Richard Edwards

University of Otago · Department of Public Health (Wellington)

Introductions An increasing number of countries are adopting the tobacco endgame goal. High levels of public support can accelerate momentum towards implementing tobacco endgame policies. We aimed to conduct a systematic review of public support for tobacco endgame policies and to examine the geographical distribution of studies, support among key...

Background Philip Morris International (PMI) claims to be transforming and has committed to a ‘smoke-free’ future. In 2020, it announced an ‘aspirational’ target for reduced cigarette shipments by 2025. Methods PMI cigarette shipment data are taken from PMI quarterly financial reports 2008–2023. Trends in these data before and after the 2020 annou...

Background Racism is an important determinant of health and driver of racial/ethnic health inequities. Experience of racism has been linked to negative healthcare use and experiences although most studies have been cross-sectional. This study examines the relationship between reported experience of racism and subsequent use and experience of health...

Introductions An increasing number of countries are adopting the tobacco endgame goal. High levels of public support can accelerate momentum towards implementing tobacco endgame policies. We aimed to conduct a systematic review on the level of public support for tobacco endgame policies and to examine the geographical distribution of studies, suppo...

Background: Children of people who smoke are more likely to take up smoking themselves. In Aotearoa New Zealand (NZ), adolescent smoking declined dramatically between 2000 and 2016 despite limited change in parental smoking, demonstrating that the cycle can be broken. Aim: This study aimed to identify modifiable factors associated with never smo...

Aim: The recently passed Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act has the potential to profoundly reduce smoking prevalence and related health inequities experienced among Māori. This study examined support for, and potential impacts of, key measures included within the legislation. Method: Data came from Wave...

Objective: This article aims to examine the impact on adolescents of New Zealand's 2018 legislation introducing plain (standardised) packaging and enhanced pictorial warning labels (PWLs). Methods: Data came from Year 10 (14-15 years old) students in the 2016 (2,884 participants) and 2018 (2,689 participants) Youth Insights Surveys conducted 2 y...

Smoking initiation is concentrated among young people which strongly influences future smoking prevalence. This study aimed to investigate the prevalence of smoking and other tobacco product use and potential determinants in a cross-sectional survey of 1121 students aged 13 to 15 years in Dili, Timor-Leste. The prevalence of ever using a tobacco pr...

Introduction: Initiating cannabis use at an early age elevates risk of harm. Cannabis vaping is an emerging issue, and it is unknown whether the patterning and correlates of early-onset cannabis vaping differ from those of cannabis smoking. Methods: We used repeat cross-sectional data from a nationally representative biennial survey (2012-2018)...

Background The Aotearoa/New Zealand Government is aiming to end the tobacco epidemic and markedly reduce Māori:non-Māori health inequalities by legislating: (1) denicotinisation of retail tobacco, (2) 95% reduction in retail outlets and (c) a tobacco free-generation whereby people born after 2005 are unable to legally purchase tobacco. This paper e...

Housing quality is essential for population health and broader well-being. The World Health Organization housing and health guidelines highlight interventions that protect occupants from cold and hot temperatures, injuries, and other hazards. The COVID-19 pandemic has emphasized the importance of ventilation standards. Housing standards are unevenl...

Introduction: Aotearoa New Zealand (NZ) plans to introduce a smoke-free generation (SFG) policy, alongside denicotinisation and reducing the availability of tobacco products. The SFG has a clear rationale, yet we know little about how young people, those the policy targets, perceive it. To inform policy design, communication and implementation, we...

BACKGROUND Aotearoa New Zealand (NZ) is a country with a tobacco endgame plan that includes denicotinisation of tobacco. Because of concerns these measures could increase tobacco smuggling, we aimed to provide new baseline data on such smuggling. We studied littered tobacco packs during a ‘natural experiment’ when no international tourists and re...

Background Between 2010 and 2020, the New Zealand (NZ) Government increased tobacco excise tax by inflation plus 10% each year. We reviewed market structure changes and examined whether NZ tobacco companies shifted excise tax increases to maintain the affordability of lower priced cigarette brands. Methods We cluster-analysed market data that toba...

