Journal Article

Quantifying differences in teenage vaping across countries: the importance of comparing like with like

Durkin, Sarah J, Greenhalgh, Elizabeth M, Scully, Maree, Scollo, Michelle

2026

Overview

Major international surveys such as the Global Youth Tobacco Survey have a globally standardised methodology and provide a reliable means of comparing smoking and vaping among young people in many countries.4 However, no such survey includes countries such as Australia, Canada, the USA and the UK where youth vaping has been subject to intense scrutiny and debate and across which there have been substantial variations in vaping related policies and regulations introduced over time. Large increases in school retention in Australia over the past few decades mean that early school leavers (ie, those who leave school prior to completing their final year) are increasingly characterised by social and economic disadvantage,12 populations that are known to have higher rates of tobacco and other substance use.13 Australian data show increasingly profound differences in smoking prevalence by educational attainment, with not completing high school a far stronger predictor of smoking among younger compared with older people.13 In addition, national youth surveys show that vaping increases substantially from early to late adolescence,10 14 15 so comparisons of varying age ranges—even within adolescence—can be misleading. Table 1 School-based surveys of e-cigarette use in Australia, New Zealand, USA, Canada and England Country Survey and description Year Selected age group and sample size Vaping prevalence Australia Australian Secondary Students’ Alcohol and Drug (ASSAD) survey17 A triennial survey of 12–17-year-old students measuring teenage substance use 2022/2023 Year 9 students (aged 14–15 years) n=10 314 students, including 2001 (weighted n=1874) year 9 students Ever use: 26.1% Current (past month) use: 13.1% Daily use: 2.8% New Zealand ASH Year 10 Snapshot Survey20 An annual survey of students on their smoking and vaping behaviours and attitudes 2023 Year 10 students (aged 14–15 years) n=29 260 students Ever use: 37.5% Current (at least monthly) use: 16.4% Daily use: 10.0% USA High School Youth Risk Behaviour Survey14 A biennial survey of students in grades 9–12 2023 Year 9 students (aged 14–15 years) n=20 103 students, including 5307 year 9 students Ever use: 25.4% Current (past month) use: 12.2% Daily use: 3.5% Canada Canadian Student Tobacco, Alcohol and Drug Survey18 19 A biennial survey of students in grades 7–12 2021–2022 Year 9 students (aged 14–15 years) n=61 096 students, including 11 055 year 9 students Ever use: 23.0% Current (past month) use: 14.8% Daily use: 8.1% England Smoking, Drinking and Drug Use Among Young People Survey15 A biennial survey of students in years 7–11 2023 Students aged 15 years n=13 192 students, including 2431 15-year-olds in the e-cigarette analyses Ever use: 41.9% Current (weekly or ‘sometimes’) use: 18.6% Weekly use: 10.9% Comparing the findings of the school-based surveys with the most similar methodology and timing appears to suggest some variation in use of e-cigarettes across countries. Comprehensive tobacco control strategies that have so successfully reduced smoking among young people—including making products less visible, affordable, attractive and accessible23—are urgently needed to prevent use of all nicotine and tobacco products during this critical developmental period.

• Publisher: BMJ Publishing Group LTD
• Subject: Adolescence / Adolescents / Age / Age groups / Cancer / Child development / Cigarettes / Developmental stages / Drinking behavior / Drug use / Elder care / Electronic cigarettes / Ethics / Households / Older people / Polls & surveys / Smoking / Students / Substance use / Surveys / Tobacco / Vaping / Young adults