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Carson KV, et al. 2011. Community interventions for preventing smoking in young people. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD001291.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001291/frame.htmlThis 2011 update reviewed trials comparing the effectiveness of multi-component community interventions with singlecomponent or school-based only interventions in influencing smoking behaviour in young people, including preventinguptake. The interventions used co-ordinated, widespread, multi-component programmes which aimed to influencebehaviour. The programmes included education of retailers, mass media, school and family-based components, andthere was often community involvement in planning and/or implementation. Twenty-five studies (15 RCTs and 10 nonrandomisedcontrolled trials) were included in the review, ten of which were associated with a reduction in smokinguptake in the intervention group. Changes in intentions to smoke, knowledge, attitudes and perceptions about smokingdid not generally appear to affect long-term smoking behaviour. Overall there was some evidence to support theeffectiveness of community interventions. The authors identify the strong influence of local factors and likely difficultieswith replication of interventions but suggest the principles and methods on which successful interventions are basedmay be useful in programme implementation in similar settings.Brinn MP, et al. 2010. Mass media interventions for preventing smoking in young people. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD001006.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001006/frame.htmlThis updated review evaluated the effectiveness of mass media interventions to prevent smoking in young people. Theprimary outcome was reduced smoking uptake, and secondary outcomes included improved attitudes and behaviours.Seven studies (approximately 49,398 participants), all of which had a controlled trial design, met the inclusion criteria.Three studies were associated with a reduction in smoking behaviour in young people. Common features of successfulcampaigns included multiple channels for media delivery, combined school and media components and repeatedexposure to campaign messages delivered to the same cohort of students for a minimum of three years. The authorsprovide recommendations for planning and evaluating campaigns.Stead LF & Lancaster T. 2008. Interventions for preventing tobacco sales to minors. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD001497.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001497/frame.htmlThis review assessed the effect of interventions aimed at reducing underage access to tobacco by deterring retailersfrom making illegal sales. Outcomes included both changes in retailer compliance assessed by test purchasing, andchanges in young people’s smoking behaviour and their perceived ease of access. Thirty-five studies, thirteen of whichhad a control group, were included in the review. Active enforcement and/or multi-component educational strategieswere more effective than information alone. While sales were reduced, none of the communities studied achievedcomplete, sustained compliance. There was limited evidence for an effect of retailer interventions on youth perceptionsof ease of access to tobacco, or on smoking behaviour.Thomas RE, et al. 2007. Family-based programmes for preventing smoking by children and adolescents.Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD004493.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004493/frame.htmlThis review examined the effectiveness of interventions to help family members strengthen non-smoking attitudes andpromote non-smoking by children and other family members. Twenty-two RCTs, of variable quality, were included in thenarrative synthesis. Some well-executed RCTs showed family interventions may prevent adolescent smoking, butRCTs which were less well executed had mostly neutral or negative results and it was not possible to draw firmconclusions. Implementer training and the fidelity of implementation were related to positive outcomes, but the numberof sessions was not.Thomas RE & Perera R. 2006. School-based programmes for preventing smoking. Cochrane Database ofSystematic Reviews doi:10.1002/14651858.CD001293.pub2http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001293/frame.htmlThis review identified 23 randomised controlled trials of behavioural interventions (information-giving, social influenceapproaches, social skills training, and community interventions) in schools to prevent children and adolescents startingsmoking. There was little evidence that information-giving alone is effective. The majority of trials used social influencetype interventions, about half of which had a short-term effect on children’s smoking behaviour. There was limitedsupport for interventions that included developing generic social competence and community initiatives.Other Systematic ReviewsU.S. Department of Health and Human Services. 2012. Preventing tobacco use among youth and young adults: Areport of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for DiseaseControl and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking andHealthThis recent report includes a review of the effectiveness of interventions to prevent and reduce tobacco use in youngpeople. The review found sufficient evidence to conclude that mass media campaigns, comprehensive communityprogrammes, comprehensive control programmes, and price increases can both prevent the initiation and reduce theprevalence of tobacco use in young people. The review identified short-term beneficial effects from school-basedprogrammes based on the social influences model but programmes that were implemented in combination with otherinterventions produced larger and more sustained effects.Tobacco Use in Young People - 220
