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What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use

Author

Listed:
  • Abigail T. Evans

    (Battelle Memorial Institute, Baltimore, MD 21209, USA)

  • Katherine C. Henderson

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

  • Anna Geier

    (Battelle Memorial Institute, Baltimore, MD 21209, USA)

  • Scott R. Weaver

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

  • Claire Adams Spears

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

  • David L. Ashley

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

  • Meredith Fritz

    (Battelle Memorial Institute, Baltimore, MD 21209, USA)

  • Lisa John

    (Battelle Memorial Institute, Baltimore, MD 21209, USA)

  • Terry F. Pechacek

    (School of Public Health, Georgia State University, Atlanta, GA 30303, USA)

Abstract

Switching completely from cigarettes to electronic nicotine delivery systems (ENDS) may reduce health risks for addicted smokers. This paper provides information about perceptions and other factors that may influence smokers’ ENDS use and substitution for cigarettes. We conducted 12 online focus groups ( N = 61) among smokers who had never tried using ENDS (Never Users, N = 11), currently used both cigarettes and ENDS (Dual Users, N = 21), used but discontinued ENDS (Rejectors, N = 14), and switched completely to ENDS use (Switchers, N = 15). Thematic analysis was used to interpret the transcripts. Participants described initial interest in trying ENDS in hopes of quitting smoking and because of convenience (i.e., due to rules, regulations, or social norms). Risk perceptions and higher prices relative to cigarettes were reported as disadvantages of ENDS that discouraged initiation. Dual Users and Rejectors reported product problems (e.g., products breaking) and dissatisfaction (i.e., inability to satisfy cravings for cigarettes) as factors that lowered their substitutability for cigarettes or led to discontinuing ENDS use. Switchers indicated that satisfaction, lack of product problems, and perceived safety facilitated successfully switching from cigarette smoking to exclusive ENDS use. However, Switchers reported trying many products before they found ones that satisfied their needs. We recommend that policymakers consider the potential impact of tobacco control policies on smokers’ motivation and ability to switch completely from cigarettes to ENDS.

Suggested Citation

  • Abigail T. Evans & Katherine C. Henderson & Anna Geier & Scott R. Weaver & Claire Adams Spears & David L. Ashley & Meredith Fritz & Lisa John & Terry F. Pechacek, 2020. "What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use," IJERPH, MDPI, vol. 17(23), pages 1-17, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:23:p:8865-:d:452979
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    References listed on IDEAS

    as
    1. Neil McKeganey & Tiffany Dickson, 2017. "Why Don’t More Smokers Switch to Using E-Cigarettes: The Views of Confirmed Smokers," IJERPH, MDPI, vol. 14(6), pages 1-12, June.
    2. Jessica K. Pepper & Kurt M. Ribisl & Sherry L. Emery & Noel T. Brewer, 2014. "Reasons for Starting and Stopping Electronic Cigarette Use," IJERPH, MDPI, vol. 11(10), pages 1-17, October.
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    Cited by:

    1. Sharifa Ezat Wan Puteh & Norayuni Mohd Ismail & Zaleha Md Isa & Andrea Yu-Lin Ban, 2023. "Exhaled Carbon Monoxide Level and Practices among Tobacco and Nicotine Adult Users in Klang Valley, Malaysia," IJERPH, MDPI, vol. 20(5), pages 1-15, March.

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