Objective To estimate the health gains and Māori:non-Māori health inequality reductions of the Aotearoa/New Zealand Government’s proposed endgame strategy. Design Simulation modelling: a Markov model to estimate future yearly smoking and vaping prevalence (for business-as-usual [BAU] and intervention scenarios) linked to a proportional multistate...

Background Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain an inequitable cause of avoidable suffering and early death in many countries, including among Indigenous Māori and Pacific populations in New Zealand. There is a lack of robust evidence on interventions to prevent ARF. This study aimed to identify modifiable risk facto...

This narrative review summarises the latest evidence on the causes and consequences of substance use in adolescence and describes long-term trends in adolescent alcohol, tobacco and cannabis use in Aotearoa. Adolescence is a time of rapid brain development when young people are uniquely vulnerable to the risks of substance use. It is a major cause...

Objective Tobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities. Data sources Guided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) fo...

Some tobacco companies claim they are ‘transforming’ by adopting harm reduction goals or even seeking to achieve a ‘smokefree’ world. What characterises transformation and whether companies can or are transforming is unclear. Nevertheless, such claims are gaining traction. We critically investigated tobacco industry transformation by exploring the...

Objective This paper explores transnational tobacco companies’ (TTCs) long-term policy influence strategies using two case studies, harm reduction and illicit tobacco, to identify lessons for the tobacco control movement and wider efforts to address the commercial determinants of health. Methods Evidence from a broad combination of sources includi...

Background The paper focuses on the geographical region of Oceania. We highlight the tobacco control leadership demonstrated in this region and describe the challenges and opportunities to achieving country-specific smoke-free goals. Results Significant achievements include smoke-free nation goals, world-leading initiatives such as plain packaging...

Background Co-design has increasingly been posited as a useful approach for Indigenous peoples and other social groups that experience inequities. However, the relatively rapid rise in co-design rhetoric has not necessarily been accompanied by increased understanding of whether co-design works for these social groups, and how equity is addressed....

Aim: To provide preliminary high-level modelling estimates of the impact of denicotinisation of tobacco on changes in smoking prevalence in Aotearoa New Zealand relative to the New Zealand Government's Smokefree 2025 goal. Methods: An Excel spreadsheet was populated with smoking and vaping prevalence data from the New Zealand Health Survey and w...

Background Although the harm to health from electronic nicotine delivery systems (ENDS) compared to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identified biomarkers with specificity of association with diffe...

Introduction: New Zealand's equity-focused endgame goal (Smokefree 2025) aims to reduce smoking prevalence to minimal levels (ie, <5%) in all population groups by 2025. Inadequate progress has stimulated discussion of innovative measures to reduce prevalence; because few studies have explored how marginalized groups perceive these measures, we add...

Introduction The emergence of low-cost smartphone technology has coincided with major declines in adolescent smoking and other risk behaviours. This study explores the relationship between internet use and smoking in adolescents and investigates whether rising internet use contributed to the decline in smoking between 2012 and 2018. Methods Data w...

Focus of Presentation Cohort study recruitment can be complex, often requiring extensive pre-screening to recruit sufficient numbers of exposed and unexposed participants. We discuss a prospective study of the impact of racism on adult health in New Zealand (NZ), with emphasis on propensity-score based sampling and recruitment methods accessing par...

Aim: To provide preliminary high-level modelling estimates of the impact of denicotinisation of tobacco on changes in smoking prevalence in Aotearoa New Zealand (NZ). Methods: An Excel spreadsheet was populated with smoking/vaping prevalence data from the NZ Health Survey and business-as-usual trends projected. Using various parameters from the lit...

Objectives: To assess support among smokers and recent quitters for the Smokefree New Zealand (NZ) 2025 goal and measures to facilitate its achievement. Methods: Data from CATI interviews with 1,155 (386 Māori) smokers and recent quitters in Wave 1 (August 2016–April 2017) and 1,020 (394 Māori) in Wave 2 (June–December 2018) of the International To...

