Koe fefine Tonga moe ifi tapaka: Exploration of tobacco smoking and smoking cessation amongst Tongan women in the Auckland region, New Zealand

Abstract

Tongan female smokers' smoking experiences have manifested within a realm of socioeconomic and cultural conditions in New Zealand. Their cessation service engagement remains relatively low and research including this group is limited. Due to the projected tobacco burden attributed to Pacific women in the future, pertinent research proves vital to bettering understandings of smoking and cessation within this group. This research aims to explore the knowledge and experiences of smoking and smoking cessation services among Tongan women aged 16 years and over, currently living in the Auckland region. This explored current and ex-smokers experiences of smoking and health, challenges to quit, smoking cessation support and recommendations to improve cessation processes and services. This qualitative research design utilised the Kakala model to ensure processes were culturally appropriate and meaningful. The data was collected through eight face-to-face semi-structured interviews. Interviews were transcribed by the researcher and data analysed using toli, teu and luva from the Kakala model to categorise data into relevant themes. The findings show smoking among Tongan female smokers is a social vector used to mark independence and maintain friendships, despite the known stigma and adverse health effects. Smoking has mainly been characterised as a stress relief that has habituated into day to day routine. Tongan women have highlighted that the aspiration to live longer for family is a strong stop smoking motivator but quitting is difficult and should be done according to the individual. The state of smoking cessation services are ineffective and need to be adapted and consulted by and within the community. Stop smoking services should encourage autonomy among Tonga women in order to improve utilisation and engagement. Service delivery for Tongan female smokers needs to be an on-going, long-term support reoriented within the community in order for more Tongan women to become completely smokefree. This study concludes that the current Tongan female smoking prevalence in New Zealand can be transformed by utilising existing Tongan cultural ideals to encourage and support cessation. This recommends using the relationship between a tuofēfine and tuonga'ane, specifically the tuofēfine's role as a mehikitanga, to encourage non-smoking within the extended female generations.