Why has New Zealand's smoking rate dropped so far below Australia's in recent years, and what can we subsequently learn from New Zealand's approach to safer nicotine products? In this episode of GFN News THR advocate Colin Mendelsohn highlights the striking difference in approach to vaping in New Zealand and Australia. Enjoy!
Transcription:
00:05
Joanna Junak: Hello and welcome! I'm Joanna Junak and this is GFN News on GFN.TV. Australia and New Zealand, two neighboring countries, have adopted different approaches to e-cigarette regulation despite having similar tobacco control policies and population demographics. Dr Colin Mendelsohn, the lead author of a recent study published in Addiction, comparing smoking and vaping rates in Australia and New Zealand, is with us today. Hi Colin, what was the main purpose of this study?
00:58
Colin Mendelsohn: The aim of this study was to compare the very different regulatory models for vaping in the two countries to find out which has the better outcome for smoking. So we analysed trends in daily smoking and vaping rates for the period from 2016 to 2023. Australia has a very highly restrictive medical model for vaping designed to deter youth access. Legal vapes are only available from pharmacies and in many cases a doctor's prescription is required. Most flavors are banned. In contrast, New Zealand encourages the use of vaping as a quitting aid for adult smokers. Vapes are sold as adult consumer products from licensed retail outlets like cigarettes and alcohol, in much the same way as in the UK, the US and Canada.
01:55
Joanna Junak: And what was the main finding of the study?
02:00
Colin Mendelsohn: The study found that adult smoking rates in New Zealand fell twice as fast as in Australia during the seven-year period. Daily smoking in New Zealand plummeted by 10% per year, dropping from 14.5% to 6.8%. In contrast, Australia's smoking rate declined by only 5% per year, from 12.2% to 8.3%. Australia has historically had a lower smoking prevalence than New Zealand. And for the first time, New Zealand has a lower smoking rate and is on a far faster downward trajectory. We found the decline in smoking in each country closely reflected their vaping rates. So in 2023, 9.7% of New Zealand adults vape daily, which was nearly three times the rate in Australia of 3.5%.
03:07
Joanna Junak: Was this findings consistent across all population groups in the community, including disadvantaged groups?
03:16
Colin Mendelsohn: Well, smoking rates have always declined far more slowly in disadvantaged populations, resulting in substantial health disparities. But our study found the opposite. The smoking rate fell three times faster in New Zealand's lowest socio-economic group compared to Australia's at 12% per year compared to 4% per year. The decline in New Zealand was even faster than in the general population. Similarly, smoking in New Zealand's Maori population declined twice as fast as Australia's Indigenous population by 13% per year compared to 6% per year. Amongst the age groups, the fastest decline in smoking in both countries occurred in the younger age groups that also had the highest rates of vaping. I mean the younger adult age groups.
04:19
Joanna Junak: Okay, and what trends were seen in youth vaping and smoking?
04:25
Colin Mendelsohn: Youth vaping rose more sharply in New Zealand, reaching 10% daily vaping in 2023, compared to just 3% in Australia. Now, most of this rise occurred prior to the introduction of regulation in New Zealand in 2021. And more recent data shows a decline in youth vaping to 8.7% in 2024. This transient rise in youth vaping and subsequent decline has been seen in other countries, like in the US. At the same time, however, daily youth smoking in New Zealand hit a record low of 1.2%. And these findings together suggest that vaping has not acted as a gateway to smoking, but instead may be diverting young people away from deadly combustible tobacco.
05:21
Joanna Junak: Was there a difference in black market sales between the countries?
05:27
Colin Mendelsohn: Australia's restrictive model for vaping has inadvertently fuelled a thriving and increasingly violent black market. More than 90% of vaping products sold in Australia come from illicit sources with no safety standards and with easy access for young people. In contrast, New Zealand's regulated retail system has shown no significant evidence of illicit trade.
05:56
Joanna Junak: And could vaping be responsible for the rapid decline in smoking in New Zealand?
06:03
Colin Mendelsohn: Yes, look, the main difference between the countries was their policy on vaping, which is well established as an effective quitting aid. Also, the populations with the highest vaping rates had the greatest declines in smoking, suggesting that vaping played an important role. But of course, the study is cross-sectional, meaning it tracks population trends rather than following individuals and can't definitively prove vaping was the cause of the rapid fall in New Zealand smoking. However, the study examined a wide range of possible factors and found no good evidence that any of these play a significant role. So other explanations we considered included changes in tobacco taxes and cigarette affordability, the effects of plain packaging, the COVID pandemic, the economic downturn and heated tobacco products. There were no significant changes in tobacco control treatments during that period.
07:10
Joanna Junak: And what were the conclusions of the study?
07:15
Colin Mendelsohn: If vaping is indeed driving the rapid decline in smoking in New Zealand, which appears likely, this study suggests that a regulated adult consumer model with sales from licensed retail outlets is substantially more effective than a restrictive medical approach, particularly amongst high-risk groups. If Australia were to adopt a similar model to New Zealand, it could accelerate the reduction in adult smoking rates and improve public health. It could reduce health disparities for disadvantaged and indigenous smokers. And it could reduce the harms associated with an unregulated black market. The solution isn't to ban vaping or to harshly restrict it. It's to regulate it sensibly, encouraging smokers to switch while implementing reasonable safeguards to protect young people. Now, New Zealand has shown us what works. It's time we all paid more attention.
08:22
Joanna Junak: Thank you, Colin. That's all for today. Tune in next time here on GFN TV or on our podcast. You can also find transcriptions of each episode on the GFN TV website. Thanks for watching or listening. See you next time.