Progress to Smokefree 2025HEATHER GIFFORD AND ZOE HAWKE

THE 19TH PUBLIC HEALTH SUMMER SCHOOL 2-20 FEBRUARY 2015

Daily Smokers – Maori aged 15+

2006 2007 2008 2009 2010 2011 2012 2013 20145

10

15

20

25

30

35

40

45

CensusNZHS (U)HLS

1

Regular Smoking by ethnicity, 14-15 year olds (daily, weekly or

monthly)

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

0

5

10

15

20

25

30

35

40

45

50

NZ EuroMaoriPacificAsian

2

Key messages

Gradient for all Māori smoking is in the right direction but its slow

Significant drop in Māori youth smoking but do we understand why

Disparities remain when compared with others Discrepancy in the data depending on what

you look at eg Census vs NZ Health Lifestyle Survey – what figure do we use to convey the public message ?

Projections from modelling suggest that with BAU Māori smoking rates in 2025 will still be almost 20%

3

Challenges

Tupeka Kore Māori kaupapa arising out of Māori Affairs Select Committee Report

Since then loss of multiple Māori leadership Confusion over the strategy for really

achieving 2025 Māori smoking implicated in broader social

and economic reality for many whānau making it even more challenging

Competing priorities for Māori Not enough resource or political will to turn

the goal into a reality

4

What’s the goal?

Abstinence or harm minimization? Not really that clear:

“…reducing smoking prevalence and tobacco availability to minimal levels, thereby making New Zealand essentially a smoke-free nation by 2025.” (Govt response to Māori Select Committee report)

5

Options we are thinking about

Traditional’ abstinence framework

No ‘safe’ level of tobacco use, No alternatives?

Aligned to Māori aspirations; Addiction not part of culture

• Harm minimisation (of nicotine use)

New technologies possible to actually minimize harm

7

8Options How do we achieve the goal?

First we need to build political support Demand reduction, supply reduction,

or both? At present operating BAU

More demand than supply reduction Strong focus on cessation This will NOT get us to 2025,

particularly for Māori

9TAHO STRATEGY

Te K

aw

a -

Key I

nfl

uen

cers

th

at

help

ed

us a

ch

ieve

the g

oalMāori leadership has engaged

communities on tobacco control strategiesClear, simple kaupapa, focused and strength - based messaging has helped to get communities on boardThere is a united vision across organisations and communities based on tikanga & tobacco not being part of who we are

Leg

isla

tion

& R

eg

ula

tion

, C

essati

on

, P

ub

lic S

up

port Government is fully committed

to 2025Government supports no commercial tobacco salesMāori leaders have influenced the supply of tobacco and are celebrating changeIndigenous cessation models/research have been promoted and are well knownWhānau are quitting through public support gainedThere is an overwhelming appetite for changeThe Māori workforce is unitedWhole communities are selling our message; everyone believes in the story of a smoke free AotearoaSmoking is in our past

2020 GOAL / VISIONWHĀNAU ARE SMOKE FREE | TOBACCO IS NOT OUR TIKANGA

10HOW WE GET TO 2020PATHWAY TO 2020 GOAL/VISION

Putting path finding

policies into place

Communicating with

and mobilising

communities

Collective community

action

2020 Goal/VisionWhānau are smoke free

Tobacco is not our tikanga

Work Streams

11Lows Year One The urgency of the task, wanting to do so much more

but with very limited resources The reality that those with the resources don’t always

understand the complexities of Māori realities and the need for stepping out of the BAU model.

Ideas about Māori leadership being a single person/group model – a contradiction to Māori models of leadership & wellbeing.

Being the constant squeeky wheel challenging the BAU can be wairua draining.

Lack Of Māori champions/ political champions Lack of unity, competitive theme, tension BAU v’s BNU Political neutrality clauses

12Highs Year One

Advisory Board support Having a clear TAHO strategy that really is all

about building political support through Māori community action

Organisations serious about reducing inequalities Having some of the squeeky wheel kōrero

seeping into the sector. A shift in practice. A decrease in Māori smoking rates Relationships with other Māori in the sector National Māori smokefree working group Growing unity Growing Māori community voices

13What we need going forward

Political support built from the ground up Māori need to be part of the process

Local community action – national focus Supporting and building leadership

Urgent need for action Innovative ideas Research keeping pace

Agree on overarching goal and strategy Best allocation of resources Depends on working together