Judy Li

A new national smokefree law increased calls to a national quitline

BackgroundA law making all indoor workplaces including bars and restaurants smokefree became operational in New Zealand in December 2004. New Zealand has a national free-phone Quitline Service which has been operational since 1999. Previous work has shown that the number of calls to the Quitline are influenced by marketing of the service through media campaigns. We set out to investigate if the smokefree law increased calls to the Quitline.MethodsFor 24 months prior to the law, and 12 months after the law, data were collected on: (i) Quitline caller registrations and the issuing of nicotine replacement therapy (NRT) vouchers by the Quitline Service; (ii) expenditure on Quitline-related television advertising; (iii) expenditure on other smokefree television advertising; and (iv) print media coverage of smoking in major New Zealand newspapers. These data were inputs to a time series analysis using a Box-Jenkins transfer function model. This used the law change as the intervention variable, with the response series being the monthly Quitline caller rates and monthly first time NRT voucher issue rates.ResultsThe monthly rates of Quitline caller registrations and NRT voucher issues were observed to increase in the months after the law change. The increase in both these outcomes was even greater when considered in terms of per level of Quitline advertising expenditure (though these patterns may have partly reflected marked reductions in advertising expenditure at the time of the law change and hence are of limited validity).In the more robust time series analyses, the law change (intervention variable) had a significant effect (p = 0.025) on increasing the monthly caller registration rate in December 2004. This was after adjusting for the possible effects of Quitline advertising expenditure, print media coverage, and other smoking-related advertising expenditure.ConclusionThe new national smokefree law resulted in increased quitting-related behaviour. This would suggest there is an extra opportunity for health agencies to promote quitting at such times.

Use of a national quitline and variation in use by smoker characteristics: ITC Project New Zealand.

INTRODUCTION We aimed to describe use of a national quitline service and the variation in its use by smoker characteristics (particularly ethnicity and deprivation). The setting was New Zealand (NZ), which takes proactive measures to attract disadvantaged smokers to this service. METHODS The NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project) utilizes the New Zealand Health Survey (a national sample) from which we surveyed adult smokers in two waves (N = 1,376 and N = 923) 1 year apart. RESULTS Quitline use in the last 12 months rose from 8.1% (95% CI = 6.3%-9.8%) in Wave 1 to 11.2% (95% CI = 8.4%-14.0%) at Wave 2. Māori (the indigenous people of NZ) were significantly more likely to call the Quitline than were European/other smokers. Relatively higher call rates also occurred among those reporting higher deprivation, financial stress, a past mental health disorder, a past drug-related disorder, and higher psychological distress (Kessler 10-item index). Independent associations in the multivariate analyses of Quitline use were being Māori, reporting financial stress, and ever having been diagnosed with a mental health disorder. DISCUSSION This national Quitline service is successfully stimulating disproportionately more calls by Māori smokers and those with some measures of disadvantage. It may therefore be contributing to reducing health inequalities. It appears possible to target quitlines to reach those smokers in greatest need.

The use of, and attitudes towards, electronic cigarettes and self‐reported exposure to advertising and the product in general

Objective: Very few studies have investigated New Zealanders’ use of, and attitudes towards, e‐cigarettes, their exposure to e‐cigarette advertising and their general exposure to this product. The current study aims to fill this information gap.

Smokers' behavioural responses before and after the 2012 tobacco excise increase

The New Zealand tobacco tax has been increased annually since 2010, and this paper determines the short-term impacts of the 2012 tax increase. We analysed two separate sets of telephone surveys of current smokers and recent quitters conducted over a six-month period (three months before and three months after the tax increase), and compared the level of behaviour change before and after the tax increase. We found that the 14.5% increase in tobacco excise had an impact on smokers. From both surveys, we saw an increase in smoking-related behavioural change (quit/tried to quit/cut down). However, the rate of change was different by ethnicity and past three-month quit attempt status. Specifically, non-Māori and those who have made a recent quit attempt had increased likelihood of reporting a smoking-related change. Despite being a major priority target group in tobacco control, Māori smokers were not benefited by the 2012 increase in tax excise.

The immediate and long-term changes in support of tobacco display ban after its implementation in New Zealand

Four recent studies, two with particularly strong methodology, have assessed post-implementation support for tobacco display bans.1–4 The first found generally high support but no difference between Canadian smokers who lived in provinces that had or had not implemented a ban.1 In Norway, public support remained the same 1 year post-implementation as before the ban (29–32% of daily and 49–58% of occasional smokers).3 Our study assessed the immediate and long-term changes in support among smokers and recent quitters in New Zealand following implementation of a display ban on 28 July 2012. We assessed support for this ban immediately before (May–July 2012—Time 1), immediately after (August–October 2012—Time 2) and 1 year after the ban (July–September 2013—Time 3). The New Zealand Smoking Monitor is a fortnightly telephone-based survey (n=120), and recruits respondents from an omnibus that has a representative adult sample. Respondents are maintained on a panel and interviewed up to six times. Those who drop out from the sample either …

The Lingering Effects of Tobacco Control Advertising The Phenomenon and Its Implications in Social Marketing