The public will soon have the opportunity to make submissions on the long-awaited Smokefree Environments and Regulated Products (Vaping) Amendment Bill ('the Bill') which will regulate vaping products and alternative nicotine delivery systems. In a previous blog, ASPIRE 2025 researchers summarised the strengths and limitations of the Bill, and conc...

Introduction Although the harm to health from electronic nicotine delivery systems (ENDS) use relative to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identified biomarkers with specificity of association with...

Background Binge-drinking prevalence among New Zealand adolescents has declined sharply since 2001, as it has in many other high-income countries. Other adolescent risk behaviours (e.g. smoking, cannabis use and precocious sexual activity) have also declined, raising the possibility of common underlying drivers. This study investigates potential co...

Alternative nicotine products like e-cigarettes could help achieve an end to the epidemic of ill health and death caused by smoking. However, in-depth information about their use is often limited. Our study investigated patterns of use of e-cigarettes and attitudes and beliefs among smokers and ex-smokers in New Zealand (NZ), a country with an 'end...

In this viewpoint we briefly review the evidence for smoke-free car legislation. We find that this legislation has been consistently associated with reduced secondhand exposure in cars with children/youth in all nine jurisdictions studied. Despite this, there are various aspects of this intervention that warrant further study-especially determining...

Many cancers can be prevented, yet Aotearoa New Zealand has high incidence and marked ethnic inequalities in some cancers. This paper explores the state of cancer prevention in New Zealand. It does so through an examination of the state of prevention in four areas: alcohol, nutrition and body weight, sun safety and tobacco. The paper concludes that...

Minister Jenny Salesa announced the Government's long-awaited Smokefree Environments and Regulated Products (Vaping) Amendment Bill on Sunday 23 February. The Bill contains some important provisions as it works to strike a balance between ensuring regulated products are available to smokers wishing to quit, while at the same time minimising uptake...

Debate over tobacco tax increases has intensified as research indicates potentially conflicting policy directions. On the one hand, excise tax increases continue to stimulate quit attempts among smokers yet, on the other hand, they may lead to financial hardship for some smokers and increase retail crime. In this blog, we explore how allocating a p...

Acute rheumatic fever (ARF) and its sequela, rheumatic heart disease (RHD), have largely disappeared from high-income countries. However, in New Zealand (NZ), rates remain unacceptably high in indigenous Māori and Pacific populations. The goal of this study is to identify potentially modifiable risk factors for ARF to support effective disease prev...

Aim: Cannabis use declined in New Zealand adolescents between 2001 and 2012. We investigated i) whether changes in adolescent cannabis use occurred across all demographic groups, and ii) whether declining cannabis use was accompanied by increasing use of other psychoactive drugs. Method: We conducted secondary analysis of repeat cross-sectional...

Objective: To explore the prevalence of e-cigarette use in New Zealand in a nationally representative sample aged 15 years and over. Methods: The Health and Lifestyles Survey (HLS) is a biennial face-to-face in-house survey of New Zealand adults aged 15 years or over. The HLS was completed by 3854 participants in 2016. Results: 17% of adults h...

Background Racial discrimination is recognised as a key social determinant of health and driver of racial/ethnic health inequities. Studies have shown that people exposed to racism have poorer health outcomes (particularly for mental health), alongside both reduced access to health care and poorer patient experiences. Most of these studies have use...

Aims This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, setting, participants and measurements A cross‐sectional an...

Aim: To estimate the numbers of people required to quit smoking in New Zealand to achieve the Smokefree 2025 goal and to compare these with current levels of quitting. Methods: We used the established BODE3 tobacco forecasting model to project smoking prevalence separately for Māori and non-Māori to 2025 under a business-as-usual (BAU) scenario....

Objectives Adolescent smoking has declined in New Zealand and in many other countries since the late 1990s, yet the reasons for the decline are not well understood. We investigated the extent to which established risk factors for adolescent smoking (parental, sibling and peer smoking, and exposure to smoking in the home) explained the downward tren...

