Youth2000 survey Series

Youth19 Rangatahi Smart Survey
Initial Findings
Substance Use

www.youth19.ac.nz
iCitation: Fleming, T., Ball, J., Peiris-John, R., Crengle, S., Bavin, L., Tiatia-Seath, J., Archer, D.,& Clark, T. (2020). Youth19 Rangatahi Smart Survey, Initial Findings: Substance Use. Youth19
Research Group, The University of Auckland and Victoria University of Wellington, New Zealand.

Acknowledgements

Thank you to the rangatahi who took part in the survey and the schools and families who
supported them – without all of you there would be no survey. We enormously appreciate yourtime, openness and energy. Thank you to the Youth19 investigators and researchers who ran thesurvey and contributed to this analysis and to the Adolescent Health Research Group who havecarried out the Youth2000 Survey Series with thousands of students over 20 years.
The Youth19 Researchers: Associate Professor Terryann Clark1 and Dr Terry (Theresa) Fleming2(co-principal investigators), Dr Roshini Peiris-John1, Associate Professor Sue Crengle3, Dr Lara
Greaves1, Dr John Fenaughty1, Professor Dave Parry4, Dr Sonia Lewycka1
The Adolescent Health Research Group: Dr Terry (Theresa) Fleming2, Associate Professor
Terryann Clark1, Dr Roshini Peiris-John1, Associate Professor Simon Denny1, Associate Professor
Melody Oliver1, Dr John Fenaughty1, Dr Jemaima Tiatia-Seath1, Dr Sonia Lewycka1, Dr Jennifer
Utter1, Dr Lara Greaves1, Dr Pat Bullen1, Lovely Dizon1, Kristy Kang1, Dr Kelsey Deane1, Dr Bridget
Farrant1, Dr Mathijs Lucassen1, Kylie Sutcliffe2, Associate Professor Sue Crengle3, Dr Jude Ball3
1 The University of Auckland, 2 Victoria University of Wellington, 3 University of Otago, 4 Auckland University of Technology

Report design and layout: Bo Moore, www.bomoore.net
Illustrations: Yasmine El Orfi, www.yasmineelorfi.com

Funding

The Youth19 Rangatahi Smart Survey is a collaboration between two Health ResearchCouncil projects:
Clark, T.C., Le Grice, J., Shepherd, M., Groot, S., & Lewycka, S. (2017). Harnessing the spark oflife: Maximising whānau contributors to rangatahi wellbeing. Health Research Council of New
Zealand Project Grant (HRC ref: 17/315).
Fleming, T., Peiris-John, R., Crengle, S., & Parry, D. (2018). Integrating survey and intervention
research for youth health gains. Health Research Council of New Zealand Project Grant (HRC ref:18/473).

Contact

youth19@auckland.ac.nz, terry.fleming@vuw.ac.nz or jude.ball@otago.ac.nz
Further Youth19 publications are available at www.youth19.ac.nz

iiSummary
This report highlights findings from the Youth19 Rangatahi Smart Survey (Youth19) aboutsmoking, vaping, alcohol use, and use of marijuana and other drugs. It is designed to be readwith the Youth19 Rangatahi Smart Survey, Initial Findings: Introduction and Methods report,
which explains how the survey was conducted, who was included and how to interpret theresults. This document and other Youth19 outputs are available at www.youth19.ac.nz.
As part of Youth19, secondary school students answered questions about their substance use.
We present an overview of these findings and changes over time, first for the total population(all students combined) and then for Māori, Pacific, Asian, and Pākehā and other Europeangroups. Finally, we outline opportunities for supporting students who face challenges with
substance use.
Youth19 data shows that:
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There were very large declines in cigarette smoking and binge drinking for New Zealandsecondary school students from 2001–2019.
This finding is consistent with international research highlighting a general decrease inyouth substance use in many countries in the first part of the 21st century. However there
are some indicators that behaviours such as smoking may no longer be declining or may be
beginning to increase again in some countries (ASH, 2020; Ball et al., 2020b; Inchley et al.,2020; Johnston et al., 2020).
Most students do not smoke, vape, drink alcohol, or use marijuana or other drugs.
Regular cigarette smoking is now uncommon overall, but ethnic and socioeconomic
differences remain stark. In particular, youth smoking remains relatively common in Māori,Pacific and low-income communities.
Vaping has emerged as a new issue.
Binge drinking is still prevalent, especially among older students.
Weekly marijuana use has been relatively stable over time, and is now more prevalent thanweekly cigarette smoking.
For many health risks, risks are higher in poorer communities, for example smoking andcannabis use are more common in higher deprivation areas. However, vaping and binge
drinking do not operate this way. Rather, regular vaping is more common in wealthiercommunities and binge drinking is common in all socioeconomic groups.

