Vaping, smoking, and mental health in young people: insights from Australia’s National Drug Strategy Household Survey

Aims: To examine trends in vaping prevalence, frequency, and associated factors in Australia, with a focus on the relationship between vaping, smoking, and mental health among young people aged 14–25.Design, Setting and Participants: A repeated cross-sectional analysis was conducted using data from the National Drug Strategy Household Surveys (NDSHS) for 2016, 2019, and 2022/23.Measurements: Key measurements include the prevalence and frequency of vaping, smoking status, rates of mental health disorders and psychological distress, and use of e-cigarettes for smoking cessation. Data were disaggregated by year of survey to assess trends over time.Findings: The study revealed a marked increase in vaping prevalence among young people, with a shift towards more frequent use. In 2022/23, 62% of young people who had ever vaped reported never having smoked before initiating e-cigarette use. Regular vaping was significantly more common among individuals with mental health disorders or high psychological distress. While e-cigarettes showed some role in smoking cessation, only 1–3% of young people who used e-cigarettes to quit smoking were no longer smoking or vaping. In 2022/23, over 50% of young people who had used e-cigarettes for smoking cessation reported they could not stop or cut down vaping in the previous 12 months. Conclusion: The findings highlight the urgent need for targeted interventions to address the rising prevalence of vaping among young people, particularly those with mental health challenges. Recommendations include partnering with youth in policy and practice development, enhancing clinician training, conducting priority population research, developing targeted policy strategies for youth mental health services, and improving school-based prevention and intervention programs.