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Damien O’Connor: National Hui of Aukati Kai Paipa

20 April 2005 Speech Notes

Hon Damien O’Connor - National Hui of Aukati Kai Paipa

Ko Kawatiri te awa, Ko Aoraki te maunga, Ko Damien O'Connor, taku ingoa Tena koutou katoa.

I would like to start by thanking Orakei Marae for inviting me here today for this important occasion. Six years ago the First National Hui of Aukati Kai Paipa was held. Today, we can be proud of the progress of Maori Smoking Cessation Programmes, the development of the Aukati Kai Paipa services, and the enhancement of collaboration among all smoking cessation providers.

I want to acknowledge the great work of the seven Aukati Kai Paipa pilot sites and in particular, the people who've been with the project since its conception. It's thanks to the ongoing commitment, guidance and support they've shown to the 37 sites throughout New Zealand, that this programme is a success.

In particular, I'd like to thank Sue Taylor in her role as training co-ordinator up until recently, and Tahu Stirling who has taken over from her in this role at Te Hotu Manawa Maori.

I'd also like to thank Shane Bradbrook for his support and tenacity in the role he's had with ATAK. Welcome and thanks to the 26 providers offering Aukati services throughout New Zealand.

We meet here in Orakei with the dual goals of building a strong infrastructure through relationships with providers, and discussing the strategic vision for the future development of Aukati Kai Paipa services.

One of the Government’s primary goals for tobacco control is the reduction of smoking in New Zealand particularly among Maori. Because Mäori, on average, have the poorest health status of any group in New Zealand.

Every year a third of all Maori deaths are attributed to smoking; just under half of Mäori adults are smokers; the smoking rate among young Mäori males is still more than double the European rate, and the rate of smoking amongst young Maori women is not dropping as quickly as for other New Zealanders. And so the list of worrying statistics goes on.

In developing existing cessation services, the Government and Maori must work together. Simply providing a Government based solution will not be adequate.

The development of culturally appropriate Mäori smoking cessation services, such as Aukati Kai Paipa and Mäori advisors on Quitline, is an essential part of reducing the burden of tobacco related illness and death among Maori.

The Aukati Kai Paipa programme has proved that implementing an internationally proven smoking cessation intervention in a Mäori health setting can work. The cessation results that have occurred support the continued provision of free, or heavily subsidised nicotine replacement therapy in the future.

In developing policy and making funding decisions relating to the advancement of Mäori health, the Ministry of Health follows the directions, threads and pathways outlined in He Korowai Oranga, the Mäori Health Strategy.

The strategy’s overall aim is of whänau ora – Mäori families being supported to achieve the fullness of health and well being within New Zealand society.

In working together towards a tobacco free New Zealand, we will seek to acknowledge the aspiration among all New Zealanders, and work to reduce the inequalities that currently exist between the health and well being of Mäori and other New Zealanders.

We must all work together if we are to successfully achieve the targets identified in the Ministry’s five-year plan. The Ministry aims to reduce smoking among Maori adults from 49% to less than 40%, to reduce daily smoking among 14 to 15 year old Maori females from 34.1% to less than 30%, and to reduce the smoking prevalence among Maori women aged 15 to 24 from 57.5% to less than 50%.

On the face of it these targets seem modest but in reality they are the least we can do to improve the health of Maori in our country. And in reality we must aim to better these Ministry targets.

Once we've achieved these goals, we'll set even lower targets and work on achieving those.

The tobacco related health burden for Maori is particularly severe, due to premature death and illness. Those who die from smoking, die an average of 14 years earlier than non-smokers. These facts are outrageous in todays world of safety, harm minimisation and risk prevention. Add to this the fact that a third of Mäori deaths are linked to tobacco and we have a serious epidemic on our hands.

Adding to the urgency for collaborative work is the fact that an estimated 33 Mäori children die each year from sudden infant death syndrome as a result of exposure to smoking by adults. Mäori smoking cessation programmes that have focused on women, and are available to pregnant Mäori women, are most certainly strengthening the long-term work of Dr David Tipene-Leach and Riripeti Haretuku’s team in preventing cot death amongst Maori infants.

Pretty much all statistics relating to Maori and smoking are alarming – we must strive for improvement. In working towards this goal, the Government will continue to focus on preventing young people from starting to smoke in the first place.

We are developing a new campaign based on work carried out by the Health Sponsorship Council and Auckland University’s Tobacco Research Group. The Government will also promote physical activity in the community to prevent smoking by encouraging sports and activities for every New Zealander. We'll also strengthen our Smokefree Schools programmes, in particular, the enhancement of activities in areas with a high proportion of Mäori.

One of the vehicles that will be used to achieve our goals is the mass media. At this stage, the provision of a youth media campaign with special emphasis on Maori youth, in particular young Maori women, is planned.

We are making progress in some areas, but failing in others and much more needs to be done. The rates of pregnant Maori women smoking have not declined. 42.2% of Maori women smoked during pregnancy in 2004, compared to 40.9% in 2000. This statistic is of particular concern given the proven link between developmental problems and smoking during pregnancy.

We must evaluate our programmes to ensure the targeted outcomes are achieved and that any new funding is correctly allocated. New funding must make a difference – it may be necessary that new approaches to old problems are adapted. While Government is often not in the best position to determine the most effective programmes, the absence of progress will inevitably lead to greater intervention in existing targeted programmes.

In acknowledging the excellent work that is being carried out by you who are here today, it is essential to also look towards the future, in order to ensure that progress continues.

Interagency coordination must be used to further the success of the Aukati Kai Paipa programmes in their effectiveness for Mäori preferring face-to-face quit advice. Special attention has also been set aside for young Mäori women, whose very high smoking rates are a major matter of concern.

As part of the new funding to help implement the Cancer Control strategy, announced last month, this Government has allocated an additional one million dollars for strengthening smoking cessation programmes across the country. Part of this money will go into strengthening Maori cessation programmes.

A bigger Maori workforce in the public health sector is also essential in supporting the smoking cessation effort. The Ministry of Health aims to increase the number, and improve the skills of the Mäori health and disability workforce at all levels.

The Government sees the training of Mäori health workers as a priority; the continuation of present training is essential, combined with the establishment of medical undergraduate and graduate educational materials on tobacco smoking and cessation that improve communication on cultural issues.

None of the achievements accomplished thus far could have happened without the efforts of those involved in Maori cessation programmes such as Aukati Kai Paipa.

The Government, in working together in partnership with Mäori must achieve the joint goal of reducing the prevalence of smoking amongst Maori in the future to improve the health of young Maori in generations to come.

Smokefree homes and workplaces must become the norm. However we cannot forget that an enormous task still lies before us. Our goals will only be achieved through continued cooperation, dedication and hard work.

I look forward to sharing the load, and the success, of our endeavours. Together we can make a difference to the health of Maori in Aotearoa New Zealand.


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