Community inequality and smoking cessation in New Zealand, 1981-2006

Barnett, Ross, Pearce, Jamie and Moon, Graham (2009) Community inequality and smoking cessation in New Zealand, 1981-2006. Social Science & Medicine, 68, (5), 876-884. (doi:10.1016/j.socscimed.2008.12.012).


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The overall prevalence of smoking in New Zealand reduced from 32% in 1981 to 23.5% in 2006 but rates
of smoking cessation have not been consistent among all social, demographic and ethnic groups. The
period 1981–2006 also saw macroeconomic changes in New Zealand that resulted in profound increases
in social and economic inequalities. Within this socio-political context we address two questions. First,
has there been a social polarisation in smoking prevalence and cessation in New Zealand between 1981
and 2006? Second, to what extent can ethnic variation in rates of quitting be explained by community
inequality, independently of socio-economic status?We find that smoking behaviour in New Zealand has
become socially and ethnically more polarised over the past two decades, with greater levels of smoking
cessation among higher socio-economic groups, and among New Zealanders of European origin. Variations
in quit rates between Maori and European New Zealanders cannot be fully accounted for by ethnic
differences in socio-economic status. Community inequality exerted a significant influence on Maori (but
not European) smoking quit rates. The association with community inequality was particularly profound
among women, and for particular age groups living in urban areas. These findings extend the international
evidence for a relationship between social inequality and health, and in particular smoking
behaviour. The research also confirms the importance of considering the role of contextual factors when
attempting to elucidate the mechanisms linking socio-economic factors to health outcomes. Our findings
emphasise that, if future smoking cessation strategies are to be successful, attention has to shift from
policies that focus solely on engineering individual behavioural change, to an inclusion of the role of
environmental stressors such as community inequality.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1016/j.socscimed.2008.12.012
ISSNs: 0277-9536 (print)
Related URLs:
Subjects: H Social Sciences > HT Communities. Classes. Races
H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions : University Structure - Pre August 2011 > School of Geography > Economy, Culture, Space
ePrint ID: 65890
Accepted Date and Publication Date:
March 2009Published
Date Deposited: 27 Mar 2009
Last Modified: 31 Mar 2016 12:51

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