This paper was part of a symposium on the decline in adolescent risk behaviour entitled: "Trends in adolescent substance use in the early 21st century: Links with delinquency, social media use, and parenting."

Testicular cancer (TC) is by far the most common cancer to affect young men; however, the exposures that cause this disease are still poorly understood. Our own research has shown that Māori men have the highest rates of this disease in New Zealand—a puzzling observation, since internationally TC is most commonly a disease of men of European ancest...

Despite the global popularity of sport, we know surprisingly little about food in sports settings. This two-phased study analysed the foods available in New Zealand sports settings. Phase one included a systematic literature review and 18 interviews with key informants from national and regional sporting organizations. Phase two involved 37 key inf...

Introduction Smoking among New Zealand (NZ) adolescents has declined since 2000, but ethnic disparities remain pronounced. To inform prevention efforts, we investigated exposure to and relative importance of known predictors of adolescent smoking and how these have changed over time, for Māori (NZ’s indigenous population) and adolescents overall....

Aims: To examine recent smoking trends among doctors and nurses in New Zealand. Methods: Analysis of smoking prevalence in the 2013 New Zealand Census and comparison with previous census data. Results: The 2013 census included 7,065 male and 5,619 female doctors, and 2,988 male and 36,138 female nurses. Non-response to smoking questions was le...

Background Tobacco products can contain a range of flavourings designed to reduce the harshness of tobacco and enhance its taste. These features can make it easier for new smokers to become addicted or existing smokers to maintain their addiction. A recently released national action plan identified removal of tobacco flavourings such as menthol as...

Background Tobacco taxes are effective for reducing smoking prevalence and in New Zealand (NZ) there have been annual 10% tax increases since 2010. There is ongoing debate in NZ about the potential unequal impact and regressive nature of these taxes for Māori (indigenous peoples of NZ). This study explored Māori and non-Māori experiences of tobacco...

Background In New Zealand (NZ), nicotine-containing e-cigarettes (ECs) and e-liquids cannot be sold legally in shops, but can be imported via the internet. We describe patterns of EC use prior to a planned legislative change in 2018 permitting sales of nicotine-containing ECs. Methods We present data from CATI interviews with 820 current smokers a...

Background In New Zealand (NZ), roll-your-own (RYO) cigarettes are commonly smoked. We explore patterns of use of RYO among NZ smokers. Methods We present data from CATI interviews with 910 current smokers from the Aug 2016-April 2017 (second cohort) of the current ITC NZ Survey. The findings are from preliminary analysis using unweighted data and...

Background Tobacco taxation is an effective intervention to reduce tobacco consumption. Tobacco taxes also generate substantial government revenue, and this is often framed as an argument to support tobacco tax increases. Achieving the tobacco endgame would eliminate tobacco taxation revenue, and the implications of this for endgame progress are no...

Background Despite their currency, there is little ‘real-world’ evidence for the health co-benefits of policies to reduce carbon dioxide emissions. Objectives To explore whether increases in market petrol and diesel price have a discernible impact on ambient air pollution. Methods A causal diagram informed the analysis. Linear regression was cond...

Background: The drivers of trends in adolescent risk behaviour at the population level are not well understood, and what little research has been undertaken has generally focused on a single risk behaviour in a single country. This presentation makes connections across risk behaviours and across countries to describe international trends, and explo...

Undescended testis - known as cryptorchidism - is one of the most common congenital abnormalities observed in boys, and is one of the few known risk factors for testicular cancer. The key factors that contribute to the occurrence of cryptorchidism remain elusive. Testicular descent is thought to occur during two hormonally-controlled phases in feta...

Background Theory, common sense and modelling studies suggest that some interventions to mitigate greenhouse gas (GHG) emissions in the transport sector can, in addition to the long term benefits from stabilising the global climate, have substantial short term benefits for population health. Policies that encourage active modes of transportation, f...