With this week marking the 10-year anniversary of a ban on smoking in restaurants, Hawke's Bay Today looks at what has changed. Smoking is the single biggest cause of preventable ill health and premature death in Hawke's Bay. The region is also worse than the national average in its tobacco consumption, and a Hawke's Bay District Health Board report this year declared the high rate of smoking among Maori women is a public health crisis. But there is light at the end of the tunnel, experts say.
Harrison Christian reports
HAWKE'S Bay has a higher rate of smoking than other parts of the country, but the habit is gradually being stamped out nationwide.
This week marked the 10th anniversary of a ban on smoking in all indoor workplaces, including restaurants, bars and clubs.
A report prepared for the Ministry of Health and released this week by the New Zealand Tobacco Control Research Turanga examined the effects of the ban 10 years on.
One of the report's authors, Dr Chris Bullen, told Hawke's Bay Today the country's tourism and hospitality industries had originally warned the ban would "destroy" business.
"But the Government went ahead with the policy on the basis of protecting the health of workers from second hand smoke."
A decade later, there was evidence the ban had contributed to a reduction in the prevalence of smoking nationwide, and bars and restaurants hadn't lost patrons.
"The sky did not fall. Retail trade in the food and beverage industry has continued to go up. There's more employment than there was 10 years ago and visitors from overseas weren't turned off."
Public parks, beaches and cars were potential places to extend the ban in future. The price of cigarettes would also go up 10 per cent every year between now and 2016.
"Ten years from now the Government's got a goal of 5 per cent of the population active smokers and I think that's quite feasible. No question I think we're heading in that direction quite rapidly."
A Hawke's Bay District Health Board (DHB) report released in October, Health Inequity in Hawke's Bay, found the region was worse than the national average in smoking. The 2013 census showed just under one in five (18 per cent) of the Hawke's Bay population were regular smokers, or nearly 20,000 people. This is higher than the New Zealand average (15 per cent) but a significant drop since the last census in 2006, when 25 per cent of the population were regular smokers.
One of the authora, DHB director of population health Caroline McElnay, said: "The situation is not dire.
"Overall we are seeing reductions in smoking rates. However, Hawke's Bay is probably worse than average because of our higher number of people living in low socioeconomic areas and higher proportion of Mãori, but there also does seem to be a higher rate of smoking compared to other places."
Mãori smoking rates were more than twice that of non-Mãori with 36 per cent regular smokers compared to 15 per cent European. People living in the poorest areas were three times more likely to be regular smokers than those living in wealthy areas.
"This is likely to be due to the normalising effect that having people you know smoke has on your own attitude to smoking and likelihood of taking it up. For example, we know that children growing up in families where parents smoke are more likely themselves to take up smoking."
The effect of chronic stress from living in poverty had also been linked to an increased likelihood of smoking. Twenty-four per cent of all women who had a baby at one of the Hawke's Bay DHB facilities during 2013 were also current smokers with big differences seen both by ethnicity and by deprivation. The higher rates amongst Maori were due to "a mixture of reasons", including a higher likelihood to be living in low socio economic areas.
"Locally focus has got to be on young people before they start and helping young Maori women stop smoking. We need to continue to create more smoke-free environments and really work out how to motivate and encourage quitting."
The DHB was also in the planning stages of a new Tobacco Control Plan, which will target populations including Maori, especially young and pregnant women, Pacific Islanders and low-decile communities.