Vaping Expectancies: A Qualitative Study among Young Adult Nonusers, Smokers, Vapers, and Dual Users

Abstract

Background: “Expectancies,” or beliefs about outcomes, robustly correlate with and predict several behaviors including electronic nicotine delivery system (“e-cigarette”) use. However, there is limited qualitative research available regarding relevant e-cigarette vaping expectancies. Objectives: The present study used a qualitative approach to derive and refine e-cigarette expectancy themes among young adults. Methods: We conducted 12 focus groups and two individual interviews with young adult nonusers, e-cigarette vapers, cigarette smokers, and dual users to assess beliefs about the effects of e-cigarettes. After a series of open-ended questions, follow-up questions assessed reactions to domains previously examined in expectancy measures for cigarette smoking and e-cigarette vaping. The constant comparative method was used to derive themes from transcripts. Results: Four main themes ( Positive Reinforcement, Social Benefits, Negative Affect Reduction, Negative Consequences) emerged from the results. Each theme contained three associated subthemes ( Positive Reinforcement: Sensorimotor Experiences, Taste, Stimulation; Social Benefits: Social Facilitation, Influence on Others, Convenience; Negative Affect Reduction: Stress Reduction, Appetite Reduction, Boredom Reduction; and Negative Consequences: Health Risks, Addiction, Secondhand Effects). Conclusions/importance: Previously identified smoking expectancies appear relevant for young adult vaping, with some notable refinements. Positive reinforcement aspects encompassed aerosol clouds, vaping tricks, and unique flavors. Social benefits included influencing others via social media and competitive activity, as well as the convenience of use in a variety of places. Negative affect reduction was controversial among user groups, but vaping was seen as more interesting than smoking and thus more effective at boredom reduction. Young adults were uncertain regarding negative consequences, but appreciated a potential for secondhand effects. Measure refinement via qualitative research and future field testing can enhance our understanding of this relatively new behavior, supporting tobacco control surveillance, marketing/labeling regulations, and counter-advertising development/evaluation.

An Observational Study of Vaping Knowledge and Perceptions in a Sample of U.S. Adults

“…We found a weak positive correlation between vape use and the belief that vaping reduces stress (0.389, p = 0.000). Our data support those of others [ 14 ] who also reported that e-cigarette users believe that vaping reduces stress.…”

“…Rates of e-cigarette use among high school students in the United States have strikingly increased from 1.5% in 2011 to 20.8% in 2018 [ 13 ], and these data have been corroborated in more recent studies [ 4 ]. In a qualitative study of young adults (N = 49), researchers [ 14 ] conducted focus groups and four main themes emerged: positive reinforcement, social benefits, negative effect reduction, and negative consequences. They found that many young adults were unsure of the negative consequences of vaping [ 14 ].…”

“…In a qualitative study of young adults (N = 49), researchers [ 14 ] conducted focus groups and four main themes emerged: positive reinforcement, social benefits, negative effect reduction, and negative consequences. They found that many young adults were unsure of the negative consequences of vaping [ 14 ].…”

Predictors of E-Cigarette Initiation: Findings From the Youth and Young Adult Panel Study

“…Vaping expectancies are beliefs about outcomes associated with vaping. 29 These beliefs can include social benefits such as social facilitation or influence on others. 29 Our findings support examining vaping expectancies as they may aid in more informed targets for interventions.…”

A Breath of Knowledge: Overview of Current Adolescent E-cigarette Prevention and Cessation Programs

“…Data show that adolescents think e-cigarettes are safer than combustible cigarettes, with some adolescents believing that e-cigarettes contain just water vapor without nicotine or other chemicals [14•, 26-28]. Several qualitative studies have found that adolescents do not fully understand the severity and negative consequences of nicotine addiction, compared with other types of addictions [29,30]. Coupled with these perceptions, recent studies show other proximal levels of influence, whereby adolescents are using e-cigarettes as a means to manage stress, anxiety, and depression [31][32][33].…”