E-cigarette use in adults: a qualitative study of users’ perceptions and future use intentions

Abstract

Background There has been an exponential increase in the prevalence of e-cigarette use, particularly among youth. However, adult use is also rising, and there have been relatively few qualitative studies with adult users to understand their reasons for use and future use intentions. Such information is needed to inform both prevention and cessation approaches. Method Thirty-one e-cigarette users participated in one of several focus groups assessing the appeal of e-cigarettes as well as comparisons to combustible cigarettes and approved smoking cessation aids. We also obtained perspectives on future use intentions and interest in e-cigarette cessation interventions. Verbatim transcripts were analyzed using the constant comparative method. Results Participants reported several aspects of e-cigarette appeal as compared to approved cessation treatment options. These included similarities to combustible cigarettes, fewer side effects, and control of e-cigarettes to suit personal preferences. Participants were split on whether they preferred flavors that mimicked or contrasted with their combustible cigarettes (i.e. tobacco vs. alternative flavors, such as candy). Some participants who were unmotivated to quit smoking reported an unanticipated disinterest in continuing use of combustible cigarettes shortly after initiating e-cigarettes. Despite strong interest in reducing nicotine dosage, the majority did not intend to fully discontinue e-cigarettes. Conclusions Understanding e-cigarette users’ perspectives can inform policy and treatment development. Regulatory and policy initiatives will need to balance the appealing characteristics of e-cigarettes with the potential for negative public health outcomes.

Keywords:

• Electronic cigarettes
• electronic nicotine delivery systems
• focus groups
• adults
• smoking
• nicotine replacement therapy

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding information

This work has been supported in part by the Survey Methods Core Facility at the H. Lee Moffitt Cancer Center & Research Institute, an NCI designated Comprehensive Cancer Center (P30-CA76292), as well as by the National Cancer Institute Behavioral Oncology Training Grant (R25CA090314) at Moffitt Cancer Center in Tampa, FL, awarded to Paul Jacobsen, and by grants R01 CA134347 and R01 DA037961 awarded to Thomas Brandon, and R01 CA154596 awarded to Vani Simmons.