Listening to Adolescents: Their Perceptions and Information Sources About E-cigarettes

Purpose: There has been a sharp increase in adolescent electronic cigarette (e-cigarette) use, and e-cigarettes are now the most commonly used tobacco product among U.S. middle and high school students. Frequent use among high school students was reported to be 27.7% in 2018, an increase of almost 8% from 2017. As yet we have only a limited understanding of adolescent perceptions of e-cigarettes and where adolescents receive information about them. Design and methods: Thirty-four adolescents from Western New York participated in semi-structured interviews. Both adolescents who had used e-cigarettes and never used e-cigarettes were included to capture a broad perspective. The interview data were analyzed using content analysis. Results: Both adolescents who had used e-cigarettes and never used e-cigarettes acknowledged the popularity and acceptance of e-cigarettes among their peers. E-cigarettes were viewed as a healthy alternative to regular cigarettes that mimicked the appearance but were less harmful and more enjoyable. Reasons for not using e-cigarettes included harms to health, risk of addiction, and the gateway effects for other risky behaviors. Major information sources about e-cigarettes included advertisements, family, peers, social media, and the internet. Conclusions: Adolescent perceptions of e-cigarettes, which contribute to reasons for e-cigarette use or not use, and the sources of information that may influence those perceptions were identified. Practical implications: Our findings provide valuable information to guide prevention initiatives and develop interventions, particularly planning for preventive messages and effective communication methods to deliver for adolescents. (c) 2019 Elsevier Inc. All rights reserved.