Sutcliffe K, et al. 2011. Young people's access to tobacco: a mixed-method systematic review. London: EPPICentre, Social Science Research Unit, Institute of Education, University of London.This report sought to identify the retail and non-retail sources of tobacco used by young people and included a review ofinternational evidence assessing the effect of interventions aimed at reducing non-retail access to cigarettes by youngpeople. Four types of intervention have been evaluated (possession laws; retail interventions measuring the impact onsocial access; school policies; and home access restrictions) using a mixture of RCTs (possession law interventions)and observational studies. None of the interventions specifically targeted proxy purchasing, identified as an importantsource of non-retail tobacco. The overall evidence base was limited.National Institute for Health and Clinical Excellence. 2010. School-based interventions to prevent the uptake ofsmoking among children and young people (NICE public health guidance 23). London: National Institute forHealth and Clinical Excellence. http://www.nice.org.uk/guidance/PH23.This NICE public health guidance provides comprehensive evidence-based guidance on school-based interventions toprevent smoking uptake by children and young people. It includes a systematic review assessing the effectiveness ofinterventions. The review included 64 RCTs, with between 500 and 17,446 participants and follow up of up to 13 years.Meta-analysis of 27 RCTs demonstrated a significant intervention effect. There was moderate evidence indicating thatmulti-component interventions incorporating both school and community components were ineffective in preventinguptake compared to usual education. There was no clear evidence to favour a particular conceptual model (socialinfluence, social competence, information giving and combined interventions). Adverse or unintentional effects were notspecifically examined in any of the studies. Despite 62 large RCTs there was little evidence about what works for whombesides weak evidence indicating that school‐based interventions starting soon after primary school entry may beeffective in reducing the uptake of smoking up to age of 14, and strong evidence that booster sessions enhanceeffectiveness of main programmes.Emory K, et al. 2010. The association between home smoking restrictions and youth smoking behaviour: areview. Tobacco Control, 19(6), 495-506.This review assessed the association between home smoking restrictions and the prevention of youth smoking.Nineteen studies met the inclusion criteria, two of which were longitudinal studies and the remainder cross-sectional.Sixteen studies, including the two longitudinal studies, showed some association between restrictions and reducedadolescent smoking behaviours. Completely smoke-free homes appear to be more effective than partial restrictions andthe benefits of smoke-free policies were less clear in homes where at least one adult smoked.National Institute for Health and Clinical Excellence. 2008. Mass-media and point-of-sales measures to prevent theuptake of smoking by children and young people. London: National Institute for Health and Clinical Excellence.http://www.nice.org.uk/PH014.This public health guidance provides as set of evidence-based recommendations on mass-media and point-of-salesmeasures to prevent the uptake of smoking by children and young people. The guidance includes a systematic review,an economic appraisal, stakeholder comments and the results of fieldwork. The review included 61 studies (40 massmedia and 21 access restriction studies). There was sufficient evidence to support mass media interventions insmoking prevention and interventions were more effective when combined with broader tobacco control strategies andwhen campaigns were long lasting with higher exposure levels. Although there was evidence that access restrictioninterventions affect young people’s ability to access cigarettes only two studies addressed the impact of interventionson smoking behaviour. It is recommended that mass-media and point-of-sales measures should be combined withother prevention activities as part of a comprehensive tobacco control strategy.Kavanagh J, et al. 2006. A systematic review of the evidence for incentive schemes to encourage positive healthand other social behaviours in young people. London: EPPI-Centre, Social Science Research Unit, Institute ofEducation, University of London.This systematic review assessed the effectiveness of incentive schemes in encouraging positive health behaviour inyoung people. The review identified two school-based anti-smoking competitions whose combined results wereassociated with significant reductions in daily smoking rates immediately after the intervention and at one year followup.The results should be interpreted with caution given the small number of studies and the authors recommend thatclassroom-based incentive schemes which aim to delay the onset of or reduce levels of smoking should be piloted andevaluated in RCTs.Tobacco Use in Young People - 221
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Cover Artwork: Long-tailed Blue But
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LIST OF FIGURESFigure 1. Gross Dome
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Figure 41. Number of Students Invol
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Figure 85. Proportion of Babies Bor
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Figure 127. Relationship Between th
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Table 21. Policy Documents Relevant
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Table 108. Proportion of Young Peop
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INTRODUCTION AND OVERVIEWIntroducti
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three then reviews mental health is
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Table 1. Overview of the Determinan
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Stream Indicator New Zealand Distri
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47MACROECONOMICINDICATORS
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Expenditure-based Measure of GDPThe
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Gini Coefficient: The Lorenz curve
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CHILD POVERTY AND LIVING STANDARDSI
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After Housing Costs (AHC)Relative P
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Figure 8. Proportion of Dependent C
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14 Items (Enforced Lacks) are inclu
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Local Policy Documents and Evidence
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Other Relevant New Zealand Evidence
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UNEMPLOYMENT RATESIntroductionIn th
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Figure 12. Unemployment Rates by Ag
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Unemployment Rates by Qualification
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Figure 18. Quarterly Unemployment R
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CHILDREN RELIANT ON BENEFIT RECIPIE
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Table 4. Number of Children Aged 0-
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Table 5. Number of Children Aged 0-
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YOUNG PEOPLE RELIANT ON BENEFITSInt
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Table 7. Number of Young People Age
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New Zealand Distribution by Ethnici
