting and their reasons for participating and not participating in TGG. The assumption explored in this paper is that as Pacific peoples move outside their social sphere and become more acculturated with other ethnic groups, TGG was more likely to diminish rather than increase. This paper addresses the TGG participation rates among Pacific peoples in inter-ethnic relationships and intra-ethnic relationships. It argues that couples in an intra-ethnic intimate relationship are more likely to participate in traditional gift-giving than those who are in inter-ethnic intimate relationships. While this is true for most PI inter ethnic relationships the level of participation increases further with inter-ethnic intimate relationships among Tongans and Samoans who are also the largest participators of all ethnic groups in traditional gift-giving.