In New Zealand [NZ], electronic-cigarettes [e-cigarettes] are available at specialist e-cigarette stores, traditional tobacco retailers and through online stores. Online sales data are not readily available in NZ 1 ; however, other high-income countries highlight the significance of online retailing. For example, the United States reports that internet sales of e-cigarettes account for 30% of total sales. 2 It is expected that online sales have increased during the COVID-19, as many physical retail outlets were closed. Online promotion transcends national boundaries of legal jurisdiction, making this mode of marketing the most penetrating and engaging.

E-cigarette companies claim their products are key to improving health outcomes by providing smokers with lower-risk alternatives. However, the rapid uptake of e-cigarettes among young people has prompted concern about company marketing practices. In 2019, there was no legislation to govern e-cigarette marketing in New Zealand. This period provides an ideal context for examining how e-cigarette companies promoted their products before the introduction of marketing regulations. We conducted a content analysis of the Instagram accounts of five prominent e-cigarette retailers based in New Zealand during 2019–2020. We assessed health- and risk-related claims and marketing techniques. Less than 10% of Instagram posts refer to smoking alternatives or risk of nicotine addiction. E-cigarette devices were more likely to be promoted for stylistic features such as colours and ease of use (29.7%). Music festival sponsorship (19.1%), social media influencers (9.2%), and lifestyle marketing (41.5%) were identified as youth-oriented promotional strategies. E-cigarette retailers claim to promote harm-reduction tools to smokers, yet this study finds few references to smoking alternatives in any content. Instead, retailers utilised strategies to engage with a young audience, including festival sponsorship and stylish influencers. This youth-oriented marketing, in combination with weak and delayed government action, may have contributed to the high use of e-cigarettes among young New Zealanders.

Objectives Scientific evidence to support the development of appropriate policy for electronic cigarette use is limited by rapidly changing technology and a lack of long-term data. Perceptions of risk and benefits determine diverse framings of the e-cigarette debate and complicate policy decisions. E-cigarette use by smokers who are attempting to quit may result in improved health outcomes, while their use among young people and non-smokers may lead to adverse health consequences. The purpose of this study was to identify the types of evidence used during public consultations on proposed revisions to New Zealand’s e-cigarette legislation in 2020. Methods Using submissions to parliament made by the tobacco/e-cigarette industry and the health sector, we assessed the cited evidence for quality and independence measured by publication type and tobacco industry connections. We identified themes from a sub-sample of frequently cited evidence to understand how stakeholders and organisations used evidence. Results The sample consisted of 57 submissions from the e-cigarette and tobacco industry (n = 21) and health organisations (n = 36). A total of 442 pieces of evidence were cited at least once. Health organisations were more likely to cite peer-reviewed evidence (OR = 2.99). The industry was more likely to cite evidence outside of peer review and sources with tobacco industry connections (OR = 4.08). In the sample of frequently cited evidence, youth prevalence and flavours were the most common themes. In some cases the same evidence was used by both groups to support opposing policy positions. Conclusions The industry continues to rely more heavily on evidence published outside of the peer-review process, which is, therefore, subjected to less scientific scrutiny. By using a smoking-cessation or harm-reduction narrative, the industry could be seen as a legitimate stakeholder in policy development.

Issue addressedThe use of e‐cigarettes is increasing; New Zealand (NZ) has witnessed a rapid rise in consumption. Policymakers face a challenge to balance the impacts of regulation on those who use e‐cigarettes as a smoking cessation tool while protecting people who do not smoke from the harms of e‐cigarette use, particularly young people. Previous research has demonstrated varying perspectives on e‐cigarette regulation according to different stakeholders and interest groups. This study examined key stakeholders' positions on the drafted legislation to regulate e‐cigarettes in NZ.MethodsUsing written submissions made during public consultation in 2020, we conducted a content analysis to determine levels of support for e‐cigarette regulations. Submissions made by the e‐cigarette industry and the health sector were included for analysis.ResultsThe tobacco industry is heavily invested in ensuring that e‐cigarettes continue to be promoted and available in NZ with minimal restrictions. On the contrary, health organisations supported the introduction of regulations to reduce marketing to, and use of e‐cigarettes by youth and people who do not smoke.ConclusionsThe industry opposes restrictions using similar approaches employed against tobacco control measures. Despite perceptions of division, the health sector is generally unified in support of e‐cigarette restrictions.So what?Policymakers must protect public health policies from commercial interests and be cautious of opposition framed as public health concerns.