HPA tobacco control research programme Tobacco Control Webinar June 2016
Acknowledgements The work presented today represents significant input from: Hayley Guiney Joanna White Judy Li Holly Trowland Sicily Sunseri Rebecca Bell We also acknowledge the funding received from the Ministry of Health
Overview 1. National monitors and outputs 2. Latest findings on selected topics Electronic nicotine delivery system (ENDS) Public support for tobacco control measures Impact of tobacco tax increases Youth smoking and co-morbidity 3. Other areas of work 4. Tobacco control data repository
National monitors and outputs
National monitors Monitor Topics Frequency Population HPA runs three monitors that have a focus on tobacco Health and Lifestyles Survey Youth Insights Survey (part of NZ Youth Tobacco Monitor) Tobacco, alcohol, mental health, gambling, etc Tobacco, alcohol, mental health, social connectedness, youth culture and lifestyles, etc Biennial Adults aged 15+ Biennial Year 10 students (14-15 year olds) New Zealand Smoking Monitor Tobacco Fortnightly Current smokers 18+ Recent quitters 18+ Serious quitters 18+
Outputs Types Examples from 2015/2016 HPA factsheets Articles in peer-reviewed journals Awareness of the Smokefree 2025 goal Acceptability of exposure to secondhand smoke among young people Young smokers usual source of cigarettes Young people s alcohol use during first smoking experience Responses towards additional tobacco control measures: data from a population-based survey of NZ adults Tripling use of e-cigarettes among NZ adolescents between 2012 and 2014 The prevalence, correlates and reasons for using e-cigarettes among NZ adults Barriers to successful cessation among young late-onset smokers
Latest findings on selected topics
1) Electronic nicotine delivery systems (ENDS): E-Cigarettes
% 70 60 50 40 30 20 10 0 E-cigarette use among 14 & 15- year-olds 64.7 Rate of ever-use is rapidly increasing 2014: 20% (= 11,900) 2012: 7% Current smokers 53.8 Infrequent smokers 41.2 Ex-smokers 16.5 Susceptible never-smokers 6.1 Non-susceptible never-smokers Smoking status Main reasons for first trying 1. Curiosity (65%) 2. Recommended by another person (24%) 3. Safer than tobacco cigarettes (20%) NOT cessation Estimate (approx) Current smokers 3,000 Infrequent/ex- smokers 4,900 Never smokers 3,900 Source: White, J., Li, J., Newcombe, R., &.Walton, D. (2015). Tripling use of electronic cigarettes among New Zealand adolescents between 2012 and 2014. Journal of Adolescent Health, 56, 5, 522-8.
E-cigarette use among adults Ever-use = 13% (= 415,000) Current use = 1% (= 32,000) Differed by tobacco smoking status Main reasons for first trying 1. Curiosity (57%) 2. Cessation (31%) 3. Replace smoking some of the time (8%) 60 50 40 30 49.9 Ever-use (%) Current use (%) 20 10 0 8.4 4 3.4 0.1 0.1 Current smokers Ex-smokers Never-smokers Source: Li, J., Newcombe, R., &.Walton, D. (2015). The prevalence, correlates and reasons for using electronic cigarettes among New Zealand adults. Addictive Behaviour, 45, 254-51.
2) Tobacco control policy
Youth sentiment for tobacco control policy Selected data from 2014 YIS (% agreed): Policy options % Reduce number of places that sell cigarettes and tobacco 77 Ban smoking in all outdoor places where young people go 68 Increase tax on cigarettes every year 60 Ban sale of cigarettes and tobacco in NZ 56 White, J. (2015). Young peoples opinions on tobacco control measures 2014 [In Fact]. Wellington: Health Promotion Agency Research and Evaluation Unit.
Public sentiment for tobacco control policy Selected data from 2014 HLS (% agreed): Policy options % Ban smoking in cars when there are children in them 97 Reduce nicotine content in cigarettes 81 Ban smoking in all public outdoor dining areas 76 Ban smoking in all outdoor transport waiting areas 75 Standardised/plain packaging 71 Reduce number of places that sell cigarettes and tobacco 68 Ban duty free sales 50 Li, J., Newcombe, R., &.Walton, D. (2016). Responses towards additional tobacco control measures: data from a population-based survey of New Zealand adults. New Zealand Medical Journal, 129, 1428.
3) Tobacco tax increases
Self-reported responses NZ Smoking Monitor in field since July 2011 Data collected from 2012, 2014 and 2015 have been analysed Data relevant to 2016 tax increase still being collected Analytical approach: Before (Oct-Dec) and after (Jan-Mar) analysis Walton et al. (2013). Smokers behavioural responses before and after the 2012 tobacco excise increase. Kotuitui: New Zealand Journal of Social Sciences Online. Li et al. (in draft). Small annual increases in tobacco tax lose impact over time: Evidence from smokers self-reported responses to the 5 th and 6 th increases in an annual series.
Response categories Categories (mutually exclusive, prioritised) Smoking-related change Product-related change Other change No change Survey responses Quit Tried to quit Cut down Changed to cheaper type Changed to cheaper brand Rolled smaller cigarettes Smoked duty free Other change No change Analysis approach was modelled on: Dunlop et al. (2011).
2012 tax increase (3 rd ) Categories (mutually exclusive, prioritised) Survey responses Before After Smoking-related change Quit* 51.8 58.0 Tried to quit Cut down Product-related change Changed to cheaper type 14.5 13.0 Changed to cheaper brand Rolled smaller cigarettes Smoked duty free Other change Other change 0.8 0.3 No change No change 33.0 28.7 *Quit 1.7% before, and 2.8 after the tax increase
4) Youth smoking and co-morbidity
Smoking prevalence among youth Smoking prevalence among Year 10 students, 2000-2014 ASH Year 10 Snapshot annual, n=30,000 Youth Insights Survey biennial, n=3,000 Jo 6.1% 2.8% Females; Māori Source: Action on Smoking and Health (2015). 2014 Factsheet 1 ASH Year 10 Snapshot Survey: Topline results. Auckland; Action on Smoking and Health
Young people engage in multiple risky behaviours Year 10 students who had smoked tobacco in the past month... % TOTAL 11.4
Young people engage in multiple risky behaviours Year 10 students who had smoked tobacco in the past month... TOTAL 11.4 Tobacco only 2.6 Tobacco + marijuana 1.4 Tobacco + binge drinking 2.2 Tobacco + marijuana + binge drinking 4.7 %
Other areas of work Tobacco sales data (in the TC data repository) Cotinine study (n=700) from the Youth Tobacco Monitor Preliminary analysis shows convergent evidence for self-reported prevalence estimates E-Cigarette focus groups and expanding E-Cigarette questions
Update on the Tobacco Control Data Repository
TCDR Data sources Health and Lifestyles Survey (HLS) New Zealand Cancer Registry (NZCR) and Mortality Collection (MORT) New Zealand Census New Zealand Health Survey (NZHS) New Zealand Smoking Monitor (NZSM) Quitline data Sales data Smoking Cessation Services (MoH) Year 10 Snapshot (ASH) Youth Insights Survey (YIS)
HLS Ever smoked tobacco
Cancer Registration and Mortality
Census - smoking status
http://www.tcdata.org.nz/census%20data/census_14.aspx
Current Status In the last year: 5802 users 6900 sessions 30% in NZ 1:07min average duration Business case in progress to MoH for ongoing maintenance and development
Thank you Greg Martin g.martin@hpa.org.nz