New Zealand Youth19 survey: vaping has wider appeal than smoking in secondary school students, and most use nicotine‐containing e‐cigarettes

Objective To investigate smoking and vaping in secondary school students (aged 13–18 years) in New Zealand (NZ) following the introduction of ‘pod’ e‐cigarettes, which have been associated with the rapid escalation of youth vaping elsewhere. Methods Data on smoking and vaping were collected in 2019 as part of a comprehensive youth health survey (N=7,721). Results Vaping was 2–3 times more prevalent than smoking, with 10% of students vaping regularly (monthly or more often), and 6% weekly or more often, compared with 4% and 2%, respectively, for tobacco smoking. Nicotine‐containing e‐cigarettes were sometimes or always used by 80% of regular and 90% of weekly vapers. Regular and weekly smoking was rare in low deprivation (affluent) areas, whereas regular and weekly vaping prevalence was similar across the socioeconomic spectrum. More than 80% of ever‐vapers (N=2732) reported they were non‐smokers when they first vaped, and 49% of regular vapers (N=718) had never smoked. Conclusions A significant proportion of New Zealand adolescents, many of whom have never smoked, use nicotine‐containing e‐cigarettes regularly. Implications for public health Vaping is less harmful than smoking, but it is not harmless. Public health action is needed to support young non‐smokers to remain smokefree and vape‐free