16th December 2016, Volume 129 Number 1447

Danny Tu, Rhiannon Newcombe, Richard Edwards, Darren Walton

Tobacco smoking remains a major preventable cause of mortality and morbidity in New Zealand.1 One component of a comprehensive tobacco control programme is robust monitoring of tobacco use at a population level to determine the priority populations to target with interventions, monitor progress and assess the impact of tobacco control efforts.2 The importance of monitoring has also been underscored through the Framework Convention on Tobacco Control.

In 2011 the New Zealand government adopted a goal of reducing the prevalence of smoking and the availability of tobacco products to minimal levels by 2025.3 The goal is commonly interpreted as meaning that the smoking prevalence will fall below 5%.4 In this context, it is particularly important to have a robust method for tracking smoking prevalence in the population as a whole and within key demographic sub-groups.

Currently, information on smoking prevalence in New Zealand comes from a variety of sources, including nationally representative surveys such as the Ministry of Health’s New Zealand Health Survey (NZHS) and the Health Promotion Agency’s Health and Lifestyles Survey (HLS). Recent results from these surveys suggest that the prevalence of tobacco use is declining, however, large disparities in smoking by ethnicity remain with less pronounced declines in smoking among high prevalence groups such as Māori.5 In New Zealand, a further monitoring mechanism is the national census, which uniquely includes questions on smoking status.

This paper reports on smoking data from the New Zealand Census of Population and Dwellings (the Census). The Census achieves 97.6% coverage of New Zealanders and so provides an important source of information to understand the impact of the tobacco control programme.6 This paper reports in detail on the latest census data in 2013, and makes selected comparisons with data from the 2006 Census to estimate recent changes in prevalence.

Method

The Census, conducted by Statistics New Zealand, is the official count of how many people and dwellings there are on census night in New Zealand. The Census has been conducted every five years since 1877, with only four exceptions. The most recent Census was not held as scheduled in March 2011 due to the disruption caused by the Christchurch earthquakes on 22 February 2011.7 Instead it was delayed until 5 March 2013.

Everyone in New Zealand on census night is required to complete a census form under the Statistics Act 1975.8 Two census forms are hand-delivered by the collectors prior to the census night, a dwelling form and an individual form for everyone who will be in the dwelling on census night. Collectors attempt to cover all dwellings including private and non-private dwellings, ie hotels, prisons, hospitals, camp grounds and cruise ships. Foreigners who are in New Zealand on census night are counted in the census. New Zealand residents who are overseas on census night are not included in the census. The data reported in this paper is for the ‘usually resident’ population and excludes foreign visitors.

The Census aims to cover the entire population of New Zealand, so it is not subject to sampling error. However, it may be subject to non-sampling error, which includes undercounts, respondent errors, collection and processing errors. Statistics NZ has made every effort to reduce each of these error types.Two questions were asked in the 2006 and 2013 Censuses to determine smoking status: “Do you smoke cigarettes regularly? (that is, one or more a day)” and “Have you ever been a regular smoker of one or more cigarettes a day?” The definition of a regular smoker is someone who smokes cigarettes regularly (ie one or more cigarettes a day) currently. An ex-smoker is defined as someone who used to smoke regularly, but no longer does now. The definition for ‘never smoked regularly’ were people who had never been regular smokers. Smoking of pipes, cigars and cigarillos, other smoked substances such as marijuana and tobacco used for chewing were not included in these definitions.

Prevalence estimates were calculated for regular smokers, ex regular smokers and people who have never smoked regularly. People not answering one or both smoking questions were excluded from the analysis. Crude prevalence estimates were calculated by gender, age groups, ethnicity and categories of education level, employment status and income. Age standardised estimates using the direct method were calculated by gender, ethnic groups and area-based socioeconomic deprivation levels using the WHO World Standard Population.10 Crude prevalence estimates are provided for the 2013 data, and age standardised prevalence figures are provided when comparing data from 2006 and 2013.

