Method of contraception and risk of ovarian cancer data.

The data presented here were obtained for a New Zealand nationwide population-based case-control analysis undertaken to assess the association between ovarian cancer and depot medroxyprogesterone acetate (DMPA), intrauterine contraceptive devices (IUDs), and vasectomy of a woman's sexual partner (Chesang et al., 2021). The research involved women aged 35 to 69 years. Controls were randomly selected from the New Zealand electoral roll. Cases were women with a diagnosis of incident ovarian cancer recruited from the New Zealand Cancer Registry and had to be listed on the electoral roll. Data collection was conducted between 1st May 2013 and 31st October, 2015. A structured postal questionnaire was used to gather information. Data were analysed using IBM Statistical Package for the Social Sciences (IBM SPSS statistics 22). Odds ratios adjusted for age were calculated using the method of Mantel and Haensze (Rosner et al., 2007). For multivariable analyses, binary logistic regression was used. Description of study participants and age-adjusted and multivariable analyses of the association between ever-use and specifics of use of DMPA, IUDs, and vasectomy were presented in a journal article (Chesang et al., 2021). Here, we present data from analyses of the risk of ovarian cancer by histological type associated with the use of DMPA, IUDs and ever having had a vasectomised partner. In addition, analyses assessing the association between ovarian cancer and these contraceptives restricted to ever-users and never-users of hormonal contraceptives (defined as oral contraceptives or DMPA) are presented. Data from analyses of the association between history of tubal ligation and the risk of ovarian cancer are also presented. These data, including the findings of a related study (Chesang et al., 2021) and the raw data, can be included in a collaborative analysis of existing studies undertaken to assess the association between IUDs, long-acting progestogen-based contraceptives, and partner vasectomy and the risk of ovarian cancer.

Cigarette smoking and e-cigarette use among university students in New Zealand before and after nicotine-containing e-cigarettes became widely available: results from repeat cross-sectional surveys.

AIM: To estimate prevalence and patterns of smoking and vaping, and associations between smoking and vaping, among university students in New Zealand when access to nicotine-containing e-cigarettes was restricted (ie, time point 1 or T1) and 12-months after restrictions were relaxed (ie, time point 2 or T2). METHOD: Cross-sectional surveys of university students across all eight universities: T1, March 2018 (n=1,932), and T2, March 2019 (n=2,004). Chi-squared tests compared responses between T1 and T2 and logistic regression examined associations between smoking and vaping with student characteristics. RESULTS: The patterns of smoking (T1 vs T2): current (10.6% vs 12.1%, p=0.716), daily (5.0% vs 4.6%, p=0.121), and cigarettes/day, time to first cigarette, and avoidance of smoking in smoke-free spaces were not significantly different. In contrast, vaping: current (6.8% vs 13.5%, p<0.001), daily (2.7% vs 5.4%, p<0.001), and possibly vaping in smoke-free spaces, were significantly higher at T2. At both periods, males had higher odds of smoking, vaping and dual use; students aged 25-34 and long-term residents had higher odds of vaping. Asian and Other students had lower odds of smoking at T1, and Other students had higher odds of vaping at T2. CONCLUSION: Vaping was significantly more prevalent at T2 than T1, without their being a corresponding decrease in smoking. Age, sex, student type and ethnicity predicted smoking and vaping.

Association of partner vasectomy, depot medroxyprogesterone acetate and intrauterine contraceptive devices with ovarian cancer.

