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1.
Drug Alcohol Rev ; 41(2): 365-376, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34487593

RESUMEN

INTRODUCTION: The emergence of low-cost smartphone technology has coincided with major declines in adolescent smoking and other risk behaviours. This study explores the relationship between internet use and smoking in adolescents and investigates whether rising internet use contributed to the decline in smoking between 2012 and 2018. METHODS: Data were drawn from a nationally representative New Zealand survey of students aged 14-15 (N = 11 299), conducted biennially between 2012 and 2018. We used logistic regression to explore the association between internet use and smoking and test whether increasing time on the internet was associated with declining adolescent smoking over the study period. RESULTS: The proportion of students spending 5+ hours per day online increased from 15% to 35%. Heavy internet use was not a protective factor for smoking at the individual level. In 2016/2018, some types of past week internet use were associated with decreased risk of smoking (e.g. doing schoolwork, finding out about news), some were associated with increased risk (e.g. social media use) and others appeared to have no association with smoking (e.g. gaming, online shopping). The relative risk of smoking was lower in 2018 relative to 2012 (relative risk 0.68, 95% confidence interval 0.51, 0.90, after adjustment for demographic factors). Adding internet use to the model did not help to account for smoking decline. DISCUSSION AND CONCLUSIONS: We found no evidence that increasing time spent on the internet during the 2012-2018 period (during which smartphones became ubiquitous) contributed to the decline in adolescent smoking.


Asunto(s)
Uso de Internet , Teléfono Inteligente , Adolescente , Humanos , Internet , Fumar/epidemiología , Estudiantes , Fumar Tabaco
2.
Aust N Z J Public Health ; 45(6): 546-553, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34648227

RESUMEN

OBJECTIVE: To investigate smoking and vaping in secondary school students (aged 13-18 years) in New Zealand (NZ) following the introduction of 'pod' e-cigarettes, which have been associated with the rapid escalation of youth vaping elsewhere. METHODS: Data on smoking and vaping were collected in 2019 as part of a comprehensive youth health survey (N=7,721). RESULTS: Vaping was 2-3 times more prevalent than smoking, with 10% of students vaping regularly (monthly or more often), and 6% weekly or more often, compared with 4% and 2%, respectively, for tobacco smoking. Nicotine-containing e-cigarettes were sometimes or always used by 80% of regular and 90% of weekly vapers. Regular and weekly smoking was rare in low deprivation (affluent) areas, whereas regular and weekly vaping prevalence was similar across the socioeconomic spectrum. More than 80% of ever-vapers (N=2732) reported they were non-smokers when they first vaped, and 49% of regular vapers (N=718) had never smoked. CONCLUSIONS: A significant proportion of New Zealand adolescents, many of whom have never smoked, use nicotine-containing e-cigarettes regularly. Implications for public health: Vaping is less harmful than smoking, but it is not harmless. Public health action is needed to support young non-smokers to remain smokefree and vape-free.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Vapeo , Adolescente , Humanos , Nueva Zelanda/epidemiología , Nicotina , Instituciones Académicas , Fumar/epidemiología , Estudiantes , Encuestas y Cuestionarios , Fumar Tabaco
4.
N Z Med J ; 134(1542): 109-118, 2021 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-34531589

RESUMEN

The Climate Change Commission's draft report and recommendations provide a pathway towards achieving the New Zealand Government's commitment to net zero emissions by 2050. However, the Commission has not adequately considered the health co-benefits of climate change mitigation. In this viewpoint, we assess how the Commission has considered health co-benefits in the key response domains. Extrapolating UK evidence to the New Zealand context suggests climate change mitigation strategies that reduce air pollution, transition the population towards plant-based diets and increase physical activity via active transport could prevent thousands of deaths per year in coming decades. Substantial health co-benefits would also arise from improved housing, cleaner water, noise reductions, afforestation and more compact cities. The Commission's draft report only briefly mentions many of these health co-benefits, and some are completely absent. We recommend the Commission's final report: (i) use health co-benefits as an explicit frame; (ii) ensure the government's Treaty of Waitangi obligations are met in all the domains covered to maximise benefits for Maori health and wellbeing; (iii) build on the successful COVID-19 response that demonstrated rapid, science-informed and vigorous government action can address major global health threats; (iv) include both public health expertise and Maori health expertise among its commissioners; (v) explain how health co-benefits are likely to generate major cost-savings to the health system.


