23rd February 2018, Volume 131 Number 1470

Sarah Merry, Christopher Bullen

Electronic cigarettes (e-cigarettes) are a global phenomenon. These diverse devices have surged in popularity since their introduction to the market just over a decade ago.1,2 E-cigarettes have, however, been subject…

Subscriber content

The full contents of this page is only available to subscribers.

To view this content please login or subscribe

Summary

This study summarises current research on the use of e-cigarettes in New Zealand. The study found that the number of people who have ever used an e-cigarette has increased over time. However, the number of New Zealanders who regularly use e-cigarettes remains low. Most people who use e-cigarettes are smokers or ex-smokers. While people commonly first try an e-cigarette because they are curious, many hope to reduce the number of tobacco cigarettes they smoke, or quit smoking. Further research is needed to monitor the use of e-cigarettes in New Zealand and any impact this may have on smoking rates.

Abstract

Aim

This study aimed to systematically review the literature on e-cigarette use in New Zealand, focusing on prevalence, rationale for use, perceptions and exposure to the devices.

Method

Six databases were systematically searched for articles regarding e-cigarette use in New Zealand, supplemented with a grey literature search. Seven hundred and eighteen abstracts were identified and full text of 100 articles reviewed. Studies addressing prevalence of and rationale for use, perceptions of and exposure to e-cigarettes were included. Relevant data were synthesised in a narrative summary.

Results

Fourteen studies addressed aspects of e-cigarette use in New Zealand, published between 2010 and 2017. Ever-use of e-cigarettes among adults and adolescents has increased, although current use remains low. Smoking strongly predicts use, and ever-use may decrease with age. Investigation of other predictors has been hindered by low prevalence and small samples. While curiosity is commonly cited for sampling e-cigarettes, many smokers are drawn by harm reduction or cessation. More complex motivators are becoming evident. Although exposure to e-cigarettes is common, many remain uncertain about their harm relative to tobacco.

Conclusion

While the available evidence provides an overview of current use, exposure and acceptance of e-cigarettes in New Zealand, it highlights knowledge deficits and informs future monitoring.

Author Information

Sarah Merry, Public Health Medicine Registrar, Auckland; Christopher R Bullen, Professor and Director, National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland.

Correspondence

Professor Chris Bullen, National Institute for Health Innovation, School of Population Health, University of Auckland, Private Bag 92019, Auckland.

Correspondence Email

c.bullen@auckland.ac.nz 

Competing Interests

Nil.

