1. Why & How Kiwis Stop Smoking Dr Marewa Glover 1, Dr Vili Nosa 2, Donna Watson 1 & Dr Janine Paynter 3 1 Centre for Tobacco Control Research and 2 Pacific Health, University of Auckland, 3 ASH Tobacco-Free Aotearoa Conference November 4th-5 th, 2010

2. Research Aims Explore what motivates Māori, Pacific Island and lower socio-economic smokers to stop smoking. Identify how tobacco control services can be more relevant to Māori and Pacific Island smokers.

3. Method Exploratory - qualitative research Focus groups (smokers /ex-smokers) Participants: – Māori and Pacific Island peoples – over the age of 16 – who currently smoke – or who have been smokefree for at least one year and who stopped smoking in the last four years Auckland only focus groups of Pacific participants who smoke. Groups for Māori to be held in Auckland as well as in a number of urban, metropolitan and rural settings in NZ

4. Our Participants No. of groups No. of participants Ethnicity (by group)Māori14 90 Pacific Island15 89 Ex-smokers 6 32 Age (by group)16-26years 11 64 >26years 14 79 Mixed age 10 68 35 groups (N=211)

5. Focus group exercises Exercise 1: Previous quit attempts and relapses

6. Exercise 2: Relative ranking of reasons for quitting

7. Exercise 3: Knowledge of and feedback about cessation products and services – i) Unprompted – ii) Prompted

8. Exercise 4: Facilitators for and barriers to staying smokefree

9. Results..... Motivation to stop smoking varies from day-to-day, depending on what’s happening.

10. Snakes & Ladders: How it works The dice in the game of Snakes & Ladders represents the changing context of daily life. Some days you hardly move fowards toward stopping smoking, other days motivation is quite strong.

11. Some things move people towards stopping smoking, but are just not strong enough to prompt a quit attempt. Some things happen which trigger people to actually stop.

12. Some things encourage smoking and make it hard to not smoke. Some things push people back into smoking.

13. The Research Team Dr Marewa Glover, Co-Principal Investigator Dr Vili Nosa, Co-Principal Investigator Donna Watson, Study Manager, CTRC Dr Janine Paynter, ASH Jade Le Grice, Māori Research Assistant, CTRC Jane Stephen, B.HSc.Hons Scholar Raina Tutini, B.HSc.Hons Scholar Bibi de Zeeuw, Wageningen University, Netherlands, MPH & Soc Visiting Scholar Shenella Tuilotolava, Research Assistant, CTCR

14. Acknowledgements Thanks to the Quit Group for their support of this project, and to the New Zealand Health Research Council and Ministry of Health for funding this study. We gratefully acknowledge the input from our participants, and thank the following participant recruiters and organisations: Donna Glover and the Te Korowai Aroha o Ngati Whatua; the Glen Innes Cook Island group; Eastern Institute of Technology Students’ Association; Ka Mau Te Wero; Manukau Samoan Methodist Church; Ngati Whatua Kapa Haka group; South Waikato YMCA; Te Kura o Hoani Waititi; Tokoroa Council of Social Services; University of Auckland’s Cook Island Students Association; and Whai Marama.

15. Acknowledgements (contd.) Others who helped prepare focus group materials, recruit participants, facilitate groups, translate group recordings, and/or carry out data entry were: Vaipulu Manuopangai, Maria Lafaele and Rennie Lagaluga Douglas from Auckland Regional Public Health Services; Josephine Samuelu from Smokefree Pacific Action Network (SPAN); Nicola Graham, Perri Tatana, Jacqueline Spiers and Victoria Te Tau from Whaiora, Masterton; Annabel Ahuriri-Driscoll; Toia Chase; Bibi de Zeeuw; Erana Kaye-Berghan; Jade Le Grice; Dr. Ieti Lima; Robert Loto; Angilla Perawiti; Missy Purnomo; Dr. Nuhisifa Seve-Williams; Loimata Simati; Christine Solomon; Jane Stephen; Yvonne Stirling- Mohi; Ruiha Stirling; Tracey and Anna Taufaeteau; Shenella Tuilotolava; and Raina Tutini. Janet Templeman, Fidgety Digits provided transcription services, and Annette Kira and Trish Fraser reviewed the draft report.