Tobacco Control

The toolkit for tobacco control is available at: http://www.newhealth.govt.nz/toolkits/tobaccocontrol.htm

Here are links to resources on tobacco control:

• New Zealand
• Maori and Pacific
• International
• NZ Links and other resources
  

New Zealand

• Bimler, D.//Kirkland, J.//Stewart, R. (2000). Understanding tobacco smokers' motivations. New Zealand Association for Research in Education Conference, November 30 - December 3, Hamilton, NZ.
• Kirkland, J.//Bimler, D. (2000). Understanding tobacco smokers' motiviations. Annual Conference, December 2, New Zealand Association for Education Research, Hamilton, NZ.
• Benn, C. (2000). Smoking at the Breast. Breastfeeding Communique, 11 2.
• Benn, C. (2000). Smokefree Breastfeeding. New Zealand Lactation Consultant's Conference, 3 March, New Zealand Lactation Consultant's, Rotorua, NZ.
• Benn, C. (2002). Patterns of infant feeding by women who smoke. July 4-6, New Zealand College of Midwives 7th Biennial National Conference, Dunedin, NZ.
• Benn, C.A. (2001). Breastfeeding and Smoking. Manawatu and District Area Three La Leche Workshop, 2001, May 5, Palmerston North.
• Webster, M.//Benn, C. (2002). Smoking cessation and nicotine replacement therapy during pregnancy and breastfeeding. Wellington, NZ: Massey University.
• STOMP (stop smoking with mobile phones trial)
• Laugesen, M.3, Swinburn, B. ‘New Zealand’s tobacco control programme 1985-1998’. Tobacco Control 9, 155-162, 2000.
• Crampton, P., Salmond, C., Woodward, A. and Reid, P. Socioeconomic deprivation and ethnicity are both important for anti-tobacco health promotion, Health Education and Behaviour 2000;27:317-327. Email: hsrc@vuw.ac.nz
• McLeod D, Pullon S, Cookson T. Factors that influence changes in smoking behaviour during pregnancy. NZMJ 2003;116(1173)
• McLeod D, Pullon S, Cookson T. Factors influencing continuation of breastfeeding in a cohort of women. J Hum Lact 2002;18(4):335-343.
• The Tobacco Industry in New Zealand: A case study of the behaviour of multinational companies
  Authors: George Thomson, Dr Nick Wilson, February 2002
• New Zealand's tobacco industry taken to task
  

