Public Health Expert

Professor Tony Blakely is an epidemiologist at the University of Otago, Wellington. He has an extensive portfolio of research. Tony initiated and implemented the New Zealand Census-Mortality Study (NZCMS) in the late 1990s, a pioneering study linking the national censuses with mortality data to allow monitoring and research on ethnic and socio-economic inequalities and the contribution of smoking to mortality (the NZ census periodically includes smoking). He has also led the parallel study, CancerTrends, that links census and cancer registration data to allow cancer incidence and survival studies.

Cost-effective personalised medicine: Herceptin as a case study - Public Health Expert

Oct 25, 2016

Prof Tony Blakely, Dr Nisha Nair This blog is, and isn’t, about the breast cancer drug Herceptin. It is about Herceptin in that we report on a study we just published in the journal PLoS Medicine about the health gains, costs, and cost-effectiveness of Herceptin. It isn’t about Herceptin in that the key point is far more general: in the age of personalised and precision medicine, our country’s funding decisions are often blunt and imprecise, some may even say wasteful. We raise some hard and contentious issues – but talking about money and health in the same breath always is. Most of you will recognise Herceptin (trastuzumab) for the controversy that surrounded it, rather than for the breast cancer treatment drug itself. Breast cancer which is human epidermal growth factor receptor-2 positive (HER2+ for short) is more aggressive than other … Read More

Smokefree Aotearoa 2025 – how might tobacco retail restrictions contribute? - Public Health Expert

Oct 19, 2016

By Dr Amber Pearson, Frederieke Sanne van der Deen, Dr Cristina Cleghorn, Dr Nhung Nghiem, Prof Tony Blakely, Prof Nick Wilson We have just published research on the health gains and cost-savings from various legally mandated restrictions on tobacco retail outlets. In this blog, we briefly consider the results and put the findings in a wider context of how New Zealand might reach its Smokefree 2025 goal. There is increasing policy and research interest in restrictions on tobacco retail outlet locations and density – including for achieving tobacco endgame goals. Many studies in the ‘neighbourhoods and health’ research stream have estimated the health effects of access to features of the built environment, including access to: alcohol outlets and harmful drinking (1), parks and obesity (2), gambling outlets and behaviours (3), etc. Easy access to tobacco retail outlets … Read More

Should Smokefree Indoor Areas = Vapefree Areas? - Public Health Expert

Oct 03, 2016

Prof Nick Wilson, Prof Janet Hoek, A/Prof George Thomson, Prof Richard Edwards The NZ Ministry of Health is currently reviewing public submissions on options that would allow nicotine-containing e-cigarettes to be sold legally in NZ. This consultation raises questions about how the wider uptake of e-cigarette use (known as “vaping”) will be managed. In this blog, we consider arguments about the indoor public settings where vaping should be allowed or prohibited. We conclude that there seems an overall strong rationale for “Smokefree = Vapefree” in all circumstances for the indoor areas covered by current smokefree laws and policies. It is timely that the Ministry of Health is considering whether and how to allow access to nicotine-containing e-cigarettes in NZ. These products could potentially increase quit rates (though scientific evidence on this point remains unclear) or move nicotine-users to where … Read More

Note to the Havelock North Inquiry – Think Big - Public Health Expert

Sep 26, 2016

Prof Alistair Woodward, A/Prof Simon Hales An Independent Inquiry is now investigating the cause of the water-borne outbreak caused by Campylobacter in Havelock North. In this blog we consider the background to this issue and argue the Inquiry must not miss the opportunity to think up-stream, on the scale of water catchments, agricultural economies and climate systems. “Alarming new threats to NZ’s drinking water” is the headline on the cover of a recent New Zealand Listener. It refers to the outbreak in August in Havelock North, in which more than 5000 people, a third of the population, became acutely ill after contamination of the town’s water supply with the organism Campylobacter, and which is now the subject of an Independent Inquiry. It certainly is alarming that so many people can become sick so quickly due to a failure … Read More

A policy and research agenda for roll-your-own tobacco - Public Health Expert

Sep 19, 2016

By Professor Janet Hoek, Professor Karine Gallopel-Morvan, Professor Richard Edwards, Professor Tony Blakely New Zealand’s Smokefree 2025 goal is now less than ten years away but we are unlikely to achieve this world-leading goal unless the Government introduces innovative new policies that reduce smoking prevalence (1). Existing measures have tackled different facets of tobacco marketing, with plain packaging reducing a potent form of tobacco marketing and excise tax increases making smoking less affordable. However, tobacco products themselves have received less attention. In this blog we outline findings from recent studies examining roll-your-own tobacco use and explore potential policy implications. Roll-your-own tobacco (RYO) has increased in popularity, largely due to its cost advantages, which have persisted despite efforts to reduce differences in the excise tax on RYO tobacco and tailor made (TM) cigarettes (2). Many New Zealand smokers now use loose … Read More

