Background:
There has been an exponential increase in the prevalence of e-cigarette use worldwide, particularly among youth. There is no current evidence of ENDS use in India, but the sale online and in retail outlets has grown due to lack of regulations and experimentation with an option to quit or reduce conventional smoking. There is currently no qualitative study carried out among Indian adult E-cigarettes users to understand their behaviour, perceptions and barriers to use. Such information is needed to develop regulatory, preventive as well as cessation strategies.

Methods:
Forty Two e-cigarette users in Delhi, India voluntarily participated in the semi-structured individual in-depth interview which assessed behaviour, perceptions and barriers to use of e-cigarettes. Information was also obtained on sociodemographic aspects, access to cessation services, reasons for initiating and continuing use along with barriers of e-cigarettes use in India. Verbatim transcripts were analyzed after being captured by voice recording and themes were created.

Results:
Participants reported several aspects of e-cigarette experimentation and curiosity as compared to approved cessation treatment options. They expressed that flavour and taste, safer alternative, moderation in nicotine content and satisfaction were factors affecting their continued use. Participants were divided on the issue of cost and availability. Most of them were not aware of any regulations currently on the e-cigarettes in India. E-cigarettes complemented standard cigarettes in the sense that the users satisfied their desire to smoke in areas where it was not permitted.

Conclusions:
Understanding e-cigarette users perspectives provides us an insight into their current practices along with understanding the barriers to e-cigarette use. Regulatory and policy initiatives will need to counter the marketing strategies of e-cigarette companies with a prospect of improving coordinated cessation services, increasing awareness and improving health outcomes.