This annual report - Taranaki District Health Board

Table 42. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention ofSmoking in Young PeopleMinistry of Health Policy DocumentsMinisterial Committee on Drug Policy. 2007. National Drug Policy 2007–2012. Wellington: Ministry of Health.http://www.ndp.govt.nz/moh.nsf/indexcm/ndp-publications-nationaldrugpolicy20072012This document sets out Government policy on tobacco, alcohol and other drugs and provides guidance for policies andpractices aimed at minimising drug-related harm in the community. The overarching goal is to prevent and reduce thehealth, social and economic harms linked to tobacco, alcohol and other drug use, by means of supply control, demandreduction and problem limitation. Objectives include preventing or delaying the uptake of tobacco, particularly in Māori,Pacific peoples and young people; and decreasing the harm caused by tobacco by reducing the prevalence of tobaccosmoking, the consumption of tobacco products and exposure to second-hand smoke. The policy aims to helpgovernmental and nongovernmental agencies develop strategies consistent with the national direction.Ministry of Health. 2004. Clearing the Smoke: A Five-Year Plan for Tobacco Control in New Zealand (2004-2009).Wellington: Ministry of Health. http://www.health.govt.nz/publication/clearing-smoke-five-year-plan-tobacco-control-newzealand-2004-2009This document provides the action plan for tobacco control developed under the National Drug Policy. The goals of theplan are to: significantly reduce levels of tobacco consumption and smoking prevalence; reduce inequalities in healthoutcomes; reduce the prevalence of smoking among Māori to at least the same level as among non-Māori; and reduceNew Zealanders’ exposure to second-hand smoke. The objectives to achieve these goals are to: prevent smokinginitiation; promote smoking cessation; prevent harm to non-smokers from second-hand smoke; improve support formonitoring, surveillance and evaluation; improve infrastructural support and co-ordination for tobacco control activities.Cochrane Systematic ReviewsJohnston V, et al. 2012. Incentives for preventing smoking in children and adolescents. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD008645.pub2http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008645.pub2/abstractThis review examined whether incentives prevent children and adolescents from starting to smoke. Seven controlledstudies (age range 11 to 14 years) met inclusion criteria, five of which had analysable data and contributed to the metaanalysis(6362 participants, non-smokers at baseline). All bar one of the studies were trials of the Smokefree ClassCompetition (SFC), widely implemented throughout Europe. Classes in the SFC commit to being smoke-free for a sixmonth period. They report regularly on their smoking status; if 90% or more of the class is non-smoking at the end ofthe six months, the class goes into a competition to win prizes. One non-randomised controlled trial of SFC reported asignificant effect of the competition on the prevention of smoking at the longest follow-up, but after adjustment by thereviewers the result was no longer statistically significant. The pooled RR for the more robust RCTs (3 studies, n =3056) did not identify a significant difference in smoking initiation in the long term (RR 1.00, 95% CI 0.84 to 1.19). Therewas little robust evidence to suggest that unintended consequences (such as youth making false claims about theirsmoking status and bullying of smoking students) were consistently associated with the interventions, although this wasnot a focus of the research. The authors conclude that incentive programmes have not yet been shown to preventsmoking initiation among youth, and further robust research in different population groups is required.Lovato C, et al. 2011. Impact of tobacco advertising and promotion on increasing adolescent smokingbehaviours. Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD003439.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003439/frame.htmlThis review identified 19 longitudinal studies that assessed individuals' smoking behaviour and exposure to advertising,receptivity or attitudes to tobacco advertising, or brand awareness at baseline, and assessed smoking behaviour atfollow ups. The studies followed over 29,000 baseline non-smokers aged 18 and under. In 18 of studies participantswho were more aware of or receptive to tobacco advertising, were more likely to have experimented with cigarettes orbecome smokers at follow up, supporting a causal link between advertising and tobacco use in young people.Carson KV, et al. 2012. Interventions for tobacco use prevention in Indigenous youth. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD009325.pub2http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009325.pub2/abstractThis review assessed the effectiveness of intervention programmes to prevent tobacco use initiation or progression toregular smoking amongst young indigenous populations. Two RCTs (1505 participants) met inclusion criteria. Bothstudies were based in Native American populations and employed multi-component community-based interventionstailored to the specific cultural aspects of the population. No difference was observed in weekly smoking at 42 monthsfollow up in the one study assessing this outcome (skills-community group versus control: RR 0.95, 95% CI 0.78 to1.14; skills only group versus control: RR 0.86, 95% CI 0.71 to 1.05). Positive change found in the second study atpost-test was not maintained at six month follow up. Given the paucity of evidence the authors conclude thatmethodologically rigorous trials are needed to investigate interventions aimed at preventing the uptake of tobacco useamongst indigenous youth and to assist in bridging the gap between tobacco-related health disparities in indigenousand non-indigenous populations.Tobacco Use in Young People - 219