Vaping and smoking in adolescents 14 and under in Aotearoa New Zealand: cross-sectional study of e-screening data
FanZhen Zhou 1 , James Warren 1 , Felicity Goodyear-Smith
2 *
1
2
Abstract
YouthCHAT (Youth electronic Case-Finding and Help Assessment Tool) assesses lifestyle issues in young people in New Zealand (NZ) primary care settings, including questions on smoking and vaping.
This study aimed to assess adolescent vaping/smoking rates, reasons, and interest in help.
An analysis of a de-identified extract of adolescent smoking and vaping YouthCHAT responses with chi-squared testing of independence of reporting ever-smoking and ever-vaping was performed. Gender and gender-by-ethnicity differences were tested by chi-squared test for females versus males and Māori and Pacific versus NZ European. Bonferroni correction for multiple comparisons was applied by multiplying P-values by 10. Follow-up responses, including help questions, were tallied.
Of 3462 completed YouthCHAT screens of adolescents aged ≤14 years, 753 (22%) reported ever-vaping and 427 (12%) ever-smoking (P < 0.001). Fifty-five (7%) ever-vaped reported vaping for smoking cessation. All currently smoked had also vaped. Girls were more likely to vape (25%) and take up vaping having never-smoked (13%) than boys (adjusted P = 0.001; 0.003, respectively). The rate of having ever-vaped and of vaping-never-smoked was higher in Māori (adjusted P < 0.001) and Pacific (adjusted P = 0.005 for vaping; 0.001 for vaping-never-smoked) girls compared to NZ Europeans. For ever-vaped, 511 (68%) had felt the need to cut down. Of those who vaped in the past 3 months, 120/558 (22%) wanted help.
Vaping is more frequent than smoking among young NZ adolescents under 15 years of age but many are open to receiving help. Relatively few adolescents are vaping to stop smoking. Tight controls of vaping products are needed to prevent e-cigarette marketing from attracting non-smoking adolescents, while ensuring access for those who wish to quit smoking.
Keywords: adolescent, e-cigarettes, e-screening, marketing, smoking, smoking cessation, vaping, YouthCHAT.
References
1 Lindson N, Butler A, McRobbie H, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev 2024; 1(1): CD010216.
| Crossref | Google Scholar | PubMed |
2 Miech R, Johnston L, O’Malley PM, et al. Trends in adolescent vaping, 2017–2019. N Engl J Med 2019; 381(15): 1490-91.
| Crossref | Google Scholar | PubMed |
3 Walker N, Parag V, Wong SF, et al. Use of e-cigarettes and smoked tobacco in youth aged 14–15 years in New Zealand: findings from repeated cross-sectional studies (2014–19). Lancet Public Health 2020; 5(4): e204-e12.
| Crossref | Google Scholar | PubMed |
4 Al-Hamdani M, Manly E. Smoking cessation or initiation: the paradox of vaping. Prevent Med Rep 2021; 22: 101363.
| Crossref | Google Scholar | PubMed |
5 Goodyear-Smith F, Martel R, Darragh M, et al. Screening for risky behaviour and mental health in young people: the YouthCHAT programme. J Pub Rev 2017; 38: 20.
| Crossref | Google Scholar | PubMed |
6 Elliott B, Warren J, Darragh M, et al. Towards a youth mental health screening analytics tool. Health Informatics & Knowledge Management. Proceedings Australasian Computer Science Week (ACSW). 2019. p. 14. 10.1145/3290688.3290717
7 Goodyear-Smith F, Arroll B, Coupe N. Asking for help is helpful: validation of a brief lifestyle and mood assessment tool in primary health care. Ann Fam Med 2009; 7(3): 239-44.
| Crossref | Google Scholar | PubMed |
8 Thabrew H, D’Silva S, Darragh M, et al. Comparison of YouthCHAT, an Electronic Composite Psychosocial Screener, With a Clinician Interview Assessment for Young People: randomized controlled trial. J Med Internet Res 2019; 21(12): e13911.
| Crossref | Google Scholar | PubMed |
9 Thebrew H, Corter A, Goodyear-Smith F, et al. Randomised trial comparing the electronic composite psychosocial screener YouthCHAT with a clinician-interview assessment for young people: a study protocol. JMIR Res Protoc 2017; 6: 135.
| Crossref | Google Scholar | PubMed |
10 Clare H, Darragh M, Goodyear-Smith F. Screening in schools: the acceptability and feasibility of guidance counsellors using YouthCHAT. Br J Guid Couns 2022; 52: 207-20.
| Crossref | Google Scholar |
11 Thabrew H, Goodyear-Smith F. Youth version, Case-finding and Help Assessment Tool (YouthCHAT): an electronic, psychosocial screener for young people with long-term physical conditions. J Paed Child Health 2020; 56(1): 102-6.
| Crossref | Google Scholar |
12 Martel R, Shepherd M, Goodyear-Smith F. He awa whiria a ‘braided river’: an indigenous Māori approach to mixed methods research. J Mix Method Res 2021; 16: 17-33.
| Crossref | Google Scholar |
13 Gurram N, Carroll F, Elers CNH, et al. Understanding ethnic inequities associated with tobacco use in Aotearoa New Zealand: a quantitative analysis. Health Promot Inter 2024; 39(3): daae060.
| Crossref | Google Scholar | PubMed |
14 Ministry of Health. Sale of smoking and vaping products to minors Wellington: MoH; 2024. Available at https://www.health.govt.nz/our-work/regulation-health-and-disability-system/vaping-herbal-smoking-and-smokeless-tobacco-products-regulation/information-retailers-notifiable-products/obligations-notifiable-products/sale-smoking-and-vaping-products-minors#:~:text=Tobacco%20products%20and%20notifiable%20products,the%20age%20of%2018%20years [updated March; accessed August 2024].
16 Smokefree. Cost of smoking. Wellington: Health New Zealand Te Whatu Ora. 2024. Available at https://www.smokefree.org.nz/smoking-its-effects/cost-of-smoking [accessed December 2024].
17 Prestwich-Dyer H. How many cigarettes is 20 mg of nicotine equivalent to?: Evapo. 2023. https://evapo.co.uk/blog/how-many-cigarettes-is-20mg-of-nicotine-equivalent-to#:~:text=1%20ml%20of%2020%20mg,experience%20for%20your%20personal%20needs.
18 Leventhal AM, Goldenson NI, Cho J, et al. Flavored e-cigarette use and progression of vaping in adolescents. Pediatrics 2019; 144(5): e20190789.
| Crossref | Google Scholar | PubMed |
19 Lyons A, Barnes AM, Goodwin I, et al. Exposure to digital vape marketing among young people in Aotearoa New Zealand. N Z Med J 2024; 137(1589): 20-38.
| Crossref | Google Scholar | PubMed |
20 Dyer O. New Zealand’s new government says it will repeal groundbreaking anti-smoking law. BMJ 2023; 383: 2814.
| Crossref | Google Scholar | PubMed |
