a qualitative analysis of the Experiences of People Who Resumed Smoking Following Exclusive Electronic Nicotine Delivery Systems Use.

Introduction:
This text is a qualitative analysis of the experiences of people who resumed smoking following exclusive electronic nicotine delivery systems (ENDS) use. The study aims to examine common cues, settings, and triggers to smoking resumption and identify strategies that could promote sustained smoking abstinence.

Key points:

* The study conducted in-depth, semi-structured interviews with 20 people who smoke tobacco at least weekly, had smoked at least 100 cigarettes in their lifetime, and reported using ENDS to stop smoking cigarettes for at least 30 days.
* Participants discussed their experiences of ENDS use, probed critical return-to-smoking settings and triggers, and analyzed strategies that could promote sustained smoking abstinence.
* The study identified three themes that explained participants’ experiences, including the functional role of ENDS, their inauthenticity, and the burden of self-regulation required when using ENDS.
* Return to smoking reflected two factors: ENDS’ failure to replicate core smoking attributes that remained appealing, and the burden of self-regulation required when using ENDS.
* Participants experienced ENDS as inauthentic across physical, social, and affectual domains, including in the most common return-to-smoking situations.
* Fewer constraints on ENDS usage led participants to feel they could perpetuate addiction and risk of harm.
* Understanding and informing people about the challenges involved in transitioning to ENDS, beyond obtaining sufficient nicotine, could help support informed ENDS use and may potentially prevent people returning to smoking.

Main message:
The study extends our understanding of the satisfaction people seek when attempting to transition from smoking to exclusive ENDS use, and how ENDS’ failure to replicate that satisfaction, in addition to uncertainty about ENDS-related risks, contributes to smoking resumption. Conceptualizing satisfaction more broadly could support a richer understanding of factors that prompt return to smoking. People might manage challenges more effectively if they understood these before attempting to switch from smoking to ENDS, and if they are advised to monitor and regulate their ENDS use. Educational resources and behavioral support could provide more guidance on these points.

Robertson L, Sanford KR, Waa a, hoek J. a qualitative analysis of the Experiences of People Who Resumed Smoking Following Exclusive Electronic Nicotine Delivery Systems Use. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2023;25(3):470-477. doi:10.1093/ntr/ntac157