Views From a Small Pacific Island: Prospects for Tobacco Control on Niue

Background and aims. Tobacco smoking is a significant public health issue in Niue, a small Western Pacific nation where 31% of males and 16% of females smoke, and smoking initiation is still occurring at high levels among young people. There is evidence of political support for stronger tobacco control measures in Niue with ratification of the Framework Convention on Tobacco Control in 2005 and the Niue Tobacco Control Bill 2007 currently in discussion. However, more information is needed about how best to implement tobacco control measures in Niue. The aim of this research was to identify key contextual factors for progressing effective tobacco control in Niue. Methods. Twelve in-depth interviews were conducted with health, tobacco control, and public health professionals selected purposively from both Niue and New Zealand. A semistructured interview format was used and a qualitative thematic analysis undertaken to explore common and divergent viewpoints. Results. Significant progress in tobacco control is feasible in Niue, but outside technical assistance will be needed as there is very limited capacity to undertake all that needs to be done. Key steps will include developing a comprehensive tobacco control plan that will adopt a health promotion paradigm. This will include the building of strong cross-sectoral political support and community engagement to ensure local contextual knowledge guides the development of interventions. Capacity building throughout will be vital. Conclusion. A comprehensive health promotion approach that draws on outside technical assistance for support and capacity when needed is recommended to advance tobacco control in Niue.