Academic journal article New Zealand Journal of Psychology

Analysing Smoking Using Te Whare Tapa Wha

Academic journal article New Zealand Journal of Psychology

Analysing Smoking Using Te Whare Tapa Wha

Article excerpt

In a doctorate study on Maori smoking cessation behaviour, Te Whare Tapa Wha, a contemporary Maori paradigm was used as the theoretical framework for analysing smoking behaviour. One hundred and thirty Maori smokers aged 16-62, who were intending to quit were interviewed prior to their quit attempt and on average four months later. Physical aspects of smoking behaviour, such as, smoking history variables and number of cigarettes smoked per day were grouped under te taha tinana. Variables, such as, participants' beliefs about their reasons for smoking, motivation and intention to quit were grouped under te taha hinengaro. Social and familial factors that influenced participants' smoking are discussed under te taha whanau and data pertaining to actions or beliefs about the effects on and the role of wairua are discussed under te taha wairua. The results show how the application of Te Whare Tapa Wha to the problem of smoking supports the need for holistic approaches to intervention. Smoking cessation interventions, for instance, need to combine treatment of nicotine dependency with cognitive behavioural therapy, whilst targeting the whole whanau. Attending to te taha wairua should improve effectiveness for Maori. Public health policies and programmes, such as a strong Smokefree Environments Act and frequent exposure to smokefree media campaigns, help create a supportive environment for change.

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Tobacco smoking is the biggest killer of Maori people, killing about 440 annually based on 1989-93 Maori deaths (Laugesen & Clements, 1998). Maori have the highest death rates from coronary heart disease in the OECD group of countries and Maori women have the highest rate of lung cancer in the world and suffer cervical cancer at more than twice the national rate (22.4 vs. 10.4 per 100 000 annual average 1993-95) (Ministry of Health, 1998), High rates of smoking among Maori women during pregnancy (two thirds of Maori women smoke during peak child rearing age) (Glover, 2004), contributes to higher rates of miscarriage, preterm births, low birth weight babies and other difficulties during childbirth (Pomare, Keefe-Ormsby, Ormsby, Pearce, Reid, Robson, & Watene-Haydon, 1995). In 1996, the Maori Sudden Infant Death Syndrome rate was around five times higher than that of non-Maori (4.6 vs. 0.9 deaths per 1000 live births) (Ministry of Health, 1998). From birth, Maori record proportionately higher rates of hospital admission for asthma and glue ear (Pomare et al., 1995). Through adulthood Maori are undermined by disproportionately higher hospitalisation rates for smoking-related chronic obstructive respiratory disease, hypertensive disease and other forms of heart disease and cancers. In addition to the impact of illness and death from tobacco, "tobacco use has dramatically affected Maori cultural, social and economic development" (Reid & Pouwhare, 1991, p.59). "Smoking desecrates the mana of our marae" (Ellis, 1995, p. 1) and it brings about the early death of kaumatua which represents a vital loss (Te Puni Kokiri, 1998) as "they are the storehouses of our culture" (Fisher cited in Health Research Council, 1996). Maori economic development is also seriously undermined by tobacco use, with the tax take per annum from Maori smokers alone approximating $260 million (Apaarangi Tautoko Auahi Kore, 2003).

In 1976, nearly 60% of Maori smoked. This rate dropped to 50% by 1991 but there it remains. In 2002, 49% of all Maori adults smoked, which is double the non-Maori non-Pacific smoking prevalence rate (Ministry of Health, 2003). Higher smoking rates are concentrated in younger people, for example, nearly 60% of Maori women aged between 15 and 44 years, smoke. (Ministry of Health, 1999) while Maori men aged between 25 and 39 have the highest smoking rate (46%) (Statistics New Zealand, 1997). Among women aged 15 and over, Maori have the highest smoking rates (48%) compared with Pakeha (22%), Pacific (19%) and other women (5%) (Ministry of Health, 1999). …

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