Credit: Nery Zarate/Unsplash

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 and those who had recently quit .

The principal investigator of the study, Professor Richard Edwards from the University's Department of Public Health, says 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 use among New Zealand smokers from population-based data.

The 2018 survey found there to be a high awareness of vaping devices, with 98 percent of smokers and recent quitters saying they were aware of e-cigarettes. Seventy-seven percent of respondents reported having tried vaping, while 22 percent reported currently using e-cigarettes at least monthly and 11 percent 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 percent) compared to current smokers (eight percent) and among 18-24 year olds (19 percent) compared to older age groups (10 percent). The most common reasons given for using e-cigarettes were to help quit (78 percent) or cut down on smoking (81 percent).

Professor Edwards says the 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 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 percent of participants thought vaping was less satisfying than smoking and 39 percent incorrectly believed that e-cigarettes were as or more harmful than smoking cigarettes, or were unsure (15 percent)."

He says such beliefs underline the importance of public education, such as through the Vaping Facts website (vapingfacts.health.nz/).

"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."

More information: Richard Edwards et al. Patterns of Use of Vaping Products among Smokers: Findings from the 2016–2018 International Tobacco Control (ITC) New Zealand Surveys, International Journal of Environmental Research and Public Health (2020). DOI: 10.3390/ijerph17186629