PURPOSE: To assess the associations between ovarian cancer and depot medroxyprogesterone acetate (DMPA), intrauterine contraceptive devices (IUDs), and partner vasectomy. METHODS: We undertook a New Zealand-wide population-based case-control study. During 2013-2015, 205 eligible cases were identified from the cancer registry (152 [74%] participated) and 1,735 eligible controls were randomly selected from the electoral roll (837 [48%] participated). A postal questionnaire was used to gather information. RESULTS: Ever-use of vasectomy was inversely associated with ovarian cancer in age-adjusted analysis, but not in multivariable analysis (OR = 0.67, 95% CI = 0.46-0.96, and OR = 0.82; 95% CI = 0.54-1.23, respectively). A suggestive trend towards lower risk with longer duration of reliance on partner vasectomy was observed (P-trend = 0.08). Ever-use and duration of use of DMPA were not associated with ovarian cancer. Although ever-use of IUDs was not associated with ovarian cancer, duration of use of IUDs was associated with higher risk (P-trend = 0.04). There were also statistically significant inverse associations between ovarian cancer and use of oral contraceptives, parity, and breastfeeding. CONCLUSIONS: Prolonged use of IUDs may increase the risk of ovarian cancer. It is also possible that an inverse association exists between ovarian cancer and partner vasectomy.

Cigarette smoking and e-cigarette use among university students in Queensland, Australia and New Zealand: results of two cross-sectional surveys.

OBJECTIVES: Examine the patterns of cigarette smoking and e-cigarette use (vaping), the perceived harm of e-cigarettes compared with tobacco cigarettes, and associations between smoking and vaping with student characteristics. DESIGN: Cross-sectional studies. SETTING: The University of Queensland (UQ), Australia and eight New Zealand (NZ) universities. PARTICIPANTS: Students at UQ: 4957 (70.8% aged <25 years, 63.0% women) and NZ: 1854 (82.5% aged <25 years, 60.1% women). METHODS: Χ2 tests compared smoking by age and gender, and vaping by age, gender and smoking status. Two-sided p<0.05 was considered significant and 95% CIs reported where appropriate. Multinomial logistic regression examined associations between smoking and vaping (exclusive smoking, exclusive vaping, dual use and non-use) with age, gender and student type (domestic vs international). RESULTS: Smoking (UQ vs NZ, 95% CI): ever 45.2% (43.8% to 46.6%) vs 50.0% (47.7% to 52.3%), current 8.9% (8.1% to 9.7%) vs 10.4% (9.1% to 11.9%) and daily 5.2% (4.6% to 5.8%) vs 5.6% (4.6% to 6.7%), and not smoking in indoor 98.3% vs 87.7% or outdoor smoke-free spaces 83.8% vs 65.3%.Vaping (UQ vs NZ, 95% CI): ever 20.9% (19.8% to 22.1%) vs 37.6% (35.4% to 39.9%), current 1.8% (1.5% to 2.2%) vs 6.5% (5.4% to 7.7%) and daily 0.7% (0.5% to 1.0%) vs 2.5% (1.9% to 3.4%), and not vaping in indoor 91.4% vs 79.6% or outdoor smoke-free spaces 84.4% vs 71.3%. Of respondents, 71.7% (70.3% to 73.2%) vs 75.3% (72.9% to 77.6%) perceived e-cigarettes as less harmful than tobacco cigarettes.Men were more likely than women to smoke and vape, and to believe that e-cigarettes are less harmful. Regression models containing all predictors for smoking and vaping were significant and the effect of gender was significant for dual use, exclusive smoking and exclusive vaping (all p<0.01). Men had higher odds for smoking, vaping or dual use. CONCLUSIONS: Results suggest significant differences in patterns of smoking and vaping of university students in Australia and NZ, and a strong influence of gender on smoking and vaping.

Associations of history of mental illness with smoking and vaping among university students aged 18-24 years in New Zealand: Results of a 2018 national cross-sectional survey.

