Book of the day: Vaccine Nation by Raina MacIntyre
The latest book by internationally acclaimed Australian epidemiologist Raina MacIntyre traces the widespread post-pandemic drop in support for public health measures and vaccination. It was mostly written last year, but by now, as it is arriving in bookshops and anti-vax beliefs and conspiracies have
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NZ Herald
19 hours ago
- NZ Herald
Opinion: Youth vaping is a problem, let's look at the evidence
It risks reinforcing a narrative implied by e-cigarette companies, including some owned by Big Tobacco: that New Zealand should never clamp down on e-cigarettes or smoking rates may rise again. Let's re-examine the evidence. Beaglehole claims: 'So far, there is no evidence that teen vaping leads to smoking.' This is incorrect. I was an investigator on the only New Zealand study to date to directly compare adolescent smoking trends before and after e-cigarettes became available. We found that the decline in 14– and 15-year-olds initiating smoking – and smoking regularly – significantly slowed after the emergence and rise of vaping in New Zealand. Had pre-vaping trends in adolescent smoking continued, the smoking initiation rate in 2023 would have been around 6.6%, rather than the 12.6% it ultimately reached. Also, our new study – published today in The Medical Journal of Australia – adds to the evidence, albeit from the other side of the Tasman. As in New Zealand, we found that Australia's progress in reducing adolescent smoking significantly slowed after the emergence and rise of vaping. In both countries, the pattern is similar in a manner that seems unlikely to be a coincidence. While youth vaping may be less of a problem in Australia than in New Zealand, it is still a serious problem. But it's not just our New Zealand and Australian studies. There is also a large body of evidence from international cohort studies – the strongest type of observational study for understanding cause-and-effect relationships. These studies track individuals over time and have consistently found that adolescents who vape are more likely to go on to smoke. None have yet been conducted in New Zealand, but their findings are so consistent across countries and cultures that it seems likely a New Zealand cohort study would show the same. To suggest all of these studies provide 'no evidence that teen vaping leads to smoking' is simply inaccurate. What about adult smoking? Beaglehole's claim that vaping has significantly contributed to its decline in New Zealand also deserves a closer look. It is true that adult daily smoking in New Zealand declined more sharply than expected between 2020 and 2023 – from 11.9% to 6.8%, a period when daily vaping rose rapidly from 3.5% to 9.7%. This four-year window is what many e-cigarette advocates rely heavily on when declaring victory on behalf of e-cigarettes. But the most recent New Zealand data diverge from that narrative. Despite daily vaping continuing to increase from 9.7% in 2023 to 11.1% in 2024, the rate of daily smoking failed to decrease for the first time in a decade. Other countries offer further reason for caution. In England, although smoking rates declined between 2016 and 2023, there was no acceleration in that decline among adults aged 18-24 and 25-44, despite a sharp rise in e-cigarette use from 2021. Among those aged 45 and over, the decline in smoking not only failed to accelerate – it actually slowed. Smoking rates in New Zealand were already falling before e-cigarettes emerged – and they continued to fall afterwards. This progress is at least partly due to the impact of strong tobacco control policies accumulating over many years – policies that continue to influence smoking patterns today. These include smokefree bars and restaurants, regular increases in tobacco excise taxes, graphic health warnings on packaging, point-of-sale display bans, plain packaging and legislation prohibiting smoking in cars carrying children. At best, vaping may have slightly sped up the decline in adult smoking. At worst, it may have made no difference – or even slowed progress – while embedding a commercial nicotine industry that will be hard to wind back. The risk of overstating the evidence is that it fuels the idea that New Zealand now needs a thriving vaping industry. That if it's reined in, smoking will inevitably rise. It's a convenient narrative. Especially for companies that profit from it. Vaping may have a role to play in quitting smoking. But that doesn't mean efforts to limit access to young people who have never smoked should be dismissed. Now more than ever, New Zealand should double down on a progressive, evidence-based approach to tobacco control. Decades of hard-won progress shouldn't now be handed to an industry eager to claim the credit.
