title: Has smoking prevalence markedly decreased despite more cigarettes released for sale?
abstract: OBJECTIVE
  To assess whether smoking declined markedly since 2003, as reported by the New Zealand Health Survey (NZHS) of 2007.
  
  
  METHODS
  Comparison of daily smoking prevalence from the NZHS, Census, and annual ACNielsen Ltd smoking prevalence survey against tobacco and cigarette volumes released to the domestic market, 1996-2007.
  
  
  RESULTS
  From 2003 to 2007, NZHS-reported daily cigarette smoking prevalence decreased from 22.8% to 18.1%, implying 125,000 (-17%) fewer smokers, whereas cigarettes annually released for sale increased 7.5% from 3957 to 4253 million sticks. In contrast, the Census and the ACNielsen commercial survey estimated 1.0 and 1.5 percentage point decreases respectively in numbers smoking. Identifiable factors explained up to 34% of the decrease in numbers smoking. Anti-smoking sentiment was greater in 2007.
  
  
  CONCLUSIONS
  It is highly doubtful if adult daily smoking prevalence has yet decreased below 20%. Smokers responding to the 2007 NZHS, more than in previous health surveys, tended to underreport their smoking. They may have opted out of responding altogether, or otherwise not reported they smoked. Future health surveys should include biochemical validation of smoking status.
authors.affiliation: Health New Zealand Ltd, Lyttelton, Christchurch, New Zealand. hnz@healthnz.co.nz
authors.forename: Murray
authors.initials: M
authors.lastname: Laugesen