Objective Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them.
Design 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14–17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed.
Results Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as ‘fun’ and having ‘great flavourings’. Seeing websites or social media featuring e-cigarettes, especially YouTube ‘vaping tricks’, prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit.
Conclusions Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers.
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Contributors SH and SVK conceived of the study and initiated the study design. FT collected the data and coded it with SH, HW, HS and SVK. SH and FT conducted the analysis and SH prepared the initial draft of the paper. All authors contributed to redrafting, and approving the final manuscript.
Funding SH, HW, FT, HS and SVK are funded by the UK Medical Research Council as part of the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow on core funding (grant number MC_UU_12017/6/ 171339-01). In addition, we received a small amount of funding for the project from Chest, Heart and Stroke Scotland, Fresh North-East and Tobacco Free Futures.
Disclaimer The funders had no influence over study design or interpretation of results.
Competing interests None declared.
Ethics approval The University of Glasgow.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
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