“When I Don’t Have a Cigarette It’s Helpful, but It Really Don’t Satisfy:” Qualitative Study of Electronic Nicotine Delivery Systems (ENDS) Use among Low-Income Smokers

Claire A. Spears, Dina M. Jones, Cherell Cottrell-Daniels, Hala Elahi, Courtney Strosnider, Jackie Luong, Scott R. Weaver and Terry F. Pechacek
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Claire A. Spears: Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA
Dina M. Jones: Center for the Study of Tobacco, Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Cherell Cottrell-Daniels: Department of Health Outcomes and Behavior, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL 33617, USA
Hala Elahi: Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA
Courtney Strosnider: Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA
Jackie Luong: Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA
Scott R. Weaver: Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA
Terry F. Pechacek: Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30303, USA

IJERPH, 2022, vol. 19, issue 3, 1-15

Abstract: Background: Little is known about the use of electronic nicotine delivery systems (ENDS) among low-income adult cigarette smokers, who experience severe tobacco-related health disparities. Methods: This study conducted interviews to examine experiences and perceptions associated with ENDS use among predominantly low-income adult smokers ( n = 30; mean age 30.2 ± 12.9; 60% male, 46.7% African American, 30% white, 10% more than one race; 76.7% annual household income ≤USD 24,000). Interviews were transcribed verbatim and coded in NVivo 11. Results: Overall, participants reported complementing rather than substituting their smoking with ENDS use (e.g., using ENDS only when smoking is not allowed). Predominant reasons for vaping were convenience, smoking reduction/cessation, stress management, social acceptability, lower long-term costs than smoking, and appealing flavors. Common reasons for not switching to exclusive vaping were that ENDS did not satisfy cigarette cravings and concerns about ENDS health effects. Participants indicated higher likelihood of switching to exclusive ENDS use if the products were more affordable, perceived as substantially less harmful, tasted and felt more like smoking a cigarette, and more effective for reducing cravings. Conclusions: Continued research is needed to maximize any harm reduction potential of ENDS and ensure that these products do not contribute to worsening health disparities.

Keywords: cigarettes; e-cigarettes; electronic nicotine delivery systems; income; disparities; qualitative (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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