10 February 2025
by Alan Gore & Pippa Starr
"A new study published in Addiction has revealed that smoking rates declined twice as fast in New Zealand as in Australia between 2016 and 2023. "
Smoking remains one of the leading causes of preventable death, with up to two in three long-term smokers dying prematurely from smoking-related diseases. For adult smokers who struggle to quit using other methods, nicotine vaping serves as an effective quitting aid and can also be used long-term as a significantly less harmful alternative to smoking. This approach, known as tobacco harm reduction, acknowledges that while quitting nicotine entirely is ideal, switching to a far less harmful option like vaping can still provide substantial health benefits.
Vaping is now the most popular quitting aid in Australia and New Zealand and has been shown to be more effective than traditional nicotine replacement therapies such as patches and gum. Additionally, while vaping does contain nicotine, it is far less harmful and less dependence-forming than smoking. However, it is intended only for current smokers—those who do not smoke should not start vaping. The focus should remain on helping smokers transition to safer alternatives rather than discouraging them from using an effective harm reduction tool.
A new study published in Addiction has revealed that smoking rates declined twice as fast in New Zealand as in Australia between 2016 and 2023.
The findings of a recent study suggest that more liberal regulation of nicotine vaping could significantly improve public health outcomes.
From 2016-2023, the adult daily smoking rate 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%. These declines closely mirror differences in vaping rates: in 2023, 9.7% of New Zealand adults vaped daily, compared to just 3.5% of Australian adults.
(see graph below)
Australia has implemented a highly restrictive, medical-only model for vaping, focussing on limiting youth access. In contrast, New Zealand allows regulated sales of vaping products through licensed retailers, a framework aligned with countries like the UK, USA, and Canada.
Emeritus Professor Wayne Hall from the University of Queensland emphasised the significance of the findings. “For the first time, the smoking rate in New Zealand has dropped below that of Australia and it is declining rapidly as smokers transition to vaping, a much less harmful alternative to smoking.”
“Importantly, the study found that the greatest reductions in smoking rates were in the most disadvantaged populations in New Zealand with high smoking rates,” he said. “Smoking declined three times faster in New Zealand’s lowest socioeconomic communities compared to Australia. Similarly, smoking in New Zealand’s Māori population declined at nearly three times the rate of Australia’s Indigenous population.”
Professor Hall cautioned that cross-sectional studies like this cannot definitively prove that vaping caused the accelerated decline in smoking in New Zealand. However, he said, “We examined a wide range of possible explanations and found no good evidence that other factors played a significant role”.
The greatest decline in smoking in both countries occurred in the younger adult age groups, who also had the highest rates of vaping. This finding supports the conclusion that vaping was an important contributory factor.
Youth vaping rose sharply in New Zealand, reaching 10% daily vaping in 2023 compared to just 3% in Australia. Encouragingly, most recent data show a decline in youth vaping in New Zealand with rates falling to 8.7% in 2024.
At the same time, daily youth smoking hit record lows in both countries in 2023 (0.3% in Australia and 1.2% in New Zealand), suggesting that vaping has not acted as a gateway to smoking. “Instead, vaping appears to be diverting young people away from smoking,” Professor Hall said.
The study also noted that Australia’s restrictive approach has fostered a thriving and often violent black market for vapes, supplying over 90% of products. In contrast, New Zealand’s regulated market has shown no significant evidence of illicit trade.
According to Professor Ron Borland from Deakin University, this study highlights the potential benefits of more permissive vaping regulations. “If vaping is driving the rapid decline in smoking in New Zealand as appears likely, the findings suggest that regulated retail sales to adults, while framing vapes as a better alternative, is more effective in reducing smoking, particularly among high-risk groups,” he said.
Professor Borland concluded, “If Australia were to adopt a similar model to New Zealand, it could accelerate the reduction in smoking rates, improve public health, reduce health disparities for disadvantaged and Indigenous populations, and curtail the illicit vape market. At the same time, both countries must implement stricter measures to prevent youth access while encouraging adult smokers to switch to vaping”.
The Study: Mendelsohn CP, Beaglehole R, Borland R, Hall WD, Wodak A, Youdan A, Chan GCK. Do the differing vaping and smoking trends in Australia and New Zealand reflect different regulatory policies? Addiction 2025. DOI: 10.1111/add.70006
Notes from paper:
Background and Aims: Comparing regulatory models for nicotine vaping products in different countries can provide insights into the most effective regulatory approach but can be confounded by cross-national differences. This study compared two neighbouring countries with very different vaping regulatory models but with similar tobacco control policies and population demographics. Australia has a highly restrictive prescription-only vaping policy, while New Zealand adopted a regulated consumer model. Methods: This study compared trends in daily smoking and vaping among adults and youth from 2016 to 2023 in Australia (adults ≥14 years and ≥15 years; youth 12– 17 years) and New Zealand (adults ≥15 years, youth 14–15 years), using published statistics from large nationally representative surveys. Results: Between 2016 and 2023, the decrease in adult daily smoking in New Zealand (from 14.5% to 6.8%) was larger than in Australia (from 12.2% to 8.3%) by a factor of 0.67 [95% confidence interval (CI) = 0.43, 0.93]. However, the increase in adult vaping in New Zealand (from 0.9% to 9.7%) was larger than in Australia (0.5% to 3.5%) by a factor of 0.56 (95% CI = 0.17, 1.02). The largest smoking reductions in both countries were in young adults, who also reported the highest vaping rates. There was a more rapid decline in smoking in the lower socioeconomic groups and Indigenous people in New Zealand than in Australia. Youth smoking rates declined in both countries to very low levels. Youth vaping rates in New Zealand were higher but have started to decline since regulations were introduced. Conclusions: If the association is causal, New Zealand’s less restrictive approach to vaping (compared with Australia’s more restrictive approach) may have contributed to a more rapid decline in adult smoking, and reduced social inequalities and Indigenous smoking, but at the possible expense of increased youth vaping.