ObjectivesAlthough the smoking prevalence continues to decline in New Zealand (NZ) overall, little is known about smoking in university students. A 2013 survey of students aged 17–25 years found that 14% were current smokers, and 3% daily smokers. However, the sample did not include students from all NZ universities. This study examines the prevalence and patterns of cigarette smoking among students aged 18–24 years.SettingUniversity students across NZ.MethodsData came from a March to May 2018 survey of students from all NZ universities, and were weighted to account for undersampling and oversampling, based on gender and university size. χ2 tests were used to compare smoking by age, gender and ethnicity.Participants1476 participants were included: 919 (62.3%) aged 18–20 years and 557 (37.7%) aged 21–24 years; 569 (38.6%) male and 907 (61.4%) female; and 117 (7.9%) Māori and 1359 (92.1%) non-Māori.Results49.8% (95% CI 47.2 to 52.4) of respondents reported ever smoking, 11.1% (95% CI 9.5 to 12.9) currently smoked (smoked at least once a month) and 5.9% (95% CI 4.8 to 7.3) smoked at least daily (daily smokers). Of current smokers, 63.6% smoked 1–5 cigarettes/day, 45.8% smoked daily, 73.4% smoked first cigarette >60 min after waking, 86.0% never/almost never smoked in indoor and 64.6% in outdoor smokefree spaces, 69.9% planned to quit and 32.4% had tried to quit. Ever, current and daily smoking were significantly higher in 21–24 compared with 18–20 years olds, and in males compared with females. Older participants were more likely to report smoking more cigarettes/day. Māori were more likely to report ever smoking than non-Māori.ConclusionsCurrent smoking among NZ university students aged 18–24 years appears to be declining but daily smoking could be increasing. However, many students appeared less addicted to nicotine, and willing to quit. We recommend increasing the availability of smokefree services for students who wish to quit.

Tobacco smoking is common among people with mental illnesses, and they carry a higher burden of smoking-related illnesses. Despite this, smoke-free policies and systems for supporting cessation have proved difficult to introduce in mental health and drug and alcohol services (MHDAS). This paper examines the barriers to becoming smoke free within New Zealand services. Key informants, including staff, smoke-free coordinators, and cessation specialists were interviewed. Of the 142 invited informants 61 agreed (42%) to participate in a telephone interview, and 56 provided useable data. Organizations had a permissive or transitioning smoking culture, or were smoke free, defined by smoke-free environments, smoke-free-promoting attitudes and behaviours of management and staff, and cessation support. Most organizations were on a continuum between permissive and transitional cultures. Only eight services had a fully smoke-free culture. MHDAS face many challenges in the transition to a smoke-free culture. They are not helped by exemptions in smoke-free policies for mental health services, staff smoking, negative staff attitudes to becoming smoke free, poor knowledge of nicotine dependence, smoking-related harm and comorbidities, and poor knowledge and skills regarding cessation-support options. Health inequalities will continue across both service and socioeconomic divides without a concerted effort to address smoking.

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In this, the largest pre-cessation NRT trial to date, using NRT 2 weeks before the target quit day was safe and well tolerated but offered no benefit over usual care. However, in conjunction with previous pre-cessation trials there appears to be a moderate benefit, but not as large as that seen in most smaller trials.

ObjectivesTo examine electronic cigarette use, reasons for use and perceptions of harm among university students.DesignCross-sectional study.SettingUniversity students across New Zealand.MethodsWe analysed data from a 2018 cross-sectional survey of university students, weighted to account for undersampling and oversampling by gender and university size. χ2 tests were used to compare e-cigarette use, reasons for use and perceptions of harm by age, gender, ethnicity and cigarette smoking.ParticipantsThe sample comprised 1476 students: 62.3% aged 18–20 years, 37.7% aged 21–24 years; 38.6% male, 61.4% female; 7.9% Māori and 92.1% non-Māori.Results40.5% of respondents (95% CI 37.9 to 43.1) reported ever, 6.1% (4.9–7.4) current and 1.7% (1.1–2.5) daily use. Regardless of frequency, 11.5% of vapers had vaped daily for ≥1 month, 70.2% of whom used nicotine-containing devices; 80.8% reported not vaping in indoor and 73.8% in outdoor smoke-free spaces. Among ever vapers, curiosity (67.4%), enjoyment (14.4%) and quitting (2.4%) were common reasons for vaping. 76.1% (73.4–78.7) of respondents believed e-cigarettes were less harmful than cigarettes.More males than females reported vaping (ever, current, daily and daily for ≥1 month), nicotine use and belief that e-cigarettes were less harmful than cigarettes. More participants aged 18–20 years reported not vaping in outdoor smoke-free spaces, vaping out of curiosity and belief that e-cigarettes were less harmful than cigarettes, while more participants aged 21–24 years vaped daily for ≥1 month and for enjoyment. More Māori than non-Māori ever vaped. More cigarette smokers than non-smokers vaped (ever, current, daily and daily for ≥1 month), used nicotine and vaped to quit, while more non-smokers did not vape in smoke-free spaces and vaped out of curiosity.ConclusionsOur results suggest high prevalence of e-cigarette ever and current use, particularly among males and smokers. Many vaped out of curiosity and perceived e-cigarettes as less harmful than cigarettes.