New Zealand’s vaping strategy drove fivefold acceleration in smoking decline

Major new research reveals that New Zealand’s progressive approach to vaping has resulted in an unprecedented decline in smoking across all age groups, strengthening the case for safer nicotine alternatives as a central part of tobacco control.

The analysis, published in The Lancet Regional Health – Western Pacific, found that the annual rate of decline in New Zealand’s adult daily smoking jumped from 3.5% before 2018 to 17.9% between 2018 and 2023.

That represents a fivefold acceleration in the pace at which New Zealanders stopped smoking.

The sharp change followed years of much slower progress under conventional tobacco control policies and coincided with the rapid growth of vaping, clearer regulation of vaping products and government promotion of vaping as a tool to help adults quit cigarettes.

Smoke Free Sweden says the findings should force governments to reconsider policies that restrict adult access to safer alternatives while cigarettes remain widely available.

“This is a public health result that governments around the world should study carefully,” said Smoke Free Sweden leader Dr Delon Human.

“New Zealand’s smoking decline accelerated fivefold after vaping became widely used as a way out of smoking. That is an extraordinary change with the potential to prevent thousands of cases of cancer, heart disease and lung disease.”

The researchers found that improvement was even more substantial among Māori adults, who have historically experienced much higher smoking rates. Their annual rate of decline accelerated from 2.2 % to 13.3%, while Māori smoking prevalence halved.

The study also revealed that New Zealand’s youth smoking is at historic lows, with authors noting that youth vaping has fallen following tighter youth-focused regulations.

Dr Human, a former secretary-general of the World Medical Association, said the same broad lesson could be seen in Sweden, where access to snus, nicotine pouches and vaping products has accompanied a fall in smoking to below the internationally recognised 5% smoke-free threshold.

“Sweden and New Zealand have shown that rapid progress becomes possible when smokers have acceptable alternatives to cigarettes,” he said.

“Countries that ban flavours, restrict safer products or tax them like cigarettes risk slowing the very transition that could save millions of lives.”

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