Patterns, reasons and characteristics of e‐cigarette use in Australia: Findings from the 2022–2023 National Drug Strategy Household Survey

BACKGROUND AND AIMS: E-cigarette use (vaping) has increased in Australia despite restrictive policies. Little is known about the profiles and reasons to vape in this tightly regulated setting. This study aimed to determine the distinct profiles of individuals who vape and the socio-demographic, psychological and substance use related correlates of these profiles. DESIGN: Observational study using cross-sectional data from from the 2022-2023 National Drug Strategy Household Survey. SETTING: Australia. PARTICIPANTS: 21 500 respondents aged 14 years and older. MEASUREMENTS: Latent class analysis was used to identify distinct subgroups based on smoking status, vaping status, use of nicotine vapes, prescription vapes, inability to stop or cut down on the use of vapes and motivations to vape. Multinomial logistic regression explored the sociodemographic, mental health and substance use correlates of each identified class. FINDINGS: A five-class solution was identified among the 18.7% of survey participants who have ever vaped. Class 1 (Experimented with vapes to quit smoking, 4.1%) predominantly included individuals who smoked daily and had experimented with vapes, presumably in the context of smoking cessation. Class 2 (Experimented with vapes for curiosity, 9.2%) mostly included individuals who had never smoked but had tried vaping once or twice out of curiosity. Class 3 (Exclusive Vaping, 4.2%) was characterised by individuals who regularly vaped but had never smoked. Class 4 (Non-use, 80.3%) comprised individuals who did not currently smoke or vape. Class 5 (Using vapes to quit smoking, 2.2%) featured individuals who smoked and used e-cigarettes as a cessation aid. Using Class 4 (non-use) as a reference group, respondents in other classes, especially those in Class 5 (using vapes to quit smoking) reported very high psychological distress [odds ratio (OR) = 4.0, 99.6% confidence interval (CI) = 2.3-6.9], hazardous alcohol consumption (OR = 2.1, 99.6% CI = 1.4-3.3) and use of illicit drugs in the past year (OR = 6.4, 99.6% CI = 4.6-9.0). CONCLUSIONS: Australians who vape appear to be associated with younger age, lower educational attainment, higher psychological distress and higher recent use of other substances compared with Australians who do not vape.