Maori and Pacific

• Changes in smoking behaviour among young women over life stage transitions: Liane McDermott, Annette Dobson and Anne Russell
  School of Population Health, University of Queensland, Queensland, (Aust N Z J Public Health 2004; 28: 330-5)
  Abstract
  Objective: To examine changes in smoking behaviour among young women over four life stages: leaving home; employment or attending college or university; marriage; and parenthood.
  Methods: Young women participating in the Australian Longitudinal Study on Women's Health completed postal questionnaires in 1996 and 2000.
  Results: Unmarried women who moved out of their parents' home between 1996 and 2000 had higher odds of adopting smoking than those who had not lived with their parents at either time (OR 1.8, 95% CI 1.2-2.6). Married women had lower odds of resuming smoking after quitting (OR 0.4, 95% CI 0.2-0.7) than unmarried women. Women who were pregnant in 2000 had higher odds of quitting smoking (OR 3.8, 95% CI 2.5-5.6) and women who were pregnant in 1996 and not in 2000 had higher odds of starting to smoke again (OR 3.2, 95% CI 1.6-6.2) than women who were not pregnant. The odds of being a current smoker or adopting smoking were significantly greater for women who binge drank alcohol or used cannabis and other illicit drugs.
  Conclusions: Adoption, maintenance and cessation of smoking among young women is strongly related to major life stage transitions, illicit drug use and alcohol consumption.
  Implications: Life changes such as marriage and actual or contemplated pregnancy provide opportunities for targeted interventions to help women quit smoking and not relapse after having a baby. Legislation to control smoking on licensed premises would reduce the social pressure on women to smoke.
  Correspondence to:  Professor Annette Dobson, School of Population Health, University of Queensland, Herston Road, Herston, Queensland 4006. Fax: (07) 3365 5540; e-mail:a.dobson@sph.uq.edu.au
• Aboriginal mothers, breastfeeding and smoking: Dawn Gilchrist, Goldfields South-East Health Region, Western Australia; Beth Woods, Aboriginal community member, Western Australia; Colin W. Binns, School of Public Health, Curtin University of Technology, Western Australia; Jane A. Scott, Division of Developmental Medicine, University of Glasgow, United Kingdom; Michael Gracey, formerly Curtin University of Technology, Western Australia; Hannah Smith (Aust N Z J Public Health 2004; 28: 225-8)
  Abstract
  Objective: To document the smoking practices of Aboriginal mothers living in Perth during pregnancy and during the subsequent year while feeding their infants.
  Method: A cohort of mothers was followed from the time of delivery for 12 months to obtain details of infant feeding practices. A total of 455 mothers delivered between May 2000 and July 2001 and 425 completed the baseline questionnaire.
  Results: Prior to and during pregnancy, 67% of the mothers smoked regularly. While the rate appeared to decline slightly with the length of breastfeeding, the trend was not significant. The rate of smoking of Aboriginal mothers was significantly greater than for an earlier study of non-Aboriginal mothers in Perth, where the rate was 28.4%. Among Aboriginal women there was no difference in the percentage of smokers and non-smokers who initiated breastfeeding. While fewer women who smoked were still breastfeeding at 24 weeks postpartum, compared with non-smokers (58% vs. 64%), this difference was not significant.
  Conclusions: The percentage of women smoking in this study is consistent with rates reported in the 2001 National Drug Strategy Household Survey. In other studies, smoking is associated with lower rates of breastfeeding initiation and duration, but this was not the case in the Aboriginal mothers.
  Implications: Although the high prevalence of smoking identified in this study did not appear to adversely affect breastfeeding, smoking during and after pregnancy does contribute to increased rates of low birth weight and other health problems in early childhood. Targeted antenatal smoking cessation programs are needed for Aboriginal mothers.
• Why is lone-motherhood so strongly associated with smoking?; Mohammad Siahpush, VicHealth Centre for Tobacco Control, The Cancer Council Victoria (Aust N Z J Public Health 2004; 28: 37-42)
  Abstract
  Objective: Lone mothers are among the most disadvantaged groups in many countries. Smoking prevalence among this demographic group is considerably higher than the general population. Previous work has shown that only part of this difference can be explained by age, not having a partner, living alone, and socio-economic factors. This study examined the contribution of mental health, the social environment, and the lifecourse in explaining the effect of lone motherhood on smoking status.
  Methods: Cross-sectional data from the 1995 National Health Survey and 2001 National Drug Strategy Survey were used. Smoking was defined as daily smoking. Mental health was assessed using a 14-item scale from the SF-36. Proportion of friends who smoke was used as an indicator of the social environment. Age started smoking daily (?18 and >18) was used as a lifecourse factor.
  Results: Mental health, proportion of friends who smoke and age of smoking initiation had strong associations with smoking status. However, they accounted for a small part of the association of being a lone mother and a smoker. After controlling for these factors, the odds of being a smoker among lone mothers were still twice those of mothers with partners (OR 2.1, 95% CI 1.7-2.7).
  Conclusions and Implications: Improving the socio-economic status (SES), mental health and the social environment of lone mothers could help reduce their high smoking prevalence. However, much of the effect of being a lone mother remains even after controlling for these factors. More research is needed to discover why prevalence is so high among this demographic group.
• The financial effects of tobacco tax increases on Maori and low-income households
  Authors: George Thomson, Des O’Dea, Nick Wilson, Papaarangi Reid, Philippa Howden-Chapman
• The Impact on Maori and Low-Income Families/ Whanau of Tobacco Tax Increases: A Brief Review
  Authors: Dr Nick Wilson, George Thomson
• Glover, M. ‘Alcohol use by a sample of Maori attempting smoking cessation, extracted from a Doctoral thesis on Maori smoking cessation behaviour’. Report prepared for ALAC.
• Waldon, J. (2002). Community based survey to determine awareness of mental health needs and support for new mental health service. September 26, Australasian Epidemiology Association (AEA) Annual Conference, Wellington, NZ.
• Waldon, J. (2002). Epidemiology and Maori perceptions of mental health need in a rural community. September 27, Australasian Epidemiology Association (AEA) Annual Conference, Wellington, NZ.
• Taite, S., Dowden, A., Taylor, S., McCulloch, M. (2000). Aukati kai paipa 2000 a New Zealand smoking cessation pilot programme for Maori women. 11th World Conference on Tobacco OR Health (WCTOH), August 7, The American Cancer Society, The American Medical Association, The Robert Wood Johnson Foundation, Chicago.
• Support at hand for Maori nicotine addicts - WHU Jan 2000
  

