Over the past decade, concerns about the emergence and growing popularity of electronic nicotine delivery systems (ENDS) have been raised by the public health community. Three specific concerns related to ENDS have emerged in the literature as relevant for adolescents and young adults, whose use of ENDS has increased substantially in recent years. These concerns include: (1) ENDS may threaten tobacco denormalization efforts that are intended to make smoking socially unacceptable, (2) ENDS may be used together with, not in place of, conventional cigarettes (dual-use), and (3) ENDS may serve as a gateway into smoking. To date, these concerns are only speculative because too little research has investigated their relevance for young people.
Our study considers ENDS from a socio-cultural perspective that emphasizes the role that ENDS play in the lives of young people. Our study considers the role of ENDS in youth cultures, the meanings associated with its use, its connections to conventional smoking, and the practices of ENDS for California young people between the ages of 15-25. This qualitative project will include 2 phases of data collection. In Phase 1, we will conduct 4 online group interviews in open discussion forums catering to ENDS users in California. Phase 2 includes 60 in-depth, face-to-face interviews with ENDS users. Our study also includes an extensive and ongoing dissemination component that makes data from the study regularly available to the public. Analyses of the data will shed light on the potential of ENDS to (1) promote nicotine dependency by encouraging dual-use with cigarettes, (2) act as a gateway into cigarette smoking, (3) serve as a cessation aid for young people, and (4) jeopardize tobacco denormalization efforts that aim to make cigarette smoking socially unacceptable.
By investigating the socio-cultural factors associated with ENDS use among young people, we can more fully understand (1) the broader role that ENDS play in young people’s lives as well as the reasons for their adoption, (2) the potential unanticipated consequences that may result from the growing popularity of ENDS among young people, and (3) the possible impact of various ENDS regulations for young people. Understanding these issues is critically important for designing an effective public health response to the increasing use of ENDS.