He arorangi whakamua : reducing the uptake of tobacco in Ngāti Hauiti rangatahi : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy at Massey University, Wellington Campus, New Zealand
Tobacco is the leading cause of preventable death in New Zealand and is known to cause various types of cancers, heart disease and respiratory illnesses such as emphysema. As well as harm to smokers, tobacco products cause harm to non-smokers by exposure to tobacco smoke. Smoking is a major issue for Māori in terms of health, equity, economic status and cultural identity as smoking rates, for both adults and youth, are about double the New Zealand European rate. The author of this thesis and tribal leaders of Ngāti Hauiti believe a comprehensive Māori tobacco intervention strategy, based on traditional values, using current iwi development principles and incorporating contemporary evidence may impact in significant ways on the attitude to smoking in Ngāti Hauiti rangatahi and whānau. In the longer term, the prevalence and social costs of tobacco use can be reduced most effectively and substantially through the adoption of whānau-centred policies aimed at preventing tamariki and rangatahi from initiating tobacco use. The objectives of this research programme were to collect and analyse data on the historical, social, economic and cultural context of smoking for Ngāti Hauiti tamariki, rangatahi and whānau. The data, combined with information about the context for the intervention and substantial reviews of the literature, would be used to develop a comprehensive framework for the progress of tobacco control research and intervention activities within Ngāti Hauiti. The study has produced a tobacco uptake intervention strategy using five separate data sources, two of which are original to this thesis: the analysis of Ngāti Hauiti as the intervention context; and defining of the social constructions of tobacco uptake from a whānau perspective. A Tobacco Uptake Intervention Strategy has been outlined incorporating the contexts for the intervention, the whānau constructions around tobacco uptake, Ngāti Hauiti research principles, and best practice evidence. The study concludes that Māori health promotion principles were consistent with iwi development principles, therefore aligning the tobacco control intervention with a wider whānau hapā iwi development role was seen as advantageous to both goals; the context for the intervention is clearly able to be identified as a distinctive community setting with a range of strengths that will enable effective implementation of the tobacco control intervention; and, it is clear from qualitative data and evidence that a comprehensive approach that targets multiple sites and multiple levels, and uses complementary components from each intervention approach studied may result in positive changes in tobacco smoking attitudes and behaviours.