Tupeka Kore Aotearoa
Logic Model and Outcomes Map
Introduction
Context
The Tupeka Kore Logic Model and Outcomes Map is the culmination of a
three-month consultation process with the Māori tobacco control sector
during the months of August-October 2015, and a review of a number of
key tobacco control documents.
The purpose of the logic model and map is to help build a common
understanding and consensus around the Tupeka Kore Aotearoa vision by
providing a detailed description of the steps required – from resources to
results - to achieve the vision.
Since its introduction during the early years of colonisation, tobacco
smoking remains the single largest contributor to preventable illness and
death for Māori.
Currently 32.7 per cent of Mā ori identify as being regular smokers – more
than double the smoking rates of non-Māori.1 Among Mā ori men the
regular smoking rate is 30.5 per cent and among women it is 34.7 per cent. 2
40.5 per cent of Mā ori women of childbearing age (20- 44 years) smoke
regularly.3 In 2014, Māori girls were more than three times more likely to
be a regular smoker than non-Māori girls.4 Māori boys were also more than
three times more likely to be regular smokers than non-Māori boys.5 Māori
girls have consistently had the highest daily smoking rates of Māori and
non-Māori boys and girls since 2000.6 Although data is limited, it is
estimated that 33 per cent of all cigarette equivalents are smoked by those
with a mental illness.7 Figures from the Ministry of Health also show that
in 2010/11 Māori had the highest rate of mental health and addiction
service use (4938 people seen for every 100,000 Māori) when compared
with Pacific people and other ethnicities.8
Māori Vision
Government Goal
The relative lack of information on ‘what is effective’ for Māori has been a
major concern in Māori health promotion. While a number of programmes
have been shown to be effective with non-Māori, less impact has been
shown on Māori health (Barwick & others, 2000). In response, there has
been a strong push from Māori in tobacco control for a more holistic
‘whānau based’ approach to smoking cessation, and population-based
interventions that alter the social and environmental conditions that
contribute to tobacco use.
Tupeka Kore Aotearoa/Aotearoa is tobacco free
 Whānau, hapū and iwi are tobacco free
Smokefree New Zealand 2025
 Defined as smoking prevalence across all populations being less
than five per cent by 2025
 ‘Business as usual’ will not get Māori to 2025 hence the need for
tougher policies and innovative ‘by Māori for Māori’ services.
 The Smokefree 2025 goal will be used as a ‘stepping-stone’ toward
the Tupeka Kore Aotearoa vision
Retrieved from http://www.ash.org.nz/wp-content/uploads/2015/03/Maori-smoking-2013-14.pdf
Retrieved from http://www.ash.org.nz/wp-content/uploads/2015/03/Maori-smoking-2013-14.pdf
3 Retrieved from http://www.ash.org.nz/wp-content/uploads/2015/03/Maori-smoking-2013-14.pdf
4 Retrived from http://www.ash.org.nz/wp-content/uploads/2015/03/F4-2014-Maori-smoking.pdf
5 Retrived from http://www.ash.org.nz/wp-content/uploads/2015/03/F4-2014-Maori-smoking.pdf
6 Retrived from http://www.ash.org.nz/wp-content/uploads/2015/03/F4-2014-Maori-smoking.pdf
7 Retrived from http://www.quit.org.nz/file/research/2014/mental-illness-research-paper-24-november-2014.pdf
8 Retrieved from http://www.mentalhealth.org.nz/assets/Uploads/MHF-Quick-facts-and-stats-FINAL.pdf
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Principles/Values
Outcomes
Kaupapa Māori/strength based approach
 “Tobacco. Not our tikanga”
 Te Tiriti o Waitangi
o Principles of partnership, participation, protection9
 Values and principles
o Kaitiakitanga – protection of our environment (manaaki
taiao); protecting our whakapapa
o Tino Rangatiratanga – Sovereignty; Recovery from
addiction; state of being
o Aroha - Positive regard: the necessary motivation;
Whānau orientation
o Manaakitanga - To care for a person’s mana
o Whanaungatanga – Inter-Relatedness
Long-term:
 Reduced health inequalities caused by tobacco
Medium-term:
 Reduced demand for tobacco products
 Reduced access and availability of tobacco products
 More environments are tupeka kore
 More whānau are tupeka kore
 More iwi/community support for the Tupeka Kore vision
 More legislation and regulation that support the Tupeka Kore
vision
 More whānau are using stop smoking support and other effective
cessation options
Outcome
Measures
Short-term:
 Increased awareness of the Tupeka Kore vision and key messages
 Increased leadership around the Tupeka Kore vision
 Increased community action around the Tupeka Kore vision
 Increased awareness of the need for research, legislation and
regulation that support the Tupeka Kore vision
 Increased awareness of available stop smoking support and other
cessation options
 Increased awareness of ‘what works’ for whānau
Long-term
 Five per cent smoking prevalence across all populations
 (Reduction in the inequitable) number of tobacco related illnesses
and deaths experienced by Māori
Medium-term
 Number of tobacco free environments (e.g. Marae, Wāhi tapu etc.)