International

• Lung Cancer Risk Higher in Women Smokers but Survival Better
  Women who smoke appear more susceptible to tobacco carcinogens than men, but women's lung-cancer death rate is lower, according to researchers.
  http://www.cwhn.ca/hot/research/default.html#dawnLung
  
• Turning a New Leaf: Women, Tobacco, and the Future
  Lorraine Greaves, Natasha Jategaonkar, Sara Sanchez British Columbia Centre of Excellence for Women's Health (BCCEWH) and International Network of Women Against Tobacco (INWAT)
  This report is concerned with preserving the health of women worldwide. However, it is equally concerned with improving women's economic, political, and social empowerment and progress. These issues are inextricably linked — without health, women cannot prosper. Without equality, women are at a disadvantage in achieving and maintaining good health. Indeed, the women and girls experiencing health inequities in developed countries are also most likely to be among the remaining smokers, and smokers in developed countries are those most likely to be disadvantaged or marginalized. Because access to power and resources is gendered, there are numerous female populations that are a priority for tobacco control. In countries with fewer resources and capacity, where women are often just beginning to smoke or increase their smoking rates, tobacco use will impair their long-term health. In these countries, where most of the global growth in women's tobacco use is occurring, the irony of the marketers' messages linking smoking to independence has yet to be fully exposed. Hence Turning a New Leaf: Women, Tobacco, and the Future addresses the issues of women, gender, tobacco use, tobacco production, and legislation, and draws important links between tobacco use, production, and women's struggle for equality.
  Read the full report: Turning a New Leaf: Women, Tobacco, and the Future (PDF 936KB/48p.)
  
• Women and Tobacco: An International Epidemic
  Natasha Jategaonkar and Lorraine Greaves, British Columbia Centre of Excellence for Women’s Health
  Tobacco use is increasingly a global epidemic. Currently, 1.1 billion people worldwide are smokers, and this number is expected to increase to 1.6 billion by 2025.[1] Although overall rates of smoking are declining in some developed countries, including Canada, they are increasing in many developing nations, particularly among women. By 2020, 20 percent of the world’s women will be smokers.[2] Given these escalating rates of cigarette smoking among women, women’s susceptibility to related diseases, and the lack of knowledge about the effects of tobacco policies on girls’ and women’s lives, it is clear that the world is on the verge of an international epidemic of female morbidity and mortality arising from women’s use of tobacco.
  The British Columbia Centre of Excellence for Women’s Health (BCCEWH) is engaged in several projects with Health Canada, the International Network of Women Against Tobacco (INWAT), the World Health Organization (WHO), the American Cancer Society and Cancer Research UK that examine different aspects of women’s roles in the consumption and production of tobacco, the effects of tobacco use on women’s health and the impact of tobacco control efforts on girls and women around the world. Available online at: http://www.cewh-cesf.ca/en/publications/RB/v5n1/page2.shtml
  
• Better Practices: Promising Approaches to Tobacco Cessation During Pregnancy
  Lorraine Greaves, Renée Cormier, Karen Devries, Joan Bottorff, Joy Johnson, Susan Kirkland, David Aboussafy, British Columbia Centre of Excellence for Women’s Health
  Maternal smoking during pregnancy remains a serious public health problem. Despite concerted efforts by researchers and health care professionals, approximately 20-30% of pregnant women use tobacco during pregnancy. [1] Many of these women do quit smoking during pregnancy, while others manage to reduce their tobacco use. However, cessation is often temporary, with the majority of women returning to cigarette use either during pregnancy or soon after the baby is born. Tobacco cessation during pregnancy has considerable positive health ramifications for both women and fetuses, and reduces health problems for children born to mothers who smoke. However, facilitating successful and sustained tobacco cessation during pregnancy is an ongoing public health challenge.
  More details here: http://www.cewh-cesf.ca/en/publications/RB/v4n2/page11.shtml
  
