Key findings from the 2009 New Zealand ... - Ministry of Health

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Chapter 2: Methodology The 2008 NZTUS Methodology Report is available on the Ministry of Health’s website (Ministry of Health 2009b). This report contains detailed information on the sample design and analysis. A 2009 NZTUS methodology report will not be produced, because there were very few differences between the two surveys in terms of methodology. Any changes from the 2008 NZTUS methodology are discussed in this section. Survey design and analysis In order to be consistent with previous Tobacco Use Surveys, the target population for the 2009 NZTUS was the usually resident population aged 15–64 years living in permanent private dwellings in New Zealand. A multi-stage, stratified, probability-proportional-to-size sampling design was used. The design included a Pacific stratum, as well as sampling by District Health Board area and a screen sample to boost the proportions of Māori, Pacific people and those aged 15–24 years. Participation in the 2009 NZTUS was voluntary, relying on the good will of participants, and consent was obtained without coercion. The survey was carried out by trained interviewers from January to May 2009 using a face-to-face computer-assisted personal interview system. A total sample size of 5222 people aged 15–64 years was achieved, with a weighted response rate of 71.3%. The total sample included 980 Māori, 522 Pacific people, 560 Asian people and 3202 European/Other people. 3 The survey data were weighted so that estimates of population totals, averages and proportions are representative of the total resident population of New Zealand. Survey weights can be thought of as the number of members of the population represented by each survey participant. Using weights in analyses ensures that no population group is under- or over-represented in estimates from the survey. The process used to calculate the survey weights is described in more detail in the 2008 Methodology Report (Ministry of Health 2009b). What has been analysed and reported? Data in this report have been presented for the total adult population aged 15–64 years, by sex. Analyses by age group, ethnic group and neighbourhood socioeconomic deprivation (NZDep2006) have also been reported, where possible. Important information about the analyses presented in this report is set out below. 3 Note that these sample sizes sum to more than 5222 because total response ethnicity was used. 2 Tobacco Use in New Zealand
Total response ethnicity Ethnicity is a self-defined concept. Participants in the 2009 NZTUS were able to report affiliation with multiple ethnicities, using the Statistics New Zealand standard ethnicity question and Level 4 response categories. For this report, participants’ ethnicity was output to the following ethnic groups: European/Other, Māori, Pacific, Asian. The ‘Other’ ethnic group (comprising mainly Middle-Eastern, Latin-American and African ethnicities) was combined with ‘European’ to avoid small number problems. Because participants could be counted in one or more of the four ethnic groups, the sum of the ethnic group populations exceeds the total New Zealand population. This method is referred to as total response ethnicity. For more information on total response ethnicity, refer to Statistics New Zealand’s classification for ethnicity output (Statistics New Zealand 2009), or see Presenting Ethnicity: Comparing prioritised and total response ethnicity in descriptive analyses of New Zealand Health Monitor surveys (Ministry of Health 2008). In this report unadjusted prevalences by ethnic group for some indicators have been presented, to show the burden on different population groups, and include estimates of the number of people affected in each group. Age-standardised rate ratios are presented after the unadjusted prevalence to allow comparisons of each ethnic group with a reference group. For example, Pacific male current smokers are compared with male current smokers in the total population. The reference group does not represent ‘the best outcome group’ but provides an indication of the current level in New Zealand for comparison. Ethnic groups should not be compared with each other (eg, comparing Māori and Pacific data) using either the unadjusted rates or the standardised rate ratios. Instead, comparisons should be made with the reference population as explained in the following section on ‘How to interpret graphs in this report’. Ethnic groups have not been compared with independent comparison groups (ie, Māori/ non-Māori, Pacific/non-Pacific and Asian/non-Asian) in this report. These will be available in online web tables in 2011. Age standardisation Age is an important determinant of cigarette smoking, so populations with different age structures (such as males and females, due to females having a longer life expectancy) will have different rates of smoking due to these age differences. Age standardisation involves adjusting for the effects of any differences in the age distributions between population groups. For this report, age standardisation was performed by the direct method using the World Health Organization (WHO) world population age distribution (Ahmad et al 2000). This statistical method of standardising for age has been used in analyses by sex, ethnic group and neighbourhood deprivation (NZDep2006), and for time-trend comparisons. Age standardisation is not used when data are presented by age group and for youth. Tobacco Use in New Zealand 3
Page 1 and 2: Tobacco Use in New Zealand Key find
Page 3: Authors This report was prepared on
Page 6 and 7: Chapter 7: Smoker Regret and Quitti
Page 8 and 9: List of Figures Figure 1: Annual nu
Page 10 and 11: Figure 51: Received the ABC approac
Page 12 and 13: Key Points Current smoking in New Z
Page 14 and 15: Of Pacific smokers who made a recen
Page 17: Chapter 1: Introduction This report
Page 21 and 22: For example, the survey only covere
Page 23 and 24: questions asked of these groups. Gi
Page 25 and 26: Rate ratio graphs The rate ratio gr
Page 27 and 28: Figure 1: Annual number of tobacco
Page 29 and 30: Figure 3: Annual number of deaths a
Page 31 and 32: Chapter 4: Current Smoking A curren
Page 33 and 34: Current smoking, by ethnic group Ta
Page 35 and 36: Current smoking, by neighbourhood d
Page 37 and 38: For Māori, there was no change in
Page 39 and 40: Māori youth were more than twice a
Page 41 and 42: Time trends in current smoking in y
Page 43 and 44: Chapter 5: Type of Cigarette Consum
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Page 47 and 48: Time trends in roll-your-own cigare
Page 49 and 50: Manufactured cigarette consumption
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Page 53 and 54: Time trends in manufactured cigaret
Page 55 and 56: Type of cigarette consumption in yo
Page 57 and 58: Source of cigarettes/tobacco produc
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After adjusting for age, 15-64-year
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Time trends in the use of any quitt
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Time trends in services and product
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Use of the Quitline The National Qu
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Use of nicotine replacement therapy
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3. Age standardised to the WHO worl
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Preferred choice of services and pr
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Use of the ABC approach by health c
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Figure 45: Asked smoking status by
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Provided with quitting advice and r
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Received the ABC approach from a he
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Received the ABC approach from a he
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Asked smoking status by a general p
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Asked smoking status by a general p
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For Māori, the age-standardised pr
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Figure 60: Received the ABC approac
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Time trends in receiving the ABC ap
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Chapter 10: Exposure to Second-hand
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Figure 65: Exposure to second-hand
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Exposure to second-hand smoke at ho
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Exposure to second-hand smoke at ho
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Exposure to second-hand smoke in th
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Exposure to second-hand smoke in th
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Figure 72: Exposure to second-hand
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Chapter 11: Discussion The 2009 NZT
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A further limitation is that differ
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P-value Prevalence Quintile Recent
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References Ahmad O, Boschi-Pinto C,
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