Ethnic group

Ethnicity was derived using the total response method, which involved each participant in the Census being allocated to all ethnic groups that they identified with. This means that if a person identifies as being Māori and Chinese, they are classified as both Māori and Asian in the analysis.11 Those people who gave no response and responses that could not be classified or did not provide the type of information asked for to the Census ethnic group question were coded as “Not elsewhere included”. 5.5% of the subject population was coded to “Not elsewhere included” in the 2013 census ethnic group variable.12 It was called “Not Specified” in this study.

Neighbourhood socioeconomic deprivation

The New Zealand Index of Socioeconomic Deprivation 2013 (NZDep2013) was used as a measure of neighbourhood socioeconomic deprivation and a proxy for individual socioeconomic position. NZDep2013 is an area-based index of deprivation that measures the level of socioeconomic deprivation for each neighbourhood (meshblock). It was created using nine variables from the 2013 Census: income, benefit receipt, transport (access to car), household crowding, home ownership, employment status, qualifications, support (sole-parent families) and communication (access to internet).13 This study presents results by NZDep 2013 deciles 1 to 10, with each decile containing 10% of small areas in New Zealand. Decile 1 represents people living in the least deprived 10% of areas, and decile 10 represents people living in the most deprived 10% of areas in New Zealand.

Non-response

The Census contains three types of non-responses relevant to this study. Firstly, there are national net undercounts. These are estimates of the number of people missed by the Census based on findings of a post-enumeration survey.6 Secondly, some people were included in the Census as substitute records with a limited range of imputed variables (not including smoking status) from either households, which were identified but where no census forms were received or for individuals where there was evidence that they existed but no form was completed. Thirdly, there were individuals who took part in the Census but did not complete the smoking questions or did not complete them adequately.8 Categories two and three are described as ‘not elsewhere included’ and was 8.6% of the estimated adult resident population in 2006 and 9.3% in 2013 (Table 1). The net undercount of adults estimate was 2.1% in 2006 and 2.3% in 2013.13 Prevalence calculations in this paper use adults included in the Census with a valid smoking status as the denominator.

Table 1: New Zealand Census 2006 and 2013 estimates of usually resident adult population, response and numbers stratified by smoking status.

 

2006

2013

Change 2013–2006

Estimated adult (≥15 years) usually resident population

3,160,371

3,376,419

216,048

Total adults with Census smoking status

2,889,009

3,065,823

176,814

 Not elsewhere included (%)

271,362 (8.6)

310,593 (9.2)

39,231

 Regular smoker (%)

597,792 (20.7)

463,194 (15.1)

134,598

 Ex-smoker (%)

637,293 (22.1)

702,015 (22.9)

64,722

 Never smoked regularly (%)

1,653,924 (57.2)

1,900,617 (62.0)

246,693

Results

Smoking prevalence by age and gender in 2013

In 2013, the crude prevalence of regular smokers aged 15 years and over in New Zealand was 15.1% (see Table 1). Smoking prevalence was higher in men (16.4%) than women (13.9%), and male smoking prevalence was higher than female prevalence in every age group (Table 2). Smoking prevalence peaked in the 25–29 year-old age group for men and 20–24 year-old group for women, and then declined progressively with age, more quickly from 55–59 years onwards. The greatest increase in smoking prevalence across the age groups was between 15–19 and 20–24 years in men and women.

Table 2: Crude prevalence of regular smokers, ex-smokers and never regular smokers, 2013 Census—by gender and age group.

Age group

(years)

Regular smoker

Ex regular smoker

Never smoked regularly

Male (%)

Female (%)

Total (%)

Male (%)

Female (%)

Total (%)

Male (%)

Female (%)

Total (%)