 (Reduced) levels of exposure to second hand smoke
 Number of tobacco free retailers
 (Reduction in) tobacco product sales
 (Increased) number of never smokers/abstainers
 Number of successful Māori quits
 Denormalisation of smoking
 Number of iwi with a tupeka kore strategy
 Number of regulations and legislation implemented (that support
the Tupeka Kore vision)
 Number of tupeka kore champions
 Number of tupeka kore community action/advocacy groups
Retrieved from http://www.health.govt.nz/our-work/populations/maori-health/he-korowai-oranga/strengtheninghe-korowai-oranga/treaty-waitangi-principles
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Priority Areas
Priority Groups
Work streams
and Priority
Actions
Short-term (measures not included on logic model)
 (Increased) recognition (coverage, reach, engagement, influence)
of, the Tupeka Kore brand/key messages/available stop smoking
support/other cessation options/’what works’ for whānau/the
need for research, legislation and regulation that supports the
Tupeka Kore vision
 (Increased) leadership and community action capability
 Māori tobacco control workforce development
 Increased leadership around the Tupeka Kore vision
 Increased awareness of the Tupeka Kore vision and key messages
 Wāhine hapū (pregnant Māori women)
 Rangatahi Māori
 Māori mental health and addiction service users
 Whānau; hapū; iwi
Legislation and Advocacy
 Priority Actions:
 Advocate for further annual taxation increases (beyond 2016)
 Advocate for ‘equity based’ allocation of tobacco excise tax for
Māori tobacco control
 Advocate for lower nicotine levels/removal of additives
 Advocate for more punitive type tariffs i.e. increased import
tariffs/taxes
 Advocate for and continue to support National Smokefree
Working Group policy priorities (i.e. Smokefree Cars, Plain
packs, retail licensing etc.)
 Advocate for ENDS/ANDS regulation
Health Promotion
 Priority Actions:
 Create supportive environments. Build healthy public policy
 Reorient stop smoking services/support to better meet the
needs of whānau
 Reorient health focus towards prevention of illness
 Strengthen community action around the Tupeka Kore vision.
 Continue to nurture and grow community leaders,
organisations, and champions in the tupeka kore kaupapa
 Develop a consistent and appropriate communications
message(s) for priority groups (wāhine hapū; rangatahi; Māori
mental health service users; whānau; hapū; iwi)
 Develop capability of whānau to be tupeka kore
Cessation
 Priority Actions:
 Develop standardised cessation training programme for the
cessation workforce including best practice guidelines
 Targeted support for vulnerable groups (wāhine hapū;
rangatahi Māori; Māori mental health users)
 Develop and maintain a coordinated cessation network system
 Develop and promote Māori treatment models for cessation
(e.g. Whānau ora/Whānau centred/holistic approach; rongoa
Māori; noho marae; waiata, karakia, taonga pūoro)
 Resource: dedicated staff, IT resources, multiple skillsets;
equitable funding pay
 Integrated service delivery across sectors, organisations and
kaupapa (e.g.. Midwives/ GP’s; WERO, Stoptober; nutrition;
physical activity)
 Provide support and quality information for those choosing to
use ANDS and ENDS
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Development of
the Tupeka Kore
Logic Model and
Outcome Map
Research and Evaluation
 Priority Actions:
 Identify and set Māori tobacco control research and evaluation
priorities:
o Why Māori relapse and how to better support them to
be tupeka kore
o The cultural dimensions of addiction
o More research on ‘what works for Māori’
o Research more technologies/ APPS – web based,
smart phone, social media, Wi-Fi friendly; make a
connection with Google/Apple
o Focus on vulnerable groups
o Evaluate the outcomes of a cessation approach vs.
whānau ora approach/Māori approach vs.
mainstream approach
o Research on why whānau are tupeka kore
o More research on why wāhine Māori have such high
smoking rates
o Develop best practice guidelines for working with
whānau
o Evaluate the impact of tied taxation on the Māori
population using appropriate Māori research
methodology
 Networking and building relationships with non Māori
research institutes and other indigenous groups
After consultation with the sector, it was decided that a logic model and a
separate ‘user-friendly’ version of the model – in the form of an outcomes
map - be developed. The following resources were used to inform the
design and development of the logic model and outcomes map:
Sector document review
Documents reviewed included:
 National Māori Tobacco Control Strategy and Action Plan 20032007
 Te Ara Hiringa: Strategic Plan for the National Mā ori Tobacco
Control Service 2011–2016
 New Zealand Tobacco Control Research Strategy 2009-2012
 Te Ara Hā Ora Strategic Plan
 Smokefree National Action Plan (SNAP)
 Latest District Health Board tobacco control plans
 Tupeka Kore - Kahungunu Tobacco Free Strategy
 Tupeka Kore Te Tai Tokerau Tobacco Free Northland 2011 to
2013
Stakeholder hui
Key stakeholder hui were held in Auckland, Wellington and Christchurch
on the 20th Aug, 8th Aug and 11th Sept respectively.
