Quantifying differences in teenage vaping across countries: the importance of comparing like with like

Substantial increases in vaping among young people in recent years is of great concern, and governments around the world have implemented a range of policies and programmes to discourage uptake of e-cigarettes.1 Effective monitoring and evaluations are needed to inform regulations that aim to prevent youth vaping, including examining prevalence of e-cigarette use within the different regulatory environments. However, a rapidly evolving product landscape, differences in the wording and timing of questions between surveys, and difficulties in accurately capturing frequency of use can lead to challenges in accurately quantifying and comparing youth vaping.2 3 When analysing youth vaping across countries it is crucial that the data selected are as comparable as possible—in respondents, age groups and survey methods. Major international surveys such as the Global Youth Tobacco Survey have a globally standardised methodology and provide a reliable means of comparing smoking and vaping among young people in many countries.4 However, no such survey includes countries such as Australia, Canada, the USA and the UK where youth vaping has been subject to intense scrutiny and debate and across which there have been substantial variations in vaping related policies and regulations introduced over time. Several commentators have claimed that vaping among young people in Australia is similar or higher than in countries with fewer e-cigarette restrictions,5–7 and some argue that strong regulation of e-cigarettes may in fact increase youth …