15–19

11.1

9.7

10.4

2.6

3.0

2.8

86.3

87.3

86.8

20–24

22.9

19.8

21.4

9.1

10.5

9.8

68.0

69.7

68.9

25–29

24.4

19.3

21.7

15.5

17.0

16.3

60.1

63.7

62.0

30–34

22.1

16.8

19.3

19.9

21.2

20.6

57.9

62.1

60.1

35–39

20.0

15.9

17.8

21.4

22.7

22.1

58.6

61.4

60.1

40–44

19.6

16.8

18.1

22.4

23.6

23.0

57.9

59.7

58.9

45–49

18.5

16.6

17.5

24.1

23.3

23.7

57.4

60.1

58.8

50–54

17.5

16.5

17.0

27.3

25.4

26.3

55.2

58.0

56.7

55–59

15.3

13.8

14.5

31.5

26.8

29.0

53.2

59.5

56.4

60–64

12.2

11.2

11.7

35.2

27.6

31.3

52.6

61.2

57.0

65–69

10.3

9.4

9.8

40.7

29.9

35.2

49.1

60.6

55.0

70–74

7.4

6.7

7.0

43.6

27.8

35.4

49.1

65.5

57.6

75–79

5.0

4.8

4.9

45.5

25.7

34.9

49.6

69.4

60.2

80–84

3.6

3.4

3.5

48.6

24.7

35.2

47.8

71.9

61.3

85+

2.5

2.0

2.2

50.5

21.0

31.6

47.0

77.0

66.2

Total

16.4

13.9

15.1

24.6

21.3

22.9

59.0

64.7

62.0 


In 2013, the crude l prevalence of ex-regular smokers in New Zealand was 22.9%. Ex-regular smoking prevalence increased steadily across the age groups for males, and increased to a peak in the 65–69 year-old age group for females and then declined. Ex-smoker prevalence was higher among males, particularly in the older age groups. The prevalence of ‘Never smoked regularly’ was 62.0%, and was most common in the youngest age group. It was also more common in women compared to men—particularly among the older age groups.

Ethnicity

Among the major New Zealand ethnic groups, around one-third (32.7%) of Māori were regular smokers, followed by Pacific (23.2%), European (13.9%), ‘Other’ (14.4%) and Asian (7.6%) ethnic groups (see Table 3). Smoking prevalence peaked at 20–24 or 25–29 years for almost all ethnic groups, with extremely high prevalence among young adult Māori (eg over 40% among Māori women aged 20–34 years and Māori men aged 25–29 years). Smoking prevalence declined after 25–29 years among Māori men, but remained high for older Māori women (eg around 40% among Māori women aged 35–54 years). Smoking prevalence was similar for men and women among European, Māori and Pacific ethnic groups, but was much higher among men for Asian and Middle-Eastern/Latin and American/African ethnic groups.

Table 3: Smoking prevalence by age, gender and ethnic group, 2013 Census.

c

Table 3: Smoking prevalence by age, gender and ethnic group, 2013 Census (Continued).

 

Middle Eastern/Latin
American/African

Other ethnicity*

Ethnicity not specified 

Age group
(years)

Male
(%)

Female
(%)

Total
(%)

Male
(%)

Female
(%)

Total
(%)

Male
(%)

Female
(%)

Total
(%)

15–19

6.5

3.4

5.0

9.0

5.4

7.6

18.4

13.4

16.5

20–24

17.2

7.7

12.7

20.4

15.5

18.5

28.1

22.2

26.1

25–29

19.8

8.4

14.0

22.0

16.3

19.8

29.1

19.3

25.0

30–34

16.9

6.4

11.5

21.7

18.3

20.4

24.3

17.5

21.5

35–39

16.7

5.9

11.1

19.3

16.9

18.3

27.7

15.1

22.4

40–44

17.0

5.0

11.3

18.2

17.4

17.9

26.7

21.4

24.2

45–49

17.5

8.3

13.1

16.6

16.4

16.5

20.4

18.5

19.7

50–54

17.8

9.0

13.4

14.3

15.9

15.1

20.8

14.6

18.5

55–59

15.7

8.0

11.7

13.2

13.6

13.3

17.4

19.5

18.3

60–64

11.9

7.2

9.8

8.3

9.6

8.9

14.1

12.6

13.4

65–69

9.0

5.4

6.7

5.7

9.7

7.3

10.2

11.5

11.1

70–74

6.5

4.8

5.6

3.3

5.6

4.2

7.9

6.3

7.1

75–79

2.8

2.5

2.7

4.4

4.6

4.2

9.9

6.8

8.2

80–84

9.1

3.6

3.9

2.2

5.6

3.9

2.9

5.1

4.1

85+

7.1

0.0

2.7

2.4

0.0

0.8

3.9

2.6

3.1

15+

15.7

6.7

11.2

14.8

13.8

14.4

19.5

13.8

17.0

Age-standardised rate

14.7

6.5

10.6

15.5

13.7

14.8

21.8

16.5

19.7

*Other Ethnicity category includes the response of “New Zealander”. 

