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A quit-smoking programme aimed at Mâori nursing students folded in 2016 after failing to attract sufficient enrolments. However, there are hopes the model may yet be implemented.
Mâori nurses are vital to helping whanau and Mâori communities quit smoking and avoid starting smoking. Their success in this work can make a huge difference to improving Mâori health. Mâori nurses who smoke face real challenges in the quit smoking and uptake prevention work they do. Often these nurses have to deal with their conflicting feelings about being both a health worker and a smoker.
In 2012, a survey done by NZNO, Whakauae Research for Mâori Health and Development and Taupua Waiora at Auckland University of Technology (AUT), found 20 per cent of the Mâori registered nurses who took part were smokers. For Mâori student nurses, the smoking rate was much higher, at 32 per cent.12
To better support Mâori nurses to be smokefree, the researchers wanted to find out more about nurses' smoking behaviours, as well as their thoughts on quitting and giving quit advice to others. We interviewed 43 Mâori nurses and found many felt professionally marginalised in the context of being Mâori, a nurse and a smoker. As a result, their effectiveness as nurses in supporting others to quit was being undermined. They often tended to give minimal, or ineffective quit advice.13
Mâori nursing students also experienced conflict about being both smokers and health professionals. They talked about having strong motivations to quit but knew little about best evidence for supporting either their own quit attempts or those of others. We concluded that Mâori nursing students would be a prime audience for trialling a quit programme specifically tailored to their needs.
Developing a model
Informed by our research, we developed a quit programme model45 and tested its feasibility with 157 NZNO members at the 2014 indigenous hui a-tau in Auckland. The model, Tapuhi TO Toa (TTT), was further tested at a hui a-tau in the Eastern Bay of Plenty later the same year. As the model was designed for Mâori student participation, nursing schools were also consulted on its feasibility.
Figure 1, p17, shows the intervention logic behind TTT. The overarching approach of the model, the theory of change informing it and the...