SWOT Analysis
An analysis of current gaps and opportunities in the Māori tobacco control
sector was conducted by Te Ara Hā Ora and sent out to Waka Tupeka Kore
members on 4th May, 2015. A copy of the document is available on request.
Peer review
The Logic Model and Outcomes Map were sent to Mā Te Rae (The National
Māori Evaluation Association) for peer review on the 24th September 2015.
The model and map was then sent out on the 16th November to those who
attended the three Waka Tupeka Kore stakeholder hui for peer review
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Tupeka Kore Logic Model
Key
Long Term
Tupeka Kore Aotearoa
= Government Goal
Whànau, hapù, iwi are tobacco free
= Outcomes
Smokefree New Zealand 2025
= Measures
Less than 5% smoking prevalence
Reduced health inequalities caused by tobacco
# of tobacco related illnesses
More iwi/community
support for the tupeka
kore vision
Reduced access and
availabiltiy of tobacco products
Short Term
Increased awareness
of the tupeka kore
vision and key
messages
Reduced demand for
tobacco products
More whànau are
tupeka kore
# of tobacco product sales
# of tobacco free retailers
# of iwi with a tupeka kore
strategy
# of tupeka kore champions
More legislation and regulation
that support the tupeka kore vision
Increased leadership
around the tupeka
kore vision
# of reg and leg implemented that
support Tupeka Kore vision
Increased community
action around the
tupeka kore vision
Cessation
Legislation and
advocacy
Increased awareness
of the need for
research,policies and
legislation that support
the tupeka kore vision
# of whànau using stop smoking
support
# of whànau using other
cessation support/products
(e.g. mist, inhilator, Apps,
websites, ENDS/ANDS)
Increased awareness
of available stop
smoking support and
other cessation options
# of never smokers/
abstainers
# of succesful
quits
# of initiations
More whànau use stop
smoking support and
other effective
cessation options
Increased awareness
of 'what works' for
whànau
Health Promotion
Everything informs everything in a cycle of equitable quality improvement
Màori Tobacco Control Workforce Development
Kaupapa Màori/strength based approach/"Tobacco. Not our tìkanga"/Principles of Te Tiriti o Waitangi
doview.com model
Medium Term
Pollution from tobacco
products (eg smoke
butts)
Denormalisation of
smoking
More environments are
tupeka kore
# of tupeka kore community action/
advocacy groups
Work
streams
Research and Evaluation
Exposure to SHS
This logic model is to be read from bottom to top. Underpinning the model is “Kaupapa Māori/Tobacco. Not our tīkanga”/Principles of Te Tiriti o Waitangi/strength
based approach” and “Māori Tobacco Control Workforce Development”, that is, kaupapa Māori underpins the principles and values of the strategy and that a welltrained and resourced workforce will be key to the success of this strategy. The next layer is the Work Streams, “Cessation”, “Legislation and Advocacy” and “Health
Promotion”. On the side of the logic model is the “Research and Evaluation” Work Stream. It is envisioned that research and evaluation will be used to inform the
design, development and implementation of the tupeka kore strategy and track and monitor outcomes. Directly above the Work Streams are the short, medium and
long-term outcomes derived from our consultation with the sector and a document review of key sector documents. Directly above the Outcomes is the Smokefree
2025 goal, which will act as the stepping-stone to the to the Tupeka Kore vision. At the top of the logic model is the “Tupeka Kore Aotearoa” vision.
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Tupeka Kore Outcomes Map
More iwi/
community support
Key
Key Messages
= Description
Capacity Building
More
environments are
tupeka kore
Environmental Change
Cessation
Legislation
and
advocacy
Health
Promotion
Ngà Hoe
Capability Building
Community Action
Everything informs everything in a cycle of
equitable quality improvement
Capability Building
Stop Smoking
support
Awareness Building
More legislation
and regulation
Reduced access,
availability and
demand for
tobacco products
Capacity Building
Increased demand for stop smoking support
Environmental
and Behaviour
Change
More whànau use
stop smoking
support
More whànau are
tupeka kore
Capacity Building
Behaviour Change
Màori Tobacco Control Workforce Development
Research and Evaluation/evidence based approach
Kaupapa Màori/strength based approach/"Tobacco. Not our tìkanga"/Principles of Te Tiriti o Waitangi
Tupeka
Kore
Aotearoa
doview.com model
Reduced supply of tobacco products
Leadership
Reduced health inequalities
Awareness Building
It was suggested as part of our consultation hui that the logic model be simplified and made more assessable to the sector. One suggestion was to base the model on
the journey of a waka. In this context, the work streams are the “hoe” that “row” Waka Tupeka Kore toward the Tupeka Kore Aotearoa Vision. Each of the outcomes
would be a destination along the way and a way to track our progress as a sector in relation to the Tupeka Kore Aotearoa vision.
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References
Barwick, H., & others. (2000). Improving access to primary care for Maori and Pacific peoples. A
Literature Review Commissioned by the Health Funding Authority. Retrieved from
http://www.moh.govt.nz/notebook/nbbooks.nsf/0/0ff9b7c2186f2628cc2574b2000220cf/$FIL
E/HFAimprovingaccess.pdf
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