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

Abigail T. Evans, Katherine C. Henderson, Anna Geier, Scott R. Weaver, Claire Adams Spears, David L. Ashley, Meredith Fritz, Lisa John and Terry F. Pechacek
Additional contact information
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

IJERPH, 2020, vol. 17, issue 23, 1-17

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.

Keywords: electronic cigarette; decision making; motivation; focus groups; dual use (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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