Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Department of Public Health, University of Otago, Wellington, New Zealand.
PLoS One. 2022 May 27;17(5):e0268449. doi: 10.1371/journal.pone.0268449. eCollection 2022.
Electronic nicotine delivery systems (ENDS) likely pose fewer health risks than smoking. Yet ENDS uptake has increased among never-smoking young adults, who likely face greater health risks relative to non-users of ENDS. To date, few qualitative studies have explored ENDS uptake and use by never-smokers.
We conducted in-depth, semi-structured interviews with 16 current ENDS users from New Zealand aged 18 to 24 years old who reported never having smoked cigarettes regularly. We explored participants' experimentation with conventional tobacco products, trial, uptake and patterns of ENDS use, and their future intentions regarding both ENDS and conventional tobacco products. We managed the data using NVivo12 and used thematic analysis to interpret the transcripts.
ENDS use enhanced connection and belonging by providing communal experiences and facilitating social interactions. Participants' mastery of tricks generated social cachet within friendship groups and counteracted the ENDS-related stigma they experienced. Flavours, clouds and devices' physical attributes provided stimulation and engagement, and some used ENDS for stress or appetite management. Lastly, participants rationalised ENDS uptake by referencing the far greater risks smoking posed.
ENDS uptake by young adult never-smokers is driven by both psycho-social and functional factors. ENDS provided shared hedonic experiences and physical pleasures, and generated both bonding and bridging social capital, although many participants had also experienced judgement from others for using ENDS. Policies that denormalise ENDS as recreational devices could discourage uptake by never-smokers, though measures will require careful nuancing to avoid deterring smokers from switching to ENDS.
电子尼古丁传送系统（ENDS）的健康风险可能低于吸烟。然而，从不吸烟的年轻成年人中，ENDS 的使用率有所增加，他们可能比非使用者面临更大的健康风险。迄今为止，很少有定性研究探讨过从不吸烟的人对 ENDS 的使用情况。
我们对来自新西兰的 16 名年龄在 18 至 24 岁之间的当前 ENDS 用户进行了深入的半结构化访谈，这些用户报告从未有规律地吸烟。我们探讨了参与者对传统烟草产品的尝试、试用、使用 ENDS 的情况以及他们对 ENDS 和传统烟草产品的未来意图。我们使用 NVivo12 管理数据，并使用主题分析来解释转录本。
ENDS 的使用通过提供社交体验和促进社交互动，增强了联系和归属感。参与者掌握的技巧在朋友圈中产生了社交声望，并抵消了他们所经历的与 ENDS 相关的耻辱。口味、烟雾和设备的物理属性提供了刺激和参与感，一些人使用 ENDS 来缓解压力或食欲。最后，参与者通过参考吸烟带来的更大风险来合理化他们对 ENDS 的使用。
年轻的成年从不吸烟者使用 ENDS 的原因既有心理社会因素，也有功能因素。ENDS 提供了共同的愉悦体验和身体愉悦感，产生了联系和桥接社会资本，尽管许多参与者也因使用 ENDS 而受到他人的评判。将 ENDS 视为娱乐设备的政策可能会阻止从不吸烟者使用，但这些政策需要谨慎调整，以避免阻止吸烟者转向 ENDS。