A Youth19 factsheet about smoking and vaping is available on our website. Further publications
are in development and will also be accessible via www.youth19.ac.nz.

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Findings
Cigarette smoking
In Youth19, 4.7% of students reported
smoking at least monthly, and 2.6% reported
smoking at least weekly, as shown in Table 1.
Although youth smoking has reduced
markedly over recent decades, smoking
remains an important cause of preventable
health problems and is still a concern,
particularly in higher deprivation
communities. Smoking at least weekly was
more prevalent among students from low
decile schools (5.2%) and high deprivationneighbourhoods (4.6%), than among students
from high decile schools (1.3%) and low
deprivation neighbourhoods (1.3%).

Weekly smoking was also more common
in students living in small towns (5.0%)
compared with urban (2.2%) and rural (2.2%)
areas. Similar differences were found forsmoking monthly or more often.
Youth smoking has decreased dramaticallysince 2001, and that decrease continued
between 2012 and 2019, from 4.5% to 2.6%
for weekly smoking, as shown in Table 3.
However, recent data suggests this downward
trend may have slowed or even be reversing(ASH, 2020). Reducing youth smoking remains
important for health among New Zealandyoung people.

E-cigarette use / vaping
In Youth19, 12% of students reported using
e-cigarettes or vapes at least monthly, and 8%
reported vaping at least weekly, as shown in
Table 1.
Vaping was more common than smoking inhigh school students, and many teens whovape are non-smokers (Ball et al., 2020a).
For smokers, switching to vaping can reduce
harm (Villalobos et al., 2019), however
vaping is not recommended among those
who do not smoke (Health Promotion Agency,2019). Our factsheet on vaping provides
more detail about possible health effects(Ball et al., 2020a).

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Vaping at least weekly was more prevalent
among students living in small towns (12%)
than in urban areas (7%), and among older
students. Similar differences were found forusing e-cigarettes monthly or more often.
In contrast to cigarette smoking, regularvaping (weekly or monthly) was morecommon in low, rather than high deprivation
communities.
Questions about vaping were not included inprevious Youth2000 surveys, so trend data is
not available. However, other New Zealandsurveys show that youth vaping has increased
rapidly in recent years (Lucas et al., 2020).

Binge drinking
As a measure of binge drinking, we asked
how many times students had five or more
alcoholic drinks in one session (within 4hours) in the last 4 weeks.
In Youth19, more than one in five students(22%), reported binge drinking in the last 4
weeks. Binge drinking increased with age, andprevalence was very high in the 17+ age group(42%), as shown in Table 2.
Binge drinking was common in all deprivationgroups and geographic areas. However binge
drinking was slightly more common among
students living in lower deprivation (generally
higher income) neighbourhoods (24%) than inhigh deprivation neighbourhoods (19%), andthose living in rural areas (26%) than in urban
areas (19%).
The decline in youth binge drinking froma peak in of 36% in 2007 is an important
health gain. Binge drinking is associated withharm both from the drinking itself and fromassociated behaviours, such as drink driving,
violence, risky or unwanted sex, and suicidal
behaviour. Despite these improvements,
youth binge drinking remains high in New
Zealand compared with other countries andcontinues to cause preventable physical,
mental and social harm in our communities.

Marijuana use
In Youth19, 23% of students reported everusing marijuana, and 4.1% reported
using marijuana at least weekly, as shownin Table 2.
Using marijuana at least weekly was
more prevalent among males (5.1%) thanfemales (3.1%), and in students from low
decile schools (6.2%) than from high decile
schools (2.5%). As with other substance use
indicators, regular use of marijuana increases
with age.

