Source: University of Otago
Aotearoa’s progress in reducing smoking has slowed for Māori, Pacific and European adolescents, and vaping could be the reason, according to research published today in The Lancet Regional Health – Western Pacific.
The study, conducted by researchers from the Universities of Otago, Auckland, and Sydney, along with the Daffodil Centre in Australia, analysed population-level data from almost 600,000 Year 10 students aged 14–15. The students were surveyed between 2003 and 2024 as part of the Action on Smoking and Health (ASH) Year 10 Survey.
Using interrupted time series analysis, the researchers compared smoking trends from 2003-2009 (before vaping became common in Aotearoa) with those from 2010-2024 (when vaping became increasingly common).
They found rates of regular smoking among 14-15-year-olds declined significantly for Māori, Pacific, European, and Asian adolescents between 2003 and 2024. However, these declines in smoking slowed for Māori, Pacific, and European youth after vaping emerged in 2010.
A senior author of the research, Associate Professor Andrew Waa from the Department of Public Health at the University of Otago, Wellington – Ōtākou Whakaihu Waka, Pōneke, says the findings are especially concerning for Māori and Pacific youth, who already have much higher rates of smoking and vaping than their peers.
“We sometimes hear that e-cigarettes might be a harm-reduction device for Māori and Pacific youth, by reducing or stopping them from smoking.
“Our results show the opposite. Rather than supporting claims that vaping reduces harms for Māori and Pacific youth, vaping has substantially added to them. It has become a major additional source of nicotine dependence, carries its own health risks, and appears to have led to more adolescents smoking.”
In 2024, regular smoking among 14-15-year-olds was approximately 6.2 per cent for Māori, 3.3 per cent for Pacific, and 2 per cent for European adolescents. However, the study found that if each group’s pre-2010 smoking trend had continued, the estimated 2024 prevalences would have been 4.2 per cent for Māori, 1.8 per cent for Pacific, and 0.7 per cent for European adolescents.
A co-author on the paper, Dr Lucy Hardie, a Research Fellow at the School of Population Health at the University of Auckland – Waipapa Taumata Rau, says the numbers make the impact clear.
“Our results indicate that, for every 1,000 students, there were 20 more Māori, 15 more Pacific and 13 more European students smoking regularly in 2024 than there would have been if pre-2010 smoking trends had continued.”
Associate Professor Waa says the implications extend beyond biomedical harm and into Indigenous rights and obligations under Te Tiriti o Waitangi and international frameworks.
“Before colonisation, Māori were free from nicotine addiction. Today, nicotine from cigarettes and vapes undermines Māori self-determination by embedding dependence within our communities.”
He says governments have duties under Te Tiriti o Waitangi and the WHO Framework Convention on Tobacco Control to reduce health inequities and protect Māori youth from commercial determinants of health.
“Policies that enable easy access to vaping products don’t just miss the mark on health, they also fall short of Te Tiriti o Waitangi commitments and of Aotearoa’s international obligations to address inequities affecting Indigenous peoples.”
Waa says urgent action is needed to align government policy with these obligations.
“We should be closing the door on all sources of nicotine dependence, not opening new ones. Protecting Māori youth is an obligation under Te Tiriti o Waitangi, and protecting all young people is a core public health responsibility.”
Notes:
The research paper, ‘Trends in smoking prevalence before and after the emergence of vaping in Aotearoa/New Zealand among 14-15-year-olds identifying as Māori, Pacific, European, or Asian: an interrupted time series analysis of repeated cross-sectional data, 2003-2024’ is published in The Lancet Regional Health – Western Pacific. A companion explainer will be published in The Conversation and will be live at this link when the embargo lifts: https://theconversation.com/vaping-is-slowing-progress-in-cutting-teen-smoking-rates-in-nz-widening-inequities-for-maori-and-pacific-youth-267851