• Website Looks to Help LGBT Cigarette Smokers Quit
  San Francisco, CA- Researchers at the University of California, San Francisco (UCSF) are currently recruiting lesbian, gay, bisexual, and transgender (LGBT) cigarette smokers for a study that looks to evaluate the use of the Internet to assist people in quitting smoking.
  This study comes on the heels of research showing high rates of smoking in the LGBT community. In some parts of the community, LGBT smoking rates can be as much as 50% higher than their heterosexual counterparts. This along with the fact that smoking kills more people each year than HIV/AIDS, car accidents, and drug and alcohol use combined, makes smoking treatment programs an emerging public health priority for LGBT individuals.
  The study will compare two Internet-based smoking treatments: one that provides general information that has been helpful in a variety of smoking treatment programs, another that includes the general information plus information and support designed especially for an LGBT audience. Smokers will be randomly selected to participate in one or the other. Researchers hope to enroll 600 participants over the course of a year. The purpose of the study is to determine if either treatment results in higher rates of use, more quit attempts, or higher quit rates. iQuit is unique in offering participants cessation services that are highly convenient and private. LGBTs can access the site's resources any time of day, from multiple locations, and their participation is kept confidential. To be eligible for the study, individuals must be 18 years of age or older and identify as LGBT.
  For more information about this study, visit the iQuit website at http://iquit.medschool.ucsf.edu.
• Association between lifestyle factors and mental health measures among community-dwelling older women: Kellie Cassidy; Ria Kotynia-English; John Acres; Leon Flicker; Nicola T. Lautenschlager; Osvaldo P. Almeida; Australian and New Zealand Journal of Psychiatry, November 2004, vol. 38, no. 11-12, pp. 940-947(8) 
• The International Network of Women Against Tobacco (INWAT) Fall 2004 NET Newsletter is now available.
  Visit www.inwat.org to download your copy.
  This issue's feature article was written by Soon-Young Yoon on how treaties, including the WHO Framework Convention on Tobacco Control (WHO - FCTC), can improve women's health. Other contributions include an article about nurses around the world supporting the FCTC, preliminary results of a study on pregnant women in South Africa and a list of new women and tobacco resources.
  
• Smoking cessation and weight gain; Filozof C.; Fernández Pinilla M.C; Fernández-Cruz A.; Obesity Reviews, May 2004, vol. 5, no. 2, pp. 95-103(9); Blackwell Publishing 
• Hypnosis more helpful to men than women in quitting smoking
  Men who try hypnosis to help them quit smoking are more likely to be successful than women who use the same treatment, according to new research.
  A review of 18 studies of hypnosis-based smoking cessation programs found that about 30 percent of men who used such a treatment successfully quit smoking, compared to 23 percent of women. See http://researchnews.osu.edu/archive/genhypno.htm for more details.
  
• Nicotine Therapy: Same for Teens as Adults, Better for Men than Women
  Nearly half a million Americans die prematurely from tobacco-related disease and smoking is projected to in some way kill one third of all smokers. Two new studies report on how well nicotine replacement therapy helps two important groups: teenagers and women.
  Articles: “Randomized Clinical Trial of the Efficacy of Bupropion Combined with Nicotine Patch in the Treatment of Adolescent Smokers," Joel D. Killen, PhD; Thomas N. Robinson, MD; Seth Ammerman, MD; Chris Hayward, MD; Jayna Rogers, MPH; Christi Stone; Deanne Samuels, PhD; Sara K. Levin; Sarah Green; and Alan F. Schatzberg, MD; Stanford University School of Medicine; Journal of Consulting and Clinical Psychology, Vol. 72, No. 4.
  Also: “Meta-Analysis of the Efficacy of Nicotine Replacement Therapy for Smoking Cessation: Differences Between Men and Women,” Antonio Cepeda-Benito, PhD; Jose T. Reynoso, PhD; and Stephen Erath, MS, Texas A&M University; Journal of Consulting and Clinical Psychology, Vol. 72, No. 4.
  Full text of the articles is available at http://www.apa.org/journals/ccp/press_releases/august_2004/ccp724.html
  
• 10th Anniversary APPEAL National Conference Rising above the Clouds: Advancing the AAPI Tobacco Control Movement towards Social Justice, September 9 -10, 2004, Washington, DC, USA
  Join dynamic advocates and leaders from around the country and the Pacific to celebrate the AAPI tobacco control movement at the 10th Anniversary APPEAL (Asian Pacific Partners for Empowerment and Leadership) National Conference!! This year's conference will address advocacy and policy change to promote social justice and tobacco control for AAPI communities.
  Conference activities include:
  • APPEAL's 10 year anniversary commemorative celebration
  • Nationally recognized speakers on tobacco control and social justice
  • Interactive skills building workshops
  • Networking and exchanging of ideas and experiences contributing to the AAPI tobacco control agenda for the next decade
  • For registration information go to: http://www.appealforcommunities.org/pages/APPEAL_National_Conference49.php?project_id=49 
• NEW FUNDING OPPORTUNITIES FROM THE CTCRI AND ITS PARTNERS* * *
  The CTCRI is pleased to announce the next round of its Knowledge Synthesis grant program.
  One time grants of up to $80,000 will be offered for research that supports original reviews and identification of "better practices" to prevent, treat, or otherwise control tobacco abuse and nicotine addiction. Check out the different grants available on their website.
  Co-ordination is provided by the Canadian Tobacco Control Research Initiative (CTCRI) www.ctcri.ca, email: info@ctcri.ca
  
