Six years after vapes became legal in New Zealand in 2018, Health New Zealand has released guidance for health workers on supporting people to quit vaping.
Royal New Zealand College of General Practitioners medical director Dr Luke Bradford is welcoming the document as a “step-forward, albeit a little delayed”.
Vaping is a less harmful alternative to smoking cigarettes, but not harmless.
The University of Auckland was contracted to create the guidance, which states it’s based on the current evidence for what is good practice for vaping cessation and vaping to stop smoking.
The guidance recommends adult and youth vapers who don’t smoke and want to quit are given a combination of behavioural therapy strategies including taking instant or gradual quitting action along with behavioural counselling.
But accessing that support can be difficult, with no targeted funding from the Government for vaping cessation services.
One parent who wanted to remain anonymous told 1News about her experience with a child with a nicotine addiction.
“They crave it, they are shaking, they can’t concentrate at school.”
She said she’s concerned her daughter’s health has been affected and numerous visits to the general practitioner have not led to support: “She was an athlete and then couldn’t get her out of bed, couldn’t get her to go to school, always sick, real big mood changes and the times that I’ve got her off it, the withdrawals are just terrible.
“The doctors actually have no support at the moment, there’s no support for these kids.”
The Royal New Zealand College of General Practitioners and Asthma and Respiratory Foundation New Zealand are among those calling for targeted funding for providers to support youth addicted to vaping.
“A great deal more has to be done to stop youth in the first place from taking up vaping and then to support them as they want to quit,” Bradford told 1News.
He said general practitioners are often seeing high levels of addiction among vapers.
“There’s a lot of nicotine in vapes and they’re easy to use and no natural off, which can see quite a lot of problems with addiction, so that funding and resource into the quitting services being targeted at youth who are vaping is what we are calling for,” he said.
“Certainly the way we communicate with teenagers and people in their early twenties has to be different from those who’ve been smoking cigarettes for the last 30 or 40 years.
“How do we go to where the young people are and access them and offer them services there.”
Bradford said vaping was already widespread when the country’s smoke-free by 2025 goal was set up.
“It’s time to chase that down now, it has become an epidemic in the young, it is of serious concern and we do need to really focus on how we address that before we see the next wave of health problems from it,” he said.
‘More research is needed’
Health New Zealand Te Whatu Ora declined to be interviewed on the subject, but in an earlier statement said vaping cessation actions need to be evidence-based to “ensure they address the specific behaviours, motivations and needs of young people”.
“Both internationally and in New Zealand, more research is needed into the prevalence of vaping among young people, its long-term health effects, understanding motivations and effective prevention strategies.”
Health New Zealand health promotion director Kathrine Clarke said in another statement the organisation recognises “the best thing people can do is be vape and smokefree”.
Health New Zealand said in another statement “people concerned about their vape use or who want to reduce or quit can access assistance from existing smoking cessation programmes”.
Asthma and Respiratory Foundation New Zealand chief executive Letitia Harding said this support for young people is “ad hoc” around the country.
“The support now for our kids, especially those that became addicted early on when we had no regulations in this country, they’re falling through the cracks,” Harding said.
The organisation released the country’s first guidelines to support youth to quit vaping last November.
Harding said there’s been little action on the issue of youth vaping addiction since then and a strong message from the Ministry of Health is required: “We have a real problem with our youth vaping and we need to target that with some solutions.”
She said public messaging needs to separate the currently “muddied waters” between the country becoming Smokefree and the youth vaping problem.
“That’s really important for the services, for the funding and the attention from the Ministry and public policy.”
The issue in numbers
The Action for Smokefree 2025 survey on Year 10 students last year revealed one in 10 were vaping daily. One in five Māori Year 10 students were vaping daily, according to the survey.
The 2023 Year 10 survey reported vaping regularly but not daily had decreased for the second year in a row, to 16.4%.
Harding said the addiction levels in teenagers are a result of the country’s delayed regulations and regulation decisions.
“We’re trying to fix things up as we go and that’s the real difficulty.
“I think we should have gone down a prescription model like Australia did and we should have classified these under a therapeutic goods administration product, a MedSafe product and if they’re going to be used as a smoking cessation product that’s what should have happened early on.”
The Government invests around $15 million in quit smoking support each year.
In May, Quitline began offering three-month quit vaping support programmes to all age groups. The programme originally launched for people aged 18 and over in November last year.
Since November 2023, more than 3700 people have signed up to the programme. Around 370 people who signed up were aged 18 or under.
Harding said the Quitline website does not include a youth vaping focus.
“It’s very hard to navigate if you’re wanting to actually quit vaping so we need to invest in having that separate entity.”
The anonymous parent 1News spoke to said the situation for addicted teenagers is complex. She said she felt teenagers would not contact Quitline about quitting vaping.
“David Seymour needs to address this before prosecuting parents like me (for truancy) when I’m trying my damnedest every single day but the vapes are at schools and punishing these kids isn’t going to help,” she said.
The parent said there’s been instances of lying and stealing money to keep up the habit, with vapes purchased illegally from dairies. She’s also concerned about students sharing vapes and spreading sickness.
She supports marketing campaigns introduced by the Australian Government this year encouraging students to stop vaping.
Protect Your Breath
The New Zealand Government’s vaping investment has been on youth education campaigns and resources for schools, parents and other health providers.
One of the initiatives, the Protect Your Breath campaign was designed by youth and experts to get young people thinking about their vaping.
“The campaign appears on social media channels where young people spend their time, with the aim of provoking conversations and encouraging people to consider the impact of vaping on themselves and their communities,” Clarke stated.
The anonymous parent said students are likely to listen to influencers they respect sharing quit vaping messages.
“The big tobacco companies have got influencers all over Tik Tok and their channels telling them how ‘cool’ it is.
“We need to counteract that. Why are we not doing anything about it?”
The mum advocates for open conversations with teenagers to understand more about their situation.
“They all want to give it up… it’s just like heroin to them, they’re hooked.”
Nicotine is one of the most addictive substances in the world.
She said siblings and peers at school are also affected mentally and physically by those around them vaping.
“We need acceptance, we need medical support, we need mental health support for these kids, we need parent support, we need the doctors and Starship to know what to do and tell these kids they’re not just guinea pigs.”
Limited evidence on vaping cessation
Adding to the challenging situation is the limited evidence of what strategies are useful for vaping cessation – but evidence is evolving rapidly, according to the guidance for health workers commissioned by Health New Zealand.
Evidence for the health effects of vaping is also still emerging.
The guidance states it’s not a set of mandatory guidelines or best practices.
“There is currently insufficient evidence for the use of NRT (nicotine replacement therapy) or any medications for the indication of vaping cessation,” the guidance for health workers states.
Medical doctors and dentists can prescribe NRT for vaping cessation despite the treatment not being officially approved for the condition, only for smoking cessation. Quit smoking support providers cannot prescribe or recommend NRT.
Bradford said doctors will judge what is right for the individual patient.
He said the Government guidance takes a “safety-first” approach because of the lack of research on the effectiveness of NRT for vaping cessation.
“But there’s nothing to suggest it wouldn’t, it is a nicotine addiction… so it’s our suspicion that nicotine replacement would likely be effective for those who are vaping heavily.”
Harding also suggested NRT could be useful for youth vapers but said it’s something that needs to be discussed by a patient with their health professional.
“These products have been around a while, way before you know e-cigarettes and vaping products were, so that’s going to be something that needs to be looked at.
“I’d have less reservations around NRT for nicotine addiction than using something which has got no FDA or Medsafe approval as a smoking cessation product like vapes in the first place to quit smoking.”
