Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Departments of Public Health and Marketing, University of Otago, Dunedin, New Zealand.
Tob Control. 2019 Jan;28(1):13-19. doi: 10.1136/tobaccocontrol-2017-054070. Epub 2018 Feb 1.
Electronic nicotine delivery systems (ENDS) arguably pose fewer health risks than smoking, yet many smokers adopt ENDS without fully relinquishing smoking. Known as 'dual use', this practice is widespread and compromises the health benefits that ENDS may offer. To date, few studies have explored how dual use practices arise and manifest.
We conducted in-depth, semi-structured interviews with 20 current ENDS users from New Zealand who reported smoking tobacco at least once a month. We explored participants' smoking history, their recent and current smoking, trial, uptake and patterns of ENDS use, and future smoking and vaping intentions. We managed the data using NVivo V.11 and used a thematic analysis approach to interpret the transcripts.
Dual use practices among participants evolved in four ways. First, as an attempt to manage the 'inauthenticity' of vaping relative to smoking and to retain meaningful rituals. Second, as complex rationalisations that framed decreased tobacco use, rather than smoking cessation, as 'success'. Third, as a means of alleviating the financial burden smoking imposed and to circumvent smoke-free policies. Lastly, dual use reflected attempts to comply with social group norms and manage stigma.
Dual use reflects both social and physical cues. It assisted participants to navigate smoking restrictions and allowed them to manage divergent norms. Policies that discourage smoking, particularly excise tax increases on smoked tobacco and smoke-free space restrictions, appear important in prompting ENDS use. Future research could explore whether these policies also help foster complete transition from smoking to exclusive ENDS use.
电子尼古丁传送系统（ENDS）的健康风险据称比吸烟要小，但许多吸烟者在不完全放弃吸烟的情况下采用了 ENDS。这种被称为“双重使用”的做法很普遍，损害了 ENDS 可能带来的健康益处。迄今为止，很少有研究探讨双重使用的做法是如何产生和表现的。
我们对来自新西兰的 20 名目前正在使用 ENDS 的吸烟者进行了深入的半结构化访谈，这些吸烟者报告每月至少吸一次烟。我们探讨了参与者的吸烟史、最近和当前的吸烟情况、试用、采用和使用 ENDS 的模式，以及未来的吸烟和 vaping 意图。我们使用 NVivo V.11 管理数据，并使用主题分析方法来解释转录本。
参与者的双重使用做法有以下四种方式。首先，作为一种试图管理相对于吸烟而言的 vaping 的“不真实性”，并保留有意义的仪式。其次，作为一种将减少烟草使用而不是戒烟视为“成功”的复杂合理化。第三，作为一种缓解吸烟带来的经济负担和规避禁烟政策的手段。最后，双重使用反映了试图遵守社会群体规范和管理污名化的努力。
双重使用反映了社会和物理线索。它帮助参与者应对吸烟限制，并使他们能够管理不同的规范。不鼓励吸烟的政策，特别是对吸烟烟草征收更高的消费税和限制吸烟空间，似乎对促使 ENDS 的使用很重要。未来的研究可以探讨这些政策是否也有助于促进从吸烟到完全使用 ENDS 的过渡。