• $5 Million approved in grants for research on tobacco abuse and nicotine addiction. July 13, 2004
  The coalition of funding partners for the strategic initiative "Advancing the Science to Reduce Tobacco Abuse and Nicotine Addiction" launched in June 2003 is proud to announce the successful applicants for the April 2004 competition.
  A total of $5 million over the years 2004/2009 has been awarded to 18 successful teams of 77 investigators. This is the largest sum of grants given to tobacco abuse and nicotine addiction research in Canada in a single strategic initiative announcement.
  The initiative is enabled by a partnership of:
  • Canadian Institutes of Health Research (represented by the Institutes of Neurosciences, Mental Health and Addiction; Cancer Research; Aboriginal Peoples' Health; Circulatory and Respiratory Health; Gender and Health; and Human Development, Child and Youth Health)
  • Canadian Cancer Society
  • National Cancer Institute of Canada
  • Health Canada
  • Heart and Stroke Foundation
  • The Lung Association in partnership with l'Association pulmonaire du Québec
    
    The partnership is coordinated by the Canadian Tobacco Control Research Initiative (CTCRI).
    To view more extensive information on the grants and all the team members please visit our website at http://www.ctcri.ca/en-pages/awards.htm#Jun03
    
• What can be done to prevent smoking in pregnancy? a literature review; Bull L; Early Child Development and Care, December 2003, vol. 173, no. 6, pp. 661-667(7)
  Smoking in pregnancy is a serious health risk to mother and baby that is associated with premature birth, low birth weight and respiratory disorders. Recently it has become apparent that smoking in pregnancy can have long-term consequences for the child, including learning difficulties, elevated risk of diabetes, obesity and asthma. Over the past 30 years there has been a considerable volume of research activity searching for effective smoking cessation interventions that are suitable for pregnant women. This paper will review recent research literature to identify effective smoking cessation interventions and make recommendations for further research.
• Check the links at links to the excellent recent series in the British Medical Journal http://www.socialmedicine.org/smatoz.html#smoking
• Teenage lesbians have worst rates of smoking , April 2004, NewScientist.com news service
  Teenage lesbian or bisexual girls are many times more likely to smoke regularly than straight girls their age. They are the worst hit by tobacco among all groups of young people, according to a new US study. read more at: http://www.newscientist.com/news/news.jsp?id=ns99994850
• Youth Smoking Survey, 2002
  Between 1994 and 2002, the rate of smoking among Canadian youths in Grades 5 to 9 declined by more than half, according to new data from the Youth Smoking Survey. However, girls are smoking slightly more than boys, and young people are still ignoring the warnings on cigarette packages about hazards to their health. In addition, the majority of Grade 7 to 9 smokers had tried either marijuana or alcohol.See more at Statistics Canada - http://www.statcan.ca/Daily/English/040614/d040614b.htm
  
