RESEARCH PAPER
An exploratory analysis of adult daily smokers’ experiences using e-cigarettes in smoke-free places
 
More details
Hide details
1
Department of Preventive Medicine, Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, United States
2
Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, United States
3
Milken Institute School of Public Health, George Washington University, Washington, United States
4
School of Community Health Sciences, University of Nevada, Reno, United States
Publish date: 2018-11-19
 
Tob. Induc. Dis. 2018;16(November):54
KEYWORDS:
TOPICS:
ABSTRACT:
Introduction:
Evidence indicates that one reason cigarette smokers value e-cigarettes is the ability to use them in places where smoking is not permitted. We sought to: 1) explore adult daily smokers’ experiences using e-cigarettes in the context of smoke-free places; and 2) describe smokers’ perceptions of bystanders’ reactions.

Methods:
Twenty adult daily smokers in Washington, DC initiated e-cigarettes for three weeks and completed in semi-structured interviews at the end of each week. All interviews (n=60) were digitally-recorded, transcribed verbatim, imported into NVivo 10.0, and analyzed using thematic analysis methodology.

Results:
The sample had a mean age of 37.9 years and 18 participants reported having smoked their first cigarette by age 18. Common themes included descriptions of: 1) uncertainty about whether smoke-free policies included e-cigarettes; 2) using e-cigarettes in smoke-free places (e.g. restaurants, workplace, public transit-bus and rail); 3) approaches to e-cigarette use in smoke-free places as part of a complex decision-making process, ranging from testing and establishing the social and spatial boundaries of e-cigarette use, to confining e-cigarette use to inside their home; and 4) favorable, unfavorable, and impartial reactions from bystanders facilitated or impeded e-cigarette use, indicating social approval/social disapproval.

Conclusions:
Results suggest a continuum of factors, including smoke-free policies and reactions from bystanders may facilitate or impede e-cigarette use among smokers in environments where a smoke-free imperative is well-established. As e-cigarette use evolves, study findings indicate the importance of the social environment and how it could affect those switching from cigarettes to e-cigarettes.

CORRESPONDING AUTHOR:
Sabrina L. Smiley   
Department of Preventive Medicine, Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, University of Southern California, 2001 North Soto Street, 90032-3628, Los Angeles, CA, United States
 
REFERENCES (25):
1. King BA, Patel R, Nguyen KH, Dube SR. Trends in awareness and use of electronic cigarettes among US adults, 2010-2013. Nicotine Tob Research. 2014;17(2):219-227. doi:10.1093/ntr/ntu191
2. Syamlal G, King BA, Mazurek JM. Tobacco use among working adults- United States, 2014-2016. MMWR Morb Mortal Wkly Rep. 2017;66(42):1130-1135. doi:10.15585/mmwr.mm6642a2
3. Grana RA, Ling PM. “Smoking revolution”: a content analysis of electronic cigarette retail websites. Am J Prev Med. 2014;46(4):395-403. doi:10.1016/j.amepre.2013.12.010
4. Pearson JL, Richardson A, Niaura RS, Vallone DM, Abrams DB. e-Cigarette awareness, use, and harm perceptions in US adults. Am J Public Health. 2012;102(9):1758-1766. doi:10.2105/AJPH.2011.300526
5. Shi Y, Cummins SE, Zhu S-H. Use of electronic cigarettes in smoke-free environments. Tob Control. 2017;26(e1):e19-e22. doi:10.1136/tobaccocontrol-2016-053118
6. Zhu S-H, Gamst A, Lee M, Cummins S, Yin L, Zoref L. The use and perception of electronic cigarettes and snus among the US population. PloS One. 2013;8(10):e79332. doi:10.1371/journal.pone.0079332
7. Luo C, Zheng X, Zeng DD, Leischow S. Portrayal of electronic cigarettes on YouTube. BMC Public Health. 2014;14(1):1028. doi:10.1186/1471-2458-14-1028
8. Pokhrel P, Herzog TA, Muranaka N, Regmi S, Fagan P. Contexts of cigarette and e-cigarette use among dual users: a qualitative study. BMC Public Health. 2015;15:859. doi:10.1186/s12889-015-2198-z
9. Trumbo CW, Harper R. Use and Perception of Electronic Cigarettes Among College Students. J of ACH. 2013;61(3):149-155. doi:10.1080/07448481.2013.776052
10. Wackowski OA, Delnevo CD. Smokers’ attitudes and support for e-cigarette policies and regulation in the USA. Tob Control. 2015;24(6):543-546. doi:10.1136/tobaccocontrol-2014-051953
11. Majeed BA, Dube SR, Sterling K, Whitney C, Eriksen MP. Opinions about electronic cigarette use in smoke-free areas among U.S. adults, 2012. Nicotine Tob Res. 2015(6);17:675-681. doi:10.1093/ntr/ntu235
12. Tan ASL, Bigman CA, Sanders-Jackson A. Sociodemographic correlates of self-reported exposure to e-cigarette communications and its association with public support for smoke free and vape-free policies: results from a national survey of US adults. Tob Control. 2015;24(6):574-581. doi:10.1136/tobaccocontrol-2014-051685
13. Department of Health Functions Clarification Act of 2001. In: Health Do. DC; 2001: 14-28.
14. Public Health Law Center, Mitchell Hamline School of Law. E-cig Regulations - Washington DC. http://www.publichealthlawcent.... Updated, 2017. Accessed June 5, 2017.
15. Pearson JL, Smiley SL, Rubin LF, et al. The Moment Study: protocol for a mixed method observational cohort study of the Alternative Nicotine Delivery Systems (ANDS) initiation process among adult cigarette smokers. BMJ Open. 2016;6(4):e011717. doi:10.1136/bmjopen-2016-011717
16. Kvale S. Interviews: An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage; 1996.
17. Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks, CA: Sage; 2002.
18. Reference for Windows: NVivo qualitative data analysis software [computer program]. Version 10. QSR International Pty Ltd.; 2012.
19. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi:10.1191/1478088706qp063oa
20. Charmaz K. Constructing grounded theory: A practical guide through qualitative analysis. London: Sage; 2006.
21. Whittemore R, Chase SK, Mandle CL. Validity in qualitative research. Qual Health Res. 2001;11(4):522-537. doi:10.1177/104973201129119299
22. Grana R, Benowitz N, Glantz SA. E-cigarettes. Circulation. 2014;129(19):1972-1986. doi:10.1161/circulationaha.114.007667
23. Smiley SL, DeAtley T, Rubin LF, et al. Early Subjective Sensory Experiences with “cigalike” E-cigarettes Among African American Menthol Smokers: A Qualitative Study. Nicotine & Tobacco Research. 2017;20(9):1069-1075. doi:10.1093/ntr/ntx102
24. Merrick E. An exploration of quality in qualitative research: Are "reliability" and "validity" relevant? In: Kopala M, Suzuki LA, eds. Using qualitative methods in psychology. SAGE Publications, Inc.; 1999: 25-36. doi:10.41359781452225487.n3
25. Zhu SH, Sun JY, Bonnevie E, et al. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control. 2014; 23(Suppl 3):iii3-iii9. doi:10.1136/tobaccocontrol-2014-051670
eISSN:1617-9625