Reasons for E-cigarette initiation and discontinuation among adolescents and young adults


Aims: E-cigarettes (e-cigs) are increasing in popularity among youth. Understanding reasons that promote and prevent initiation and encourage discontinuation is crucial to the development of effective prevention messages for youth.

Methods: We conducted 18 focus groups (6-8 participants each) in 2 colleges, 2 high schools and 2 middle schools in CT. All groups were stratified by gender and college and high school groups were also split by cigarette smoking status. A focus group manual guided discussions about reasons for use and non-use. Focus group transcripts were examined by independent raters using thematic analysis.

Results: All groups reported curiosity as a reason for experimenting with e-cigs. Influences from friends and family were a common factor related to initiation among college and high school students as were perceived easy access, desire to quit smoking, and availability of flavors. Middle school students cited novelty and perceptions that e-cig use represents a sign of independence. For high school and college smokers, reasons for discontinuation included e-cigs being less satisfying than cigarettes. College non-smokers cited loss of interest once the novelty wore off. College and high school smokers who had never tried e-cigs were deterred by the high cost. College and high school students were also hesitant to try e-cigs due to unknown health and safety risks. Both high school and middle school students described parental disapproval as a deterrent, high school students also cited friend disapproval as deterring use. Across all groups, those who had not tried e-cigs described lack of “coolness” as an additional deterrent.

Conclusions: This qualitative study indicated several reasons why youth initiated, abstained from and discontinued e-cigarettes. While there were some common themes across groups, different themes also emerged across the age groups. Understanding these factors may inform e-cig prevention messages.



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Drug and Alcohol Dependence



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