Asunto(s)
Cambio Climático , Salud Pública/tendencias , COVID-19/epidemiología , COVID-19/prevención & control , Humanos , Nueva Zelanda/epidemiología , Pandemias/prevención & control , SARS-CoV-2
6.
Int J Drug Policy ; 84: 102826, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32721865

RESUMEN

BACKGROUND: Binge-drinking prevalence among New Zealand adolescents has declined sharply since 2001, as it has in many other high-income countries. Other adolescent risk behaviours (e.g. smoking, cannabis use and precocious sexual activity) have also declined, raising the possibility of common underlying drivers. This study investigates potential contributing factors - both factors that predict risk behaviours in general, and alcohol-specific factors - and the extent to which they account for the decline in binge drinking. METHODS: The study used nationally representative survey data collected in 2001 (N = 6513), 2007 (N = 5934) and 2012 (N = 5489). The outcome measure was prevalence of past month binge drinking (5+ drinks/session). Predictor variables included factors that predict risk behaviours in general (parental monitoring, family attachment, school attachment, having a part-time job, time spent hanging out with friends); alcohol-specific factors (parental alcohol use, adolescent attitude toward alcohol use); and attitude toward and current use of tobacco and cannabis. Likelihood of binge drinking was modelled for each survey year (ref=2001), adjusting for demographic factors. Predictors were added to this base model, with the degree of attenuation of the odds ratio for year indicating the extent to which the included predictor(s) accounted for the trend. RESULTS: Compared with 2001 the odds of binge-drinking in 2012 were 0.33. The strongest independent contributor to the decline was adolescent attitude toward alcohol use, followed by current cannabis use, then current tobacco use. Collectively, general factors in home, school and leisure settings did not significantly contribute to the downward trend in binge drinking. CONCLUSION: Decreasing acceptability of alcohol use among adolescents was the most important identified contributor to adolescent binge-drinking decline. Drinking, smoking and cannabis use trends were empirically linked, yet the decline in binge drinking was not significantly explained by the included predictors common to risk behaviours in general.


Asunto(s)
Conducta del Adolescente , Consumo Excesivo de Bebidas Alcohólicas , Consumo de Alcohol en Menores , Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Humanos , Nueva Zelanda/epidemiología
10.
N Z Med J ; 132(1500): 12-24, 2019 08 16.
Artículo en Inglés | MEDLINE | ID: mdl-31415495

RESUMEN

AIM: Cannabis use declined in New Zealand adolescents between 2001 and 2012. We investigated i) whether changes in adolescent cannabis use occurred across all demographic groups, and ii) whether declining cannabis use was accompanied by increasing use of other psychoactive drugs. METHOD: We conducted secondary analysis of repeat cross-sectional data from nationally representative surveys of secondary school students (2001, 2007, 2012) to determine trends in never-use of cannabis and other psychoactive drugs by age, sex, ethnicity, deprivation, school decile and urban/rural locale. Logistic regression was used to test whether changes in cannabis non-use over time varied between demographic groups. RESULTS: Never-use of cannabis and of other psychoactive substances increased between 2001 and 2012 in all included age, ethnic, sex and socioeconomic groups. Maori, younger students and those in low decile schools demonstrated the greatest reductions in cannabis use over the study period. CONCLUSION: The decline in adolescent cannabis use between 2001 and 2012 occurred across all main demographic groups and was not accompanied by a rise in the use of other psychoactive drugs. Ethnic and socioeconomic inequities in adolescent cannabis use decreased over the study period.


Asunto(s)
Fumar Marihuana/epidemiología , Psicotrópicos , Estudiantes/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Conducta del Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Nueva Zelanda/epidemiología
11.
Nicotine Tob Res ; 21(4): 430-438, 2019 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-29554315