In commercial market research, “pulsing” advertising is found to be more cost-effective than placing advertisements continuously. However, the benefits of pulsing policy in social marketing have rarely been tested. This study explores the lingering effect of tobacco control advertising. If the effects of tobacco control advertisements linger beyond the time they are on-air, this would provide a theoretical basis for using pulsing policy in tobacco control campaigns. This study analyzed responses from two independent samples of smokers and recent quitters, where respondents reported whether they were exposed to any tobacco control advertising in the last week. Sample 1 was cross-sectional (n = 3,106), and Sample 2 followed a self-refreshed panel methodology where 846 participants were interviewed for up to 6 times (3,120 interviews). Both studies used the same survey instrument and were in field concurrently. Eighty percent of Sample 1 reported recent exposure to advertising. This was strikingly similar to the response from Sample 2 recorded at their first interview (81%). However, panel members’ self-reported exposure to campaigns decreased at each subsequent interview (approximately a fortnight apart) and eventually reached 56% at the sixth interview. Building on the premises of priming theory, the first response from each Sample 2 respondent represented his or her intuitive thought—a result of the lingering effect of advertising. The drop in recall over time could be due to respondents self-correcting their responses after being primed in the previous surveys. Our findings suggest the effects of tobacco control campaigns linger and support the use of pulsing policy in tobacco control advertising.

An annual pre-announced step-increase in tobacco excise in New Zealand

New Zealand is implementing a policy of pre-announced 10 per cent annual increases in tobacco excise for 7 years (from 2010 to 2016). Internationally, little is known about smokers’ receptiveness to persistent step-increases in tobacco excise. This article reports on data collected in 2013 (600 interviews in total). The New Zealand Smoking Monitor is a fortnightly survey of smokers and recent quitters; respondents are maintained on a panel and interviewed up to six times. We found that, one-quarter of respondents supported continuing with a 10 per cent annual increase. Eight in ten were aware that a pack of cigarettes will cost US

Does prior contact with police reduce the likelihood of suicide? Examining the predictive ability of different incident types and the interaction effects

16.50 in 3 years, and six in ten believed knowing the future cost of cigarettes gave them a strong reason to stop smoking now. While most respondents did not want the annual excise increase to continue, how they perceived the impact of persistent excise increases suggests this policy has the potential to increase quit attempts.

Stages of physical dependence in New Zealand smokers: Prevalence and correlates☆

This study explores the relationship between prior contact with the police as a victim or person at risk and death by suicide. Findings from this study will improve our understanding of the role the police can have in preventing suicide. The sample comprised working age men who died suddenly in New Zealand during 2007–2011. Univariate and multivariate logistic regression models were used to assess the ability of age, ethnicity and prior police contact to predict whether the death was from suicide (n = 1140) or other causes (n = 7236). The analysis focused on prior police contact relating to: (1) threatened/attempted suicide, (2) domestic disputes and (3) potential mental health issues. Age, ethnicity and the three prior police contact types all independently predicted suicide. After controlling for demographic variables, prior police contact remained a predictor, with those relating to threatened/attempted suicide having the strongest predictive ability (Adjusted odds ratio [AOR] = 6.05, 4.75–7.70). Importantly, interaction effects were found between prior police contact types. The predictive ability of contact relating to threatened/attempted suicide reduced significantly if the person also had prior contact relating to a domestic dispute or potential mental health issue. Consistent with previous research, the main effects reported in this study suggest that the police have a role in suicide prevention. This study also makes a novel contribution by exploring the interaction effects between types of prior contact. Future research may investigate the interaction effects in more depth to reveal the contributing factors that reduce the odds of suicide.

Tripling use of electronic cigarettes among New Zealand adolescents between 2012 and 2014.

BACKGROUND Physically dependent smokers experience symptoms of wanting, craving or needing to smoke when too much time has passed since the last cigarette. There is interest in whether wanting, craving and needing represent variations in the intensity of a single physiological parameter or whether multiple physiological processes may be involved in the developmental progression of physical dependence. AIM Our aim was to determine how a population of cigarette smokers is distributed across the wanting, craving and needing stages of physical dependence. METHODS A nationwide survey of 2594 New Zealanders aged 15years and over was conducted in 2014. The stage of physical dependence was assessed using the Levels of Physical Dependence measure. Ordinal logistic regression analysis was used to assess relations between physical dependence and other variables. RESULTS Among 590 current smokers (weighted 16.2% of the sample), 22.3% had no physical dependence, 23.5% were in the Wanting stage, 14.4% in the Craving stage, and 39.8% in the Needing stage. The stage of physical dependence was predicted by daily cigarette consumption, and the time to first cigarette, but not by age, gender, ethnicity or socioeconomic status. CONCLUSION Fewer individuals were in the craving stage than either the wanting or needing stages. The resulting inverted U-shaped curve with concentrations at either extreme is difficult to explain as a variation of a single biological parameter. The data support an interpretation that progression through the stages of wanting, craving and needing may involve more than one physiological process. WHAT THIS RESEARCH ADDS Physical dependence to tobacco develops through a characteristic sequence of wanting, craving and needing which correspond to changes in addiction pathways in the brain. It is important to neuroscience research to determine if the development of physical dependence involves changes in a single brain process, or multiple processes. Our data suggests that more than one physiologic process is involved in the progression of physical dependence.