Educational level

Smoking varied greatly by level of education (Table 4) with people with a higher qualification much less likely to smoke and those with no qualifications more likely to smoke among all ethnic groups. Smoking prevalence for those people with no qualification were more than four times higher than those people with bachelor degree and level 7 or higher qualification (23.9% vs. 5.5%).

Table 4: Crude smoking prevalence by gender, ethnic group, education status, workforce and labour status and personal income, 2013 Census.

c 

*The purposes of the certificate levels are to qualify individuals with: level 1—basic knowledge and skills for work, further learning and/or community involvement; level 2—introductory knowledge and skills for a field(s)/areas of work or study; level 3—knowledge and skills for a specific role(s) within fields/areas of work and/or preparation for further study.14
**The purposes of the certificate levels are to qualify individuals with: level 4—to work or study in broad or specialised field(s)/areas; level 5—theoretical and/or technical knowledge and skills within an aspect(s) of a specific field of work or study; level 6—theoretical and/or technical knowledge and skills within an aspect(s) of a specialised/strategic context.14
***Not in the labour force includes people who are in the working-age population (people aged 15 years and over), but are neither employed nor unemployed. For example, retired people; people with personal or family responsibilities, such as unpaid housework and childcare; people permanently unable to work due to physical or mental disabilities; people who are not actively seeking work.15

Workforce, labour status and personal income

Smoking prevalence was markedly higher among people who were unemployed (30.0%) compared with those who worked full-time (15.9%), part-time (12.4%) or who were not in the labour force (12.9%) (Table 4). Smoking prevalence also differed by personal income status. The highest smoking prevalence was among those earning NZ $30,001–$50,000 per year (18.0%) and was lowest among those people earning NZ $100,000 or more per year (5.9%).

Socioeconomic deprivation

There was a strong relationship between smoking and area-based socioeconomic deprivation. The prevalence of regular smoking increased steadily across the deprivation deciles from least deprived (decile 1) to most deprived (decile 10) areas (Figure 1). The crude regular smoking prevalence among people living in the most-deprived (decile 10) areas was more than four times greater than among people living in the least-deprived (decile 1) areas among both males and females.

Figure 1: Crude prevalence of regular smokers by gender, ethnic group and level of deprivation, 2013 Census. 

c 

Changes between 2006 and 2013 Censuses: regular smokers

There were marked changes observed between the 2006 and 2013 Censuses (Table 5). The overall crude prevalence of regular smoking dropped in absolute terms by 5.6% from 20.7% in 2006 to 15.1% in 2013. The number of regular adult smokers dropped from 597,792 in 2006 to 463,194 in 2013, meaning there were 134,598 (22.5%) fewer regular smokers in New Zealand in 2013. Large absolute and relative declines in age-standardised smoking prevalence occurred among both genders in almost all ethnicity groups.

Table 5: Smoking prevalence by gender and ethnic group, 2006 and 2013 Census.

c
There were some variations in the decreases in age-standardised prevalence between 2006 and 2013, with for example, prevalence reducing more in relative terms (28.8% vs 23.5%) and absolutely (6.0% vs 5.4%) in females compared to males. The relative percentage reduction was greater for European (27.8%) compared with Māori (20.2%) and Pacific people (21.0%), while the absolute reduction was greater among Māori (8.2%) compared to European (5.9%) and Pacific people (6.1%) (Table 5). 

Crude and age-standardised smoking prevalence fell among males and females for all ethnic groups between 2006 and 2013 (Table 5). The absolute reductions in age-standardised prevalence among males were similar (4.9%–6.8%) among European/other, Māori, Pacific and Asian ethnic groups. For females there was more variation in the absolute reduction in age-standardised prevalence, ranging from 9.5% among Māori to 1.9% among Asians among the four main ethnic groups.

