A community controlled smoking cessation programme: ABC for Maori communities
The introduction of tobacco to Aotearoa, and the socio-political context in which this occurred, contributed directly to its quick uptake by Māori, and led to the normalisation in Māori culture and society, of smoking as an imposter “tikanga” (custom, meaning, criterion) (Ryan, 1999). In Māori communities tobacco use and dependence remain a significant barrier to well being and fulfilment of Māori potential to lead long and healthy lives – smoking not only kills more Māori than any other disease – it also robs Māori of the ability to be self determining with regard to health. In 2010, a kaupapa Māori (Māori worldview) smoking cessation programme was initiated, established, promoted and maintained by Māori workers in a high Māori population area in Te Tai Tokerau as an independent community-based initiative. The programme was integrated into the community through well-established work, whānau/family and social relationships and networks and was effective in recruiting young Māori smokers to make at least one quit smoking attempt during a four-week period. This research investigation of a community controlled smoking cessation programme sought to determine the acceptability and outcomes of the programme from the perspectives of the regular smokers who were involved. A literature review was undertaken prior to the research investigation to determine effective elements of smoking cessation interventions (Tane, 2009), demographic data and smoking history of the programme participants’ was analysed, and semi-structured interviews yielded transcripts of rich descriptions in this qualitative descriptive study. The investigation has confirmed the acceptability and positive outcomes of a community led initiative providing evidence based smoking cessation support of nicotine replacement therapy and advice, and demonstrates that Māori smokers can and will make repeated quit attempts if they are well supported to do so within their own whānau and communities. The research highlights the need for equitable and just distribution of sufficient resources to establish kaupapa Māori smoking cessation initiatives within Māori communities and whānau – wherever smokers are – to prevent further unnecessary loss of life through tobacco use. The issue of access to resources and funding is fundamental in addressing the unacceptably high smoking prevalence rates of Māori and there is an urgent need for better provision of and access to evidence-based medications; Māori smokers do want to quit, with support and advice from well-known and trusted peers, available to them quickly and conveniently at home, and in their communities.