• Lung Cancer Risk May be Higher in Female Smokers February 5, 2004 (Reuters Health)
  Female smokers may be more likely to develop lung cancer than men who smoke a similar amount, new study findings suggest. The investigators found that of nearly 2,500 men and women age 40 and older screened for lung cancer, women had more than twice the risk of being diagnosed with the disease.
  Visit http://www.tobacco.org/news/152183.html to read more.
• Smoking as a risk factor in the health of women; Seltzer V.1, International Journal of Gynecology and Obstetrics, September 2003, vol. 82, no. 3, pp. 393-397(5)
  Document available online and click on proceed
  Abstract
  It is estimated that more than 200 million women smoke worldwide. It is also estimated that if current smoking rates among men and women persist worldwide, by 2025, 9% of the world's deaths and disabilities will be related to tobacco use. Smoking is associated with an increased risk of cardiovascular disease, cancer (lung, cervix, pancreas, kidney, bladder, esophagus, pharynx), pulmonary disorders, cerebrovascular disease, and many other health risks. Smoking also adversely affects fertility and reproductive outcomes. Although a greater percentage of women smoke in developed than in developing countries, women in developing countries appear to be initiating smoking habits in increasing numbers. If current trends persist, the adverse effects of smoking on women's health clearly will continue to escalate.
• Working Class Matters: Socioeconomic Disadvantage, Race/Ethnicity, Gender, and Smoking in NHIS 2000 Elizabeth M. Barbeau, Nancy Krieger, Mah-Jabeen Soobader. American Journal of Public Health. 94(2):269-278. February 2004.
  Objectives. We sought to describe the burden of smoking on the US population, using diverse socioeconomic measures. Methods. We analyzed data from the 2000 National Health Interview Survey. Results. Overall, the prevalence of current smoking was greatest among persons in and independently associated with working class jobs, low educational level, and low income. Attempts to quit showed no socioeconomic gradient, while success in quitting was greatest among those with the most socioeconomic resources. These patterns held in most but not all race/ethnicity-gender groups. Finer resolution of smoking patterns was obtained using a relational UK occupational measure, compared to the skill-based measure commonly used in US studies. Conclusions. Reducing social disparities in smoking requires attention to the complexities of class along with race/ethnicity and gender.
• Abel G, Plumridge L and Graham P. Peers, networks or relationships: strategies for understanding social dynamics as determinants of smoking behaviour, Drugs: Education, Prevention and Policy 9 (4) : 325-38, 2002.
• Project related to smoking cessation and women of low socioeconomic status
  I am currently working on a project related to smoking cessation and women of low socioeconomic status. I am interested in learning about any programs (broadly speaking) or resources that have been developed (or are in development) with this particular group in mind. Materials that have been adapted for this group would also be welcome. I would like to learn about programs or resources that use a women-centred approach, focusing on empowerment and building on women's experiences. Ideally they would also aim to break down isolation and work to increase skills to cope with the day-to-day stressors in these women's lives. The programs and resources do not need to focus on smoking cessation per say, they may instead focus on helping women to examine the role of smoking in their lives. Any programs that use a community development approach would be of great interest. I am familiar with the work of ASH in Scotland and would be interested in hearing from others aboard. Thank you in advance, Karly Holmes kholmes@aldergroup.com
• Preventive Medicine Volume 37, Issue 5 , November 2003, Pages 529-533 Is restricting tobacco sales the answer to adolescent smoking?
  M. Staff MBBS, MMedSc, FAFPHM, , a, C. M. Bennett BSc(Hons), MappEpid, Ph.D.b and P. Angel BSca a Public Health Unit, Northern Sydney Health, Sydney, Australia b Department of Public Health, University of Melbourne, Melbourne, Australia
  Available online 24 September 2003.
  Abstract:
  Background Enforcement of legislation restricting retail access to tobacco is increasingly relied on to reduce adolescent smoking rates. In 1996, health authorities in the Northern Sydney Health Area began monitoring tobacco retailer compliance (PROOF program) with staged purchase attempts by adolescents below the legal age (18 years). Methods Repeat cross-sectional surveys before (1995) and after (2000) the introduction of PROOF monitored changes in adolescent smoking behaviour. Students aged 12 to 17 years from 11 Northern Sydney metropolitan public secondary schools were surveyed for self-reported smoking and tobacco purchasing behavior in 1995 (n = 5,206) and 2000 (n = 4,120). Results Between 1996 and 2000, 545 retailer compliance checks found 34% unlawfully sold cigarettes to minors and 28% of these repeated the offence. Nine prosecutions resulted. Modelling revealed a significant association between the intervention and never having smoked (adjusted OR = 1.16, 95% CI = 1.01?1.33) although there was no significant association with being a current smoker. The odds of being a smoker were greater for students from coeducational schools, with this effect being modified by gender. Conclusions There was no reduction in adolescent smoking with active enforcement of tobacco access laws despite an apparent increase in students who reported never to have smoked.
• Benn, C. (2000). Midwifery Education for Women Who Smoke. International Lactation Consultants' Conference, 27 July, International Lactation Consultants, Washington D.C., USA.
• Women and Smoking: Issues and Opportunities, Kelly A. 1; Blair N.; Pechacek T. F.; Journal of Women's Health & Gender-Based Medicine, 1 July 2001, vol. 10, no. 6, pp. 515-518(4)
  Abstract
