a qualitative analysis of electronic nicotine delivery systems (ENDS) uptake and use among young adult never-smokers in New Zealand.

Introduction
Electronic nicotine delivery systems (ENDS) likely pose fewer health risks than smoking.
Yet ENDS uptake has increased among never-smoking young adults, who likely face
greater health risks relative to non-users of ENDS. To date, few qualitative studies have
explored ENDS uptake and use by never-smokers.
Methods
We conducted in-depth, semi-structured interviews with 16 current ENDS users from New
Zealand aged 18 to 24 years old who reported never having smoked cigarettes regularly.
We explored participants’ experimentation with conventional tobacco products, trial, uptake
and patterns of ENDS use, and their future intentions regarding both ENDS and conventional
tobacco products. We managed the data using NVivo12 and used thematic analysis
to interpret the transcripts.
Results
ENDS use enhanced connection and belonging by providing communal experiences and
facilitating social interactions. Participants’ mastery of tricks generated social cachet within
friendship groups and counteracted the ENDS-related stigma they experienced. Flavours,
clouds and devices’ physical attributes provided stimulation and engagement, and some
used ENDS for stress or appetite management. Lastly, participants rationalised ENDS
uptake by referencing the far greater risks smoking posed.

Robertson L, hoek J, Blank ML. a qualitative analysis of electronic nicotine delivery systems (ENDS) uptake and use among young adult never-smokers in New Zealand. PloS one. 2022;17(5):1. doi:10.1371/journal.pone.0268449