Perceptions, Motivations, and Experiences of Adolescents Using Electronic Cigarettes: A Review of Qualitative Studies

Abstract

ABSTRACT Background Electronic cigarettes have rapidly emerged as a popular alternative to traditional tobacco products, with a significant increase in e-cigarette use observed among youth globally. This trend has raised significant public health concerns, prompting the World Health Organization to call for strict measures to prevent e-cigarette uptake among children and young people. Addressing the perceptions and attitudes towards e-cigarettes is essential for developing effective strategies to protect adolescents from their potential harms, as understanding these factors can help tailor interventions and educational programs to combat the popularity of e-cigarettes among youth. Qualitative studies provide a more in-depth understanding of why adolescents are drawn to these products by exploring the social, cultural, and personal factors that influence the use of e-cigarettes. In recent years, a number of qualitative studies on this topic have been published but not yet reviewed. Aim This project aimed to review and summarise existing qualitative research on the perceptions, motivations, and experiences of adolescents regarding the use of electronic cigarettes. Methods A narrative literature review of qualitative studies published between 2013 and 2024 on adolescents' perceptions of electronic cigarettes was conducted. The literature search was conducted using the online database ‘Ovid’, which retrieved 450 studies. Thirty-six studies that matched the eligibility criteria were included for review. A narrative synthesis was 4 conducted to extract and summarise the key themes related to adolescents' perceptions of electronic cigarettes, as reported in each study. Results Adolescents generally perceive e-cigarettes as less harmful and more socially acceptable than traditional cigarettes, while awareness of potential health risks appears to be limited. Peer influence, family norms, and marketing strategies significantly impact vaping initiation and continuation. Access to vaping products is facilitated through social networks and online purchasing. Adolescents expressing a desire to quit face challenges and barriers such as peer pressure and nicotine dependence. Conclusion This review highlights the complex interplay of perceptions, motivations, and the experience of using and quitting e-cigarettes among adolescents. Addressing this public health challenge requires a multifaceted approach that combines regulation, education, and support for behaviour change. By understanding the factors that contribute to e-cigarette use, policymakers and public health professionals can develop targeted interventions to protect young people from the potential harms of vaping.