Protective Factors Against e-Cigarette Use Among First Nations People Aged 16–24 in the Next Generation Youth Wellbeing Study

Issue Addressed: Adolescent e-cigarette use is increasing and is associated with subsequent smoking. This study examines potential protective factors associated with not vaping among First Nations adolescents in Australia to inform community programs. 

Methods: The ‘Next Generation: Youth Wellbeing Study’ is a cohort study of First Nations adolescents aged 10–24 years from urban, rural and remote communities in Central Australia, Western Australia and New South Wales. Analysis of self-reported vaping from 16 to 24-year-olds, collected 2018–2020, using multi-level mixed-effects Poisson regression to estimate age-site-adjusted prevalence ratios (PRs) for never-vaping in relation to various factors. 

Results: Among 419 participants, 65% were female, 75% had never vaped, 49% had never smoked and 82% lived in smoke-free homes. Never vaping was more common among those who had: never-smoked (PR = 1.78, 95%CI: 1.56–2.04); never used cannabis (1.89, 1.60–2.24); non-smoking friends (1.38, 1.26–1.51); good mental health (1.15, 1.01–1.30), never diagnosed with depression (1.21, 1.01–1.46) or anxiety (1.31, 1.08–1.57); and no experiences of racism (1.21, 1.08–1.36), no negative criminal justice system experiences (1.25, 1.11–1.41), or vicarious racism through negative media (1.24, 1.10–1.39). 

Conclusions: Most First Nations adolescents have never vaped, with potential protective factors being better mental health, no other substance use and fewer experiences of racism and justice system interactions. Comprehensive community adolescent prevention programs are needed to prevent vaping and protect future health, including preventing nicotine addiction and future smoking. 

So What?: Policies and programs must address e-cigarettes directly as well as structural factors, promoting broader adolescent wellbeing, centring culture and family in a strengths-based approach.