New Study Reveals Vaping Impedes Progress in Teen Smoking Decline

A recent study has found that vaping has hindered efforts to reduce smoking rates among teenagers in Aotearoa New Zealand. While adult smoking rates have dropped significantly—from 18% in 2011/12 to 8% in 2023/24—inequities remain for Māori and Pacific peoples, who suffer from higher rates of tobacco-related illnesses and mortality. As tobacco addiction frequently begins in adolescence, lowering smoking rates among young people is crucial for addressing these health disparities.

Prior research suggested that vaping might displace traditional smoking among youth, potentially accelerating the decline in smoking rates. However, the latest findings challenge this notion, indicating that the progress in reducing adolescent smoking rates has actually slowed since vaping became prevalent in Aotearoa in 2010. This new study, published in the Lancet Regional Health-Western Pacific, is the first to analyze whether the impact of vaping on smoking habits varies across different ethnic groups, including Māori, Pacific, European, and Asian populations.

The researchers examined smoking trends among school students aged 14 to 15, comparing data from 2003 to 2009—before vaping gained widespread availability—with data from 2010 to 2024, when vaping became increasingly common. Before the introduction of e-cigarettes, smoking rates among this age group were declining across all ethnicities. The study aimed to determine if the advent of vaping led to a reduction in the speed of this decline, a phenomenon termed the “gateway effect,” or if vaping was actually displacing smoking.

The analysis included nearly 600,000 students, with 20% identifying as Māori, 9% as Pacific, 58% as European, and 13% as Asian. By 2024, approximately one in three Māori (29%) regularly vaped, compared to 19% of Pacific, 11% of European, and 4% of Asian students. Overall, from 2003 to 2024, regular smoking rates among 14 to 15-year-olds fell significantly in all four ethnic groups. Yet, the decline slowed notably from 2010 for Māori, Pacific, and European adolescents, while it remained stable for Asian adolescents.

In 2024, regular smoking rates were about 6.2% for Māori, 3.3% for Pacific, and 2% for European adolescents. If pre-2010 trends had continued, these rates would have been approximately 4.2% for Māori, 1.8% for Pacific, and 0.7% for European adolescents. This indicates that, in 2024, there were 20 more Māori, 15 more Pacific, and 13 more European students regularly smoking per 1,000 than would have been expected had the trends from before vaping continued.

The researchers considered other potential factors for the slowing decline in smoking, including whether 2010 was the correct year to mark the emergence of vaping, as it was still relatively uncommon at that time. They also examined whether changes in cigarette affordability played a role. However, testing different change years and accounting for affordability did not significantly alter the findings.

The study concluded that there is no evidence to suggest that vaping is displacing smoking among Māori, Pacific, European, or Asian adolescents. In fact, the data indicates that the decline in regular smoking rates for Māori, Pacific, and European youth has significantly slowed since the rise of vaping, while Asian adolescents did not experience a similar change.

For Māori and Pacific youth, who have higher rates of both smoking and vaping, these findings carry serious implications. The data suggests that rather than alleviating smoking-related harms, vaping has exacerbated nicotine dependence among these communities. This situation undermines individual agency and collective self-determination, particularly for Māori, who face ongoing challenges stemming from historical colonial impacts.

To address these public health issues, the study calls on the government to fulfill its constitutional and World Health Organization obligations regarding tobacco control. It emphasizes the importance of engaging with Māori and Pacific perspectives while supporting equitable and socially just approaches to combatting nicotine addiction and its related health risks.

This article is republished from The Conversation under a Creative Commons license.