Study links New Zealand's smoking decline to vaping, harm reduction

A new study has linked New Zealand's historic decline in smoking rates to the country's embrace of tobacco harm reduction strategies, including the use of vaping products as an alternative to combustible cigarettes.

Published in the June 2026 issue of The Lancet Regional Health, the study found that adult smoking prevalence declined at a significantly faster pace beginning in 2018.

Researchers reported that New Zealand's annual rate of decline in smoking prevalence accelerated from 3.5 percent before 2018 to 17.9 percent between 2018 and 2023.

"Join point regression analysis confirms this period as a statistically significant acceleration in decline compared with earlier trends," the study stated.

Titled New Zealand's accelerating smoking decline: Lessons for tobacco harm reduction, the study was authored by Robert Beaglehole and Ruth Bonita, professors emeriti at the University of Auckland, and independent health adviser Ben Youdan.

According to the researchers, the turning point came in 2019 when vaping became more widely adopted and New Zealand's Ministry of Health formally recognized vaping products as substantially less harmful than smoking while supporting their use as smoking cessation tools.

Led by Beaglehole, a former director at the World Health Organization, the researchers found that increased vape use coincided with the accelerated decline in smoking rates.

The study also distinguished vaping from combustible cigarette smoking, noting that nicotine itself is not the primary cause of smoking-related diseases. Instead, it emphasized that exposure to combustible tobacco remains the leading source of tobacco-related illnesses.

The researchers reviewed two decades of tobacco control in New Zealand, noting that after the country ratified the WHO Framework Convention on Tobacco Control in 2004, policies such as smoke-free environments, graphic health warnings and higher tobacco taxes contributed to a gradual decline in smoking.

However, they found that the reduction became substantially steeper only after 2018.

The study said New Zealand would have missed its Smokefree 2025 target by several decades had pre-2018 trends continued.

Current data show smoking prevalence has stabilized below seven percent, with most remaining smokers belonging to older age groups and long-term smokers, particularly within the Māori community.

The researchers noted that smoking prevalence among Māori was cut by half over six years.

The authors concluded that traditional tobacco control measures can be effectively complemented by tobacco harm reduction strategies to accelerate declines in smoking.

"Maintaining a clear focus on reducing harm from combustible tobacco will be critical to sustaining progress as smoking prevalence declines," the authors wrote. "Further progress will require compassionate and targeted equity-focused interventions and a coherent regulatory framework that covers all nicotine products in proportion to the risks they incur."