Figure 2 shows that the decline in smoking prevalence between 2006 and 2013 for males and females were mostly more pronounced among younger age groups for all ethnic groups.

Figure 2: Smoking prevalence by age, gender and ethnic group, 2006 and 2013 Census.

c 

Figure 3 shows that smoking prevalence declined between 2006 and 2013 in all age groups, particularly in younger (less than 30 years) age groups. The greatest absolute (8.4%) and relative declines (44.7%) occurred among 15- to 19-year-olds from 18.8% in 2006 to 10.4% in 2013. The absolute (10.0%) and relative (50.7%) fall was greatest among females in this age group, from 19.7% in 2006 to 9.7% in 2013 (Table 6).

Figure 3: Prevalence of regular smokers, ex-smokers and never regular smokers by age group, 2006 and 2013 Census. 

c 

Table 6: Age-group specific smoking prevalence by gender, 2006 and 2013 Census.

Age group

2006

2013

Male (%)

Female (%)

Male (%)

Female (%)

15–19 Years

17.8

19.7

11.1

9.7

20–24 Years

31.6

28.1

22.9

19.8

25–29 Years

30.9

26.6

24.4

19.3

30–34 Years

28.2

24.3

22.1

16.8

35–39 Years

26.8

23.5

20.0

15.9

40–44 Years

25.1

22.8

19.6

16.8

45–49 Years

23.4

21.8

18.5

16.6

50–54 Years

20.8

19.0

17.5

16.5

55–59 Years

18.3

16.5

15.3

13.8

60–64 Years

16.3

14.2

12.2

11.2

65–69 Years

12.7

10.6

10.3

9.4

70–74 Years

9.3

7.9

7.4

6.7

75–79 Years

7.2

6.2

5.0

4.8

80–84 Years

5.1

4.6

3.6

3.4

85 Years +

3.6

2.8

2.5

2.0

15+ years

21.9

19.5

16.4

13.9

Age-standardised rate

23.0

20.8

17.6

14.8 


Changes ex- and never smokers between 2006 and 2013 Census

Ex-smoker prevalence was similar in both years for most age groups, while never smoking prevalence increased, particularly among younger age groups (Figure 3). In 2013, the overall prevalence of ex-smokers in New Zealand was 22.9%; it was very similar in 2006 (22.1%). However, the proportion of people who had never smoked regularly was 62.0% in 2013, higher than the prevalence in 2006 (57.2%).

Smoking prevalence declined among both genders living in each individual socioeconomic deprivation deciles between the 2006 and 2013 Census. The absolute reduction in the age-standardised prevalence ranged from 4.0% to 6.8%. Similar declines were also found for all major ethnic groups across all deprivation deciles (Figure 4).

Figure 4: Age-standardised smoking prevalence by gender, ethnic group and socioeconomic deprivation, 2006 and 2013 Census. 

c 

Discussion

This paper shows that there has been a decline in smoking prevalence from 20.7% to 15.1% between 2006 and 2013. This represents about 22.5% fewer smokers and an average fall of 0.8% in prevalence per year. The decline was observed across all age groups, genders, ethnicities and socio-economic status groups. The equivalent fall in prevalence between 1996 and 2006 was 3% from 23.7% to 20.7%, an average decline of 0.3% per year.16 However, smoking prevalence remains strongly patterned by age, ethnicity and socio-economic status, with smoking more prevalent among young adults aged 20 to 29 years, Māori and Pacific peoples and lower socio-economic groups.

The prevalence of regular smoking in this study are similar to the findings of the 2013/14 New Zealand Health Survey (NZHS), a nationally representative continuous survey conducted by New Zealand Ministry of Health. Its target population included New Zealand adult population aged 15 and over. The NZHS result showed the daily smoking prevalence was 15.5% (95 CI, 14.7%–16.3%) in 2013. The current smoking (smoke at least monthly) prevalence was 17.2% (95 CI, 16.4%–18.1%). The NZHS also found a significant decrease in daily and current smoking in New Zealand since 2006/07. The daily and monthly smoking prevalence was 18.3% (95 CI, 17.4%–19.2%) and 20.1 (95 CI, 19.1%–21.1%) respectively in 2006/07,17 although the mean annual rate of decline in daily smoking from 2006/7 to 2013/14 based on the NZHS data was lower at between 0.4% and 0.5%.

