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    Declines and Plateaux in Smoking Prevalence Over Three Decades in Fiji

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    Author
    Linhart, C; Tukana, I; Lin, S; Taylor, R; Morrell, S; Vatucawaqa, P; Magliano, DJ; Zimmet, P
    Date
    2017-11-01
    Source Title
    Nicotine and Tobacco Research
    Publisher
    OXFORD UNIV PRESS
    University of Melbourne Author/s
    Magliano, Dianna
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Linhart, C., Tukana, I., Lin, S., Taylor, R., Morrell, S., Vatucawaqa, P., Magliano, D. J. & Zimmet, P. (2017). Declines and Plateaux in Smoking Prevalence Over Three Decades in Fiji. NICOTINE & TOBACCO RESEARCH, 19 (11), pp.1315-1321. https://doi.org/10.1093/ntr/ntw292.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/257067
    DOI
    10.1093/ntr/ntw292
    Abstract
    Objectives: To examine trends from 1980 to 2011 in daily tobacco smoking by sex, ethnicity, age, and urban/rural in Fiji Melanesian (i-Taukei) and Indian adults aged 25-64 years. Methods: Unit record data from five population-based surveys (n = 14 528) allowed classification of participants as: (1) never-smoker, ex-smoker, or non-daily smoker; or (2) daily smoker, reporting smoking <20 or ≥20 tobacco products (cigarettes/cigars/pipes) a day. Trends were examined using spline analyses. Results: Over 1980-2011 the prevalence of reported daily tobacco smoking decreased significantly in both sexes and ethnicities, with the greatest decline during 1980-2000. Declines were from 81.7% to 27.0% in i-Taukei men; 55.3% to 26.3% in Indian men; 48.1% to 9.5% in i-Taukei women; and 13.8% to 1.3% in Indian women (p < .0001). Declines were consistent across all age groups in men, while there were greater declines among older age groups in women; and greater declines from higher prevalences in rural compared to urban areas in both sexes and ethnicities. Smoking ≥20 tobacco products per day declined significantly in i-Taukei men from 8.0% to 1.9% (p < .0001); there were also declines in Indian men (4.6% to 2.0%) and i-Taukei women (2.6% to 0.6%), but these were not statistically significant; and Indian women remained <0.2% throughout the period. Conclusions: Significant declines in daily tobacco smoking have occurred in Fiji in both sexes and ethnicities during the past 30 years, which is consistent with declines in tobacco apparent consumption and household expenditure. However, prevalence remains high in men at around 27% in 2011, with plateau at this level in i-Taukei. Implications: This is the first study to show nationally representative population trends in tobacco smoking in a developing country over such a long period (>30 years) based on empirical unit record data (n = 14 528). Cardiovascular disease is a leading cause of mortality throughout the Pacific Island region. This is the first study to show evidence of substantial declines over several decades in a cardiovascular disease risk factor in a Pacific Island country, and provides important evidence for further research into the interventions and events which may have facilitated this decline.

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