Results from New Zealand’s ‘vape to quit’ initiative show that nearly half of the participants have remained smokefree.
Researchers conducting follow-up interviews with 100 people who took part in the Te Hā – Waitaha ‘vape to quit’ strategy found that after six months 16% were smoke and vape free, 31% were smokefree and vaping and 31% were smoking and not vaping.
Of the 53 participants still vaping in the follow-up cohort, 38% stated that their intention was to stop vaping eventually, while the remainder either planned to continue vaping (19%) or were undecided (43%).
Lead author Kelly Burrowe, from the University of Auckland’s Bioengineering Institute, explained that the team also compared the use of smoking cessation aids for 1,118 people, across different ethnic and age groups, to assess the uptake and effectiveness of e-cigarettes for smoking cessation.
“The most common product used by all groups were e-cigarettes containing nicotine with at least 65% uptake across all ethnic groups,” Ms Burrowe said.
“Most smokers want or intend to quit; however, support is needed to do so, and cessation support more than doubles the chances of successful quitting.”
“Based on our data the use of e-cigarettes in a “vape to quit” strategy is attractive to smokers, based on the high uptake of their selected use as a smoking cessation aid (75%), and in total, 16% of those in the follow up “vape to quit” cohort were both smokefree and vape free.”
However, of particular concern was the finding that 22% of participants were now vaping and smoking, with the authors noting that dual use may increase tobacco harm by exposing individuals to a broader range of inhaled chemicals.
“Dual use has been shown to be associated with a higher risk of cardiovascular risk factors, but more work is needed to fully understand the impacts of dual use or e-cigarette use alone,” the authors stated.
NZ has set an ambitious goal – Smokefree Aotearoa 2025 – which aims to reduce the prevalence of smoking to 5% or less within three years, capitalising on the fact that NZ’s smoking rates more than halved over the last 25 years, dropping from 25% in 1996 to a current rate of 10.9% (with 9.4% classed as daily smokers).
However, Māori, have continued to have a substantially higher smoking rate of 25.7%, with a daily smoking rate 22.3%, and Te Hā – Waitaha, the pro-equity quitting service, was formed in 2017 to help engage the Māori population more effectively in Canterbury, NZ.
The region is home to some 500,000 people and anonymised data was collected for the study between 2017 to 2019, generating 4,551 initial records, from which all incomplete datasets (3,300) were removed.
Ethnicity and age were analysed for the final 1,118 participants for smoking cessation aid analysis and the 100 participants who were contacted for the “vape to quit” programme, who identified their ethnicity as NZ European (745, 66.6%), Māori (314, 28.1%), from a Pacific nation (35, 3.1%), or from Asia (24, 2.2%).
The most common product used by all groups were e-cigarettes containing nicotine with at least 65% uptake across all ethnic groups.
The greatest uptake of e-cigarettes amongst Māori and Pacific were the 19–29-year-olds; in the Asian group it was 30 – 49-years; and for NZ Europeans, the highest e-cigarette uptake was observed among 50–59-year-olds.
NZ’s harm reduction strategy has embraced e-cigarettes and the use of predominantly nicotine-containing products, to support smoking cessation has increased rapidly, with 6.2% of adults being categorised as daily vapers.
“Of our cohort, 56% recommended that vaping should be used as an aid for smoking cessation compared to 44% who did not support this,” the authors observed.
“Those who were vaping were more likely to recommend its use as a smoking cessation aid, with 84% of those smokefree and vaping recommending it, and 68% of those smoking and vaping recommending it.
“This contrasted with levels of 50% and 22.5% in the groups ‘smokefree and not vaping’ and ‘smoking and not vaping’, respectively.”
The most popular reasons for liking vaping were around improvement of finances and to support smoking cessation, while the greatest reason for disliking vaping was that it was not ‘satisfying enough’.
Interestingly, the most common reasons that participants gave for eventually stopping vaping were: ‘went back to tobacco smoking’, ‘not satisfying enough’, ‘media advertising that it [vaping] is bad’, ‘exacerbations of respiratory symptoms”, ‘gave up altogether’, ‘swapping one habit for another’, ‘the vape broke’, and finally, ‘pregnancy’.
“More long-term research into the effectiveness of e-cigarettes as part of smoking cessation strategies and its long-term outcomes is needed,” the authors concluded.
“From a public health perspective, it would be preferable that e-cigarettes are used as an interim measure to an eventual smokefree/vapefree state.”