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Figure 25. Young People Aged 16-24
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Table 10. Number of Young People Ag
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HOUSEHOLD COMPOSITION91
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Data Source and MethodsDefinitionPr
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Figure 29. Proportion of Children A
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Robertson J, et al. 2006. Review of
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Canadian National Occupancy Standar
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Figure 33. Proportion of Children a
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Other Relevant EvidenceMarmot Revie
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106
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108
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Note 2: The number of new school en
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Figure 36. Proportion of New Entran
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Sylva K, et al. 2004 The Effective
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Table 15. Enrolments in Māori Medi
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Table 16. Number of Students (Māor
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Local Policy Documents which Consid
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HIGHEST EDUCATIONAL ATTAINMENT AT S
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Figure 43. Highest Educational Atta
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Figure 46. Highest Educational Atta
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SENIOR SECONDARY SCHOOL RETENTION A
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Participation in Tertiary Education
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Midland Region Distribution and Tre
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The following section uses informat
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Figure 54. Age-Standardised Rates o
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Figure 56. Age-Standardised School
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TRUANCY AND UNJUSTIFIED ABSENCESInt
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Figure 60. Total Unjustified Absenc
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Figure 63. Total Unjustified Absenc
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152
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154
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156
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Table 22. The National Immunisation
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Figure 64. Immunisation Coverage by
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Figure 67. Immunisation Coverage by
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Figure 71. Immunisation Coverage at
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Soares-Weiser K, et al. 2012. Vacci
Page 169 and 170: Briss PA, et al. 2000. Reviews of e
Page 171 and 172: Data Sources and MethodsIndicatorPr
Page 173 and 174: Figure 75. Proportion of New Zealan
Page 175 and 176: Proportion Receiving Core Contacts
Page 177 and 178: Figure 81. Proportion of Babies who
Page 179 and 180: The B4 School CheckThe B4 School Ch
Page 181 and 182: Local Policy Documents and Evidence
Page 183 and 184: Other Relevant EvidenceThe Scottish
Page 185 and 186: 185SUBSTANCE USE
Page 188 and 189: Notes on InterpretationNote 1: The
Page 190 and 191: Maternal Smoking at First Registrat
Page 192 and 193: Figure 86. Proportion of Babies Bor
Page 194 and 195: Table 32. Number of Cigarettes Smok
Page 198 and 199: National Institute for Health and C
Page 200 and 201: 2. Proportion of babies born to mot
Page 204 and 205: Table 37. Number of Cigarettes Smok
Page 208 and 209: Figure 93. Proportion of Year 10 St
Page 210 and 211: Figure 95. Proportion of Year 10 St
Page 212 and 213: TOBACCO USE IN YOUNG PEOPLEIntroduc
Page 214 and 215: Figure 96. Daily Smoking Rates in Y
Page 216 and 217: 2009 New Zealand Tobacco Use Survey
Page 218 and 219: Source of Tobacco in the Last Month
Page 222 and 223: Other Relevant PublicationsMāori A
Page 224 and 225: Other Cochrane Systematic Reviews o
Page 226 and 227: ALCOHOL-RELATED HOSPITAL ADMISSIONS
Page 228 and 229: Figure 100. Alcohol-Related Hospita
Page 230 and 231: Table 45. Listed External Causes of
Page 232 and 233: Midland Region Distribution and Tre
Page 234 and 235: Local Policy Documents and Evidence
Page 236 and 237: Shults RA, et al. 2009. Effectivene
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Page 244 and 245: Mortality from conditions with a so
Page 246 and 247: Table 50. Mortality from Conditions
Page 248 and 249: Figure 105. Hospital Admissions for
Page 250 and 251: Midland Region Distribution and Tre
Page 252 and 253: Table 55. Hospital Admissions for C
Page 254 and 255: Table 57. Hospital Admissions for C
Page 256 and 257: Midland Region Distribution by Caus
Page 258 and 259: Figure 107. Hospital Admissions for
Page 260 and 261: INFANT MORTALITY AND SUDDEN UNEXPEC
Page 262 and 263: New Zealand Distribution and Trends
Page 264 and 265: Figure 111. Total Infant Mortality,
Page 266 and 267: Table 62. Neonatal and Post Neonata
Page 268 and 269: Table 65. Neonatal and Post Neonata
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Distribution by Ethnicity, NZ Depri
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Figure 116. Sudden Unexpected Death
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Vennemann M, et al. 2007. Do immuni
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276
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with a review of interventions aime
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deprivation in some parts of the wo
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who delay a second pregnancy by two
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Family ViolenceDefinitions and New
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need for multidisciplinary interven
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6 days to determine gestational age
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In New Zealand, information on fact
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post intervention. Engagement in ed
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antenatal care, including two nutri
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throughout pregnancy, birth and the
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Alcohol and Other DrugsNational and
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Zealand had a number of specialist