Perspective: Options for licensed retailing of nicotine-containing e-cigarettes in NZ - Public Health Expert

Sep 08, 2016

Professor Nick Wilson, Professor Janet Hoek, Frederieke Sanne van der Deen, Associate Professor George Thomson, Professor Richard Edwards The NZ Ministry of Health is currently consulting on options around making nicotine-containing e-cigarettes available in NZ. This Perspective Blog briefly examines possible pros and cons of two plausible licensed retail options: pharmacies and vape shops. It also highlights the need for a very well-considered approach, given consecutive NZ Governments’ poor track record in making policy to regulate addictive substances and reduce harm to public health. The Ministry of Health is inviting comment on a proposal to allow nicotine-containing e-cigarettes to be sold in New Zealand.* It appropriately covers many potential regulatory issues – but not the important ones of who should be able to sell such products and retailer licensing. In this Perspective Blog, we argue the … Read More

Cycling and walking in six NZ cities: Where are we at? - Public Health Expert

Sep 04, 2016

Dr Caroline Shaw, Dr Marie Russell On-road cycle lane Wellington. Photo credit: Jenny Ombler. Active transport is important for health and sustainability. But no one has previously looked systematically at how NZ cities support cycling and walking. Therefore, a new study has been performed and is now published online. This blog reports its main findings. Walking and cycling for transport, instead of using cars, is a sustainable (lower carbon emissions), egalitarian and, mostly, fun way of getting around. Many cities with high levels of cycling and walking, such as Amsterdam and Berlin, are exciting and dynamic places to live. The other benefits of ‘active transport’ (i.e. walking and cycling) are also well-known. Active transport is good for health, the environment and the economy (1-3). But how well are cities in NZ doing in this area? In this … Read More

Much scope for improvement: The NZ Health Research Strategy - Public Health Expert

Jul 18, 2016

By Professor Nick Wilson The Government deserves congratulations for coming up with a Health Research Strategy. But the current Discussion Document needs a firmer strategic outlook with greater coherence. In this Perspective Blog a simple SWOT analysis is conducted and an alternative Vision Statement is proposed. It makes a lot of sense for a country to have a health research strategy. It should make it easier for prioritising how best to target limited research funding and for the country to play to its strengths in a globalising world. So congratulations to the Government for kicking off this process and for inviting submissions (due by the end of this month) on its Discussion Document (1). Unfortunately the current version of this document has many problematic aspects – and it will need substantial additional work to make it more fit … Read More

The likely harm from e-cigarettes compared to tobacco - Public Health Expert

Jul 04, 2016

Prof Nick Wilson, Dr Coral Gartner, Prof Richard Edwards This blog considers recent studies in which the biomarker levels in e-cigarette users (vapers) are compared to those from tobacco smokers. The results are highly variable but all suggest lower levels of risk to vapers relative to tobacco smokers. Yet as the situation with vaping is very dynamic (new products, changing ways people vape) and there is no evidence yet about long-term effects of e-cigarette use on health outcomes, a lot more future research will be needed to get a reasonable understanding of the relative harms. Why focus on biomarker studies? Estimating the potential harm to health from using e-cigarettes is very complex given the ongoing changes and large diversity of e-cigarette products in the international market. How vapers actually use these products is also a likely determinant of what toxicants … Read More

Modifying homes to prevent falls is very cost-effective: new NZ study - Public Health Expert

Jun 13, 2016

By Prof Nick Wilson, Dr Giorgi Kvizhinadze, Dr Eamonn Deverall, Prof Tony Blakely A just published modelling study by the BODE3 Team has reported that “home safety assessment and modification” (e.g., adding hand rails and removing tripping hazards in homes) appears to be a very cost-effective health sector intervention. But even more cost-effective was targeting this intervention to older people with previous injurious falls. In this blog we take a closer look at this intervention and consider what policy-makers, NGOs and citizens might wish to consider doing in response to the evidence. The NZ Burden of Disease Study (NZBDS) reported that falls cause 10% of all the injury-related health loss in this country – in third place behind transport and self-inflicted injuries. For adults aged 65 years or over, falls are the most common cause of injury-related health loss, and … Read More