E-cigarette use (vaping) by Aotearoa New Zealand youth continues to trend upwards. Vapes are promoted in Aotearoa New Zealand as a less harmful source of nicotine for current smokers who have unsuccessfully attempted to quit. However, non-smokers face increased risks if they begin to vape. Surveys of young people show many vape on a daily or “regular” (at least monthly) basis, many of whom had not previously smoked. The 2022 ASH Year 10 Snapshot Survey shows that 10.2% of respondents vaped daily—a 1.1% increase compared to 2021.[[1,2]] The survey also showed an increase in rangatahi Māori daily vaping, from 5.9% in 2019 to 21.7% in 2022 (25% for Māori girls). Never-smokers continue to take up vaping, 4.3% having reported daily use compared to 3.1% in 2021. The 2021 ARFNZ/SPANZ vaping in NZ youth survey found that youth who vaped were overall vaping more frequently than before, and with higher nicotine concentrations.[[3]] Many respondents reported feeling addicted to their vapes, and thought vaping affected their health. Thus, youth vaping in Aotearoa New Zealand remains a significant public health issue. We suggest that stronger regulations on vaping products supported by knowledge-based interventions with tamariki and whānau are important to reduce the likelihood of never-vapers taking up vaping and encouraging current youth users to quit.

Stronger regulations on vaping products are necessary to reduce youth vaping in Aotearoa New Zealand. Current regulations prevent retailers from selling to minors, restrict vape flavours to tobacco/menthol/mint, and prohibit the advertisement of vapes similar to the way other tobacco products are controlled.[[4]] Specialist vape retailers remain exempt from some of these restrictions.[[5]]  A recent study surveying teenagers and parents of children attending Christchurch Hospital shows that teenagers are accessing vapes primarily from friends and whānau members.[[6]] Furthermore, the majority of vaping teenagers stated their favourite vape flavours are fruit-based. This means that teenagers are bypassing regulations and age-restrictions through friends/whānau who can buy more diverse and appealing vape flavours through specialist vape stores or via online suppliers. The recent December 2022 legislation changes and the proposal on restriction of flavour names are important, but on their own may not be a sufficient barrier to youth accessing vapes. Areas that need to be addressed include the financial barrier to youth purchase, plain packaging, and phasing out cheap disposable vapes that are marketed and attractive to youth, as indicated by a rapid rise in use by young people in the UK.[[7]] Vapes are highly addictive products that are marketed as a consumer product—they require sound regulation to assist smokers without attracting non-smokers, particularly youth.

In addition to stronger regulations, it is important to educate the public that vapes are not a safe recreational product for tamariki and non-smokers. A variety of education strategies targeted at tamariki and whānau are needed to address widespread misunderstanding of vape safety. Friends and whānau are a significant way to bypass regulation and access vapes; thus, education about vaping for teenagers and adults should be emphasised. Education through media and schools is unlikely to change behaviour of regular vapers, but it may influence those curious to explore what they think is a safe recreational product. While teenagers have ready online access to information, there is doubt as to the quality of this information. A study in the USA reported that students sought information about vaping from Google, where searches can be dominated by vape marketers (85% of YouTube videos on vaping).[[8]] Locally, the Christchurch Hospital study reported that teenagers get information about vaping from friends and social media.[[6]] Thus, evidence-based education is needed. Chaplin et al. showed that in-person evidence-based education successfully improved American high school students’ knowledge of the risks of vaping.[[9]] In Christchurch, we are currently investigating whether delivering educational sessions to high school students influences knowledge and attitudes related to vaping. Other educational alternatives deserve exploration. A recent systematic review of interventions for adolescent substance use found that interventions addressing family function significantly reduced smoking behaviours in adolescents.[[10]] Mass media campaigns utilising personal testimonials were also effective. The recent Protect Your Breath campaign is one such initiative—its impact remains to be seen. Education can work in concert with regulations to help people understand the rationale for restrictions, and to provide credible information, which helps them inform choices.

Increasing e-cigarette use by youth in Aotearoa New Zealand means vapes are being utilised by the wrong population for the wrong purpose—this poses a significant public health problem. The regulations applying to e-cigarette marketing, flavours, and accessibility are necessary and require improvement, as well as supporting measures. One such measure is to continue researching and applying quality education about vaping for tamariki, parents, and wider whānau. Stronger regulations supplemented by education are important to prevent the development of a new generation of nicotine addiction.