A qualitative study of e-cigarette emergence and the potential for renormalisation of smoking in UK youth

Brown, R., Bauld, L., de Lacy, E., Hallingberg, B., Maynard, O., McKell, J., Moore, L. and Moore, G. (2020) A qualitative study of e-cigarette emergence and the potential for renormalisation of smoking in UK youth. International Journal of Drug Policy, 75, 102598. (doi:10.1016/j.drugpo.2019.11.006) (PMID:31785547)

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Abstract

Background: Growth of e-cigarette use among smokers has raised concerns over uptake by non-smokers, particularly young people. Legislative changes aimed in part at reducing youth exposure to e-cigarettes include the EU Tobacco Products Directive (TPD). A core justification for such measures is the belief that e-cigarettes can lead to tobacco smoking through mechanisms of renormalisation including: mimicking and normalizing the act of smoking; increasing product acceptability via marketing; nicotine exposure. These mechanisms are here explored in relation to findings from qualitative research. Methods: This paper reports results from twenty-one group interviews with 14–15 year olds in Wales, England and Scotland, conducted as part of an ongoing evaluation of the impact of the TPD on youth smoking and e-cigarette use. Interviews were conducted around the end of the transitional period for TPD implementation, and explored perceptions of e-cigarettes and tobacco, as well as similarities and differences between them. Results: Young people differentiated between tobacco and e-cigarettes, rejecting the term e-cigarette in favour of alternatives such as ‘vapes’. Experimental or occasional use was common and generally approved of where occurring within social activity with peers. However, regular use outside of this context was widely disapproved of, unless for the purpose of stopping smoking. Increased prevalence of e-cigarettes did not challenge strongly negative views of smoking or reduce perceived harms caused by it, with disapproval of smoking remaining high. Nicotine use was variable, with flavour a stronger driver for choice of e-liquid, and interest more generally. Conclusion: The extent to which participants differentiated between vaping and smoking, including styles and reasons for use in adults and young people; absence of marketing awareness; and continued strong disapproval of smoking provides limited support for some of the potential mechanisms through which e-cigarettes may renormalise smoking. However caution over nicotine exposure is still necessary.

Item Type:Articles
Additional Information:This paper presents independent research funded by the National Institute for Health Research (NIHR) in England under its Public Health Research Board (grant number 16/57/01). The views expressed in this publication are those of the authors and do not necessarily reflect those of the National Health Service (NHS), the NIHR or the Department of Health for England. The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UKCRC Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Moore, Professor Laurence
Authors: Brown, R., Bauld, L., de Lacy, E., Hallingberg, B., Maynard, O., McKell, J., Moore, L., and Moore, G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:International Journal of Drug Policy
Publisher:Elsevier
ISSN:0955-3959
ISSN (Online):0955-3959
Published Online:27 November 2019
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in International Journal of Drug Policy 75: 102598
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190877Quinquennial Core FundsLaurence MooreMedical Research Council (MRC)MC_UU_12017/14HW - MRC/CSO SPHSU Support Services
SPHSU14