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Item Estimating the alcohol-related burden of child maltreatment among Māori in Aotearoa, New Zealand.(John Wiley and Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs, 2024-07-21) Huckle T; Barnes HM; Romeo JSIntroduction To assesses the alcohol-related burden of child maltreatment among Māori in Aotearoa New Zealand. We compared the risk of child maltreatment among Māori (0–17 years) exposed to parents with alcohol-related hospitalisation or mental health/addiction service use. We also conducted a sensitivity analysis to estimate the number of cases of maltreatment that could be attributed to alcohol among Māori. Methods A cohort study of 16,617 Māori aged 0–17 and their parents from 2000 to 2017 was conducted using the Statistics New Zealand Integrated Data Infrastructure. A Bayesian piecewise exponential model estimated the risk of time to first child maltreatment event. This analysis used data from child protection, hospital, mortality and police records, and specifically focused on the risk associated with exposure to parents with an alcohol-attributable hospitalisation or mental health/addiction service use event. Potential confounders for both parents and Māori (0–17 years) were included. We calculated a population-attributable fraction to estimate the proportion of maltreatment cases that could be attributed to alcohol in 2017. Results Results showed a 65% increased risk for young Māori exposed to parents with heavy alcohol use. We estimated 17% of substantiated child maltreatment among Māori could be attributed to parental hazardous alcohol consumption. Discussion and Conclusions Severe or hazardous alcohol consumption among parents is a risk factor for child maltreatment among Māori. Māori alcohol consumption and harm are symptomatic of wider inequities related, among other things, to the ongoing effects of colonisation, as well as gaps in the regulation of alcohol sales.Item Exploring Differences in Daily Vaping of Nicotine and Cannabis among People Who Use Drugs in New Zealand.(Taylor and Francis Group, 2023-06-16) Rychert M; Romeo JS; Wilkins CBackground: Little is known about daily vaping of different substances, particularly cannabis. Aim: To explore daily vaping of cannabis and nicotine products in a sample of people who use drugs in New Zealand. Method: The online New Zealand Drug Trends convenience survey (N = 23,500) was promoted to those aged 16+ via a targeted Facebook™ campaign, with 9,042 reporting vaping in the past six months. Multivariate logistic regression models were fitted to identify predictors of daily vaping of: (i) nicotine e-liquids, (ii) no-nicotine e-liquids, (iii) cannabis e-liquids/oils, (iv)cannabis herb. Results: Forty-two percent of past 6-month vapers used a vaporizing device "daily or near daily" (n = 3,508). Nicotine was most common substance used by daily vapers (96%), followed by dry herb cannabis (12%), no-nicotine e-liquids (10%) and cannabis e-liquid (6%). Daily vaping of no-nicotine e-liquids was associated with abstinence from tobacco use. Frequency of cannabis use was negatively correlated with daily vaping of nicotine liquids and positively correlated with daily vaping of no-nicotine and herbal cannabis. Younger age strongly predicted daily vaping of nicotine and no-nicotine liquids, but the reverse association was observed for daily vaping of herbal cannabis. Māori were less likely to daily vape cannabis herb than NZ Europeans. Daily vaping of both cannabis e-liquid and cannabis herb was associated with medicinal cannabis use. Conclusion: Daily vapers of nicotine and cannabis differed by several characteristics. Younger age group is at risk of daily vaping nicotine and non-nicotine, while herbal cannabis vaping is associated with older and medicinal use, suggesting a need for a nuanced vape policy response.Item Foetal alcohol spectrum disorder in Aotearoa, New Zealand: Estimates of prevalence and indications of inequity.(John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs, 2023-02-21) Romeo JS; Huckle T; Casswell S; Connor J; Rehm J; McGinn VINTRODUCTION: Foetal alcohol spectrum disorder (FASD) is 100% caused by alcohol. The lifelong disability caused by prenatal alcohol exposure cannot be reversed. Lack of reliable national prevalence estimates of FASD is common internationally and true of Aotearoa, New Zealand. This study modelled the national prevalence of FASD and differences by ethnicity. METHODS: FASD prevalence was estimated from self-reported data on any alcohol use during pregnancy for 2012/2013 and 2018/2019, combined with risk estimates for FASD from a meta-analysis of case-ascertainment or clinic-based studies in seven other countries. A sensitivity analysis using four more recent active case ascertainment studies was performed to account for the possibility of underestimation. RESULTS: We estimated FASD prevalence in the general population to be 1.7% (95% confidence interval [CI] 1.0%; 2.7%) in the 2012/2013 year. For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. In the 2018/2019 year, FASD prevalence was 1.3% (95% CI 0.9%; 1.9%). For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. The sensitivity analysis estimated the prevalence of FASD in the 2018/2019 year to range between 1.1% and 3.9% and for Māori, from 1.7% to 6.3%. DISCUSSION AND CONCLUSIONS: This study used methodology from comparative risk assessments, using the best available national data. These findings are probably underestimates but indicate a disproportionate experience of FASD by Māori compared with some ethnicities. The findings support the need for policy and prevention initiatives to support alcohol-free pregnancies to reduce lifelong disability caused by prenatal alcohol exposure.Item Quantifying alcohol-attributable disability-adjusted life years to others than the drinker in Aotearoa/New Zealand: A modelling study based on administrative data.