RESUMEN

INTRODUCTION: Smoking among New Zealand (NZ) adolescents has declined since 2000, but ethnic disparities remain pronounced. To inform prevention efforts, we investigated exposure to and relative importance of known predictors of adolescent smoking and how these have changed over time, for Maori (NZ's indigenous population) and adolescents overall. METHODS: We used repeat cross-sectional data, 2003-2015, from a national survey of 14- to 15-year olds (N = 20 443-31 696 per year). For the overall sample and for Maori and non-Maori, we calculated adjusted odds ratios (aORs) to assess the association between regular smoking and risk factors each year: one or more parents smoke, best friend smokes, older sibling(s) smoke, and past week exposure to smoking in the home. We calculated population attributable risk (PAR) for risk factors in 2003 and 2015. RESULTS: Between 2003 and 2015, aORs for exposure to smoking in the home increased from 1.7 (95% CI 1.6% to 1.8%) to 2.6 (2.1% to 3.1%) overall and from 1.8 (1.6% to 2.1%) to 3.4 (2.5% to 4.5%) for Maori; aORs for "best friend smokes" also increased, while aORs for sibling smoking and parental smoking did not change meaningfully. PAR for exposure to smoking in the home increased from 17% to 31% overall and from 28% to 57% for Maori, while PARs for other risk factors decreased. CONCLUSIONS: Exposure to smoking in the home has become more strongly associated with adolescent smoking over time and is an increasingly important risk factor at the population level (independent of parental smoking), particularly for Maori. IMPLICATIONS: Our findings have implications for reducing smoking uptake and ethnic disparities in NZ, and potentially elsewhere, given the similarity in risk factors and trends for adolescent smoking internationally. Our findings suggest that reducing second-hand smoke exposure in homes will likely reduce uptake of smoking. Because Maori children are both more exposed and appear to be more strongly influenced by exposure to smoking in the home, interventions to reduce indoor smoking could have differentially positive effects for Maori. Greater research and policy attention to reducing smoking in homes is warranted.


Asunto(s)
Conducta del Adolescente/etnología , Conducta del Adolescente/psicología , Contaminación por Humo de Tabaco/efectos adversos , Fumar Tabaco/etnología , Fumar Tabaco/psicología , Adolescente , Niño , Estudios Transversales , Femenino , Amigos/psicología , Humanos , Masculino , Nueva Zelanda/epidemiología , Padres/psicología , Factores de Riesgo , Fumar Tabaco/efectos adversos
12.
BMJ Open ; 8(10): e020320, 2018 10 25.
Artículo en Inglés | MEDLINE | ID: mdl-30366911

RESUMEN

OBJECTIVES: Adolescent smoking has declined in New Zealand and in many other countries since the late 1990s, yet the reasons for the decline are not well understood. We investigated the extent to which established risk factors for adolescent smoking (parental, sibling and peer smoking, and exposure to smoking in the home) explained the downward trend. DESIGN: Trend analysis of repeat cross-sectional data from an annual nationally representative survey. SETTING: New Zealand. PARTICIPANTS: Secondary school students aged 14-15 (n=398 221). OUTCOME MEASURE: Regular (at least monthly) smoking. METHODS: For each risk factor (parental smoking, best friend smoking, older sibling smoking and past week exposure to smoking in the home) we plotted prevalence of exposure, 2002-2015. Next, using multivariable logistic regression, we modelled the trend in regular smoking (expressed as an OR for year) adjusting for age, sex, ethnicity and socioeconomic position. The risk factors were added to the model-individually and collectively-to test whether they attenuated the OR for year. RESULTS: Exposure to all risk factors except 'past week exposure to smoking in the home' decreased between 2002 and 2015. We observed a strong downward trend in regular smoking among adolescents (OR=0.88 per year, 95% CI 0.88 to 0.88, p<0.001). 'Best friend smoking' was the only risk factor that significantly attenuated the trend. However, due to circularity, this factor provides an unsatisfactory explanation for population level smoking decline. CONCLUSIONS: The established risk factors that we explored do not appear to have contributed to the remarkable decline in adolescent smoking in New Zealand between 2003 and 2015. Further research is needed to assess the possible contribution of factors outside our model, such as changes in the policy context, the social meaning of smoking and broader social and economic conditions.