OBJECTIVE: Data on associations of history of mental illness (HMI) with smoking and vaping in New Zealand (NZ) are lacking. This study examines these associations in university students aged 18-24 years. METHODS: Data came from a 2018 national cross-sectional study of university students and included information on demographic characteristics, smoking, vaping and participant health in the previous 12-months. χ2 tests compared patterns of smoking and vaping, and logistic regression assessed associations of HMI with smoking and vaping, controlling for age, gender and ethnicity. An HMI was defined as a diagnosis/treatment for depression, anxiety/nervous disorder, or other mental health condition in the previous 12-months. RESULTS: The sample comprised 1293 students: 61.3% aged 18-20; 62.8% female; 7.8% Maori, 92.2% non-Maori, and 18.5% reported an HMI. Smoking: 49.7% (95% CI 47.0-52.5) reported ever, 10.5% (8.9-12.3) current and 5.0% (3.9-6.4) daily smoking. Vaping: 38.7% (36.0-41.4) reported ever, 6.3% (5.1-7.8) current and 1.9% (1.3-2.8) daily vaping. Participants with HMI were significantly more likely to smoke: ever (64.9% vs 46.3%, p < .001), current (15.1% vs 9.5%, p = .011) and daily (7.5% vs 4.5%, p = .050), and vape: ever (49.4% vs 36.3%, p < .001) and current (9.2% vs 5.7%, p = .044) than participants without HMI. The model containing all predictors of HMI was significant, χ2 (5, N = 1293) = 24.09, p < .001. Gender (OR 0.54, (0.4-0.75)), current smoking (OR 1.82, (1.19-2.78)) and current vaping (OR 1.73, (1.02-2.93)) made unique significant contributions to the model. CONCLUSIONS: The prevalence of smoking and vaping were significantly higher in students with HMI, and there were strong associations between HMI and smoking and vaping.

Attitudes towards the New Zealand Government's Smokefree 2025 goal associated with smoking and vaping in university students aged 18 to 24 years: results of a 2018 national cross-sectional survey.

OBJECTIVE: In March 2011, New Zealand (NZ) launched an aspirational goal to reduce smoking prevalence to 5% or less by 2025 (Smokefree 2025 goal). Little is known about university students' awareness of, support for and perceptions about this goal. We sought to narrow the knowledge gap. SETTING: University students in NZ. METHODS: We analysed data from a 2018 cross-sectional survey of university students across NZ. Logistic regression analysis examined the associations between responses about the Smokefree goal with smoking and vaping, while controlling for age, sex and ethnicity. Confidence intervals (95% CI) were reported where appropriate. PARTICIPANTS: The sample comprised 1476 students: 919 (62.3%) aged 18 to 20 and 557 (37.7%) aged 21 to 24 years; 569 (38.6%) male and 907 (61.4%) female; 117 (7.9%) Maori and 1359 (92.1%) non-Maori. Of these, 10.5% currently smoked (ie, smoked at least monthly) and 6.1% currently vaped (ie, used an e-cigarette or vaped at least once a month). RESULTS: Overall awareness of the Smokefree goal was 47.5% (95% CI: 44.9 to 50.1); support 96.9% (95% CI: 95.8 to 97.8); belief that it can be achieved 88.8% (95% CI: 86.8 to 90.7) and belief that e-cigarettes/vaping can help achieve it 88.1% (95% CI: 86.0 to 89.9).Dual users of tobacco cigarettes and e-cigarettes had greater odds of being aware of the Smokefree goal (OR=3.07, 95% CI: 1.19 to 7.92), current smokers had lower odds of supporting it (OR=0.13, 95% CI: 0.06 to 0.27) and of believing that it can be achieved (OR=0.15, 95% CI: 0.09 to 0.24) and current vapers had greater odds of believing that e-cigarettes/vaping can help to achieve it (OR=8.57, 95% CI: 1.18 to 62.52) compared with non-users. CONCLUSIONS: The results suggest strong overall support for the Smokefree goal and belief that it can be achieved and that e-cigarettes/vaping can help achieve it. Smoking and vaping were associated with high awareness of the Smokefree goal, but lower support and optimism that it can be achieved.

Electronic cigarette use among university students aged 18-24 years in New Zealand: results of a 2018 national cross-sectional survey.

