What the rest of the world is doing to combat youth vaping

As Labour announces a new policy that would halve the number of vape stores around the country, we take a look at how other countries are dealing with the rise of vaping among young people.

Prime minister Chris Hipkins announced this week that if elected for another term, a Labour government would cap the number of vaping stores around the country to 600, require retailers to have a licence to sell vape products, impose harsher fines on those who sell vapes to young people and make vapes less visible in retail space. National is yet to announce its policy, but leader Chris Luxon has said in the past he’s open to a ban, and yesterday told Newshub he was “broadly supportive of the direction of travel with what the government’s put on the table”.

So no matter which party is elected in October, it’s clear that anti-vaping measures are ramping up. The new rules will follow a range of measures that have already been taken to combat vaping in Aotearoa, especially among those who have not smoked before. The number of vapers is rapidly increasing: the 2021 New Zealand Health Survey found that 10.2% of New Zealanders over the age of 15 were vaping daily, up from 3.9% in 2019. A 2021 survey of 19,000 high school students found that 27% had vaped in the last week, compared to 15% smoking traditional cigarettes. Teenagers report that they feel addicted to vapes, but don’t think hard about potential health impacts. Or, to take another measure: litter experts say the number of vapes in waterways is skyrocketing too.

These numbers are increasing despite a range of policy tactics that have attempted to limit vape access. This month, a regulation that vape stores are not allowed to open within 300 metres of a school or marae came into force. Earlier this year, a law change meant that vape shops had to make at least 70% of their revenue from vape products and operate in a separate physical venue – a way to make vapes less normalised within dairies. In response, many dairies built separate stores within their premises, divided by plywood, to keep selling vapes.

From September, new laws mean that disposable vapes now have to have replaceable batteries. Vape flavours have to be described generically: “strawberry” rather than “candyfloss wonderland”. Outside of specialist vape stores, only neutral flavours like menthol and tobacco can be sold. Since 2020, vaping has fallen under the Smokefree Environments and Regulated Products Act, which means that all places meant to be “smokefree” also have to be vape-free, and it is illegal to supply vaping products directly or indirectly to those under the age of 18. Vaping products can only be advertised within stores that sell them. The Ministry of Health still says on its website that vaping as a means to quit smoking is part of Aotearoa’s smokefree goals and recommends vapes for smokers only – even though they’re clearly being used much more widely.

In announcing the latest tranche of health regulations, health minister Ayesha Verrall referred to Australia, where vapes are now prescription products; the rise in youth vaping in New Zealand is part of a global trend. So what are other countries doing about it?

What they’re doing: In May a law change made vapes available only as prescription products through pharmacies, including those without tobacco. Single-use e-cigarettes have been banned. Doctors need to be authorised to prescribe vapes, which are intended as smoking cessation aids only. Packaging is intended to look clinical: the range of flavours and concentration of nicotine are limited too. Australia’s federal states and territories are still figuring out how they will implement these changes.

Is it working? School children say that it remains easy to get their hands on vapes. The number of kids who vape has significantly increased in the last five years.

What they’re doing: Vaping has been completely illegal in Singapore since 2018. Possessing a vape leads to a fine of SG$2,000 (NZ$2,484); importing vapes for the purpose of sale can get a fine of SG$10,000 (NZ$12,485).

Is it working? The number of people being fined for vape usage has steadily increased since the law was implemented. It’s hard to get exact data, but at least some of those who have been penalised have been high school students, a demographic where use is anecdotally increasing.

What they’re doing: The sale of e-cigarettes was banned in April last year in the territory. However, after considering the amount of income in manufacturing and exporting e-cigarettes, the government relaxed its ban to not include exports, a move that has been criticised.

Is it working? Despite the ban, local youth support groups say that teens are still using vapes; the government is now considering a ceiling on the age of people who are allowed to buy any kind of smoking products.

What they’re doing: Electronic cigarettes have been banned since 2019. However, enforcement has been limited, and vapes are easily available online, used primarily by young people. The Indian ministry of health is encouraging federal states to enforce the ban more thoroughly.

Is it working? One in five young Indians has vaped at least once. So far, e-cigarettes remain widely accessible.

What they’re doing: As an EU country, France adheres to European regulations for vaping devices: as consumer products, they cannot be sold in pharmacies. There are strict rules around where vaping can be advertised – only within shops, not on TV or billboards – and vaping is banned in educational institutions, but legal in bars and restaurants. There’s currently no tax on e-liquids. To combat waste, the country is considering banning disposable e-cigarettes by the end of this year.

Is it working? Three times as many young people said that they used a vape every day in 2022 compared to 2017. Use of other common substances, including cannabis, alcohol and traditional cigarettes, has decreased.

What they’re doing: Vaping devices don’t need a prescription and can be consumed in public spaces, but some companies and public transport services have their own restrictions. While the country has left the EU, the UK continues to follow European regulations for vapes. Packaging carries a health warning and manufacturers are required to submit detailed reports about their products to the ministry of health. Smokers trying to quit are offered vaping kits as a replacement. Advertising vapes is OK on billboards and in shops but isn’t allowed on TV or radio. An “enforcement squad” to fine and restrict underage access to vapes was created earlier this year.

Is it working? More than one in five young people between 11 and 18 have tried vaping. The government is asking for more research on how vapes can continue to be available to smokers but not to kids; like many of these countries, these regulations are new, and so the effect is not clear yet.

What they’re doing: Only those aged 19 or older can purchase vaping devices. The amount of nicotine in vapes is limited to a max of 20mg/mL (this is the same as the limit in NZ for disposable vapes). Tobacco and vape products cannot be given or sold to young people in public places; advertising of vapes is not allowed to be attractive to young people, or to associate vaping with a glamorous or exciting lifestyle. Vapes are not allowed to have flavours that would appeal to young people including confectionery (lolly) flavours.

Is it working? The latest Canadian Nicotine and Tobacco Survey showed that youth vaping rates were essentially unchanged since 2019.

What they’re doing: If marketed as medical devices, e-cigarettes are regulated by the South African health ministry. If sold simply as a consumer product, which they nearly all are, vapes are completely unregulated. Earlier this year, a sharp tax was imposed on vaping liquid that will lead to prices nearly doubling, even though no consumer regulations have been put in place. A tobacco and vape law that has been in progress since 2018 has just finished its final period of consultation and is expected to regulate vaping to some extent.

Is it working? The taxes and regulations have been criticised, as 20% of the adult population are smokers and easy access to vapes is seen as a key harm-reduction tool. Experts say the new tax is not well targeted to limit vape access for youth.

What they’re doing: The US’s federal system means that laws around vape access are all over the place. The minimum age to buy any tobacco products, including e-cigarettes, is 21. In California, high taxes on tobacco products fund awareness and education programmes for young people. A referendum at the end of last year meant a ban on all flavoured tobacco products was passed in the state. The US’s Food and Drug Administration (FDA) is reviewing a ban of popular e-cigarette brand Juul, as the company failed to provide evidence it was protecting public health, and was accused of targeting young people with its marketing. Juul can continue to sell its unflavoured products and devices, but not its popular flavoured pods, each of which has the same amount of nicotine as a pack of cigarettes.

Is it working: Juul’s and other super-high-nicotine products are now much less widely available. Due to loopholes, the California jurisdiction remains full of black-market flavoured drugs, which are easy to purchase in neighbouring states. Teen vaping rates are now close to pre-pandemic levels.

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