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.