References

  1. Farsalinos KE, Poulas K, Voudris V, Le Houezec J. Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries. Addiction. 2016; 111(11):2032–40.
  2. Wilson FA, Wang Y. Recent findings on the prevalence of e-cigarette use among adults in the U.S. Am J Prev Med. 2017; 52(3):385–90.
  3. Gilmore AB, Hartwell G. E-cigarettes: threat or opportunity? Eur J Public Health. 2014; 24(4):532–3.
  4. Ministry of Health. Policy Options for the Regulation of Electronic Cigarettes: A consultation document. Wellington: Ministry of Health; 2016.
  5. Ministry of Health. Regulatory Impact Statement: Regulation of e-cigarettes and emerging tobacco and nicotine-delivery products. Wellington: Ministry of Health; 2017.
  6. Correa JB, Ariel I, Menzie NS, Brandon TH. Documenting the emergence of electronic nicotine delivery systems as a disruptive technology in nicotine and tobacco science. Addict Behav. 2017; 65:179–84.
  7. Zyoud SH, Al-Jabi SW, Sweileh WM. Worldwide research productivity in the field of electronic cigarette: A bibliometric analysis. BMC Public Health. 2014; 14(1):667 doi: 10.1186/1471-2458-14-667.
  8. Ministry of Health. Annual update of key results 2015/16: New Zealand Health Survey. Wellington: Ministry of Health; 2016.
  9. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010; 8(5):336–41.
  10. McNeill A, Brose LS, Calder R, et al. E-cigarettes: an evidence update. A report commissioned by Public Health England. London: Public Health England; 2015.
  11. Guiney H, Li J, Walton D. Barriers to successful cessation among young late-onset smokers. N Z Med J. 2015; 128(1416):51–61.
  12. Li J, Newcombe R, Newcombe R, Walton D. Susceptibility to e-cigarette use among never-users: findings from a survey of New Zealand adult smokers and ex-smokers. N Z Med J 2015; 128(1421):65–8.
  13. Li J, Bullen C, Newcombe R, Walker N, Walton D. The use and acceptability of electronic cigarettes among New Zealand smokers. N Z Med J. 2013; 126(1375):48–57.
  14. Fraser T, Chee N, Laugesen M. Perspectives of New Zealand health professionals and smokers on e-cigarettes. N Z Med J. 2016; 129(1441):98–100.
  15. White J. Young people’s use of electronic cigarettes and tobacco products other than cigarettes [In Fact]. Wellington: Health Promotion Agency Research and Evaluation Unit; 2013.
  16. Faletau J, Glover M, Nosa V, Pienaar F. Looks like smoking, is it smoking?: children’s perceptions of cigarette-like nicotine delivery systems, smoking and cessation. Harm Reduct J. 2013; 10:30. doi: 10.1186/1477-7517-10-30.
  17. Grace RC, Kivell BM, Laugesen M. Gender differences in satisfaction ratings for nicotine electronic cigarettes by first-time users. Addict Behav. 2015; 50:140–3.
  18. Li J, Newcombe R, Walton D. The use of, and attitudes towards, electronic cigarettes and self-reported exposure to advertising and the product in general. Aust N Z J Public Health. 2014; 38(6):524–8.
  19. Grace RC, Kivell BM, Laugesen M. Estimating cross-price elasticity of e-cigarettes using a simulated demand procedure. Nicotine Tob Res. 2015; 17(5):592–8.
  20. Bullen C, McRobbie H, Thornley S, et al. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control. 2010; 19(2):98–103.
  21. Li J, Newcombe R, Walton D. The prevalence, correlates and reasons for using electronic cigarettes among New Zealand adults. Addict Behav. 2015; 45:245–51.
  22. White J, Li J, Newcombe R, Walton D. Tripling use of electronic cigarettes among New Zealand adolescents between 2012 and 2014. J Adolesc Health. 2015; 56(5):522–8.
  23. Li J, Newcombe R, Walton D. Contextual information around the first use of electronic cigarettes among New Zealand smokers and recent quitters. Nicotine Tob Res. 2016; 18(5):737–8.
  24. Hoek J, Thrul J, Ling P. Qualitative analysis of young adult ENDS users’ expectations and experiences. BMJ Open. 2017; 7(3):e014990. doi: 10.1136/bmjopen-2016-014990.
  25. Health Promotion Agency. Data release: Preliminary analysis on 2016 Health & Lifestyle Survey electronic cigarette questions. Wellington: Health Promotion Agency; 2017.
  26. Pearson JL, Hitchman SC, Brose LS, et al. Recommended core items to assess e-cigarette use in population-based surveys. Tob Control. Epub 2017 Jun 17. doi: 10.1136/tobaccocontrol-2016-053541
  27. Wills TA, Knight R, Sargent JD, et al. Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii. Tob Control. 2017; 26(1):34–9.
  28. Singh T, Agaku IT, Arrazola RA, et al. Exposure to Advertisements and Electronic Cigarette Use Among US Middle and High School Students. Pediatr. 2016; 137(5): e20154155. doi:10.1542/peds.2015-4155.
  29. Villanti AC, Rath JM, Williams VF, et al. Impact of exposure to electronic cigarette advertising on susceptibility and trial of electronic cigarettes and cigarettes in US young adults: a randomized controlled trial. Nicotine Tob Res. 2016; 18(5):1331–9.
  30. Ball J, Stanley J, Wilson N, et al. Smoking prevalence in New Zealand from 1996–2015: a critical review of national data sources to inform progress toward the Smokefree 2025 goal. N Z Med J. 2016; 129(1439):11–22.

Download

The downloadable PDF version of this article is only available to subscribers.

To view this content please login or subscribe