(John Wiley & Sons Ltd on behalf of Society for the Study of Addiction, 2024-02-26) Casswell S; Huckle T; Romeo JS; Moewaka Barnes H; Connor J; Rehm JBACKGROUND AND AIMS: Quantifying the health burden of alcohol has largely focused upon harm to drinkers, which is an underestimate. There is a growing literature on alcohol's harm to others (HTO), but it lacks the systematic transfer of HTO into a comparative risk assessment framework. This study calculated disability-adjusted life years (DALYs) for fetal alcohol spectrum disorder (FASD), interpersonal violence and traffic injury due to another's drinking. DESIGN: This study is a disease burden analysis, using modelling of DALYs for New Zealand in 2018. SETTING AND PARTICIPANTS: The study took place among the Aotearoa/New Zealand population in 2018. MEASUREMENTS: The involvement of others' drinking was obtained from prevalence, alcohol-attributable fraction studies and administrative data. Disability weights (DW) for FASD were adapted from fetal alcohol syndrome (FAS) weights using a Beta-Pert probability distribution; for interpersonal injury, DWs used hospital events linked with injury compensation; for traffic injury, DWs used hospital events. Populations were stratified by ethnicity, age group and gender. A descriptive comparison was made with a previous estimate of DALYs for drinkers. FINDINGS: In 2018, 78 277 healthy life years were lost in Aotearoa/New Zealand due to alcohol's HTO. The main contributor (90.3%) was FASD, then traffic crashes (6.3%) and interpersonal violence (3.4%). The indigenous population, Māori, was impacted at a higher rate (DALYs among Māori were 25 per 1000 population; among non-Māori 15 per 1000 population). The burden of HTO was greater than that to drinkers (DALYs HTO = 78 277; DALYs drinkers = 60 174). CONCLUSIONS: Disability from fetal alcohol spectrum disorder (FASD) appears to be a major contributor to alcohol's harm to others in Aotearoa/New Zealand. Taking FASD into account, the health burden of harm to others is larger than harm to the drinker in Aotearoa/New Zealand, and ethnicity differences show inequity in harm to others. Quantification of the burden of harm informs the value of implementing effective alcohol policies and should include the full range of harms.Item The relationship between children’s third-place play, parental neighbourhood perceptions, and children’s physical activity and sedentary behaviour(Taylor and Francis Group, 2022-09-27) Lin E-Y; Witten K; Carroll P; Romeo JS; Donnellan N; Smith MThis study takes a child-centred approach to examine the relationship between children’s third-place play, parents’ perceptions of their neighbourhood environment, and time spent by children in physical activity and sedentary behaviour during weekday out-of-school hours. A total of 1102 children aged 8–13 years from 19 schools across Auckland, New Zealand took part in a public participation geographic information systems (PPGIS) survey utilising closed- and open-ended questions and child mapping of destinations. The results suggested that playing in green places near home were associated with more time spent in light physical activity and less sedentary behaviour. Children who played in street places near home (e.g. driveways, footpath, carpark) spent more time in moderate to vigorous physical activity. Although parental perceptions of their neighbourhood environment were not directly associated with children’s time spent in physical activity, children with parents who perceived their neighbourhood as more connected were more likely to engage in third-place play.Item Estimating child maltreatment cases that could be alcohol-attributable in New Zealand(John Wiley & Sons Ltd on behalf of Society for the Study of Addiction, 2023-04) Huckle T; Romeo JSAims Children are an important group harmed by others' alcohol consumption. This study (1) compared the risk of occurrence of child maltreatment among children exposed versus not exposed to parents with an alcohol-attributable hospitalization or service use for mental health/addiction and (2) conducted sensitivity analyses to estimate the cases of child maltreatment that could be attributable to alcohol under two different conditions in New Zealand. Design A cohort study conducted among children 0−17 years and their parents (years 2000–2017) using the Statistics New Zealand Integrated Data Infrastructure. The New Zealand Health Survey 2017 was also used. Setting New Zealand. Participants 58 359 children aged 0–17 years and their parents. Measurements Survival analysis based on a Bayesian piecewise exponential model was used to estimate the risk of time to first substantiated child maltreatment event (identified from social service, hospital, mortality and police data) related to exposure to parents with an alcohol-attributable hospitalization or who used a mental health/addiction service (versus no exposure). Potential confounders were included for parents and children. The sensitivity analyses (i) estimated an alcohol-attributable admissions/service use fraction for maltreatment in 2017 and (ii) calculated a population-attributable fraction using the relative risk from the cohort and prevalence of hazardous drinking (AUDIT 8+) among parents in 2017. Findings There was a 65.1% [1.65; 95% confidence interval (CI) = 1.46−1.86] increased risk of child maltreatment if a child was exposed to parents who had an alcohol-attributable hospitalized or mental health/addictions service use. The sensitivity analyses estimated that in 2017 14.6% (CI = 14.0−15.3%) and 11.4% (95% CI = 8.4−14.3%) of the documented cases of child maltreatment in New Zealand could be attributable to parents with severe or hazardous consumption. Conclusions In New Zealand, exposure to parents with an alcohol-attributable hospitalization or service use is a risk factor for substantiated child maltreatment.