E-cigarette use and the relationship to smoking among Aboriginal and Torres Strait Islander and non-Indigenous Australian Secondary Students, 2017

Objective: Estimate the prevalence of e-cigarette use (vaping) among Aboriginal and Torres Strait Islander adolescents and explore the relationship between vaping and tobacco use. Methods: N=18,199 students aged 12–17 years (n=1,097 Aboriginal and Torres Strait Islander) participating in the 2017 Australian Secondary Students’ Alcohol and Drug (ASSAD) Survey self-reported their e-cigarette and lifetime, past month and past week smoking behaviours. Results: Twenty-two per cent of Aboriginal and Torres Strait Islander students (14% all) reported having ever used e-cigarettes. Significantly greater odds of e-cigarette use among Aboriginal and Torres Strait Islander students was observed overall, but not among regular (past month/week) smokers. There were significant associations between e-cigarette use and any level of smoking for all students (p<0.001), with no variation by Indigenous status. While e-cigarette use was more common among smokers, 28% of Aboriginal and Torres Strait Islander ever-vapers (35% all ever-vapers) were never smokers. Conclusions: There is substantial prevalence of e-cigarette ever-use among Australian secondary students, including Aboriginal and Torres Strait Islander students, and a strong relationship with tobacco use. Implications for public health: Policies facilitating e-cigarette access must not undercut tobacco control efforts for adolescents, particularly Aboriginal and Torres Strait Islander people who continue to experience higher smoking rates.