The decreases in the smoking prevalence of young adults were much greater between 2006 and 2013 than between 1996 and 2006. For example, prevalence among 15–19 year-olds fell (absolute difference) by 8.4% and 20–24 year-olds by 8.5% between 2006–2013. The equivalent figures for 1996–2006 were 2.3% and 2.4%. Similarly, smoking prevalence among Māori fell (absolute difference) by 8.2% from 40.6% to 32.4% between 2006 and 2013, and Pacific people smoking prevalence by 6.1% from 29.1% to 23.0%. Between 1996 and 2006 the absolute decrease in smoking prevalence was only 1.5% among Māori and was not reported for Pacific peoples.16 The findings provide evidence that the decline in smoking prevalence accelerated between 2006 and 2013, and that the decline was occurring in all groups, including priority groups such as young adults and Māori, where smoking prevalence was previously reducing least.

The data also suggest that a substantial proportion of the decline in regular smoking prevalence is due to decreases in smoking initiation as evidenced by the large falls in prevalence among young adults and large increases in never smoking.

Between 2006 and 2013, New Zealand implemented some important tobacco control interventions, including a series of above inflation tax increases on tobacco products from 2010 onwards, legislation changes (eg retail display bans, smokefree prisons) and improved provision of smoking cessation products and services. It is likely that these interventions contributed to the decrease in smoking prevalence.

Our analysis also revealed persisting disparities in smoking prevalence between population sub-groups. For example, although we found Māori smoking prevalence has declined between 2006 and 2013 (from 40.6% to 32.4%), it was still far higher than for other population groups. The findings on trends in Māori smoking prevalence contrast with the data from the recent New Zealand Health Survey (2012/13), which found no significant difference in Māori smoking prevalence between 2006/7 (42.1%, 95% CI: 39.9%–44.3%) and 2013/4 (40.6%, 95% CI: 38.0%–43.2%).5 The findings from the Census data showed that smoking also remained very high among Pacific peoples. The decline in Pacific smoking observed in our Census analysis (29.1% in 2006 to 23% in 2013) was also greater than the non-statistically significant fall reported in the New Zealand Health Survey (from 27.1% (95% CI 23.9–30.6) in 2006/7 to 25.1% (20.6–30.3)) in 2013/14.5 The reasons for these differences are not clear, and have been examined in more depth in a companion paper.18 These findings highlight the need to continue to focus on implementing evidence-based interventions that address Māori and Pacific smoking to ensure the 2025 goal will be reached for all New Zealanders.19 As well as these high prevalence groups, it is worth noting that there are some population sub-groups with very low smoking prevalence, at or close to 5%, which is sometimes interpreted as a key target figure. For example, smoking prevalence was around 3% among Asian females, 5.5% among people with a degree and 6% among females living in the most affluent areas (NZDep decile one). These suggest that there are groups within the population who are already reaching the Smokefree 2025 goal of very low smoking prevalence.

This study found a high smoking prevalence for Māori women, both young adults and middle aged. Māori are disproportionately affected by the negative consequences of tobacco use from conception onwards,20 and tobacco use negatively affects Māori health and development.21 Reasons why Māori women may have a high smoking prevalence compared with other population groups are complex. They include that Māori women are among the most socio-economically deprived groups in New Zealand;22 they often live in environments where smoking is commonplace and entrenched,20 are more likely to be exposed to second-hand smoke and have lower cessation rates. Addressing ethnic inequalities in smoking for Māori women is likely to involve addressing the broader determinants in health (eg, improving income, housing, employment and access to healthcare.23) as well as tobacco control specific measures (policy, regulation, reducing initiation and increasing cessation).

Strengths and limitations

A strength of this study was that as a Census, the sample size is extremely large and the data are likely to be highly representative of the New Zealand population. Further, this study includes comparable data from two Censuses, using the same methodology, definitions and classifications. The level of non-response was similar in 2006 and 2013, so the changes in smoking prevalence are unlikely to have been greatly affected by differences in smoking among non-responders.