The proportion of youth using marijuana
weekly or more often is lower now (4.1%)
than in 2001 (6.5%), however it did not
substantially change between 2012 and 2019,as shown in Table 3.
Marijuana use, particularly frequent use
starting from a young age, can harm mental
health and have other negative effects (Royal
Society Te Apārangi, 2019), so marijuana harm
reduction remains important for youth health,and declines since 2001 are good news.

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Use of other drugs
In Youth19, 3.7% of students reported evertrying any other drugs (such as P, huffing,
synthetics), as shown in Table 2.
The proportion of students who had evertried other drugs increased with age.
There were no substantial differences
between male and female students, between
school deciles or neighbourhood deprivationlevels, or between students living in small
towns compared to urban or rural areas.

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Table 1: Cigarette and e-cigarette use, 2019

1 NZ Deprivation Index 2018, Low deprivation (1-3), Medium deprivation (4-7), High deprivation (8-10)
2 School Decile, Low decile (1-3) indicating higher deprivation, Medium decile (4-7), High decile (8-10) indicating lower deprivation
3 Urban (population of 10,000 or more), Small towns (population between 1,000 and 9,999 people), Rural (population fewer than 1,000)

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3 Urban (population of 10,000 or more), Small towns (population between 1,000 and 9,999 people), Rural (population fewer than 1,000)

2 School Decile, Low decile (1-3) indicating higher deprivation, Medium decile (4-7), High decile (8-10) indicating lower deprivation

1 NZ Deprivation Index 2018, Low deprivation (1-3), Medium deprivation (4-7), High deprivation (8-10)

Table 2: Use of alcohol, marijuana and other drugs, 2019

Table 3: Substance use trends

When comparing survey years: 1) students from kura kaupapa Māori are not included in 2019 results, as previous years did not include kura kaupapa Māori
students. 2) The data reported has been calibrated to adjust for differences between the national population of students and those who took part in surveys. See
Youth19 Rangatahi Smart Survey, Initial Findings: Introduction and Methods for details (available at www.youth19.ac.nz).

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Substance use among rangatahi Māori
Youth19 data shows that most rangatahi
Māori do not use substances and there havebeen dramatic reductions in substance use
among rangatahi over the last two decades.
However, when compared to their peers, alarger proportion of rangatahi Māori:••smoke cigarettes weekly or more often(4.7% compared to 2.1% for Pākehā andother European youth)
use marijuana weekly or more often (8.5%
compared to 3.3% for Pākehā and other
European youth).

A greater proportion of rangatahi Māorifrom high deprivation areas smoke cigarettes
weekly or more often (5.4%) than from low
deprivation areas (1.7%), as shown in Table 4.

We have seen strong decreases in theprevalence of cigarette smoking and binge
drinking, particularly among rangatahi Māori
females. From 2012 to 2019, the proportionof Māori females who smoked cigarettes
weekly or more often decreased from 10.4%
to 3.4%, and binge drinking reduced among
Māori females from 36% in 2012 to 28%.
These are continuations of major declines that
occurred in the 2001–2012 period, as shownin Table 5.
There have been reductions in weekly
marijuana use since 2001, however there
was no substantial change between 2012 and2019.
More detailed Māori health publications will
be coming soon.

Table 4: Rangatahi Māori substance use, 2019**Ethnicity is categorised using the NZ census ethnicity prioritisation method
1 NZ Deprivation Index 2018, Low deprivation (1-3), Medium deprivation (4-7), High deprivation (8-10)

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Table 5: Rangatahi Māori substance use trends**Ethnicity is categorised using the NZ census ethnicity prioritisation method
When comparing survey years: 1) students from kura kaupapa Māori are not included in 2019 results, as previous years did not include kura kaupapa Māori students.
2) The data reported has been calibrated to adjust for differences between the national population of students and those who took part in surveys. See Youth19
Rangatahi Smart Survey, Initial Findings: Introduction and Methods for details (available at www.youth19.ac.nz).

9Substance use among Pacific youth
Youth19 data shows that most Pacific youth
do not use substances and there have been
reductions in Pacific youth substance use overrecent years.
When compared to their peers:••a greater proportion of Pacific youth
smoke cigarettes weekly or more often(4.3% compared to 2.1% for Pākehā andother European youth)a smaller proportion of Pacific youth
report binge drinking at least once in thepast 4 weeks (13% compared to 24% forPākehā and other European youth).

