Article Text

It’s Just Steam: a qualitative analysis of New Zealand ENDS users’ perceptions of secondhand aerosol
  1. Kerri Haggart1,
  2. Lindsay Robertson2,3,
  3. Mei-Ling Blank1,4,
  4. Lucy Popova5,
  5. Janet Hoek1,6
  1. 1Public Health, University of Otago, Wellington, New Zealand
  2. 2Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
  3. 3Department for Health, University of Bath, Bath, Somerset, UK
  4. 4Marketing, University of Otago, Dunedin, New Zealand
  5. 5School of Public Health, Georgia State University, Atlanta, Georgia, USA
  6. 6Institute of Advanced Study, Durham University, Durham, UK
  1. Correspondence to Professor Janet Hoek, Public Health, University of Otago, Wellington, New Zealand; janet.hoek{at}


Introduction Many smokers who begin using electronic nicotine delivery systems (ENDS) report vaping in settings where they would not have smoked and believe secondhand aerosol (SHA) is simply steam. However, current understanding of how ENDS users differentiate between secondhand smoke and SHA, or how vaping norms develop, is limited.

Methods We conducted in-depth, semi-structured interviews with 39 current ENDS users (dual users and former smokers, now exclusive ENDS users) from New Zealand to explore participants’ perceptions of SHA. We probed how these perceptions arose and examined implications for vaping practices and policy. We managed the data using NVivo V.11 and used a thematic analysis approach to interpret the transcripts.

Results Participants had limited understanding of SHA, its constituents or its possible effects on others. They drew on the absence of harm information, and their sensory experiences and perceptions of others’ views of vaping, to support the conclusion that SHA posed few, if any, risks to bystanders. Yet despite this perception, some felt they should recognise others’ rights to clean air and most would not vape around children to avoid setting an example.

Conclusions In the absence of trusted information, participants used sensory heuristics to rationalise their ENDS practices. Policy-makers face the challenge of correcting misperceptions about SHA without deterring full transition from smoking to ENDS use. They could consider including vaping in current smoke-free area policies; this measure would signal that SHA is not harmless, and could protect clean-air settings and reduce potential normalisation of vaping among non-smokers.

  • electronic nicotine delivery devices
  • secondhand smoke
  • public policy

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  • Contributors JH conceptualised and designed the project, obtained research funding and is senior author. LR and LP provided feedback on the funding application. JH, M-LB and LR designed the interview guide. LP provided feedback on this guide. LR, JH and M-LB conducted the fieldwork. KH and JH led analysis of the transcripts. JH developed the manuscript with assistance from KH, and led the revisions; all authors provided feedback on draft versions of the manuscript. All authors have seen and approved the final version. JH is guarantor of the manuscript.

  • Funding This research was funded by the Health Research Council of New Zealand (grant 16/149).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The University of Otago Human Ethics Committee (reference 16/132) approved the study. Māori consultation: University of Otago Ngāi Tahu Research Consultative Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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