“It Didn't Fill the Void”: reasons for e-cigarette and tobacco dual use
More details
Hide details
1
University of Otago, Preventive and Social Medicine, New Zealand
2
University of Otago, Marketing, New Zealand
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A259
Download abstract book (PDF)
KEYWORDS
TOPICS
ABSTRACT
Background:
Although
moving from smoking to electronic nicotine delivery systems (ENDS) could reduce
the harms smokers face, many ENDS users continue to smoke tobacco. We explored the contributing
factors to tobacco use among ENDS users.
Methods:
We conducted
in-depth interviews with n=20 past
30-day ENDS and tobacco users (16 used ENDS daily; the median duration of ENDS use was
4.5 months). Interviews explored motivations for using ENDS, experiences of using
ENDS and tobacco, and dual use patterns.
We used qualitative thematic analysis to analyse interview data.
Results:
Most, but
not all, participants used ENDS to try and quit smoking entirely. Among those who
reported trying to quit, social exposure to tobacco use and alcohol consumption
cued cravings and undermined a full transition to vaping. Some participants
found ENDS did not sufficiently alleviate stress or replicate the nicotine hit,
mouth-feel or rituals they experienced with smoking. The convenience and perceived
social acceptability of using ENDS indoors also facilitated dual use. Several participants
cited financial reasons as the primary motivation for using ENDS; they reported
alternating between ENDS and smoking as rationing their 'real' cigarettes
helped manage the cost of tobacco. Younger, social tobacco smokers reported experiencing
stigma when using ENDS, which inhibited their ENDS use in some social settings where
tobacco use was normative. While many participants
saw dual use as a transition towards becoming smokefree, others viewed their
reduced smoking levels alongside ENDS use as a successful outcome. Some perceived ENDS as healthful, not merely less harmful than
tobacco; this view appeared to offset dissonance about using tobacco and positioned
cigarette smoking as a reward for being "good".
Conclusions:
Understanding
factors that facilitate and support dual use of ENDS and smoked tobacco may help
inform interventions that support ENDS users to make a full transition from tobacco
smoking to vaping.