Otago Daily Times
3 days ago
- Otago Daily Times
Less than half of recent nursing graduates employed by Heath NZ
Nursing students and recent graduates say they are being "failed" by Health NZ, which has employed just 45% of mid-year graduates. Health NZ figures show just 323 of 722 applicants have got jobs in hospitals through its Advanced Choice of Employment Mid-Year matching process. Co-president of the Nurses Organisation student unit, Bianca Grimmer - who is set to graduate at the end of the year - said it was "really discouraging". "It's certainly affecting all of our cohorts from year one to year three, lot of uncertainty and students wondering if they continue with their degree or look at finding a job somewhere else. "Te Whatu Ora used to hire 80-90% of all graduates. We were blindsided this time last year when only three in every five mid-year graduates were hired. This year is even worse." Health NZ said for the mid-year matching process, there were 173 applications from graduates who were still looking for jobs after graduating at the end of last year. National Chief Nurse Nadine Gray said those who did not get hospital jobs were placed in the talent pool, which was open to all registered employers across the health sector. In recent years, the majority of initially unmatched applicants had successfully secured positions from the talent pool with about 84% of nurses eventually finding roles in both 2023 and 2024. "Graduate RNs [registered nurses] often look to hospitals for their first role, and while we are working to employ as many graduate RNs as possible, I want to encourage students to look right across the health system when looking for their first job." The government was investing in expanding and strengthening the nursing workforce in primary and community care, Gray said. The investment includes: $30 million over five years to fund 400 graduate nurses into primary and community care each year, with providers receiving $15,000 for employing a nurse in an urban setting and $20,000 in a rural setting. $34.2 million over five years to fund 120 nurse practitioner training places in primary care each year from 2026. An additional $21.6 million over four years to accelerate advanced tertiary education for up to 120 primary care registered nurses annually. The Nurses Organisation said a recent survey of 1246 nursing students found 62% would consider seeking a nursing job overseas if they were unable to get a new graduate job in Aotearoa New Zealand. This increased to 73% for Māori students. Bianca Grimmer said nursing students recently attended a jobs expo where Australian recruiters were offering graduates better wages and conditions. "We have a health system in crisis and desperately need more homegrown nurses. With 30,000 Kiwis leaving for Australia in the past year, this short-sighted decision by Te Whatu Ora will see more graduate nurses packing their bags." About 36,000 of NZNO's Te Whatu Ora members are preparing for a 24-hour national strike on July 30 after Collective Agreement negotiations stalled. The union said Health NZ's "refusal to commit to its obligation to employ new graduates" was one of the sticking points.
RNZ News
3 days ago
- RNZ News
Nursing students, graduates say they are being 'failed' by Health NZ
National Chief Nurse Nadine Gray says those who do not get hospital jobs are placed in the talent pool. Photo: 123RF Nursing students and recent graduates say they are being "failed" by Health NZ, which has employed just 45 percent of mid-year graduates. Health NZ figures show just 323 of 722 applicants have got jobs in hospitals through its Advanced Choice of Employment Mid-Year matching process. Co-president of the Nurses Organisation student unit, Bianca Grimmer - who is set to graduate at the end of the year - said it was "really discouraging". "It's certainly affecting all of our cohorts from year one to year three, lot of uncertainty and students wondering if they continue with their degree or look at finding a job somewhere else. "Te Whatu Ora used to hire 80-90 percent of all graduates. We were blindsided this time last year when only three in every five mid-year graduates were hired. This year is even worse." Health NZ said for the mid-year matching process, there were 173 applications from graduates who were still looking for jobs after graduating at the end of last year. National Chief Nurse Nadine Gray said those who did not get hospital jobs were placed in the talent pool, which was open to all registered employers across the health sector. In recent years, the majority of initially unmatched applicants had successfully secured positions from the talent pool with about 84 percent of nurses eventually finding roles in both 2023 and 2024. "Graduate RNs [registered nurses] often look to hospitals for their first role, and while we are working to employ as many graduate RNs as possible, I want to encourage students to look right across the health system when looking for their first job." The government was investing in expanding and strengthening the nursing workforce in primary and community care, Gray said. The Nurses Organisation said a recent survey of 1246 nursing students found 62 percent would consider seeking a nursing job overseas if they were unable to get a new graduate job in Aotearoa New Zealand. This increased to 73 percent for Māori students. Bianca Grimmer said nursing students recently attended a jobs expo where Australian recruiters were offering graduates better wages and conditions. "We have a health system in crisis and desperately need more homegrown nurses. With 30,000 Kiwis leaving for Australia in the past year, this short-sighted decision by Te Whatu Ora will see more graduate nurses packing their bags." About 36,000 of NZNO's Te Whatu Ora members are preparing for a 24-hour national strike on 30 July after Collective Agreement negotiations stalled. The union said Health NZ's "refusal to commit to its obligation to employ new graduates" was one of the sticking points. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