There were very large declines in Pacificyouth smoking from 2001 to 2007. These
positive trends appear to have continued, as
shown in Table 7. For Pacific youth, we haveseen a reduction in rates of binge drinking,particularly among males. From 2012 to 2019,
the proportion of Pacific males who reported
binge drinking in the past week reduced
from 21% in 2012 to 13% in 2019. Pacificyouth from low deprivation areas (generally
wealthier neighbourhoods) reported higher
rates of binge drinking (23%) than those fromhigh deprivation areas (10%), as shown in
Table 6.

Table 6: Pacific youth substance use, 2019**Ethnicity is categorised using the NZ census ethnicity prioritisation method
1 NZ Deprivation Index 2018, Low deprivation (1-3), Medium deprivation (4-7), High deprivation (8-10)

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Table 7: Pacific youth substance use trends**Ethnicity is categorised using the NZ census ethnicity prioritisation method
When comparing survey years: 1) students from kura kaupapa Māori are not included in 2019 results, as previous years did not include kura kaupapa
Māori students. 2) The data reported has been calibrated to adjust for differences between the national population of students and those who took partin surveys. See Youth19 Rangatahi Smart Survey, Initial Findings: Introduction and Methods for details (available at www.youth19.ac.nz).

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Substance use among Asian youth
Youth19 data shows that, when comparedto their peers, a smaller proportion of Asianyouth:•••

smoke cigarettes weekly or more often(0.9% compared to 2.1% for Pākehā andother European youth)
report binge drinking at least once in thepast 4 weeks (8% compared to 24% forPākehā and other European youth)
report using marijuana weekly or more
often (1.1% compared to 3.3% for Pākehā
and other European youth).

A greater proportion of Asian youth fromlow deprivation (higher income) areas

reported binge drinking (12%) than from highdeprivation (lower income) areas (6%), as
shown in Table 8. However, risk of smoking
cigarettes went in the opposite direction: agreater proportion of Asian youth from highdeprivation (lower income) areas reported
smoking cigarettes weekly or more often(1.6%) than from low deprivation (higher
income) areas (0.1%).
Overall, smoking among Asian youth declined
dramatically from 2001 to 2019. Binge
drinking and marijuana use among Asianyouth are relatively low compared with otherethnicities and have remained low over time,
as shown in Table 9.

Table 8: Asian youth substance use, 2019**Ethnicity is categorised using the NZ census ethnicity prioritisation method
1 NZ Deprivation Index 2018, Low deprivation (1-3), Medium deprivation (4-7), High deprivation (8-10)

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Table 9: Asian youth substance use trends**Ethnicity is categorised using the NZ census ethnicity prioritisation method
When comparing survey years: 1) students from kura kaupapa Māori are not included in 2019 results, as previous years did not include kura kaupapa
Māori students. 2) The data reported has been calibrated to adjust for differences between the national population of students and those who took partin surveys. See Youth19 Rangatahi Smart Survey, Initial Findings: Introduction and Methods for details (available at www.youth19.ac.nz).

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Substance use among Pākehā
and other European youth
Binge drinking is relatively common among
Pākehā and other European young peopleof all socio-economic groups, as shown in
Table 10. However, it has markedly declined
from 2001.
A greater proportion of Pākehā and other
European youth from high deprivation areas
reported smoking cigarettes weekly or more

often (5.1%) than from medium deprivation(1.5%) and low deprivation (1.4%) areas.
From 2012 to 2019, there was a decline in
the proportion of Pākehā and other European
youth smoking cigarettes weekly or more
often, decreasing from 3.4% to 2.1%, asshown in Table 11.

Table 10: Pākehā and other European youth substance use, 2019**Ethnicity is categorised using the NZ census ethnicity prioritisation method
1 NZ Deprivation Index 2018, Low deprivation (1-3), Medium deprivation (4-7), High deprivation (8-10)

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Table 11: Pākehā and other European youth substance use trends**Ethnicity is categorised using the NZ census ethnicity prioritisation method
When comparing survey years: 1) students from kura kaupapa Māori are not included in 2019 results, as previous years did not include kura kaupapa
Māori students. 2) The data reported has been calibrated to adjust for differences between the national population of students and those who took partin surveys. See Youth19 Rangatahi Smart Survey, Initial Findings: Introduction and Methods for details (available at www.youth19.ac.nz).