  In March 2001, the U.S. Surgeon General released Women and Smoking, the second Surgeon General's report to focus on tobacco use among women, compelling the nation to make reducing tobacco use among women one of the highest priorities for women's health. Since 1980, 3 million women have died prematurely from smoking-related diseases and injuries. Lung cancer mortality rates among U.S. women have increased about 600% since 1950, and now lung cancer is the leading cause of cancer death among U.S. women, having surpassed breast cancer in 1987. Although the report documents the devastating impact of the tobacco epidemic among women, a growing arsenal of science-based recommendations for implementing comprehensive tobacco control programs suggests that achieving the nation's ambitious Healthy People 2010 objectives, including cutting in half the rates of smoking among women and girls, is within our reach. While states continue to debate the use of tobacco settlement funds, it is important to note that when significant resources have been devoted to the implementation of evidence-based strategies, the results have been dramatic for the population overall and for women in particular. For example, in California, which has had a comprehensive tobacco control program for 11 years, smoking prevalence has declined throughout the 1990s at rates two or three times faster than in the rest of the country, and while lung cancer incidence rates increased by 13% among women in other parts of the United States, they decreased by 4.8% among women in California. These promising findings indicate that although tobacco-related diseases have become a women's health issue of epidemic proportions, we have the ability to reverse these trends.
• HerCancer Campaign Launched
  The Society recently kicked off the Her Cancer campaign, a lung cancer awareness initiative to educate women about the deadly disease, the dangers of tobacco and how addiction affects women. Smoking-associated diseases claim the lives of nearly 165,000 women each year, with lung cancer ranked as the nation's leading cancer-killer of women. Country music singer Trisha Yearwood stars in a series of radio and television public service announcements (PSA's) designed to educate women of all ages about the disease that kills more than breast or any other form of cancer. The campaign also includes a Web site at http://www.hercancer.org and free educational materials available by calling 1-866-HerCancer. The on-line and print information outlines women's unique cancer risks, how and why smoking cessation is more difficult for women, and also provides resources for those trying to quit. For more information visit the campaign Web site at http://www.hercancer.org.
• Addressing nicotine addiction in women - a randomized trial, Ward S.; Journal of Nurse-Midwifery, January 1999, vol. 44, no. 1, pp. 3-18(16)
  Document available online click on proceed
  Smoking is the leading preventable cause of cancer, cardiovascular disease, and other premature deaths among women in the United States. Tobacco use accounts for 10% of perinatal mortality and is 100% preventable. Smoking is now more common among adolescent girls than among boys. Women’s health care providers are in an excellent position to intervene in this growing epidemic. This article addresses the health consequences of smoking as well as the social, economic, and emotional toll of cigarette smoking on the woman and her family. The reasons women begin and continue smoking in spite of known risks are examined. The role of the midwife in treating nicotine addiction in women throughout the life span is examined. A theoretical model based on the woman’s stage of change is presented as a framework for intervention. Behavioral and pharmacologic treatment recommendations are included. Opportunities for professional activities for community education and advocacy for a tobacco-free society are presented.
• Women Get More From Kicking the Habit Lung function improves more for them than for men
  WEDNESDAY, June 4 (HealthDayNews) -- Lung function in women who quit smoking improves much more than in men who kick the habit. More at: http://www.healthday.com/view.cfm?id=513488
• Gender, social pressure, and smoking cessations: the community intervention trial for smoking cessation (commit) at baseline; COMMIT Research Group; Royce J.M.1; Corbett K.; Sorensen G.; Ockene J., Social Science and Medicine, February 1997, vol. 44, no. 3, pp. 359-370(12)
  Document available online and click on proceed
  Abstract: This study was undertaken to examine gender differences in the perception of social constraints against smoking and to explore the role of other sociodemographic and smoking factors that influence the perception of social pressure. Baseline data from the 20 U.S. sites in the National Cancer Institute's Community Intervention Trial for Smoking Cessation (COMMIT) were analyzed. We found that women were less likely than men to be heavy smokers and to report that smoking had affected their health, but more likely to report behavior indicating physiological addition (timing of first cigarette). At all smoking levels, women were about twice as likely as men to report feeling pressure to quit, after adjusting for education, income, ethnic group, age, and other factors. The source of pressure, however, was different: more women report pressure from their children, whereas more men report pressure from friends and coworkers. Women were equally likely as men to make quit attempts, after adjusting for other factors, but were less likely to remain abstinent for at least 10 days. Women, regardless of education, ethnicity, and age, reported a greater tendency to ask permission before smoking in non-restricted public places. College-educated men were less likely than men without college education to smoke without asking in non-restricted places, but education did not influence whether women asked permission. For both sexes, smoking level and nicotine dependence were significant predictors of lighting up without asking in public places, after adjustment for other variables. We discuss these findings and their implications for the gender gap in smoking cessation and women's conflicting pressures to stop/continue smoking. Tobacco control efforts are discussed within the context of gender differences in social norms, roles, socialization, and communication cultures.
• Tobacco on Trial - A BBC World Service Initiative
  The tobacco industry employs millions of people worldwide but it produces a product that has serious health implications. The World Health Organisation (WHO) estimates that every minute, eight people die from tobacco-related disease. By the year 2030, it foresees 10m people will be dying every year. WHO is now negotiating the Framework Convention on Tobacco Control, a tough treaty which it aims to complete by 2003. If ratified, FCTC is likely to restrict tobacco marketing, advertising and sponsorship. This website helps you to understand the health, political and economic issues at stake as tobacco goes on trial. Website: http://www.bbc.co.uk/worldservice/sci_tech/features/health/tobaccotrial/index.shtml
• Teenage Girls and Smoking: A Research Agenda http://www.bccewh.bc.ca/PDFS/girlssmoke.pdf
  

