The use of the 'rollie' in New Zealand: preference for loose tobacco among an ethnically diverse low socioeconomic urban population

Aim To examine the prevalence of and reasons for smoking roll-your-own (RYO) cigarettes in a population of South Auckland adults. Method Cross-sectional survey of the parents of 2,973 children at four South Auckland Intermediate Schools in 2007-2009. Result Just over a quarter (813; 27%) of parents were smokers. Most (82%) were Mori or Pacific peoples (47% and 34% respectively) of whom 47% smoked only factory-made (FM) and 38% smoked only RYO cigarettes. Exclusive RYO smoking was more common among European (53%) than Mori (40%), Pacific (38%) and Asian ethnic groups (23%). The most common reasons for preferring RYO over FM cigarettes were lower cost (50%), lasting longer (42%), and taste (8%). A few chose RYO because they perceived them to be less harmful (5%). Conclusion Reducing the cost benefit of RYO should lessen the potential use of RYOs as an alternative to quitting. Health education campaigns are needed to counter incorrect beliefs surrounding RYO. Such programmes should include awareness in schools, churches and Pacific communities. Despite several decades of comprehensive tobacco control efforts, tobacco use remains the largest preventable cause of death and disease in New Zealand (NZ). 1 Population-wide tobacco control interventions appear to be most effective for groups with already low smoking prevalence. 2 Increasing the cost of tobacco using tax has been found to be effective in reducing smoking in the general population. 3 Youth are reported to be particularly price sensitive 4 and lower socioeconomic status (SES) smokers may similarly be responsive to tobacco tax increases. 5,6 Indicators of SES include income, occupation, education, access to a telephone, access to a car, income support received, living space and home ownership. 7 Large differences exist in smoking prevalence between ethnic groups and between socioeconomic groups, 2,8 contributing to substantial health inequalities between ethnic and socioeconomic groups. 9 In particular, Mori suffer from marked negative health and economic consequences of smoking. 10 Mori have higher rates than non-Mori of cardiovascular disease (CVD), many cancers, a number of respiratory diseases, and adverse pregnancy outcomes all causally linked to smoking. 10 Reducing smoking among Mori is therefore an important means to substantially reduce ethnic health inequalities.