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in one Cochrane review [274] (see p
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interventions to treat antenatal de
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In ConclusionWhile it is hoped that
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308
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Data Source and MethodsDefinition1.
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Figure 119. Hospital Admissions for
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Other Systematic ReviewsLouwers ECF
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INJURIES ARISING FROM ASSAULT IN YO
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New Zealand Distribution by Age and
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Flood M & Fergus L. 2008. An Assaul
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Note 2: The numbers in this section
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Table 78. Number of Notifications t
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Table 80. Outcome of Assessment for
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Table 82. Number of Notifications R
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Table 84. Outcome of Assessment for
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Data Source and MethodsDefinition1.
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Family Violence Investigations Wher
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Table 90. Local Policy Documents an
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Stover CS, et al. 2009. Interventio
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348
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350
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oader contextual influences on the
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In addition, Table 112 on Page 414
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Williams SB, et al. 2009. Screening
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Ministries of Education, Health, Ju
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Figure 129. Children and Young Peop
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Table 92. Children Aged 0-14 Years
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IN-DEPTH TOPIC: MENTAL HEALTH ISSUE
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this [350]. The review stated that
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psychotic disorders including first
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Social Workers in SchoolsIn 2011 th
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Children or young people with sever
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EpidemiologyThe 2009 review by Meri
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A diagnosis of conduct disorder acc
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programme using a questionnaire. Si
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developmentally appropriate diagnos
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playthings or the environment, appe
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state more than it cost) provided t
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ACCESS TO MENTAL HEALTH SERVICES: L
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Table 97. Children and Young People
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Midland Region DistributionChildren
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ACCESS TO MENTAL HEALTH SERVICES: L
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Table 101. Hospital Admissions for
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Numbers Accessing Services by Diagn
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Table 103. Young People Aged 15-24
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Table 108. Proportion of Young Peop
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Midland Region DistributionAmongst
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Fletcher A, et al. 2008. School Eff
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New Zealand Distribution and Trends
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Figure 138. Mortality from Suicide
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Figure 139. Mortality from Suicide
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Ougrin D & Latif S. 2011. Specific
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426
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428
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Guide to Community Preventive Servi
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information on all of the events oc
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3. In addition, some providers admi
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as in the majority of the analyses
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APPENDIX 5: THE NATIONAL MORTALITYC
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As a result of these changes, there
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2. Research also suggests that ethn
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APPENDIX 8: POLICE AREA BOUNDARIESF
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Figure 142. Police Area Boundaries
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3. The condition exhibits a socioec
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REFERENCES1. Children's Commissione
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33. Mackay R. 2005. The Impact of F
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71. Ministry of Health. 2011. Immun
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107. ASH New Zealand. 2011. Nationa
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141. Child and Youth Mortality Revi
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175. Pihama L. 2011. Overview of M
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208. King-Hele S, Webb RT, Mortense
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244. Nelson Marlborough District He
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274. Ramsay J, Carter Y, Davidson L
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306. Jewkes R. 2002. Intimate partn
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347. Heflinger CA, Hinshaw SP. 2010
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376. Ministry of Education. 2012. W
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410. Ministry of Health. 2001. New
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443. Zeanah PD, Bailey LO, Berry S.
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480. Weinberg MK, Olson KL, Beeghly
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