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Abstract
Objective To describe how young adults use electronic cigarettes (electronic nicotine delivery systems (ENDS)) for smoking cessation and reasons why they may or may not successfully quit smoking.
Methods Longitudinal qualitative data were collected annually from 2017 to 2019 for 25 young adult tobacco users (aged 18–29 years) in California (USA) who used ENDS to quit/reduce smoking. Thematic and trajectory analyses were used to identify key within-person and between-person changes in tobacco/nicotine use over time.
Results Five types of tobacco use transition were identified among baseline dual users of cigarettes and ENDS: sustained dual use without reduced smoking (n=8), transition to exclusive daily ENDS use (n=6), sustained dual use with reduced smoking (n=5), transition back to exclusive smoking (n=4) and transition to neither smoking nor vaping (n=2). Participants’ ENDS use behaviour varied over time in terms of vaping quantity and device characteristics (eg, changing nicotine concentrations/flavours, switching between multiple devices). Three themes that related to successfully replacing cigarettes with ENDS were perceived positive physical effects, perceived satisfaction and enjoyment and context changes. Four themes for unsuccessful replacement were perceived negative physical discomforts, perceived addictiveness and harm, unsatisfactory substitution for cigarettes and device malfunction.
Conclusions Young adults’ experiences with using ENDS as a smoking cessation aid were highly variable. Adequate nicotine delivery and perceived safety and benefits contributed to successfully reducing or quitting cigarettes. Providing behavioural counselling and standardising ENDS products may enhance cessation for young adults.
- cessation
- electronic nicotine delivery devices
- nicotine
- priority/special populations
Data availability statement
Data are available on reasonable request. The qualitative data underlying this article, even deidentified, may include some information that can sufficiently specify the participant, therefore cannot be shared outside the research team. The quantitative data including tobacco use and sociodemographic characteristics will be shared on reasonable request to the corresponding author.
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Data availability statement
Data are available on reasonable request. The qualitative data underlying this article, even deidentified, may include some information that can sufficiently specify the participant, therefore cannot be shared outside the research team. The quantitative data including tobacco use and sociodemographic characteristics will be shared on reasonable request to the corresponding author.
Footnotes
Contributors All authors have been involved in analysing the data, interpreting the results and writing the manuscript. NN conceptualised the study, obtained funding, planned and conducted the analysis, drafted the initial manuscript and contributed to all subsequent drafts of the manuscript. KAK, MK and SLW conducted interviews, assisted with the data analyses, reviewed and revised the manuscript. PML conceptualised the parent study, obtained funding, supervised the data collection and analyses, reviewed and revised the manuscript, and served as guarantor. All authors have read and approved the final manuscript for submission.
Funding This research was supported by the California Tobacco-Related Disease Research Program (grant numbers T31FT1564 and T32KT5071 to NN, and TRDRP 27IR-0042 to PML), by the Food and Drug Administration Center for Tobacco Products and the National Heart, Lung, and Blood Institute (grant number U54 HL147127 to NN and PML), by the National Cancer Institute (grant number R01CA141661 to PML) and by the UCSF Clinical and Translational Science Institute (grant number UL1 TR001872-06 to NN).
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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