Cigarette smoking and e-cigarette use among university students in New Zealand before and after nicotine-containing e-cigarettes became widely available: results from repeat cross-sectional surveys.

Aim: To estimate prevalence and patterns of smoking and vaping, and associations between smoking and vaping, among university students in New Zealand when access to nicotine-containing e-cigarettes was restricted (ie, time point 1 or T1) and 12-months after restrictions were relaxed (ie, time point 2 or T2).

Method: Cross-sectional surveys of university students across all eight universities: T1, March 2018 (n=1,932), and T2, March 2019 (n=2,004). Chi-squared tests compared responses between T1 and T2 and logistic regression examined associations between smoking and vaping with student characteristics.

Results: The patterns of smoking (T1 vs T2): current (10.6% vs 12.1%, p=0.716), daily (5.0% vs 4.6%, p=0.121), and cigarettes/day, time to first cigarette, and avoidance of smoking in smoke-free spaces were not significantly different. In contrast, vaping: current (6.8% vs 13.5%, p<0.001), daily (2.7% vs 5.4%, p<0.001), and possibly vaping in smoke-free spaces, were significantly higher at T2. At both periods, males had higher odds of smoking, vaping and dual use; students aged 25-34 and long-term residents had higher odds of vaping. Asian and Other students had lower odds of smoking at T1, and Other students had higher odds of vaping at T2.

Conclusion: Vaping was significantly more prevalent at T2 than T1, without their being a corresponding decrease in smoking. Age, sex, student type and ethnicity predicted smoking and vaping.