Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study

Abstract

Introduction: Understanding adolescent perceptions of vaping and roles it plays in their lives is needed to design effective interventions to help adolescents quit. We explored vaping experiences of 11 adolescents from initiation through quit attempts. Methods: A convenience sample of students who vaped in the last 90 days was recruited from one suburban high school in Massachusetts. Qualitative interviews were transcribed and coded. An inductive thematic analysis approach was employed. Areas of agreement and range of responses in code reports were summarized. Results: Eleven open-ended semi-structured interviews were conducted (mean = 32.5 minutes each). Vaping initiation often occurred when socializing with friends who also supplied vaping devices. Vaping was “something to do” and new flavors engaged adolescents further. Solitary activities coupled with vaping included video gaming, getting ready for school, talking on the phone, or studying. Peak hours for vaping included morning, before and after school, before parents returned from work, and after parents went to bed. Several vaped to address anxiety/stress. For some, anxiety control was a main reason for vaping. Participants were concerned about health effects and nicotine dependence. Cost and health effects were drivers of quitting. Quit strategies relied on willpower and distraction. Conclusions: Peers have powerful influences on the initiation and maintenance of adolescent vaping. Vaping habits can become routinized into adolescent lives. Addiction is a concern although nicotine’s anxiolytic effects were valued by many. Social connection was enhanced by communal vaping, sharing, and common vernacular, secrecy and rule-breaking. We describe the context in which adolescents vape nicotine, their reasons for vaping, and reasons to quit. This information can inform the development of interventions to better address adolescents’ triggers to vape, and social and psychosocial barriers to quitting. Our findings suggest a desire to quit vaping but a limited awareness of quitting strategies.

Letter to the Editors of Substance Abuse: Research and Treatment; Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study; Regarding Dubé et al. (2023)

“…The emphasis on the psychosocial aspects that induce vaping behavior is particularly interesting in the manuscript. The strength of the peer group and family emerges very strongly in the choices of adolescents and underlines, in line with the research of Dubé et al, 1 the need to know deeply these dynamics in the world of youth. In light of these considerations, future research should examine the causal relationship between vaping and traditional smoking, in order to investigate whether adolescents would have smoked even in the absence of vaping tools.…”

“…We read with great interest the research conducted by Dubé et al 1 that explores the perception that teenage students have of vaping and the role that it plays in their lives. Currently, it is estimated that 14.1% of U.S. high schoolers vaped at least once in the past 30 days, 2 and vaping is more common than smoking any tobacco product.…”

“…Future research also should investigate whether vaping systematically leads to the use of more harmful smoke tools or whether it remains a separate practice - preferred for example for the less perceived risks, or perhaps for the taste. 1 …”

The Effects of Nicotine Vaping on High Schoolers in South Texas

“…Many teens start vaping due to peer pressure, seeking acceptance and fitting into societal norms. 40 With the availability of various flavors in vaping products, many teenagers tend to be attracted to them. 40 While electronic cigarettes may provide pleasure through dopamine release, they can also negatively impact students' academic performance.…”

“…40 With the availability of various flavors in vaping products, many teenagers tend to be attracted to them. 40 While electronic cigarettes may provide pleasure through dopamine release, they can also negatively impact students' academic performance. Nicotine's interference with cognitive functions can make it difficult to focus and recall knowledge.…”