Asunto(s)
Conducta del Adolescente , Fumar/epidemiología , Fumar/tendencias , Adolescente , Estudios Transversales , Femenino , Amigos , Humanos , Modelos Logísticos , Masculino , Análisis Multivariante , Nueva Zelanda/epidemiología , Grupo Paritario , Prevalencia , Medición de Riesgo , Factores de Riesgo , Encuestas y Cuestionarios
14.
BMJ Open ; 7(12): e017837, 2017 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-29229655

RESUMEN

OBJECTIVES: Reducing smoking in young adults, particularly young Maori and Pacific, is vital for reducing tobacco harm and health inequalities in New Zealand (NZ). We investigated how NZ policy experts appraised the feasibility and likely effectiveness of interventions designed to reduce smoking prevalence among 18-24 year olds. DESIGN: We used a qualitative design, conducting semistructured interviews and applying thematic analysis. PARTICIPANTS: We interviewed 15 key informants, including politicians, senior policy analysts and leading tobacco control advocates. Participant selection was based on seniority and expertise and ensuring diverse perspectives were represented. INTERVENTIONS: We examined nine interventions that could either promote greater mindfulness or introduce barriers impeding smoking uptake: smoke-free outdoor dining and bars; no tobacco sales where alcohol is sold; social marketing campaigns; real life stories (testimonials); life skills training; raise purchase age to 21; tobacco-free generation; smokers' licence; make tobacco retail premises R18. RESULTS: The policies perceived as more effective denormalised tobacco; made it less convenient to access and use; highlighted immediate disadvantages (eg, impact on fitness); aligned with young people's values; and addressed the underlying causes of smoking (eg, stress). Participants highlighted some political barriers and noted concerns that some interventions might widen ethnic disparities. Exceptions were social marketing campaigns and extending smoke-free regulations to include outdoor areas of cafes and bars, which participants saw as politically feasible and likely to be effective. CONCLUSIONS: Our findings suggest the merit of an approach that combines social marketing with regulation that makes accessing and using tobacco less convenient for young adults; however, political barriers may limit the regulatory options available in the short term. Strategies to support self-determination and address the underlying causes of smoking in young people warrant further investigation. Determining policy acceptability to Maori and Pacific, and likely effectiveness for these populations, should be key priorities.


Asunto(s)
Cese del Hábito de Fumar , Prevención del Hábito de Fumar/legislación & jurisprudencia , Fumar/legislación & jurisprudencia , Mercadeo Social , Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Estudios de Factibilidad , Humanos , Entrevistas como Asunto , Nueva Zelanda , Investigación Cualitativa , Industria del Tabaco/legislación & jurisprudencia , Adulto Joven
17.
Tob Control ; 26(6): 669-673, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-27777326

RESUMEN

OBJECTIVE: Tobacco companies often assert that adults should be free to make an 'informed choice' about smoking; this argument influences public perceptions and shapes public health policy agendas by promoting educative interventions ahead of regulation. Critically analysing 'informed choice' claims is pivotal in countries that have set endgame goals and require new, more effective policies to achieve their smoke-free aims. METHODS: In-depth interviews with 15 New Zealand politicians, policy analysts and tobacco control advocates examined how they interpreted 'informed choice' arguments. We used a thematic analysis approach to review and explicate interview transcripts. RESULTS: Participants thought 'informed choice' implied that people make an active decision to smoke, knowing and accepting the risks they face; they rejected this assumption and saw it as a cynical self-justification by tobacco companies. Some believed this rhetoric had countered calls for stronger policies and thought governments used 'informed choice' arguments to support inaction. Several called on the government to stop allowing a lethal product to be widely sold while simultaneously advising people not to use it. CONCLUSIONS: 'Informed choice' arguments allow the ubiquitous availability of tobacco to go unquestioned and create a tension between endgame goals and the strategies used to achieve these. Reducing tobacco availability would address this anomaly by aligning government's actions with its advice.


Asunto(s)
Conducta de Elección , Cese del Hábito de Fumar/psicología , Fumar/legislación & jurisprudencia , Fumar/psicología , Industria del Tabaco/métodos , Política de Salud , Humanos , Nueva Zelanda
18.
N Z Med J ; 129(1439): 11-22, 2016 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-27507718

RESUMEN

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 Maori 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 Maori and Pacific peoples. Continuation and improvement of tobacco-related surveillance is crucial for monitoring progress toward the 2025 goal.


Asunto(s)
/estadística & datos numéricos , Política para Fumadores/legislación & jurisprudencia , Fumar/epidemiología , Fumar/tendencias , Contaminación por Humo de Tabaco/prevención & control , Censos , Objetivos , Encuestas Epidemiológicas , Humanos , Nueva Zelanda/epidemiología , Factores Socioeconómicos
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