STACK. Smoke-Free Environments
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STACK. Smoke-free Environments Act (Part II), 1990: Student Smoking Status and Retailers Perceptions Ray Kirk Nicolette Edgar O92O8 WA 754 KIR Health Research and Analytical Services - IQQ?. Ministry of Health STACK - MOH Library I I1IlIMI ll I 99208M Copyright No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, photocopying or otherwise, without the prior written permission of the Ministry of Health. Disclaimer This report was prepared by Ray Kirk and Nicolette Edgar of Health Research and Analytical Services, Ministry of Health for the Public Health Services section of the Ministry of Health. Its purpose is to inform discussion and assist future policy development. Therefore, the opinions expressed in the report do not necessarily reflect the official views of the Ministry of Health. This is an internal report not intended for wide distribution outside the Ministry of Health. As such it has not been reviewed outside the Ministry of Health. Information Centre. Ministry of Health Wellington U Acknowledgements U U We would like to thank the students and retailers who participated in the surveys for their valuable replies. Also, we are grateful to the retailers who provided candid and constructive comments about the services and support they would like to receive from U the Ministry of Health. ci Bob Halliday undertook the detailed and extremely thorough statistical analyses of the student smoking survey. We are particularly grateful for his contribution to this report. U We are very grateful to Helen Leonard and Marie OConnell who entered the questionnaire responses onto a paradox database. U Maureen Parkyn provided helpful secretarial and editorial assistance. ci We appreciate the valuable assistance and support provided by the Health Research and Analytical staff, especially Penny Brander. ci U U ci ci U ci ci U U ci 11 ci Table of Contents Chapter 1 Introduction ........................................................................ 1 1.1 Introduction ........................................................................1 1.2 What this report covers...........................................................4 1.3 Aims and purposes of the research..............................................4 Chapter 2 Review of Literature on Adolescent ........................................... 5 2.1 Introduction ........................................................................ 5 2.2 Aims of the literature review .....................................................6 2.3 Literature review methods .......................................................7 2.4 Health and tobacco use ...........................................................7 2.4.1 Health risks for tobacco users..........................................7 2.4.2 Health risks, tobacco use, and gender/ethnicity.....................7 2.4.3 Health risks for the unborn child and the passive smoker .........8 2.4.4 Financial costs versus financial gains .................................8 2.4.5 Conclusions...............................................................9 2.5 Smoking prevalence - International literature ...............................10 2.5.1 Smoking prevalence amongst U.S. adults..........................10 2.5.2 Trends in smoking prevalence amongst adolescents ..............10 2.5.2.1 U.S. ............................................................ 10 2.5.2.2 Australia.......................................................14 2.5.3 Gender differences in smoking trends ..............................15 2.5.3.1 U.S. ............................................................ 15 2.5.3.2 Australia.......................................................16 2.5.3.3 Great Britain ..................................................16 2.5.4 Ethnic differences in smoking trends ...............................16 2.5.4.1 U.S. ............................................................ 16 2.5.4.2 Australia.......................................................17 2.5.5 Conclusions.............................................................20 2.6 Smoking prevalence - New Zealand..........................................21 2.6.1 Historical Background.................................................21 2.6.2 Smoking prevalence amongst New Zealand adults................21 2.6.2.1 In general.......................................................21 2.6.2.2 Gender differences ...........................................22 26.23 Ethnic differences ...............................................23 2.6.2.4 Demographic differences....................................24 2.6.3 Smoking prevalence amongst New Zealand adolescents .........25 2.6.4 Gender differences......................................................28 2.6.5 Ethnic differences......................................................28 2.6.6 Conclusions.............................................................32 ii 11 2.7 Why do young adults initiate and maintain smoking . behaviours) .............................................................33 II 2.7.1 Correlates of adolescent smoking behaviour.......................33 II 2.7.1.1 Peer group smoking behaviour. ............................ 33 2.7.1.2 Family smoking behaviour ...... ............................ 35 2.7.1.3 Knowledge and attitudes about smoking................... 37 2.7.1.4 Demographics .................................................. 39 H 2.7.1.5 School related factors........................................41 2.7.1.6 Personal factors...............................................42 2.7.1.7 Advertising.................................................... 45 II 2.7.1.8 Availability ..................................................... 46 2.7.2 Conclusions..............................................................46 II 2.8 Smoking prevention - International and New Zealand.....................48 2.9 School based educational programmes .......................................49 II 2.9.1 Smoking prevention programmes - historical background .......49 2.9.2 Efficacy of school based smoking prevention programmes......50 2.9.3 Smoking cessation programmes - historical background.........53 H 2.9.4 Efficacy of school based smoking cessation programmes........54 2.9.5 Suggestions for more effective school based educational strategies and policies ............................................ 55 II 2.9.6 Conclusions.............................................................59 2.10 Media campaigns...............................................................60 II 2.10.1 Are mass media interventions effective) ..........................60 2.10.2 Future media campaigns.............................................62 2.10.3 Conclusions ...........................................................64 ii 2.11 Restricting access to tobacco .................................................65 2.11.1 How easily can minors obtain tobacco? ........................... 66 II 2.11.1.1 Direct estimates ..............................................66 2.11.1.2 Self-report estimates........................................67 II 2.11.2 Interventions to increase the effectiveness of legislation........68 2.11.3 Suggestions for ways to make future II legislation more effective.......................................70 2.11.4 Conclusions ...........................................................71 2.12 Taxation of tobacco............................................................72 11 2.12.1. The higher the taxation, the lower the tobacco consumption......................................................72 2.12.2 Taxation as part of a multiple intervention strategy............. 73 2.12.3 Other taxation strategies ..........................................73 2.12.4 Killing the golden goose) ...........................................74 II 2.12.5 Conclusions ...........................................................74 II II IV 11 2.13 Banning cigarette advertising . 75 2.13.1 Tobacco advertising - market share or total sales................76 2.13.1.1 Evidence to support the total sales argument ...........76 2.13.1.2 Evidence to support the market share argument........77 2.13.2 Adolescents - the market target? ...................................78 2.13.3 Females and Maori - market targets"..............................80 2.13.4 Conclusion - to ban or not to ban? ................................. 81 2.13.4.1 Television/radio advertising...............................83 2.13.4.2 Written advertising .........................................83 2.13.4.3 Tobacco product packaging ...............................84 2.13.4.4 Tobacco company sponsorship............................ 85 2.13.4.5 Other .......................................................... 85 2.14 Limitations on where smoking is allowed..................................86 2.14.1 Conclusions ............................................................86 2.15 Multiple level interventions ..................................................87 2.15.1 Conclusions ............................................................91 Chapter 3 Smoking survey of 12-17 year old school...................................93 3.1 Introduction ......................................................................93 3.2 Aims...............................................................................94 3.3 Methods...........................................................................94 3.3.1 Ethnic representation in the sample .................................94