Smoking rates fell by five per cent in seven years in the Hunter New England district while vaping rates soared, federal data shows.
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The data, released on Thursday, showed alcohol remained the most commonly used drug, with increasingly risky use in the Hunter.
The number of people in the district who drank alcohol in ways that increased the risk of disease or injury rose from 37 per cent in 2016 to 43 per cent in 2023.
Smoking rates in the district fell from 14 per cent in 2016 to 9 per cent in 2023.
However, smoking remained the leading cause of preventable disease and death.
The rate of people aged 14 and over currently vaping in Australia rose from 2.5 per cent in 2019 to 7 per cent in 2022-2023.
Vapes could be more addictive than smoking and cause greater withdrawals, former Newcastle drug and alcohol counsellor Grant Hume said.
Mr Hume said many young people "don't realise they're actually getting a nicotine addiction from vaping".
"They've probably vaped with all the flavours," Mr Hume said, but without knowing withdrawals will come from quitting.
"You can see the anxiety when they realise they have to stop."
The data was released in the National Drug Strategy Household Survey.
It coincided with federal health minister Mark Butler saying the ban on "importation of all vapes without a licence and permit will begin on March 1".
Also from this date, quality and safety standards for therapeutic vapes will be strengthened.
The importation of single-use disposable vapes was banned on January 1.
Mr Butler said education was key to "stopping Big Tobacco companies from luring a new generation into nicotine dependency".
Byron Williams, headspace Newcastle's community development officer, said it was concerning that vaping had become normalised among young people.
"As these changes take effect, we will continue to work with our young, their families and the community to provide education and support," Mr Williams said.
The national survey asked about people's use of tobacco, e-cigarettes, alcohol and illicit drugs.
It found the number of high risk drinkers rose in Hunter New England from 8.9 per cent in 2019 to 9.5 per cent in 2023.
This referred to people requiring specialist assessment and treatment for their drinking.
Recent illicit drug use in the Hunter district rose from 13 per cent in 2016 to 20 per cent in 2023.
More than 21,000 people aged 14 and over participated in the national survey.
"Half of people aged 18 to 24 reported having tried an e-cigarette in their lifetime," Australian Institute of Health and Welfare spokesperson Dr Gabrielle Phillips said.
Regular use of vapes among this age group rose from 5 per cent in 2019 to 21 per cent in 2023.
Mr Hume, now a Central Coast-based counsellor, sees young vape users aged from about 14 to 17.
"Some would have to go on nicotine replacement therapies [to quit]. And obviously some counselling and therapy as well," he said.
Headspace CEO Jason Trethrowan said helping young people "address the underlying reasons for using e-cigarettes" was important.
Mr Trethrowan said this included peer pressure and avoiding psychological distress.
The government will soon introduce new laws to prevent the domestic manufacture, advertisement and supply of vapes.
It has partnered with social media influencers to combat vaping misinformation.
Quitline is on 137 848.