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What helps to reduce smoking,substance abuse and risky drinking?
There are many things we can do in ourhomes, schools and communities to reducerisks of problem substance use and to support
young people to make positive decisions.
These generally include factors that promotestrengths and positive environments such as:
•
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•

safe communities where there are funthings to do
freedom from violence, bullying anddiscrimination
supportive schools, where there
are adults who care, teachers havehigh expectations, and students aretreated fairly
acceptance of identity (ethnicity, abilities,
sexual and gender identity, etc.)••

fostering a strong sense of cultural identityand belonging
caring and supportive families.

In addition there are factors that more
directly address substance use and addictive
behaviours such as:••••

ensuring harmful substances are notavailable in communities
adults role modelling healthy choices andnot supplying substances
clear communication of expectations toyoung people
families knowing where young people are
and who they are with.

Getting help
To get help with concerns about substanceuse, contact:
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Quitline – www.quit.org.nz/help-to-quitsmoking
Alcohol and drug helpline – 0800 787 797
or text 8681
Gambling helpline – 0800 654 655 or text
8006
Youthline – 0800 376 633, text 234 orwebchat (www.youthline.co.nz/web-chatcounselling.html)
Health services, e.g. family doctor, schoolbased health teams, youth one stop shops
or Whānau Ora.

You can find other sources of help by visiting
Health Navigator New Zealand (www.
healthnavigator.org.nz) or Family Services
Directory (www.family.services.govt.nz).

References
ASH. (2020). 2019 ASH Year 10 Snapshot: Topline Results – Smoking. Auckland,
ASHNZ https://d3n8a8pro7vhmx.cloudfront.net/ashnz/pages/70/attachments/
original/1583197940/2019_ASH_Y10_Snapshot_Topline_smoking_FINAL.pdf?1583197940
Ball, J., Edwards, R., Sim, D., Cook, H., & Denny, S. (2020b). What explains the decline inadolescent binge-drinking in New Zealand? International Journal of Drug Policy, 84,102826. https://doi.org/10.1016/j.drugpo.2020.102826
Ball, J., Fleming, T., Archer, D., Sutcliffe, K., & Clark, T. (2020a). Youth19: Vaping Fact Sheet.
Youth19 Research Group, The University of Auckland and Victoria University of Wellington.
Available from www.youth19.ac.nz
Health Promotion Agency. (2019). Vaping Facts. Ministry of Health. https://vapingfacts.health.
nz/Inchley, J., Currie, D., Budisavljevic, S., Torsheim, T., Jåstad, A., Cosma, A., et al. (Eds.). (2020).
Spotlight on adolescent health and well-being. Findings from the 2017/2018 HealthBehaviour in School-aged Children (HBSC) survey in Europe and Canada. International
report. Volume 2. Key data. Copenhagen: WHO Regional Office for Europe. Licence: CC BYNC-SA 3.0 IGO
Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M.
E. (2020). Monitoring the Future national survey results on drug use 1975-2019: Overview,
key findings on adolescent drug use. Ann Arbor: Institute for Social Research, University ofMichigan. http://www.monitoringthefuture.org//pubs/monographs/mtf-overview2019.pdf
Lucas, N., Gurram, N. & Thimasarn-Anwar, T. (2020). Smoking and vaping behaviours among
14 and 15-year-olds: Results from the 2018 Youth Insights Survey. Wellington: Health
Promotion Agency/Te Hiringa Hauora Research and Evaluation Unit.
Royal Society Te Apārangi. (2019). Cannabis: How it affects our health. Wellington: Royal Society
Te Apārangi.
Villalobos, R., Ambrocio, G., & Fernandez, L. (2019). Electronic cigarettes for smoking cessation:
an individual patient meta-analysis of randomized controlled trials. European Respiratory
Journal, 54(suppl63). https://doi.org/10.1183/13993003.congress-2019.OA5135

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Youth2000 survey Series
www.youth19.ac.nz
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