NZ Links and other resources

• New Zealand Census-Mortality Study (NZCMS) Overview http://www.wnmeds.ac.nz/nzcms-info.html The New Zealand Census-Mortality Study (NZCMS) aims to measure mortality differences by socio-economic status in New Zealand. In order to do this, we are working with Statistics New Zealand to anonymously and probabilistically link census records and mortality records, thereby creating cohort studies. This linkage has been achieved for all four censuses (1981, 1986, 1991 and 1996) followed for mortality for three years. We are currently preparing the various cohort datasets to enable analyses to be undertaken. Analyses will then be conducted on these cohorts to: #measure the relationship between individual socio-economic factors (e.g. employment status, education, income, occupational class, and asset ownership) and mortality #compare the strength of the relationship of socio-economic factors with mortality across time - the four cohort studies traverse a 20-year period of major macro-economic and social change in New Zealand #investigate the extent to which smoking acts as an intermediate variable in the relation between socio-economic factors and mortality, using the 1996 census cohort #investigate possible contextual effects for variables such as neighbourhood deprivation and income inequality on mortality #examine discrepancies in the coding of ethnic group between census and mortality data (the so-called numerator denominator bias). The NZCMS is funded by the Health Research Council of New Zealand. It is one of the major research projects in the Society and Health group of the Department of Public Health, Wellington School of Medicine & Health Sciences. Further information Dr Tony Blakely, Department of Public Health, Wellington School of Medicine & Health Sciences, PO Box 7343, Wellington South, New Zealand, Tel 64 4 385 5999 (ext 6086), Fax 64 4 389 5319, Email tblakely@wnmeds.ac.nz
• MEWS - (Midwifery Education for Women who Smoke ) The midwife's role in the provision of breastfeeding education and support for women who smoke. (Accepted for publication by Midwifery) Smoking cessation: information and resources for use by midwives for women who smoke. (Accepted for publication by Health Promotion Intl)
  Flip Chart for Midwives (PDF 8537 KB)
  A4 Breastfeeding sheet (PDF 2871 KB) Resource material developed for the MEWS Study is available here.
• McLeod D, Pullon S, Cookson T, Cornford E. Factors influencing alcohol consumption during pregnancy and after giving birth. NZMJ 2002;115(1157). (PDF 255 KB)
  NZMJ 02 July 2002, Vol 115 No 1157 Page 1 of 7 http://www.nzma.org.nz/journal/
• Smoking Cessation and Nicotine Replacement Therapy during Pregnancy and Breastfeeding (PDF 718 KB)
• Grant No. 974
  To undertake interviews with smokers and experts in Tobacco control.
  Ms Trish Fraser This research investigated the public and political acceptability of eliminating nicotine from tobacco. The research found that whilst overall there was not enough support for de-nicotinisation of tobacco, there was support for reducing nicotine and tar levels in New Zealand cigarettes. There was interest in de-nicotinisation of tobacco but it was also considered to be a type of social prohibition. #There was acknowledgement from both the 'public health experts', the 'smokers' and the literature reviewed that the policy could provide a significant population health gain in the future by reducing population addiction and harm. However, there was concern that current smokers could increase harm to themselves in the short term, by oversmoking to access the diminishing levels of nicotine. More smokers may be encouraged into the market believing the de-nicotinised cigarettes to be safer than nicotine cigarettes.
• Guidelines for Smoking Cessation
• New guidelines bring good news for smokers Associate Minister of Health Georgina te Heuheu will launch tomorrow a set of best practice guidelines for health professionals to use in the fight to help smokers quit. Smoking takes a high toll on New Zealanders’ lives. Every year it causes the premature death of an estimated 4,700 people — people who die, on average, 14 years earlier than their non smoking counterparts.
  

From Women's Health Action publications

• Passive smoking increases stroke risk - WHW Sept 1999
• More evidence links smoking to cervical cancer - WHW Sept 1999
• Smoking passes carcinogens to foetus - WHU Nov 1998
• Fear of fat fuels tobacco use- WHU Nov 1998
• Smokers and The Pill - WHU Oct 1997
• Smoking...the way to go? - WHU Oct 1997