Study suggests e-cigarettes are contributing to reduce smoking prevalence

Reviewed by Emily Henderson, B.Sc.Sep 18 2020

People who smoke are increasingly using e-cigarettes to try to quit smoking, a study by researchers at the University of Otago, Wellington, has found.

The researchers found that between 2016 and 2018 the level of awareness, as well as the use of e-cigarettes, increased among smokers and those who had recently quit smoking.

The principal investigator of the study, Professor Richard Edwards from the University's Department of Public Health, says e-cigarette use was most common among those aged 18-24 years and among those who had recently quit smoking.

The research is part of the New Zealand arm of the International Tobacco Control Policy Evaluation (ITC) project and involved surveys with 1,155 people between 2016 and 2017 and 1,020 people in 2018 (400 of them Māori) who smoked or had recently quit smoking.

Participants were recruited from the nationally-representative New Zealand Health Survey and were asked about their awareness and use of e-cigarettes, reasons for use and related beliefs.

The study, funded by the Health Research Council, provides the most in-depth description of patterns of vaping use among New Zealand smokers from population-based data.

The 2018 survey found there to be a high awareness of vaping devices, with 98 per cent of smokers and recent quitters saying they were aware of e-cigarettes. Seventy-seven per cent of respondents reported having tried vaping, while 22 per cent reported currently using e-cigarettes at least monthly and 11 per cent reported using them daily.

Professor Edwards says use was generally similar between Māori and non-Māori participants. Daily use was greatest among recent quitters (23 per cent) compared to current smokers (eight per cent) and among 18-24 year olds (19 per cent) compared to older age groups (10 per cent). The most common reasons given for using e-cigarettes were to help quit (78 per cent) or cut down on smoking (81 per cent).

Professor Edwards says the survey results are promising, particularly the findings that use is most common among recent quitters and that a high proportion of regular users are using e-cigarettes to quit smoking.

"This suggests e-cigarettes are contributing to reducing smoking prevalence and to achieving the goal of Aotearoa becoming smokefree by 2025.

"However, it is of concern that e-cigarette use is more prevalent among 18-24 year olds. If e-cigarettes are to make a substantial contribution to reducing smoking, their use needs to be greater among older age groups."

While the research shows more people are using e-cigarettes to quit smoking, more smokers reported using e-cigarettes on a trial basis, rather than regularly, which suggests there might be barriers to more sustained use, he says.

"The most common potential barriers identified were that 68 per cent of participants thought vaping was less satisfying than smoking and 39 per cent incorrectly believed that e-cigarettes were as or more harmful than smoking cigarettes, or were unsure (15 per cent)."

He says such beliefs underline the importance of public education, such as through the Vaping Facts website.

"This could inform smokers about the relative costs and harmfulness of smoking and e-cigarettes to encourage people who smoke to quit or switch completely to vaping, and encourage people who smoke to visit specialist retailers to get expert advice about the best vaping products for them."

The most common motivation for using e-cigarettes was to save money compared to smoking, suggesting that using the tax system to keep the price of cigarettes high relative to vaping may motivate more smokers to quit.

Professor Edwards warns New Zealand is unlikely to achieve its goal of becoming smokefree by 2025, particularly in relation to Māori and Pacific peoples, with much more action needed.

E-cigarettes are making a useful contribution, but much more is needed to get to a Smokefree Aotearoa for all New Zealanders. A comprehensive strategy is needed that makes smoked tobacco products less appealing, addictive, and accessible to complement the impact of alternative products like e-cigarettes in reducing smoking prevalence."

Professor Richard Edwards, University of Otago