OBJECTIVES: To examine electronic cigarette use, reasons for use and perceptions of harm among university students. DESIGN: Cross-sectional study. SETTING: University students across New Zealand. METHODS: We analysed data from a 2018 cross-sectional survey of university students, weighted to account for undersampling and oversampling by gender and university size. χ2 tests were used to compare e-cigarette use, reasons for use and perceptions of harm by age, gender, ethnicity and cigarette smoking. PARTICIPANTS: The sample comprised 1476 students: 62.3% aged 18-20 years, 37.7% aged 21-24 years; 38.6% male, 61.4% female; 7.9% Maori and 92.1% non-Maori. RESULTS: 40.5% of respondents (95% CI 37.9 to 43.1) reported ever, 6.1% (4.9-7.4) current and 1.7% (1.1-2.5) daily use. Regardless of frequency, 11.5% of vapers had vaped daily for ≥1 month, 70.2% of whom used nicotine-containing devices; 80.8% reported not vaping in indoor and 73.8% in outdoor smoke-free spaces. Among ever vapers, curiosity (67.4%), enjoyment (14.4%) and quitting (2.4%) were common reasons for vaping. 76.1% (73.4-78.7) of respondents believed e-cigarettes were less harmful than cigarettes.More males than females reported vaping (ever, current, daily and daily for ≥1 month), nicotine use and belief that e-cigarettes were less harmful than cigarettes. More participants aged 18-20 years reported not vaping in outdoor smoke-free spaces, vaping out of curiosity and belief that e-cigarettes were less harmful than cigarettes, while more participants aged 21-24 years vaped daily for ≥1 month and for enjoyment. More Maori than non-Maori ever vaped. More cigarette smokers than non-smokers vaped (ever, current, daily and daily for ≥1 month), used nicotine and vaped to quit, while more non-smokers did not vape in smoke-free spaces and vaped out of curiosity. CONCLUSIONS: Our results suggest high prevalence of e-cigarette ever and current use, particularly among males and smokers. Many vaped out of curiosity and perceived e-cigarettes as less harmful than cigarettes.

Cigarette smoking among university students aged 18-24 years in New Zealand: results of the first (baseline) of two national surveys.

OBJECTIVES: Although the smoking prevalence continues to decline in New Zealand (NZ) overall, little is known about smoking in university students. A 2013 survey of students aged 17-25 years found that 14% were current smokers, and 3% daily smokers. However, the sample did not include students from all NZ universities. This study examines the prevalence and patterns of cigarette smoking among students aged 18-24 years. SETTING: University students across NZ. METHODS: Data came from a March to May 2018 survey of students from all NZ universities, and were weighted to account for undersampling and oversampling, based on gender and university size. χ2 tests were used to compare smoking by age, gender and ethnicity. PARTICIPANTS: 1476 participants were included: 919 (62.3%) aged 18-20 years and 557 (37.7%) aged 21-24 years; 569 (38.6%) male and 907 (61.4%) female; and 117 (7.9%) Maori and 1359 (92.1%) non-Maori. RESULTS: 49.8% (95% CI 47.2 to 52.4) of respondents reported ever smoking, 11.1% (95% CI 9.5 to 12.9) currently smoked (smoked at least once a month) and 5.9% (95% CI 4.8 to 7.3) smoked at least daily (daily smokers). Of current smokers, 63.6% smoked 1-5 cigarettes/day, 45.8% smoked daily, 73.4% smoked first cigarette >60 min after waking, 86.0% never/almost never smoked in indoor and 64.6% in outdoor smokefree spaces, 69.9% planned to quit and 32.4% had tried to quit. Ever, current and daily smoking were significantly higher in 21-24 compared with 18-20 years olds, and in males compared with females. Older participants were more likely to report smoking more cigarettes/day. Maori were more likely to report ever smoking than non-Maori. CONCLUSIONS: Current smoking among NZ university students aged 18-24 years appears to be declining but daily smoking could be increasing. However, many students appeared less addicted to nicotine, and willing to quit. We recommend increasing the availability of smokefree services for students who wish to quit.

Prevalence of contraceptive use in New Zealand women.