This study has a number of limitations. The first involves the definition of smoking status. The Census defines a regular smoker as someone who smokes cigarettes regularly (ie one or more cigarettes a day), so regular smoking approximates daily smoking. This will underestimate the prevalence of smoking in the population as it excludes non-daily and occasional smokers, and does not allow patterns of non-daily and occasional smoking to be described—in contrast to national surveys like the New Zealand Health Survey. Another limitation is that the estimates of smoker numbers are calculated from among the Census responders and do not include smokers among those classified as ‘Not elsewhere included’. Hence, these numbers will be an under-estimate.

Conclusion

This study suggest that the recent decline in smoking prevalence is accelerating in New Zealand, including among high priority groups like Māori, Pacific peoples and young adults. These findings are promising, as evidence of progress towards the goal of a smokefree New Zealand by 2025. However, the findings of substantial decreases in smoking prevalence among Māori and Pacific peoples between 2006 and 2013 contrast with those in the New Zealand Health Survey. The study confirms the importance and value of Census data in understanding the patterns of tobacco use in New Zealand. Access to accurate and reliable data aids the activities of those in the tobacco control sector to ensure effective tobacco control programmes are implemented. The data are particularly important for investigating smoking prevalence and trends, and progress towards the Smokefree 2025 goal in population sub-groups where this is not possible with reasonable statistical precision in general population surveys due to small numbers within the groups.

Summary

In this study we described the smoking prevalence by key socio-demographic characteristics (age, gender, ethnicity, education, labour status, income and socioeconomic deprivation) in New Zealand in 2013, and make comparisons with 2006. Data on cigarette smoking and key socio-demographics variables were obtained from the 2013 New Zealand Census of Population and Dwellings. The findings suggest that the decline in smoking prevalence is accelerating in New Zealand, including among high priority groups like Māori, Pacific peoples and young adults.

Abstract

Aim

To describe the smoking prevalence by key socio-demographic characteristics (age, gender, ethnicity, education, labour status, income and socioeconomic deprivation) in New Zealand in 2013 and make comparisons with 2006.

Method

Data on cigarette smoking and key socio-demographics variables were obtained from the 2013 New Zealand Census of Population and Dwellings. Age standardised smoking prevalence rates were calculated by gender, ethnicity and socioeconomic deprivation using the WHO Population Standard. Results were compared against 2006 Census data to identify changes in smoking prevalence.

Results

In 2013, around one in seven (15.1%) of New Zealand adults aged 15 years and older reported that they were regular smokers (smoked one or more cigarettes per day), a 5.6% absolute decrease in the smoking prevalence since the previous Census in 2006. The number of regular adult smokers dropped from 597,792 in 2006 to 463,194 in 2013, a 22.5% decrease. Falls in smoking prevalence occurred among all demographic sub-groups, including Māori and young adults. There were substantial disparities in smoking by age, ethnicity and socio-economic status. Māori continue to have the highest age-standardised smoking prevalence (32.4%), with the highest prevalence (43.1%) among young Māori women aged 25 to 29 years. Decreases in smoking prevalence were greater between 2006 and 2013 than between 1996 and 2006.

Conclusion

The findings suggest that the decline in smoking prevalence is accelerating in New Zealand, including among high priority groups like Māori, Pacific peoples and young adults. This study confirms the value of census data for understanding patterns of tobacco use in New Zealand, to inform effective intervention development and monitoring progress towards the Smokefree 2025 goal.

Author Information

Danny Tu, Policy, Research and Advice, Health Promotion Agency, Wellington; Rhiannon Newcombe, Cancer Society Social and Behavioural Research Unit, Preventive and Social Medicine, University of Otago, Dunedin; Richard Edwards, Department of Public Health, University of Otago, Wellington; Darren Walton, Psychology Department, University of Canterbury, Christchurch.

Acknowledgements

We thank the New Zealand Census participants and Statistics New Zealand for managing the Census.

Correspondence

Danny Tu, Policy, Research and Advice, Health Promotion Agency, PO Box 2142, Wellington 6140.

Correspondence Email

danny.tu@education.govt.nz

Competing Interests

Nil.

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