AIMS: To estimate the prevalence of contraceptive use among New Zealand women and to measure changes in contraceptive use since the last population-based prevalence estimates were published in 1988. METHODS: Nine hundred and four women, aged 35-69 years were randomly selected from the electoral roll. A postal questionnaire was used to gather information on contraceptive use, socio-demographic characteristics and risk factors for ovarian cancer. Data were collected in 2013-2015. Estimates of current and ever-use of contraceptives were made and compared with the findings of the 1988 study by Paul et al. In both studies, participants were members of the control arm of case-control studies. RESULTS: The study by Paul et al had a response proportion of 84%, whereas that of the current study was 47%. Oral contraceptives had the highest prevalence of ever-use among women aged 35-69 years (89% [347/389]), followed by condom use (54% [211/389]) and vasectomy (44% [170/389]). Compared to the previous study, there has been an increase in ever-use of condoms (24% [185/767] to 64% [148/231]), vasectomy (26% [202/767] to 40% [92/231]) and oral contraceptives (75% [575/767] to 89% [205/231]) among women aged 35-54 years. In contrast, a lower prevalence of tubal ligation (22% [168/767] to 8% [19/231]) was observed. CONCLUSION: The study demonstrates a change in patterns of contraceptive use among women aged 35-54 years. The prevalence of ever-use of oral contraceptives and vasectomy remains high in New Zealand compared with other countries.

Christchurch earthquakes: how did former refugees cope?

AIM: This study investigated how former refugees now living in Christchurch (Canterbury Province, New Zealand) communities coped after the 4 September 2010 and subsequent earthquakes. METHOD: A systematic sample of one in three former refugees from five ethnic groupings (Afghanistan, Kurdistan, Ethiopia, Somalia and Bhutan) was selected from a list of 317 refugees provided by the Canterbury Refugee Council and invited to participate in the study. Seventy-two out of 105 potential participants completed a 26 item questionnaire regarding the impact of the quakes, their concerns and anxieties, coping strategies and social supports. The methodology was complicated by ongoing aftershocks, particularly that of 22 February 2011. RESULTS: Three-quarters of participants reported that they had coped well, spirituality and religious practice being an important support for many, despite less then 20% receiving support from mainstream agencies. Most participants (72%) had not experienced a traumatic event or natural disaster before. Older participants and married couples with children were more likely to worry about the earthquakes and their impact than single individuals. There was a significant difference in the level of anxiety between males and females. Those who completed the questionnaire after the 22 February 2011 quake were more worried overall than those interviewed before this. CONCLUSION: Overall, the former refugees reported they had coped well despite most of them not experiencing an earthquake before and few receiving support from statutory relief agencies. More engagement from local services is needed in order to build trust and cooperation between the refugee and local communities.

The New Zealand Socio-economic Index of Occupational Status: methodological revision and imputation for missing data.

OBJECTIVES: To revise and update the New Zealand Socio-economic Index (NZSEI) in the light of methodological issues in its construction, and to develop an imputation method for use where occupational information is not available. METHODS: Data were drawn from the following New Zealand national surveys: 1996 Population Census; 1996/97 and 1997/98 Household Economic Surveys; 1996/97 Household Health Survey. Three sets of statistical analyses were applied: alternating least squares to generate socio-economic scores; cluster and discriminant function analyses to identify cut-points; and regression and logistic regression to develop and test imputation methods. RESULTS: Socio-economic scores for the full-time workforce in 1996 showed a different distribution, but much the same occupational ordering, as in 1991. The introduction of part-time workers and income adjustment multipliers for self-employed workers significantly affected scores for management and agricultural titles. The application of cluster and discriminant function analyses generated six groupings that were relatively distinct occupationally. An imputation method based on an averaging of scores within age/qualification categories was found to achieve acceptable results. CONCLUSIONS: Methodological improvements in the construction of the NZSEI have enhanced its empirical robustness, while a simple imputation technique has widened the potential application of the scale.